Contemporary issues in Patient education, Patient involvement and engagement practices for nurses.

Contemporary issues in Patient education, Patient involvement and engagement practices for nurses.

In the past, controlled evaluations have shown uncertainty when replicated in the real
world, particularly around systems of service provision. Nevertheless, models that routinely
collected data and use a risk adjusted cost-effectiveness (RAC-E) analysis of alternative applied
models of primary health care for the management of obese adult patients reported a need for a
high level of involvement of practice in the provision of clinical-based activities. High
involvement was associated with lower costs and better outcomes (more patients losing weight,
and larger mean reductions in BMI). Excluding hospital costs, high level practice nurse
involvement was associated with slightly higher costs. Preliminary results provide a strong
indication that increased involvement of practice nurses in clinical activities is associated with
additional health benefits that are achieved at reasonable additional cost. Dissemination activities
and incentives are required to encourage general practices to better integrate practice nurses in
the active provision of clinical services (Karnon, et al., 2013) .
The New Graduate Nurse Transition to Primary Health Care Program is an untested yet
promising health policy in Australia that aims to improve the nursing workforce development

and sustainability strategy. It highlights the need for more integration of nursing with
multidisciplinary teams to meet the service needs of a growing ageing population in rural
communities. Australia is currently experiencing a surplus of and a corresponding lack of
employment opportunities for new graduate nurses. This situation is likely to compound
workforce shortages in the future. A national nursing workforce plan that addresses supply and
demand issues of primary health care nurses is required. Innovative solutions are required to
support and retain the current primary health care nursing workforce, whilst building a skilled
and sustainable workforce for the future. A graduate transition program to primary health care
may play an important role in addressing primary health care workforce shortages in the future.
There are, however, a number of factors that need to be simultaneously addressed if a skilled and
sustainable workforce for the future is to be realized. The development of a transition program to
primary health care should be based on a number of core principles and be subjected to both a
summative and cost-effectiveness evaluation involving all key stakeholders (Gordon, et al.,
2014) .
The idea to support job readiness and retention focuses on the feasibility of implementing
cooperative education for nursing students. The efforts have resulted in connecting classroom
learning with paid work experience for the purpose of enhancing students' education. Reported
benefits for students were improved job preparation and graduate retention, additional staffing
and reduction in orientation time, increased practice judgment and better workload. A work-
study model reported in the literature offered benefits similar to those of cooperative education,
with greater flexibility in design. An example was the University of Texas Health Science Center
at Houston's collaborative work-study scholarship program where students in second clinical
semesters were employed as unlicensed personnel by hospitals (Kee and Ryser 2001) working at

the level of their nursing preparation reported benefits for participants. They got better academic
credit, financial assistance, interaction with multidisciplinary teams, opportunity to refine clinical
skills, understanding of nurses' roles and guaranteed interview for positions on graduation (Kee
and Ryser 2001). Benefits for practice organizations were skilled help, the opportunity to recruit
new nurses and increased interaction with a university nursing program. While nurse education
stakeholders in British Columbia were exploring options, the concept of undergraduate student
nurse employment was initiated by a group of fourth-year students at the University of Victoria
who were completing the course "Nurses Influencing Change." The students were concerned
about having enough practice experience to meet increasing nursing competency requirements
and their survival as new graduates given workplace realities. Debt load also was a concern
because extensive student practicum time limited opportunities for paid employment during the
nursing education program. Students found that the idea of paid undergraduate nurse positions,
based on the student employment model in Alberta, was supported by nurse leaders, many
practising n