1. Board of Higher Education Nursing Initiative Nursing Education/Practice Partnership Survey 2004 Prepared by Farley Associates, Inc. In association with Tobin Communications

2. 2 Overview Survey Development Collaborative Effort Chancellor’s Office Mass. Hospital. Association. Mass. Extended Care Federation. Mass. Organization of Nurse Executives Home Health Care Association. Mass. Center for Nursing Commonwealth Corporation Department. of Workforce Development. UMass System State College System Community College System Board of Registration in. Nursing Executive Office of Community Colleges

3. 3 Overview Survey Focus Partnerships (beyond clinical placements) between publicly funded Schools of Nursing and Healthcare facilities and agencies. Partnership activities related to rapidly increasing the supply of skilled nurses, increasing nursing faculty and meeting the future demand for healthcare personnel. Characteristics and elements of Most Successful Partnerships. Factors contributing to least successful partnerships. Other factors including student retention, strategic planning for workforce and faculty development, ideas for improvements in nursing education, resources and programs.

4. 4 Overview Survey Process Telephone Survey Based on partnerships information and research models utilized by AACN and AONE Question Types (26 questions) –Forced choice responses Selection lists Importance ranking –Open ended responses –Sections for all participants –Sections for schools only –Sections for facilities only

5. 5 Overview Survey Analysis BHE regions served as grouping framework Descriptive, qualitative analysis Responses totaled by frequency on a regional framework Statewide summary Executive Summary Two surveyor review for thematic categories Not all participants answered all questions Some facilities did not have any partnerships

6. 6 Statewide Response Rate Initial Volunteers = 116 Health Care facilities/agencies 91 Schools of Nursing 25 Completed Interviews = 103 Acute Care 50* LTC 14* Home Health 14* Schools of Nursing 25* Overall Response rate 89% (based on initial volunteers) * Some without partnerships

7. 7 Summary of Partnership Activity Parameters by Institution Type Institution Type ResponsesRapidly Increase Nurses Increase Faculty Future Demand SON25402155 Acute46*1013082 LTC13*9114 HH3*401 Totals87*15452152 *Remaining participants in Non-Partnerships group Total Partnership activity statewide = 358 activities Rapidly Increase Nurses = 43% Future Demand = 42% Increase Faculty = 15%

8. 8 Partnership Focus Acute Care Schools of Nursing

9. 9 Partnership Focus Home Health CareLong-term Care

10. 10 Partnership Activity Parameters by Region RegionResponsesRapidly Increase Nurses Increase Faculty Meet Future Demand Berkshire4611 Central1820522 Greater Boston East 17516 Greater Boston West 710817 Northeast1413516 Pioneer Valley14211026 Southeast13331719 Total87*15452152 * Remaining 16 participants in Non-Partnership Group

11. 11 Partnerships Education Parameters by Region RegionResponsesLPNADNBSNMSNPhD Berkshire434210 Central181213783 Greater Boston East 1711345221 Greater Boston West 72611100 Northeast144111351 Pioneer Valley1411121430 Southeast139182441 Total87*4277116536 Statewide: 14% of partnerships focus on LPN education 26% of partnerships focus on ADN education 40% of partnerships focus on BSN education 18% of partnerships focus on MSN education 2% of partnerships focus on PhD education

12. 12 Elements of Successful Partnerships Most frequently occurring: Strong, trusting relationships with individuals in partnership Flexible work schedules for employees attending school Shared funding Initiatives NUCLI and ECCLI $7,500--over $100,000 Other contributing factors; Flexible scheduling of classes Onsite classes Specific slots for employees in needed courses Good follow through and communication between partners Willingness to solve problems

13. 13 Most Important Contributions in Successful Partnerships When asked of SONs and Healthcare facilities separately agreement found on first choice: For SONs: Faculty maintains clinical knowledge & expertise required to be effective partners with nurses in clinical setting. For facilities/agencies: Recognize and reward nurses who participate in clinical education of nursing students

14. 14 Activities Involved in Successful Partnerships For Health Care facilities/agencies: –Strong orientation program for students when work on patient care units –Recruitment of Students For Schools of Nursing: –Recruitment of students as employees into health care facility –Clearly defined roles for clinicians who serve as adjunct faculty

15. 15 Factors Found in Least Successful Partnerships Insufficient Skills –Current clinical skills for faculty –Preparedness of students –Organization and management within programs –Technical/online skills of faculty Insufficient Commitment –Support for faculty –Facilities not wanting to accept students –Limited number of employees as students –Limited number of students who become employees –Inability of partners to work out logistics

16. 16 Factors Found in Least Successful Partnerships Insufficient Collaboration and Communication –Lack of flexibility between partners –Lack of follow through –Lack of flexibility in scheduling nurses to maximize clinical experience Competition – Intense among schools for clinical placements –Competition between health care facilities interferes with efforts to build regional collaborative actions between multiple partners Insufficient Funding –Facilities lack resources –Facilities need backfill to free up staff –Programmatic funding for schools of nursing –Faculty salary increases

17. 17 For Schools of Nursing Reasons for turning away students The lack of budgeted faculty positions 56% The lack of available clinical sites44% The lack of clinical lab space15% Clinical placements Lack adequate number of clinical placements 44% Lack of adequate type 40% Statewide there is difficulty in finding placements in pediatrics, maternal child and behavioral health

18. 18 Actual Vs Ideal Education Levels There was no consistent numerical data provided across all regions for this question. The consistent theme expressed was the need for all levels of nursing staff to advance in their educational development including more LPN to RN; ADN to BSN; BSN to MSN and MSN to PhD programs. There is a statewide indication of the need for more BSN prepared staff.

19. 19 Resources Needed to Achieve Strategic Goals Clinical and educational excellence of nursing faculty including: Strong, clinically current skills Strong teaching skills Awareness of service demand on nurses Willingness to work in the clinical setting on routine basis Collaboration with nurse preceptors Joint appointments beneficial to both schools of nursing and health care facility Preparedness of students Improved critical thinking, knowledge and skills More focus/training in long-term care and home care Programs to assist in transition into work/clinical settings (mentor/intern programs) Increased accessibility to BSN programs Strengthening retention programs, including availability of career coaches

20. 20 Resources Needed to Achieve Strategic Goals New approaches to Nursing Curriculum Curriculum that is aligned with today’s demanding nursing practice Unified, standardized. Seamless and coordinated curriculum across all nursing programs Accelerated nursing pathways at all levels Better coordination of clinical placements to decrease competition Increased use of simulation More funding to: Support program development Support nursing students in all programs Increase faculty salaries. Expand faculty development

21. 21 Regional Need Variations Berkshire: A BSN and MSN nursing program that is conveniently located within the region. More classroom, lab and clinical teaching spaces More regional dialogue Central Greater involvement of health care facilities in nursing program curriculum development A registry of available faculty Greater Boston East Nursing curriculum aligned with current and future nursing practice More flexibility in clinical placements Increased student time in clinical areas

22. 22 Regional Need Variations Greater Boston West Development of a faculty Pipeline. Long term solutions to faculty retirement. Expansion of career coach program. Northeast Clinically competent nursing faculty who regularly spend time tint the clinical setting. Additional MSN programs that are conveniently scheduled and located in the region. Pioneer Valley Decreased competition between schools for nursing for clinical placements. More nurse educator programs and resources.

23. 23 Regional Need Variations Southeast Competitively paid joint appointments in which nurses teach a few days a week and work in a clinical capacity on other days. Conveniently located LPN to RN; ADN to BSN, BSN, MSN and PhD nursing programs. Should be onsite an accommodate the schedules of full time nurses. More meeting conferences among all constituents that encourage shared dialogue. Non-Partnerships facilities Schools of nursing willing to partner will small facilities who lack resources. Creative, new teaching technologies. More social needs help for staff interested in attending school.

24. 24 Areas for Future Project Development “No Silver Bullet” Strengthening and Expanding Partnerships Formalized Agreements Joint Appointments Faculty Development programs Improved access to BSN/MSN programs Flexibility Capacity On site classes Improved management of clinical placements Regional reviews and follow-up More funding focused on nursing education program development