University of Maryland Medical System Nursing Initiative Published in Journal of Nursing Administration

An innovative nursing initiative which reimagines the preparation of student nurses and their transition to hospital practice has received international attention with publication of a manuscript in the January issue of the prestigious Journal of Nursing Administration (JONA).

Authored by Lisa Rowen, DNSc, RN, CENP, FAAN, Chief Nurse Executive for the University of Maryland Medical System and a team of co-authors, "Academy of Clinical Essentials: A Revolutionary Nurse Staffing and Education Model" highlights the successful pilot which placed seven cohorts of students from the University of Maryland School of Nursing (UMSON) at the bedside under instruction of an experienced hospital-based nurse.

This past semester, UMMS welcomed its first full class of nursing students as the ACE initiative expanded to many of the System's 11 hospitals, with participation from UMSON, the Community College of Baltimore County and Chesapeake College on Maryland's Eastern Shore. Students enrolled in any of three courses were eligible to participate in ACE: Medical-Surgical for ADN, Medical-Surgical Nursing for BSN, and Medical-Surgical Nursing for entry-to-practice CNL. More than 30 nursing cohorts with over 120 nursing students participated in ACE during the fall 2022 semester. In the spring 2023 semester, nursing students from Towson University and the UMSON Shady Grove campus in Montgomery County will join the program, which will also expand to include Maternal Health and Behavioral Health units. The program will also expand to include 50 cohorts across the System, including the System's hospitals in Prince George's County (UM Capital Region Health) and Charles County (UM Charles Regional Medical Center).

JONA is the authoritative source of information on developments and advances in patient care leadership. Content is geared to nurse executives, directors of nursing and nurse managers in hospital, community health, and ambulatory care environments. All articles are peer-reviewed, selected and developed with the guidance of a distinguished group of editorial advisors.

"The Journal of Nursing Administration is a premiere journal that is the authoritative source for developments and advances in patient care leadership," said Dr. Rowen. "It's affirming to have the UMMS Academy of Clinical Essentials and our academic-practice partnership with the University of Maryland School of Nursing recognized through the publication of our work. We are also delighted to disseminate our program and its outcomes to all nurse leaders and hope that it becomes an international model to sustain the future of the nursing profession."

As highlighted in the published manuscript, the ACE model offers significant advantages and benefits which can be replicated across the country through academic-practice partnerships at hospitals which partner with schools of nursing to offer experiential and competency-based education.

• Benefitting from an ACE collaboration, hospitals can have a fortified daily workforce, robust recruitment pipeline, and pathway from nursing student to new-graduate nurse
• Students are offered a realistic clinical education where they are integrated into the care delivery team and learn from UMMS bedside nurses who are acclimated to the unit and knowledgeable about the patient population, team members and hospital policies
• Provision of hospital clinical instructors to schools of nursing which will enable schools to accept more qualified applicants to their programs and ultimately grow the nursing workforce

Co-authors of the ACE manuscript include:

• Maeve Howett, PhD, APRN, CPNP-PC, Professor and Associate Dean for Baccalaureate Education, UMSON
• Casey Embert, BA, Project Manager, Nursing, UMMS
• Nicole Beeson, MBA, MSN, RN, Senior Vice President of Patient Care Services & Chief Nursing Officer, University of Maryland St. Joseph Medical Center (UM SJMC)
• Barbara Bosah, MS, RN, PCCN, Nurse Manager, Thoracic/Surgical Intermediate Care Unit and Vascular Progressive Care Unit, University of Maryland Medical Center (UMMC)
• Lynn Chen, PhD, Assistant Professor and Director of Evaluation, UMSON;
• Jenni Day, PhD, RN, Director of Nursing Inquiry, UMMC
• DoRhonja Nichols, DNP, RN, NEA-BC, Director of Critical Care and Behavioral Health Services, UM SJMC Cassie O'Malley, DNP, RN, OCN, Director of Clinical Excellence, Professional Development and Nursing Practice, UM SJMC

The manuscript's authors wrote, "We believe that the UMMS ACE model can serve as a prototype for academic-practice partnership internationally to support the education of nursing students and growth of the future supply of nurses to the workforce. This model could impact the curve of the nursing shortage and ultimately offer a sustainable solution to supply the necessary number of nurses for acute hospital settings, while increasing the resilience and support those new nurses need to remain in the profession."

Feedback from ACE student participants:

• "I loved being able to dive right in. While my peers were doing simulations on the computer or in the lab, I was getting first-hand experience."
• "This experience should be for everyone! We are working as soon as we walk in the door and we do everything. I feel like a real nurse!"
• "I feel more prepared for my nursing career."

Maeve Howett, PhD, APRN, CPNP-PC, CNE, Professor and Associate Dean for Baccalaureate Education at the University of Maryland School of Nursing, said, "The ACE program has provided excellent learning opportunities for our students in a time of critical need for additional nurse educators and sites. Our ongoing partnership with UMMS has successfully contributed to being able to increase enrollments to help meet the growing demand for nurses in Maryland. ACE has created an enthusiasm among experienced UMMS nurses to help teach and mentor the next generation of nurses."

Deborah Trautman, PhD, RN, FAAN, AACN President and Chief Executive Officer of AACN and a board member of UMMC, is a strong supporter of the ACE program. "In April 2021, the American Association of Colleges of Nursing released new guidelines for nursing education, urging schools of nursing to adopt a more experiential and competency-based framework for preparing professional nurses," she said. "The UMMS ACE model illustrates how practice and academic leaders can work together to meet these new expectations, which will take the profession of nursing into the future."

More information about the ACE initiative is available in this press release which announced the pilot program.

Key nursing national stats: (per the United States Bureau of Labor Statistics)

• The average age of registered nurses (RNs) has increased to 52-years-old
• Nineteen percent of the RN workforce is 65 or older, up from less than 15% in 2017
• Greater than 20% of RNs report they plan to retire from nursing within the next five years
• Employment opportunities for RNs are expected to grow 9% between now and the year 2030, with about 194,500 openings projected annually
• By 2030, the United States could be short as many as 1.9 million nurses

About the University of Maryland Medical System

The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.