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  1. Page | 1 SUBJECT: ADVACED NURSING PRACTICE ASSIGNMENT ON “NURSING INNOVATION”
  2. Page | 2 S.NO CONTENT PAGE 1. INTRODUCTION OF NURSING INNOVATION 2. Definition Aspects and need of innovation Process for implementation of new innovation approach 3. CLASSIFICATION OF INNOVATION OF NURSING Innovation in nursing practice Innovation in nursing education Innovation in nursing care Innovation in nursing management 4. INNOVATION IN HEALTH PROMOTION AND DISEASE PREVENTION 5. INNOVATIVE APPROACHES IN NURSING EDUCATION PROGRAMS 6. RECOMMENDATION OF THE COMMITTEE 7. “TOP TEN LIST” MISCONCEPTION PREVENTING INNOVATION 8. TIPS FOR PLANNING NURSING EDUCATION 9. INNVATIVE APPROACHES 10. BIBLIOGRAPHY
  3. Page | 3 INTRODUCTION Innovation is an imperative for nursing education programs as valiant efforts are made to prepare a sufficient number of competent nurses for the 21st century. Education programs are challenged to implement new innovative strategies to expand educational capacity to meet the workforce needs for the future. The word “innovation” has commonly been associated with revolutionary ideas, current trends, technology, creativity and excellence, and is usually goal-directed. Innovation in nursing education involves either developing something new to nursing or to a particular nursing program. Innovation may involve a simple change or a radical redesign of the system, but it is using something different that seems to be the answer (Warner & Burton, 2009). What is needed now is dramatic reform and innovation in nursing education to create and shape the future of nursing practice. All levels of nursing education, undergraduate and graduate, are obligated to challenge their long-held traditions and design evidence-based curricula that are flexible, responsive to students' needs, collaborative, and integrate current technology. Like the National League for Nursing's call for Curriculum Revolution in the 1980s, this current challenge demands bold new thinking and action. Faculty, students, consumers and nursing service personnel must work in partnership to design innovative educational systems that meet the needs of the health care delivery system now and in the future. Innovation must call into question the nature of schooling, learning, and teaching and how curricular designs promote or inhibit learning, as well as excitement about the profession of nursing, and the spirit of inquiry necessary for the advancement of the discipline (Die kelmann, 2001). For too long nurse educators and nursing service personnel, although cordial and respectful of each other, have not been fully engaged in collaborating to prepare a workforce that can practice effectively in new healthcare environments. New pedagogies are required that are research-based, responsive to the rapidly-changing health care system, and reflective of new partnerships between and among students, teachers and clinicians. Our students and recipients of nursing care deserve no less. DEFINITIONS Nursing department, international university of health and welfare, the innovation of nursing education conducted a through review of the literature in nursing, higher education, business, and other field and engaged in extended discussion before formulating the FOLLOWING DEFINITION:-  “Innovation is using knowledge to create ways and service that are new in order to transform system. It require deconstructing (challenging) long held assumption and values. The outcome of innovation in nursing education in nursing practice and the development of culture that support risk taking, creativity and excellence.
  4. Page | 4  All innovation begin with creative ideas we define innovation as the successful implementation of creative ideas with in an origin. In this view, creativity by individual and teams is a starting point for innovation, the first us necessary but not sufficient for the second.  When devising the definition for innovation, the group recognized that the etymology of the word derives from the Latin word innove are, which means “to renew or change” (Online Etymology Dictionary, 2001). • Innovation - A dynamic, systematic process that envisions new approaches to nursing education. • Regulatory barrier - Real or perceived regulatory parameters that hinder innovation in nursing education. ASPECTS & NEED OF INNOVATION A NEW IDEA, METHOD OR DEVICE  Doing something altogether different  Usually involves a need for resources  May be new to the nursing program or new to nursing education in general  Responds to explosion in knowledge WORDS ASSOCIATED WITH INNOVATION  Partnerships  Revolution  Trends  Technology  Flexibility  Innovation and excellence – implementing some new process while maintaining quality ON-GOING PROMOTION FOR INNOVATION IN NURSING EDUCATION  Maintaining Quality in Nursing Education  Flexibility in Regulation  Collaboration with other Agencies  Participation in State andNational Initiatives  Dissemination of Information THE ERA OF PATIENT SAFETY: NURSINGIMPLICATIONS  Informatics  Global Health  Nursing Shortage
  5. Page | 5  Blame Free environments that serve as learning organizations  Genetics Competencies  Inter-professional teams  New Leadership skills  New knowledge of safe practices HEALTH CARE SHOULD BE…  Safe  Effective  Patient cantered  Timely  Efficient  Equitable WHAT WE MAY FIND…  Errors  Decentralized and  Fragmented  Culture of Blame  Inefficiency and Waste  Health care Disparities CURRICULUMS OF THE PAST… Past focus in nursing education was on nursing process and the nurse‐patient relationship may have made graduates less prepared for today’s world which emphasizes outcomes and new work settings which are now learning organizations complexity is at the heart of care today. CURRENTLY PROGRAM  Overloaded with content  Repeat content  Covering everything in class  Faculty adding in content  Information that students need to know is often not distinguished from nice to know  Not enough information pulled from previous learning  Lack innovation and use of e‐tools for learning
  6. Page | 6 PROCESS FOR IMPLEMENTATION OF NEW INNOVATIVE APPROACH PURPOSES ELIGIBILITY APPLICATION STANDARDS FOR APPROVAL REVIEW OF APPLICATION AND BOARD ACTION PERIODIC EVALUATION REQUESTING CONTINUATION OF THE INNOVATIVE APPROACH
  7. Page | 7 GOALS OF INNOVATION IN NURSING  To maintain the quality of care.  To improve the quality of care.  To find new information.  To find new ways of promoting health.  To find new ways for preventing illness.  To find better ways of care and cure.  To comfort to the regulation. INNOVATION IN NURSING WE CAN BROADLY CLASSIFY THESE INTO THE FOLLOWING:-  Innovation in nursing practice.  Innovation in nursing education.  Innovation in nursing care.  Innovation in nursing management. INNOVATION IN NURSING PRACTICE Innovation in the clinical practice occur across the continue of care. Advance in medical equipment and technology have formed a significant driver in change in clinical practice, demanding new skill and technique as well as the new ways of working. Similarly change in the availability and effectiveness of drug based treatment have also brought about significant shifts in the clinical in the practice. INNOVATION IN NURSING EDUCATION Development of computer assisted thinking : in order to enhance student active thinking, faculty member at international university of health welfare develop the CAT ( computer assisted thinking ) programme. The CAT programme is different from CAI ( computer assisted instruction ) which mainly ask user to choose correct answer. there are two two function in the CAT programme. 1.one is to keep the student action log each time they use the programme. 2.The other is to serve as medical dictionary. The innovation of nursing to help advance the ideas of substitute innovation of nursing, task group developed four strategies are as follows:-  Distribute an online survey that ask faculty o share their perception about the current state of innovation in nursing education.
  8. Page | 8  Formulate specific question shared with dean, director, and chairperson of nursing programme, that are designed to stimulate thoughtful dialogue at any for where faculty engage in conversation about thinking and learning  Develop an electronic community where educators can share on innovative practice and engage in on going dialogue.  The purpose of the focus group was to gather baseline date about how nurse educator are beginning to frame ideas surrounding innovation and strategies reforms in nursing innovation. INNOVATION IN THE NURSING CARE  Difference between primary and secondary care oriented counties in the kind of innovation implemented are discussed.  Health care system are increasingly being confronted with chronic patient who need complex intervention tailored to their individual needs.  However it seems that today healthcare professional, organization and budgets are not sufficiently prepared to provide this kind of care. As a result health care policy in many countries targets innovation which reduce healthcare costs and at the same time, improve the quality of care.  Frequently these innovation are related directly to the substitution of care phenomenon in which care is provide by the most appropriate at the lowest cost level and encompass advanced nursing practice hospital at home care and integrated.  The conclusion of this is that integrated care innovation are implemented in both primary hospital at home care and integrated care.  Innovation in hospital at home care and advanced nursing practice are primary care as well as in secondary care oriented countries. INNOAVATION IN NURSING MANAGEMENT There are many changes in national health service t the same time, not just to economic and funding policy, but also at the very heart of nursing care delivery. The introduction of managerialism into the senior clinical grades of nursing, midwifery and other professional staff has characterized the past few years. INNOVATION IN HEALTH PROMOTION AND DISEASE PREVENTION The realm of health promotion and disease prevention provide a range of example of the influence of nursing in the improving population health status. Nurse are uniquely positioned to identify risk factor, provide information about how to manage these risk and promote o health their lifestyle, diet and avoid risky behaviors.
  9. Page | 9 INNOVATIVE APPROACHES IN NURSING EDUCATION PROGRAMS A nursing education program may apply to implement an innovative approach by complying with the provisions of this section. Nursing education programs approved to implement innovative approaches shall continue to provide quality nursing education that prepares graduates to practice safely, competently, and ethically within the scope of practice as defined in jurisdiction’s statutes. 1. PURPOSES a. To foster innovative models of nursing education to address the changing needs in health care. b. To assure that innovative approaches are conducted in a manner consistent with the Board’s role of protecting the public. c. To assure that innovative approaches conform to the quality outcome standards and core education criteria established by the Board. 2. ELIGIBILITY a. The nursing education program shall hold full Board approval without conditions. b. There are no substantiated complaints in the past 2 years. c. There are no rule violations in the past 2 years. 3. APPLICATION The following information with a 1-page executive summary shall be provided to the Board prior to a Board meeting: A. Identifying information (name of nursing program, address, responsible party and contact information). B. A brief description of the current program, including accreditation and Board approval status. C. Identification of the regulation(s) affected by the proposed innovative approach. D. Length of time for which the innovative approach is requested. E. Description of the innovative approach, including objective(s). F. Brief explanation of why you want to implement an innovative approach at this time. G. Explanation of how the proposed innovation differs from approaches in the current program. H. Rationale with available evidence supporting the innovative approach. I. Identification of resources that support the proposed innovative approach. J. Expected impact innovative approach will have on the program, including administration, students, faculty, and other program resources. K. Plan for implementation, including timeline. L. Plan for evaluation of the proposed innovation, including measurable criteria/outcomes, method of evaluation, and frequency of evaluation.
  10. Page | 10 M. Additional application information as requested by the board. 4. STANDARDS FOR APPROVAL A. Eligibility criteria and application criteria are met. B. The innovative approach will not compromise the quality of education or safe practice of students. C. Resources are sufficient to support the innovative approach. D. Rationale with available evidence supports the implementation of the innovative approach. E. Implementation plan is reasonable to achieve the desired outcomes of the innovative approach. F. Timeline provides for a sufficient period to implement and evaluate the innovative approach. G. Plan for periodic evaluation is comprehensive and supported by appropriate methodology. 5. REVIEW OF APPLICATION AND BOARD ACTION A. Annually the board may establish the number of innovative approach applications it will accept, based on available board resources. B. The board shall evaluate all applications to determine if they meet the eligibility criteria in 9.3.2.and the standards established in section 9.3.4. C. The board shall inform the education program of the approval process timeline within days of the receipt of the application. D. If the application meets the standards, the board may: 1) approve the application, or 2) approve the application with modifications as agreed between the board and the nursing education program. E. If the submitted application does not meet the criteria in 9.3.2.and 9.3.4., the board may deny approval or request additional information. F. The board may rescind the approval or require the program to make modifications if: 1) the board receives substantiated evidence indicating adverse impact. 2) the nursing program fails to implement the innovative approach as presented and approved. 6. PERIODIC EVALUATION A. The education program shall submit progress reports conforming to the evaluation planannually or as requested by the Board. B. The final evaluation report shall conform to the evaluation plan, detailing and analysing the outcomes data. C. If any report indicates that students were adversely impacted by the innovation, the nursing program shall provide documentation of corrective measures and their effectiveness. D. Nursing education program maintains eligibility criteria in 9.3.2.
  11. Page | 11 7. REQUESTING CONTINUATION OF THE INNOVATIVE APPROACH A. If the innovative approach has achieved the desired outcomes and the final evaluation has been submitted, the program may request that the innovative approach be continued. B. Request for the innovative approach to become an on-going part of the education program must be submitted <> days prior to a regularly scheduled board meeting. C. The board may grant the request to continue approval if the innovative approach has achieved desired outcomes, has not compromised public protection, and is consistent with core nursing education criteria. For consideration by the Nursing Council, the proposals of innovative changes have to include the following components:  A clearly defined need;  Sufficient valid research data to support the need;  Development of the proposed pilot program;  Identification of measurable outcomes;  Appropriate timeline;  Adequate financial support;  Resources to continue the pilot program if successful;  Adequate methodology;  Data collection process; and  An evaluation plan. RECOMMENDATIONS OF THE COMMITTEE  Collaboration and partnerships often are required for innovation in nursing education.  Innovation can occur at all levels of nursing education.  Nursing regulation recognizes the value of evidence-based innovation in meeting nursing education program outcomes.  Quality can be maintained amidst innovative changes.  The ultimate responsibility and accountability of any innovation rests with the nursing program.  Advances in technology may influence innovation in nursing education.  Nursing is a practice discipline requiring supervised clinical instruction.  Regulation criteria for nursing programs should reflect minimum requirements and be the least burdensome criteria consistent with public protection.
  12. Page | 12 TOP TEN LIST “MISCONCEPTIONS PREVENTING INNOVATION” 1. Don’t worry! Be happy! ( I can handle it. I don’t need any help!) 2. I’m not sharing my secrets! 3. Our pass rate will go in the toilet! 4. I don’t have time! (Doing things differently takes time.) 5. If it ain’t broke, don’t fix it! (Change is not necessary or good. We’ve been doing it this way forever and it works!) 6. I don’t do windows! (I’m not teaching that content.) 7. Back off! This is my territory! (Change your own stuff. Leave my stuff alone! Don’t mess with my stuff!) 8. The students won’t like it! 9. Nobody does it better! (I’m the expert. I’ve been doing this since Florence Nightingale was a nurse.) 10. #1 The Nursing Council won’t let us do it! TIPS FOR PLANNING NURSING EDUCATION INNOVATIVE APPROACHES Health care delivery in the U.S. is becoming increasingly complex, requiring the use of sophisticated technologies and the need for systems thinking in order for nurses to practice safely. Further, more than ever before nurses are caring for sicker, older, and more diverse patients with myriad chronic conditions. In order to keep up with this these changes, innovative approaches in nursing education are being encouraged. However, before educators begin to plan innovative approaches to nursing education, they might consider the following: Hargreaves (2008) suggests that it is important to think about consequences (intended and unintended) before beginning to plan an innovative instructional strategy. Answering questions such as those listed below will provide guidelines as decisions are made:  What are the likely outcomes of a given learning and teaching strategy?  Will it work for all students/staff/the institution?  What is the intention?  What is the worst possible outcome?  What is the best possible outcome?  On balance, how great is the likelihood that positive consequences will outweigh negative ones?  When the consequences are identified, then think about:  Would greater support make a difference?
  13. Page | 13  Which assessment tasks ensure students can complete the course/education without being compromised by uncertain outcomes? If the decision is made to go ahead with the innovative strategy, review your jurisdiction’s nurse practice act and administrative rules. If your innovation constitutes a significant departure from the way a nursing education program currently functions under the rule structure, contact your Board of Nursing about implementing an innovative approach. Early consultation with your Board is highly recommended.
  14. Page | 14 BIBLIOGRAPHY 1. Ben-Zur, H., Yagi, D., & Spitzer, A. (1999). Evaluation of an innovative curriculum: Nursingeducation in the next century. Journal of Advanced Nursing, 30, 1432-1531. 2. Bevis, E. (1988). New directions. In Curriculum revolution: Mandate for change (pp. 27-52). NewYork: National League for Nursing Press. 3. Bevis, E.O., & Watson, J. (1989). Toward a caring curriculum: A new pedagogy for nursing. NewYork: National League for Nursing Press. 4. Diekelmann, N, (2001). Narrative pedagogy: Heideggerian hermeneutical analyses of livedexperiences of students, teachers, and clinicians. Advances in Nursing Science, 23(3), 53-71. 5. Diekelmann, N. (2002). "Too much content…", epistemologies' grasp and nursing education.Journal of Nursing Education, 41, 469-470. 6. Diekelmann, N., &Ironside, P. (2002). Developing a science of nursing education: Innovation withresearch. Journal of Nursing Education, 41, 379-380. 7. Hasse , P.T. (1990). The origins and rise of associate degree nursing education. Durham, NC:Duke University Press. 8. Oesterle, M., & O'Callaghan, D. (1996). The changing health care environment: Impact oncurriculum and faculty. Nursing & Health Care: Perspectives on Community, 17, 78-81. 9. Porter-O'Grady, T. (2003). A different age for leadership. Journal of Nursing Administration, 33,105-110. 10. Porter-O'Grady, T. (2001). Profound change: 21st century nursing. Nursing Outlook, 49, 182-186. 11. Standard curriculum for schools of nursing. (1917, 1927,1937). New York: National League forNursing. 12. Tagliareni, M.E., & Sherman, S. (1999). When ambiguity replaces certainty: New faculty roles incommunity settings. In M. E. Tagliareni&B.B. Marckx (Eds.). Teaching in the community:Preparing nurses for the 21st century (pp. 20-34). Sudbury, MA: Jones & Bartlett Publishers/ NLNPress. 13. Tanner, C. (2002). Clinical education, circa 2010. Journal of Nursing Education, 41, 51-52. 14. Tyler, R.W. (1949). Principles of curriculum and instruction. Chicago: Chicago University Press
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