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In order to meet South Dakota’s need for a unified approach towards Advance Care Planning (ACP), the University of South Dakota’s (USD) Department of Nursing assembled an interprofessional, collaborative network of health professionals to pilot an ACP process. The ultimate goal is to implement a process statewide. The project starts by training learners in USD’s School of Health Science as “First Steps Facilitators,” based on the model pioneered by the Gunderson Respecting Choices® program. Following initial implementation of the training in Sioux Falls, ACP Facilitator training will be integrated into USD’s Health Sciences’ curriculum at USD campuses throughout the state. Trained facilitators will implement the approach to ACP at a number of intervention sites in Vermillion, South Dakota. The community was chosen because it has a hospital, a senior center, and a nursing home that already partner with USD as part of the health sciences curriculum. If the intervention has positive results, it will be scaled up to a state-wide level. A pre-post design will be used to assess the impact of the unified approach to ACP on the state.

In order to implement IPE in the clinical practice setting, this intervention incorporates UNE’s Clinical Interprofessional Curriculum (CIPC), which can be found at: http://www.une.edu/clinical-interprofessional-curriculum. CIPC is based on the NCQA patient-centered medical home (PCMH) recognition standards, such as those involving a comprehensive visit and assessment with a complex patient, as well as quality improvement and population health standards. The learning activities also infuse the IPEC competencies and reinforce the use of TeamSTEPPS skills. While helping students to achieve interprofessional competencies, the CIPC is also meant to assist the practice in achieving the PCMH standards. UNE students are also provided robust on-campus IPE during their pre-clinical training years, including: interprofessional seminars; joint curricula between, for instance, dental medicine and osteopathic medicine; interprofessional simulations; and interprofessional service learning.

This descriptive research used social network analysis to explore the influence of relationships and communication among hospital nursing (RN, LPN, CNA) and discharge planning staff on adherence to evidence-based practices (EBP) for reducing preventable hospital readmissions. Although previous studies have shown that nurses are a valued source of research information for each other, there have been few studies concerning the role that staff relationships and communication play in adherence to evidence-based practice.