enhancing nurse practitioner education through ...enhancing nurse practitioner education through...
TRANSCRIPT
Enhancing Nurse Practitioner Education Through Interprofessional Collaboration
with Medical , Dental and Pharmacy Faculty and Students
B McLear, DNP, FNP-c, ACNP-BC
P Bowman, DNP, FNP-C
Augusta University
College of Nursing
Objectives
• Describe outcomes associated with interprofessionaleducation, collaboration and practice
• Describe the core competencies of interprofessionaleducation
• Outline interprofessional initiatives currently at Augusta University
• Develop strategies for planning and implementing of interprofessional education
Outcomes
Improved teamwork
Improved communication
Decrease errors
Brandt & Lutfiyya,2015Tricco, et al., 2014
The Journey Begins...
• All health professionals should be educated to deliver patient-centered care in an interprofessional teams, emphasizing evidence-based practice, quality improvement approaches, safety and informatics.
Greiner and Knebel, et al.,2003
Interprofessional Education (IPE)
WHO, 2010IPEC, 2016
IPE Competency Domains
• maintain a climate of mutual respect: and shared values
Values/Ethics:
• work within roles and responsibilities for all team members to meet health care needs of those served
Roles and
Responsibilities:
• communicate all team members with respect to support a team approach in providing care
Communication:
• build team dynamics and relationships to effectively deliver patient centered care
Teamwork and Team Based Care
IPEC,2016
The University of North Texas Health Science Center (UNTHSC)
2012(UNTHSC) identifies interprofessional Education and Practice (IPE/P) as a primary initiative in the institutional strategic plan
2013IPE Curriculum Committee is developed consisting of representation from each of five UNTHSC colleges/schools
Faculty Development Depends
2014A common institutional IPE calendar is established
An annual Interprofessional Symposium for Interprofessionalcollaboration between academics, the clinical practice community, and health care organizations is inaugurated
Barriers
Structural
• Curriculum structure and delivery
• Regulatory/ Accreditation requirements
• Finances (faculty time, resources)
Attitudes
• Value of IPE
• Power struggles
• Student experiences
Bennett et al. (2011); Angelini (2011); Weller, Boyd & Cumin (2014)
Elements of Design
Stakeholders
Sustainability
Mission and Vision
Target Audience
Methods
Design
Timeline, Structure
Stepwise Approach in NP program
Lectures
FCCS
Cadaver lab
Academic Half Days
Ultrasound
IPEC Conference
Shared OSCE’s
Disaster Drill IPE
Substance abuse IPE
Oral Health Exams
Grant submissionwith MCG
Pharmacy, Dental, Medical and NP
Medical
Nurse practitioner
M2NP1M4NP4
Pharmacy, Dental, Medical and NP
• MINI OSCE
Survey
0
10
20
30
40
50
60
70
80
Agree Strongly Agree
Improved Communication
NP MD
Survey
0
10
20
30
40
50
60
70
80
StronglyDisagree
Neutral Agree StronglyAgree
Will Change Practice
NP MD
Survey
• “The more complex cases (diabetic patient, psychiatric cases) fit very well with this exercise, as the nurse practitioner students had an entirely different perspective on patient care and the 15 minute encounter than the medical students, which benefitted us medical students tremendously.”
• “The experience could have been more realistic; i.e. instead of seeing the patient at the same time, we could have gone in one at a time or together to see and evaluate the patient. Additionally, the time frame of 15 minutes did limit how much information “
Pharmacy, Dental, Medical and NP
M4P3NP1
Pharmacy
Medical
Nurse practitioner
Dental
Survey
0
10
20
30
40
50
60
70
StronglyDisagree
Disagree Neutral Agree StronglyAgree
Improved Communication
NP MD Dental PharmD
Survey
0
10
20
30
40
50
60
70
80
90
StronlgyDisagree
Disagree Neutral Agree StronglyAgree
Will Change Practice
NP MD Dental PharmD
Survey
• “All dental school students should have this opportunity!I understand the purpose of the exercise and am thankful for the opportunity to meet with students from other programs.”
• “Overall experience wonderful and doing additional similar experiences would be quite beneficial.”
Pharmacy, Dental, Medical and NP
• Oral Health Exams –NP1 and Dental 4
Pharmacy, Dental, Medical and NP
• Ultrasound
Emergency Medicine/NP
Medical
Nurse practitioner
M4NP1
UGA/MCG PartnershipEM ClerkshipAcademic Half Days
Public Health -CHIP
• Georgia Public Health
• CON
• MCG
• Grant application submitted
Pharmacy, Dental, Medical and NP
Medicine Pharmacy
M2P2M3P3
Pharmacy, Dental, Medical and NP
Dental Medical
M1D2
M4D1
Planning IPE
Issues from silo healthcare education
Who provides instruction
Faculty challenges
Structure and logistics
Resources
Leveling for learners
Planning IPE: Letting Go of Old Frameworks
Changing Mindset
• More than a set of activities, it is a mindset for how work is accomplished collaboratively
• Searching for evidence base designs for IPE
• Need applied theoretical frameworks to educate and evaluate ways to structure IPE
• Apply theories to understand how health care teams function within the complex healthcare environments
• Re-evaluate & Re-envision current practices within organizational science
On the Horizon….Wish ListDidactic Simulation Clinical
Common Course-
Ethics
Critical Care
Simulation
IPE Inpatient Unit
Ultrasound for NP Ultrasound for NP
Geropsych Geropsych Geropsych
Public Health-CHIP Public Health-CHIP Public Health-CHIP
IPE Intro
Course/Student
Course and Faculty
Development
IPE Intro
Course/Student
Course and Faculty
Development
Ambulatory Clerkship
IPE Inpatient Unit
Moving forward….
• More closely aligning the education and health care delivery systems
• Develop a conceptual framework for measuring the impact of IPE
• Strengthening the evidence base for IPE
• Link IPE with changes in collaborative behavior
» IOM, 2015I
References
• Angelini, D. (2011) Interdisciplinary and interprofessional education: What are the key issues and considerations for the future. Journal of Perinatal and Neonatal Nursing. 25(2) 175-179
• DOI: 10.1097/JPN.0b013e318212ee7a
• Bennett, R., Lyn, G., Lindeman, I., Lawn., McAllister, S., Kelton, M., (2011) Faculty perceptions of interprofessional education. Nursing Education Today (31) . 571-576
• Brandt B, Lutfiyya MN. Interprofessional Practice, Research, and Education [webinar]. http://webfiles.anpd.org/InterprofessionalPracticeResearchEducation.mp4. Presented September 24, 2015. Accessed September 24, 2015.
• Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.
• Greiner AC, Knebel E, eds. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press; 2003.Accessed http://www.nap.edu/catalog/10681/health-professions-education-a-bridge-to-quality.
• Institute of Medicine. Measuring the Impact of Interprofessional Education (IPE) on Collaborative Practice and Patient Outcomes: A Consensus Study. Washington, DC: National Academies Press; 2015.
• Interprofessional Education Collaborative, Core Competencies for Interprofessional Practice, 2016 Update. Accessed http://www.aacn.nche.edu/education-resources/IPEC-2016-Updated-Core-Competencies-Report.pdf
• Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000.
References• Tricco AC, Antony J, Ivers NM, et al. Effectiveness of quality improvement
strategies for coordination of care to reduce use of health care services: a systematic review and meta-analysis. CMAJ. 2014;186:E568-E578.
• University of North Texas Health Science Center, Interprofessional Education and Practice. Accessed https://www.unthsc.edu/interprofessional-education/interprofessional-practice/about-us/history-of-ipe-at-unthsc/
• University of Toronto, Centre for Interprofessional Education, Framework for development of IPE, accessed http://ipe.utoronto.ca
• Weller, J., Boyd, M., & Cumin, D., (2014). Teams, tribes and safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal (90); 149-154. doi:10.1136/postgradmedj-2012-131168
• World Health Organization. Framework for action on interprofessionaleducation & collaborative practice. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/10665/70185/1/WHO_HRH_HPN_10.3_eng.pdf. Published 2010.