Critical element | Indicators of success | Indicators of challenge |
---|---|---|
Activities | ||
Operationalize proposed innovations | ● Sufficient office space was provided for faculty to prepare for clinical sessions, grade assignments and meet with students | ● There was a lack of dedicated office space for VANA faculty at either institution |
● Computer access and email accounts were provided to all partnership personnel at both the VAMC and the nursing school | ● Ad hoc availability of non-private space at the VAMC was often the only option for faculty to meet with students | |
● Meeting space was provided for partnership personnel to conduct regularly held partnership meetings | ● Only limited or inconvenient access to email accounts was provided | |
● Necessary instructional resources (e.g., textbooks and other teaching materials) were provided to faculty | ● Only limited parking was available at one or both locales, which made commuting between institutions difficult | |
Initiate proposed innovations | ● Program launch at the beginning of the first academic year was well-planned and staged from time of grant notification | ● There were significant deviations from the proposed launch schedule by the end of year one |
● Program launch process mostly kept to schedule delineated in partnership’s proposal | ● Limited evidence of proposed innovations being implemented by end of first year, often due to the continuing distraction of coping with unforeseen logistical barriers since launch (e.g., faculty and/or leadership turnover) | |
● Nontraditional care areas of the VAMC (e.g., ambulatory mental health clinics) were used for some clinical placements | ||
● Clinical experiences often included home health or outpatient clinics that focused on care continuity and the whole patient (e.g., co-morbid conditions, social situations) | ● Neither partner seemed to recognize unique clinical teaching opportunities available within the VAMC (e.g., use of mental health units) | |
● Presence of VANA program facilitated creation of or bolstered existing VA student nurse apprenticeship programs (e.g., pre-baccalaureate residency, other VA programs) | ||
● DEU-style learning units were developed specifically for VANA clinical placements | ||
● Scope of student experiences was increased on some units, particularly where clinical faculty was well-known to nursing staff as a colleague | ||
● Simulation Lab resources and use, often at both facilities, were expanded to enhance VANA student learning | ||
● Curricular content, both didactic and simulation, was infused with veteran-specific content and case studies | ||
Collaborate on research and quality improvement initiatives | ● At least one of the program directors has strong research background and expertise | ● No clear plans exist for collaborative research or QI projects between partners |
● QI projects are based on needs identified at the unit level | ● No attempt to engage nursing staff in QI initiatives | |
● Embedding VANA faculty on particular units facilitates implementation of QI projects | ||
● VANA faculty are members of VA evidence-based practice committees | ||
Refine program components as needed | ● Partnership conducted local site evaluation | ● No local site evaluation activities conducted |
● Partnership had planned measurement strategy to use as feedback in modifying program | ● Little evidence of any performance monitoring in place to refine program | |
Outputs | ||
Increased stakeholder satisfaction with participation | ● Nursing staff on units used for VANA clinical placements eager to teach students | ● Presence of VANA nursing students on units not viewed as a beneficial influence on delivery of care quality (perhaps even viewed as detrimental in some circumstances) |
● Veteran patients enthusiastic about having VANA nursing students provide their care | ||
Increased evidence-based care | ● Unit nurses are actively involved in EBP journal clubs | ● Weak or no attempt to integrate EBP changes into unit routines |
● EBP changes introduced by VANA faculty become institutionalized on certain units | ||
Perceived improvements in nursing care quality | ● Improvements to patient care resulting from VANA innovations (e.g., DEU) recognized by nursing staff | ● No influence of VANA innovations on patient care or on how VA units interact with nursing students |