HealthMay 03, 2018

Interprofessional education for nursing: Top 9 ways to implement IPE in your nursing curriculum

Interprofessional collaboration has been identified as a vital component of nursing education - one that can improve the quality of healthcare in the United States. Yet there aren"t many solid models of interprofessional education (IPE) in nursing programs to try to emulate. If there is such widespread recognition of the importance of interprofessional education in teaching the medical professionals of tomorrow how to effectively treat patients, why aren"t there more successful examples or strategies to look to for guidance?

That reality is, the education of a vast majority of health professions students, including nursing students, still takes place in silos without much crossover or interaction among or between disciplines. These silos even often exist on the job, as well, as clinicians operate independently of one another. In fact, for the past 50 years or so, there has been a lackluster commitment to interprofessional learning in health professions training programs, including nursing. Good models for IPE experiences are particularly lacking at the undergraduate level.

But there is some good news! The Patient Protection and Affordable Care Act (aka “Obamacare") mandated more team approaches, which has led to a stronger commitment to integrate IPE into nursing and health education. Plus, we have identified nine ways to work toward implementing IPE experiences in your nursing curriculum, fertile ground for nurturing these exercises in collaboration in health care.

Why we need collaboration in health care

So, what is interprofessional education in healthcare and how can collaboration in healthcare increases patient outcomes? Let's start with the basics"¦

Interprofessional education (IPE) in healthcare is a model in which, in this case, nursing students work together across disciplines to help them develop interprofessional communication, collaboration, and team work. IPE “occurs when two or more professions learn about, from, and with each other to enable effective collaboration and improved health outcomes," according to the World Health Organization. This model helps nursing students and other healthcare students understand the roles of other health disciplines by sharing experiences. It helps meet the increasing need to deliver health care in a way that achieves better health outcomes, at a lower cost, for the populations that need it the most. Collaborative healthcare is most widely used in geriatrics, hospice, rehabilitation, and some aspects of mental health, but is used more infrequently in other areas of medicine. But this is beginning to change.

At the college level, integrating interprofessional education for nursing into the nursing curriculum has been identified as a key factor in transforming nursing education. Nursing students need to learn how to work together to brainstorm the best approaches to patient care, and to think outside the box when it comes to possible treatments.

The Interprofessional Education Collaborative (IPEC), comprised of educational associations including the AACN, Institute of Medicine and the National League for Nursing (NLN), established core competencies for interprofessional collaborative practice that apply to all students of the health professions. IPEC also identified IPE as a crucial component of education needed to improve the quality of health care in the United States and increase patient outcomes, particularly those related to quality and safety. Team work and collaboration are core pre-licensure competencies that nursing students should attain according to the Quality and Safety Education for Nurses (QSEN) initiative. Plus, evidence backs up the idea that team-delivered health care is more effective and efficient (National Academies of Practice, 2011).

What's more, it's estimated that we will having a shortage of 45,000 primary care physicians and 46,000 surgeons and medical specialists by 2020, thanks in part to the growing population of aging Baby Boomers and the increasing number of people being covered by health insurance as a result of Obamacare. Some say these shortages can be avoided by practicing more team-based care that is more reliant on clinicians other than physicians for primary care. This approach could reduce the physician shortage by more than half.

So why the shortage in interprofessional education in healthcare?

But making sure undergrad nursing students get the chance to practice in interprofessional teams that are aligned with their core competencies hasn"t been easy. Nursing instructors, who are the ideal people to lead IPE initiatives, already feel pressure to cover a lot of material in their curriculum with not enough time. Plus, nursing faculty need to be trained on how to properly engage students in IPE, and they need to hone their own skills in this area. Nursing schools and their administrators need to foster relationships with other schools to make the most out of their IPE efforts. But faculty and administrators of many nursing schools often lack the necessary time, resources, and commitment essential to make IPE truly successful.

Training modules need to be developed, funded and promoted, but there hasn"t been much funding available for interprofessional training at the graduate, post-graduate or practice level. There's also very little funding for research that can provide enough evidence-based information about how to best structure IPE teams to effectively meet patient needs.

In their paper, “Preparing Nursing Students for Interprofessional Practice: The Interdisciplinary Curriculum for Oncology Palliative Care Education," Carla P. Hermann, PhD, RN, Barbara A. Head, PhD, RN, MSSW, Karen Black, MSN, RN, and Karen Singleton, MSN, RN, highlight a project that uses team-based palliative oncology education as the framework for teaching students interprofessional practice skills. “This project can serve as a model of a successful IPE initiative involving nursing students," they stress.

Palliative care at its core is interdisciplinary, team-based care - an approach that has gained steam over the last few years, particularly with cancer patients. Palliative care has since developed standards of practice and evidence-based knowledge relating to interdisciplinary communication, collaboration and techniques - such as how to give family members bad news about their loved one, or conducting family meetings, which form the foundation to IPE. “The marriage of IPE and palliative care allows for dual benefits and joint synergy in teaching two important aspects of contemporary healthcare practice - interdisciplinary practice and palliative care principles.," the paper by Hermann, Head, et al states.

Collaboration in healthcare: How to integrate IPE into your nursing classroom

While it may seem like an uphill battle for some nursing schools to effectively integrate IPE experiences into their nursing curriculum without many successful models to look to, it's getting easier. With organizations like the NLN and IPEC putting out helpful information for nursing school administrators and instructors and offering tools to help integrate IPE into their classrooms, more faculty are becoming trained and proficient in this area.

So here are nine things nursing instructors can do as they move toward adopting and integrating IPE into their own nursing programs.

  1. Check out the NLN's “Guide to Effective Interprofessional Education Experiences in Nursing" toolkit.  This toolkit includes sections on: a brief history of IPE education into a standard of nursing; a guide to infusing a culture of collaboration and patient-centeredness into your institution; eight guides for IPE activities suitable for a variety of nursing environments; strategies for evaluating a program's impact and implementing evidence-based teaching practices, and more.
  2. Utilize Team STEPPS (Team Strategies & Tools to Enhance performance and Patient Safety) - This is a free program of study that can be done independently by nursing educators. Developed by the Agency for Healthcare Research and Quality and the Defense Department, this program includes 12 modules in which a learner utilizes tools to help foster interprofessional practice and allows the learner to do a teach-back session to become a master IPE trainer.
  3. Explore IPE initiatives underway at other institutions and in other states. Connect with those health care professionals involved in those initiatives and learn from them. You need to truly understand how it can work before you can try to integrate IPE into your curriculum.
  4. Start moving toward a collaborative practice by introducing nursing students to collaborative educational experiences. Start offering joint courses introducing students to interprofessional concepts and behaviors, followed by strategically designed collaborative clinical rotations.
  5. Engage patients, families, and communities in the design, implementation, improvement, and evaluation of efforts to link IPE and collaborative practice.
  6. Be sure to have space to run simulations. Some types of simulations don't need a sim center, but if you want to utilize one and don't have a designated space for a center, reach out to nearby institutions that do and inquire about partnering with them. Interprofessional simulations help students hone their skills, so be sure you have some sort of space to practice.
  7. Work with various departments to develop simulations that engage other discipline areas of nursing so the students can learn from each other.
  8. Focus on faculty development. Reform the education and continuing career development of health professionals - in this case, nursing instructors - to incorporate interprofessional learning and team-based care.
  9. Strengthen ties to the academic health centers your nursing school may be integrated with, or, if your school isn"t associated with a specific health care institution, find one nearby that is willing to work with you on IPE experiences.

How DocuCare can help

Educational electronic health records (EHRs) like Lippincott DocuCare are not only great for ensuring nursing students get real-life documentation training in a safe and managed environment, but they provide vast benefits to IPE, as well. In order to make sure nurses are adequately prepared for clinical settings, they not only need practice in collaboration but they need to be proficient in technologies that help them meet today's health care demands. And one of those technologies is EHRs. EHRs enable nursing students and practicing nurses from multiple disciplines to care for virtual patients collaboratively and in a safe, monitored environment.

Lippincott DocuCare includes more than 200 assignable, true-to-life patient scenarios covering a wide range of diagnoses and demographics"”from medical-surgical to mental health to maternal-pediatric and beyond"”appropriate for all levels of nursing. Numerous evidence-based patient records developed jointly with the NLN provide a seamless clinical learning experience across vSim for Nursing and Laerdal Medical simulation scenarios. Or, as an instructor, you can create your own scenarios. But DocuCare includes screens not only for the nurse. It also has screens for the occupational therapist, respiratory therapist, and provider; screens for the physical therapist are coming soon.

Some of these DocuCare scenarios include:

  • Christopher Parrish - Nutrition (Fundamentals)
  • Jared Griffin - Asepsis and Infection control (Fundamentals)
  • Millie Larsen - Fall Risk and Functional Assessment (Gerontology)
  • Henry Williams - Discharge to Pulmonary Rehabilitation (Gerontology)
  • Skyler Hansen - Diabetes: Hypoglycemia (Medical-Surgical)
  • Vincent Brody - COPD: Spontaneous Pneumothorax (Medical-Surgical)
  • Andrew Davis - Alcohol Withdrawal (Psychiatric - Mental Health Nursing)
  • David Carter - Schizophrenia (Psychiatric - Mental Health Nursing)

In addition, DocuCare includes screens specifically created so that occupational therapists, respiratory therapists, and providers can chart in the program as well; so DocuCare can be used in interprofessional simulation in those specialties.

And there are IPE opportunities for nearly every patient situation. Instructors can pick a virtual case patient, have students from across disciplines discuss their concerns and learn from each other. And in your nursing school's sim lab, students can work together to provide care to the patient, or take turns, using direct observation with an oral or written debrief on the plan of care.

By utilizing DocuCare within your IPE program, students can focus on interprofessional collaboration within the EHR, to practice providing the best patient care.

Ready to see how DocuCare can help you succeed in your IPE and interprofessional collaboration efforts? Click below to request a demo!

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