Publications by authors named "Patricia B Howard"

Academic-practice partnerships foster innovation and transition to nursing practice in healthcare systems. The purpose of this paper is to describe the impact of a public-private academic-practice partnership for Doctor of Nursing Practice (DNP) education designed to transform a large healthcare system's nursing workforce and model of care. The conceptual framework is organized around Rogers's (2003) principles of diffusion of innovation in organizations.

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Teaching innovations in Doctor of Nursing Practice (DNP) programs are essential for preparing practitioners for role responsibilities. The purpose of this paper is to describe a teaching model implemented in a public-private academic-practice partnership in which DNP-prepared healthcare organization nursing leaders joined with college of nursing faculty to teach didactic courses in the DNP program. The conceptual framework for this model is organized around Boyer's (1990) principles of the scholarship of teaching, integration, and application, and the American Association of Colleges of Nursing definition of scholarship (2018).

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This article describes a practice improvement initiative (PII) demonstrating the impact of doctorate of nursing practice (DNP) skills beyond direct patient care. The Donna Wright Competency Assessment Model, AACN DNP Essentials, and National Organization of Nurse Practitioner Faculties nurse practitioner competencies framed the PII. The DNP graduates planned, implemented, and evaluated an assessment of 1,055 staff nurses on shift hand-off, physical assessment, and hand hygiene.

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Colleges of Nursing (CONs) and health care organizations (HCOs) are increasingly embracing academic-practice partnerships (AcaPP). An HCO's workforce development plan prompted an AcaPP agreement with a CON for the purpose of increasing the number of doctor of nursing practice (DNP) advanced practice nurses in the HCO. Over a period of 6 years, 4 consecutive cohorts of approximately 100 HCO baccalaureate prepared nurses were enrolled in the CON DNP program.

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Objective: The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study.

Background: The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing.

Methods: An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program.

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During the past decade, the growth of doctor of nursing practice (DNP) programs in the United States has been phenomenal, with most focusing on the preparation of advanced practice registered nurses. Simultaneously, academic-practice partnerships have been a frequent subject of discussion for nursing's leading academic, administrative, and practice organizations. Numerous reports about academic-practice partnerships concerning aspects of baccalaureate nursing education exist, but partnership accounts for DNP programs are essentially nonexistent.

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Leadership behaviors and actions influence others to act, and leadership in clinical practice is an important mediator influencing patient outcomes and staff satisfaction. Indeed, positive clinical leadership has been positioned as a crucial element for transformation of health care services and has led to the development of the Practice Doctorate Movement in the United States. Nurse educators in health care have a vital leadership role as clinical experts, role models, mentors, change agents, and supporters of quality projects.

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Little is known about the factors that influence health behavior decision-making among people with schizophrenia. The purpose of this qualitative study was to describe the processes used by 10 African-American adults with schizophrenia when making health behavior decisions and identification of perceived barriers and facilitators to health. Three phases of health behavior decision-making were identified: Recognizing Complex Components of Health, Personalizing Components of Health, and Tracking Health Status.

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The Medication Management Approaches in Psychiatry (MedMAP) is a medication management evidence-based practice (EBP) to guide the use of psychotropic medications in the treatment of schizophrenia. This qualitative study examined facilitators and barriers to implementing MedMAP in community mental health treatment settings. Audio-taped qualitative interviews were conducted with practitioners and administrators involved in a MedMAP implementation project conducted in six community mental health centers.

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Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate.

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The physical health of people with schizophrenia is poor, and the challenges in finding effective treatment and optimizing health outcomes are significant. However, it is likely that people diagnosed with schizophrenia can be partners in the treatment of their physical health problems. Research suggests that many people with schizophrenia value physical health and will participate in health-related behaviors when they are provided with the opportunity to do so.

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Chronic medical illness among children and adolescents is a growing concern with implications for informal and formal caregivers. When coupled with a psychiatric comorbidity, implications grow exponentially. Nurses who care for child and adolescent populations play a crucial role in optimizing physical and mental health when they interface with patients and their caregivers.

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Objective: Medication Management Approaches in Psychiatry (MedMAP) is an evidence-based practice developed to guide the management and monitoring of psychotropic medications for individuals with schizophrenia. This article reports prescriber fidelity to MedMAP principles in a public mental health service system.

Methods: This three-year longitudinal intervention study implemented MedMAP in six community mental health centers in Kentucky.

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This paper describes the psychometric properties of two fidelity scales created as part of the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsored medication management toolkit and their metric properties when used in 26 public mental health clinics with 50 prescribers. A 23-item scale, based on chart reviews, was developed to assess whether prescribers are following good medication practices, in conjunction with a 17-item scale to assess organizational support for and evaluation of prescriber adherence to recommended medication-related practices. Fundamental gaps in routine practice, including poor documentation of medication history and infrequent monitoring of symptoms and side effects were found.

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The gradual transition from paper records to electronic records presents challenges for nurses. In particular, split paper/electronic records can interfere with staff communication during shift change reports. A project was implemented to facilitate documentation of individualized care plans and improve staff communication during shift change report.

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This study measured service satisfaction, perceptions of service quality and general health, and overall quality of care among 787 adult recipients of Medicaid mental health services. Methods included cross-sectional retrospective design and stratified random sampling technique. Respondents were satisfied with consumer-provider relationships and were dissatisfied with functional outcomes resulting from treatment.

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The purpose of this retrospective, cross-sectional, descriptive study was to measure self-reported frequencies of medical problems, overall health, and health-related quality of life among mental health consumers. The sample included 787 adults who had received a mental health service paid for by Medicaid over a one-year period. The self-administered questionnaire included the 12-item Medical Outcomes Study (MOS) Short-Form (SF) Physical and Mental Health Summary Scales, and items about physical health problems and health-related quality of life.

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In the United States, the patient has emerged as the central focus in evaluations of mental health services (Buckley, 1993). Whereas evaluation research in the 1980s emphasised the structure and process of mental health care, current evaluation research incorporates client-based measurements of treatment outcomes, such as symptom reduction, functional status and quality of life (Chisholm , 1997; Campbell, 1998). In addition, patient satisfaction with mental health services is increasingly used as an outcome dimension and an indicator of service quality (Center for Mental Health Services, 1996; Teague , 1997; Howard , 2003).

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This study, conducted at two public-sector psychiatric hospitals in a south-eastern state, investigated satisfaction with inpatient services and treatment outcomes among 204 hospitalized mental health consumers. A simple survey design with nonrandom sampling technique was used; instruments included the KY-CSI, the 21-item MHSIP Consumer Survey, and the CSQ-8. Respondents reported satisfaction with time available to be with other patients, staff availability, and their degree of comfort talking to staff.

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