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PARTNERS IN THE HEALTHCARE TEAM
Nurses should be full partners, with physicians and other health professionals, in redesigning healthcare in the United States.
Nurses have enormous potential for leadership as they are called on to coordinate care and collaborate with physicians, dentists, social workers, physical and occupational therapists, and other healthcare professionals. But that level of leadership requires an advanced education, not just in medicine but in management, business, communication, behavioral science, and more. Consequently, the IOM study recommends doubling the number of doctorally trained nurses over the next decade. UAB offers both a research-based PhD program and a Doctor of Nursing Practice (DNP) program. To date, 36 students have received their PhD, while 122 have completed their DNP. Larry Slater, PhD, RN, is one of those graduates. Now a postdoctoral fellow, he said the challenge for new PhD’s is carving out the time to write grant proposals and get the necessary funding to establish a program of research. “Most people get their PhD’s and start teaching right away because there’s such a shortage of nursing faculty,” Dr. Slater says. “The postdoctoral fellowship allows time for proposal development, writing, and research. UAB is creating these fellowships to help develop research careers for its PhD graduates.” As PhD’s build the body of research, the DNP program trains nurses to translate that research into best practices for quality patient care. “Our goal is to have our DNP's so highly educated that they can provide and design care for very complex patients and populations,” says DNP Program Coordinator Anne Alexandrov, PhD, RN, CCRN, FAAN. “Advanced practice nurses should be expert, solid clinicians—and not just in nursing care but across the spectrum from primary to tertiary to long-term care.” Dr. Alexandrov heads NET SMART—Nursing Education and Training in Stroke Management and
Acute Reperfusion Therapies—funded by the Health Resources and Services Administration (HRSA). Through a federally funded fellowship, NET SMART placed 17 APN’s and one physician’s assistant—all first-year graduates from 12 different states—in stroke centers in a variety of settings, from community hospitals to university-affiliated primary stroke centers. The goal is to significantly increase rates of tPA treatment, shown to be very effective in acute stroke care. Across the board, NET SMART nurses became experts at diagnosing stroke, delivering tPA treatment, and significantly improving patient outcomes. The only intervention ever shown to significantly increase tPA treatment of stroke at such a high rate, NET SMART speaks to the impact of APN’s in clinical practice, Dr. Alexandrov said. Three new HRSA grants awarded to the School of Nursing will offer nurses the intensive education and training they need to meet other critical healthcare needs across the Deep South. UAB will use HRSA funding to develop distance-accessible curricula for APN specialty tracks in 1) advanced management of diabetes; 2) acute and primary care in pediatrics; and 3) adult/gerontological care. “Everything in nursing comes back to education, to a lifetime of learning,” Dean Harper says. “As a leading academic health science center, UAB gives students keys for the future through world-renowned faculty, cutting-edge research projects, and over 100 interdisciplinary research centers. Our nursing students train in two magnet-status hospitals—UAB and Children’s Hospital of Alabama—as well as the Birmingham VA Medical Center. I’m proud to say that UAB has produced over 12,000 nurses whose leadership has made a lasting impact on healthcare in Alabama and around the world.”
Photographs by Steve Wood
Innovative Model for Patient-Centered Care By UAB Magazine
A unique partnership between primary-care physicians at UAB’s Kirklin Clinic and the UAB School of Nursing aims to develop an innovative care-delivery model. This model focuses on a more comprehensive, proactive, team-based approach that engages patients as partners in their own healthcare via a Patient-Centered Medical Home (PCMH). Such models are a key component of the 2010 healthcare reform. They coordinate all patient care, including referrals to subspecialties such as cardiology, orthopedics, and rheumatology; follow-ups with patients who have been hospitalized; and education on managing chronic diseases. The Kirklin Clinic’s medical home staff includes six physicians, a full-time nurse practitioner and two part-time nurse practitioners, Amy Brooks, MSN, ANP-BC, CRNP, RN and Laura Steadman, EdD, MSN, CRNP, RN, who are members of the School of Nursing faculty. “Nurse practitioners are a wonderful resource and partner. They can educate patients and families on the nuances of self-management, focus on the importance of diet and exercise, and address some behavioral aspects of chronic disease,” says Cynthia Selleck, DSN, ARNP, Associate Dean for Clinical Affairs and Partnerships at the School of Nursing, who helped forge the PCMH alliance. It’s no longer practical for physicians to make house calls, but if there were ever a time when patients could benefit from a home visit, it would be after discharge from the hospital. That’s another area where the partnership with the School of Nursing may provide added value, Dr. Selleck says. “We already have nursing students who do communityhealth rotations and who could visit PCMH patients at home. Incorporating students in the care of patients in a team-based PCMH model is a win-win for everyone—patients, students, providers, and payers.”
Cindy Selleck, DSN, ARNP Associate Dean for Clinical Affairs and Partnerships