Assessing school readiness for a practice arrangement using decision tree methodology.

Decision-tree methodology provides a systematic approach for schools to use in examining their own situation to determine if a faculty practice arrangement is appropriate for their particular school at this particular time. Questions in the decision tree address mission, faculty interest, administrative support, a practice plan, and practice models. Specific questions in the decision tree include the following: Does the institutional mission include service/practice? Does the college/school mission include practice? Does the college/school have a critical mass of faculty interested in practice? Does college/school administration support practice? Does a critical mass of faculty desire a faculty practice plan? Can faculty and administration work together to produce a mutually beneficial practice arrangement? Do faculty and administration desire to operate their own practice arrangement? Is there an identified need for nursing services that can be met by the college/school? Does the internal and external environment support the college/school operating a practice? Do internal or external organizations desire the talents/expertise of faculty members? Schools frequently evaluate two models, the Integration/Nursing Center Model and the Organizational Contracting/Entrepreneurship Model, for their specific risks and benefits. Critical to the success of any practice arrangement is that there be congruency between the school's allocation of human resources and its reward system.

Building healthier communities in a managed care environment: opportunities for advanced practice nurses.

Two paradigm shifts are occurring in health care: managed care and community partnerships. The distinct principles and trends of each paradigm are certain to determine the future practice of advanced practice nurses (APNs). The impact of managed care and community partnerships will affect the resource management, clinical decision making, and time management of APNs. Concomitantly, APNs will have opportunities to influence practice guidelines, individual and community decision making, cultural competence, and the cost-effectiveness of care in communities. Capitalizing on these opportunities will enhance the value of APNs to their managed care plan employer and their community.

Establishing a nursing center: learning from the literature and the experiences of others.

In the midst of health care reform, academic nursing centers are well-positioned as cost-effective health care providers. As practice sites that are integral components of nursing academic units, these centers provide educational experiences for students, practice sites for faculty, nursing services to the community, and settings for nursing research. The success of these centers is determined by their ability to manage seven major issues of implementation: funding, integrating the center into the community, services, marketing, legal and regulatory issues, faculty issues, and research issues. While these issues require considerable attention, it is critical that centers capitalize on the opportunities provided by the current health policy climate.

Community health service programs in academe: unique learning opportunities for students.

Services provided by a college of nursing allow students to participate in unique clinical experiences in nurse-managed healthcare. The authors describe the use of a nursing center, wellness program, and home health program of a college of nursing to provide clinical experiences for nursing students.

Facilitators and inhibitors of practice: a faculty perspective.

Nurse educators are being encouraged to integrate the role of faculty practice into the role expectations of the educational institution. Schools of nursing are faced with the challenge of facilitating faculty who wish to adopt the practice role. There are limited studies documenting factors that facilitate or inhibit faculty who engage in practice. This article presents the findings of a Delphi procedure used to collect the consensus of practicing faculty concerning organizational and personal facilitators and inhibitors of faculty practice. In this study, 299 faculty representing 170 schools of nursing completed all three rounds of the Delphi. The findings present the top five factors identified by practicing faculty as personal and organizational facilitators and inhibitors of their practice.

The delivery of Early and Periodic Screening, Diagnosis and Treatment Program services by NPs in a nursing center.

Enacted in 1967 as a required component of the Medicaid program, the Early and Periodic Screening, Diagnosis and Treatment Program combines outreach, health screening, follow-up care for detected conditions, and case management. This article describes the delivery of this program's services by nurse practitioners in an academic nursing center. Detailed are the Nursing Center's activities to develop a services contract for the Early and Periodic Screening, Diagnosis and Treatment Program and to improve client access. Issues discussed include protocol development, prescriptive authority and referral to health care providers accepting Medicaid. Services are evaluated by auditors, faculty, students and clients. The article concludes with suggestions for other providers or potential providers of the program.

Schools with nursing centers: a 5-year follow-up study.

The article reviews the growing body of literature that examines academic nursing centers in the aggregate including the first such study conducted by the primary author 5 years earlier. A follow-up study to this original work was conducted to determine current demographics and faculty practice policies of schools or colleges of nursing that operate nursing centers and to compare these findings with those of schools without nursing centers. A survey was sent to the deans or directors of the 462 National League of Nursing (NLN)-accredited baccalaureate nursing programs. Although there were 362 respondents to the survey (78 per cent), only 41 indicated they had a nursing center. Schools with nursing centers were significantly more likely to be in public institutions (P = .05), and offer master's degrees (P = .01). They also were significantly larger (P = .01), with a mean of 34 full time-equivalent (FTE) faculty members. Then the administrative policies of schools with nursing centers (N = 41) were compared with those of schools without centers but with practicing faculty (N = 187). Requiring practice was not a common policy in either group. While about one-third of both groups had practice plans, the majority were described as informal. More schools with nursing centers had other formalized practice arrangements than did schools without centers (P = .01). Faculty practice was more likely to be a criterion for promotion (P = .05) but not for tenure in schools with nursing centers. An inverse relationship (P = .05) was found between the amount of practice revenue generated and the presence of a nursing center.(ABSTRACT TRUNCATED AT 250 WORDS)

Nursing faculty practice: an organizational perspective.

After reviewing the faculty practice literature of the 1980s and finding philosophical support for practice but also growing concerns about faculty role overload, the authors report a study to identify organizational factors that influence the role expectations of faculty members about practice. A survey was sent to the deans or directors of all National League for Nursing--accredited baccalaureate nursing programs (n = 462). Of the 356 respondents (78 per cent), 224 (63.3 per cent) reported that their school had practicing faculty, but only 20 schools (8.8 per cent) required practice. Written faculty practice plans were reported by 23 schools (10.2 per cent), and nursing centers by 41 schools. Thirty-six respondents (16 per cent) reported that practicing faculty generated revenue for the school. Practice was required for promotion in 15.8 per cent and for tenure in 15.3 per cent of all schools surveyed. The study showed significant direct relationships between master's and doctoral programs and practicing faculty, but there was an inverse relationship between the presence of a health science center and schools with practicing faculty. Organizational factors relating to both the number and per cent of faculty who practiced included requiring practice, having a practice plan, and having practice as a criterion for promotion and for tenure. Revenue generation and presence of formalized practice arrangements were related to the number of faculty who practiced but not the per cent of the total faculty who practiced. The study's findings have implications for nursing education in designing organizational structures and rewards that support faculty practice.

Entrepreneurial nursing: the right course at the right time.

As more nurses start businesses of their own, there is a need for a course to help them learn to plan, organize, finance, and operate these businesses. The author describes the course's organization, its outcomes, and reactions of the first students to participate in the course.

Public health nursing partnership: agencies and academe.

The authors describe an approach to bridging the education-practice gap in nursing through a joint venture between a nursing center in a college of nursing and a public health department. The purposes of the cooperative efforts are defined and the services described. Administrative problems and solutions in such a venture are explored and evaluation methods explained. Finally, opportunities for expansion of the venture are considered.

An assessment of academic nursing centers.

The authors discuss the status of academic nursing centers. Included are data on the age, location, population served, and sources of financial support for these centers. In addition, the authors assess the centers' ability to accomplish the purposes of faculty practice, student education, nursing research and community service. Implications for developing academic nursing centers are presented.