University of Minnesota

Problem:

Children with special health care needs constitute 10-20% of all children/adolescents in the U.S. They have significant, complex health problems requiring nursing leadership to provide child/family centered, coordinated, continuous, community-based high quality care to meet 2010 Express goals.

Goals and Objectives:

Goal 1: Develop MCH nursing leaders at the graduate level for careers focused on CSHCN and their families. Objective 1: After 5 years 35 (seven/year) master's prepared nurses will have graduated. Objective 2: After 5 years, two doctoral students will have graduated, one will be in the 3rd year of study, one in the 4th and one in the first. Objective 3: Each year, at least one doctoral and three masters students will participate in research or other educational activities with an MCH partner at the state, regional or the national level. Goal 2: Support innovative continuing education for nursing leaders regionally and nationally in the care of CSHCN and their families. Objective 1: Each year, one leadership conference will be conducted in partnership with the Center for Adolescent Nursing. Objective 2: Each year two new or revised learning modules on CSHCN will be available via the web, DVD, or video. Objective 3: In years two and four a needs assessment will be conducted to determine the educational needs of nurses in service positions in the upper Midwest. Results will be made available via the listserv. Goal 3: Assure technical assistance to Maternal and Child Health. The Center for CSHCN will provide technical assistance to state health departments in the upper Midwest and other MCH-related programs. Objective 1: After 5 years, faculty will have provided technical assistance to at least 5 state health and related MCH/CSHCN agencies in the upper Midwest. Objective 2: Through electronic or e-mail information dissemination strategies, relevant CSHCN information will be sent to all MCH/CSHCN nursing leaders in the Title V and Shriner's Hospitals at least monthly. Objective 3: All nursing courses, special events, conferences, workshops will be announced and available to all students and trainees enrolled in the five MCH-funded training programs at the University of Minnesota. Goal 4: Address health disparities by preparation of MCH/CSHCN leaders from diverse backgrounds and from rural settings. Objective 1: Each year one to two master's students from rural backgrounds will receive at least 75% of their education in their home location. Objective 2: After 5 years, five to six master's students will come from diverse backgrounds and/or will be serving diverse populations in rural or inner city locations. Objective 3: After 5 years, two doctoral students will come from diverse and rural backgrounds. Goal 5: Disseminate nationally MCH/CSHCN educational materials and faculty research to other MCHB sponsored programs, MCH-related programs and institutions of higher learning in nursing. Objective 1: After 5 years the faculty will have published at least two curriculum-related articles or conference proceedings in professional nursing journals. Objective 2: After 5 years, the faculty will have published an average of two data based articles on children with special health needs and their families each year. Objective 3: After 5 years, 5 graduate students will have published an article on CSHCN or will have presented a paper or poster session at a national meeting.

Methodology:

Two graduate programs are available; one at the master's level with an option for three tracks (CSHCN/Pediatric Nurse Practitioner, CSHCN and CSHCN/Pediatric Clinical Nurse Specialist) and another at the doctoral level. The CSHCN/PNP is the basis for the other two-master's level tracks. All three tracks prepare the student for MCH/CSHCN leadership. Those choosing the CSHCN/PNP course of study are eligible to take the PNP certification examination following the completion of their degrees. Likewise, students that choose the CSHCN Pediatric Clinical Nurse Specialist course of study are eligible to take that certification examination. The doctoral program is a three-year full-time program of study designed to prepare MCH/CSHCN nurse educators and scientists. Both programs are interdisciplinary and are linked with Title V agencies and MCH projects throughout the region and nation. The Center for CSHCN recruits applicants from rural settings in the upper Midwest as well as applicants from diverse backgrounds from either rural or urban environments. Over two-thirds of master's level course work is web-based. A committee of MCH/CSHCN nursing leaders advises the training program. Parents of CSHCN are on our advisory committee as well. Continuing education is designed to offer high quality learning opportunities for CSHCN nursing leaders in Title V programs, academic and clinical settings.

Coordination:

The program is linked with all other Title V funded projects at the University of Minnesota as well as with the Minnesota Department of Health's program Minnesota Children with Special Health Needs (MCSHN), the National Center for Health and Ready to Work and the Division of Pediatric Pulmonology at the University of Wisconsin. The Institute of Community Integration, at the University of Minnesota is closely linked with the Center for CSHCN.

Evaluation:

The Center for CSHCN programs are evaluated using standardized measurements available through the University of Minnesota as well as those designed by the project faculty and staff. Both formative evaluation as well as summative evaluation is conducted including follow-up of graduates five years after completion of the program.

Experience to Date:

Eight master’s nurses graduated, 17 continue into year two, 7 were admitted. Eight doctoral students continue, one new doctoral student begins Fall 2006. Two new courses were developed: Palliative care for children/adolescents and an on-line grant writing one-credit course to be offered Janary 2007 in collaboration with the Center for Adolescent Nursing and the MCH program in the School of Public Health, University of MN. Two new DVDs were created, "Connecting with Children: The therapeutic interview & Teaching Self Regulation Skills", and "Hearing Loss: Everyday Effects and Education". All DVDs are sold at cost. The faculty provided 20 hours of continuing education to 1145 recipients, technical assistance to 26 organizations, and produced 17 publications. We expect that the goals and objectives for the 5 year cycle will be met or exceeded. Performance measures 07, 08, 09, and 11 were on target. Collaboration with MCHB funded programs at the University of MN continues, as does work with the MN Dept. of Health, MNSCHN program. Data collection for needs assessment on pediatric nursing faculty shortage was completed and manuscript was submitted for publication.