Academic journal article Nursing and Health Care Perspectives

Linking Remote Practice to Research: TECHNOLOGY IN ACTION

Academic journal article Nursing and Health Care Perspectives

Linking Remote Practice to Research: TECHNOLOGY IN ACTION

Article excerpt

NURSING FACULTY PRACTICES TODAY CONFRONT A MULTIEDGED SWORD THAT CAN BITE AND NICK THOSE WHO LACK THE KNOWLEDGE TO MASTER IT.

Such knowledge comes from detailed data about the structure, processes, costs, and outcomes of faculty practice, coupled with a clear vision about the practice environment and other contextual factors. * This article describes a strategy that links faculty research programs with practice and teaching activities. Faculty practice informs research and is informed by it. The relationship of faculty research/practice linkages to a new curriculum framework is explored.

ABSTRACT Nursing faculty practices are rarely set up to collect and analyze data, but evidence about the effects and costs of clinical care provided by faculty is required by health plans and other payers. This article describes a strategy that links faculty research programs with practice and teaching activities in various locations. An informatics infrastructure uses a common language for data collection and a set of coherent processes for implementation. The theoretical basis for conducting practice-based research is explored.

Background Faculty practices are rarely set up to collect and analyze data. But, in today's health care environment, any practice -- no matter how well intentioned -- will fail if it lacks an ongoing means of support. Evidence about the effects and costs of clinical care provided by faculty and other clinicians is required by health plans, other payers, and those recipients of care who are knowledgeable enough to ask. Such evidence-based practice is increasingly the standard of the health care marketplace. And although it can appear to represent a "cookbook" approach to health care delivery, the reality is that such evidence is required for clinicians to be accepted for practice in clinical settings and/or to receive payment for clinical services.

Traditionally, faculty practices have been developed primarily for some combination of the following purposes:

* Meeting the needs of vulnerable and underserved populations.

* Providing clinical experiences for students in the presence of expert clinicians.

* Assuring that faculty who are clinical experts are consistently able to practice.

* Bringing income into schools of nursing for faculty practice. The combination and priority of these elements will vary in each setting.

At the University of Colorado Health Sciences Center (UCHSC) School of Nursing, faculty practices have existed for many years, primarily to provide clinical practice sites for pre-professional and advanced practice students. The sites for primary care practice are diverse and include school-based clinics, senior citizen centers, youth detention centers, adult correctional facilities, community clinics, and shelters for battered women and the homeless. They have been primarily supported though contractual arrangements with various community agencies or through out-of-pocket payment by patients or their families; rarely was third-party payment available.

In the early 1990s, the School of Nursing formalized its faculty practice plan as Health Care Partners (HCP). HCP provided the administrative infrastructure required for seeking third-party payment where available, billing patients directly, and providing free care as needed. HCP was also designed to provide the primary clinical education sites for nurse-midwifery, nurse practitioner, and other advanced practice students. But only limited linkage existed between the faculty's practices, its research, and the school's overall curriculum.

Developing a Curricular Framework The direct linkage of faculty practice with research enables an inherently important concept in education, that expert faculty teach what they know at the expert level because their research informs their practice and their practice and research inform their teaching. To integrate these missions, the UCHSC School of Nursing faculty have developed a curricular framework designed to focus on four research-practice elements (1):

* Human experience of health, illness, and healing. …

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