Integrating Correctional and Community Health Care: An Innovative Approach for Clinical Learning in a Baccalaureate Nursing Program.

PROBLEM: With an evolving focus on primary, community-based, and patient-centered care rather than acute, hospital-centric, disease-focused care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses need to be prepared from a different and broader knowledge base and skills set. A culture change among nurse educators and administrators and in nursing education is needed to prepare competent registered nurses capable of practicing from a health promotion, disease prevention, community- and population-focused construct in caring for a population of patients who are presenting health problems and conditions that persist across decades and/or lifetimes. While healthcare delivery is moving from the hospital to ambulatory and community settings, community-based educational opportunities for nursing students are shrinking due to a variety of reasons, including but not limited to increased regulatory requirements, the presence of competing numbers of nursing schools and their increased enrollment of students, and decreasing availability of community resources capable and willing to precept students in an all-day interactive learning environment. METHODS: A detailed discussion of one college of nursings\u27 journey to find an innovative solution and approach to the dilemma of limited and decreasing available community clinical sites to prepare senior level prelicensure baccalaureate nursing students for healthcare practice in the twenty-first century. FINDINGS: This article demonstrated how medium/maximum prisons can provide an ideal learning experience for not only technical nursing skills but more importantly for reinforcing key learning goals for community-based care, raising population-based awareness, and promoting cultural awareness and sensitivity. In addition, this college of nursing overcame the challenges of initiating and maintaining clinical placement in a prison facility, collaboratively developed strategies to insure student and faculty safety satisfying legal and administrative concerns for both the college of nursing and the prison, and developed educational postclinical assignments that solidified clinical course and nursing program objectives. Lastly, this college of nursing quickly learned that not only did nursing students agree to clinical placement in an all-male medium- to maximum-security prison despite its accompanying restrictive regulations especially as it relates to their access to personal technology devices, but there was an unknown desire for a unique clinical experience. CONCLUSION: The initial pilot program of placing eight senior level prelicensure baccalaureate nursing students in a 4,000-person all male medium- to maximum-security prison for their community clinical rotation has expanded to include three state-run maximum all male prisons in two states, a 3,000-person male/female federal prison, and several juvenile detention centers. Clinical placement of students in these sites is by request only, resulting in lengthy student waiting lists. This innovative approach to clinical learning has piqued the interest of graduate nurse practitioner (NP) students as well. One MSN, NP student has been placed in the federal prison every semester for over a year. Due to increasing interest from graduate students to learn correctional health nursing, the college of nursing is now expanding NP placement to the other contracted maximum-security prisons. This entire experience has changed clinical policies within a well-established academic culture and promoted creative thinking regarding how and where to clinically educate and prepare registered baccalaureate nurses for the new culture of health and wellness

Creating a new education paradigm to prepare nurses for the 21st Century

Nurse educators are accountable to keep baccalaureate education responsive to the ever changing healthcare delivery environment. The changing context of healthcare delivery requires focusing on population health and social determinants, providing interprofessional, team-based care, advancing innovation, and preparing practice ready baccalaureate nursing graduates. To be practice ready, nursing graduates must be agile and think and reason on their feet due to increasing care complexity beyond the hospital walls, changing care needs of individuals and families, advancing technology, shifting settings of care delivery, and managing multiple transitions. The purpose of this paper is to consider these healthcare changes and share a new baccalaureate nursing curriculum that radically shifts the paradigm from caring for patients to caring for people, and transforms from a diseased-based, acute care focused curriculum to one promoting a culture of health and multiple new and emerging roles of registered nurses

Designing a New Model for Clinical Education: An Innovative Approach.

To keep pace with the ever-changing health care delivery system, it is important to transform the way future nurses are educated, both in classroom and in clinical settings, to care for people along the life and care continuum, not only in acute-care settings. The purpose of this article is to describe a new approach to educating baccalaureate nursing students using immersion practicums that expose students to population health, transitions of care, care coordination, and the multiple roles a nurse engages in along the continuum. The curriculum includes 5 immersions, each with a specific life and care continuum focus to develop anticipatory thinkers

A Retrospective Analysis of Nursing Students\u27 Clinical Experience in an All-Male Maximum Security Prison.

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today\u27s changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison

An examination of modulation in Shipley S1400 positive photoresist as resist thickness varies

A method of determining photoresist image modulation was investigated and utilized, in determining the effect of varied resist thicknesses on modulation for both a high and low contrast system. Modulation is defined in terms of maximum and minimum energy required to clear a line/space pattern in the resist image. In This study, useing the resist as the threshold detector, chemical contrast is compared to physical contrast in terms of modulation. Shipley\u27s MF314 and MF312 are the two different contrast development systems used. This study has shown that beyond 11700 Å of resist thickness, physical modulation is reduced to a measure of difference between Emax and Emin, and tells very little about the true modulation. This is in part due to a loss of developer interaction with modulation at resists thicker than 11000 Å. This holds for both MF312 and MF314

Implementing a graduate nursing program at a distance through an urban-rural partnership.

The purposes of this poster presentation are to 1) describe the implementation of a master’s of science in nursing (MSN) program by providing access to rigorous distance education to students living in rural Pennsylvania; 2) discuss building a critical mass of master’s prepared advanced practice nurse experts in rural communities; and 3) share formative and summative evaluation information. Through funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) expanded its MSN program currently offered at the urban Philadelphia campus to the rural campus in Danville. Using the methodologies of live web-casting and live video over the Internet, distance students are afforded the opportunity to participate in a live classroom setting rather than experience the static distance methodology of reading through lectures themselves. For example, during the clinical courses, the faculty teaches onsite in Philadelphia webcasting to students in their rural homes so that they can view and hear the lecture. These newer technologies make possible real-time faculty-student dialogue, student-to-student dialogue, and enhance socialization. Furthermore, the use of advanced technologies allows distance students to discuss with peers and faculty alike, in real time, the problems, successes, and questions which arise during class and clinical practica, thereby enhancing critical thinking and diagnostic reasoning skills. This urban-rural partnership addresses increasing demands for educating greater numbers of master’s prepared advanced practice nurses to work in north and central rural Pennsylvania thus promoting access to health care in rural underserved communities

Interprofessional Education and Practice Implications of the Institute of Medicine Future of Nursing Report

The Future of Nursing: Leading Change, Advancing Health, released by the Institute of Medicine (IOM) on October 5, 2010, is the latest in a series of reports that have had a significant impact on creating positive change to improve health care in the United States. The report provides a vision of a future health care system that would make high-quality care accessible to all, promote wellness and disease prevention, reliably improve health outcomes, and provide compassionate care throughout a person’s lifespan. This report, in concert with the provisions of the Affordable Care Act, must act as a catalyst for all health professions to find significant opportunities for collaboration and the impetus to play to each of our strengths to advance quality health care for all citizens

Implementing a Practice Doctorate Program at a Distance through an Urban-Rural Partnership

The purposes of this poster presentation are to 1) describe the implementation of a doctor of nursing practice (DNP) program by providing access to rigorous distance education to students living in rural Pennsylvania; 2) discuss building a critical mass of doctorally prepared advanced practice nurse experts in both urban and rural communities; and 3) share formative and summative evaluation information. Through funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) expanded its DNP program currently offered at the urban Philadelphia campus to the rural campus in Danville. Using the methodologies of live web-casting and live video over the Internet, distance students are afforded the opportunity to participate in a live classroom setting rather than experience the static distance methodology of reading through lectures themselves. For example, during the applied biostatistics course, the faculty teaches onsite in Philadelphia projecting the SPSS and the database on screen so that students on both campuses can simultaneously view, hear, and interact with the discussion. There is a doctorally prepared faculty member onsite in Danville as a resource for the students. These newer technologies make possible real-time faculty-student dialogue, student-to-student dialogue, and enhance socialization. Furthermore, the use of advanced technologies allows distance students to discuss with peers and faculty alike, in real time, the problems, successes, and questions which arise during class and clinical practica, thereby enhancing critical thinking and diagnostic reasoning skills. This unique urban-rural partnership, made possible through advanced technologies, addresses increasing demands for educating greater numbers of doctorally prepared advanced practice nurses to work in north and central rural Pennsylvania, thus promoting access to health care in rural underserved communities. Other than in academia, there are no doctorally prepared advanced practice nurses employed in practice in the area

Chiasma

Newspaper reporting on events at the Boston University School of Medicine in the 1960s