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Nursing Education & Practice: Bridging the Gap

Every player in the healthcare system can play a role in enhancing education and bridging the gap between school and work.

Given the demands of healthcare reform and the American Recovery and Reinvestment (ARRA) "meaningful use" of electronic health records, nurses will increasingly participate in multispecialty care coordination and collaboration on new models of care, treatment and policy.

Nurses will care for a growing elderly population with increasingly high levels of chronic disease, and they will continue to work across the continuum of care - from prevention, employee wellness and public health, to treatment and end-of life care.

In short, nurses will continue to function as what President Obama calls "the bedrock" of healthcare.

Unfortunately, "nurses are ill-prepared for the profound changes in science, technology and the nature and settings of nursing practice," observes the authors of Educating Nurses: A Call for Radical Transformation, a 2010 report from the Carnegie Foundation for the Advancement of Teaching.

The solution will only come from an intentional change in the methods used to educate future nurses, which is possible by altering the traditional preparation nurse educators receive.

Every player in the healthcare system can play a role in enhancing education and bridging the gap between school and work.

For example, Elsevier, a company which provides learning tools at all levels of nursing education, can team with healthcare systems, hospitals, primary providers, nursing associations and schools to ensure essential knowledge, skill and experience are integrated into basic and advanced nursing degree and lifelong learning programs through clinical decision support (CDS) simulations and education courses.

What can be done to make clinical practicum experiences in academic nursing education more relevant to clinical nursing practice?

We propose a series of strategies that will more closely align clinical teaching in nursing education with the reality of clinical practice in today's healthcare environments.

Knowledge Sharing

We should tap and expand the existing programs or consortiums such as the American Nurses Credentialing Center's Magnet Program or the CPM Resource Center (CPMRC) international healthcare consortium to intentionally bridge education and practice.

For years the CPM Resource Center has experienced Practice-Education Partnerships amongst its consortium members who have found that utilizing common, evidence-based tools to teach and to actualize in the practice setting has been very successful. In addition, faculty and hospital clinical leaders have become members on each other's Partnership Councils in an effort to enhance learning and collaboration.

Members of CPMRC's consortium have spent the past 25 years sharing lessons learned through Partnership Councils, which encourage partnerships across settings and teamwork across disciplines; consortium gatherings, which advance models of care that address health and healing care, interdisciplinary integration, evidence-based practice application, partnership culture, health informatics; and the CPMRC International Conference, which highlights learnings and outcomes produced in the clinical and academic settings of consortium members.

With an effort to advance the bridge between clinical and academic settings on a larger scale, more focus is being placed on faculty engagement, integrating evidence-based clinical tools throughout the curriculum, sharing information on-line and at conferences, and more thought leadership on education and practice transformation.

The same types of models could be applied to nursing education and practice with functions such as online community information sharing and education, real-world conferences and boot camps, searchable databases of innovations, partnership mentoring and training, survey and academic research on provider and educator needs, practice trends, awards programs, and thought leadership on nursing education .

Technology Education, Hands-On Experience and Support

We should provide nursing students and practitioners with education, training and experience in handling new and emerging information and clinical technologies-EHRs, CDS and medical devices-as well as the opportunity to share real-world experiences and lessons learned.

Both students and practitioners can benefit from software that allows them to practice and perform electronic documentation and care planning within a simulated electronic health record (EHR), along with a tool to assess their knowledge and competency.

What role do EHR and CDS vendors and providers play in helping students and practitioners obtain the necessary skills?

If these vendors increasingly involve nurses in developing clinical decision support and EHR content and learning materials, they could reduce the potential for errors and improve clinical coordination and patient care outcomes.

Just as essential to the professional development of nurses as EHR and CDS proficiency is the expanding use of patient simulation as an adjunct to clinical teaching and evaluation. Such technology has been created in response to intense competition for clinical sites, the growing complexity of the healthcare setting and the desire of faculty to move away from straight didactic lecture.

Nursing Education & Practice: Bridging the Gap

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There is a yawning gap between theory and practice in nursing because what is taught in the classroom is not exactly practised in the clinical setting.


Your article brings out a critical reality---clinical practice drives our thirst for "new knowledge" and educational foundations and theory shapes our clinical practice.
Though I am an educator, I continue to practice full time as an advanced practice nurse and as a part time adjunct faculty. Theses particular domains of nursing practice should not be separate to those of us who are educating nurses in attaining graduate and undergraduate degrees.

We as a nation are moving to population based health care management and this requires all of us to advance our educational preparation while at the same time remain current in our clinical practices.

I would like to see more "work place" initiatives with community collaborative partnerships between our health care devliery institutions and our educational institutions. Also funding for the advancement of nursing education over the past decade has been tenuous at best and there is a need for more community based funding for the advancement of nursing education.

Just my thoughts....

Yvette Marie Petti, PhD, APRN-BC

Yvette Petti,  Nurse Practitioner/Graduate Fa,  VA/Grand Valley State UniversityJanuary 16, 2011
Battle Creek, MI

Please include details of handling laboratory speciments in Nursing Education. Over last 5 years all vacutainers are made of plastic except blue top and need to be mixed several times immediately upon full fill to engage chemicals lining each tube and barcode placed over manufacterers label so we can see the blood in the tube. These details are imperative for quick turnaround time of results of lab tests. Signing of initials on barcode with pen entails relabeling specimen for sample to be automated. These issues impact 10% of specimens which translates into 400 samples in a 24 hour period of time. The enviornment is inefficient and a patient safety oriented problem.

geraldine critz,  xlinical laboratory scientist,  R.I.HospitalJanuary 12, 2011
Prividence, RI

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