Leadership Option Graduate Nursing Program

Project Title: Leadership Options: Children with Special Health Needs

Project Director: Marilyn J. Krajicek, Ed.D., R.N., FAAN

Grantee: University of Colorado Health Sciences Center School of Nursing

Address: 4200 East Ninth Avenue, Box C-288, Denver, CO 80262

Phone Number: (303) 315-8662

FAX Number: (303) 315-8660

Project Period: 07/01/98 - 06/30/03

PROBLEM

Children with disabilities and chronic conditions and their families continue to experience significant barriers to access to health care systems and providers due to their specialized and often unique needs. Factors that influence access to health services for this population include: type and severity of disability; geographic location of family and provider, i.e. urban or rural; costs of services; type and availability of insurance; family resources; and lack of specialized knowledge on the part of many health care providers.

There remains a paucity of nurses prepared to provide services on both an individual and population basis for these children and their families. To adequately provide services and supports for children with disabilities and chronic conditions and their families, advance practice nurses must be prepared to influence state and regional service systems through leadership, scholarship, collaboration, clinical excellence and public policy activities. The education of the next generation of advanced practice nurse leaders dedicated to the interests of children with special needs and their families is dependent in large part upon availability of fully prepared nurse educators who share a commitment to a future-oriented nursing agenda. An aging nursing professorate, coupled with the scarcity of fully prepared faculty replacements, threatens nursing's role in achieving the goal of improved maternal and child health status in this population. Furthermore, nurses currently serving this goal also need ongoing continuing education, technical assistance and access to expert consultants.

GOALS AND OBJECTIVES

The primary goals of this project are

GOAL I. Improve and enhance the skills, knowledge and leadership capacity of advanced practice nurses at the master's, post-master's and doctoral levels by establishing a Leadership Option in Excellence in MCH Nursing Services for Children with Special Health Care Needs. Objective 1: Expand and enhance graduate education programs at the master's, postmaster's and doctoral levels to improve the skills and abilities of students for developing knowledge and providing advanced practice nursing care for infants, children and youth with special health care needs and their families.

GOAL II. Facilitate ongoing development of faculty leadership skills and knowledge of maternal -child health issues with emphasis on children with special health care needs.

Objective 1: Provide yearly retreats to update faculty and promote curricular innovation in current MCH issues and models of care related to children with special needs and their families.

Objective 2: Provide mini-fellowships to faculty to pursue special MCH nursing projects in scholarship, research, education, leadership and development of community partnerships related to the care of children with special health care needs and their families.

Objective 3: Develop and maintain a World Wide Web page on Excellence in MCH Nursing Services for children with special needs to promote scholarship and exchange of ideas that will be accessible to local, state and national faculty, students, families of children with special needs, other professionals and policy makers.

GOAL III. Provide continuing education offerings using multiple methods which include on-site conferences and distance learning for advanced practice nurses.

Objective 1: Provide continuing education (CE) offerings to advanced practice nurses in the state and region to improve and enhance quality and integration of individual and population-based health services for children with special health care needs.

Objective 2: Increase accessibility of CE offerings by using distance learning methodology

Objective 3. Strengthen the skills, knowledge and leadership capacity of advanced practice nurses in a variety of settings including state agencies, school health and mental health, higher education institutions and primary care systems serving children with special needs and their families.

METHODOLOGY

A. Improve and enhance the skills, knowledge and leadership capacity of advanced practice nurses at the master's, post-master's and doctoral levels by establishing a Leadership Option in Excellence in MCH Nursing Services for Children with Special Health Care Needs. Students are recruited locally and regionally with special attention to recruitment of students from minority groups, including those with disabilities. Two categories of students are addressed: 1) students in or entering current UCHSCSON programs in the master's clinical specialist track, the master's pediatric nurse practitioner, the Nursing Doctorate Program, and the Ph.D. program; and 2) post-graduate nurses entering a fellowship in the Leadership Option. Providing these two options enables the project to better tap the potential for leadership of a larger pool of advanced practice nurses Students choose a focus, or track, within the area of MCH services for children with disabilities and chronic conditions. Tracks include 1) primary care; 2) community health; 3) school health; and 4) policy/systems development. Students are required to complete the core courses for their degree program. Student advising focuses on the student's unique needs and goals within the overarching outcome competencies. Practica are available within the student's individual focus, including clinical service, community health, school health and policy/systems development, within community based programs.

B. Facilitate ongoing development of faculty leadership skills and knowledge of maternal child health issues with emphasis on children with special needs and their families. Faculty development occurs through yearly retreats, mini-fellowships and through participation in administering the Leadership Options course work and practica. Opportunities to develop collaborative relationships with Title V programs and other community service agencies in MCH are fostered by interagency initiatives. The World Wide Web page provides a forum for MCH nursing faculty and students to share models, research, and performance measures and develop partnerships to promote excellence in MCH nursing services.

C. Provide continuing education offerings using multiple methods which include on-site conferences and distance learning for advanced practice nurses. Continuing education is provided using a variety of methods including traditional lecture based workshops and conferences, distance learning methods such as videoconferencing and Internet courses. A .20 FTE Continuing Education Coordinator ensures quality and coordination of CE offerings.

COORDINATION

The UCHSCSON has a long-standing and firm relationship with the Colorado Title V program, the regional Title V program and with the Colorado University Affiliated Program. The Children's Hospital is associated with the UCHSC and provides a rich practice resource for students and faculty. Existing relationships with local health agencies, schools and School-Based Clinics also provide sites for practica as well as sources for members of the program Advisory Board. Children's advocacy groups, and parent advocacy groups who currently work with the UCHSCSON on state and local initiatives will be represented on the Advisory Board. The close working relationships enjoyed by the UCHSCSON with these agencies and programs allow for the communication, facilitation and networking of programs throughout the state and region to identify practica sites for students, resources for education and CE and faculty training.

EVALUATION Evaluation assesses the quality of the training program, the achievement of outcome competencies of the students and numbers of students prepared. Formative and summative methods are used. Each student completes a portfolio, which addresses the competencies identified by the student and advisor.

EXPERIENCE TO DATE The LOP program has expanded opportunities for non-traditional, diverse and rural students to enhance their knowledge and leadership skills on behalf of children with disabilities/chronic conditions and their families through distance education and internet course work. The curriculum has been approved as a Master's and post-master's option within the Community Health focus area. Graduates of the program provide clinical leadership in urban and rural settings in Colorado. Faculty development has enhanced the quality of education available for advanced practice nursing students working with this population.

TEXT OF ANNOTATION The purpose of this project is to improve and enhance the skills, knowledge and leadership capacity of advanced practice nurses at the master's level and above, in individual and systems-level care for children with special health care needs and their families. The Leadership Option: Excellence in Nursing Services for Children with Special Health Care Needs implements graduate and post graduate education for nursing students, faculty and practicing nurses in the community through course work, practica, interagency collaboration and distance learning methods. KEY WORDS Leadership education Maternal Child Health Children with special health care needs Title V Chronic conditions Family-centered care Advanced Practice Nurses Community-based Nursing Culturally sensitive Distance learning Mental health