The continuing education of registered nurses is the responsibility of both the Continuing Education Department of a college of nursing and the Staff Development Department of a hospital. Both departments have commitments and responsibilities to respond to the increasing pressures of meeting the educational needs of the nurse. These educational needs are related to the rapid increase in health-related knowledge and technology and its effect on the nurses' role and responsibilities. The trend toward mandatory continuing education for nursing re-Iicensure has increased the demand for formal continuing education programs. In an attempt to respond to the educational needs of nurses, both the College of Nursing and Nursing Staff Development have become increasingly involved in nursing continuing education. "With an increasing number of agencies involved in continuing education, coordination becomes more complex. Without coordination, efforts are duplicated and resources wasted, and educational gaps occur."1 The College of Nursing Continuing Education Department and Nursing Staff Development Department have similarities and differences which often result in duplication and fragmentation in nursing continuing education.
Major similarities exist between the departments of Nursing Staff Development and university based nursing continuing education. The basic purpose of both departments is similar: to improve the quality of patient care through nursing education. The pressures to provide continuing education to nurses are the same for both departments: 1. the rapid increase in knowledge and technology, 2. the recent emphasis on nursing continuing education for re-licensure, and 3. the consumer's increased awareness of health care and his demand for the most current approaches to care. Nurse educators are employed in both departments. These nurse educators have their basic preparation in nursing and are licensed registered nurses. They have graduate preparation in nursing and/or education. Frequently they have graduated from the same educational institutions. Those similarities result in personnel who are similar in their philosophies, understanding, and approaches to nursing continuing education (Table 1).
Complementary differences exist between the Nursing Staff Development and College of Nursing Continuing Education Departments. The university educator may be a nurse-researcher and/or nursing theory specialist. The faculty member has access to the most recent research results and theoretical approaches related to nursing care. The university educator works with scholars who are faculty members in non-health related disciplines. These faculty members can assist in planning and providing nursing continuing education programs. There are also specialists in educational technology who the university based nurse educator has access to for continuing education efforts. Nursing Staff Development educators have access to the total health care facility, as well as the total health care team. The educators in Nursing Staff Development may be expert nurse clinicians who are expected to teach the practical and realistic approaches to the provision of patient care. Although the nurse educators of both departments have many similarities, their employment settings often result in complementary differences in the two groups.
The differences between a universitybased Nursing Continuing Education Department and a hospital-based Staff Development Department do not justify the cost for both institutions to separately provide education to the same community of nurses. Each department duplicates nurse educators, assessment tools, audiovisual equipment, educational software, facilities, printing cost, publicity efforts and cost, secretarial support, and most of all, effort, time and subject content for programs. Program planning and implementation are costly. Duplication many times leads to the two institutions competing for nurse participants (Table 2).
When two institutions serve the same nursing population, the nurse educators should consider an approach which fosters collaboration rather than competition. One approach to collaboration is a committee composed of nurse educators from each institution. This joint nursing continuing education committee should have equal representation from Nursing Staff Development and the School of Nursing Continuing Education faculty. The foundation of the committee is the many similarities of the members of both departments. The committee could effectively utilize the differences in the departments, thus eliminating duplication in the provision of continuing education to the nursing community. The primary function of the committee could include assessing the need for and feasibility of planning, implementing and evaluating specific continuing education programs. The combined efforts of both departments could result in increasing the quality of nursing continuing education, greater program attendance, and decreased cost to each institution. This committee would serve as an indication of the commitment of both institutions to meet the educational needs of the nursing community through a collaborative approach (Table 3).
The Collaborative Process: An Example
A current topic of interest to nurses is quality assurance. Accrediting bodies have demanded the utilization of a quality assurance program in the hospital. The institution of a quality assurance program has resulted in educational needs for many components of the nursing community. Nurses employed in the hospital need programs on many aspects of quality assurance. Nurse faculty members must be educated about quality assurance. They must instruct student nurses on quality assurance content. The recency of the topic indicates that the responsibilities of many nurses will be affected by the implementation of a quality assurance program. Thus, the topic of quality assurance will be used to illustrate the collaborative process between the two institutions.
During the assessment phase, the university could be responsible for designing an instrument to evaluate the nurses' perce ived learn ing needs . Th is wou Id include learning needs of quality assurance teaching methods, most convenient time, length, location and a day for a program. Staff Development could be responsible for collecting the data from nurses in their institution.
Staff Development could investigate, through utilization of the assessment tool, nurses' perceived needs in relationship to a quality assurance program. Nursing Staff Development would have access to the results of the quality assurance program within their specific hospital. Through observing the nurses' role in quality assurance and analyzing data from the quality assurance program, Staff Development could identify gaps between practice and theory. Both Staff Development and the Continuing Education Department would be responsible for reviewing past educational programs on quality assurance to insure that the topic is not repetitive of other educational programs.
Analysis of the assessment data could be the responsibility of the College of Nursing representatives. Their recommendations should address the need for a continuing education program on the topic of quality assurance for their nursing population. Other data from the assessment tool related to learner-preference for location, time, a-nd other aspects of the program could be presented to the total committee. A discussion of all of the data related to the need for a continuing education program on the topic of quality assurance will result in a decision that such a program should or should not be planned.
The next step, after the decision that a program on quality assurance is needed, is the planning of the program. It is suggested that a sub-committee be developed. The sub-committee should be composed of personnel from both the hospital and university. A sub-committee on quality assurance program planning could include the hospital quality assurance director, a Staff Development educator who teaches quality assurance during orientation, a staff nurse who utilizes the quality assurance process, a nursing faculty educator who teaches quality assurance to students and also a university faculty member who is an evaluation expert. Two members from the joint educational committee would also be members of the subcommittee. Their purpose would be to explain the implement functions of the sub-committee.
The major functions of the sub-committee could be to identify the objectives of the educational program, identify major content to be included, determine the ratio of time to content, and recommend resources to implement the program. Program participants should have quality assurance knowledge as well as teaching ability. The participants may be members of the subco'mmittee, or committee, as well as personnel from within or outside the two institutions.
Implementation of the program is the responsibility of the joint educational committee. At this point, the committee should review the recommendations from the sub-committee. They must decide on a date, time and location of the program by reviewing the analysis of the assessment data. They should also contact speakers and receive their vitae. Next, they must apply for continuing educational units.
The responsibility for publicity should be shared by both the university and Staff Development Departments. After the flyers and posters of the program have been devised, both institutions are responsible for their distribution. The Staff Development Department can disperse information through its educational newsletter, nursing meetings within the institution, inservice instructors at other hospitals within the community area, and its mailing list from past programs. The university could distribute information about the program through faculty meetings, student nurses, meeting with other universities in the community and also its mailing list from past programs.
Registration responsibility could be shared by the committee. It is suggested that at every other program, registration be planned and executed by the secretarial support of only one of the institutions. This would enable registration forms and communications about the program to involve only one institution forwarding information to the committee.
An evaluation tool to evaluate the objectives and content of the program, as well as the process of the program, should be devised by the joint committee. This evaluation form should be filled out by the program authence. The committee should also do an internal evaluation of the program utilizing the same form. To further measure the success of the quality assurance program, a Staff Development committee member should review the effectiveness of the quality assurance program in the hospital within a three month period. A member of the committee from the university could review course outlines to determine if faculty members are incorporating content on quality assurance into their Nursing courses.
The committee's final responsibility is to summarize all aspects of the program evaluations and, with a cost analysis, submit the results to both the hospital and the university administration.
In summary, it can be stated that Nursing Staff Development and the Continuing Nursing Educational Department of a university can collaboratively produce effective continuing education for nurses. Their similarities, differences, and duplications can be utilized constructively rather than in a competitive manner. To accomplish this, the two departments could collaborate through a joint committee that has equal representation, equal respect and an equal workload from both departments. The joint committee can reduce the cost and effort of providing continuing education and improve the efficiency and effectiveness of meeting the educational needs of the nursing community.
- 1. Cooper S, Hornback M: Continuing Nursing Education. New York, McCraw-Hill Book Co, 1973.