Sample records for united states nursing

  1. 34 CFR 600.52 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... education in professional nursing leading to a degree equivalent to an associate degree in the United States... equivalent to a bachelor of arts, bachelor of science, or bachelor of nursing in the United States, or to a degree equivalent to a graduate degree in nursing in the United States, and including advanced training...

  2. Forecasting Nursing Student Success and Failure on the NCLEX-RN Using Predictor Tests

    ERIC Educational Resources Information Center

    Santiago, Lawrence A.

    2013-01-01

    A severe and worsening nursing shortage exists in the United States. Increasing numbers of new graduate nurses are necessary to meet this demand. To address the concerns of increased nursing demand, leaders of nursing schools must ensure larger numbers of nursing students graduate. Prior to practicing as registered nurses in the United States,…

  3. U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency

    PubMed Central

    Aiken, Linda H

    2007-01-01

    Objectives To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Principal Findings Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Conclusions Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and implementing evidence-based initiatives to improve nurse retention and productivity could prevent future nurse shortages. PMID:17489916

  4. US nurse labor market dynamics are key to global nurse sufficiency.

    PubMed

    Aiken, Linda H

    2007-06-01

    To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and implementing evidence-based initiatives to improve nurse retention and productivity could prevent future nurse shortages.

  5. Going alone: the lived experience of female Arab-Muslim nursing students living and studying in the United States.

    PubMed

    McDermott-Levy, Ruth

    2011-01-01

    Since 2004, international student enrollment in the United States has increased. Middle Eastern students studying in the United States have been part of the increase. In 2008-2009 there were 29 140 Middle Eastern students, representing an 18% increase from the previous academic year. Despite these increases, there is limited research examining the experience of Arab-Muslim international students or international nursing students studying in the United States. Phenomenological inquiry was used to describe the experience of 12 female Omani nurses living in the United States while studying for their baccalaureate degrees in nursing. The women described the experience of going alone and being away from the support and presence of their large, extended families; this influenced their international student experience. They also described their religious, cultural, and educational adaptation. The experience of living and studying nursing in the United States was transformational as they became self-reliant, learned their capabilities, and adapted to cultural and educational expectations. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. 77 FR 20645 - Agency Information Collection Activities: Proposed Collection: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... care facility with a critical shortage of nurses as defined by the program. NSP recipients must be... critical shortage of nurses in the United States, which includes, in addition to the several States, only... health care facility with a critical shortage of nurses in the United States or these territories are...

  7. Nurse Workforce Challenges in the United States: Implications for Policy. OECD Health Working Papers, No. 35

    ERIC Educational Resources Information Center

    Aiken, Linda H.; Cheung, Robyn

    2008-01-01

    The United States has the largest professional nurse workforce in the world numbering close to 3 million but does not produce enough nurses to meet its growing demand. A shortage of close to a million professional nurses is projected to evolve by 2020. An emerging physician shortage will further exacerbate the nurse shortage as the boundaries in…

  8. The Use of the Nursing Process in Spain as Compared to the United States and Canada.

    PubMed

    Huitzi-Egilegor, Joseba Xabier; Elorza-Puyadena, Maria Isabel; Asurabarrena-Iraola, Carmen

    2017-05-18

    To analyze the development of the nursing method process in Spain, and compare it with the development in the United States and Canada. This is a narrative review. The teaching of the nursing process in nursing schools started in Spain as from 1977 and that it started being used in professional practice in the 1990's. The development, the difficulties, the nursing models used and its application form are discussed. The development of the nursing process in the United States and Canada started to happen in Spain about 15-20 years later and, today, is a reality. Cross-sectional studies are needed to determine the changes in the development of the nursing process in Spain. © 2017 NANDA International, Inc.

  9. Sympathy and Strategy: Issues in the Development of Nursing Education in the United States. ASHE Annual Meeting 1981 Paper.

    ERIC Educational Resources Information Center

    Brand, Barbara

    The development of nursing and nursing education in the United States during the late nineteenth and early twentieth centuries is described. Professionalization accompanied by feminization in nursing, as in teaching, librarianship, and social work, opened opportunities to middle class women for respectable employment and sometimes prestige and…

  10. Hospice and nursing homes.

    PubMed

    Castle, N G

    1999-01-01

    In this article a descriptive analysis of nursing homes with special care hospice units is provided. These are compared to nursing homes with other special care units and to nursing homes without any special care units. An analysis of the determinants of nursing homes with special care hospice units is also provided. Factors such as ownership, staffing levels, having other special care units, case-mix intensity, competitiveness of the nursing home market, and the state Medicaid reimbursement rate structure are examined. Finally, the influence of policies on hospice care in nursing homes is discussed.

  11. 77 FR 34390 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... the NSP) at a health care facility with a critical shortage of nurses as defined by the program. NSP... facility with a critical shortage of nurses in the United States, which includes, in addition to the States... health care facility with a critical shortage of nurses in the United States or these territories are...

  12. Developing blended online and classroom strategies to deliver an occupational health nursing overview course in a multi-state region in the United States.

    PubMed

    de Castro, A B; Shapleigh, Erin; Bruck, Annie; Salazar, Mary K

    2015-03-01

    This article describes how hybrid online and classroom learning approaches were used to design and offer an occupational health nursing review course throughout a multi-state region of the northwest United States. In response to demand from practicing occupational health nurses for board certification preparation, a series of asynchronous and synchronous continuing education modules was created covering a range of occupational health nursing topics. This review course illustrates how innovative educational delivery models can serve the needs of occupational health nurses challenged by geographic and time constraints. © 2015 The Author(s).

  13. Using the Practice Environment Scale of the Nursing Work Index on Asian nurses.

    PubMed

    Liou, Shwu-Ru; Cheng, Ching-Yu

    2009-01-01

    Researchers have used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to examine the perception of practice environment among U.S. nurses in general; however, the scale has not been used to measure perceptions specifically among Asian nurses working in the United States, the largest group of international nurses in the nation. The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States. The study used a cross-sectional design with snowball sampling. Data from 230 Asian nurses who were born in Far Eastern countries and had worked at least 6 months in their current job at a U.S. hospital were analyzed, using Cronbach's alpha, item-total and interitem correlation, and factor analysis. The Cronbach's alpha for the PES-NWI was.96, and the item-total correlation coefficients ranged from.49 to.79. Five factors, which explained 59.12% of variance in the perception of practice environment, emerged: Nurse Participation and Development; Nurse Manager Ability, Leadership, and Support of Nurses; Nursing Foundations for Quality of Care; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations. Four derived factors were reconstructed, and one factor was renamed based on the meanings of scale items that were included in the factor. Study findings demonstrate that the PES-NWI is a reliable and a valid scale when applied to Asian nurses working in the United States. Findings also indicate that Asian nurses perceive practice environments differently than do American nurses, most likely due to dissimilar cultural beliefs. A better understanding of these differences may help develop more individualized support for Asian nurses as they adapt to working in the United States.

  14. International collaboration in pediatric nursing: mutual learning success.

    PubMed

    Metcalfe, Sharon Elizabeth

    2010-01-01

    This article describes an innovative international collaboration between a children's hospital in the United Kingdom and a university school of nursing in the United States that created opportunities for networking among nurses in similar specialties. Nurses from two countries joined in an educational partnership to share dialogue and clinical experience in the United Kingdom.

  15. The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

    PubMed

    Baernholdt, Marianne; Mark, Barbara A

    2009-12-01

    The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.

  16. [The development and impacts of professional nursing in senior care and senior business management: the perspective of a U.S.-based nurse entrepreneur].

    PubMed

    Chang, Theresa

    2008-10-01

    The three main parts of this article include (1) the process of transition from a clinical nurse to a nurse entrepreneur, (2) senior care business management and social responsibility and (3) the development of senior care business in the future as well as the chances for nursing development. The article analyzes the development of gerontology nursing careers in the United States and Taiwan and the role professional nurses can play in ageing societies. A prospective plan for collaboration between gerontology nurses and long-term care health professionals in the United States and Taiwan concludes the article.

  17. Immigration and contract problems experienced by foreign-educated nurses.

    PubMed

    Pittman, Patricia; Herrera, Carolina; Spetz, Joanne; Davis, Catherine R

    2012-06-01

    More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

  18. Advancing nursing enterprises: A cross-country comparison.

    PubMed

    Pittman, Patricia; Salmon, Marla E

    2016-01-01

    Health system transformations in the United States are creating new opportunities for nursing innovation, although financial sustainability has limited the expansion of nurse managed clinics. We explore case studies of nursing enterprises in the developing world and discuss their potential for informing related work in the United States. Cases were selected from the Center for Health Market Innovations. We describe a professional association network of clinics in Tanzania, a social franchise in Kenya, and a cooperative in the Philippines. All programs empowered nurses to own, lead, and advance their professional influence. They had a social mission of improving access to care for disadvantaged populations, while increasing employment and autonomy of women. They also provided a shared platform for branding, purchasing, and quality assurance. Organization sponsors in these models may be relevant to different actors in the United States. Each demonstrates the importance of a collective approach to advancing nursing enterprises. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Identification of factors which affect the tendency towards and attitudes of emergency unit nurses to make medical errors.

    PubMed

    Kiymaz, Dilek; Koç, Zeliha

    2018-03-01

    To determine individual and professional factors affecting the tendency of emergency unit nurses to make medical errors and their attitudes towards these errors in Turkey. Compared with other units, the emergency unit is an environment where there is an increased tendency for making medical errors due to its intensive and rapid pace, noise and complex and dynamic structure. A descriptive cross-sectional study. The study was carried out from 25 July 2014-16 September 2015 with the participation of 284 nurses who volunteered to take part in the study. Data were gathered using the data collection survey for nurses, the Medical Error Tendency Scale and the Medical Error Attitude Scale. It was determined that 40.1% of the nurses previously witnessed medical errors, 19.4% made a medical error in the last year, 17.6% of medical errors were caused by medication errors where the wrong medication was administered in the wrong dose, and none of the nurses filled out a case report form about the medical errors they made. Regarding the factors that caused medical errors in the emergency unit, 91.2% of the nurses stated excessive workload as a cause; 85.1% stated an insufficient number of nurses; and 75.4% stated fatigue, exhaustion and burnout. The study showed that nurses who loved their job were satisfied with their unit and who always worked during day shifts had a lower medical error tendency. It is suggested to consider the following actions: increase awareness about medical errors, organise training to reduce errors in medication administration, develop procedures and protocols specific to the emergency unit health care and create an environment which is not punitive wherein nurses can safely report medical errors. © 2017 John Wiley & Sons Ltd.

  20. Preparing underemployed Latino U.S. nurses through the Mexico NCLEX-RN Success Program.

    PubMed

    Lujan, Josefina; Little, Kermit

    2010-12-01

    The critical nursing shortage in U.S. communities along the United States-Mexico border is compounded by the need for nurses who are linguistically and culturally concordant with the growing number of Latinos in these communities. The innovative 16-week Mexico NCLEX-RN Success Program responds to this need by helping underemployed Latino nurses, who were educated in Mexico and live in the United States, adapt linguistically and culturally to multiple-choice testing. Ten of the program students have taken the NCLEX-RN with a 50% pass rate, which is twice as high as the internationally educated candidate passing average. This demonstrates potential for the program to build the human capacity of U.S. communities along the United States-Mexico border by infusing linguistically and culturally concordant nurses into the workforce and materializing the dream of underemployed Latino nurses to implement their hard-earned and urgently needed nursing skills. Lessons learned from the program are discussed. Copyright 2010, SLACK Incorporated.

  1. Cops, Consultants, and Goldfish: Variations in Nursing Home Regulation.

    ERIC Educational Resources Information Center

    Gardiner, John A.

    Nursing home regulatory agencies are subjected to a variety of pressures. Nursing home residents' families and friends want the agencies to "get tough" while the nursing home industry wants agencies to act as consultants rather than cops. The task of regulating nursing homes in the United States is primarily carried out by units of state…

  2. Professional identity of Korean nurse practitioners in the United States.

    PubMed

    Seo, Kumsook; Kim, Miyoung

    2017-04-01

    Despite nurse practitioners' (NPs) professional identity having important implications for the confirmation of nursing practice characteristics, few studies have examined the professional identity of NPs overlaid with the immigrant experience. The aim of this study was to explore the career characteristics of Korean nurse immigrants who became NPs in the United States. Seven Korean NPs in the United States underwent in-depth interviews from August 2013 to May 2015. Content analysis was employed for data analysis. Five themes were identified regarding their professional identity as NPs: patient-centered thinking, responsibility for patient care, dedicated life, diligence, and feelings of achievement. Of these, patient-centered thinking appeared to be the overriding theme. The findings add to nursing knowledge about immigrant nurses and their abilities and striving to develop into new roles in nursing. The participants focused on listening, interpersonal relationships, and education in patient care, which helped differentiate their roles from those of other healthcare professionals. Nurse managers should consider the study findings when making policies to assist immigrant nurses to acculturate into practice, and there is a need for the development of educational materials to guide and promote the NPs' professional role. ©2017 American Association of Nurse Practitioners.

  3. The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

    PubMed

    Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

    2016-10-01

    Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.

  4. Challenges and issues facing the future of nursing education: implications for ethnic minority faculty and students.

    PubMed

    Davis, Sheila P; Davis, Danyetta D

    2010-01-01

    Current trends in higher education in the United States demand that nursing take stock of how it is prepared or being prepared to face challenges and issues impacting on its future. The intense effort made to attract students to pursue advanced training in science and engineering in the United States pales in comparison to the numbers of science and engineering majors produced yearly in international schools. As a result, more and more jobs are being outsourced to international markets. Could international outsourcing become a method of nursing education? Authors submit that to remain competitive, the nursing profession must attract a younger cohort of technologically savvy students and faculty reflective of the growing diverse population in the United States. Additionally, nursing programs in research universities face even more daunting challenges as it relates to mandates for funded research programs of educational units. This article offers suggestions and recommendations for nursing programs in higher education institutions on ways to attract and retain ethnic minorities and of how to harness the power of research to address burgeoning societal health challenges.

  5. "The relation of the nurse to the working world": professionalization, citizenship, and class in Germany, Great Britain, and the United States before World War I.

    PubMed

    Soine, Aeleah

    2010-01-01

    Campaigns for state nursing registration in the United States and Great Britain have a prominent place in the historical scholarship on nursing professionalization; the closely related German campaign has received less scholarly attention. Applying a transnational perspective to these three national movements highlights the collaborative and interrelated nature of nursing reform prior to World War I and recognizes the important contribution of German nurses to this dialogue and agenda. Focusing particularly on the years 1909-12, this article depicts a generation of German, American, and British nurses who organized national and international nursing associations to realize state registration as a stepping stone to other markers of professional recognition, such as collegiate education, full political citizenship, social welfare, and labor legislation. However, the consequent reliance of these strategies on nation-states as arbiters of citizenship and professional status undermined the shared ideological foundation of international and national nursing leaders. This article contributes to a more multinational understanding of how these international nursing leaders transcended and were confined by the limits of their nation-states in the years leading up to World War I.

  6. End-of-Life and Palliative Care Issues in Medical and Nursing Schools in the United States

    ERIC Educational Resources Information Center

    Dickinson, George E.

    2007-01-01

    Medical and nursing schools in the United States have traditionally had a limited emphasis on end-of-life care. The present study is a comparison of these 2 professional programs' current offerings on death education. Data were gathered via a mailed survey from the 122 medical schools in 2005 and the 580 baccalaureate nursing programs in 2006.…

  7. Nurse overtime, working conditions, and the presence of mandatory nurse overtime regulations.

    PubMed

    Bae, Sung-Heui

    2012-05-01

    Although more states have regulated mandatory nurse overtime, limited research has examined the impact of these regulations on the actual time nurses work and their working conditions. The purpose of this study was to compare nurse overtime and working conditions between states with and states without regulations limiting mandatory nurse overtime. Data were collected from registered nurses working in hospitals located in states with and without mandatory nurse overtime regulations; the final sample consisted of 219 nurses. No difference was found in overtime worked between nurses who worked in states with regulations or without. Those nurses working in states with regulations cared for more patients per shift and experienced more chronic nursing shortages on their nursing units than those working in states without regulation. Continuous efforts are needed to improve the implementation of regulations to reduce nurse mandatory overtime and long work hours. Copyright 2012, SLACK Incorporated.

  8. Time motion analysis of nursing work in ICU, telemetry and medical-surgical units.

    PubMed

    Schenk, Elizabeth; Schleyer, Ruth; Jones, Cami R; Fincham, Sarah; Daratha, Kenn B; Monsen, Karen A

    2017-11-01

    This study examined nurses' work, comparing nursing interventions and locations across three units in a United States hospital using Omaha System standardized terminology as the organizing framework. The differences in nurses' acute-care work across unit types are not well understood. Prior investigators have used time-motion methodologies; few have compared differences across units, nor used standardized terminology. Nurse-observers recorded locations and interventions of nurses on three acute-care units using hand-held devices and web-based TimeCaT ™ software. Nursing interventions were mapped to Omaha System terms. Unit-differences were analysed. Nurses changed locations approximately every 2 min, and averaged approximately one intervention/minute. Unit differences were found in both the interventions performed and the locations. Most interventions were case-management related, demonstrating the nurses' patient management/coordination role. Unit differences in nursing interventions and location were found among three unit types. Omaha System terminology, as well as the observational method used, were found to be feasible and practical. Nursing work varies by unit, yet managers have not been armed with empirical data with which to make more informed decisions about nurses' work priorities, clinical outcomes, patient satisfaction, staff satisfaction and cost. The results from this study will help them to do so. © 2017 John Wiley & Sons Ltd.

  9. A global service-learning experience for nursing students in Tanzania: a model for collaboration.

    PubMed

    Kreye, Judy; Oetker-Black, Sharon

    2013-01-01

    This article addresses a model for creating a short-term global service-learning program. The Global Standards for the Initial Education of Professional Nurses and Midwives guided the development of a collaborative program involving a school of nursing in the Midwestern United States and one in Tanzania. Evaluation of the school of nursing and subsequent collaborative planning led to development and implementation of a 3-week global service-learning experience for nursing students. International academic partnerships, developed in accordance with WHO standards, will enhance educational experiences for nursing students both in the United States and abroad. © 2013 Wiley Periodicals, Inc.

  10. Comparing nurse managers and nurses' perceptions of nurses' self-leadership during capacity building.

    PubMed

    Jooste, Karien; Cairns, Lindi

    2014-05-01

    This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. © 2014 John Wiley & Sons Ltd.

  11. Staff Nurse Decisional Involvement in the United States and Turkey.

    PubMed

    Ugur, Esra; Scherb, Cindy A; Specht, Janet P; Sen, Sevim; Lazzara, Lydia K

    2017-12-01

    The purpose of this descriptive comparative study is to compare the levels of decisional involvement of staff nurses between one Midwestern health care system in the United States with a nongovernmental University hospital in Turkey. The Decisional Involvement Scale was used for data collection. U.S. ( n = 163) and Turkey ( n = 50) staff nurses were included in the study. Both samples preferred more decisional involvement than they currently experienced. However, Turkish nurses experienced and preferred lower levels of decisional involvement than the U.S. Shared governance structures may be a strategy used to enhance staff nurse decisional involvement.

  12. Best Practices for Onboarding New Nursing Faculty: The Role of the Nurse Administrator

    ERIC Educational Resources Information Center

    Lee, Antwinett O.

    2017-01-01

    This study explored best practices for onboarding new faculty in nursing programs in Washington State of the United States. The purpose of this study was to examine, (a) onboarding practices to orient new faculty currently used at nursing programs that provide an Associate Degree, (b) the perceived nurse administrator's role in providing…

  13. Transition from Associate's Degree in Nursing to Bachelor's of Science in Nursing

    ERIC Educational Resources Information Center

    Allar, Deborah T.

    2014-01-01

    Areas throughout the United States lack baccalaureate-prepared registered nurses to meet the health care needs of individuals, forcing health care providers to rely on associate degree nurses (ADN). In an effort to increase the numbers of Bachelor of Science in Nursing (BSN) students, technical colleges and state and private universities have…

  14. Part 1--Factors Associated with School Nurse Ratios: An Analysis of State Data

    ERIC Educational Resources Information Center

    Maughan, Erin

    2009-01-01

    Despite the recognized importance of school nurses, the ratios of nurse to pupil are insufficient in many states across the country. The purpose of this study was to describe school nurse-to-pupil ratios by state and to statistically identify factors that may influence these ratios. Funding per pupil unit in general and support services and laws…

  15. Barriers to participation in governance and professional advancement: a comparison of internationally educated nurses and registered nurses educated in the United States.

    PubMed

    Wheeler, Rebecca M; Foster, Jennifer W

    2013-01-01

    This study compared the perspectives of internationally educated nurses (IENs) and registered nurses (RNs) educated in the United States regarding participation in hospital governance structures and professional advancement. Nurses' participation in hospital governance is reported to contribute to empowerment. No research has examined how IENs' perceptions about participation in governance compared with those of U.S. RNs. Semistructured interviews were held with 82 nurses in 2 urban hospitals. Forty nurses were reinterviewed to follow up on themes. Internationally educated nurses and US RNs shared similar perspectives. Nurses in both samples did not value participation in governance, lacked guidance about how to advance, and preferred to at the bedside. Strategies to encourage nurses to participate in and value governance and professional advancement opportunities should be explored and adopted.

  16. Nursing, social contexts, and ideologies in the early United States birth control movement.

    PubMed

    Lagerwey, M D

    1999-12-01

    Using historical discourse analysis, this study provides a thematic analysis of writings of nursing and birth control as found in The Birth Control Review from 1917 to 1927. The author contrasts this publication with the official journal of the American Nurses Association, the American Journal of Nursing from the same years to explore nursing voices and silences in early birth control stories. In dialogue with social contexts, nursing endeavors and inactivity have played important yet conflicting roles in the birth control movement in the United States. Nursing writings from the early twentieth century reflect eugenic beliefs, national fears of immigrants, and ambivalence about women's roles in society and the home. Nurses simultaneously empowered women to choose when to become pregnant and reinforced nativist and paternalistic views of the poor.

  17. The migration of nurses: trends and policies.

    PubMed Central

    Buchan, James; Sochalski, Julie

    2004-01-01

    This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States. We also examine the policy challenges for workforce planning and the design of health systems infrastructure. Data are derived from registries of professional nurses, censuses, interviews with key informants, case studies in source and destination countries, focus groups, and empirical modelling to examine the patterns and implications of the movement of nurses across borders. The flow of nurses to these destination countries has risen, in some cases quite substantially. Recruitment from lower-middle income countries and low-income countries, as defined by The World Bank, dominate trends in nurse migration to the United Kingdom, Ireland, and the United States, while Norway and Australia, primarily register nurses from other high-income countries. Inadequate data systems in many countries prevent effective monitoring of these workforce flows. Policy options to manage nurse migration include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Recommendations for enhancements to workforce data systems are provided. PMID:15375448

  18. Moral decision making in neonatal intensive care.

    PubMed

    Chally, P S

    1992-01-01

    To gain information about the perspective that neonatal intensive-care unit nurses use to make moral decisions. Descriptive. Neonatal intensive-care unit of a large teaching hospital in the midwestern United States. Convenience sample of 26 female nurses working in a neonatal intensive-care unit. Audiotaped, semistructured interviews and demographic questionnaires. The results indicated that most (65%) of the nurses used the care perspective to make moral decisions. A small number (12%) used the justice perspective, and the remaining nurses (23%) used a combined care and justice perspective. Both the care and justice perspectives were found to be important for understanding how nurses make moral decisions.

  19. State-Wide Nursing Assistant Curriculum. Health Occupations Education: We Make a Difference.

    ERIC Educational Resources Information Center

    Richards, Beverly; Moore, Susan

    These curriculum materials for preparing nursing assistants in Pennsylvania provide 14 units of secondary and postsecondary instruction. Presented within the topic of the role and function of the nursing assistant are units providing an introduction to health care, communications, infection control, emergency and disaster procedures, and ethical…

  20. Use of physical restraints in adult critical care: a bicultural study.

    PubMed

    Martin, Beth; Mathisen, Lars

    2005-03-01

    Although controversial, physical restraints are commonly used in adult critical care units in the United States to prevent treatment interference and self-inflicted harm. Use of physical restraints in Norwegian hospitals is very limited. In the United States, an experimental design for research on use of restraints has not seemed feasible. However, international research provides an opportunity to compare and contrast practices. To describe the relationship between patients' characteristics, environment, and use of physical restraints in the United States and Norway. Observations of patients and chart data were collected from 2 intensive care units (n = 50 patients) in Norway and 3 (n = 50 patients) in the United States. Sedation was measured by using the Sedation-Agitation Scale. The Nine Equivalents of Nursing Manpower Use Score was used to indicate patients' acuity level. Restraints were in use in 39 of 100 observations in the United States and not at all in Norway (P = .001). Categories of patients were balanced. In the Norwegian sample, the median Nine Equivalents of Nursing Manpower Use Score was higher (37 vs 27 points, P < .001), patients were more sedated (P < .001), and nurse-to-patient ratios were higher (1.05:1 vs 0.65:1, P < .001). Seven incidents of unplanned device removal were reported in the US sample. Critical care units with similar technology and characteristics of patients vary between nations in restraint practices, levels of sedation, and nurse-to-patient ratios. Restraint-free care was, in this sample, safe in terms of treatment interference.

  1. Delegation of Glucagon(r) in the school setting: a comparison of state legislation.

    PubMed

    Wilt, Lori; Foley, Marie

    2011-06-01

    Delegation of nursing procedures and medication in school is fraught with legal and ethical concerns for the school nurse. Because nurses may be responsible for coordinating care for several school buildings, delegation of nursing care and medication administration has occurred out of necessity. Nurse Practice Acts in some states, but not all, allow for delegation of medication to unlicensed assistive personnel. This article explores Glucagon(®) delegation laws in the United States and presents an argument against such delegation in states where Nurse Practice Acts do not allow for delegation of medication to unlicensed assistive personnel.

  2. Relationships between nurse- and physician-to-population ratios and state health rankings.

    PubMed

    Bigbee, Jeri L

    2008-01-01

    To evaluate the relationship between nurse-to-population ratios and population health, as indicated by state health ranking, and to compare the findings with physician-to-population ratios. Secondary analysis correlational design. The sample consisted of all 50 states in the United States. Data sources included the United Health Foundation's 2006 state health rankings, the 2004 National Sample Survey for Registered Nurses, and the U.S. Health Workforce Profile from the New York Center for Health Workforce Studies. Significant relationships between nurse-to-population ratio and overall state health ranking (rho=-.446, p tf?>=.001) and 11 of the 18 components of that ranking were found. Significant components included motor vehicle death rate, high school graduation rate, violent crime rate, infectious disease rate, percentage of children in poverty, percentage of uninsured residents, immunization rate, adequacy of prenatal care, number of poor mental health days, number of poor physical health days, and premature death rate, with higher nurse-to-population ratios associated with higher health rankings. Specialty (public health and school) nurse-to-population ratios were not as strongly related to state health ranking. Physician-to-population ratios were also significantly related to state health ranking, but were associated with different components than nurses. These findings suggest that greater nurses per capita may be uniquely associated with healthier communities; however, further multivariate research is needed.

  3. Integrative Review of the Current Educational Strategies for Teaching Pediatric Nursing in the Prelicensure Nursing Program

    ERIC Educational Resources Information Center

    Villora, Rosalie Crisostomo

    2013-01-01

    Background: The United States Census Bureau stated that there were 76.1 million children aged birth to 17 years in the United States, and 13.9% of these children are estimated to have special health care needs. In California, 9.9% of children have special health care needs. This background information leads to question the pediatric nurse…

  4. Nurse work environment and quality of care by unit types: A cross-sectional study.

    PubMed

    Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E

    2015-10-01

    Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. A student nurse experience of an intervention that addresses the perioperative nursing shortage.

    PubMed

    Monahan, J Carter

    2015-11-01

    Registered nurses are the largest group of professionals in the global healthcare system. The number of nurses is estimated to be 19.3 million throughout the world (Flinkman et al 2013). In the United States the need for registered nurses is growing. It has been predicted that 260,000 positions for registered nurses will remain unfilled by the year 2025 (Harris et al 2014) with a shortage of registered nurses projected to spread across the United States between 2009 and 2030 (Juraschek et al 2012). Compounding the projected nursing shortage is the increased attrition rate, which is as high as 61% within the first year (Pine & Tart 2007). There are several reasons for this shortage including supply and demand issues, projected changes to healthcare and the aging population. Additionally, the number of college graduates who have majored in nursing has not met the demand (Dunn 2014).

  6. Succession Planning for Nursing Leaders in a College of Nursing

    ERIC Educational Resources Information Center

    Tucker, Cheryl A.

    2017-01-01

    The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous…

  7. Ensuring Quality Nursing Home Care

    MedlinePlus

    Ensuring Quality Nursing Home Care Before you choose a nursing home Expert information from Healthcare Professionals Who Specialize in the Care ... Nearly 1.6 million older Americans live in nursing homes in the United States. The move to ...

  8. Call to Action: The Case for Advancing Disaster Nursing Education in the United States.

    PubMed

    Veenema, Tener Goodwin; Lavin, Roberta Proffitt; Griffin, Anne; Gable, Alicia R; Couig, Mary Pat; Dobalian, Aram

    2017-11-01

    Climate change, human conflict, and emerging infectious diseases are inexorable actors in our rapidly evolving healthcare landscape that are triggering an ever-increasing number of disaster events. A global nursing workforce is needed that possesses the knowledge, skills, and abilities to respond to any disaster or large-scale public health emergency in a timely and appropriate manner. The purpose of this article is to articulate a compelling mandate for the advancement of disaster nursing education within the United States with clear action steps in order to contribute to the achievement of this vision. A national panel of invited disaster nursing experts was convened through a series of monthly semistructured conference calls to work collectively towards the achievement of a national agenda for the future of disaster nursing education. National nursing education experts have developed consensus recommendations for the advancement of disaster nursing education in the United States. This article proposes next steps and action items to achieve the desired vision of national nurse readiness. Novel action steps for expanding disaster educational opportunities across the continuum of nursing are proposed in response to the current compelling need to prepare for, respond to, and mitigate the impact of disasters on human health. U.S. educational institutions and health and human service organizations that employ nurses must commit to increasing access to a variety of quality disaster-related educational programs for nurses and nurse leaders. Opportunities exist to strengthen disaster readiness and enhance national health security by expanding educational programming and training for nurses. © 2017 Sigma Theta Tau International.

  9. Comparison of professional values of Taiwanese and United States nursing students.

    PubMed

    Alfred, Danita; Yarbrough, Susan; Martin, Pam; Mink, Janice; Lin, Yu-Hua; Wang, Liching S

    2013-12-01

    Globalization is a part of modern life. Sharing a common set of professional nursing values is critical in this global environment. The purpose of this research was to examine the professional values of nursing students from two distinct cultural perspectives. Nurse educators in Taiwan partnered with nurse educators in the United States to compare professional values of their respective graduating nursing students. The American Nurses Association Code of Ethics served as the philosophical framework for this examination. The convenience sample comprised 94 Taiwanese students and 168 US students. Both groups reported high scores on an overall measure of values. They did differ substantially on the relative importance of individual items related to advocacy, competence, education, self-evaluation, professional advancement, and professional associations. Global implications for the collaborative practice of nurses from different cultures working together can be improved by first recognizing and then attending to these differences in value priorities.

  10. Public School Nursing Practice in the United States

    ERIC Educational Resources Information Center

    Willgerodt, Mayumi A.; Brock, Douglas M.; Maughan, Erin D.

    2018-01-01

    School nursing practice has changed dramatically over the past 20 years, yet few nationally representative investigations describing the school nursing workforce have been conducted. The National School Nurse Workforce Study describes the demographic and school nursing practice patterns among self-reported public school nurses and the number and…

  11. Academic Incivility in Nursing Education

    ERIC Educational Resources Information Center

    Marlow, Sherri

    2013-01-01

    A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN),…

  12. Survey of Foreign Nurse Graduates.

    ERIC Educational Resources Information Center

    Harris, Ruby; And Others

    A survey of fifty-one State Boards of Nursing (SBNs) was conducted to secure 1970 through 1972 information regarding the (1) number and characteristics of foreign nurse graduates (FNGs) who apply for licensure and those who fail to achieve licensure in the United States; (2) the availability and effectiveness of remedial courses and their…

  13. Programs that Internationalize Nursing Curricula in Baccalaureate Schools of Nursing in the United States.

    ERIC Educational Resources Information Center

    Lindquist, Gay J.

    1986-01-01

    Results of a national survey of baccalaureate nursing programs are presented concerning programs for study abroad, international exchange programs, and other approaches to internationalizing nursing curricula, including courses dealing with health care and nursing in foreign countries. (Author/MSE)

  14. The Impact of Critical Care Nursing Certification on Pediatric Patient Outcomes.

    PubMed

    Hickey, Patricia A; Gauvreau, Kimberlee; Porter, Courtney; Connor, Jean A

    2018-06-14

    To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States. A cross-sectional descriptive survey of nursing and organizational characteristics was sent electronically. Free-standing children's hospitals in the United States. Children undergoing congenital heart surgery (congenital cardiac cases). Nursing and unit characteristics from children's hospitals were obtained via electronic survey during years 2010 and 2014. Survey data from 2014 were linked with patient-level data age less than 18 years old using the Pediatric Health Information System for years 2013-2014. The Complication Screening Method of Congenital Heart Surgery was used to adjust for baseline patient differences. Among 23 of 43 free-standing children's hospitals (53%) in 2014, the median proportion of nurses with Bachelor of Science in Nursing preparation or higher at each site was 77% and with Critical Care Registered Nurse certification was 24%. Among 12,324 eligible congenital cardiac cases, the rate of complication was 34.4%. The odds of complications significantly decreased as the institutional percentage of nurses with a Bachelor of Science in Nursing increased (odds ratio, 0.83; p = 0.04). The odds of complications also significantly decreased as the institutional percentage of nurses with Critical Care Registered Nurse certification increased (odds ratio, 0.86; p = 0.02). Bachelor of Science in Nursing education and Critical Care Registered Nurse certification significantly impact pediatric patient outcomes. Recognition of nursing and organizational characteristics that are associated with improved pediatric patient outcomes is important to patients, their families, and society. Clinical leaders must commit to facilitating pathways for hiring candidates with Bachelor of Science in Nursing as a minimum to practice in PICUs and supporting a culture of professional certification.

  15. A synthesis of Vroom's model with other social theories: an application to nursing education.

    PubMed

    Gyurko, Charlene C

    2011-07-01

    In 2009, the National League for Nursing reported that there are over 3.4 million persons in the United States employed in nursing in the roles of Registered Nurses (RNs) and Advanced Practice Nurses (APRNs). In 2007, the Bureau of Labor Statistics also reported that in 2006, there were over 749,000 Licensed Practical Nurses (LPNs) working in the United States with a projected increase of 14% by 2016. Buerhaus et al, in 2009, stated that between 2016 and 2025, it is estimated that the U.S. will need over 260,000 registered nurses (RNs) Using the conceptual framework of Vroom's expectancy theory on motivation as well as theories addressing student and career development, this paper demonstrates a synthesis of Vroom's model with other educational theories and its application to nursing education, specifically the prediction of motivation to advance one's nursing education. By putting Vroom's theory into a context, Vroom's fairly simple model could help nurse educators predict the factors that make for success in midcareer educational advancement--and even possibly manipulate those factors to increase that success. In today's economy, that practical part seems too good to lose. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. The history of the nurse anesthesia profession.

    PubMed

    Ray, William T; Desai, Sukumar P

    2016-05-01

    Despite the fact that anesthesia was discovered in the United States, we believe that both physicians and nurses are largely unaware of many aspects of the development of the nurse anesthetist profession. A shortage of suitable anesthetists and the reluctance of physicians to provide anesthetics in the second half of the 19th century encouraged nurses to take on this role. We trace the origins of the nurse anesthetist profession and provide biographical information about its pioneers, including Catherine Lawrence, Sister Mary Bernard Sheridan, Alice Magaw, Agatha Cobourg Hodgins, and Helen Lamb. We comment on the role of the nuns and the effect of the support and encouragement of senior surgeons on the development of the specialty. We note the major effect of World Wars I and II on the training and recruitment of nurse anesthetists. We provide information on difficulties faced by nurse anesthetists and how these were overcome. Next, we examine how members of the profession organized, developed training programs, and formalized credentialing and licensing procedures. We conclude by examining the current state of nurse anesthesia practice in the United States. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Educating Nurses in the United States about Pressure Injuries.

    PubMed

    Ayello, Elizabeth A; Zulkowski, Karen; Capezuti, Elizabeth; Jicman, Wendy Harris; Sibbald, R Gary

    2017-02-01

    To provide information about the current state of educating nurses about wound care and pressure injuries with recommendations for the future. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Discuss the importance of pressure injury education and wound care for nurses and identify the current state of nursing education on the subject. 2. Identify strategies that can be used to put improved wound care and pressure injury education into practice. Wound care nursing requires knowledge and skill to operationalize clinical guidelines. Recent surveys and studies have revealed gaps in nurses' knowledge of wound care and pressure injuries and their desire for more education, both in their undergraduate programs and throughout their careers. Data from baccalaureate programs in the United States can pinpoint areas for improvement in nursing curriculum content. Lifelong learning about wound care and pressure injuries starts with undergraduate nursing education but continues through the novice-to-expert Benner categories that are facilitated by continuing professional development. This article introduces a pressure injury competency skills checklist and educational strategies based on Adult Learning principles to support knowledge acquisition (in school) and translation (into clinical settings). The responsibility for lifelong learning is part of every nurse's professional practice.

  18. Nurse Burnout and Patient Satisfaction

    PubMed Central

    Vahey, Doris C.; Aiken, Linda H.; Sloane, Douglas M.; Clarke, Sean P.; Vargas, Delfino

    2010-01-01

    Background Amid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes. Objectives This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. Research Design/Subjects We conducted cross-sectional surveys of nurses (N = 820) and patients (N = 621) from 40 units in 20 urban hospitals across the United States. Measures Nurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Results Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. Conclusions Improvements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care. PMID:14734943

  19. The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review

    PubMed Central

    2016-01-01

    Background Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. Objective The aim of this paper was to perform a comprehensive literature review on nurses’ quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Methods Using publications from 2004–2014, contributing factors to American and Canadian nurses’ QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Results Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses’ quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. Conclusions This review’s findings support the importance of QWL as an indicator of nurses’ broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system. PMID:27734769

  20. Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

    PubMed Central

    Himmelstein, D U; Lewontin, J P; Woolhandler, S

    1996-01-01

    OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs. PMID:8633732

  1. History of Continuing Nursing Education in the United States.

    ERIC Educational Resources Information Center

    Stein, Alice M.

    1998-01-01

    Nursing history since 1853 is presented to identify issues in continuing nursing education, such as the influence of feminism and professionalism, changing constituencies, and philosophies in health care. (SK)

  2. Mandatory overtime regulations and nurse overtime.

    PubMed

    Bae, Sung-Heui; Brewer, Carol

    2010-05-01

    A descriptive study used data from the 2004 National Sample Survey of Registered Nurses to examine the nature and occurrence of RN mandatory, voluntary overtime, paid on-call, and total work hours and their association with mandatory overtime regulations in United States. About half of the nurses worked more than 40 hrs per week. Nurses working in states regulating mandatory overtime reported lower levels of mandatory overtime hours than states without regulations or states restricting total work hours. The percent of RNs working 61 hrs and over per week in states without regulations was lower than that in states with regulations. Nurses working in nursing homes reported higher levels of the percentage of mandatory overtime hours worked than those working in hospitals. This suggested that governments need to continuously supervise healthcare institutions, including both hospitals and nursing homes, to ensure adherence to mandatory overtime regulations.

  3. The Influence of Verapamil and Nicardipine on the Rate of Metabolism of Midazolam

    DTIC Science & Technology

    2000-10-01

    premedicant and for induction and maintenance of anesthesia . Midazolam produces anxiolysis, amnesia, hypnosis , skeletal muscle relaxation, and anticonvulsant...Dean CIRRICULUM VITAE Name: Gregg Steven Lowe Major, United States Air Force, Nurse Corps Graduate Student - Nurse Anesthesia Program Uniformed Services...Nurse University of the Anesthesia Health Sciences Bethesda, Maryland 1993-1995 Midwestern State BSN May 1995 Nursing University Wichita Falls, Texas

  4. Exploring Student Perceptions of Retention Issues in a 3-Year Baccalaureate-Level Nursing Program

    ERIC Educational Resources Information Center

    Taulbee, Rebecca

    2017-01-01

    The nursing shortage, a major concern for the United States, has a multitude of causative factors. Nursing education has been tasked with helping to decrease the shortage of qualified registered nurses. Poor retention of nursing students in higher education is impacting the number of qualified nurses entering the workforce. Nursing education has…

  5. Perceptions of Novice Clinical Adjunct Nursing Faculty

    ERIC Educational Resources Information Center

    Himmelberg, Layna

    2011-01-01

    The anticipated nursing shortage in the United States is well documented and continues to be a topic of discussion. A nationwide solution has been for nursing programs to increase their enrollment of nursing students. This could be difficult for many nursing schools; as many have a shortage of qualified nursing faculty with which to instruct…

  6. Genomics education in nursing in the United States.

    PubMed

    Calzone, Kathleen A; Jenkins, Jean

    2011-01-01

    Discovery of the genetics/genomics underpinnings of health, risk for disease, sickness, and treatment response have the prospects of improving recognition and management of at risk individuals; improving screening, prognostics, and therapeutic decision-making; expanding targeted therapies; and improving the accuracy of medication dosing and selection based on drug metabolism genetic variation. Thus, genetics/genomics science, information, and technologies influence the entire health care continuum and are fundamental to the nursing profession. Translating the benefits of genetics and genomics into health care requires that nurses are knowledgeable about and able to integrate this information and technology into their practice. This chapter explores the development of essential nursing competences in genetics and genomics and outcome indicators. Included is an overview of projects aimed at measuring and/or supporting adoption and integration of such competencies. Included as well is an update reviewing current evidence of the state of genomics nursing education in the United States and recommendations for next steps.

  7. Immigration policy and internationally educated nurses in the United States: A brief history

    PubMed Central

    Masselink, Leah E.; Jones, Cheryl B.

    2015-01-01

    Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. PMID:24345614

  8. Association of the nurse work environment with nurse incivility in hospitals.

    PubMed

    Smith, Jessica G; Morin, Karen H; Lake, Eileen T

    2018-03-01

    To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.

  9. Educational preparation of black nurses: a historical perspective.

    PubMed

    Carnegie, M Elizabeth

    2005-01-01

    To where minority nursing needs to proceed, the minority nursing community must understand where we have been. This historical perspective traces our roots through every level of nursing education. Parallels are drawn between minority nurse educational evolution and the historical events occurring in the greater society in the United States.

  10. Explaining direct care resource use of nursing home residents: findings from time studies in four states.

    PubMed

    Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

    2007-04-01

    To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design. Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents.

  11. Is There a Trade-off Between Quality and Profitability in United States Nursing Homes?

    PubMed

    Godby, Tyler; Saldanha, Sarah; Valle, Jazmine; Paul, David P; Coustasse, Alberto

    Nursing home residents across the United States rely on quality care and effective services. Nursing homes provide skilled nurses and nursing aides who can provide services 24 hours a day for individuals who could not perform these tasks for themselves. Not-for-profit (NFP) versus for-profit (FP) nursing homes have been examined for utilization and efficacy; however, it has been shown that NFP nursing homes generally offer higher quality care and generate greater profit margins compared with FP nursing homes. The purpose of this research was to determine if NFP nursing homes provide enhanced quality care and a larger profit margin compared with FP nursing homes. Benefits and barriers in regard to financial stability and quality of care exist for both FP and NFP homes. Based on the findings of this review, it is suggested that NFP nursing homes have achieved higher quality of care because of a more effective balance of business aspects, as well as prioritizing resident well-being, and care quality over profit maximization in NFP homes.

  12. Design characteristics of acute care units in china.

    PubMed

    Lu, Yi; Wang, Yijia

    2014-01-01

    To describe the current state of design characteristics of acute care units in China's public hospitals and compare these with characteristics with acute care units in the United States. The healthcare construction industry in China is one of the fastest growing sectors in China and, arguably, in the world. Understanding the physical design of acute care units in China is of great importance because it will influence a large population. Descriptive study was performed of unit configuration, size, patient visibility, distance to nursing station and supplies, and lighting conditions in 25 units in 19 public hospitals built after 2003. Data and information were collected based on spatial and visibility analysis. The study identified major design characteristics of the recently built (from 2003 onward) acute care units in China, comparing them, where appropriate, with those in U.S. It found there are three dominant types of unit layout: single-corridor (52%), triangular (36%), and double-corridor (12%). The number of private rooms is very low (11%), compared with two- or three-bed rooms. Centralized nursing stations are the only type of nurses' working area. China also has a large unit size in terms of number of patient beds. The average number of patient beds in a unit is 40.6 in China (versus 32.9 in U.S.). The care units in China have longer walking distance from nursing station to patient bedside. The percentage of beds visible from a nursing station is lower in China than in the U.S. The access to natural light and direct sunlight in patient rooms is greater in China compared with those in U.S.-100% of patient rooms in China have natural lighting. A majority of them face south or southeast and thus receiving direct sunlight (91.4%). Because of the differences in economies and building codes, there are dramatic differences between the spatial characteristics of acute care units in China and the United States. © 2014 Vendome Group, LLC.

  13. Mentoring Relationships and the Levels of Role Conflict and Role Ambiguity Experienced by Neophyte Nursing Faculty

    ERIC Educational Resources Information Center

    Specht, Jennifer A.

    2011-01-01

    After an examination of the current issues related to the shortages of nurses and nursing faculty in the United States, the importance of facilitating the transition of interested nurse clinicians into their roles as nurse educators in order to address the decreased number of nurses and nursing faculty became apparent. Mentoring in nursing…

  14. Nursing Educator Retention: The Relationship between Job Embeddedness and Intent to Stay among Nursing Educators

    ERIC Educational Resources Information Center

    Hamlin, Amy S.

    2013-01-01

    The United States is in the midst of an increasingly worsening shortage of registered nurses, due, in part, to the nursing educator shortage. Further, nursing programs nationwide are turning away qualified applicants because of a lack of nursing educators. Unfortunately, the nursing educator shortage is not a problem that will be easily fixed. As…

  15. Credentials, Curriculum, and Access: The Debate Over Nurse Preparation.

    ERIC Educational Resources Information Center

    Karp, Melinda Mechur; Jacobs, James; Hughes, Katherine L.

    The question of how to best prepare nurses for practice continues to be debated extensively. The crux of the debate is whether a bachelor of science in nursing (BSN) should be required of all registered nurses in the United States or whether an associate degree in nursing (ADN) and diploma programs adequately prepare novice nurses for practice.…

  16. 24 CFR 882.401 - Eligible properties.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

  17. 24 CFR 882.401 - Eligible properties.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

  18. 24 CFR 882.401 - Eligible properties.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

  19. 24 CFR 882.401 - Eligible properties.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

  20. Regulation of prescriptive authority for certified nurse-midwives and certified midwives: a national overview.

    PubMed

    Osborne, Kathryn

    2011-01-01

    Certified nurse-midwives (CNMs) and certified midwives (CMs) provide primary care to women across the lifespan. Yet these primary care providers face barriers to practice that include restrictive state laws and regulations regarding prescriptive authority. The purpose of this review is to critically examine and report the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States. State statutes and rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia. CNMs have been granted the authority to write prescriptions in all 50 United States and the District of Columbia, while CMs have been granted prescriptive authority only in the state of New York. Prescriptive authority for CNMs and CMs is regulated by individual state agencies and regulatory boards. Regulations regarding prescriptive authority for CNMs and CMs vary widely from state to state and are described, with a summary for each state presented. While CNMs are granted fully independent prescriptive authority in some states, the regulatory requirements relative to prescriptive authority for CNMs/CMs limit patients' access to necessary services in most states. © 2011 by the American College of Nurse-Midwives.

  1. Examination of Academic Self-Regulation Variances in Nursing Students

    ERIC Educational Resources Information Center

    Schutt, Michelle A.

    2009-01-01

    Multiple workforce demands in healthcare have placed a tremendous amount of pressure on academic nurse educators to increase the number of professional nursing graduates to provide nursing care both in both acute and non-acute healthcare settings. Increased enrollment in nursing programs throughout the United States is occurring; however, due to…

  2. A Brief History of Continuing Education in Nursing in the United States

    ERIC Educational Resources Information Center

    Cooper, Signe S.

    1973-01-01

    Outlines the history of continuing education in nursing from the earliest activities sponsored by alumnae associations through its necessity as a condition for the relicensure of nurses and other health professionals. (Author/RK)

  3. Cross-cultural perspectives on critical thinking.

    PubMed

    Jenkins, Sheryl Daun

    2011-05-01

    The purpose of this cross-cultural study was to explore critical thinking among nurse scholars in Thailand and the United States. The study used qualitative methodology to examine how nurse scholars describe critical thinking in nursing. Nurse educators in Thailand and the United States were questioned concerning the following aspects of critical thinking: essential components; teaching and evaluation techniques; characteristics of critical thinkers; and the importance of a consensus definition for critical thinking in nursing. Their statements, which revealed both common and specific cultural aspects of critical thinking, were subjected to content analysis. Certain themes emerged that have not been widely discussed in the literature, including the link between staying calm and thinking critically, the assertion that happiness is an essential component of critical thinking, and the participants' nearly unanimous support for coming to a consensus definition of critical thinking for nursing. Copyright 2011, SLACK Incorporated.

  4. Organisational commitment in nurses: is it dependent on age or education?

    PubMed

    Jones, April

    2015-02-01

    In hospitals in the United States, the ratio of nurses to patients is declining, resulting in an increase in workloads for the remaining nurses. Consequently, the level of commitment that these nurses have to their jobs is important. Outside health care, employees from different generations working for a variety of organisations differ in their levels of organisational commitment, but this information has not been available for nurses. This study, carried out in the state of Alabama, looks at whether nurses from different generations differ in their levels of organisational commitment, and also whether there are any differences in organisational commitment between licensed practical nurses (LPNs) and registered nurses (RNs). A questionnaire designed to measure levels of organisational commitment was answered by 145 nurses. The results were analysed for any differences in organisational commitment in nurses from different generations and with different nursing degrees. Nurses from different generations showed the same levels of organisational commitment, but LPNs showed significantly less affective commitment, that is, lower feelings of loyalty to their workplace, than RNs. This information may be useful for hospital administrators and human resource managers in the United States to highlight the value of flexible incentive packages to address the needs of a diverse workforce. For healthcare employers in the UK, the concept that there is an association between nursing qualifications and levels of organisational commitment is critical for building organisational stability and effectiveness, and for nurse recruitment and retention.

  5. School Nurse Perspectives of Challenges and How They Perceive Success in Their Professional Nursing Roles

    ERIC Educational Resources Information Center

    Smith, Shirley G.; Firmin, Michael W.

    2009-01-01

    This is a phenomenological study of 25 school nurses employed in a large, urban school district in the midwestern section of the United States. In addition to school nursing, the participants also had professional work experience in other nursing specialties. Thematic analysis of the data focused on the challenges faced by the school nurses, their…

  6. Explaining Direct Care Resource Use of Nursing Home Residents: Findings from Time Studies in Four States

    PubMed Central

    Arling, Greg; Kane, Robert L; Mueller, Christine; Lewis, Teresa

    2007-01-01

    Objective To explain variation in direct care resource use (RU) of nursing home residents based on the Resource Utilization Groups III (RUG-III) classification system and other resident- and unit-level explanatory variables. Data Sources/Study Setting Primary data were collected on 5,314 nursing home residents in 156 nursing units in 105 facilities from four states (CO, IN, MN, MS) from 1998 to 2004. Study Design Nurses and other direct care staff recorded resident-specific and other time caring for all residents on sampled nursing units. Care time was linked to resident data from the Minimum Data Set assessment instrument. Major variables were: RUG-III group (34-group), other health and functional conditions, licensed and other professional minutes per day, unlicensed minutes per day, and direct care RU (wage-weighted minutes). Resident- and unit-level relationships were examined through hierarchical linear modeling. Data Collection/Extraction Methods Time study data were recorded with hand-held computers, verified for accuracy by project staff at the data collection sites and then merged into resident and unit-level data sets. Principal Findings Resident care time and RU varied between and within nursing units. RUG-III group was related to RU; variables such as length of stay and unit percentage of high acuity residents also were significantly related. Case-mix indices (CMIs) constructed from study data displayed much less variation across RUG-III groups than CMIs from earlier time studies. Conclusions Results from earlier time studies may not be representative of care patterns of Medicaid and private pay residents. New RUG-III CMIs should be developed to better reflect the relative costs of caring for these residents. PMID:17362220

  7. Intercultural-global competencies for the 21st century and beyond.

    PubMed

    Esterhuizen, Philip; Kirkpatrick, Mary K

    2015-05-01

    Increased diversity exists in Anglo-Saxon countries, such as Australia, the United Kingdom, and the United States. By 2050, no single ethnic group is expected to be in a majority in the United States. Health care reform points to an urgent need for health care professionals, such as nursing, medicine, allied health, nutrition, and other interdisciplinary health care team members, to serve a multi-ethnic population by developing intercultural-global and 21st-century competencies. Nurse educators must acknowledge the need to familiarize themselves and integrate these competencies into university and continuing education programs by evaluating and reporting outcomes. All nurses can be expected to have these competencies as global citizens through local, intercultural, and global interactions and exchanges. Copyright 2015, SLACK Incorporated.

  8. Nursing in Crisis

    ERIC Educational Resources Information Center

    Fulcher, Roxanne

    2007-01-01

    Both the nation's health-care and nursing education systems are in crisis. While the care provided by registered nurses (RNs) is essential to patients' recovery from acute illness and to the effective management of their chronic conditions, the United States is experiencing a nursing shortage that is anticipated to increase as baby boomers age and…

  9. Designing Online Instruction for Internationally Educated Nurses

    ERIC Educational Resources Information Center

    Smith, Virginia R.

    2012-01-01

    Internationally educated nurses (IENs), when adequately prepared, can make a valuable contribution to the nursing profession in the United States, particularly in cities with large immigrant populations, where their language skills and cultural background can bring a dimension to health care that nurses educated in this country do not have.…

  10. School Nurse Perspectives regarding Their Vocational Decisions

    ERIC Educational Resources Information Center

    Smith, Shirley G.; Firmin, Michael W.

    2009-01-01

    This is a phenomenological, qualitative study of 25 school nurses employed in a large, urban school district in the Midwestern section of the United States. The study's participants possess histories of professional work experiences in nursing specialties other than school nursing. Thematic analysis of the data revealed three prominent factors…

  11. International Dimensions of Nursing and Health Care in Baccalaureate and Higher Degree Nursing Programs in the United States.

    ERIC Educational Resources Information Center

    Mooneyhan, Esther L.; And Others

    1986-01-01

    Results of a national survey of undergraduate and graduate nursing programs to determine the extent of curriculum content and faculty training in international health issues are reported. The importance of this aspect of nursing education is discussed. (MSE)

  12. Immigration policy and internationally educated nurses in the United States: A brief history.

    PubMed

    Masselink, Leah E; Jones, Cheryl B

    2014-01-01

    Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue

    PubMed

    Rudner Lugo, Nancy

    2016-05-04

    In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it. She presents the study findings, limitations of the comparison, and discussion of the findings and implications. In conclusion, the findings demonstrated that progress toward full APRN practice will require building strategies for political support and framing the need to update APRN regulations in a manner that aligns with each state’s social and political values.

  14. Predictors of NCLEX-PN Success for Practical Nursing Students

    ERIC Educational Resources Information Center

    Eickhoff, Mary Ann

    2016-01-01

    There is currently a nursing shortage in the United States. By 2022, the Bureau of Labor Statistics (BLS) expects, the number of job openings for Practical Nurses (PN) will be 168,500, an increase of 25% over 2012 (BLS, 2014). Nursing education does not currently meet present, much less future needs. Nursing programs have limited space; according…

  15. Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies.

    PubMed

    Dawson, Angela J; Stasa, Helen; Roche, Michael A; Homer, Caroline S E; Duffield, Christine

    2014-04-08

    This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.

  16. A synthesis of the literature on Asian nurses' work experiences in the United States.

    PubMed

    Lin, Li-Chen

    2009-01-01

    Nursing shortages in the United States have underscored the need for foreign nurse recruitment. The major population of foreign nurse recruits has long been Asian. When employing foreign nurses, fair employment practices and quality of care must be ensured; however, few empirical studies were found on this topic. Thus, the purpose of this article is to synthesize the extant literature about Asian nurses' work experiences in and adaptation to the U.S. health care system. The author searched four major bibliographic databases, as well as the ProQuest Dissertation and Thesis Database and analyzed eight empirical studies based on four predetermined inclusion criteria. The major themes identified in the selected scholarly works were: (a) overcoming language barriers, (b) dealing with discrimination, (c) adopting U.S. nursing practices, (d) adjusting to U.S. social customs, (e) becoming accustomed to U.S. culture, and (f) reconciling work ethics. Additional research studies, using both quantitative and qualitative approaches, are necessary to gain in-depth knowledge related to this phenomenon.

  17. Model for heart failure education.

    PubMed

    Baldonado, Analiza; Dutra, Danette; Abriam-Yago, Katherine

    2014-01-01

    Heart failure (HF) is the heart's inability to meet the body's need for blood and oxygen. According to the American Heart Association 2013 update, approximately 5.1 million people are diagnosed with HF in the United States in 2006. Heart failure is the most common diagnosis for hospitalization. In the United States, the HF direct and indirect costs are estimated to be US $39.2 billion in 2010. To address this issue, nursing educators designed innovative teaching frameworks on HF management both in academia and in clinical settings. The model was based on 2 resources: the American Association of Heart Failure Nurses (2012) national nursing certification and the award-winning Pierce County Responsive Care Coordination Program. The HF educational program is divided into 4 modules. The initial modules offer foundational levels of Bloom's Taxonomy then progress to incorporate higher-levels of learning when modules 3 and 4 are reached. The applicability of the key components within each module allows formatting to enhance learning in all areas of nursing, from the emergency department to intensive care units to the medical-surgical step-down units. Also applicable would be to provide specific aspects of the modules to nurses who care for HF patients in skilled nursing facility, rehabilitation centers, and in the home-health care setting.

  18. Nursing, occupational therapy, and physical therapy preparation in rheumatology in the United States and Canada.

    PubMed

    Jette, A M; Becker, M C

    1980-11-01

    Directors of undergraduate programs in nursing, physical therapy, and occupational therapy in the United States and Canada were surveyed to determine the amount and perceived adequacy of the current degree of classroom and clinical exposure to the rheumatic diseases. One hundred ninety-one (73%) of the 262 mailed questionnaires were returned. Results indicate that regardless of the actual degree of rheumatologic classroom exposure, directors in all three disciplines view current amounts as adequate. A larger proportion views levels of clinical exposure as inadequate. In general, the Canadian programs had a greater emphasis on rheumatology than their United States counterparts.

  19. International recruitment of nurses: policy and practice in the United Kingdom.

    PubMed

    Buchan, James

    2007-06-01

    To synthesize information about nurse migration into and out of the United Kingdom in the period to 2005, and to assess policy implications. There has been rapid growth in inflow of nurses to the United Kingdom from other countries. In recent years, 40-50 percent of new nurse registrants in the United Kingdom have come from other countries, principally the Philippines, Australia, India, and South Africa. Outflow has been at a lower level, mainly to other English-speaking developed countries--Australia, the United States, New Zealand, Ireland, and Canada. The United Kingdom is a net importer of nurses. The principal policy instrument in the United Kingdom, the Code of Practice on International Recruitment, has not ended the inflow of nurses to the United Kingdom from sub-Saharan Africa. Given the increasing globalization of labor markets, it is likely that the historically high levels of inflow of internationally recruited nurses to the United Kingdom will continue over the next few years; however the "peak" number reached in 2002/2003 may not be repeated, particularly as large-scale active international recruitment has now been ended, for the short term at least. New English language tests and other revised requirements for international applicants being introduced by the Nurses and Midwives Council from September 2005 may restrict successful applications from some countries and will also probably add to the "bottleneck" of international nurse applicants. Demographic-driven demand for health care, combined with a potential reduction in supply of U.K. nurses as many more reach potential retirement age means that international recruitment is likely to remain on the policy agenda in the longer term, even with further growth in the number of home-based nurses being trained.

  20. 20 CFR 655.35 - Required departure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  1. 20 CFR 655.30 - Supervised recruitment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  2. 20 CFR 655.6 - Temporary need.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B Workers...

  3. Outcomes and Costs of Community Health Worker Interventions: A Systematic Review

    DTIC Science & Technology

    2010-09-01

    E7(/(3+21(180%(5 ,QFOXGHDUHDFRGH Sep 2010 Journal article 1980 - Nov 2008 Outcomes and costs of community health worker interventions: a...the Cumulative Index to Nursing and Allied Health Literature for studies conducted in the United States and published in English from 1980 through...to Nursing and Allied Health Literature for studies conducted in the United States and published in English from 1980 through November 2008. We dually

  4. Nursing research in the United States: the protection of human subjects.

    PubMed

    Oddi, L F; Cassidy, V R

    1990-01-01

    In the United States the protection of the rights of human subjects in experimentation has evolved at three levels: professional, public, and private. At the professional level, codes, guidelines and the Patient's Bill of Rights address the issues of protecting the dignity, privacy and autonomy of individuals who serve as research subjects. At the public level, regulations promulgated by the Food and Drug Administration and the Department of Health and Human Services have become the standard for protecting human subjects. At the private level, United States common law regulates the conduct of individual researchers by requiring them to act in a manner consistent with generally accepted standards of care. As professionals, nurses must be actively involved in the formation of public policy regarding the conduct of research and strive to formulate a research agenda that will ensure that the ethics of research in nursing is above question.

  5. Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies

    PubMed Central

    2014-01-01

    Background This study aimed to reveal nurses’ experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Method A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Results Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Conclusion Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover. PMID:24708565

  6. 20 CFR 655.2 - Territory of Guam.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  7. 20 CFR 655.74 - Conduct of proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  8. 20 CFR 655.60 - Violations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B Workers... application process. ...

  9. 20 CFR 655.7-655.9 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  10. 20 CFR 655.71 - Request for hearing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  11. 20 CFR 655.73 - Service of pleadings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  12. Newborn screening policy in the United Kingdom & the United States: two different communities of practice.

    PubMed

    Patch, Christine

    2006-01-01

    Newborn screening is a rapidly developing area driven by both technological advances and public pressure. If they are not yet, all nurses working with mothers and children will soon be involved with implementing newborn-screening programs, and it is therefore important that they appreciate both the benefits and potential harms of such programs. In the United Kingdom, policy regarding the implementation of newborn-screening programs is developed at national level, and consideration of the introduction of new tests is subject to a formalized evaluation framework. In the United States, by contrast, each state develops its own screening program. Knowledge of developments in newborn screening in different countries that have diverse types of healthcare systems helps to inform nurses about the totality of healthcare for newborns, and assists them in becoming more knowledgeable about how international standards differ from those in the United States.

  13. Effects of learning climate and registered nurse staffing on medication errors.

    PubMed

    Chang, Yunkyung; Mark, Barbara

    2011-01-01

    Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

  14. Delegation Guided by School Nursing Values: Comprehensive Knowledge, Trust, and Empowerment

    ERIC Educational Resources Information Center

    Gordon, Shirley C.; Barry, Charlotte D.

    2009-01-01

    As health care institutions in the United States respond to shrinking budgets and nursing shortages by increasing the use of unlicensed assistive personnel (UAP), school nursing practice is changing from providing direct care to supervising activities delegated to UAP. Therefore, delegation is a critical area of concern for school nurses. The…

  15. Nursing Effort and Quality of Care for Nursing Home Residents

    ERIC Educational Resources Information Center

    Arling, Greg; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

    2007-01-01

    Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado,…

  16. Nursing Faculty Roles in Teaching Racially and Ethnically Diverse Nursing Students in a Registered Nurse Program

    ERIC Educational Resources Information Center

    Beard, Kenya V.

    2009-01-01

    Racial and ethnic health care disparities continue to plague the United States, placing a tremendous personal and societal burden on individuals. A culturally diverse nursing work force can help eliminate these disparities and improve the quality of health care that is delivered. However, the nursing profession does not reflect the nation's…

  17. Rurality and Nursing Home Quality: Evidence from the 2004 National Nursing Home Survey

    ERIC Educational Resources Information Center

    Kang, Yu; Meng, Hongdao; Miller, Nancy A.

    2011-01-01

    Purpose of the Study: To evaluate the impact of rural geographic location on nursing home quality of care in the United States. Design and Methods: The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used…

  18. Illuminating the Experiences of African-American Nursing Faculty Seeking Employment in Higher Education in Nursing

    ERIC Educational Resources Information Center

    Loyd, Vanessa

    2015-01-01

    This study explored and described the experience of female African-American nursing faculty seeking employment in higher education in nursing. The lack of diversity in the nursing workforce has been attributed as a major underlying cause of disparity in healthcare in the United States. The importance of increasing the number of minority nursing…

  19. Peterson's Guide to Nursing Programs. Baccalaureate and Graduate Nursing Education in the U.S. and Canada. Second Edition.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    This revised and updated directory of nursing programs in the United States, U.S. Territories, and Canada includes details on over 2,000 undergraduate and graduate programs at over 625 colleges. Information is also listed for continuing education programs, fast-track options for Registered Nurses and Licensed Practical Nurses, clinical nurse…

  20. The Prevalence of Employed Nurses Identified or Enrolled in Substance Use Monitoring Programs

    PubMed Central

    Monroe, Todd B.; Kenaga, Heidi; Dietrich, Mary S.; Carter, Michael A.; Cowan, Ronald L.

    2017-01-01

    Background For over 100 years, nurses’ particular work conditions have been anecdotally associated with increases in substance abuse. Reasons include job-related stress and easy access to medications. Current research has suggested that prevalence of nurses with substance use problems is actually similar to, if not less than, that seen in the general population. However, given nurses’ proximity to critical patient care, the potential threat to public health, as well as the current shortage of practitioners and problems related to retention, the lack of research on the effectiveness of the two existing treatment protocols (disciplinary and alternative-to-discipline [ATD]) is a pressing issue of concern to the nursing profession. Objectives The aims of this study were to estimate the 1-year prevalence of employed nurses requiring an intervention for substance use problems in the United States and the 1-year prevalence of nurses enrolled in substance abuse monitoring programs and to compare the sum total of nurses identified in disciplinary and alternative programs with the general population. Methods This was a balanced stratified sampling design study. Measurements included the National Council of State Boards of Nursing 2010 Survey of Regulatory Boards Disciplinary Actions on Nurses, the 2009 annual reports of alternative programs, the 2008 National Sample Survey of Registered Nurses, and the 2009 National Survey on Drug Use and Health. Results The 2009 1-year prevalence of employed nurses identified with substance use problems in the United States and its territories was 17,085 or 0.51% of the employed nursing population. The 1-year prevalence of nurses newly enrolled in substance abuse monitoring programs in the United States and its territories was 12,060 or 0.36%. Although every National Council of State Boards of Nursing jurisdiction has a disciplinary monitoring program, only 73% (n = 43) of these jurisdictions have alternative programs. Despite this, on average, alternative programs had nearly 75% more new enrollees (9,715) when compared with disciplinary programs (2,345). The prevalence of nurses identified with a substance use problem requiring an intervention (and likely treatment) is lower than the prevalence of those who report receiving substance abuse treatment in the general population (0.51% vs. 1.0%). Conclusions The ATD programs potentially have a greater impact on protecting the public than disciplinary programs because ATD programs identify and/or enroll more nurses with substance use problems, thereby initially removing more nurses with substance use problems from direct patient care. PMID:22960589

  1. College nursing faculty job satisfaction and retention: A national perspective.

    PubMed

    Lee, Peggy; Miller, Michael T; Kippenbrock, Thomas A; Rosen, Chris; Emory, Jan

    The need for registered nurses in the United States continues to grow. To meet this need for increased numbers of nurses, recruitment and retention of qualified nurse educators has become a priority. In addition, the factors associated with nursing faculties' intent to stay have emerged as important considerations for administrators. The concepts of job satisfaction and intent to stay become vital to recruiting and retaining nursing faculty. In the past decade few empirical studies have been conducted on a national scale to address job satisfaction and intent to stay in academia. The purpose of this retrospective study is to analyze variables of relationships with nurse faculty job satisfaction and intent to stay from data collected throughout the United States. The Collaborative on Academic Careers in Higher Education (COACHE) survey was employed for the purposes of this study. Over 1350 nurse educators were included in the survey. The findings support a variety of modifiable variables that are viewed as important by nursing faculty. The strongest relationship was found to be institutional leadership. The implications can inform academic administrators seeking to retain nursing faculty. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Perinatal death: uncovering the needs of midwives and nurses and exploring helpful interventions in the United States, England, and Japan.

    PubMed

    Gardner, J M

    1999-04-01

    Perinatal death is a crisis for midwives and nurses as well as for bereaved parents and extended families. Surveys and interviews conducted in the United States, England, and Japan described the needs and responses of nurses and midwives as they coped with their own feelings while caring for bereaved parents. Results emphasized common needs of caregivers for increased knowledge, mentored experience, communication skills, and personal support to confidently provide sensitive care to families. Although need for education regarding cultural-specific care was revealed, participants identified helpful strategies of care for bereaved parents that could extend and improve care universally.

  3. Empowering the "Cheerers": Role of Surgical Intensive Care Unit Nurses in Enhancing Family Resilience.

    PubMed

    Ellis, Lauren; Gergen, Jessica; Wohlgemuth, Leah; Nolan, Marie T; Aslakson, Rebecca

    2016-01-01

    Supporting family resilience, the ability of families to rebound from stressful events, is a goal of family nursing. Critical care nurses act as liaisons between patients' families and other clinicians and thus are uniquely situated to promote family resilience. To explore how nurses perceive the experiences of long-stay surgical intensive care unit patients and their families in order to gain insights on how nurses could cultivate family resilience. A qualitative study including semistructured interviews (n = 13) and 4 focus groups (n = 17) with nurses in 3 surgical intensive care units in a large teaching hospital. Three themes were identified: expectations, support, and communication. Nurses noted that clinicians' and families' unrealistic expectations regarding the patient's recovery can foster false hope. Nurses recognized families as "cheerers" who provide support by being involved in patient care and observed how extensive family involvement can be beneficial to patients but overwhelming for families. Nurses noted that communication among providers, families, and patients is the cornerstone of creating meaningful relationships. Nurses stated that with many teams involved, discrepancies in information can occur and often confuse and disturb patients' families. Thus, nurses identified ways to enhance family resilience through routine and consistent communication. Nurses note unique stresses faced by families of patients in surgical intensive care units. Using the family resilience model, nurses can identify and enhance key family resilience factors. ©2016 American Association of Critical-Care Nurses.

  4. Predictors of success for Saudi Arabian students enrolled in an accelerated baccalaureate degree program in nursing in the United States.

    PubMed

    Carty, Rita M; Moss, Margaret M; Al-Zayyer, Wael; Kowitlawakul, Yanika; Arietti, Lesley

    2007-01-01

    In the mid 1980s, a professional nursing education program was initiated between the Kingdom of Saudi Arabia and the United States. Based on a perceived and documented need, a collaborative education and research program was established with George Mason University in Fairfax, Virginia, to begin building a community of new scholars to assist in the advancement of professional nursing in the Kingdom of Saudi Arabia. Four cohorts of Saudi citizens from three institutions (King Faisal Specialist Hospital and Research Center, Saudi Arabia National Guard Hospital, and Ministry of Aviation and Defense Hospital), who held a degree in science or a related field, were enrolled in an accelerated baccalaureate program leading to a bachelor of science in nursing degree. This project was funded by Saudi Arabian sources. A descriptive research study was conducted to identify predictors of success in the program. Results indicated a rate of program completion that was higher than expected. Some of the first graduates went on for a doctor of philosophy degree, but not all enrolled completed the program. Many countries around the world are seeking ways to upgrade and increase the supply of qualified nurses within their own borders. This study identified those factors that were predictors of success for Saudi Arabian students who completed a baccalaureate degree in nursing program in the United States.

  5. American Nursing's First Textbooks.

    ERIC Educational Resources Information Center

    Flaumenhaft, Eugene; Flaumenhaft, Carol

    1989-01-01

    Discusses the four textbooks, written in the last quarter of the 19th century, that shaped nursing in the United States. They provided technical information in a systematic fashion, established an autonomous literature that guided nurses in school and beyond, and defined the training school curriculum. (JOW)

  6. 20 CFR 655.80 - Notice to OFLC and DHS.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  7. 20 CFR 655.20 - Applications for temporary employment certification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and... Nursing in the United States (H-2B Workers) § 655.20 Applications for temporary employment certification...

  8. Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

    PubMed

    Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T

    2007-01-01

    Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.

  9. Cancer and Palliative Care in the United States, Turkey, and Malawi: Developing Global Collaborations

    PubMed Central

    Walker, Deborah Kirk; Edwards, Rebecca L.; Bagcivan, Gulcan; Bakitas, Marie A.

    2017-01-01

    As the global cancer burden grows, so too will global inequities in access to cancer and palliative care increase. This paper will describe the cancer and palliative care landscape relative to nursing practice, education, and research, and emerging global collaborations in the United States (U.S.), Turkey, and Malawi. It is imperative that nurses lead efforts to advance health and strengthen education in these high-need areas. Leaders within the University of Alabama at Birmingham School of Nursing, through a Pan American Health Organization/World Health Organization Nursing Collaborating Center, have initiated collaborative projects in cancer and palliative care between the U.S., Turkey, and Malawi to strengthen initiatives that can ultimately transform practice. These collaborations will lay a foundation to empower nurses to lead efforts to reduce the global inequities for those with cancer and other serious and life-limiting illnesses. PMID:28695167

  10. Nursing diagnosis in intensive care unit: the Turkey experience.

    PubMed

    Korhan, Esra Akn; Yönt, Gülendam Hakverdioğlu; Erdemir, Firdevs; Müller-Staub, Maria

    2014-01-01

    The purpose of this study was to determine intensive care unit nurses diagnostic abilities and diagnoses that they provide. A vignette study was performed. The vignette contained a patient's history, treatment, and signs/symptoms of 18 nursing diagnoses based on NANDA-I as the criterion standard. Turkish intensive care unit nurses (N = 45) stated nursing diagnoses described by patient data in the vignette. The resulting nursing diagnoses were grouped into Gordon's Functional Health Patterns, and descriptive analyses were performed. One-way analysis of variance was used to detect possible differences in diagnostic abilities based on nurses' education levels. Nurses identified 14 nursing diagnoses. Four of the predetermined psychosocial nursing diagnoses were not identified. The highest percentage of diagnoses was risk for impaired skin integrity (62.2%) and impaired oral mucous membrane (60.0%). The lowest number of diagnoses was impaired verbal communication (2.2%). A statistically significant difference was found between the educational level of nurses and their abilities to determine nursing diagnoses (P < .05). The findings are important for nursing education. They demonstrate the need to focus on patients as complete human beings, covering not only biological aspects but also cultural and social values, as well as emotional and spiritual care needs.

  11. Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

    PubMed

    Mathews, Rahel; Zachariah, Rachel

    2008-07-01

    Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

  12. Teaching Accelerated Second-Degree Nursing Students: Educators From Across the United States Share Their Wisdom.

    PubMed

    Christoffersen, Jean E

    2017-04-01

    Over the past decade, there has been a proliferation of accelerated second-degree (ASD) nursing programs. These programs are designed to educate students with prior degrees in increasingly shorter periods of time than they have traditionally been educated. As a result, nurse educators and administrators in these programs need to tailor their approaches to best meet the educational needs of this unique cohort. This qualitative study sought to elicit best practices from nursing faculty across the United States. Previous investigators primarily examined a limited number of programs from the same region. In this study, a roughly equal number of participants experienced in teaching ASD students from across the United States were recruited. Initially focus groups were conducted to form a semistructured interview guideline, which was then was used to guide participant interviews. Results of the interview data were analyzed using standard qualitative research techniques of concept analyses. Themes that emerged were (a) extreme organization, (b) engage students through active listening, (c) mutual respect, (d) engage via life/work experience, (e) effective pedagogy adaptations, and (f) early immersion. The specifics of these themes will be useful in guiding faculty and program directors involved with ASD nursing students. © 2016 Wiley Periodicals, Inc.

  13. Predicting Persistence in Practical Nursing and Success on the NCLEX-PN: Examining Demographic, Non-Academic, and Academic Variables

    ERIC Educational Resources Information Center

    Davis, Alicia Debra

    2015-01-01

    The United States is now in the midst of a major nursing shortage that is predicted to get worse over the next ten years (Kurzen, 2005). The Health Resources and Services Administration reports that all 50 states will suffer from a nursing shortage by 2020 (U.S. Department of Health and Human Services, 2004). This means that there will be a…

  14. Caring for burn patients at the United States Institute of Surgical Research: the nurses' multifaceted roles.

    PubMed

    Serio-Melvin, Maria; Yoder, Linda H; Gaylord, Kathryn M

    2010-06-01

    Nursing plays a critical role in the comprehensive burn care delivered at the US Army Institute of Surgical Research, otherwise known as the US Army's Burn Center serving the Department of Defense. This center serves as a model for burn units nationally and internationally. It also provides a challenging and innovative work environment for military and civilian nurses. Nurses in the Burn Center contribute to innovations in acute, rehabilitative, and psychological care for patients with burns. This article provides an overview of the complex nursing care provided to burn patients treated at the Burn Center. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  15. 77 FR 19273 - National Advisory Committee on Institutional Quality and Integrity (NACIQI)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... distance education.) Requested Scope: The accreditation of nursing education programs in the United States... preaccreditation (Accreditation Candidate) throughout the United States of education programs in audiology and... States offering undergraduate programs through both campus- based instruction and distance education...

  16. 20 CFR 655.11 - Certifying officer review of prevailing wage determinations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and... Nursing in the United States (H-2B Workers) § 655.11 Certifying officer review of prevailing wage...

  17. Think Like a Nurse: A Critical Thinking Initiative.

    PubMed

    Ward, Terry D; Morris, Tiffany

    2016-01-01

    Critical thinking is essential in the practice of the nurse generalist, today. Nursing faculty is frequently trying to identify teaching strategies in promoting critical thinking and engaging students in active learning. To close the gap between critical thinking and student success, a school in the south east United States implemented the use of the 'think like a nurse initiative" for incoming junior nursing students. Faculty collaborated to adopt the fundamental and essential nursing concepts for nursing students to support thinking like a nurse.

  18. Recruitment and Retention of Hispanic Nursing Students: Through the Lens of Associate Degree Nursing Program Administrators and Hispanic Nursing Students

    ERIC Educational Resources Information Center

    Handlos DeVoe, Debra Jean

    2016-01-01

    The Hispanic population in the United States is changing and will constitute 30% of the population in 2050; however, the Hispanic registered nurse population is less than 3%. Cultural differences between patients and nurses may cause harm and a mistrust that can affect patient outcomes. A mixed methods convergent research study was done by an…

  19. Program Exit Examinations in Nursing Education: Using a Value Added Assessment as a Measure of the Impact of a New Curriculum

    ERIC Educational Resources Information Center

    Morris, Tama; Hancock, Dawson

    2008-01-01

    To become a registered nurse in the United States, one must pass the National Council License Examination for Registered Nurses (NCLEX-RN). To address the growing national nursing shortage, nurse preparation programs must better prepare students to pass this national licensure examination. The purpose of this study was to determine whether a new…

  20. Emphasizing the Value of Nephrology Nursing Through Nursing-Sensitive Indicators: A Call for Action.

    PubMed

    Thomas-Hawkins, Charlotte; Latham, Carolyn E; Hain, Debra J

    2017-01-01

    Nursing is the largest healthcare profession in the United States (U.S.). As principal frontline caregivers in the U.S. healthcare system, nurses have tremendous influence over a patient's healthcare experience. A growing body of evidence states that the nursing workforce has a direct impact on healthcare quality. A standardized approach to measuring nursing's contribution to patient care and safety using nursing-sensitive quality indicators assists in examining the extent to which nurses and nursing affect the quality and safety of health care. This article focuses on nursing-sensitive quality indicators and discusses healthcare quality indicators and nursing-sensitive indicators used in the U.S. A summary of the work of the American Nephrology Nurses' Association Task Force on Nephrology Nursing-Sensitive Quality Indicators (NNSQI) and an NNSQI exemplar are provided. Copyright© by the American Nephrology Nurses Association.

  1. Foreign nurse importation and the supply of native nurses.

    PubMed

    Cortés, Patricia; Pan, Jessica

    2014-09-01

    The importation of foreign registered nurses has been used as a strategy to ease nursing shortages in the United States. The effectiveness of this policy depends critically on the long-run response of native nurses. We examine the effects of immigration of foreign-born registered nurses on the long-run employment and occupational choice of native nurses. Using a variety of empirical strategies that exploit the geographical distribution of immigrant nurses across US cities, we find evidence of large displacement effects - over a ten-year period, for every foreign nurse that migrates to a city, between 1 and 2 fewer native nurses are employed in the city. We find similar results using data on nursing board exam-takers at the state level - an increase in the flow of foreign nurses significantly reduces the number of natives sitting for licensure exams in more dependent states relative to less dependent states. Using data on self-reported workplace satisfaction among a sample of California nurses, we find suggestive evidence that part of the displacement effects could be driven by a decline in the perceived quality of the workplace environment. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Effects of Teaching Critical Thinking within an Integrated Nursing Curriculum

    ERIC Educational Resources Information Center

    Brown Basone', Lauren

    2014-01-01

    Nursing students need to think critically in order to pass their nursing courses and the critical thinking portion of the national licensure exam. To improve students' critical thinking skills, a nursing program in the southern United States recently required that 4th semester students take a 1-credit critical thinking course. This study evaluated…

  3. Curriculum Development and Faculty Perceptions of an RN to BSN Program Development at a Community College

    ERIC Educational Resources Information Center

    Davis, Kelly

    2017-01-01

    Transformative change is occurring in the nursing profession, higher education, and healthcare. There is increased employer demand for baccalaureate prepared nurses. Currently, associate degree programs educate the majority of entry-level nurses in the United States. One solution to meet the increased demand for baccalaureate prepared nurses is to…

  4. The Nurse as Advocate: A Grounded Theory Perspective

    ERIC Educational Resources Information Center

    Sessler Branden, Pennie

    2012-01-01

    The nursing profession is entering an exciting time of new professional opportunities. As the United States of America (USA) deals with its health care crisis, nursing is positioned to determine the trajectory of health care and health policy. However, nurses are underrepresented in major forums where they could be change agents on this new path.…

  5. Factors Related to Nursing Student Persistence in an Associate Degree Program

    ERIC Educational Resources Information Center

    Farley, Patricia A.

    2017-01-01

    The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across…

  6. SIDS Education in Nursing and Medical Schools in the United States.

    ERIC Educational Resources Information Center

    Lerner, Helen; McClain, Mary; Vance, John C.

    2002-01-01

    Responses from 214 nursing and 63 medical schools indicated that 92% of nursing and 79% of medical programs taught about sudden infant death syndrome. Prevention was addressed by less than half. Nursing schools were more likely to address bereavement and family support. Reliance on textbooks raised concerns about the currency of the content. (SK)

  7. Undergraduate Nursing Students' Attitudes toward Mental Illness and Mental Health Nursing

    ERIC Educational Resources Information Center

    Konzelman, Lois

    2017-01-01

    Historically, nurses have lacked recognition for the work they do, especially in the area of mental health. There is a shortage of qualified mental health nurses to meet the demand for services. Many rural areas in the United States have few or no mental health services to offer communities. Encouraging positive attitudes toward mental health…

  8. Marijuana and Children. Position Statement

    ERIC Educational Resources Information Center

    Endsley, Patricia; Embrey, Mary Louise

    2014-01-01

    Registered professional school nurses (hereinafter referred to as school nurses) promote wellness and disease prevention to improve health outcomes for our nation's children. It is the position of the National Association of School Nurses (NASN) that the marijuana plant remain under the United States Drug Enforcement Agency's (DEA) Schedule I…

  9. Curriculum considerations for enhancing baccalaureate learning for international students.

    PubMed

    Pardue, Karen T; Haas, Barbara

    2003-01-01

    International students studying nursing in the United States present unique teaching opportunities and challenges. Student language, culture, and academic expectations are major factors for faculty to consider in delivering international education. An RN to BSN program provides baccalaureate completion study for registered nurses residing in Israel. Students can choose to complete the final semester in the United States. Israeli nursing students demonstrate a strong collectivistic orientation to their academic work. Issues related to English language fluency and academic paper preparation were identified. Success in international teaching endeavors is facilitated when faculty carefully evaluate course materials and assignments. Clarity of language, cultural expectations, and availability of academic resources are important considerations for promoting student success.

  10. Obesity and Nursing Home Care in the United States: A Systematic Review.

    PubMed

    Harris, John Alexander; Castle, Nicholas George

    2017-12-14

    Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and morbidity in this setting. The purpose of this article is to describe the scope and depth of evidence regarding the impact of obesity among nursing home residents in the United States. A systematic literature review was performed in PubMed, EMBASE, CINAHL, and Web of Science databases as well as additional hand-searched documents. Included articles were published from 1997 to March 2017. The characteristics and content of the included articles were systematically reviewed and reported. Twenty-eight studies met inclusion criteria for review. The median study size was 636 residents (interquartile range 40-11,248); 18 (64%) studies were retrospective and 10 (36%) were prospective in nature. Ten (36%) studies examined medical and functional morbidity, 10 (36%) examined health system effects, and 5 (18%) examined the risk of admission to nursing homes. Most studies found that obesity poses serious issues to resident health and the provision of health care, as well as broad health system and nursing challenges in the provision of high-quality nursing home care and services. Although obesity affects about one in four nursing home residents in the United States, relatively limited evidence exists on the complex challenges of obesity for their residents and their care. A continued focus on resident quality of life, health system improvement, and nursing best practices for properly caring for individuals with obesity is needed. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. A profile of U.S. nursing faculty in research- and practice-focused doctoral education.

    PubMed

    Smeltzer, Suzanne C; Sharts-Hopko, Nancy C; Cantrell, Mary Ann; Heverly, Mary Ann; Nthenge, Serah; Jenkinson, Amanda

    2015-03-01

    This study, which is part of a larger project, was conducted to profile the nursing faculty in the United States teaching in PhD and DNP programs. This is a descriptive study. A sample of 554 nursing faculty who teach in PhD and DNP programs was recruited by email solicitation to represent all geographic regions of the United States. Data were collected from November 2013 through January 2014 using an online survey instrument. The instrument was developed based on results of review of the literature and of focus groups of doctoral faculty (faculty teaching in doctoral programs) to ascertain characteristics of faculty teaching in doctoral programs and of the schools in which they teach. Frequencies and descriptive statistics are reported. Growth in DNP programs has outpaced growth in PhD programs, and DNP graduates have moved into doctoral education in greater numbers than PhD graduates. DNP faculty report less prior experience and current productivity scholarship than faculty in PhD programs only or both types of programs. Strategies are needed to ensure that doctoral programs are staffed by faculty who are prepared for doctoral education and the development of nursing science. The Institute of Medicine has recommended doubling the number of doctorally prepared nurses in the United States by 2020 to ensure that sufficient numbers of faculty are available to prepare the nursing labor force that is needed for delivery of healthcare services. Nurse scientists are needed to contribute to improvement in patient care quality and safety, and practice leaders are needed to facilitate the translation of research into safe, high-quality, and cost-effective care. The landscape of doctoral education in nursing is rapidly changing. © 2015 Sigma Theta Tau International.

  12. Hospital nurse staffing and public health emergency preparedness: implications for policy.

    PubMed

    McHugh, Matthew D

    2010-01-01

    Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation's emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage.

  13. Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy

    PubMed Central

    McHugh, Matthew D.

    2010-01-01

    Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation’s emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage. PMID:20840714

  14. Nursing Fatigue: An Evidence-Based Practice Review for Oncology Nurses
.

    PubMed

    Ferris, Jordan

    2015-12-01

    Nursing fatigue is a current and well-researched topic. Many negative outcomes and consequences exist for patients and nurses that have been linked to nursing fatigue. Medical errors are one such consequence, and these errors have become one of the top three preventable deaths in the United States. Oncology nurses are not immune to fatigue, and the consequences of their fatigue can be much more harmful to patients.

  15. Oncology nursing in Cuba: report of the delegation.

    PubMed

    Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

    2012-08-01

    In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

  16. Development of a Mental Health Nursing Simulation: Challenges and Solutions

    ERIC Educational Resources Information Center

    Kidd, Lori I.; Morgan, Karyn I.; Savery, John R.

    2012-01-01

    Nursing education programs are proliferating rapidly in the United States in an effort to meet demand for nurse professionals. Multiple challenges arise from this rapid expansion. One challenge is finding sufficient clinical sites to accommodate students. Increased competition for scarce resources requires creativity in clinical contracting. This…

  17. Measuring Critical Thinking in Newly Licensed Registered Nurses

    ERIC Educational Resources Information Center

    Rush, Carreen W.

    2017-01-01

    A national conversation is stirring in the United States about mandating residency programs of newly-licensed nurses as findings indicate that newly-licensed registered nurses are not prepared to make appropriate patient care decisions. Even with many commercial instruments available on the market for outcome measurements, accurately assessing the…

  18. Nursing Admission Practices to Discern "Fit": A Case Study Exemplar

    ERIC Educational Resources Information Center

    Sinutko, Jaime M.

    2014-01-01

    Admission to a baccalaureate nursing school in the United States is currently a challenging proposition for a variety of reasons. This research explored a holistic nursing school admission process at a small, private, baccalaureate college using a retrospective, mixed-method, approach. The holistic method included multiple admission criteria, both…

  19. Registered Nurse Persistence in Baccalaureate Education

    ERIC Educational Resources Information Center

    Krov, Kathleen Nadler

    2010-01-01

    There is a need to increase the number of baccalaureate prepared registered nurses to safely meet the complex healthcare needs of citizens of the United States. Since there is no research on the characteristics of registered nurse students persisting in baccalaureate education, this quantitative descriptive case study was designed to identify the…

  20. The Experiences of International Nursing Students in a Baccalaureate Nursing Program.

    ERIC Educational Resources Information Center

    Sanner, Susan; Wilson, Astrid H.; Samson, Linda F.

    2002-01-01

    Eight female Nigerians studying nursing in the United States experienced social isolation, became resolved to acceptance of antagonistic attitudes encountered in the program, and persisted in spite of obstacles. From their experiences, recommendations for the adjustment of international students were developed. (Contains 20 references.) (SK)

  1. Treating Nurses and Student Nurses with Chemical Dependency: Revising Policy in the United States for the 21st Century

    ERIC Educational Resources Information Center

    Monroe, Todd; Pearson, Frances

    2009-01-01

    For more than a century, the US nursing profession has been aware of substance abuse problems among its practitioners and student nurses but has generally dealt with the issue by taking disciplinary action rather than pursuing nonpunitive options. The latter course would allow more healthcare providers, following successful rehabilitation, to…

  2. An Exploration of Factors That Impact Role Strain among Undergraduate Clinical Instructors Teaching in Wisconsin Nursing Programs

    ERIC Educational Resources Information Center

    Astrella, Julie A.

    2017-01-01

    The United States is in the midst of a nursing faculty shortage, particularly those that provide clinical instruction. Clinical instructors play an integral role in undergraduate nursing education by bridging the gap between theoretical knowledge and nursing practice; this position is also the most difficult to recruit for and retain. The factors…

  3. A Correlational Study of the Relationship between TEAS V and Success in Licensed Practical Nursing Students

    ERIC Educational Resources Information Center

    Grace, Jamila

    2017-01-01

    Practical nurses can provide quality, cost-effective care in an ever-changing health care setting which is faced with a shortage of nurses. A community college system in the southeastern area of the United States began using the Test of Essential Academic Skills (TEAS) V as part of admission criteria for nursing programs. While Assessment…

  4. The Nursing Shortage and the Role of Community Colleges in Nurse Education. Executive Summary. AACC Research Brief.

    ERIC Educational Resources Information Center

    Viterito, Arthur; Teich, Carolyn

    This is a report by the American Association of Community Colleges (AACC) on a the shortage of registered nurses (RN) in the United States and the role of community colleges in nurse education. Reasons for the shortage include: (1) inadequate wages; (2) heavy workloads; (3) undesirable work schedules; (4) increased administrative duties; (5) low…

  5. Factors Affecting Graduate Degree Pursuit for BSN-Prepared Filipino and Filipino American Nurses Working in the United States

    ERIC Educational Resources Information Center

    Nagtalon-Ramos, Jamille Kristine

    2017-01-01

    Although Filipino and Filipino American nurses represent an impressive share of the nursing workforce, they are not well represented in advanced practice, faculty, and executive leadership positions. Obtaining a graduate degree in nursing has the potential to open a wider range of opportunities to meet the healthcare demands of a population that…

  6. Informing Leadership Models: Nursing and Organizational Characteristics of Neonatal Intensive Care Units in Freestanding Children's Hospitals.

    PubMed

    Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A

    Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.

  7. POLYBROMINATED DIPHENYL ETHERS (PBDES) CONTAMINATION OF UNITED STATES FOOD

    EPA Science Inventory

    Elevated levels of polybrominated diphenyl ethers (PBDEs), a type of brominated flame retardant, were recently detected in United States (U.S.) nursing mothers' milk. These halogenated compounds chemically and toxicologically resemble others such as polychlorinated biphenyls (PC...

  8. Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare.

    PubMed

    Bayramzadeh, Sara; Alkazemi, Mariam F

    2014-01-01

    This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.

  9. Aspects that facilitate or interfere in the communication process between nursing professionals and patients in critical state.

    PubMed

    Achury Saldaña, Diana Marcela; Pinilla Alarcón, Maribel; Alvarado Romero, Herly

    2015-01-01

    To describe aspects facilitating or interfering in the communication process between nursing professionals and patients in critical state. Descriptive study conducted during the second semester of 2013, with the participation of 112 nurses who work in Intensive Care Units of Bogotá (Colombia). To gather the information, the researchers designed a survey. A total of 91.6% of the nursing professionals considers communication important with patients and their families; 75.9% seeks to provide, during the care interventions, physical care and communicate per shift from two to four times with the patient and from one to two times with the family; 50% states feeling afraid to communicate; only 53.7% integrate their emotions in the patient's physical care. Regarding the elements of communication developed during their graduate formation, 42.8% received tools of therapeutic communication during their undergraduate studies and only 33.0% during graduate studies. It is worth to indicate that 80.36% of the Intensive Care Units, where the nursing professionals work, privilege interventions aimed at satisfying physiological needs. The communication process between nurses and patients in critical state is limited by restrictive institutional policies and by the nurse' scarce academic formation. The need exists to start a process of change in relation to models of professional practice deeply rooted in physical care of critical patients to establish models that, during physical care, are centered on communication and the patient-family-professional relationship.

  10. Corporate Welfare: The Third Stage of Welfare in the United States.

    ERIC Educational Resources Information Center

    Stoesz, David

    1986-01-01

    Corporate involvement in social welfare represents a third stage in the evolution of welfare institutions in the United States, following the voluntary sector and the welfare state. Examining health and welfare corporations reveals rapid growth and consolidation in nursing homes, hospital management, health maintenance organizations, child care,…

  11. International Classification for Nursing Practice (ICNP)

    PubMed Central

    Warren, Judith J.; Coenen, Amy

    1998-01-01

    The International Classification for Nursing Practice (ICNP) is a collaborative project under the auspices of the International Council of Nurses. The alpha version ia available online for comment in preparation for the release of the beta version in 1999. The authors answer the most-frequently asked questions about the ICNP and encourage nurses in the United States to participate in the revision by sending comments and suggestions to the American Nurses Association. PMID:9670130

  12. Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes.

    PubMed

    Plough, Avery C; Galvin, Grace; Li, Zhonghe; Lipsitz, Stuart R; Alidina, Shehnaz; Henrich, Natalie J; Hirschhorn, Lisa R; Berry, William R; Gawande, Atul A; Peter, Doris; McDonald, Rory; Caldwell, Donna L; Muri, Janet H; Bingham, Debra; Caughey, Aaron B; Declercq, Eugene R; Shah, Neel T

    2017-08-01

    To define, measure, and characterize key competencies of managing labor and delivery units in the United States and assess the associations between unit management and maternal outcomes. We developed and administered a management measurement instrument using structured telephone interviews with both the primary nurse and physician managers at 53 diverse hospitals across the United States. A trained interviewer scored the managers' interview responses based on management practices that ranged from most reactive (lowest scores) to most proactive (highest scores). We established instrument validity by conducting site visits among a subsample of 11 hospitals and established reliability using interrater comparison. Using a factor analysis, we identified three themes of management competencies: management of unit culture, patient flow, and nursing. We constructed patient-level regressions to assess the independent association between these management themes and maternal outcomes. Proactive management of unit culture and nursing was associated with a significantly higher risk of primary cesarean delivery in low-risk patients (relative risk [RR] 1.30, 95% CI 1.02-1.66 and RR 1.47, 95% CI 1.13-1.92, respectively). Proactive management of unit culture was also associated with a significantly higher risk of prolonged length of stay (RR 4.13, 95% CI 1.98-8.64), postpartum hemorrhage (RR 2.57, 95% CI 1.58-4.18), and blood transfusion (RR 1.87, 95% CI 1.12-3.13). Proactive management of patient flow and nursing was associated with a significantly lower risk of prolonged length of stay (RR 0.23, 95% CI 0.12-0.46 and RR 0.27, 95% CI 0.11-0.62, respectively). Labor and delivery unit management varies dramatically across and within hospitals in the United States. Some proactive management practices may be associated with increased risk of primary cesarean delivery and maternal morbidity. Other proactive management practices may be associated with decreased risk of prolonged length of stay, indicating a potential opportunity to safely improve labor and delivery unit efficiency.

  13. The creation of a synchronous learning environment to support a study abroad program for nursing majors at a traditional liberal arts university.

    PubMed

    Folse, Victoria N; Jarvis, Carolyn M; Swanlund, Susan L; Timan, Mitzi Runyard

    2015-01-01

    In response to an increased need for Spanish-speaking and culturally competent nurses, a small private undergraduate-only liberal arts university implemented a semester-long study abroad program for nursing majors in Barcelona, Spain. Prior to the creation of this program, study abroad for nursing students was limited because of prelicensure requirements and limitations of a traditional nursing curriculum. Students studying in Spain enroll in four courses--including two core nursing courses delivered using Polycom hardware and telepresence software by nursing faculty who remain in the United States, a Spanish language course, and one general education course taught either by the University's Spain Director or by an experienced Spanish professor. Participants live with host families and participate in clinical and community observational experiences in Spanish health care agencies. Students then complete direct patient care requirements upon return to the United States. To our knowledge, no other undergraduate-only institution offers a semester-long study abroad experience for nursing majors embedded within the curriculum using synchronous learning; we believe our Spain program, which is in its fourth year being open to nursing majors, is truly an innovative approach to establish cultural competence for undergraduate nursing majors that could serve as a model for other schools of nursing and health disciplines. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. The Maternity Care Nurse Workforce in Rural U.S. Hospitals.

    PubMed

    Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B

    To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (<300 annual births) and 49% were high volume (≥300 annual births). Among low-volume hospitals, 78% used a shared nurse staff model. In contrast, 31% of high-volume hospitals used a shared nurse staff model. Respondents praised the teamwork, dedication, and skill of their maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  15. What role can nurse leaders play in reducing the incidence of pressure sores?

    PubMed

    Wurster, Joan

    2007-01-01

    Pressure sores have plagued the nursing profession for many years as a major health care problem in terms of a patient's suffering and financial cost. Pressure sores are increasingly common in hospitalized patients in the United States with a 63% increase from 1993 to 2003. The nurse leader is accountable for the occurrence of pressure sores, a nurse-sensitive indicator, by a scorecard which is benchmarked against other facilities. The nurse leader must take a systematic approach in the prevention of pressure sores, with the strategy being consistent and motivating to the staff in order to improve patient outcome. The chief nursing officer, the unit manager, and the bedside nurse must all collaborate to prevent tissue injury in patients at risk for developing pressure sores and to promote wound healing in patients with existing breakdown.

  16. Nursing Home Litigation and Tort Reform: A Case for Exceptionalism

    ERIC Educational Resources Information Center

    Studdert, David M.; Stevenson, David G.

    2004-01-01

    The medical malpractice crisis that is currently spreading across the United States bears many similarities to earlier crises. One novel aspect of the current crisis is the explicit inclusion of litigation against nursing homes as a target of reform. Encouraged by the nursing home industry, policymakers are considering the extension of…

  17. Using the Health Belief Model to Understand School Nurse Asthma Management

    ERIC Educational Resources Information Center

    Quaranta, Judith E.; Spencer, Gale A.

    2015-01-01

    Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude,…

  18. An Analysis of Barriers to Online Learning as Perceived by Registered Nurses

    ERIC Educational Resources Information Center

    Thomas, Eddie D.

    2010-01-01

    The United States faces a substantial nursing shortage that is expected to increase over the next decade and beyond. Understaffing and erratic work schedules result in minimal opportunities to participate in continuing education courses, which are required for registered nurses (RNs) to maintaining proficiency and licensure. Online learning is…

  19. Observational Learning among Older Adults Living in Nursing Homes

    ERIC Educational Resources Information Center

    Story, Colleen D.

    2010-01-01

    The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

  20. Experiences of Underrepresented Minorities in Doctoral Nursing Programs at Predominantly White Universities

    ERIC Educational Resources Information Center

    Gregory, Linda D.

    2017-01-01

    The representation of racial and ethnic minorities in the nursing workforce is disproportionately low in comparison with their representation in the general population in the United States. Despite diversity initiatives, the slight increase in enrollment of under-represented minority (URM) students in graduate schools of nursing at predominantly…

  1. Certified Registered Nurse Anesthetists: Relationship between Educator Development and Self-Efficacy toward Clinical Teaching

    ERIC Educational Resources Information Center

    Pipkin, Jessica Monique

    2015-01-01

    A high-demand is placed on healthcare providers to be educators during student clinical training evolutions. Certified registered nurse anesthesia clinical educators (CRNACEs) affiliated with nurse anesthesia education programs (NAEPs) in the United States face the complex duality of assuming the combined role of teacher and anesthesia provider.…

  2. Dimensions of nursing process: the leadership cure.

    PubMed

    McBride, Karin; Snyder, Eugene R

    2011-08-01

    The field of nursing is in a state of crisis. This crisis has a number of causes: a shortage of registered nurses to fill job vacancies, lack of professional growth opportunities, inability to participate in decision making, and lack of orientation and training for newly graduated nurses. Democratic leadership can result in respect and greater levels of trust among staff in a neonatal intensive care unit.

  3. Perceptions of Teaching Effectiveness of Part-Time and Full-Time Clinical Nursing Faculty of BSN Education

    ERIC Educational Resources Information Center

    DeSantis, Kimberly L.

    2012-01-01

    The United States faces a critical shortage of full-time registered nurses, which is . directly affected by the shortage of nurse educators. Many schools of nursing are already seeing the impact as qualified program applicants are being turned away due to the lack of qualified educators available to teach them. The trend has become to employ…

  4. Novice nurse educator entry-level competency to teach: a national study.

    PubMed

    Poindexter, Kathleen

    2013-10-01

    Expert nurse clinicians who are transitioning into academic positions after successful clinical careers often find they are unprepared to assume their new educator roles. Although nursing clinical expertise may be a necessary expectation, this knowledge is not sufficient to assume a nurse educator position. The purpose of this study was to identify essential entry-level nurse educator competencies, as reported by nurse administrators of accredited prelicensure nursing programs in the United States. Responses were categorized according to the type of academic institution housing the prelicensure nursing program and type of entry-level nurse educator position. A total of 374 program administrators representing 48 states participated, for a 44% response rate. The results indicate that administrators expect entry-level nurse educators to acquire teaching competencies prior to obtaining an entry-level position. Expected proficiency levels of competencies differed based on the position type and the academic setting. Copyright 2013, SLACK Incorporated.

  5. Impact of nursing overtime on nurse-sensitive patient outcomes in New York hospitals, 1995-2000.

    PubMed

    Berney, Barbara; Needleman, Jack

    2006-05-01

    During the past several years, nurses and their advocates have expressed concern about heavy use of overtime in hospitals and claimed that it undermines the quality of nursing care. Using staffing and discharge data covering 1995 to 2000 from 161 acute general hospitals in New York State, this study uses multi variate regression to analyze the relationship between overtime and the rates of six nurse-sensitive patient outcomes and mortality. We find an association of overtime with lower rates of mortality in medical and surgical patients but do not consider these findings definitive. Because overtime use is episodic and unit specific, further study of these issues using data that examines the occurrence of adverse events by unit during periods of heavy nurse overtime is recommended.

  6. Neonatal nurse practitioners: identity as advanced practice nurses.

    PubMed

    Beal, J A; Maguire, D; Carr, R

    1996-06-01

    To define how neonatal nurse practitioners (NNPs) perceive their identity as advanced practice nurses. Non-experimental descriptive and correlational survey. Nationwide random sample drawn from NNPs certified by the National Certification Corporation. Two hundred fifty-eight neonatal nurse practitioners practicing in neonatal intensive-care units across the United States. Neonatal Nurse Practitioners indicated on a visual analogue scale at which point their philosophy of practice fell on a continuum from nursing to medicine and specified on a 5-point bipolar Likert scale how various role socialization factors influenced their identity. The NNPs predominantly were certificate-prepared and aligned themselves with a medical philosophy. Those NNPs who were master's-prepared (p < .01), precepted by another NNP (p < .05), espoused a philosophy of nursing (p < .001), belonged to a professional nursing organization (p < .05), and had an NNP role model (p < .001) were more likely to have a strong nursing identity (95% confidence interval). The issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care need further exploration. These data support the American Nurses' Association mandate of graduate nursing education for advanced nurse practitioners.

  7. A looming public health crisis: the nursing shortage of today.

    PubMed

    Ross, Jacqueline

    2002-10-01

    The present and anticipated nursing shortage poses a public health concern. This is a unique shortage because nursing is encountering both an increased demand for nursing care and a lower supply of nurses available to deliver it. Nurses, known for patient advocacy, are ethically bound to provide competent, quality care. Currently, nurses comprise the largest group of health care providers in the United States. Through increased understanding of the current situation, the profession will be in a better position to advocate and promote nursing as a viable, attractive career. Copyright 2002 by American Society of PeriAnesthesia Nurses.

  8. Six-part series on the state of the RN workforce in the United States.

    PubMed

    Buerhaus, Peter I

    2005-01-01

    This series on the state of the nursing workforce focuses on describing the results of the national surveys of RNs. The series begins with an analysis of RNs' perceptions of the current nursing shortage and whether they perceive the shortage has gotten better or worse over the past few years. Future topics will include RNs' perceptions of being a nurse and how they perceive certain aspects of their jobs; RNs' awareness of the J&J Campaign and whether they think it has been effective; RNs' perceptions of the impact of the shortage on the quality of patient care in hospitals; and various issues related to the age and diversity of the nursing profession.

  9. Perceptions of Nursing Education Administrators Regarding the Relationship of Admission Criteria to Student Graduation

    ERIC Educational Resources Information Center

    Cline, Joy F.

    2013-01-01

    This research investigated admission criteria of baccalaureate nursing students related to their success in a multi-state sample of peer universities in the United States. The researcher used mixed methods to collect data that were analyzed using descriptive and phenomenological approaches. The sample of the study was chairpersons from peer…

  10. Navigating Long-Term Care

    PubMed Central

    Holt, James D.

    2017-01-01

    Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care. PMID:28491911

  11. Assessing nursing staffing ratios: variability in workload intensity.

    PubMed

    Upenieks, Valda V; Kotlerman, Jenny; Akhavan, Jaleh; Esser, Jennifer; Ngo, Myha J

    2007-02-01

    In 2004, California became the first state to implement specific nurse-to-patient ratios for all hospitals. These mandated enactments have caused significant controversy among health care professionals as well as nursing unions and professional organizations. Supporters of minimum nurse-to-patient ratios cite patient care quality, safety, and outcomes, whereas critics point to the lack of solid data and the use of a universally standardized acuity tool. Much more remains to be learned about staffing policies before mature links may be made regarding set staffing ratios and patient outcomes - specifically, how nurses spend their time in terms of variability in their daily work. This study examines two comparable telemetry units with a 1:3 staffing ratio within a California hospital system to determine the relative rates of variability in nursing activities. The results demonstrate significant differences in categorical nursing activities (e.g., direct care, indirect care, etc.) between the two telemetry units (chi(2) = 91.2028; p < or = .0001). No correlation was noted between workload categories with daily staffing ratios and staffing mix between the two units. Although patients were grouped in a similar telemetry classification category and care was mandated at a set ratio, patient needs were variable, creating a significant difference in registered nurse (RN) categorical activities on the two units.

  12. Mental Health Care: Licensing and Certification Requirements for Staff in State Hospitals. Fact Sheet for the Honorable Daniel K. Inouye, United States Senate.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    The Office of United States Senator Daniel Inouye requested information on state minimum licensing and certification requirements for physicians, psychiatrists, psychologists, social workers, and nurses who work directly with patients in state mental hospitals. To obtain this information, the General Accounting Office called the offices of the…

  13. Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review.

    PubMed

    Cook, Wendy A; Morrison, Megan L; Eaton, Linda H; Theodore, Brian R; Doorenbos, Ardith Z

    The United States has a complex healthcare system that is undergoing substantial reformations. There is a need for high-quality, economic evaluations of nursing practice. An updated review of completed economic evaluations relevant to the field of nursing within the U.S. healthcare system is timely and needed. The purpose of this study was to evaluate and describe the quantity and quality of economic evaluations in nursing-relevant research performed in the United States between 1997 and 2015. Four databases were searched. Titles, abstracts, and full-text content were reviewed to identify studies that analyzed both costs and outcomes, relevant to nursing, performed in the United States, and used the quality-adjusted life year to measure effectiveness. For included studies, data were extracted from full-text articles using criteria from U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. Twenty-eight studies met the inclusion criteria. Most (n = 25, 89%) were published in the last decade of the analysis, from 2006 to 2015. Assessment of quality, based on selected items from the panel guidelines, found that the evaluations did not consistently use the recommended societal perspective, use multiple resource utilization categories, use constant dollars, discount future costs and outcomes, use a lifetime horizon, or include an indication of uncertainty in results. The only resource utilization category consistently included across studies was healthcare resources. Only 28 nursing-related studies meeting the inclusion criteria were identified as meeting robust health economic evaluation methodological criteria, and most did not include all important guideline items. Despite increases in absolute numbers of published studies over the past decade, economic evaluation has been underutilized in U.S. nursing-relevant research in the past two decades.

  14. The effectiveness of a standardised positioning tool and bedside education on the developmental positioning proficiency of NICU nurses.

    PubMed

    Spilker, Arlene; Hill, Constance; Rosenblum, Ruth

    2016-08-01

    In order to improve the developmental proficiency of neonatal intensive care unit nurses, a standardised infant positioning assessment tool and a bedside education programme were introduced to the registered nurses in a 46 bed level III neonatal intensive care unit in the western United States. A developmental positioning team collected pre-intervention positioning scores on 54 preterm infants. This was followed by a survey of the registered nurses beliefs and attitudes, the introduction of the standardised assessment tool and an informal education programme. Post-intervention positioning scores were collected on 55 preterm infants, and analysis of the data indicated there was a statistically significant change in mean positioning scores. Additionally, the registered nurses identified several barriers to the implementation of developmental positioning. This research indicates the use of a standardised infant positioning assessment tool and bedside education may be useful strategies for improving the developmental positioning proficiency of NICU nurses. Copyright © 2016. Published by Elsevier Ltd.

  15. Education Policy Initiatives To Address The Nurse Shortage In The United States

    PubMed Central

    Aiken, Linda H.; Cheung, Robyn B.; Olds, Danielle M.

    2009-01-01

    Employment opportunities are expected to grow much faster for registered nurses (RNs) than for most other occupations. Yet a major shortage of nurses is projected by 2020. A nurse faculty shortage and financially strapped colleges and universities are limiting the ability of U.S. nursing schools to take advantage of historically high numbers of qualified applicants. Increased public subsidies are needed to provide greater access to nursing education, with a priority on baccalaureate and graduate nursing education, where job growth is expected to be the greatest. PMID:19525285

  16. Health care work environments, employee satisfaction, and patient safety: Care provider perspectives.

    PubMed

    Rathert, Cheryl; May, Douglas R

    2007-01-01

    Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction. The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors. We examined perceptions of nurses from three acute care hospitals in the eastern United States. Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units. Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.

  17. Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.

    PubMed

    Allen, Lilian A

    2018-02-12

    The purpose of this study was to explore the experiences of internationally educated nurses in management positions in United States health care organisations to understand the obstacles and support these individuals' experience when pursuing and working in managerial roles. Although internationally educated nurses are an integral part of the US health care industry, few work in managerial roles. Little is known about the experiences of internationally educated nurses who do obtain management positions. In this qualitative, phenomenological study, seven internationally educated nurses who were managers in Chicago, Illinois, responded to open-ended interview questions. Supervisors contributed to the participants' acceptance of management positions. The participants experienced challenges such as cultural differences, language, and communication. Despite these challenges, the participants had positive working relationships with staff and supervisors. Further, the participants had opportunities for education and professional growth. Internationally educated nurses benefit from participating in organisational committees. They face challenges related to work responsibilities, cultural differences and communication but can succeed in management roles through developing strategies to overcome the challenges and through receiving support from staff, colleagues and supervisors. More internationally educated nurses may obtain managerial positions if supervisors provide encouragement and support. © 2018 John Wiley & Sons Ltd.

  18. A Preliminary Analysis of Compassion Satisfaction and Compassion Fatigue With Considerations for Nursing Unit Specialization and Demographic Factors.

    PubMed

    Mooney, Claire; Fetter, Katrina; Gross, Brian W; Rinehart, Cole; Lynch, Caitlin; Rogers, Frederick B

    Compassion fatigue (CF), or vicarious traumatization, is a state of physical/emotional distress that results from caring for those experiencing pain. We sought to characterize levels of CF in intensive care unit (ICU) and oncology nursing populations with subanalyses comparing specific personal/professional demographic factors. The Professional Quality of Life (ProQOL) scale, a validated tool for assessing CF, burnout (BO), and compassion satisfaction (CS), was distributed to the ICU and oncology divisions of a community hospital. Demographic data and ProQOL scale scores were collected and compared within specialty and gender subgroups. Two-sample t tests and regression analyses were used to compare groups. Statistical significance was defined as p < .05. A total of 86 nurses submitted completed surveys able to be analyzed. Levels of CS were significantly lower (p = .023) and levels of BO were significantly higher (p = .029) in ICU nurses than in oncology nurses. Male nurses exhibited significantly higher CS (p = .001) and significantly lower BO (p = .021) and CF (p = .014) than female nurses. Intensive care unit nurses and female nurses from both ICU and oncology specialties may be at increased risk for developing a poorer overall ProQOL and CF.

  19. Hawai‘i's Nursing Workforce: Keeping Pace with Healthcare

    PubMed Central

    Qureshi, Kristine

    2015-01-01

    Nursing is the largest segment of the healthcare workforce, but over the next decade even more nurses will be required. Changing population demographics, new technologies, and evolving models of healthcare will stimulate expansion of nursing roles and the need for a highly educated nursing workforce. The current nursing workforce is aging, and large numbers of retirements are anticipated. By 2025, the United States is expected to experience a nursing shortage; in Hawai‘i this shortfall is forecast to be 3,311 professional nurses. Currently there are nine nursing programs across the state in public and private universities and colleges. These programs are partnering to implement the Institute of Medicine's recommendations for the future of nursing. In Hawai‘i, nursing practice is being expanded; different pathways to advanced nursing education are being implemented; and nurses are partnering with other groups to reshape healthcare. The Hawai‘i State Center for Nursing collects ongoing data on the nursing workforce to inform strategic planning. Current gaps in nursing specialty education include school health and mental health. The purpose of this paper is to provide an overview of Hawai‘i's nursing workforce in relationship to statewide population demographics, healthcare needs and gaps, and then outline steps being taken by the profession to address these needs and gaps while implementing the Institute of Medicine recommendations. PMID:25755912

  20. Transcultural nursing course in Tanzania, Africa.

    PubMed

    Owens, Rhoda

    2012-06-01

    A transcultural nursing course in Tanzania was offered in fall 2010 at Williston State College, located in North Dakota. Madeleine Leininger's Culture Care: Diversity and Universality Theory (Principles of Developing Cultural Competence) was the framework used for the experience. The course provided nursing students the opportunity to learn about the culture, health, and illness beliefs of Tanzanians; their values and practices; the prevalence of HIV/AIDS; and the differences and similarities between the healthcare systems, hospice/palliative care, and home visits in Tanzania as compared to the United States.

  1. Factors That Contribute to a Successful Nursing Student's Decision to Withdraw from a Bachelor of Science in Nursing Program before Graduation

    ERIC Educational Resources Information Center

    Randall, Shelly

    2013-01-01

    There is an extreme shortage of registered nurses (RNs) in the United States (U.S.). This shortage is projected to grow to 260,000 RNs by the year 2025 (American Association of Colleges Nursing [AACN], 2010a). In order to meet the current and future health care needs of the population of the U.S., nursing schools would have to graduate at least…

  2. Process for Mapping Global Health Competencies in Undergraduate and Graduate Nursing Curricula.

    PubMed

    Dawson, Martha; Gakumo, C Ann; Phillips, Jennan; Wilson, Lynda

    2016-01-01

    Determining the extent to which existing nursing curricula prepare students to address global health issues is a critical step toward ensuring competence to practice in an increasingly globalized world. This article describes the process used by nursing faculty at a public university in the southern United States to assess the extent to which global health competencies for nurses were being addressed across nursing programs. Steps used and lessons learned throughout this process are discussed.

  3. Policies to sustain the nursing workforce: an international perspective.

    PubMed

    Buchan, J; Twigg, D; Dussault, G; Duffield, C; Stone, P W

    2015-06-01

    Examine metrics and policies regarding nurse workforce across four countries. International comparisons inform health policy makers. Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom (UK) and the United States (US). Workforce policy context was explored. Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co-ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries. There are differences as well as variation in the overall impact of the global financial crisis in these countries. Future supply of nurses in all four countries is vulnerable. Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries. © 2015 International Council of Nurses.

  4. Pakistan: Can the United States Secure an Insecure State?

    DTIC Science & Technology

    2010-01-01

    do not have female staff; the male-to-female staff ratio in the health field is 7 to 1.130 More nurses and female staff are needed, especially to...exercise was rescheduled for 2009. 9 Interview with Ninth Air Force personnel, September 12, 2008. 200 Pakistan: Can the United States Secure an Insecure

  5. [(Re)configuration of the nursing field in the new state (1937-1945)].

    PubMed

    Barreira, Ieda de Alencar; Baptista, Suely de Souza

    2002-01-01

    The subject of this study is the changes the nursing field went through during the period called Novo Estado. Analyze the nursing environment in the Federal Capital during the period mentioned; discuss the effects of the influence of the Catholic Church and nurses of the American government in the Brazilian nursing environment. Documents obtained from the Documentation Center in Anna Nery/UFRJ School of Nursing and from literature on the topic. The interpretation of the findings was based on the Theory of the Social World by Pierre Bourdieu. Results showed deep changes in terms of professional education, labor market and institutionalization of the nursing assistance in a period (after the World War II) in which the Catholic Church and the United States had increased their power and influence. This new context determined the reconfiguration of the identity of Brazilian nurses and of the nursing field.

  6. Nurses leading change to advance health.

    PubMed

    Polansky, Patricia; Gorski, Mary Sue; Green, Alexia; Perez, G Adriana; Wise, Robert P

    The article includes a review of selected past and current leadership initiatives as well as a summary of three leadership meetings convened by The Center to Champion Nursing in America, a partnership of the Robert Wood Johnson Foundation (RWJF), AARP and the AARP Foundation. These "Leadership in Action" meetings were designed to address the Campaign for Action's (CFA) goal to increase the number of nurse leaders in health- and health care-related boardrooms at the local, state and national levels. RWJF supported key nursing organizations in initial discussions around integrating state and national efforts to get more nurses onto boards leading to a active vibrant coalition making significant progress. This article concludes with a call to action encouraging all nurses to consider board service as an essential component of improving health and health care and to do their part to help build a Culture of Health in the United States. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Reflections on 50 years of change.

    PubMed

    Ford, Loretta C

    2015-06-01

    In honor of the 50th anniversary of the first nurse practitioner (NP) program in the United States, Dr. Loretta Ford offers these reflections on the progress of NPs in the past half century. ©2015 American Association of Nurse Practitioners.

  8. Interpersonal violence issues in the nursing classroom.

    PubMed

    Gagan, Mary Jo

    2003-03-01

    Interpersonal violence in the United States has been called a health issue of epidemic proportions (Rudman & Alpert, 2000). Reports of interpersonal violence appear daily in popular media, and specific cases have been sensationalized. The nursing profession traditionally has attempted to respond to major health issues through education, political activity, and direct patient care. So, what have nurse educators done to prepare nurses to address this issue in their clinical practices and communities?

  9. Nursing Shortage: Strategies for Nursing Practice and Education. Report of the National Invitational Workshop (Washington, D.C., February 22-24, 1988).

    ERIC Educational Resources Information Center

    Circle, Inc., McLean, VA.

    This document reports the proceedings of a conference held in response to concerns about the nursing shortage and its implications for health care in the United States. Following a keynote address ("Nursing and Shortage: Part of the Problem or Part of the Solution?") by Dona Diers, the document is organized in five sections, with each section…

  10. Pushing the limit: forensic nursing in Germany.

    PubMed

    Lambe, Andrea; Gage-Lindner, Nancy

    2007-01-01

    Violence remains a public health challenge and the nursing profession accepts this challenge by expanding its field. Although countries such as the United States, Great Britain, and Canada have employed forensic nurses for decades in different capacities, Germany has yet to follow their lead. This report discusses the German health care and legal systems and challenges Germany to develop an innovative, cost-efficient, and competent profession of forensic nursing.

  11. 20 CFR 655.3 - Special procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B Workers) § 655.3 Special procedures. (a) Systematic process. This subpart provides procedures for the...

  12. HIV and Mexican migrant workers in the United States: a review applying the vulnerable populations conceptual model.

    PubMed

    Albarrán, Cynthia R; Nyamathi, Adeline

    2011-01-01

    Mexican migrant workers residing in the United States are a vulnerable population at high risk for HIV infection. This article critically appraises the published data surrounding HIV prevalence in this vulnerable group, as seen through the lens of the Vulnerable Populations Conceptual Model. This model demonstrates how exposure to risk and resource availability affect health status. The health status of Mexican migrants in the United States is compromised by a number of factors that increase risk of HIV: limited access to health services, multiple sexual partners, low rates of condom use, men having sex with men, and lay injection practices. Migration from Mexico to the United States has increased the prevalence of HIV in rural Mexico, making this an issue of urgent binational concern. This review highlights the implications for further nursing research, practice, and policy. Copyright © 2011 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  13. Emotional Intelligence and Academic Achievement among Senior Black Students Enrolled in Baccalaureate Nursing Programs: Implications for Nursing Education

    ERIC Educational Resources Information Center

    Nwabuebo, Elizabeth

    2013-01-01

    This quantitative correlational study investigated the relationship between trait emotional intelligence (EI) and academic achievement as evident by Grade Point Average (GPA) among senior Black students enrolled in Baccalaureate Science nursing (BSN) programs within the United States. Participants were invited via the Internet to volunteer for the…

  14. Experience of Adjunct Novice Clinical Nursing Faculty: An Interpretive Case Study

    ERIC Educational Resources Information Center

    Mann, Carol

    2013-01-01

    The purpose of this qualitative interpretive case study was to describe the experience of adjunct novice clinical nursing faculty who has less than three years teaching experience or feels novice in this setting. The nursing shortage in the United States is well documented and is forecasted to have significant impacts on the health care delivery…

  15. The Place of Race in Cultural Nursing Education: The Experience of White BSN Nursing Faculty

    ERIC Educational Resources Information Center

    Holland, Ann Elizabeth

    2011-01-01

    The growing cultural diversity in the United States confronts human service professions such as nursing with challenges to fundamental values of social justice and caring. Non-White individuals have experienced long-documented and persistent disparities in health outcomes and receipt of health care services when compared to whites. Medical…

  16. Associate Degree Nursing Graduates Perceptions of NCLEX Performance

    ERIC Educational Resources Information Center

    Pulito, Judy

    2017-01-01

    There has been a shortage of registered nurses in the United States for more than a decade, and an aging population is increasing this problem. This study was prompted by the number of associate degree nursing graduates at a Midwestern community college failing the NCLEX-RN licensure exam, which is required for employment. The purpose of this…

  17. Nurses' Comfort Level with Emergency Interventions in the Rural Hospital Setting

    ERIC Educational Resources Information Center

    Ross, Erin L.; Bell, Sue E.

    2009-01-01

    Context: One quarter of the persons living in the United States receive their emergency care in a rural hospital. Nurses employed in these hospitals see few emergencies but must be prepared to provide expert and efficient care when they do occur. Purpose: The purpose of this study was to determine the influence of registered nurses' certifications…

  18. A Bridge between Two Cultures: Uncovering the Chemistry Concepts Relevant to the Nursing Clinical Practice

    ERIC Educational Resources Information Center

    Brown, Corina E.; Henry, Melissa L. M.; Barbera, Jack; Hyslop, Richard M.

    2012-01-01

    This study focused on the undergraduate course that covers basic topics in general, organic, and biological (GOB) chemistry at a mid-sized state university in the western United States. The central objective of the research was to identify the main topics of GOB chemistry relevant to the clinical practice of nursing. The collection of data was…

  19. Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers.

    PubMed

    Ma, Chenjuan; Park, Shin Hye

    2015-11-01

    To identify how organizational nursing factors at different structural levels (i.e., unit-level work environment and hospital Magnet status) are associated with hospital-acquired pressure ulcers (HAPUs) in U.S. acute care hospitals. A cross-sectional observational study used data from the National Database of Nursing Quality Indicators®. Responses from 33,845 registered nurses (RNs) were used to measure unit work environments. The unit of analysis was the nursing unit, and there were 1,381 units in 373 hospitals in the United States. Unit work environment was measured by the Practice Environment Scale of Nurse Working Index (PES-NWI). Multilevel logistic regressions were used to estimate the effects of unit work environment and hospital Magnet status on HAPUs. All models were controlled for hospital and unit characteristics when considering clustering of units within hospitals. Magnet hospital units had 21% lower odds of having an HAPU than non-Magnet hospital units (95% confidence interval [CI], 0.64-0.98). With one unit increase of the PES-NWI score, units had 29% lower odds of having an HAPU (95% CI, 0.55-0.91). When including both hospital Magnet status and unit work environment in the model, hospital Magnet status no longer had a significant effect on HAPUs (odds ratio [OR] = 0.82; 95% CI, 0.66-1.02), whereas the significant effect of unit work environment persisted (OR = 0.73; 95% CI, 0.56-0.93). Both hospital and unit environments were significantly associated with HAPUs, and the unit-level work environment can be more influential in reducing HAPUs. Investment in the nurse work environments at both the hospital level and unit level has the potential to reduce HAPUs; and additional to hospital-level initiatives (e.g., Magnet recognition program), efforts targeting on-unit work environments deserve more attention. © 2015 Sigma Theta Tau International.

  20. Nurse Staffing in Neonatal Intensive Care Units in the United States

    PubMed Central

    Rogowski, Jeannette A.; Staiger, Douglas O.; Patrick, Thelma E.; Horbar, Jeffrey D.; Kenny, Michael J.; Lake, Eileen T.

    2016-01-01

    The neonatal intensive care unit (NICU) is a setting with high nurse-to-patient ratios. Little is known about the factors that determine nurse workload and assignment. The goals of this study were to (1) develop a measure of NICU infant acuity; (2) describe the acuity distribution of NICU infants; (3) describe the nurse/infant ratio at each acuity level, and examine the factors other than acuity, including nurse qualifications and the availability of physicians and other providers, that determined staffing ratios; and (4) explore whether nurse qualifications were related to the acuity of assigned infants. In a two-stage cohort study, data were collected in 104 NICUs in 2008 by nurse survey (6,038 nurses and 15,191 infants assigned to them) and administrators reported on unit-level staffing of non-nurse providers; in a subset of 70 NICUs in 2009–2010, census data were collected on four selected shifts (3,871 nurses and 9,276 infants assigned to them). Most NICU infants (62%) were low-acuity (Levels 1 and 2); 12% of infants were high-acuity (Levels 4 and 5). The nurse-to-infant ratio ranged from 0.33 for the lowest-acuity infants to 0.95 for the highest-acuity infants. The staffing ratio was significantly related to the acuity of assigned infants but not to nurse education, experience, certification, or availability of other providers. There was a significant but small difference in the percentage of high-acuity (Levels 4 and 5) infants assigned to nurses with specialty certification (15% vs. 12% for nurses without certification). These staffing patterns may not optimize patient outcomes in this highly intensive pediatric care setting. PMID:26291315

  1. 20 CFR 655.25-655.29 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  2. 20 CFR 655.65 - Remedies for violations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  3. 20 CFR 655.70 - WHD Administrator's determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  4. 20 CFR 655.12-655.14 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  5. 20 CFR 655.32 - Labor certification determinations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  6. 20 CFR 655.18-655.19 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  7. Does Sexual Assault Nurse Examiner (SANE) Training Affect Attitudes of Emergency Department Nurses Toward Sexual Assault Survivors?

    PubMed

    Nielson, Mary Hugo; Strong, Linda; Stewart, Julie G

    2015-01-01

    There are over 243,800 female sexual assaults in the United States annually. Of those who seek healthcare services after being sexually assaulted, 90% present to hospitals. Unfortunately, care and services for women who have been sexually assaulted are inconsistent. Increased burnout, frustration, and feelings of inadequacy can lead healthcare providers to exhibit personal biases or negative attitudes toward their patients. The Joint Commission, responsible for accreditation of healthcare organizations, has stated that nurses must provide competent care to all patients. Therefore, Sexual Assault Nurse Examiner (SANE) training needs to be available for emergency department (ED) nurses who care for patients who have been sexually assaulted. A survey using the Attitude Toward Rape Victims Scale was sent to 1503 ED nurses throughout the United States, from the Emergency Nursing Association's mailing list. The results of the survey showed that there was a significant difference in attitudes toward the patients between SANE-trained emergency nurses and those without training. This study also showed that 35.5% of hospitals represented by the respondents did not have SANE services available for adult patients who had been sexually assaulted, and furthermore, 85.5% of the respondents who cared for adult patients who had been sexually assaulted were not SANE trained. The negative attitudes held toward such patients as found in this study, coupled with a lack of training provides evidence that ED nurses may benefit from education related to appropriate treatment for patients who have been sexually assaulted. As evidence-based practice becomes the gold standard of care, ensuring that nurses are properly trained to care for all patients must be the goal.

  8. National nursing strategies in seven countries of the Region of the Americas: issues and impact.

    PubMed

    Shasanmi, Rebecca O; Kim, Esther M; Cassiani, Silvia Helena De Bortoli

    2015-07-01

    To identify and examine the current national nursing strategies and policy impact of workforce development regarding human resources for health in seven selected countries in the Region of the Americas: Argentina, Canada, Costa Rica, Jamaica, Mexico, Peru, and the United States. A review of available literature was conducted to identify publicly-available documents that describe the general backdrop of nursing human resources in these seven countries. A keyword search of PubMed was supplemented by searches of websites maintained by Ministries of Health and nursing organizations. Inclusion criteria limited documents to those published in 2008-2013 that discussed or assessed situational issues and/or progress surrounding the nursing workforce. Nursing human resources for health is progressing. Canada, Mexico, and the United States have stronger nursing leadership in place and multisectoral policies in workforce development. Jamaica shows efforts among the Caribbean countries to promote collaborative practices in research. The three selected countries in Central and South America championed networks to revive nursing education. Yet, overall challenges limit the opportunities to impact public health. The national nursing strategies prioritized multisectoral collaboration, professional competencies, and standardized educational systems, with some countries underscoring the need to align policies with efforts to promote nursing leadership, and others, focusing on expanding the scope of practice to improve health care delivery. While each country wrestles with its specific context, all require proper leadership, multisectoral collaboration, and appropriate resources to educate, train, and empower nurses to be at the forefront.

  9. Practice pattern and professional issues of nurse practitioners in mechanical circulatory support programs in the United States: a survey report.

    PubMed

    Casida, Jesus M; Pastor, Jessica

    2012-09-01

    Few data-based reports about the role and work environment of advanced practice nurses, specifically nurse practitioners in mechanical circulatory support programs, have been published. To describe the practice pattern and professional issues confronted by nurse practitioners in the rapidly evolving and expanding mechanical circulatory support programs in the United States. A descriptive research design was employed using the data from the 2010 mechanical circulatory support nurses survey. Quantitative and qualitative data that pertained to the demographic and practice profiles as well as barriers and overall issues faced by the nurse practitioners in their clinical practice were analyzed. Nonrandom sample of 48 nurse practitioners from 95 mechanical circulatory support programs nationwide. The practice pattern of nurse practitioners in mechanical circulatory support programs is similar to the practice pattern reported for nurse practitioners in acute and critical care settings. However, only 44% and 10% of nurse practitioners in mechanical circulatory support programs are authorized to admit and transfer patients into and out of the hospital, respectively. High workload, lack of institutional support, knowledge deficit, role ambiguity, lack of professional recognition, and burnout were the common issues faced by the participants in their clinical practice. The results provide preliminary evidence on the practice pattern, restrictions, and work environment issues that may threaten the viability of an mechanical circulatory support program in which nurse practitioners play a crucial role. Implications for clinical practice, research, and policy development are discussed.

  10. Alternative methods of ophthalmic treatment in Russia.

    PubMed

    Vader, L

    1994-04-01

    Russian ophthalmic nurses and physicians are using alternative methods of treatment to supplement traditional eye care. As acupuncture and iridology become more popular in the United States, ophthalmic nurses need to be more knowledgeable about these treatments and the implications for patients.

  11. Job satisfaction among nursing staff in a military health care facility.

    PubMed

    Allgood, C; O'Rourke, K; VanDerslice, J; Hardy, M A

    2000-10-01

    Job satisfaction in the workplace affects absenteeism, turnover, and performance. We conducted a cross-sectional study of 201 nursing personnel to assess satisfaction among nursing staff at a military hospital in the southwestern United States. Participants completed a self-administered survey in which they rated professional status, autonomy, pay, organizational policies, task requirements, and interaction by importance and satisfaction. Autonomy, professional status, and pay were the most important factors and organizational policies was the least important factor. Military staff were slightly more satisfied with staff interactions than civilian staff. Nursing personnel working in specialty care units were significantly more satisfied with interactions and professional status, but they valued organizational policies less than those working in general units. Professionals were significantly more satisfied with pay and autonomy, whereas nonprofessionals were more satisfied with task requirements and professional status.

  12. 20 CFR 655.50 - Enforcement process.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Enforcement process. 655.50 Section 655.50... FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B...

  13. The Impact of Out-Migration on the Nursing Workforce in Kenya

    PubMed Central

    Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes

    2011-01-01

    Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982

  14. Planning intensive care unit design using computer simulation modeling: optimizing integration of clinical, operational, and architectural requirements.

    PubMed

    OʼHara, Susan

    2014-01-01

    Nurses have increasingly been regarded as critical members of the planning team as architects recognize their knowledge and value. But the nurses' role as knowledge experts can be expanded to leading efforts to integrate the clinical, operational, and architectural expertise through simulation modeling. Simulation modeling allows for the optimal merge of multifactorial data to understand the current state of the intensive care unit and predict future states. Nurses can champion the simulation modeling process and reap the benefits of a cost-effective way to test new designs, processes, staffing models, and future programming trends prior to implementation. Simulation modeling is an evidence-based planning approach, a standard, for integrating the sciences with real client data, to offer solutions for improving patient care.

  15. Joinng the ranks: nurses as role models.

    PubMed

    Davidhizar, Ruth

    2005-01-01

    The average age of today's nurse is 45. The average age of today's nurse educator is 55. Not only is the mean age of nurses increasing, but the United States is also facing a national nursing shortage crisis--with fewer and fewer nurses both in the field and entering the profession. Massive advertising campaigns highlighting flexible nursing opportunities, increased incentives from health care agencies in need of nurses, and newly created flexible shift opportunities for nurses include strategies aimed at addressing this shortage. Fortunately, nursing education programs are seeing an increase in applicants, and many schools of nursing are filling their slots for new students to capacity. But this problem will not be solved by solely tempting new recruits.

  16. Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective.

    PubMed

    Stayer, Debbie; Lockhart, Joan Such

    2016-07-01

    Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children's families. A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children's families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying. ©2016 American Association of Critical-Care Nurses.

  17. National nursing science priorities: Creating a shared vision.

    PubMed

    Eckardt, Patricia; Culley, Joan M; Corwin, Elizabeth; Richmond, Therese; Dougherty, Cynthia; Pickler, Rita H; Krause-Parello, Cheryl A; Roye, Carol F; Rainbow, Jessica G; DeVon, Holli A

    Nursing science is essential to advance population health through contributions at all phases of scientific inquiry. Multiple scientific initiatives important to nursing science overlap in aims and population focus. This article focused on providing the American Academy of Nursing and nurse scientists in the Unites States with a blueprint of nursing science priorities to inform a shared vision for future collaborations, areas of scientific inquiry, and resource allocation. The Science Committee convened four times and using Delphi methods identified priorities with empirical evidence and expert opinion for prioritization, state of the science, expert interest, and potential target stakeholders. Nursing science priorities for 2017 were categorized into four themes including: (a) precision science, (b) big data and data analytics, (c) determinants of health, and (d) global health. Nurse scientists can generate new knowledge in priority areas that advances the health of the world's populations. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Sustaining a culture of practice development in an acute adolescent inpatient mental health unit.

    PubMed

    Vella, Natalie; Page, Laura; Edwards, Clair; Wand, Timothy

    2014-08-01

    It is recognized that facilitating change in workplace culture is a significant challenge in healthcare service delivery. Practice development strategies and principles provide a framework for initiating and sustaining programs focused on enhancing patient-centered care by concentrating on the therapeutic attributes of nursing. However, little literature exists on explicating "what worked" in practice development programs. This paper details the processes, people, resources, and relationships that enabled the successful implementation, and led to the sustainability, of a practice development program employed in an acute adolescent mental health unit in Sydney, Australia. Following an external review of the unit, a meeting of key stakeholders was convened and subsequently an advisory panel formed to address specific issues facing nursing staff. This process resulted in the development of an educational package and adoption of the tidal model as the framework for mental health nursing practice in the unit. Clinical reasoning sessions and journal article presentations were incorporated to consolidate and maintain the change in nursing care. A planned, structured, and inclusive practice development program has transformed the nursing culture and vastly improved the care provided to adolescents presenting in acute states of distress to this mental health unit. © 2014 Wiley Periodicals, Inc.

  19. A review of basic patient rights in psychiatric care.

    PubMed

    Cady, Rebecca F

    2010-01-01

    Although patient rights is a concept that all nurse managers need to be aware of, this concept often becomes confusing when applied to patients undergoing psychiatric treatment. It is important for the nurse manager to understand the basic rights that psychiatric patients are entitled to, to best be able to help staff nurses under his/her supervision to protect these rights. The nurse manager on a psychiatric unit often serves as a reference for staff nurses, and even for physicians, when questions regarding patient rights present themselves. The nurse manager should be certain to discuss these issues with the facility's legal and risk management team to be aware of particulars of the law of the state in which the facility is located, as state laws may differ somewhat in their treatment of psychiatric patients.

  20. Are word-of-mouth communications contributing to a shortage of nephrology nurses?

    PubMed

    Wolfe, William A

    2014-01-01

    Nephrology nurse shortages have historically been viewed as a subset of the overall nursing supply in the United States. Not-here-to-fore considered as a contributing factor are the effects of word-of-mouth and Internet-based word-of-mouth communications from nurses who have had disappointing work experiences in hemodialysis clinics. This article discusses the potential effects of word-of-mouse communications and posits that negative word-of-mouse communications may discourage new and experienced nurses from considering the specialty of nephrology nursing, thus contributing to a nephrology nursing shortage.

  1. Praise matters: the influence of nurse unit managers' praise on nurses' practice, work environment and job satisfaction: a questionnaire study.

    PubMed

    Sveinsdóttir, Herdís; Ragnarsdóttir, Erla Dögg; Blöndal, Katrín

    2016-03-01

    The aim of this study was to investigate the associations between praise from nurse unit managers and job satisfaction, professional practice, workload, work climate and organizational commitment of nurses caring for surgical patients. Praise influences experiences of employees. Web-based, cross-sectional explorative survey design. A structured questionnaire was used to measure praise given by nurse unit managers as perceived by nurses (n = 383; 49% response rate) working with surgical patients. Data were collected between December 2009-January 2010. Several variables assessed the major concepts under study. Binary logistic regression analysis was employed to compare nurses who receive praise very rarely/rarely as compared with very often/rather often. Praise was received often/very often by 31·6% of participants. Compared with nurses receiving praise rarely/very rarely those who received it often/rather showed more job satisfaction, stated they had more opportunities to practice professionally, described a more positive work climate and were more committed to the organization such as being proud to work at and willing to make effort for the unit and hospital. There was no difference between the groups regarding workload. Main findings of the regression analysis were that nurses display their organizational commitment by not thinking about leaving the current workplace and those who value professional recognition are likelier to receive praise than their counterparts. Nurse unit managers should praise their staff in a realistic fashion. Such praise is cost-effective, takes short time, produces positive influences on members of their staff and may improve patient safety. © 2015 John Wiley & Sons Ltd.

  2. Medical Readiness of Air Force Members Not on Deployment for Shortfall Deployments

    DTIC Science & Technology

    2001-05-01

    Thelma Mitchell, Major, United States Air Force, Nurse Corps APPROVED: _______________________________________12 April 2001...to those who greatly contributed to the initiation, process and completion of this study, especially the staff of the Graduate School of Nursing ...T. MITCHELL, BSN THESIS Presented to the Graduate School of Nursing Faculty of The Uniformed Services University of the Health Sciences in

  3. Role Expectations for United States Air Force Psychiatric Clinical Nurse Specialists.

    DTIC Science & Technology

    1986-01-01

    perspective of symbolic interactionism . Symbolic interactionism provides a matrix within which to understand how humans perceive and interact with the...theoretical framework for understanding role theory in this study is that tradition in social psychology derived from symbolic interactionism (Clayton...influence of the clinical nurse specialist. Nursing Administration Quarterly, 6(l), 53-63. Blumer, H. (1969). Symbolic interactionism : Perspective and

  4. The Registered Nurse Population, March 2000. Findings from the National Sample Survey of Registered Nurses.

    ERIC Educational Resources Information Center

    Spratley, Ernell; Johnson, Ayah; Sochalski, Julie; Fritz, Marshall; Spencer, William

    The characteristics, education, employment patterns, salaries, job satisfaction, and other characteristics of registered nurses (RNs) across the United States were examined in a national survey. Of the initial sample of approximately 54,000 of the nation's more than 3,066,000 licensed RNs, 35,579 RNs (72%) submitted usable responses. From 1980 to…

  5. A Comparison of Single-Purpose and Non-Single-Purpose Clinical Education on the Retention Rates of Registered Nursing Graduates

    ERIC Educational Resources Information Center

    Bush, Dana I.

    2012-01-01

    There are 26 single-purpose nursing programs in the United States. They are nursing programs operated by hospitals with the single purpose of supplying the hospitals with well-prepared health care staff. Using a quantitative methodology and an ex post facto design, this study compared employment retention rates between single-purpose and…

  6. International nurse recruitment in India.

    PubMed

    Khadria, Binod

    2007-06-01

    This paper describes the practice of international recruitment of Indian nurses in the model of a "business process outsourcing" of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. Despite the extremely low nurse to population ratio in India, hospital managers in India are not concerned about the growing exodus of nurses to other countries. In fact, they are actively joining forces with profitable commercial ventures that operate as both training and recruiting agencies. Most of this activity is concentrated in Delhi, Bangalore, and Kochi. Gaps in data on nursing education, employment, and migration, as well as nonstandardization of definitions of "registered nurse," impair the analysis of international migration of nurses from India, making it difficult to assess the impact of migration on vacancy rates. One thing is clear, however, the chain of commercial interests that facilitate nurse migration is increasingly well organized and profitable, making the future growth of this business a certainty.

  7. Confronting Violence, Improving Women's Lives Special Display Opens at NLM | NIH MedlinePlus the Magazine

    MedlinePlus

    ... history of nurses and nursing in relation to domestic violence and related research. Activists and reformers in the United States have long recognized the harm of domestic violence and sought to improve the lives of women ...

  8. Applying Critical Discourse Analysis in Health Policy Research: Case Studies in Regional, Organizational, and Global Health.

    PubMed

    Evans-Agnew, Robin A; Johnson, Susan; Liu, Fuqin; Boutain, Doris M

    2016-08-01

    Critical discourse analysis (CDA) is a promising methodology for policy research in nursing. As a critical theoretical methodology, researchers use CDA to analyze social practices and language use in policies to examine whether such policies may promote or impede social transformation. Despite the widespread use of CDA in other disciplines such as education and sociology, nursing policy research employing CDA methodology is sparse. To advance CDA use in nursing science, it is important to outline the overall research strategies and describe the steps of CDA in policy research. This article describes, using exemplar case studies, how nursing and health policy researchers can employ CDA as a methodology. Three case studies are provided to discuss the application of CDA research methodologies in nursing policy research: (a) implementation of preconception care policies in the Zhejiang province of China, (b) formation and enactment of statewide asthma policy in Washington state of the United States, and (c) organizational implementation of employee antibullying policies in hospital systems in the Pacific Northwest of the United States. Each exemplar details how CDA guided the examination of policy within specific contexts and social practices. The variations of the CDA approaches in the three exemplars demonstrated the flexibilities and potentials for conducting policy research grounded in CDA. CDA provides novel insights for nurse researchers examining health policy formation, enactment, and implementation. © The Author(s) 2016.

  9. 20 CFR 655.31 - Debarment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United States (H-2B Workers... a significant failure to comply with the RFI or audit process pursuant to §§ 655.23 or 655.24; (v...

  10. 20 CFR 655.75 - Decision and order of administrative law judge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and... Nursing in the United States (H-2B Workers) § 655.75 Decision and order of administrative law judge. (a... determination resulting from that process. Under no circumstances shall the administrative law judge determine...

  11. An elicitation study of critical care nurses' salient hand hygiene beliefs.

    PubMed

    Piras, Susan E; Lauderdale, Jana; Minnick, Ann

    2017-10-01

    To describe critical care nurses' hand hygiene attitudinal, normative referent, and control beliefs. Hand hygiene is the primary strategy to prevent healthcare-associated infections. Social influence is an underdeveloped hand hygiene strategy. This qualitative descriptive study was conducted with 25 ICU nurses in the southeastern United States. Data were collected using the Nurses' Salient Belief Instrument. Thematic analysis generated four themes: Hand Hygiene is Protective; Nurses look to Nurses; Time-related Concerns; and Convenience is Essential. Nurses look to nurses as hand hygiene referents and believe hand hygiene is a protective behaviour that requires time and functional equipment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Common Conditions of the Hand for the Nurse Practitioner: How to Diagnose, How to Manage, and When to Refer to a Hand Surgeon.

    PubMed

    Young, Amanda L

    In many parts of the United States, a plastics-trained hand surgeon can be in limited supply. Depending on individual state law, nurse practitioners can manage common and moderately complex hand conditions, the undertaking of which requires extensive training, high command of the anatomy, and knowing when referral is necessary.

  13. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.

    PubMed

    Mason, Virginia M; Leslie, Gail; Clark, Kathleen; Lyons, Pat; Walke, Erica; Butler, Christina; Griffin, Martha

    2014-01-01

    Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. Nurses' experience of moral distress has been measured in medical intensive care units but not in surgical trauma care units, where nurses are exposed to patients and families faced with sudden life-threatening, life-changing patient consequences.This pilot study is a nonexperimental, descriptive, correlational design to examine the effect of compassion satisfaction, compassion fatigue, moral distress, and level of nursing education on critical care nurses' work engagement. This is a partial replication of Lawrence's dissertation. The study also asked nurses to describe sources of moral distress and self-care strategies for coping with stress. This was used to identify qualitative themes about the nurse experiences. Jean Watson's theory of human caring serves as a framework to bring meaning and focus to the nursing-patient caring relationship.A convenience sample of 26 of 34 eligible experienced surgical intensive care unit trauma nurses responded to this survey, indicating a 77% response rate. Twenty-seven percent of the nurses scored high, and 73% scored average on compassion satisfaction. On compassion fatigue, 58% scored average on burnout and 42% scored low. On the secondary traumatic stress subscale, 38% scored average, and 62% scored low. The mean moral distress situations subscale score was 3.4, which is elevated. The mean 9-item Utrecht Work Engagement Scale total score, measuring work engagement, was 3.8, which is considered low.Content analysis was used to identify themes of Role Conflict With Management/Rules, Death and Suffering, Dealing With Violence in the Intensive Care Unit, Dealing With Family, Powerlessness, Physical Distress, and Medical Versus Nursing Values. Additional themes identified were caring, helping families, long-time interdependent relationships of colleagues, and satisfaction in trauma nursing.As work engagement increased, compassion satisfaction significantly increased, and burnout significantly decreased. Results of this study support moral distress as a clinically meaningful issue for surgical intensive care unit nurses. Moral distress scales were elevated, whereas work engagement scales were low. This finding was congruent with Lawrence's study and may reflect ongoing need for greater supports for experienced intensive care unit nurses, from both education and management. Future recommendations for research include examining the interaction of these variables in larger samples to examine additional explanatory factors as well as strategies for self-care, motivation, and behavior change.

  14. Communications and relationships between patient and nurse in Intensive Care Unit: knowledge, knowledge of the work, knowledge of the emotional state.

    PubMed

    Foà, Chiara; Cavalli, Lisa; Maltoni, Alessia; Tosello, Nicoletta; Sangilles, Chiara; Maron, Ilaria; Borghini, Marina; Artioli, Giovanna

    2016-11-22

    In an Intensive Care Unit (ICU) the communication between nurse and patient, the core of the care, is often hindered by patient's cognitive alterations and critical situation, by devices employed for the mechanical ventilation, and by the clinical and care-giving setting. How to overcome these barriers? How is the relational and communicative approach between nurse and patient unable to express him or herself to be managed? The available literature reveals that studies on communication with difficult patients, such as those treated in ICU are currently scarce. The present research offers a contribution in this respect, through fact-finding about the knowledge acquired by professional studies or work experiences, the personal and institutional techniques implemented in regards to communication (knowledge of the work), the relational behaviours and the emotional experience with patients (knowledge of the emotional state) of nurses working in the Intensive Care Units. A semi-structured interview have been designed and submitted to 30 nurses working in fourteen Highly Specialized Centres (HUB) in Emilia Romagna, Italy. Two nurses with different years of experience in the field have been chosen for each Operating Unit. According to the interviewees paraverbal communication is the most common way to communicate with patients: different strategies are employed such as facial expression or lip movement. In any case, the nurse has the task to choose the most suitable technique according to his or her experiences, his or her knowledge and the patient him or herself. The results claim that lack of specific training on communicative aspects of care, should be combined with an attitude of being prone to listening to and understanding the needs of the patient and of his or her family as well. The interviewees declare they have a solid preparation in the bio-clinical aspect of care, but both new hired nurses and experts affirm that they need a specific training in relational and communicative aspects, proving its importance.

  15. 20 CFR 655.22 - Obligations of H-2B employers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  16. 20 CFR 655.34 - Validity of temporary labor certifications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  17. The Swedish version of the Frommelt Attitude Toward Care of the Dying scale: aspects of validity and factors influencing nurses' and nursing students' attitudes.

    PubMed

    Henoch, Ingela; Browall, Maria; Melin-Johansson, Christina; Danielson, Ella; Udo, Camilla; Johansson Sundler, Annelie; Björk, Maria; Ek, Kristina; Hammarlund, Kina; Bergh, Ingrid; Strang, Susann

    2014-01-01

    Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  18. R. Louise Mcmanus and Mildred Montag Create the Associate Degree Model for the Education of Nurses: The Right Leaders, the Right Time, the Right Place: 1947 to 1959

    ERIC Educational Resources Information Center

    McAllister, Annemarie

    2012-01-01

    The development of the Associate Degree model for the education of nurses (ADN) in the United States is a significant milestone for the nursing profession. The purpose of this historical study was to examine how nurse leaders developed the model in the 1950s and to explore the contextual factors that fueled the growth of the model. Emphasis was…

  19. Doctoring up the Nursing Profession: Several Factors Are Contributing to the National Nursing Shortage, but Initiatives, Perceptions and College Programs Can Nurture Industry's Growth

    ERIC Educational Resources Information Center

    Keels, Crystal L.

    2004-01-01

    For all the baby boomers who've embraced and adopted healthier lifestyles, including proper diet and exercise, there may be an even more compelling reason. If you get sick or become hospitalized, you may not have the critically needed services of a well-trained nurse. It's been widely reported that there is a nursing shortage in the United States,…

  20. Computer Decision Support Software Safely Improves Glycemic Control in the Burn Intensive Care Unit: A Randomized Controlled Clinical Study

    DTIC Science & Technology

    2011-01-01

    Program Jointly Managed by the USA MRMC, NIH, NASA, and the Juvenile Diabetes Research Foundation and Combat Casualty Care Division, United States Army...were performed in the CP group (p = 0.0003), and nursing staff compliance with CP recommendations was greater (p < 0.0001). Conclusions—Glycemic...enhanced consistency in practice, providing standardization among nursing staff. Keywords Glycemic control; hypoglycemia; computer decision support

  1. The Effect of Pay-for-Performance in Nursing Homes: Evidence from State Medicaid Programs

    PubMed Central

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2013-01-01

    Objective Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting—the implementation of P4P for nursing homes by state Medicaid agencies. Data Sources/Study Setting 2001–2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Study Design Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Principal Findings Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Conclusions Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. PMID:23398330

  2. The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.

    PubMed

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2013-08-01

    Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies. 2001-2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. © Health Research and Educational Trust.

  3. 20 CFR 655.76 - Appeal of administrative law judge decision.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United...

  4. Association of Nurse Engagement and Nurse Staffing on Patient Safety.

    PubMed

    Brooks Carthon, J Margo; Hatfield, Linda; Plover, Colin; Dierkes, Andrew; Davis, Lawrence; Hedgeland, Taylor; Sanders, Anne Marie; Visco, Frank; Holland, Sara; Ballinghoff, Jim; Del Guidice, Mary; Aiken, Linda H

    2018-06-08

    Nurse engagement is a modifiable element of the work environment and has shown promise as a potential safety intervention. Our study examined the relationship between the level of engagement, staffing, and assessments of patient safety among nurses working in hospital settings. A secondary analysis of linked cross-sectional data was conducted using survey data of 26 960 nurses across 599 hospitals in 4 states. Logistic regression models were used to examine the association between nurse engagement, staffing, and nurse assessments of patient safety. Thirty-two percent of nurses gave their hospital a poor or failing patient safety grade. In 25% of hospitals, nurses fell in the least or only somewhat engaged categories. A 1-unit increase in engagement lowered the odds of an unfavorable safety grade by 29% (P < .001). Hospitals where nurses reported higher levels of engagement were 19% (P < .001) less likely to report that mistakes were held against them. Nurses in poorly staffed hospitals were 6% more likely to report that important information about patients "fell through the cracks" when transferring patients across units (P < .001). Interventions to improve nurse engagement and adequate staffing serve as strategies to improve patient safety.

  5. Full practice authority--effecting change and improving access to care: the Nevada journey.

    PubMed

    VanBeuge, Susan S; Walker, Tomas

    2014-06-01

    In 2013, Nevada shifted from a collaborative practice model to full practice authority. Given the challenges many states still face, this article provides an outline of the evolution of the "nurse practitioner" (NP) in Nevada. Reviewing the path Nevada took toward full practice authority, we hope to provide insight including lessons learned and opposition encountered to assist other states working toward full practice authority. Literature searches were conducted on PubMed and MEDLINE. Search terms included "autonomous practice," "nurse practitioner," and "full practice authority." Healthcare reform will require nurse practitioners committed to legislative change. Nurse practitioners have the knowledge and ability to affect the legislative process and improve patients' access to care. With careful planning, full engagement, and team building, making a statute change is possible and should be seriously considered in states still struggling with collaborative relationships. Nurse practitioners are well situated to provide primary care in the United States. Removing barriers to practice through statute change will empower NPs to effect positive change in our struggling healthcare system. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.

  6. Taking charge: front-line nurse leadership development.

    PubMed

    Schwarzkopf, Ruth; Sherman, Rose O; Kiger, Anna J

    2012-04-01

    The recent Institute of Medicine (2010) report, The Future of Nursing: Leading Change, Advancing Health, included a recommendation that nurses at all levels should be prepared and enabled to lead change to advance health care in the United States. Historically, in most organizations, nursing leadership development programs have focused on nurses in management or executive roles rather than those working in front-line leadership roles. This article describes a front-line leadership development initiative developed by Tenet Healthcare Corporation and attended by 400 charge nurses. Program development, evaluation, and lessons learned that can be applied in other organizations are discussed. Copyright 2012, SLACK Incorporated.

  7. The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: results of a national survey.

    PubMed

    Mealer, Meredith; Jones, Jacqueline; Newman, Julia; McFann, Kim K; Rothbaum, Barbara; Moss, Marc

    2012-03-01

    ICU nurses are repeatedly exposed to work related stresses resulting in the development of psychological disorders including posttraumatic stress disorder and burnout syndrome. Resilience is a learnable multidimensional characteristic enabling one to thrive in the face of adversity. In a national survey, we sought to determine whether resilience was associated with healthier psychological profiles in intensive care unit nurses. Surveys were mailed to 3500 randomly selected ICU nurses across the United States and included: demographic questions, the Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and the Connor-Davidson Resilience Scale. Overall, 1239 of the mailed surveys were returned for a response rate of 35%, and complete data was available on a total of 744 nurses. Twenty-two percent of the intensive care unit nurses were categorized as being highly resilient. The presence of high resilience in these nurses was significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome (<0.001 for all comparisons). In independent multivariable analyses adjusting for five potential confounding variables, the presence of resilience was independently associated with a lower prevalence of posttraumatic stress disorder (p<0.001), and a lower prevalence of burnout syndrome (p<0.001). The presence of psychological resilience was independently associated with a lower prevalence of posttraumatic stress disorder and burnout syndrome in intensive care unit nurses. Future research is needed to better understand coping mechanisms employed by highly resilient nurses and how they maintain a healthier psychological profile. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Catalog of Completed Health Care and Dental Care Studies, December 1988

    DTIC Science & Technology

    1989-12-01

    Care Nurses American Nurses’ Association American Nurses’ Foundation Association of Military Surgeons Association of the United States Army California...Applied Psychology Society of Military Surgeons American Association for the Advancement of Science Association for the Advancement of Psychology... Satisfaction and Retention AD A067592 (HCSD Report No. 78-008) Mar 79 Patient and Community Health Education Model; A Developmental and Evaluation Project

  9. What Prevents Nurses from Entering Faculty Positions Early in Their Professional Career: A Qualitative Study

    ERIC Educational Resources Information Center

    Moreland, Jack E.

    2011-01-01

    There is a nursing faculty shortage in the United States today and projections are that over the next decade nurses will retire at a rate faster than they are being replaced. The projected shortage at a time when the largest part of the population will begin to retire and enter the ranks of the elderly could potentially cause serious problems…

  10. [Contribution of the US Army Nurse Corps to the First World War].

    PubMed

    Vane, Elizabeth A P; Marble, Sanders

    2014-06-01

    A number of American nurses, on an individual basis, gave their assistance to European countries as soon as war was declared, in 1914. In 1917, when the United States entered the war, nurses from the American army arrived on the European continent before the troops. They made a major contribution to the conflict, as testified by the numerous medals they were awarded.

  11. A practical approach to labor support.

    PubMed

    Adams, Ellise D; Bianchi, Ann L

    2008-01-01

    In the United States, intrapartum nurses are present at 99% of births. These nurses have a unique opportunity to positively affect a laboring woman's comfort and labor progress through the use of labor support behaviors. These nonpharmacologic nursing strategies fall into four categories: physical, emotional, instructional/informational, and advocacy. Implementation of these strategies requires special knowledge and a commitment to the enhanced physical and emotional comfort of laboring women.

  12. Professional values, job satisfaction, career development, and intent to stay.

    PubMed

    Yarbrough, Susan; Martin, Pam; Alfred, Danita; McNeill, Charleen

    2017-09-01

    Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse-an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

  13. Evidence-based practice and research utilization activities among rural nurses.

    PubMed

    Olade, Rosaline A

    2004-01-01

    To identify the extent to which rural nurses utilize evidence-based practice guidelines from scientific research in their practice; to describe both previous and current research utilization activities in which they have participated, and to identify the specific barriers they face in their practice settings. Data for this descriptive study were collected through questionnaires with open-ended questions focused on (a) current utilization of nursing research findings, (b) previous involvement in nursing research activities, and (c) participation in medical research activities. The participants were 106 nurses from various practice areas in six rural counties of a southwestern state in the United States. Results revealed that only 20.8% of the participants stated they were currently involved in research utilization, and they were mostly nurses with bachelor's degrees. The two most common areas of current research utilization were pain management and pressure ulcer prevention and management. Barriers to research utilization, such as rural isolation and lack of nursing research consultants, were identified. The types of research utilization activities identified by these nurses indicate how much the facilities in which these nurses work in the rural areas are striving with the utilization of available scientific evidence. Rural nurses face unique barriers related to situational and geographic factors, with implications for nursing administrators, researchers, and educators.

  14. Developing a transcultural nursing leadership institute in China.

    PubMed

    Capitulo, Kathleen Leask

    2012-09-01

    Globalization has been the hallmark of the 21st century. This article focuses on developing the Transcultural Nursing Leadership Institute (TCNLI) in China. This project built a leadership program in Wenzhou, China, empowering and supporting nurses to solve problems in their own practices with evidence-based approaches and local resources using the Dreyfus International Health Foundation's method Problem Solving for Better Health (PSBH).The partnership began when I was a Visiting Professor in Wenzhou, China and established collegial relationships with the Dean of the School of Nursing and the Chief Nursing Officers of the affiliated hospitals. In contrast to previous visiting scholars who went to China to lecture on health issues, I sought to develop a sustainable program and make a lasting contribution to the nursing practice in Wenzhou. The PSBH model was the method for what became the TCNLI. The TCNLI has taught over 200 nursing leaders to develop and implement major projects and connected them to the global nursing community by facilitating joint research, publications, and education. The journeys "across the bridge" from New York to Wenzhou have taken nursing and healthcare leaders from the United States to China and reciprocally welcomed leaders from Wenzhou to the United States for professional experiences. Outcomes of our partnership include more than 200 completed change projects. International partnerships within the global healthcare community provide a vehicle to navigate the complexities of transcultural differences and ultimately a way to bridge the gap and improve global healthcare.

  15. CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States.

    PubMed

    Parmer, John; Allen, Leeanna; Walton, Wanda

    2017-08-01

    : Nurses play a critical role in the diagnosis and treatment of tuberculosis and in the prevention of tuberculosis transmission through infection control practices. To eliminate tuberculosis in the United States, however, an expanded approach to testing and treating people with latent tuberculosis infection must be implemented. Recently, the U.S. Preventive Services Task Force (USPSTF) issued a new recommendation statement on latent tuberculosis infection testing that expands nurses' opportunities to identify at-risk populations for tuberculosis prevention. In combination with newer testing methodologies and shorter treatment regimens, implementation of the USPSTF recommendation has the potential to remove previously existing barriers to screening and treatment of both patients and health care providers. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States.

  16. Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

    PubMed

    Iheduru-Anderson, Kechinyere C; Wahi, Monika M

    2018-04-01

    Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

  17. Job satisfaction of neonatal intensive care nurses.

    PubMed

    McDonald, Katie; Rubarth, Lori Baas; Miers, Linda J

    2012-08-01

    The purpose of this study was to describe the job satisfaction of neonatal intensive care unit (NICU) nurses in the Midwestern United States. The factors explored in job satisfaction were monetary compensation (pay), job stress, caring for patients in stressful situations, level of autonomy, organizational support, level of knowledge of the specialty, work environment, staffing levels, communication with physicians, communication with neonatal nurse practitioners, interdisciplinary communication, team spirit, and the amount of required "floating" to other nursing units. Participants were 109 NICU nurses working as either staff nurses (n = 72) or advanced practice nurses (n = 37). Of the participants, 96% worked in a level 3 NICU. A descriptive, correlational design was used to study job satisfaction among NICU nurses. Nurses were recruited at 2 regional NICU conferences in 2009 and 2010. The questionnaire was a researcher-developed survey consisting of 14 questions in a Likert-type response rating 1 to 5, with an area for comments. Descriptive statistics and correlations were used to analyze the resulting data. The majority of participants were moderately satisfied overall in their current position and workplace (mean ranking = 4.07 out of 5.0). Kendall's Tau b (TB) revealed that the strongest positive correlations were between organizational support and team spirit with overall job satisfaction (TB = 0.53). : The individual factors with the highest mean scores were caring for patients in a stressful situation, level of autonomy, and communication between nurses and neonatal nurse practitioners. This indicates that our population of NICU nurses feels most satisfied caring for patients in stressful situations (m = 4.48), are satisfied with their level of autonomy (M = 4.17), and are satisfied with the interdisciplinary communication in their units (m = 4.13). Nurses in the NICU are relatively satisfied with their jobs. The small sample size (n = 109) of Midwest NICU nurses proves to be a limitation for generalization. Additional research is needed to further evaluate nursing role, educational level, and job satisfaction in the NICU.

  18. Using an iPad for Basic Communication Between Spanish-Speaking Families and Nurses in Pediatric Acute Care: A Feasibility Pilot Study.

    PubMed

    Jackson, Kylie H; Mixer, Sandra J

    2017-08-01

    The growing number of Spanish speakers in the United States poses communication challenges for healthcare providers. Language barriers in pediatric acute care have been associated with an increased risk for adverse events, longer hospital stays, and decreased quality of care. In addition, clinicians' usage of interpreter services is inconsistent. In fact, nurses often lack interpreter support during daily bedside care. Nursing staff at a pediatric children's hospital in the southeastern United States identified bedside communication with Spanish-speaking patients and families as a clinical challenge. To address this challenge, a basic communication interface, UTalk version 1.0 (the author is the owner and proprietor), supported by an Apple iPad, was developed by the researcher with input from nursing staff, a certified medical interpreter, and Spanish-speaking community members. A feasibility pilot study of the interface's usability and engagement was conducted on the hospital's pediatric medical-surgical unit through qualitative interviews with nurse-family dyads. Three themes emerged from the data: UTalk-facilitated communication, UTalk needs improvement, and interpreter miscommunication. These findings indicate that a mobile digital device interface is a feasible method for augmenting bedside communication with Spanish-speaking patients and families. These results also may serve as a reference for the development of similar mobile device interfaces. Further research with a larger sample size is needed.

  19. Qualitative exploration of nurses' decisions to activate rapid response teams.

    PubMed

    Astroth, Kim S; Woith, Wendy M; Stapleton, Stephen J; Degitz, R Joseph; Jenkins, Sheryl H

    2013-10-01

    To identify barriers and facilitators to nurses' decisions regarding activation of rapid response teams (RRTs) in hospitals. Hospitalised patients in the United States who experience cardiopulmonary arrest seldom recover. Most of these patients show signs of clinical deterioration prior to cardiopulmonary arrest. RRTs have been shown to decrease the incidence of cardiopulmonary arrest by bringing needed resources to unstable patients. Despite the evidence in support of the activation of RRTs, nurses do not always use this resource. Nurses' decisions to activate or not to activate the RRT are not clearly understood. We used a qualitative design for this study. A purposive sample of 15 medical/surgical nurses was recruited from a small medical centre in the Midwest. Researchers used semistructured, open-ended questions to elicit subject responses regarding facilitators and barriers to activating RRTs. Themes emerged and were categorised as facilitators and barriers to calling the RRT. Facilitators and barriers were then subdivided into distinct subthemes: RRT characteristics and unit culture. The expertise of the RRT members and support and encouragement from nursing unit colleagues and leaders emerged as two potential facilitators. Communication of the RRT members and calling the physician first emerged as two potential barriers. We also identified educational factors that were not clearly facilitators or barriers to calling the RRT. Further study is needed using quantitative designs with larger sample sizes. Nurses can build upon knowledge of facilitators and barriers related to RRT characteristics and nursing unit culture. © 2013 Blackwell Publishing Ltd.

  20. Recommending a minimum English proficiency standard for entry-level nursing.

    PubMed

    O'Neill, Thomas R; Tannenbaum, Richard J; Tiffen, Jennifer

    2005-01-01

    When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.

  1. R. Louise McManus and Mildred Montag Create the Associate Degree Model for the Education of Nurses: The Right Leaders, the Right Time, the Right Place--1947 to 1959

    ERIC Educational Resources Information Center

    McAllister, Annemarie

    2012-01-01

    The development of the Associate Degree model for the education of nurses (ADN) in the United States is a significant milestone for the nursing profession. The purpose of this historical study was to examine how nurse leaders developed the model in the 1950s and to explore the contextual factors that fueled the growth of the model. Emphasis was…

  2. Profiling nursing resources in Australian emergency departments.

    PubMed

    Morphet, Julia; Kent, Bridie; Plummer, Virginia; Considine, Julie

    2016-02-01

    Emergency nurses have a key role in managing the large numbers of patients that attend Australian emergency departments (EDs) annually, and require adequate educational preparation to deliver safe and quality patient care. This paper provides a detailed profile of nursing resources in Australian EDs, including ED locations, annual patient attendances, nurse staffing including level of education, and educational resources. Data were collected via online surveys of emergency Nurse Unit Managers and Nurse Educators and the MyHospitals website. Data were analysed by hospital peer group and state or territory. Comparisons were made using the Kruskal-Wallis Test and Spearman Rank Order Correlation. In 2011-2012, there were a median of 36,274 patient attendances to each of the 118 EDs sampled (IQR 28,279-46,288). Most of the nurses working in EDs were Registered Nurses (95.2%). Organisations provided educational resources including Clinical Nurse Educators (80.6%), learning packages (86%) and facilitation of postgraduate study (98%), but resources, both human and educational varied substantially between states and territories. One-third of emergency nurses held a relevant postgraduate qualification (30%). There are important variations in the emergency nursing resources available between Australian states and territories. The high percentage of RNs in Australian EDs is a positive finding, however strategies to increase the percentage of nurses with relevant postgraduate qualifications are required. Copyright © 2016 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  3. Clinical education in nursing: rethinking learning in practice settings.

    PubMed

    Ironside, Pamela M; McNelis, Angela M; Ebright, Patricia

    2014-01-01

    Clinical education is a time- and resource-intensive aspect of contemporary nursing programs. Despite widespread agreement in the discipline about the centrality of clinical experiences to learning nursing, little is known about if and how current clinical experiences contribute to students' learning and readiness for practice. Before large-scale studies testing specific educational interventionals can be conducted, it is important to understand what currently occurs during clinical experiences. This study, funded by the National Council of State Boards of Nursing, examined the nature of contemporary clinical education by describing students' and faculty's experiences at three geographically diverse universities in the United States. Findings suggest that teachers' and students' focus on task completion persists and often overshadows the more complex aspects of learning nursing practice. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. A Pilot Intervention to Increase Women’s Coping Skills in Family Reintegration after Deployment in Combat Areas

    DTIC Science & Technology

    2015-04-01

    Study of Religion. Phase 2-- Quantitative Study --Completed Our hypothesis for this study was that women’s post -deployment individual and family... Post -deployment reintegration experiences • of female soldiers from national guard and reserve units in the United States. Nursing Research , 63, 5...reports and research - based studies appearing after these changes, such as that conducted with 22 Army nurses reintegrating after tours of duty in Iraq and

  5. The demise of the golden era.

    PubMed

    Inlander, C B

    1991-01-01

    As Cohen states (1991, p. 25), "The future role that nursing will play in the health care delivery system is one of many major issues faced by contemporary nursing ... Nursing must be able to determine realistically the cost of and evaluate the effectiveness of nursing care provided to its patients." A unit-based financial management committee is one very effective way of teaching the skills needed for the professional nurse to advance the practice in financial management. This will help nursing gain the professional status that they have always worked for. But beyond these very lofty ideals, a staff nurse managed financial management committee can make the nurse manager's life much easier. Staff nurses need to understand and accept the importance of managing the financial as well as the quality side of patient care. When this happens, the budget becomes theirs. Nurses develop a sense of ownership of the budget and learn how to effectively manage the unit's finances. Much staff nurse brain power is not used. Systems must be developed to access nurses' effective ideas for financial management--first in a financial management committee and then on the unit. Not only will this develop the professional status that nurses need and deserve, but it will also impact the cost of health care. In a society where the cost of an appendectomy requires Dayton Hudson to sell 39,000 Ninja Turtle action figures, Atlantic Richfield to sell 192,000 gallons of gas a day, Anheuser-Busch to sell 11,627 6-packs of 12 oz.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Better Nurse Staffing and Nurse Work Environments Associated With Increased Survival of In-Hospital Cardiac Arrest Patients

    PubMed Central

    McHugh, Matthew D.; Rochman, Monica F.; Sloane, Douglas M.; Berg, Robert A.; Mancini, Mary E.; Nadkarni, Vinay M.; Merchant, Raina M.; Aiken, Linda H.

    2015-01-01

    Background Although nurses are the most likely first responders to witness an in-hospital cardiac arrest (IHCA) and provide treatment, little research has been undertaken to determine what features of nursing are related to cardiac arrest outcomes. Objectives To determine the association between nurse staffing, nurse work environments, and IHCA survival. Research Design Cross-sectional study of data from: (1) the American Heart Association’s Get With The Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and and Patient Safety; and (3) the American Hospital Association annual survey. Logistic regression models were used to determine the association of the features of nursing and IHCA survival to discharge after adjusting for hospital and patient characteristics. Subjects A total of 11,160 adult patients aged 18 and older between 2005 and 2007 in 75 hospitals in 4 states (Pennsylvania, Florida, California, and New Jersey). Results Each additional patient per nurse on medical-surgical units was associated with a 5% lower likelihood of surviving IHCA to discharge (odds ratio = 0.95; 95% confidence interval, 0.91–0.99). Further, patients cared for in hospitals with poor work environments had a 16% lower likelihood of IHCA survival (odds ratio = 0.84; 95% confidence interval, 0.71–0.99) than patients cared for in hospitals with better work environments. Conclusions Better work environments and decreased patient-to-nurse ratios on medical-surgical units are associated with higher odds of patient survival after an IHCA. These results add to a large body of literature suggesting that outcomes are better when nurses have a more reasonable workload and work in good hospital work environments. Improving nurse working conditions holds promise for improving survival following IHCA. PMID:26783858

  7. The IOM report on the future of nursing: what perioperative nurses need to know.

    PubMed

    Battié, Renae N

    2013-09-01

    The 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, continues to be the most-viewed report in IOM history. Nearly three years after its publication, there are action coalitions of nursing and non-nursing agencies in 50 states and the District of Columbia collaborating to move the eight recommendations for action forward. There is much work to do to reshape health care delivery in the United States, and the IOM has identified nurses as key leaders in driving the reform. Every nurse must be educated on the key messages of the IOM report and become involved in moving these recommendations forward as well as in educating others on what needs to be done. AORN and perioperative nurses have a key role in voicing the unique needs of perioperative patients and in ensuring that perioperative patient care is represented in reform activities. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  8. Survey of advanced practice registered nurses disciplinary action.

    PubMed

    Hudspeth, Randall

    2007-04-02

    The nursing profession continues to struggle to find the most appropriate approach to credentialing Advanced Practice Registered Nurses (APRNs). One early step in addressing this struggle is determining the incidence of APRN disciplinary actions by boards of nursing. This article presents data from 2003 and 2004 describing the incidence of APRN disciplinary actions by United States boards of nursing. Fifty-one boards of nursing, all members of the National Council of State Boards of Nursing, were asked to report the numbers of APRN discipline cases for 2003 and 2004 which had been resolved, using a tool that differentiated disciplinary cases into four data categories: chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients. Thirty-eight (74.5%) of 51 boards of nursing reported discipline data for a total of 125,882 APRNs showing 688 disciplinary actions were taken during 2003 and 2004. This indicates that APRNs experience a low incidence of discipline related to chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients.

  9. Nursing as a Career Choice by Hispanic/Latino College Students: A Multi-Institutional Study.

    PubMed

    Stroup, Linda M; Kuk, Linda

    2015-09-01

    Despite rapid growth in the Hispanic/Latino population, there is significant underrepresentation of Hispanic/Latino individuals in the nursing workforce and nursing programs. This study investigated college students' interest in and self-efficacy for nursing as a career choice, and factors that students believe will impact their success in a nursing program. A nonexperimental, associational research study using a survey instrument was conducted at three comprehensive, public state universities and one community college in the western United States in an area with a significant Hispanic/Latino population. Descriptive and multivariable correlation statistical analysis suggested that college students' interest in and self-efficacy for nursing as a career choice was similar for both Hispanic/Latino and non-Hispanic/Latino students in the sample. Perceived facilitators for success in a nursing program were identified. Findings can be used to develop strategies and programs to enhance the success of Hispanic/Latino students interested in nursing as a career choice. Copyright 2015, SLACK Incorporated.

  10. Re-Envisioning Nurse Faculty Mentoring: Developmental Network Connections That Count

    ERIC Educational Resources Information Center

    Kennedy, Margaret Babb

    2012-01-01

    Fears surrounding the nurse faculty shortage in the United States have prompted significant emphasis on supporting novice educators and those in transition to new roles within academia through mentoring. Yet a continued focus on traditionally held notions of a hierarchical dyad limits possibilities for facilitating rich, diverse, mentoring…

  11. Recommending a Nursing-Specific Passing Standard for the IELTS Examination

    ERIC Educational Resources Information Center

    O'Neill, Thomas R.; Buckendahl, Chad W.; Plake, Barbara S.; Taylor, Lynda

    2007-01-01

    Licensure testing programs in the United States (e.g., nursing) face an increasing challenge of measuring the competency of internationally trained candidates, both in relation to their clinical competence and their English language competence. To assist with the latter, professional licensing bodies often adopt well-established and widely…

  12. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    PubMed

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  13. Psychiatric Nursing's Role in Child Abuse: Prevention, Recognition, and Treatment.

    PubMed

    Ellington, Erin

    2017-11-01

    Child abuse affects hundreds of thousands of children in the United States each year. The effects from maltreatment extend beyond the physical injuries-the lasting effects on the child's mental health can be lifelong. Psychiatric nurses have a vital role to play in the prevention, recognition, and treatment of child abuse. [Journal of Psychosocial Nursing and Mental Health Services, 55(11), 16-20.]. Copyright 2017, SLACK Incorporated.

  14. Breaking the Boundaries: Decision Factors That Lead Male Students to Enroll in Associate Degree Nursing Programs in Illinois Community Colleges

    ERIC Educational Resources Information Center

    Resurreccion, Leandro Alcovendaz

    2013-01-01

    Male nurses are but a small percentage of the total nurse population in the United States, and most certainly have potential to increase in numbers if the profession appeared more attractive as a career option for men. The purpose of this research was to discover the decision factors used by males that led them to enroll in Associate Degree…

  15. Job Satisfaction Among Family Nurse Practitioners in the United States Air Force

    DTIC Science & Technology

    1999-05-01

    role, attitude of health personnel, Herzberg, workplace, organizational culture, personnel management , workload. vi JOB SATISFACTION AMONG FAMILY NURSE...find assistance through USUHS or from the functional manager of the Family Nurse Practitioner Program. We wish you success with your research and with...Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington

  16. Perinatal Practices & Traditions Among Asian Indian Women.

    PubMed

    Goyal, Deepika

    2016-01-01

    As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.

  17. Long-term care policy for older Americans: building a continuum of care.

    PubMed

    Palley, Howard A

    2003-01-01

    This paper deals primarily with social policy considerations relevant to the development of long-term care policy for the frail elderly in the United States. However, it also includes some commentary on meeting the acute care needs of the frail elderly. It defines chronic care treatment as a mix of "short-term" and "long-term" modes of care. Furthermore, it explores the need for treatment of such long-term illnesses to recognize the importance of alternative modes of caring which include strategies, both medical and nonmedical, delivered within and outside of hospitals and nursing homes. The paper includes an analysis of public and private sector priorities based in data published by the U.S. Health Care Financing Administration. It also includes some discussion of the PACE program in the United States and some other efforts to stimulate more in-home and community-based alternatives to nursing home care. Furthermore, it includes a discussion of the policy goal of "appropriateness" in developing long-term care (as well as general health priorities) and provides a critical discussion of problems with utilizing "cost/benefit analysis." The study concludes that too exclusive a focus on nursing home care for the elderly in the United States is unfortunate-both in terms of the desires of the elderly, their families and friends and in terms of focusing on "appropriateness" as a legitimate policy goal in the development of long-term care policy for the elderly in the United States.

  18. The North American Free Trade Agreement (NAFTA) and Mexican nursing.

    PubMed

    Squires, Allison

    2011-03-01

    In the context of nurse migration, experts view trade agreements as either vehicles for facilitating migration or as contributing to brain-drain phenomena. Using a case study design, this study explored the effects of the North American Free Trade Agreement (NAFTA) on the development of Mexican nursing. Drawing results from a general thematic analysis of 48 interviews with Mexican nurses and 410 primary and secondary sources, findings show that NAFTA changed the relationship between the State and Mexican nursing. The changed relationship improved the infrastructure capable of producing and monitoring nursing human resources in Mexico. It did not lead to the mass migration of Mexican nurses to the United States and Canada. At the same time, the economic instability provoked by the peso crisis of 1995 slowed the implementation of planned advances. Subsequent neoliberal reforms decreased nurses' security as workers by minimizing access to full-time positions with benefits, and decreased wages. This article discusses the linkages of these events and the effects on Mexican nurses and the development of the profession. The findings have implications for nursing human resources policy-making and trade in services.

  19. Nurses' Perceptions and Practices Related to Alarm Management: A Quality Improvement Initiative.

    PubMed

    Cameron, Hannah L; Little, Barbara

    2018-05-01

    The purpose of this quality improvement project was to develop, implement, and assess the effects of an alarm management policy and educational program on nurses' perceptions and practices of alarm management in an acute care hospital. Nurses from an acute care hospital in the southeastern United States attended a mandatory alarm management education program. The hospital implemented the evidence-based alarm management education to achieve the NPSG.06.01.01: Alarm Management. Pre- and posttests were administered to evaluate the education and the changes in nurses' perceptions and practices of clinical alarms. A total of 417 nurses received the educational intervention. All participants completed the pretest, and 215 (51%) completed the voluntary posttest. Significant improvements were made in alarm perceptions and practices. Nurses suggested unit-specific alarm education, improved staffing, and updated equipment. Findings support the benefits of continued education in alarm management for nurses. Bedside nurses are a critical member of a multidisciplinary alarm management team because they are at the forefront of patient safety and most at risk for experiencing alarm fatigue. J Contin Educ Nurs. 2018;49(5):207-215. Copyright 2018, SLACK Incorporated.

  20. International Nurse Recruitment in India

    PubMed Central

    Khadria, Binod

    2007-01-01

    Objective This paper describes the practice of international recruitment of Indian nurses in the model of a “business process outsourcing” of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. Findings Despite the extremely low nurse to population ratio in India, hospital managers in India are not concerned about the growing exodus of nurses to other countries. In fact, they are actively joining forces with profitable commercial ventures that operate as both training and recruiting agencies. Most of this activity is concentrated in Delhi, Bangalore, and Kochi. Conclusions Gaps in data on nursing education, employment, and migration, as well as nonstandardization of definitions of “registered nurse,” impair the analysis of international migration of nurses from India, making it difficult to assess the impact of migration on vacancy rates. One thing is clear, however, the chain of commercial interests that facilitate nurse migration is increasingly well organized and profitable, making the future growth of this business a certainty. PMID:17489924

  1. Changes to nurses' practice environment over time.

    PubMed

    Roche, Michael A; Duffield, Christine; Friedman, Sarah; Twigg, Di; Dimitrelis, Sofia; Rowbotham, Samantha

    2016-07-01

    To examine changes in the nursing practice environment, retention-related factors, unit stability and patient care tasks delayed or left undone, over two periods between 2004 and 2013. Positive nurse practice environments have been linked to nurse retention and care quality outcomes. The collection of the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability and tasks delayed or not done at six acute-care hospitals across three Australian states, in two waves between 2004 and 2013; results from the two waves are compared. On average, practice environment scores declined slightly; nurses reported a greater difficulty in finding another nursing position, lower intent to leave their current job and greater instability in their current position. Rates of delayed tasks increased over the period, whereas rates of tasks left undone have decreased over the period. The decline in nurses' perceptions of the quality of the practice environment is disappointing, particularly given the protracted workforce shortages that have persisted. Significant organisational restructuring and turnover of nurse executives may have contributed to this decline. Managers need to apply existing evidence to improve nurse practice environments and manage instability. © 2016 John Wiley & Sons Ltd.

  2. The Development, Field Testing and Evaluation of Three Hierarchies of Behaviorally Stated Objectives for the Chemistry Content of a Course of Instruction in Physical Science for Pre-Service Nursing Students.

    ERIC Educational Resources Information Center

    Love, Robert Alden

    The purpose of this research was to develop hierarchies of behavioral objectives for the chemistry content of a one-semester course in physical science for preservice associate degree nursing students. Each of three content objectives was expressed by a series of behaviorally stated objectives which included a terminal objective for a unit of…

  3. A pressure ulcer and fall rate quality composite index for acute care units: A measure development study.

    PubMed

    Boyle, Diane K; Jayawardhana, Ananda; Burman, Mary E; Dunton, Nancy E; Staggs, Vincent S; Bergquist-Beringer, Sandra; Gajewski, Byron J

    2016-11-01

    Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index. Two-phase measure development study. 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors ® during the year 2013. The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. The Pressure Ulcer and Fall Rate Quality Composite Index=100-PUR-FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of physical restraint use were not associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. The Pressure Ulcer and Fall Rate Quality Composite Index is a step toward providing a more holistic perspective of unit level nursing quality than individual measures and may help nurses nursing administrators obtain a broader view of which patient care units are the higher and lower performers. Further study is needed to examine the usability of the Pressure Ulcer and Fall Rate Quality Composite Index. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. A PRESSURE ULCER AND FALL RATE QUALITY COMPOSITE INDEX FOR ACUTE CARE UNITS: A MEASURE DEVELOPMENT STUDY

    PubMed Central

    Jayawardhana, Ananda; Burman, Mary E.; Dunton, Nancy E.; Staggs, Vincent S.; Bergquist-Beringer, Sandra; Gajewski, Byron J.

    2016-01-01

    Background Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. Objective The study objective was to develop a unit-level inpatient composite nursing care quality performance index – the Pressure Ulcer and Fall Rate Quality Composite Index. Design Two-phase measure development study. Settings 5,144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013. Methods The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. Results The Pressure Ulcer and Fall Rate Quality Composite Index = 100 − PUR − FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of physical restraint use were not associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Conclusions The Pressure Ulcer and Fall Rate Quality Composite Index is a step toward providing a more holistic perspective of unit level nursing quality than individual measures and may help nurses nursing administrators obtain a broader view of which patient care units are the higher and lower performers. Further study is needed to examine the usability of the Pressure Ulcer and Fall Rate Quality Composite Index. PMID:27607602

  5. Filipino nurses in the United States: recruitment, retention, occupational stress, and job satisfaction.

    PubMed

    Hayne, Arlene N; Gerhardt, Clara; Davis, Jonathan

    2009-07-01

    Solutions to the nursing shortage in North America include the recruitment of international nurses. This descriptive study examines strategies to facilitate the cultural adaptation, job satisfaction, and perception of role and social support of a group of recruited Filipino nurses. Instruments used were the Nursing Work Index-Revised Edition and Occupation Stress Inventory-Revised Edition. Results indicated that the investment in promoting the well-being of recruits in both social and work contexts positively benefits job satisfaction and spills over into related areas of satisfaction and positive adaptation. The literature study also focuses on areas of cultural competence in the context of transcultural nursing.

  6. Academic misconduct in nursing students: behaviors, attitudes, rationalizations, and cultural identity.

    PubMed

    McCrink, Andrea

    2010-11-01

    The purpose of this study was to gain knowledge about academic misconduct in associate degree nursing students enrolled in two nursing programs in the northeastern United States. Study respondents (n = 193) identified the frequency of engagement in behaviors of misconduct in both the classroom and clinical setting and their attitudes toward the identified behaviors of misconduct, neutralization behaviors, ethical standards of the nursing profession, and the ethic of caring within the nursing profession. Findings were consistent with previous research on academic misconduct in baccalaureate nursing students. Analysis of self-reported cultural identities refuted the prevailing literature on academic misconduct across differing cultures and nations. Copyright 2010, SLACK Incorporated.

  7. Components of nurse innovation: a model from acute care hospitals.

    PubMed

    Neidlinger, S H; Drews, N; Hukari, D; Bartleson, B J; Abbott, F K; Harper, R; Lyon, J

    1992-12-01

    Components that promote nurse innovation in acute care hospitals are explicated in the Acute Care Nursing Innovation Model. Grounded in nursing care delivery systems and excellent management-organizations perspectives, nurse executives and 30 nurse "intrapreneurs" from 10 innovative hospitals spanning the United States shared their experiences and insights through semistructured, tape-recorded telephone interviews. Guided by interpretive interactionist strategies, the essential components, characteristics, and interrelationships are conceptualized and described so that others may be successful in their innovative endeavors. Successful innovation is dependent on the fit between and among the components; the better the fit, the more likely the innovation will succeed.

  8. Exploring longitudinal shifts in international nurse migration to the United States between 2003 and 2013 through a random effects panel data analysis.

    PubMed

    Squires, Allison; Ojemeni, Melissa T; Jones, Simon

    2016-06-30

    No study has examined the longitudinal trends in National Council Licensure Exam for Registered Nurse (NCLEX-RN) applicants and pass rates among internationally-educated nurses (IENs) seeking to work in the United States, nor has any analysis explored the impact of specific events on these trends, including changes to the NCLEX-RN exam, the role of the economic crisis, or the passing of the WHO Code on the International Recruitment of Health Personnel. This study seeks to understand the impact of the three aforementioned factors that may be influencing current and future IEN recruitment patterns in the United States. In this random effects panel data analysis, we analyzed 11 years (2003-2013) of annual IEN applicant numbers and pass rates for registered nurse credentialing. Data were obtained from publicly available reports on exam pass rates. With the global economic crisis and NCLEX-RN changes in 2008 coupled with the WHO Code passage in 2010, we sought to compare if (1) the number of applicants changed significantly after those 2 years and (2) if pass rates changed following exam modifications implemented in 2008 and 2011. A total of 177 countries were eligible for inclusion in this analysis, representing findings from 200,453 IEN applicants to the United States between 2003 and 2013. The majority of applicants were from the Philippines (58 %) and India (11 %), with these two countries combined representing 69 % of the total. Candidates from Sub-Saharan African countries totalled 7133 (3 % of all applications) over the study period, with half of these coming from Nigeria alone. No significant changes were found in the number of candidates following the 2008 economic crisis or the 2010 WHO Code, although pass rates decreased significantly following the 2008 exam modifications and the WHO Code implementation. This study suggests that, while the WHO Code has had an influence on overall IEN migration dynamics to the United States by decreasing candidate numbers, in most cases, the WHO Code was not the single cause of these fluctuations. Indeed, the impact of the NCLEX-RN exam changes appears to exert a larger influence.

  9. Quality nursing care in the words of nurses.

    PubMed

    Burhans, Linda Maas; Alligood, Martha Raile

    2010-08-01

    This paper is a report of a study of the meaning of quality nursing care for practising nurses. Healthcare quality continues to be a subject of intense criticism and debate. Although quality nursing care is vital to patient outcomes and safety, meaningful improvements have been disturbingly slow. Analysis of quality care literature reveals that practising nurses are rarely involved in developing or defining improvement programs for quality nursing care. Therefore, two major study premises were that quality nursing care must be meaningful and relevant to nurses and that uncovering their meaning of quality nursing care could facilitate more effective improvement approaches. Using van Manen's hermeneutic phenomenology, meaning was revealed through analysis of interviews to answer the research question 'What is the lived meaning of quality nursing care for practising nurses?' Twelve nurses practising on medical or surgical adult units at general or intermediate levels of care within acute care hospitals in the United States of America were interviewed. Emerging themes were discovered through empirical and reflective analysis of audiotapes and transcripts. The data were collected in 2008. The revealed lived meaning of quality nursing care for practising nurses was meeting human needs through caring, empathetic, respectful interactions within which responsibility, intentionality and advocacy form an essential, integral foundation. Nurse managers could develop strategies that support nurses better in identifying and delivering quality nursing care reflective of responsibility, caring, intentionality, empathy, respect and advocacy. Nurse educators could modify education curricula to model and teach students the intrinsic qualities identified within these meanings of quality nursing care.

  10. Patients of the future: a survey of school nurse competencies with implications for nurse executives in the acute care settings.

    PubMed

    Newell, Mary E

    2013-01-01

    School nursing in the United States has been in existence for many decades but has become increasingly more complex, as student health needs have escalated and the role itself has expanded in scope of practice. Given the changes in health care delivery mandated by the Patient Safety and Affordable Care Reform Act, and the increasing complexity of school nursing practice, it is important to determine whether nurses who enter this area of practice are educationally prepared to do so. The objective of this study was to determine the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and whether they felt adequately prepared to effectively practice as a school nurse. The survey The Perceptions of School Nurses' Educational Preparation: Survey of Washington State School Nurses was sent to school nurses in Washington State. This was a descriptive, quantitative online survey that asked school nurses to assess their initial nursing education and whether their baccalaureate preparation adequately prepared them for this specialty role. There are a total of 17 school nurse standards, and 8 of the standards (47%) were identified as minimally achieved upon graduation. In addition, school nurses self-assessed gaps in their ongoing continuing educational needs, such as needing additional education regarding special education laws (81%), 504 accommodations (90.5%), diabetic care (76%), and delegation skills (68.6%). The findings from this study have illustrated the need for additional didactic and clinical practicum components that could be incorporated into baccalaureate nursing programs to better prepare graduates for school nursing practice in Washington State. Participants were able to identify areas in need of further education within their baccalaureate program, and also during their orientation to the role and responsibilities of a school nurse. Nurse executives must be able to use this knowledge to support staff nurses with an understanding of school nurses' increasing responsibilities to improve both inpatient care and outpatient support.

  11. A perioperative nurse's experience in Haiti.

    PubMed

    Stobinski, J X

    1999-02-01

    Haiti is a poor Caribbean nation plagued by years of political uncertainty and a wealth of unmet health care needs. A significant amount of its health care, especially for indigent people, is provided by volunteer nongovernment organizations, including military medical staff members from the United States and Canada. One perioperative nurse, who served with a US Navy surgical company in Port au Prince, Haiti, shares his impressions and experiences of providing surgical care to United Nations troops and Haitian citizens at five hospitals in the Port au Prince area.

  12. Threading needles in the dark: the effect of the physical work environment on nursing practice.

    PubMed

    Simmons, Debora; Graves, Krisanne; Flynn, Elizabeth A

    2009-01-01

    Frequently, the most critical calculations, considerations, and preparations for patient care and medication administration are made in noisy, dimly lit, and chaotic areas of the nursing unit. Healthcare has begun to recognize the impact of the physical work environment plays in the ability of humans to perform reliably and safely. This article reviews the draft guidelines recently released by the United States Pharmacopeia for public comment for the physical environment to promote safe medication administration.

  13. The History of Preconception Care: Evolving Guidelines and Standards

    PubMed Central

    Moos, Merry-K.; Curtis, Michele

    2006-01-01

    This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail. PMID:16710764

  14. A Protocol for a Prospective Study of Pregnancy Outcomes of Operating Room Nurses and Nurse Anesthetists Occupationally Exposed to Waste Anesthetic Gases as Compared to Psychiatric Nurses in the United States Air Force.

    DTIC Science & Technology

    1980-06-01

    PROSPECTIVE STUDY OF PREGNANCY’ OUTCOMES OF OPERATING ROOM NURSES AND NURSE ANESTHETISTS OCCUPATIONALLY EXPOSED TO WASTE ANESTHETIC GASES AS COMPARED O TO...tionally Exposed to Waste Anesthetic Gases 6 Pt NFONMING 0 i REP"ORT NUMBER as Cor - p4~~ oP ciar~_Njssi Ruth L. Nancarrow 9 PERFONMtNG OI-GANIZATION...human factors involved in the control of waste anesthetic gases in the operating room; Lt. Colonel Phyllis Goins, Chief, Educa- tional Methodology

  15. The American Organization of Nurse Executives and Emergency Nurses Association Guiding Principles on Mitigating Violence in the Workplace.

    PubMed

    Chappell, Stacey

    2015-01-01

    Violence in the workplace, including violence toward staff from patients and families as well as lateral violence, has become a serious safety issue for hospitals in the United States. Concerned about this issue, the Emergency Nurses Association and the American Organization of Nurse Executives convened a Day of Dialogue to discuss ways to mitigate violence in the workplace. The result of the discussion was the development of guiding principles and a toolkit to assist nurse leaders in systemically reducing lateral violence and patient and family violence in hospitals.

  16. Expanding the capacity of nursing education.

    PubMed

    Cleary, Brenda L; McBride, Angela Barron; McClure, Margaret L; Reinhard, Susan C

    2009-01-01

    Assuring a nurse workforce that is large enough and possesses the right competencies for the changing demographic and health reform scenarios of the early twenty-first century is nothing short of an imperative. Getting there will involve continual recruitment of a talented and diverse group of people and increasing nurses' progression to a more highly educated workforce, no matter where they enter the profession. These actions will enable the United States to fill vacant nursing faculty positions as we simultaneously re-create how nursing education is delivered in this country. The nation's health is dependent on the actions we now take.

  17. Communicating with Chinese American families in the NICU using the Giger and Davidhizar transcultural model.

    PubMed

    Merritt, Linda

    2013-01-01

    Having an infant admitted to the neonatal intensive care unit (NICU) can be a frightening experience for parents. However, it can be even more frightening for them when they are from a different culture and speak a different language than the health care team. Hence, a nurse needs to be culturally competent in order to provide proper care to a multicultural society. The purpose of this article is to describe how NICU nurses can communicate with one such culture, the Chinese American, the largest Asian group in the United States. A transcultural nursing model will be described to use as a guide to help the nurse. The culture, Chinese Americans, will be described to help nurses provide culturally competent care. Research studies will be presented so the reader can develop an understanding of how parents of Chinese descent perceive the care they receive. Interventions and recommendations will be presented on how to enhance communication between the nurses and this cultural group.

  18. State of the science on postpartum depression: what nurse researchers have contributed-part 2.

    PubMed

    Beck, Cheryl Tatano

    2008-01-01

    This two-part series summarizes 141 postpartum depression studies that have been conducted by nurse researchers from around the globe. Studies contributing to the knowledge base of postpartum depression were conducted in the following nine countries: United States, Australia, Canada, China (Hong Kong, Taiwan), Finland, Iceland, Sweden, Turkey, and Malaysia. Part 1 of this series addressed the contributions of nurse researchers in the areas of epidemiology, risk factors, and transcultural perspectives related to postpartum depression. This article is Part 2, and it describes what nurse researchers have contributed to the following aspects of postpartum depression: instrumentation/screening, interventions, mother-infant interactions, family dynamics, breastfeeding, preterm births, biological factors, clinicians' knowledge, and mothers' use of health services.

  19. Time for TIGER to ROAR! Technology Informatics Guiding Education Reform.

    PubMed

    O'Connor, Siobhan; Hubner, Ursula; Shaw, Toria; Blake, Rachelle; Ball, Marion

    2017-11-01

    Information Technology (IT) continues to evolve and develop with electronic devices and systems becoming integral to healthcare in every country. This has led to an urgent need for all professions working in healthcare to be knowledgeable and skilled in informatics. The Technology Informatics Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate informatics competencies into nursing curricula and life-long learning. In 2009, TIGER developed an informatics competency framework which outlines numerous IT competencies required for professional practice and this work helped increase the emphasis of informatics in nursing education standards in the United States. In 2012, TIGER expanded to the international community to help synthesise informatics competencies for nurses and pool educational resources in health IT. This transition led to a new interprofessional, interdisciplinary approach, as health informatics education needs to expand to other clinical fields and beyond. In tandem, a European Union (EU) - United States (US) Collaboration on eHealth began a strand of work which focuses on developing the IT skills of the health workforce to ensure technology can be adopted and applied in healthcare. One initiative within this is the EU*US eHealth Work Project, which started in 2016 and is mapping the current structure and gaps in health IT skills and training needs globally. It aims to increase educational opportunities by developing a model for open and scalable access to eHealth training programmes. With this renewed initiative to incorporate informatics into the education and training of nurses and other health professionals globally, it is time for educators, researchers, practitioners and policy makers to join in and ROAR with TIGER. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care.

    PubMed

    Mejdoubi, Jamila; van den Heijkant, Silvia; Struijf, Elle; van Leerdam, Frank; HiraSing, Remy; Crijnen, Alfons

    2011-10-21

    Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s). Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Current Controlled Trials ISRCTN16131117.

  1. Emergency Department Visits by Nursing Home Residents in the United States

    PubMed Central

    Wang, Henry E.; Shah, Manish N.; Allman, Richard M.; Kilgore, Meredith

    2012-01-01

    BACKGROUND/OBJECTIVES The Emergency Department (ED) is an important source of health care for nursing home residents. The objective of this study was to characterize ED use by nursing home residents in the United States (US). DESIGN Analysis of the National Hospital Ambulatory Medical Care Survey SETTING US Emergency Departments, 2005-2008 PARTICIPANTS Individuals visiting US EDs, stratified by nursing home and non-nursing home residents. INTERVENTIONS None MEASUREMENTS We identified all ED visits by nursing home residents. We contrasted the demographic and clinical characteristics between nursing home residents and non-nursing home residents. We also compared ED resource utilization, length of stay and outcomes. RESULTS During 2005-2008, nursing home residents accounted for 9,104,735 of 475,077,828 US ED visits (1.9%; 95% CI: 1.8-2.1%). The annualized number of ED visits by nursing home residents was 2,276,184. Most nursing home residents were elderly (mean 76.7 years, 95% CI: 75.8-77.5), female (63.3%), and non-Hispanic White (74.8%). Compared with non-nursing home residents, nursing home residents were more likely have been discharged from the hospital in the prior seven days (adjusted OR 1.4, 95% CI: 1.1-1.9). Nursing home residents were more likely to present with fever (adjusted OR 1.9; 95% CI: 1.5-2.4) or hypotension (systolic blood pressure ≤90 mm Hg, OR 1.8; 95% CI: 1.5-2.2). Nursing home patients were more likely to receive diagnostic test, imaging and procedures in the ED. Almost half of nursing home residents visiting the ED were admitted to the hospital. Compared with non-nursing home residents, nursing home residents were more likely to be admitted to the hospital (adjusted OR 1.8; 95% CI 1.6-2.1) and to die (adjusted OR 2.3; 95% CI 1.6-3.3). CONCLUSIONS Nursing home residents account for over 2.2 million ED visits annually in the US. Compared with other ED patients, nursing home residents have higher medical acuity and complexity. These observations highlight the national challenges of organizing and delivering ED care to nursing home residents in the US. PMID:22091500

  2. Compassion Fatigue, Burnout, and Compassion Satisfaction Among Oncology Nurses in the United States and Canada.

    PubMed

    Wu, Stacey; Singh-Carlson, Savitri; Odell, Annie; Reynolds, Grace; Su, Yuhua

    2016-07-01

    To examine the experiences of compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada. 
. Quantitative, descriptive, nonexperimental.
. Online survey with members from the Canadian Association of Nursing Oncology and the Oncology Nursing Society.
. 486 American and 63 Canadian practicing oncology nurses.
. The Professional Quality of Life (ProQOL) scale, version 5, and modified Abendroth Demographic Questionnaire were administered through FluidSurveys™, an online data collection instrument. Chi-square tests of independence were used to investigate associations between demographic characteristics, health, personal stressors, and work-related characteristics to experiences of compassion fatigue, burnout, and compassion satisfaction. Compassion fatigue was measured using the subscales of secondary traumatic stress and burnout. 
. Compassion fatigue, burnout, and compassion satisfaction.
. Demographic characteristics were similar in American and Canadian participants, and both cohorts reported comparable levels of compassion fatigue, burnout, and compassion satisfaction. Perception of team cohesiveness within the workplace environment was found to be significant for both groups, as indicated by significant relationships in all three subscales of secondary traumatic stress, burnout, and compassion satisfaction in the ProQOL.
. Healthy and supportive work environments are imperative to nurses' health, well-being, and satisfaction. Improvements in the workplace can help prevent negative sequelae, as well as improve health outcomes for patients and nurses, decrease nurse turnover, and reduce healthcare expenditures. 
. Findings can be used to implement institutional changes, such as creating policies and guidelines for the development of preventive interventions and psychosocial support for nurses.

  3. The North American Free Trade Agreement (NAFTA) and Mexican Nursing

    PubMed Central

    2011-01-01

    In the context of nurse migration, experts view trade agreements as either vehicles for facilitating migration or as contributing to brain-drain phenomena. Using a case study design, this study explored the effects of the North American Free Trade Agreement (NAFTA) on the development of Mexican nursing. Drawing results from a general thematic analysis of 48 interviews with Mexican nurses and 410 primary and secondary sources, findings show that NAFTA changed the relationship between the State and Mexican nursing. The changed relationship improved the infrastructure capable of producing and monitoring nursing human resources in Mexico. It did not lead to the mass migration of Mexican nurses to the United States and Canada. At the same time, the economic instability provoked by the peso crisis of 1995 slowed the implementation of planned advances. Subsequent neoliberal reforms decreased nurses’ security as workers by minimizing access to full-time positions with benefits, and decreased wages. This article discusses the linkages of these events and the effects on Mexican nurses and the development of the profession. The findings have implications for nursing human resources policy-making and trade in services. PMID:20595330

  4. Applying critical theories to nursing in communities.

    PubMed

    Stevens, P E; Hall, J M

    1992-03-01

    Public health realities in the United States indicate that unsafe physical surroundings, oppressive social arrangements, economic impoverishment, and political disenfranchisement threaten the safety and well-being of countless aggregates. To affect change in health-damaging conditions, nurses are urged to join with vulnerable groups, working together to expose oppressive situations and take action. As a guide for such emancipatory practice, the use of critical theories as the conceptual basis for community health nursing is advocated.

  5. Advancing the education of nurses: a call for action.

    PubMed

    Zimmermann, Deborah T; Miner, Dianne Cooney; Zittel, Barbara

    2010-12-01

    The debate over the educational preparation of RNs has raged for over a century. In New York, chief nursing officers are partnering with academic colleagues and successfully implementing a model that standardizes education requirements, supports seamless transition from associate to baccalaureate degree programs, addresses financial barriers, and identifies expected outcomes of a more educated workforce. Nursing leaders are perfectly positioned to advance the educational standards of the profession in the United States.

  6. Validation of the Nurses' Perception of Patient Rounding Scale: An Exploratory Study of the Influence of Shift Work on Nurses' Perception of Patient Rounding.

    PubMed

    Neville, Kathleen; DiBona, Courtney; Mahler, Maureen

    2016-01-01

    Hourly rounds have re-emerged as standard practice among nurses in acute care settings, and there is the need to identify nurses' perceptions regarding this practice. Further use of the Nurses' Perception of Patient Rounding Scale (NPPRS) is needed to further validate this new instrument. In addition, there exists a dearth of literature that examines the impact of hours worked and shift on nurses' perceptions of patient rounding. The purpose of this descriptive study was to explore nurses' perception of the required practice of patient rounding, to examine the influence of nurses' shift on nurses' perception of rounding practice, and to provide additional psychometric support for the NPPRS. The NPPRS, a 42-item scale in 5-point Likert format, and a demographic information sheet were used in the study. The NPPRS yields three subscales: communication, patient benefits, and nurse benefits. Using a convenience sample of anonymous nurse participants, 76 nurses from five medical-surgical units at a medical center in the northeast corridor of the United States participated in the study. Further psychometric support for the NPPRS was demonstrated. Excellent reliability coefficients via Cronbach's alpha for the total scale (0.91) and each of the subscales were obtained. A statistically significant difference was noted among nurses working 8 hours versus 12 hours or combined 8- and 12-hour workloads. Perceptions of nurse benefits were statistically significantly higher for nurses working 8 hours. In addition, results indicated that nurses perceived rounding to be more beneficial to their own practice than to patients. Analyses revealed that leadership support was instrumental in successful rounding practice. Further support for the NPPRS was obtained through this study. Strong nursing leadership, supportive of rounding, is essential for successful rounding. Further research should examine the efficacy of nurse rounding-developed protocols specific to the shift and unit of nursing practice.

  7. Evidence-Based Practice in the United States: Challenges, Progress, and Future Directions

    PubMed Central

    Correa-de-Araujo, Rosaly

    2016-01-01

    Scientific literature demonstrates that advances in evidence-based nursing have improved systems of care and women’s health outcomes. Experts agree that nurses worldwide can play a key role in building such evidence and working with interdisciplinary health care teams and systems to accelerate its implementation. PMID:26473771

  8. Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

    ERIC Educational Resources Information Center

    Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

    2011-01-01

    Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…

  9. Developing an Impella Educational Program for the Critical Care Registered Nurse

    ERIC Educational Resources Information Center

    Jackson, Sara

    2018-01-01

    Every year, hundreds of thousands of patients have coronary angiograms performed in the United States. The Impella is a percutaneous ventricular support device that provides hemodynamic support for patients if hemodynamic instability occurs during the procedure. The critical care nurse is responsible for the recovery and management of the patient…

  10. Nurse Educators' Lived Experiences with Student Incivility

    ERIC Educational Resources Information Center

    Williamson, Myrna Milwee

    2011-01-01

    Incivility is currently a topic of concern in nursing and higher education. There is a serious and growing concern on college campuses across the United States as many forms of incivility are occurring, ranging from offensive language and rude behavior to hostility and violent behavior. The problem this study addresses is the need for specific…

  11. The Relationship between Familism and Help-Seeking with Hispanic Nursing Students

    ERIC Educational Resources Information Center

    Stearns, Cristina Perez

    2012-01-01

    Cultural mismatch between providers and patients in the United States emerges as a major factor affecting the health of minority populations. Hispanics are the largest and fastest-growing minority group and are at risk for major healthcare disparities resulting from the lack of Hispanic healthcare personnel. The dearth of Hispanic nurses in…

  12. Child Health Issues in New Zealand: An Overview

    ERIC Educational Resources Information Center

    Simmons, Darlene R.

    2007-01-01

    International travel can provide the unique opportunity to experience other cultures. For nurses, it can also provide a window through which different health care structures and services can be viewed. Many similarities and differences can be found between the country visited and the United States in terms of health issues, nursing education,…

  13. Developing human capital: what is the impact on nurse turnover?

    PubMed

    Rondeau, Kent V; Williams, Eric S; Wagar, Terry H

    2009-09-01

    To investigate the impact that increasing human capital through staff training makes on the voluntary turnover of registered nurses. Healthcare organizations in Canada, the United Kingdom, the United States, and Australia are experiencing turbulent nursing labour markets characterized by extreme staff shortages and high levels of turnover. Organizations that invest in the development of their nursing human resources may be able to mitigate high turnover through the creation of conditions that more effectively develop and utilize their existing human capital. A questionnaire was sent to the chief nursing officers of 2208 hospitals and long-term care facilities in every province and territory of Canada yielding a response rate of 32.3%. The analysis featured a three-step hierarchical regression with two sets of control variables. After controlling for establishment demographics and local labour market conditions, perceptions of nursing human capital and the level of staff training provided were modestly associated with lower levels of establishment turnover. and implications for Nursing Management The results suggest that healthcare organizations that have made greater investments in their nursing human capital are more likely to demonstrate lower levels of turnover of their registered nursing personnel.

  14. Hospital nurse wages and staffing, 1977 to 2002: cycles of shortage and surplus.

    PubMed

    Spetz, Joanne

    2004-09-01

    The author reviews the causes of nursing shortages and surpluses and examines data from California hospitals to demonstrate how these cycles are expressed in the demand for and wages of nurses. Nursing shortages have been reported cyclically for more than 50 years in the United States. There has been little data analysis demonstrating the relationship between the current shortage and changes in wages and nurse staffing. Analysis of longitudinal hospital and patient data from the California Office of Statewide Health Planning and Development. Summary statistics of patient utilization, nurse staffing, and nurse wages were computed. The data demonstrate that cyclical shortages are accompanied by higher wages and employment. This has been true in recent years. However, in medical-surgical units, hours per patient day declined between 2001 and 2002, perhaps reflecting the inability of hospitals to find more nurses to meet staffing goals. Nurse staffing per patient day and per discharge have remained stable, despite concerns about low staffing levels. Improved measures of patient care needs and studies of the precise staffing requirements for different types of patients and configurations of staff are required to make recommendations about staffing and policy.

  15. Does government oversight improve access to nursing home care? Longitudinal evidence from US counties.

    PubMed

    Howard, Larry L

    2014-01-01

    Gains in life expectancy around the world have increasingly placed pressure on governments to ensure that the elderly receive assistance with activities of daily living. This research examines the impact of government oversight of Medicaid payment policies on access to nursing home care services in the United States. Variation in price levels induced by a federal policy shift in 1997 is used to identify the effect of Medicaid reimbursements on the number of nursing homes and beds available. Court rulings prior to the policy change are used to categorically define a range of oversight treatments at the state level. Difference-in-differences estimates indicate a significant decline in access to nursing home care services for individuals living in states in which courts consistently ruled that Medicaid reimbursements did not meet the minimum standard implied by federal law. The findings suggest that nursing home care services were made more accessible through a combination of legislative and judicial oversight of Medicaid payment policies. © The Author(s) 2014.

  16. Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education.

    PubMed

    Wojnar, Danuta M; Whelan, Ellen Marie

    With the current emphasis on including registered nurses (RNs) on the primary care teams, it is essential that nursing programs prepare students for employment in these settings. This study explored the current state of prelicensure and RN-to-Bachelor of Science in Nursing (BSN) online education regarding the implementation of primary care content in the curricula. A sample of 1,409 schools and/or colleges from across the United States was invited to participate in an online survey. About 529 surveys were returned for an overall response rate of 37.5%. Summative content analysis was used to analyze survey data. Although most respondents have implemented some primary care content, some found it challenging and others have demurred from incorporating primary care content altogether. Nursing leaders and faculty in academia must collaborate with clinical partners to design and expand didactic and clinical learning experiences that emphasize primary care content in the prelicensure and RN-to-BSN education. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Does Government Oversight Improve Access to Nursing Home Care? Longitudinal Evidence From US Counties

    PubMed Central

    2014-01-01

    Gains in life expectancy around the world have increasingly placed pressure on governments to ensure that the elderly receive assistance with activities of daily living. This research examines the impact of government oversight of Medicaid payment policies on access to nursing home care services in the United States. Variation in price levels induced by a federal policy shift in 1997 is used to identify the effect of Medicaid reimbursements on the number of nursing homes and beds available. Court rulings prior to the policy change are used to categorically define a range of oversight treatments at the state level. Difference-in-differences estimates indicate a significant decline in access to nursing home care services for individuals living in states in which courts consistently ruled that Medicaid reimbursements did not meet the minimum standard implied by federal law. The findings suggest that nursing home care services were made more accessible through a combination of legislative and judicial oversight of Medicaid payment policies. PMID:25526725

  18. Safe-haven laws focus on abandoned newborns and their mothers.

    PubMed

    Kunkel, Katherine A

    2007-10-01

    In the United States, 47 states have safe-haven laws that allow a mother to relinquish her newborn infant at a hospital emergency department or a manned fire station and maintain her anonymity. In addition to anonymity, immunity from prosecution is given to the mother, provided the relinquished newborn is unharmed and meets the age specified by the state's law. This article describes safe-haven laws and how they developed, barriers to successful use, nursing implications, and the nurse's role in increasing public awareness and influencing legislative policy.

  19. Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

    PubMed

    Brewer, Barbara B; Carley, Kathleen M; Benham-Hutchins, Marge; Effken, Judith A; Reminga, Jeffrey

    2018-01-01

    The purpose of this research is to (1) investigate the impact of nursing unit design on nursing staff communication patterns and, ultimately, on patient falls in acute care nursing units; and (2) evaluate whether differences in fall rates, if found, were associated with the nursing unit physical structure (shape) or size. Nursing staff communication and nursing unit design are frequently linked to patient safety outcomes, yet little is known about the impact of specific nursing unit designs on nursing communication patterns that might affect patient falls. An exploratory longitudinal correlational design was used to measure nursing unit communication structures using social network analysis techniques. Data were collected 4 times over a 7-month period. Floor plans were used to determine nursing unit design. Fall rates were provided by hospital coordinators. An analysis of covariance controlling for hospitals resulted in a statistically significant interaction of unit shape and size (number of beds). The interaction occurred when medium- and large-sized racetrack-shaped units intersected with medium- and large-sized cross-shaped units. The results suggest that nursing unit design shape impacts nursing communication patterns, and the interaction of shape and size may impact patient falls. How those communication patterns affect patient falls should be considered when planning hospital construction of nursing care units.

  20. Nursing and Hospital Abortions in the United States, 1967-1973.

    PubMed

    Haugeberg, Karissa

    2018-03-21

    Before elective abortion was legalized nationally in 1973 with the U.S. Supreme Court decision Roe v. Wade, seventeen states and the District of Columbia liberalized their abortion statutes. While scholars have examined the history of physicians who had performed abortions before and after it was legal and of feminists' work to expand the range of healthcare choices available to women, we know relatively little about nurses' work with abortion. By focusing on the history of nursing in those states that liberalized their abortion laws before Roe, this article reveals how women who sought greater control over their lives by choosing abortion encountered medical professionals who were only just beginning to question the gendered conventions that framed labor roles in American hospitals. Nurses, whose workloads increased exponentially when abortion laws were liberalized, were rarely given sufficient training to care for abortion patients. Many nurses directed their frustrations to the women patients who sought the procedure. This essay considers how the expansion of women's right to abortion prompted nurses to question the gendered conventions that had shaped their work experiences.

  1. Nurses' attitudes toward continuing formal education: a comparison by level of education and geography.

    PubMed

    Altmann, Tanya K

    2012-01-01

    The education of nurses has an influence on patient safety and outcomes, the nursing shortage, the faculty shortage, and nurses' attitudes and actions. This article reports on a dissertation study designed to examine the attitudes of nurses, initially registered with an associate degree or diploma in nursing, toward continuing formal education. Actively licensed registered nurses in the eastern and western United States (n=535) participated. The main finding of this study was that, although nurses held positive attitudes overall, attitudes ranked barely above neutral. The findings suggest that work needs to be done to improve nurses' attitudes toward continuing formal education and research needs to be undertaken to understand what would entice nurses back to school. Implications for nursing practice and education are discussed along with suggestions for future research.

  2. Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a survey on forces, conditions and jurisdictional control.

    PubMed

    Kroezen, Marieke; Francke, Anneke L; Groenewegen, Peter P; van Dijk, Liset

    2012-08-01

    The number of Western European and Anglo-Saxon countries where nurses are legally allowed to prescribe medicines is growing. As the prescribing of medicines has traditionally been the task of the medical profession, nurse prescribing is changing the relationship between the medical and nursing professions. To gain more insight into the forces that led to the introduction of nurse prescribing of medicines in Western European and Anglo-Saxon countries, as well as into the legal, educational and organizational conditions under which nurses prescribe in these countries. Moreover, this study sought to determine which consequences nurse prescribing has for the division of jurisdictional control over prescribing between the nursing and medical professions. International survey. An email survey was sent to 60 stakeholders of professional nursing or medical associations or government bodies, at national, state or provincial level across ten Western European and Anglo-Saxon countries, namely Australia, Canada, Finland, Ireland, the Netherlands, New Zealand, Spain, Sweden, the United Kingdom and the United States of America. The survey addressed the reasons for the introduction of nurse prescribing and the conditions under which nurses are or will be prescribing medicines. The response rate was 65% (n=39). It was shown that a diversity of forces led to the introduction of nurse prescribing, and respondents from nursing and medical associations and government bodies cited different forces as being important for the introduction of nurse prescribing. Representatives of nurses' associations oftentimes emphasized the medication needs of patients living in remote geographical areas, while representatives of medical associations more often pointed to workforce shortages within the health care service. The conditions under which nurses prescribe medicines vary considerably, from countries where nurses prescribe independently to countries in which prescribing by nurses is only allowed under strict conditions and the supervision of physicians. Citing different forces as being important in the introduction of nurse prescribing can be conceived as a professional 'problem construction' in order to gain jurisdiction over the prescribing task. In most countries, nurses prescribe in a subordinate position and the jurisdiction over prescribing remains predominantly with the medical profession. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Creating a successful transcultural on-boarding program.

    PubMed

    Nease, Beth

    2009-01-01

    A diverse workforce enables an organization to reflect and respond to community diversity. With an increase in the number of nurses educated outside of the United States seeking licensure and employment within U.S. hospitals, the development of an approach to assimilate these international nurses is essential. A thorough and holistic approach will ensure an ethical and safe introduction into the U.S. nursing workforce. This article describes a program based on the hospital's nursing professional practice model that was developed to address the challenges of skill transfer, role definition, and communication.

  4. Organized music instruction as a predictor of nursing student success.

    PubMed

    Cesario, Sandra K; Cesario, Robert J; Cesario, Anthony R

    2013-01-01

    Stringent admission criteria exist for nursing programs in the United States, but better predictors of success are needed to reduce student attrition. Research indicates that organized music experiences are associated with greater academic success. This exploratory study examined the association between early music experiences and undergraduate nursing student success. Findings suggest that students with a music background were more likely to graduate, have higher grade point averages, and pass the licensure examination. Previous music education might be considered as an additional predictor of nursing student success.

  5. Increasing the linguistic competence of the nurse with limited English proficiency.

    PubMed

    Guttman, Minerva S

    2004-01-01

    Teaching linguistic competence to nursing students educated in the United States but whose families are recent immigrants is a difficult task for nurse educators. Although students may easily learn the mechanics of a new language, the cultural differences must also be addressed. In the face of the current nursing shortage, it is critically important that strategies to improve linguistic competence be incorporated into curricular efforts. This article describes integrated skills reinforcement as one academic strategy to improve reading, speaking, listening, and writing skills. Suggestions are made for incorporating and evaluating these techniques.

  6. Professional values, self-esteem, and ethical confidence of baccalaureate nursing students.

    PubMed

    Iacobucci, Trisha A; Daly, Barbara J; Lindell, Debbie; Griffin, Mary Quinn

    2013-06-01

    Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg's Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students' professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses.

  7. From bedside to classroom: the nurse educator transition model.

    PubMed

    Schoening, Anne M

    2013-01-01

    The purpose of this qualitative study was to generate a theoretical model that describes the social process that occurs during the role transition from nurse to nurse educator. Recruitment and retention of qualified nurse educators is essential in order to remedy the current staff nurse and faculty shortage in the United States, yet nursing schools face many challenges in this area. This grounded theory study utilized purposive, theoretical sampling to identify 20 nurse educators teaching in baccalaureate nursing programs in the Midwest. The Nurse Educator Transition (NET) model was created from these data.This model identifies four phases in the role transition from nurse to nurse educator: a) the Anticipatory/Expectation Phase, b) the Disorientation Phase, c) the Information-Seeking Phase, and d) the Identity Formation Phase. Recommendations include integrating formal pedagogical education into nursing graduate programs and creating evidence-based orientation and mentoring programs for novice nurse faculty.

  8. Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia.

    PubMed

    Atsalos, Christine; O'Brien, Louise; Jackson, Debra

    2007-06-01

    This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

  9. Nurses' perspectives on the intersection of safety and informed decision making in maternity care.

    PubMed

    Jacobson, Carrie H; Zlatnik, Marya G; Kennedy, Holly Powell; Lyndon, Audrey

    2013-01-01

    To explore maternity nurses' perceptions of women's informed decision making during labor and birth to better understand how interdisciplinary communication challenges might affect patient safety. Constructivist grounded theory. Four hospitals in the western United States. Forty-six (46) nurses and physicians practicing in maternity units. Data collection strategies included individual interviews and participant observation. Data were analyzed using the constant comparative method, dimensional analysis, and situational analysis (Charmaz, 2006; Clarke, 2005; Schatzman, 1991). The nurses' central action of holding off harm encompassed three communication strategies: persuading agreement, managing information, and coaching of mothers and physicians. These strategies were executed in a complex, hierarchical context characterized by varied practice patterns and relationships. Nurses' priorities and patient safety goals were sometimes misaligned with those of physicians, resulting in potentially unsafe communication. The communication strategies nurses employed resulted in intended and unintended consequences with safety implications for mothers and providers and had the potential to trap women in the middle of interprofessional conflicts and differences of opinion. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  10. Social networking in nursing education: integrative literature review.

    PubMed

    Kakushi, Luciana Emi; Évora, Yolanda Dora Martinez

    2016-01-01

    to identify the use of social networking in nursing education. integrative literature review in the databases: LILACS, IBECS, Cochrane, BDENF, SciELO, CINAHL, Scopus, PubMed, CAPES Periodicals Portal and Web of Science, using the descriptors: social networking and nursing education and the keywords: social networking sites and nursing education, carried out in April 2015. of the 489 articles found, only 14 met the inclusion and exclusion criteria. Most studies were published after 2013 (57%), originating from the United States and United Kingdom (77.8%). It was observed the use of social networking among nursing students, postgraduate students, mentors and nurses, in undergraduate programmes, hybrid education (blended-learning) and in interprofessional education. The social networking sites used in the teaching and learning process were Facebook (42.8%), Ning (28.5%), Twitter (21.4%) and MySpace (7.1%), by means of audios, videos, quizzes, animations, forums, guidance, support, discussions and research group. few experiences of the use of social networking in nursing education were found and their contributions show the numerous benefits and difficulties faced, providing resourses for the improvement and revaluation of their use in the teaching and learning process.

  11. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses.

    PubMed

    Hunsaker, Stacie; Chen, Hsiu-Chin; Maughan, Dale; Heaston, Sondra

    2015-03-01

    The purpose of this study was twofold: (a) to determine the prevalence of compassion satisfaction, compassion fatigue, and burnout in emergency department nurses throughout the United States and (b) to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty. This was a nonexperimental, descriptive, and predictive study using a self-administered survey. Survey packets including a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses throughout the United States. The ProQOL 5 scale was used to measure the prevalence of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses. Multiple regression using stepwise solution was employed to determine which variables of demographics and work-related characteristics predicted the prevalence of compassion satisfaction, compassion fatigue, and burnout. The α level was set at .05 for statistical significance. The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction among this group of emergency department nurses. The low level of manager support was a significant predictor of higher levels of burnout and compassion fatigue among emergency department nurses, while a high level of manager support contributed to a higher level of compassion satisfaction. The results may serve to help distinguish elements in emergency department nurses' work and life that are related to compassion satisfaction and may identify factors associated with higher levels of compassion fatigue and burnout. Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses may prevent emotional exhaustion and help identify interventions that will help nurses remain empathetic and compassionate professionals. © 2015 Sigma Theta Tau International.

  12. The effect of unions on the distribution of wages of hospital-employed registered nurses in the United States.

    PubMed

    Spetz, Joanne; Ash, Michael; Konstantinidis, Charalampos; Herrera, Carolina

    2011-01-01

    We estimate the impact of unionisation on the wage structure of hospital-employed registered nurses in the USA. We examine whether unions have an effect on wage differences associated with race, gender, immigration status, education and experience, as well as whether there is less unexplained wage variation among unionised nurses. In the past decade, there has been resurgence in union activity in the health care industry in the USA, particularly in hospitals. Numerous studies have found that unions are associated with higher wages. Unions may also affect the structure of wages paid to workers, by compressing the wage structure and reducing unexplained variation in wages. Cross-sectional analysis of pooled secondary data from the United States Current Population Survey, 2003-2006. Multivariate regression analysis of factors that predict wages, with models derived from labour economics. There are no wage differences associated with gender, race or immigration status among unionised nurses, but there are wage penalties for black and immigrant nurses in the non-union sector. For the most part, the pay structures of the union and non-union sectors do not significantly differ. The wage penalty associated with diploma education for non-union nurses disappears among unionised nurses. Unionised nurses receive a lower return to experience, although the difference is not statistically significant. There is no evidence that unexplained variation in wages is lower among unionised nurses. While in theory unions may rationalise wage-setting and reduce wage dispersion, we found no evidence to support this hypothesis. The primary effect of hospital unions is to raise wages. Unionisation does not appear to have other important wage effects among hospital-employed nurses. © 2010 Blackwell Publishing Ltd.

  13. Nursing shortages and international nurse migration.

    PubMed

    Ross, S J; Polsky, D; Sochalski, J

    2005-12-01

    The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

  14. Care of the Aged: Old Problems in Need of New Solutions.

    ERIC Educational Resources Information Center

    Kane, Robert; Kane, Rosalie

    The tendency in the United States to view the nursing home as an all-purpose solution to the health problems of the elderly has created a set of self-made problems: increased dependency, depression and social isolation among the aged. In the United States, unlike in many European nations, institutional care of the elderly is conceived of and…

  15. Contraceptive Care of Adolescents: Overview, Tips, Strategies, and Implications for School Nurses

    ERIC Educational Resources Information Center

    Gabzdyl, Elizabeth Mary

    2010-01-01

    The United States has one of the highest unintended pregnancy rates of all industrialized nations in the world, with 13% of those occurring among the adolescent population. In 2005, the adolescent birthrate in the United States was 40.5 per 1,000 women and increased 3% in 2006 (Martin et al., 2009). Unintended pregnancy and motherhood can have a…

  16. An Inquiry into the Factors That Contribute to Health Science Teacher Attrition and Retention

    ERIC Educational Resources Information Center

    Clarke, Wilma Lynne

    2012-01-01

    Teaching remains one of the largest occupations in the United States and accounts for 4.9% of the civilian workforce. There are over twice as many teachers as nurses (United States Bureau of Labor Statistics, 2006). The turnover rate for teachers is consistently higher than many other occupations in the nation, and this factor is driving an…

  17. Korean immigrant women's lived experience of childbirth in the United States.

    PubMed

    Seo, Jin Young; Kim, Wooksoo; Dickerson, Suzanne S

    2014-01-01

    To understand Korean immigrant women's common experiences and practices of utilizing health care services in the United States during childbirth. A qualitative interpretive phenomenological research design. Recruitment was conducted through advertisement on the MissyUSA.com website, which is the largest online community for married Korean women who live in North America. A purposive sample of 15 Korean immigrant women who experienced childbirth in the United States within the past 5 years was recruited. Data were collected using semistructured telephone interviews and were analyzed using the Heideggerian hermeneutical methodology. During childbirth in the United States, participants faced multifaceted barriers in unfamiliar sociocultural contexts yet maintained their own cultural heritages. They navigated the unfamiliar health care system and developed their own strategies to overcome barriers to health care access. Korean immigrant women actively sought health information on the Internet and through social networking during childbirth. Korean immigrant women selectively accepted new cultural beliefs with some modifications from their own cultural contexts and developed their own distinct birth cultures. Understanding a particular culture and respecting women's traditions, beliefs, and practices about their childbirth could help nurses to provide culturally sensitive care. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  18. Trends in Characteristics and Country of Origin Among Foreign-Trained Nurses in the United States, 1990 and 2000

    PubMed Central

    Polsky, Daniel; Ross, Sara J.; Brush, Barbara L.; Sochalski, Julie

    2007-01-01

    Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-trained RNs grew as a percentage of new entrants to the RN workforce, from 8.8% in 1990 to 15.2% in 2000. Compared with US-trained RNs, foreign-trained RNs were 3 times as likely to work in nursing homes and were more likely to have earned a bachelor’s degree. In 2000, 21% of foreign-trained RNs originated from low-income countries, a doubling of the rate since 1990. Conclusions. Foreign-trained RNs now account for a substantial and growing proportion of the US RN workforce. Our findings suggest foreign-trained RNs entering the United States are not of lower quality than US-trained RNs. However, growth in the proportion of RNs from low-income countries may have negative consequences in those countries. PMID:17395844

  19. Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii.

    PubMed

    Kooker, Barbara Molina; Kamikawa, Cynthia

    2011-01-01

    The purpose of this paper is to describe an assessment of a major retention initiative implemented at The Queen's Medical Center in Honolulu, Hawaii, in response to the nursing workforce shortage in the state. After tracking the situation for several years, nursing leadership at the medical centre critically analysed their registered nurse retention data. The retention rate among new nurses in their first year of employment was only 55·97%. A training programme was initiated to improve registered nurse retention and patient care outcomes with external funding from the US Health Resources and Services Administration. New nurses were supported via additional training and clinical coaches beyond the basic orientation period. Leadership skills of nurse managers were expanded to strengthen their role in retention of new nurses. Four inpatient nursing units became Magnet Pilot Units to demonstrate progress towards achievement of Magnet standards and improvement of patient outcomes. From 2005-2009, first-year-registered nurse retention improved from 55·97-68·20%; registered nurse vacancy rate decreased from 11·26-2·19%; patient satisfaction increased from 84·6-87·8%; registered nurse satisfaction-autonomy improved from 43·55-49·29; registered nurse satisfaction-decision-making went from 41·13-47·97%; and nosocomial decubitus ulcer rate decreased from 15·3-6·7% in the intensive care units. Dedicated resources and targeted activities can make a difference in outcomes for both nurses and patients. Keys to success included engaging staff, having high expectations coupled with high support, providing data to unit-level staff to measure improvements emphasising renewed accountability and maintaining the focus on quality patient care. When the goal is to provide the highest level of quality patient care, professional development of staff and managers is important to meet performance expectations and achieve target clinical goals. Improving registered nurse retention and vacancy rates while also improving patient outcomes had significant human resource and financial benefits for the organisation and contributed to achieving Magnet Recognition. © 2010 Blackwell Publishing Ltd.

  20. Nursing unit managers, staff retention and the work environment.

    PubMed

    Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen

    2011-01-01

    This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to ensure that nurse leaders receive adequate organisational support from nursing executives. © 2010 Blackwell Publishing Ltd.

  1. The moral courage of nursing students who complete advance directives with homeless persons.

    PubMed

    Nash, Woods; Mixer, Sandra J; McArthur, Polly M; Mendola, Annette

    2016-11-01

    Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. The study was approved by the Internal Review Board of the authors' university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person's dying and death, and the challenge of adequately conveying the advance directive's meaning and accurately recording a homeless person's end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings. Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service. Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants' fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes. © The Author(s) 2015.

  2. Chemical Dependency and Nursing Students: A Complicated Process Calling for Nurse Educator Involvement.

    PubMed

    Dittman, Patricia W

    2015-01-01

    Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach.

  3. Intensive Care Unit Structure Variation and Implications for Early Mobilization Practices. An International Survey.

    PubMed

    Bakhru, Rita N; McWilliams, David J; Wiebe, Douglas J; Spuhler, Vicki J; Schweickert, William D

    2016-09-01

    Early mobilization (EM) improves outcomes for mechanically ventilated patients. Variation in structure and organizational characteristics may affect implementation of EM practices. We queried intensive care unit (ICU) environment and standardized ICU practices to evaluate organizational characteristics that enable EM practice. We recruited 151 ICUs in France, 150 in Germany, 150 in the United Kingdom, and 500 in the United States by telephone. Survey domains included respondent characteristics, hospital and ICU characteristics, and ICU practices and protocols. We surveyed 1,484 ICU leaders and received a 64% response rate (951 ICUs). Eighty-eight percent of respondents were in nursing leadership roles; the remainder were physiotherapists. Surveyed ICUs were predominantly mixed medical-surgical units (67%), and 27% were medical ICUs. ICU staffing models differed significantly (P < 0.001 each) by country for high-intensity staffing, nurse/patient ratios, and dedicated physiotherapists. ICU practices differed by country, with EM practices present in 40% of French ICUs, 59% of German ICUs, 52% of U.K. ICUs, and 45% of U.S. ICUs. Formal written EM protocols were present in 24%, 30%, 20%, and 30%, respectively, of those countries' ICUs. In multivariate analysis, EM practice was associated with multidisciplinary rounds (odds ratio [OR], 1.77; P = 0.001), setting daily goals for patients (OR, 1.62; P = 0.02), presence of a dedicated physiotherapist (OR, 2.48; P < 0.001), and the ICU's being located in Germany (reference, United States; OR, 2.84; P < 0.001). EM practice was also associated with higher nurse staffing levels (1:1 nurse/patient ratio as a reference; 1:2 nurse/patient ratio OR, 0.59; P = 0.05; 1:3 nurse/patient ratio OR, 0.33; P = 0.005; 1:4 or less nurse/patient ratio OR, 0.37; P = 0.005). Those responding rarely cited ambulation of mechanically ventilated patients, use of a bedside cycle, or neuromuscular electrical stimulation as part of their EM practice. Physical therapy initiation, barriers to EM practice, and EM equipment were highly variable among respondents. International ICU structure and practice is quite heterogeneous, and several factors (multidisciplinary rounds, setting daily goals for patients, presence of a dedicated physiotherapist, country, and nurse/patient staffing ratio) are significantly associated with the practice of EM. Practice and barriers may be far different based upon staffing structure. To achieve successful implementation, whether through trials or quality improvement, ICU staffing and practice patterns must be taken into account.

  4. Health beliefs, practice, and priorities for health care of Arab Muslims in the United States.

    PubMed

    Yosef, Abdel Raheem Odeh

    2008-07-01

    The Arab Muslim population is one of the dramatically increasing minorities in the United States. In addition to other factors, religion and cultural background influence individuals' beliefs, behaviors, and attitudes toward health and illness. The author describes health beliefs and practices of the Arab Muslim population in the United States. That population is at an increased risk for several diseases and faces many barriers to accessing the American health care system. Some barriers, such as modesty, gender preference in healthcare providers, and illness causation misconceptions, arise out of their cultural beliefs and practices. Other barriers are related to the complexity of the health care system and the lack of culturally competent services within it. Nurses need to be aware of these religious and cultural factors to provide culturally competent health promotion services for this population. Nurses also need to integrate Islamic teachings into their interventions to provide appropriate care and to motivate healthy behaviors.

  5. Differences in nursing practice environment among US acute care unit types: a descriptive study.

    PubMed

    Choi, JiSun; Boyle, Diane K

    2014-11-01

    The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered to achieve an excellent nursing practice environment in all hospital units. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Delegation guided by school nursing values: comprehensive knowledge, trust, and empowerment.

    PubMed

    Gordon, Shirley C; Barry, Charlotte D

    2009-10-01

    As health care institutions in the United States respond to shrinking budgets and nursing shortages by increasing the use of unlicensed assistive personnel (UAP), school nursing practice is changing from providing direct care to supervising activities delegated to UAP. Therefore, delegation is a critical area of concern for school nurses. The purpose of this qualitative research study was to explore values guiding the delegation of health care tasks to UAP in school settings from the perspective of the school nurse. An inquiry focus group was conducted with 64 Florida school nurses. Values guiding delegation were comprehensive knowledge, trust, and empowerment. These values provided a framework for guiding the delegation process.

  7. Multisite Studies Demonstrate Positive Relationship Between Practice Environments and Smoking Cessation Counseling Evidence-Based Practices.

    PubMed

    Newhouse, Robin; Byon, Ha Do; Storkman Wolf, Emily; Johantgen, Meg

    2018-06-01

    High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices. Cross-sectional secondary analysis of survey data from two multisite studies. The sample included responses from registered nurses (N = 844) in 45 hospitals (22 rural hospitals from the Eastern United States and 23 Magnet hospitals across the United States). Linear mixed model was used to adjust intradependency among the responses of individual nurses nested within hospitals. Data were abstracted from survey responses including nurse characteristics, the Smoking Cessation Counseling Scale (SCCS), and the Practice Environment Scale-Nursing Work Index (PES). Increasing positive relationships exist between PES and SCCS total and subscales scores. Also, SCCS total scores were significantly related with favorable PES total scores (SCCS score difference of 0.26 between favorable and unfavorable PES scores, SE = .08, p = .002) controlling for other covariates. Non-White respondents (vs. White) demonstrated a positive association with SCCS total scores (difference of .18, SE = .07, p = .010), but not in advanced counseling. Nurse practice environments are positively associated with the use of evidence-based smoking cessation practices by nurses. As practice environments become more favorable, higher level counseling practices occur more often. Healthcare leaders should focus on enhancing the practice environment using a quality improvement approach and framework for evidence translation. Quality improvement initiatives should be prioritized in which high-quality evidence is available to support nursing processes. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  8. Modifiable Factors that Support Political Participation by Nurses.

    PubMed

    Woodward, Bobbi; Smart, Denise; Benavides-Vaello, Sandra

    2016-01-01

    Political participation is an opportunity for individuals to give their time and energy in such a way that it benefits others and advances relevant agendas. Political participation is a key issue for nurses because they are familiar with clinical issues that directly impact health care policies instituted at the local, state, and federal levels. Collectively, nurses also represent the largest number of health care providers in the United States and are among the most trusted health professionals. However, there are many obstacles that prevent nurses from taking a more active role in politics, creating a gap in how nurses pursue and respond to political participation, or civic engagement. The purpose of this exploratory review is to identify modifiable factors that support political participation among nurses. A review of the extant literature revealed three primary factors that promote civic engagement among nurses: (a) integration of political education in the nursing curriculum; (b) value of active psychological engagement, including a personal interest in political knowledge and information; and (c) value of collective influence such as membership in professional organizations. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The impact of cultural diversity forum on students' openness to diversity.

    PubMed

    Sanner, Susan; Baldwin, Dee; Cannella, Kathleen A S; Charles, Jennell; Parker, Lillian

    2010-01-01

    As the population demographics for the United States (U.S.) shift towards increasing diversity, it is essential that nurses provide culturally competent care. Cultural sensitivity has been identified as a major curricular element in the American Association of Colleges of Nursing's (AACN) The Essentials of Baccalaureate Education for Professional Nursing Practice. Thus it is imperative that nursing faculty use effective strategies to help nursing students develop cultural sensitivity and competence. Educational workshops focusing on cultural diversity are usually designed to increase people's cultural sensitivity. The purpose of this study was to assess the effectiveness of a cultural diversity forum on nursing students' cultural sensitivity as measured by their openness to diversity. A convenience sample of students was recruited from a public university in the southeastern United States. The workshop was designed as a forum that combined a keynote presentation, shared meal, and a small group interactional activity. Cultural sensitivity was measured using the Openness to Diversity/Challenge Scale (ODCS), and was administered to students before and after the forum. A convenience sample of 47 students agreed to participate and completed both the pretest and posttest. Following the workshop, the students had more cultural sensitivity as measured by their scores on the ODCS (Wilcoxin Signed-Rank test z= -3.286, p = 0.001). The findings suggested that an educational format like the cultural diversity forum can promote students' cultural sensitivity. Further research needs to continue to focus on the effectiveness of strategies to increase the cultural sensitivity of baccalaureate nursing students.

  10. A Capabilities Based Assessment of the United States Air Force Critical Care Air Transport Team

    DTIC Science & Technology

    2013-09-01

    usually consist of a critical care physician, critical care nurse , and respiratory therapist. A Front-end Analysis has found several problems within...critically ill and wounded. This life-saving mission is executed by CCAT teams, which usually consist of a critical care physician, critical care nurse ...ill and wounded. This life-saving mission is executed by CCAT teams, which usually consist of a critical care physician, critical care nurse , and

  11. QuickStats: Distribution of Long-Term Care Staffing* Hours,(†) by Staff Member Type and Sector - United States, 2014.

    PubMed

    2016-04-29

    In 2014, aides provided more hours of care in the major sectors of long-term care than the other staffing types shown. Aides accounted for 60% of all staffing hours in nursing homes, compared with licensed practical or vocational nurses (21%), registered nurses (13%), activities staff members (5%), and social workers (2%). Aides accounted for 75% of all staffing hours in residential care communities, in contrast to activities staff members (11%), registered nurses (7%), licensed practical or vocational nurses (6%), and social workers (1%). In adult day services centers, aides provided 41% of all staffing hours, followed by activities staff members (32%), registered nurses (12%), licensed practical or vocational nurses (9%), and social workers (6%).

  12. Mental health literacy: A cross-cultural study of American and Chinese bachelor of nursing students.

    PubMed

    Liu, W; Li, Y-M; Peng, Y

    2018-03-01

    WHAT IS KNOWN ON THE SUBJECT?: Many nursing students have inadequate preparation for practice in mental health nursing in the United States and China. The concept of mental illness has different connotations in different cultures. Studies differ from country to country concerning the influence of nursing education on students' knowledge about and attitudes towards mental disorders. There is a lack of cross-cultural research that takes a broad perspective to explore how nursing students' knowledge and beliefs about mental disorders are influenced by the culture within education and healthcare systems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Nursing students in the United States and China shared similar views on a broad range of intervention options including professional help, psychotropic medications and activity interventions for managing depression and schizophrenia. The major difference between the two nursing student groups was that the Chinese students showed more preference to occasional alcohol consumption and specialized therapies including cognitive-behavioural therapy and electroconvulsive therapy and the US students held less skepticism towards traditional and religious practices as possible treatment options for depression and schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The Chinese nursing students need to be educated about safe alcohol consumption guidelines adopted by the National Health and Family Planning Commission. The US nursing students need to increase their awareness of national practice guidelines for managing mental disorders, particularly with respect to the use of specialized therapies such as cognitive-behavioural therapy and electroconvulsive therapy. We support professional and psychosocial interventions in caring for patients with mental disorders. INTRODUCTION Nursing students in the United States and China have reported inadequate preparedness for practice in mental health nursing. It is important to investigate nursing students' mental health literacy levels for a better understanding of their practice readiness in mental health field upon completion of their education. Aim This study was aimed at developing an understanding of American and Chinese nursing students' mental health literacy regarding the effectiveness of specific interventions for managing depression and schizophrenia. Method The "Australian National Mental Health Literacy Survey" was completed by a group of 310 nursing students including 152 Americans and 158 Chinese between April 2016 and April 2017 to compare students' rated intervention options on two provided vignettes. Results The two student groups reached consensus on many intervention options. However, the Chinese students showed more preference to occasional alcohol consumption and specialized therapies and the US students held less skepticism towards traditional practices as treatment options for depression and schizophrenia. Discussion and implications for practice The findings support professional and psychosocial interventions in caring for patients with mental disorders. There is a significant need for specific education on safe alcohol consumption guidelines for Chinese nursing students and clinical practice guidelines for managing mental disorders for American nursing students. © 2017 John Wiley & Sons Ltd.

  13. Opportunities for improving patient care through lateral integration: the clinical nurse leader.

    PubMed

    Begun, James W; Tornabeni, Jolene; White, Kenneth R

    2006-01-01

    Today, healthcare organizations are faced with the growing realization that functional and professional silos within the organization are counter to the provision of efficient and effective patient care and are fertile grounds for errors or sentinel events to occur. The improvement of patient care and prevention of errors require that collaboration among professionals occur at the patient care delivery level, not just within the leadership team. A new nursing role-the clinical nurse leader, the first new nursing role advanced nationally in more than three decades--currently is under development in more than 180 pilot healthcare delivery sites across the United States and Puerto Rico. The clinical nurse leader is a master's-prepared nurse who assumes accountability for healthcare outcomes for a specific group of clients within a unit or setting through the assimilation and application of research-based information to design, implement, and evaluate client plans of care. The clinical nurse leader serves as a lateral integrator for the healthcare team and facilitates, coordinates, and oversees the care provided by the healthcare team. Healthcare administrators should seize the opportunity to work with nurses in healthcare delivery organizations to influence the early evolution and diffusion of this new role.

  14. Rapid Response Teams: Is it Time to Reframe the Questions of Rapid Response Team Measurement?

    PubMed

    Salvatierra, Gail G; Bindler, Ruth C; Daratha, Kenn B

    2016-11-01

    The purpose of this article is to present an overview of rapid response team (RRT) history in the United States, provide a review of prior RRT effectiveness research, and propose the reframing of four new questions of RRT measurement that are designed to better understand RRTs in the context of contemporary nursing practice as well as patient outcomes. RRTs were adopted in the United States because of their intuitive appeal, and despite a lack of evidence for their effectiveness. Subsequent studies used mortality and cardiac arrest rates to measure whether or not RRTs "work." Few studies have thoroughly examined the effect of RRTs on nurses and on nursing practice. An extensive literature review provided the background. Suppositions and four critical, unanswered questions arising from the literature are suggested. The results of RRT effectiveness, which have focused on patient-oriented outcomes, have been ambiguous, contradictory, and difficult to interpret. Additionally, they have not taken into account the multiple ways in which these teams have impacted nurses and nursing practice as well as patient outcomes. What happens in terms of RRT process and utilization is likely to have a major impact on nurses and nursing care on general medical and surgical wards. What that impact will be depends on what we can learn from measuring with an expanded yardstick, in order to answer the question, "Do RRTs work?" Evidence for the benefits of RRTs depends on proper framing of questions relating to their effectiveness, including the multiple ways RRTs contribute to nursing efficacy. © 2016 Sigma Theta Tau International.

  15. Clinical track faculty: merits and issues.

    PubMed

    Lee, Won-Hee; Kim, Cho Ja; Roh, Young Sook; Shin, Hyunsook; Kim, Mi Ja

    2007-01-01

    Clinical track faculty (CTF) has been in operation for more than two decades in the United States, and 12 of the top 20 schools of nursing with the highest National Institutes of Health funding in the United States have CTF in place. Yet, only limited articles have been published regarding the merits and issues related to its operation. This article examines the advantages/merits of establishing CTF in schools of nursing, discusses the qualification criteria and types of appointment for CTF, and analyzes issues related to operating CTF in Korea. A questionnaire survey and two workshops were conducted involving faculty from a college of nursing and clinical nurse managers from university-affiliated medical centers and community agencies. Most of the respondents indicated that establishing CTF was advantageous. Merits included the following: increasing reality-based clinical education and training; decreasing the reality shock of students; increasing student satisfaction; and linking education, practice, and research more effectively. Major issues were as follows: getting the approval of medical centers/universities; developing an agreement on CTF operation between the college of nursing and clinical agencies; clarifying types and criteria of appointment and promotion; and developing a statement on role and compensation policies. Most issues are similar to what U.S. schools of nursing have faced, except for the first one. In conclusion, establishing CTF in Korea appears to be highly desirable. Merits outweigh issues/concerns, and Korean nursing schools may look for an opportune time for obtaining the approval of medical centers/universities. Nursing schools in other countries that face a similar challenge of providing clinical teaching with high research performance may consider instituting CTF.

  16. Principles and practices of social entrepreneurship for nursing.

    PubMed

    Gilmartin, Mattia J

    2013-11-01

    Although social justice and action for change are among the nursing profession's core values, curricular content on social entrepreneurship for nurses is not as well developed as it is in the educational programs for students in business, engineering, or public policy. This article describes an undergraduate honors elective course in social entrepreneurship offered at New York University College of Nursing. The course uses a seminar format and incorporates content from the humanities, business, and service-learning, with the goal of promoting participants' understanding of the sources of inequality in the United States and providing the requisite skills to promote effective nursing action for social change. Copyright 2013, SLACK Incorporated.

  17. Variation in psychotropic drug use in nursing homes.

    PubMed

    Castle, N G

    1998-01-01

    Numerous studies of health service use reveal considerable variation in the degree of services provided. In this article the variation in psychotropic drug use in nursing homes is examined. First, a descriptive analysis of nursing homes with and without high levels of psychotropic drug use is provided. Second, an analysis of the determinants of high levels of psychotropic drug use in nursing homes is provided. Factors such as ownership, staffing levels, having special care units, case-mix intensity, competitiveness of the nursing home market, and the state Medicaid reimbursement rate structure are examined. The results of these analyses are discussed in terms of their policy issues.

  18. The Peace and Power Conceptual Model: An Assessment Guide for School Nurses Regarding Commercial Sexual Exploitation of Children.

    PubMed

    Fraley, Hannah E; Aronowitz, Teri

    2017-10-01

    Human trafficking is a global problem; more than half of all victims are children. In the United States (US), at-risk youth continue to attend school. School nurses are on the frontlines, presenting a window of opportunity to identify and prevent exploitation. Available papers targeting school nurses report that school nurses may lack awareness of commercial sexual exploitation and may have attitudes and misperceptions about behaviors of school children at risk. This is a theoretical paper applying the Peace and Power Conceptual Model to understand the role of school nurses in commercial sexual exploitation of children.

  19. Prayer in Clinical Practice: what does evidence support?

    PubMed

    Kim-Godwin, YeounSoo

    2013-01-01

    A Korean-born U.S. nurse educator shares a perspective on prayer in clinical settings in South Korea and asks what appropriate, ethical prayer practice should be in the United States. A review of research on prayer for health and in nursing practice is offered, concluding with evidence-based suggestions for prayer with and for patients in clinical settings.

  20. School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

    ERIC Educational Resources Information Center

    Rickard, Megan L.; Hendershot, Candace; Khubchandani, Jagdish; Price, James H.; Thompson, Amy

    2010-01-01

    Background: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. Methods: This study assessed public school…

  1. A Narrative Inquiry Using Film to Teach Critical Thinking for Associate Degree Nursing Students in the Midwestern United States

    ERIC Educational Resources Information Center

    Mackenzie, Blair Nicole

    2017-01-01

    This narrative inquiry examined how students developed critical thinking skills for nursing from viewing and discussing a commercially produced film. Community of Inquiry was the theoretical model and demonstrated the development of critical thinking when the teaching presence pulled the social presence (students) into the cognitive presence with…

  2. Can a Web-Based Course Improve Communicative Competence of Foreign-Born Nurses?

    ERIC Educational Resources Information Center

    Van Schaik, Eileen; Lynch, Emily M.; Stoner, Susan A.; Sikorski, Lorna D.

    2014-01-01

    In the years since World War II, the United States has grown increasingly dependent on foreign-born healthcare personnel at all levels of the healthcare system. Foreign-born nurses report that while they may feel clinically competent, they often feel unprepared for the use of English in the healthcare setting (Davis & Nichols, 2002; Guttman,…

  3. The Experience of African Students Studying Nursing in the United States in Relation to Their Use of Critical Thinking

    ERIC Educational Resources Information Center

    Tyson, Donald Lee

    2012-01-01

    This qualitative study explores the critical thinking experiences of African nursing students enrolled in several universities in the U.S. Using a semi-structured interview approach, twelve African students discussed their experiences using and learning a western critical thinking approach, as well as described their educational experiences in…

  4. Cost analysis of nursing home registered nurse staffing times.

    PubMed

    Dorr, David A; Horn, Susan D; Smout, Randall J

    2005-05-01

    To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.

  5. Leadership Influence: A Core Foundation for Advocacy.

    PubMed

    Shillam, Casey R; MacLean, Lola

    As the largest segment of the health care workforce, nurses have the greatest potential for advancing systems and services to improve health care delivery in the United States. This article presents a framework for nurse administrators to use in developing direct care nurses in their leadership influence competency as a means of increasing their advocacy potential. A systematic review resulted in establishing a nurse leadership influence framework based on the Kouzes and Posner leadership model. The framework includes leadership competencies by nursing professional organizations and was validated by 2 national nurse leader focus groups. Nurse administrators have the opportunity to adopt an evidence-based leadership influence framework to ensure development of advocacy competency in direct care nurses. The impact of nurse administrators systematically adopting a standardized leadership influence framework will result in setting a strong foundation for nurse advocacy. Successful long-term impacts will result in nurses skillfully integrating leadership influence and advocacy into all aspects of daily practice.

  6. Marketing nursing as a profession: integrated marketing strategies to address the nursing shortage.

    PubMed

    Somers, Mark John; Finch, Linda; Birnbaum, Dee

    2010-07-01

    The nursing shortage in the United States is at a crisis level characterized by critical shortages of highly trained nurses and of nursing faculty. Key issues in addressing these shortages include awareness and image-building, along with enhanced outreach programs. Although these issues are related to marketing theory, most studies in this area are based on a vocational choice model. This study was grounded in marketing theory and the results offer a new perspective for addressing the nursing shortage. In-depth interviews conducted with 31 first-year nursing students indicated that there were two distinct segments among nursing students: traditionals and instrumentals. Traditionals were attracted to nursing as a helping profession while instrumentals were interested in career-related rewards such as variety, mobility, and compensation. These findings were discussed in terms of building awareness and marketing programs for nursing students that are integrated across schools of nursing, private foundations and public agencies.

  7. Capturing the imagination of nurse executives in tracking the quality of nursing care.

    PubMed

    Kurtzman, Ellen T; Jennings, Bonnie M

    2008-01-01

    Nurses represent the single largest healthcare profession in the United States. A growing evidence base demonstrates nursing's direct influence on inpatient safety and healthcare outcomes. Support for nursing's essential role in quality and patient safety and mounting interest in publicly reporting performance results have led to efforts to standardized nursing-sensitive performance measures. To this end, in 2004, the National Quality Forum endorsed a set of 15 nursing-sensitive consensus standards intended for use by the public in assessing inpatient nursing care. However, until recently, only anecdotal knowledge existed regarding the implementation of these consensus standards. As a step toward better understanding the interest in and adoption of nursing performance measures, The Robert Wood Johnson Foundation funded a study that concluded in March 2007. In this article, findings from the study are summarized as they apply to nursing leadership and implications for the future role of the nurse executive.

  8. Quality of doctoral nursing education in the United Kingdom: exploring the views of doctoral students and staff based on a cross-sectional questionnaire survey.

    PubMed

    McKenna, Hugh; Keeney, Sinead; Kim, Mi Ja; Park, Chang Gi

    2014-07-01

    To evaluate the quality of doctoral education in nursing in the United Kingdom. In recent decades, doctoral education programmes in nursing are increasing worldwide. There are many reasons for this and concerns have been raised regarding the quality of provision in and across countries. To date, the quality of doctoral education on a global level has not been reported in the literature. This United Kingdom study is part of a seven country investigation into the quality of doctoral education in nursing (Australia, Japan, Korea, South Africa, Thailand, United Kingdom and United States of America). A quantitative study using a cross-sectional comparative survey design. An online survey was administered to collect the views of doctoral students and staff members on four domains: programme, faculty/staff, resource and evaluation. The study was carried out between 2010-2012. In most cases, staff perceived these more positively than students and the differences in perception were often statistically significant. Interestingly, many students rated the quality of supervision as excellent, whereas no staff member rated supervision this highly. The crucial importance of resources was confirmed in the path analysis of the four Quality of Doctoral Nursing Education domains. This demonstrates that investment in resources is much more cost-effective than investment in the other domains in relation to improving the overall quality of doctoral education in nursing. This study has wide-ranging implications for how the quality of doctoral education is monitored and enhanced. © 2013 John Wiley & Sons Ltd.

  9. Mandatory internal mobility in French hospitals: the results of imposed management practices.

    PubMed

    van Schingen, Edith; Dariel, Odessa; Lefebvre, Hélène; Challier, Marie-Pierre; Rothan-Tondeur, Monique

    2017-01-01

    To describe the impact of a mandatory internal mobility policy on nurses working in French state-funded health establishments. Public hospitals in France rely on the internal mobility of nursing staff to respond to organisational needs, to reduce costs and to increase productivity. However, there is very little data on the impact of such management practices on the nurses themselves. A cross-sectional study, including 3077 nurses from 35 hospitals in the region of Paris, was conducted. Data were collected using a validated self-assessment questionnaire. Forty per cent of French nurses are required to work in different units. This mobility differs according to individual characteristics [age (P = 0.04), length of service (P = 0.017)] and type of environment [hospital (P < 0.0001), specialty (P < 0.0001)]. We can distinguish two types of approaches for implementing a mandatory staff nurse mobility policy. The first is an event that is regular, planned and lasts for several days. The second is an event that is irregular, short and organised the day before or the day of the change. Overall, while nurses are dissatisfied with all types of mandatory unit changes, this dissatisfaction is primarily a result of the irregular mobility events. This study demonstrates the importance of implementing a planned inter-unit mobility event and proposes recommendations for this type of implementation. © 2016 John Wiley & Sons Ltd.

  10. An American tale - professional conflicts in anaesthesia in the United States: implications for the United Kingdom.

    PubMed

    Kane, M; Smith, A F

    2004-08-01

    Professional conflict between nurse anaesthetists and anaesthesiologists in the United States of America is well known in the UK but has not been explored and documented in detail. We present an account, based on critical analysis of published literature and other documentary evidence, of the historical, professional and financial factors which have led to this. In the USA, anaesthesia developed as a nursing specialty until physicians began to take on this work after the Second World War. Payment arrangements between the 1960s and the 1990s made anaesthesiology a lucrative career choice for medical graduates and this led both to considerable growth in the number of anaesthesiologists and to a strengthening of the resolve of nurse anaesthetists to retain their scope of work and preserve their professional status. Changes in payment regulations in the 1980s and 1990s threatened anaesthesiologists' income and led to re-appraisal of evidence over relative cost-effectiveness and safety of different provider models. More recently, the terms of engagement have shifted from disputes over evidence to political lobbying to promote the professional capabilities and status of each of the anaesthesia providers. Factors of relevance to possible changes in the provision of anaesthesia in the United Kingdom are highlighted.

  11. Evidence-Based Teaching Practice in Nursing Education: Faculty Perspectives and Practices.

    PubMed

    Kalb, Kathleen A; O'Conner-Von, Susan K; Brockway, Christine; Rierson, Cindy L; Sendelbach, Sue

    2015-01-01

    This national online study was conducted to describe nursing faculty perspectives and practices about evidence-based teaching practice (EBTP). Professional standards for nurse educator practice stress the importance of EBTP; however, the use of evidence by faculty in curriculum design, evaluation and educational measurement, and program development has not been reported. Nurse administrators of accredited nursing programs in the United States (N = 1,586) were emailed information about the study, including the research consent form and anonymous survey link, and invited to forward information to nursing faculty. Respondents (551 faculty and nurse administrators) described the importance of EBTP in nursing education, used multiple sources of evidence in their faculty responsibilities, and identified factors that influence their ability to use EBTP. EBTP in nursing education requires sustained institutional, administrative, and collegial support to promote faculty effectiveness and student learning.

  12. Strategic analyses in nursing schools: attracting, educating, and graduating more nursing students: part I--strengths, weaknesses, opportunities, and threats analysis.

    PubMed

    Crow, Stephen M; Hartman, Sandra J; Mahesh, Sathiadev; McLendon, Christy L; Henson, Steve W; Jacques, Paul

    2008-01-01

    The shortage of nurses in the United States remains a persistent problem. Faced with this reality, nursing programs in colleges and universities continue to struggle to expand enrollment levels to meet the spiraling demand. This research uses familiar tools in strategic management: the strengths, weaknesses, opportunities, and threats (SWOT) analysis and stakeholder analysis as initial steps to draw more students to the profession of nursing. In a 2-round modified Delphi survey, chief administrators of schools of nursing identify the main SWOT of schools of nursing and the important internal and external stakeholders that influence nursing school success. The authors of the research suggest ways to use that knowledge to increase the enrollment level of nursing students. Part I of this research focuses on the SWOT analyses.

  13. Celluloid angels: a research study of nurses in feature films 1900-2007.

    PubMed

    Stanley, David J

    2008-10-01

    This paper is a report of a study examining the influence on how nursing and nurses are portrayed in feature films made between 1900 and 2007, with a nurse as their main or a principle character and a story-line related specifically to nursing. Nurses and the nursing profession are frequently portrayed negatively or stereotypically in the media, with nurses often being portrayed as feminine and caring but not as leaders or professionals capable of autonomous practice. A mixed method approach was used to examine feature films made in the Western world. Over 36,000 feature film synopses were reviewed (via CINAHL, ProQuest and relevant movie-specific literature) for the keywords 'nurse'/'nursing'. Identified films were analysed quantitatively to determine their country of production, genre, plot(s) and other relevant data, and qualitatively to identify the emergence of themes related to the image of nurses/nursing in films. For the period from 1900 to 2007, 280 relevant feature films were identified. Most films were made in the United States of America or United Kingdom, although in recent years films have been increasingly produced in other countries. Early films portrayed nurses as self-sacrificial heroines, sex objects and romantics. More recent films increasingly portray them as strong and self-confident, professionals. Nurse-related films offer a unique insight into the image of nurses and how they have been portrayed. Nurses need to be aware of the impact the film industry has on how nurses and nursing are perceived and represented in feature films.

  14. Development of the role of public health nurses in addressing child and family poverty: a framework for action.

    PubMed

    Cohen, Benita E; Reutter, Linda

    2007-10-01

    The purpose of this paper is to invite dialogue about how public health nurses could best address child and family poverty. Their current role is reviewed and a framework for expanding this role is presented. The negative health consequences of poverty for children are well-documented worldwide. The high levels of children living in poverty in wealthy industrialized countries such as Canada should be of concern to the health sector. What role(s) can public health nurses play in addressing child and family poverty? A review of scholarly literature from Canada, the United States of America and the United Kingdom was conducted to ascertain support for public health nurses' roles in reducing poverty and its effects. We then reviewed professional standards and competencies for nursing practice in Canada. The data were collected between 2005 and 2006. Numerous nursing scholars have called for public health nurses to address the causes and consequences of poverty through policy advocacy. However, this role was less likely to be identified in professional standards and competencies, and we found little empirical evidence documenting Canadian public health nurses' efforts to engage in this role. Public health nurses' roles in relation to poverty focus primarily on assisting families living in poverty to access appropriate services rather than directing efforts at the policy level. Factors associated with this limited involvement are identified. We suggest that the conceptual framework developed by Blackburn in the United Kingdom offers direction for a more fully developed public health nursing role. Prerequisites to engaging in the strategies articulated in the framework are discussed. Given more organizational support and enhanced knowledge and skills, public health nurses could be playing a greater role in working with others to make child and family poverty history.

  15. Measurement of Quality of Nursing Practice in Congenital Cardiac Care.

    PubMed

    Connor, Jean Anne; Mott, Sandra; Green, Angela; Larson, Carol; Hickey, Patricia

    2016-03-01

    The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States. A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis. Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data. External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks. ©2016 American Association of Critical-Care Nurses.

  16. Evaluation Methods Used during the Assessment of an Academic Program at Micro-Level

    ERIC Educational Resources Information Center

    Chinembiri, France

    2017-01-01

    This paper majors on the evaluation criteria and methods used for the assessment of health education programs in the United States. The choice of the topic is dictated by the fact that there is need to improve on the quality of the graduates that the different nursing and medical institutions in the United States produce. By looking at the…

  17. Supreme Court of the United States. Southeastern Community College v. Davis. Certiorari to the United States Court of Appeals for the Fourth Circuit.

    ERIC Educational Resources Information Center

    Supreme Court of the U. S., Washington, DC.

    A suit was brought by Frances B. Davis against Southeastern Community College, which had denied her admission to its nursing program because of her serious hearing disability. (An audiologist's report indicated that she cannot understand speech directed to her except by lipreading.) She alleged that this denial constituted a violation of section…

  18. The American nursing shortage during World War I: the debate over the use of nurses' aids.

    PubMed

    Telford, Jennifer Casavant

    2010-01-01

    This article explores the history of the creation of the Army and Navy Female Nurse Corps and the debate that ensued between American nursing leaders Jane Delano, director of the Red Cross Nursing Service, M. Adelaide Nutting, president of the American Federation of Nurses, and Annie Goodrich, dean of the Army School of Nursing, over the use of untrained nurses' aids to offset the nursing shortage that resulted from the United States entry into the Great War in 1917. The recruitment of minimally or untrained nurses' aids to offset the nursing shortage of the World War I era was a logical solution for American nursing leaders who had to meet the needs for nursing personnel. The exclusion of trained African American nurses, however, was a gross oversight on the part of these leaders. Whether or not this action compromised the status of nursing as a profession is still a matter of interest. Moreover, the debate about the delivery of care by unlicensed personnel continues.

  19. Life-sustaining treatment decisions in Portuguese intensive care units: a national survey of intensive care physicians.

    PubMed

    Cardoso, Teresa; Fonseca, Teresa; Pereira, Sofia; Lencastre, Luís

    2003-12-01

    The objective of the present study was to evaluate the opinion of Portuguese intensive care physicians regarding 'do-not-resuscitate' (DNR) orders and decisions to withhold/withdraw treatment. A questionnaire was sent to all physicians working on a full-time basis in all intensive care units (ICUs) registered with the Portuguese Intensive Care Society. A total of 266 questionnaires were sent and 175 (66%) were returned. Physicians from 79% of the ICUs participated. All participants stated that DNR orders are applied in their units, and 98.3% stated that decisions to withhold treatment and 95.4% stated that decisions to withdraw treatment are also applied. About three quarters indicated that only the medical group makes these decisions. Fewer than 15% of the responders stated that they involve nurses, 9% involve patients and fewer than 11% involve patients' relatives in end-of-life decisions. Physicians with more than 10 years of clinical experience more frequently indicated that they involve nurses in these decisions (P < 0.05), and agnostic/atheist doctors more frequently involve patients' relatives in decisions to withhold/withdraw treatment (P < 0.05). When asked about who they thought should be involved, more than 26% indicated nurses, more than 35% indicated the patient and more than 25% indicated patients' relatives. More experienced doctors more frequently felt that nurses should be involved (P < 0.05), and male doctors more frequently stated that patients' relatives should be involved in DNR orders (P < 0.05). When a decision to withdraw treatment is made, 76.8% of 151 respondents indicated that they would initiate palliative care; no respondent indicated that they would administer drugs to accelerate the expected outcome. The probability of survival from the acute episode and patients' wishes were the most important criteria influencing end-of-life decisions. These decisions are made only by the medical group in most of the responding ICUs, with little input from nursing staff, patients, or patients' relatives, although many respondents expressed a wish to involve them more in this process. Sex, experience and religious beliefs of the respondents influences the way in which these decisions are made.

  20. The nursing work environment and quality of care: A cross-sectional study using the Essentials of Magnetism II Scale in England.

    PubMed

    Oshodi, Titilayo O; Crockett, Rachel; Bruneau, Benjamin; West, Elizabeth

    2017-09-01

    To explore the structure of the Essentials of Magnetism II (EOMII) scale using data from nurses working in England; and to describe the impact of different aspects of the nursing work environment on nurse-assessed care quality (NACQ). The EOMII Scale was developed in the United States to measure nursing work environments. It has been widely used in the United States and in a number of other countries, but has not yet been used in the UK. Cross-sectional study. Registered nurses (n = 247) providing direct patient care in two National Health Service hospitals in England completed the EOMII scale and a single-item measuring NACQ. Principal components analysis was used to assess the structure of the scale. Correlation and regression analyses were used to describe the relationships between factors and NACQ. A solution with explanatory variance of 45.25% was identified. Forty items loaded on five factors, with satisfactory consistency: (i) ward manager support; (ii) working as a team; (iii) concern for patients; (iv) organisational autonomy; and (v) constraints on nursing practice. While in univariate analyses, each of the factors was significantly associated with NACQ, in multivariate analyses, the relationship between organisational autonomy and NACQ no longer reached significance. However, a multiple mediation model indicated that the effect of organisational autonomy on NACQ was mediated by nurse manager support, working as a team and concern for patients but not constraints on nursing practice. Subscales of the EOMII identified in an English sample of nurses measured important aspects of the nursing work environment, each of which is related to NACQ. The EOMII could be a very useful tool for measuring aspects of the nursing work environment in the English Trusts particularly in relation to the quality of care. © 2017 John Wiley & Sons Ltd.

  1. Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

    PubMed

    Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

    2010-10-01

    The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  2. 20 CFR 655.81 - Application filing transition.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United... intended employment prior to the effective date of these regulations, the SWAs shall continue to process...

  3. 20 CFR 655.1 - Purpose and scope of subpart A.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United... governing the labor certification process for the temporary employment of nonimmigrant foreign workers in...

  4. [Nursing interventions on the physical environment of Neonatal Intensive Care Units].

    PubMed

    Miquel Capó Rn, I

    2016-01-01

    The objectives of this study are to analyse nursing interventions regarding noise and lighting that influence neurodevelopment of the preterm infant in the Neonatal Intensive Care Unit. A review of the literature was performed using the databases: Cuiden Plus, PubMed, IBECS and Cochrane Library Plus. The inclusion and exclusion criteria were established in accordance with the objectives and limits used in each database. Of the 35 articles used, most were descriptive quantitative studies based on the measurement of sound pressure levels and lighting in the Neonatal Intensive Care Units. The countries included in this study are Brazil and the United States, and the variables analysed were the recording the times of light and noise. Based on the high levels of light and noise recorded in the Neonatal Intensive Care Units, nursing interventions that should be carried out to reduce them are described. The evidence indicates that after the implementation of these interventions, the high levels of both environmental stimuli are reduced significantly. Despite the extensive literature published on this problem, the levels of light and noise continue to exceed the recommended limits. Therefore, nurses need to increase and enhance their efforts in this environment, in order to positively influence neurodevelopment of premature newborn. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  5. Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study.

    PubMed

    Shuman, Clayton J; Liu, Xuefeng; Aebersold, Michelle L; Tschannen, Dana; Banaszak-Holl, Jane; Titler, Marita G

    2018-04-25

    Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units. A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05. Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not. Nurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.

  6. Trust Development With the Spanish-Speaking Mexican American Patient: A Grounded Theory Study.

    PubMed

    Jones, Sharon M

    2018-06-01

    Interpersonal trust between patient and nurse is important in patient-centered care. Trust development may be more difficult if the patient and nurse do not speak the same language. In this grounded theory study, Spanish-speaking Mexican American adults ( n = 20) hospitalized on a medical-surgical or obstetric unit in the Midwestern United States were interviewed. Through data analysis, a model of how trust develops between nurse and patient revealed eight categories and the core category Caring for Me Well Even When Not Understanding Me. The beginning phase had four categories: Asking for Help, Bothering, Communicating, and Understanding. The middle phase had two categories: Platicando (chatting) and Being Available. The end point category was Having Trust, and outcomes were Feeling Comfortable and Feeling Supported. The language barrier was a hindrance to trust development but the nurse's way of being (personality) was more important. Therefore, the patient did develop trust with nurses who did not speak Spanish.

  7. Work experience, work environment, and blood exposure among home care and hospice nurses.

    PubMed

    Leiss, Jack K

    2012-01-01

    Blood exposure rates among home care and hospice nurses (RNs) in the United States are markedly lower for nurses with more home care/hospice experience, whether or not they have more total years of nursing experience (i.e., in other work environments). This study examined whether the protective effect of home care/hospice experience was greater for nurses who worked under three types of circumstances that are typical of the home care/hospice work environment and conducive to blood exposure. A mail survey was conducted in 2006 among home care/hospice nurses in North Carolina, a largely rural state in the southeastern U.S. The adjusted response rate was 69% (n=833). Blood exposure rates were higher among nurses with ≤5 years' experience in home care/hospice. Contrary to expectations, the protective effect of more experience was greater among nurses who did not have limited access to safety devices/personal protective equipment, did not have to rush during home visits, and did not often visit homes with unrestrained pets, unruly children, poor lighting, or extreme clutter. These results suggest that characteristics of the home care/hospice work environment limit nurses' ability to use their experience to prevent blood exposure.

  8. Nursing home quality and financial performance: does the racial composition of residents matter?

    PubMed

    Chisholm, Latarsha; Weech-Maldonado, Robert; Laberge, Alex; Lin, Feng-Chang; Hyer, Kathryn

    2013-12-01

    To examine the effects of the racial composition of residents on nursing homes' financial and quality performance. The study examined Medicare and Medicaid-certified nursing homes across the United States that submitted Medicare cost reports between the years 1999 and 2004 (11,472 average per year). Data were obtained from the Minimum Data Set, the On-Line Survey Certification and Reporting, Medicare Cost Reports, and the Area Resource File. Panel data regression with random intercepts and negative binomial regression were conducted with state and year fixed effects. Financial and quality performance differed between nursing homes with high proportions of black residents and nursing homes with no or medium proportions of black residents. Nursing homes with no black residents had higher revenues and higher operating margins and total profit margins and they exhibited better processes and outcomes than nursing homes with high proportions of black residents. Nursing homes' financial viability and quality of care are influenced by the racial composition of residents. Policy makers should consider initiatives to improve both the financial and quality performance of nursing homes serving predominantly black residents. © Health Research and Educational Trust.

  9. Medical marijuana: Legal and regulatory considerations.

    PubMed

    Kaplan, Louise

    2015-10-16

    Nearly half of the United States has legalized medical marijuana. Advanced practice registered nurses (APRNs) in six states can authorize patients for medical marijuana use. Knowledge of legal and regulatory aspects of medical marijuana laws will protect an APRN's license and the public.

  10. Comparing Smoking Cessation Outcomes in Nurse-Led and Physician-Led Primary Care Visits.

    PubMed

    Byers, Marcia A; Wright, Patricia; Tilford, John Mick; Nemeth, Lynne S; Matthews, Ellyn; Mitchell, Anita

    Smoking is a significant public health concern in the United States, yet 50% of patients do not receive recommended tobacco use screening and counseling. This project compared smoking cessation rates in newly reimbursable nurse-led wellness visits with rates in physician-led visits. Although the findings were not statistically significant, they suggested that smoking cessation is at least equivalent in patients who attend nurse-led visits compared with physician-led visits and may be higher.

  11. The importance of culture in childbearing.

    PubMed

    Lewallen, Lynne Porter

    2011-01-01

    In 1972, Mary Lou Moore wrote about the importance of nurses in the United States becoming aware of childbirth traditions of other countries. In 2010, North America has become more culturally diverse, and the dominant culture related to childbirth has become the hospital culture. Nurses must acknowledge this unique culture and work to make women of all cultures comfortable in this setting to ensure a safe and satisfying childbearing experience. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  12. Las que curan at the heart of Hispanic culture.

    PubMed

    Luna, Elaine

    2003-12-01

    Bilingual nurse-curanderas are an emerging group of health care providers who blend the profession of nursing with Hispanic folk healing, thus providing culturally competent care to one of the largest growing minority groups in the United States. Nurse-curanderas integrate curanderismo (Hispanic folk healing) with allopathic health care, evaluate safety and efficacy, and implement appropriate interventions. This balance reduces cultural conflict and improves outcomes by increasing patient compliance with the treatment regimen. A Spanish-English glossary of terms used is included.

  13. Employees in Nursing and Personal Care Homes: Number, Work Experience, Special Training, and Wages, United States, May-June 1964. Publication No. 1000, Series 12, No. 6.

    ERIC Educational Resources Information Center

    Taube, Carl A.; Bryant, E. Earl

    This report of the findings of a survey of a sample of 1,073 resident institutions which provide nursing or personal care to the aged or chronically ill emphasizes employee work experience, special training, and wages. The median total experience for all nursing and professional employees in the type of job held at the time of the survey was 4.1…

  14. Human Resources for Health Challenges in Nigeria and Nurse Migration.

    PubMed

    Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

    2016-05-01

    The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

  15. Philanthropic Donor Perspectives on Supporting Nursing Excellence in a Community Hospital.

    PubMed

    Fickley, Sharon K; Mishler, Ray R; Black, Amelia S; DeGuzman, Pam B

    2016-11-01

    The purpose of this research is to explore donors' perspectives on support of nursing excellence in a community hospital. Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals. Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis. Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received. This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.

  16. Educating Chinese Nurses About Rehabilitation Nursing: Findings From a Single Cohort Quantitative Pilot Project.

    PubMed

    Mauk, Kristen L; Li, Pei Ying; Jin, Huilu; Rogers, Julie; Scalzitti, Kristina

    The purpose of this study was to present results of a pilot program to educate nurses in China about rehabilitation nursing. A single cohort, pre- and posttest design with an educational intervention. A 3-day basic rehabilitation nursing education program was conducted in Shanghai and Hangzhou by a certified rehabilitation nurse specialist from the United States. The effect of the educational intervention was measured using pre- and posttests for six topic areas. Data were analyzed using descriptive statistics, correlations, and paired samples t tests. Paired samples t tests showed a significant improvement (p < .01) as a result of the educational intervention on all three tests covering the six basic topics. The knowledge of the nurses on topics of basic rehabilitation nursing significantly increased as a result of the educational program. Rehabilitation nurses interested in international travel and developing professional relationships with nurses in China can provide education to promote our specialty practice overseas.

  17. Impressions of nursing in China.

    PubMed

    Douglas, J

    1994-01-01

    This is the first of a series of reflections on a trip a group of nurses made to China in June 1994. John Douglas, a science writer who accompanied the group, wrote the first article in this series. He shares his reflections on the Chinese health care system and interviews conducted with several Chinese nurses. Dr. Grayce Roessler, an internationally known transcultural nursing leader, directed the tour. She has traveled extensively in China (some 30 trips over twenty years) and has worked with Chinese nurses to establish transcultural educational exchange programs between the United States and China. In a future issue of this journal, Dr. Roessler will present her reflections on nursing in China from a transcultural nursing leader's perspective. In the final article in this series Dr. Julianna Finn, a transcultural nurse educator who also made this trip, will present some reflections on nursing in China from a transcultural nursing theoretical perspective using Leininger's Culture Care Theory.

  18. Evaluation of a nurse leadership development programme.

    PubMed

    West, Margaret; Smithgall, Lisa; Rosler, Greta; Winn, Erin

    2016-03-01

    The challenge for nursing leaders responsible for workforce planning is to predict the knowledge, skills and abilities required to lead future healthcare delivery systems effectively. Succession planning requires a constant, competitive pool of qualified nursing leader candidates, and retention of those interested in career growth. Formal nursing leadership education in the United States is available through graduate education and professional nursing organisation programmes, such as the Emerging Nurse Leader Institute of the American Organization of Nurse Executives. However, there is also a need for local development programmes tailored to the needs of individual organisations. Leaders at Geisinger Health System, one of the largest rural health systems in the US, identified the need for an internal professional development scheme for nurses. In 2013 the Nurses Emerging as Leaders programme was developed to prepare nurse leaders for effective leadership and successful role transition. This article describes the programme and an evaluation of its effectiveness.

  19. Videoconferencing and Web-based conferencing to enhance learning communities.

    PubMed

    Daley, Linda K; Spalla, Tara L; Arndt, Mary Jo; Warnes, Anne-Marie

    2008-02-01

    Preparing nursing students to develop the leadership and management skills necessary to adapt to ever-changing practice environments is a challenge for educators. Videoconferencing and Web-based conferencing allow for expansion of traditional classroom walls to develop partnerships among peers, exchange perspectives, and gain a more global understanding of nursing care delivery systems. A collaborative leadership seminar using videoconferencing was used to connect two large colleges of nursing in the midwestern United States, and through Web-based conferencing, one of the midwestern colleges was connected to a university in the United Kingdom. Objectives for students were exposure to different schools of thought, management of care via technology, network and cultivation of global perspectives on health care delivery, and experience of novel educational approaches.

  20. Factors that influence the decisions of men and women nurses to leave nursing.

    PubMed

    Rajapaksa, Sushama; Rothstein, William

    2009-01-01

    The health and long-term care systems in the United States rely heavily on the services of registered nurses, but concerns exist about the adequacy of the current and projected supply of registered nurses to meet the nation's needs. One way to increase the nursing supply is to increase the retention rates of nurses, especially men nurses who are much more likely to leave nursing than are women. The study hypothesizes that the different retention rates of men and women can be explained in part by their different gender roles and careers goals. A secondary analysis was conducted of the registered nurses who left nursing for other occupations in the National Sample Survey of Registered Nurses, 2000. Three reasons for leaving nursing were cited most often by the male and female nurses who left nursing: better salaries available in current type of position, hours more convenient in other position, and find current position more rewarding professionally. Results of a multivariate logistic regression analysis show that men were 2.5 times more likely than women to cite better salaries as a reason for leaving the nursing profession, but no more likely to cite more convenient hours or to state that the non-nursing position was more professionally more rewarding. Thus, the men differed from the women in their attitudes toward the financial aspects of nursing but not the professional aspects. Suggestions are provided to redress the dissatisfactions of men nurses.

  1. A Primer on Heroin and Fentanyl.

    PubMed

    Worley, Julie

    2017-06-01

    Heroin and fentanyl use have reached epidemic proportions in the United States and are now blamed for the majority of drug-related overdose deaths. Both drugs are produced primarily in South America and Asia and enter the United States illegally. One result of smoking or injecting heroin or fentanyl is the development of a substance use disorder (SUD), which causes changes in brain chemistry and function. These changes result in negative behaviors and an inability to stop use. Yet, treatments are available and recovery is possible. Nurses have the potential to impact the heroin and fentanyl epidemic through developing therapeutic relationships with patients who are at risk or already have a SUD. Strategies for effective communication include maintaining a supportive, nonjudgmental attitude and incorporating motivational interviewing. All patients should be screened for opioid use and referred for treatment if indicated. It is important for nurses to be knowledgeable about heroin and fentanyl and available treatments. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 16-20.]. Copyright 2017, SLACK Incorporated.

  2. Perceived work and family conflict among African American nurses in college.

    PubMed

    Gipson-Jones, Trina

    2009-07-01

    This article describes the perceptions of African American nurses regarding the interaction between work-family conflict, job satisfaction, and psychological well-being. A qualitative descriptive design was employed to conduct six focus group sessions with 23 nurses at three universities in the southeastern United States. Stressors such as racism or lack of teamwork and supervisor support caused the nurses to contemplate leaving a workplace or the profession. Family stressors, such as an ill family member, also influenced any decision regarding career longevity. Future studies examining work-family interface, especially positive spillover and psychological well-being are warranted.

  3. 42 CFR 1001.2006 - Notice to others regarding exclusion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) State Medicaid Fraud Control Units; (3) Utilization and Quality Control Quality Improvement Organizations; (4) Hospitals, skilled nursing facilities, home health agencies and health maintenance...

  4. Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains.

    PubMed

    Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

    2017-01-01

    This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

  5. Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

    PubMed Central

    Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

    2017-01-01

    This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability. PMID:28634428

  6. Factors associated with increasing nursing home closures.

    PubMed

    Castle, Nicholas G; Engberg, John; Lave, Judith; Fisher, Andrew

    2009-06-01

    We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.

  7. A comparison of ethical issues in nursing practice across nursing units.

    PubMed

    Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

    2014-08-01

    The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

  8. The labor market effects of California's minimum nurse staffing law.

    PubMed

    Munnich, Elizabeth L

    2014-08-01

    In 2004, California became the first state to implement statewide minimum nurse-to-patient ratios in general hospitals. In spite of years of work to establish statewide staffing regulations, there is little evidence that the law was effective in attracting more nurses to the hospital workforce or improving patient outcomes. This paper examines the effects of this legislation on employment and wages of registered nurses. By using annual financial data from California hospitals, I show that nurse-to-patient ratios in medical/surgical units increased substantially following the staffing mandate. However, survey data from two nationally representative datasets indicate that the law had no effect on the aggregate number of registered nurses or the hours they worked in California hospitals, and at most a modest effect on wages. My findings suggest that offsetting changes in labor demand due to hospital closures, combined with reclassification of workers within hospitals, and mitigated the employment effects of California's staffing regulation. This paper cautions that California's experience with minimum nurse staffing legislation may not be generalizable to states considering similar policies in very different hospital markets. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Does empowering resident families or nursing home employees in decision making improve service quality?

    PubMed

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

  10. Learning styles and teaching/learning strategy preferences: implications for educating nurses in critical care, the operating room, and infection control.

    PubMed

    Goldrick, B; Gruendemann, B; Larson, E

    1993-01-01

    To assess the learning styles and educational strategy preferences among critical care nurses, operating room nurses, and infection control practitioners. Descriptive multicenter survey using a self-report questionnaire. 108 hospitals from nine geographic regions of the United States. A random sample of 303 (93%) nurses in the three specialties responded to the survey questionnaires. The majority of participants (64%) had an abstract learning style and preferred the self-directed, discovery approach to learning. Nurses may be more abstract in their learning styles than previously reported. Experiential learning theory is an effective means of identifying nurses' learning styles and teaching/learning preferences, which can then be used to plan basic and continuing educational programs.

  11. The Emotional Intelligence Profiles and Cognitive Measures of Nurse Anesthesia Students in the Southeastern United States

    ERIC Educational Resources Information Center

    Collins, Shawn

    2012-01-01

    Problem: The purpose of this cross-sectional correlational study was to explore the relationship between emotional intelligence and personal and academic factors of nurse anesthesia students at three points in a program: matriculation, at one year of study, and in the last semester of study and the relationship of these to clinical scores and…

  12. Using Web-Based Guided Reflection with Video to Enhance High Fidelity Undergraduate Nursing Clinical Skills Education

    ERIC Educational Resources Information Center

    Shortridge, Ann; McPherson, Maggie; Loving, Gary

    2014-01-01

    The United States is currently facing a crisis in health care and health professions education. Various studies (Committee on Quality of Health Care in America 2000; 2001; General Accounting Office, 2001) have documented astonishing death rates from medical errors as well as nursing and physician shortages. Thus it is obvious that the traditional…

  13. A Phenomenological Study of Culturally Diverse Baccalaureate Nursing Students' Persistence to Graduation

    ERIC Educational Resources Information Center

    Sweet, Laritha Hill

    2012-01-01

    Approximately 36% of people living in America today belong to a minority group. Despite the increase in diverse population of the United States, less than 17% of registered nurses in 2008 belonged to a minority group. This is a concern because people from minority backgrounds are more apt to seek ACmedical care, trust information received, and…

  14. Heroines on Horseback: The Frontier Nursing Service of Appalachia

    ERIC Educational Resources Information Center

    Sheffield, Caroline C.

    2014-01-01

    The men of the Breckinridge family have a long history of service to the nation, including many politicians, soldiers, and even a vice president of the United States. But it was a woman in the family, Mary, who had, arguably, the most direct and long-lived impact on those she served. As the founder of the Frontier Nursing Service (FNS) of Eastern…

  15. Hospice Use among Urban Black and White U.S. Nursing Home Decedents in 2006

    ERIC Educational Resources Information Center

    Lepore, Michael J.; Miller, Susan C.; Gozalo, Pedro

    2011-01-01

    Purpose: Medicare hospice is a valuable source of quality care at the end of life, but its lower use by racial minority groups is of concern. This study identifies factors associated with hospice use among urban Black and White nursing home (NH) decedents in the United States. Design and Methods: Multiple data sources are combined and multilevel…

  16. A Citation Analysis of Three American Nursing Journals.

    ERIC Educational Resources Information Center

    Williams, Barbara A.

    A citation analysis of three American nursing journals published in the United States was conducted in each of the sample journals for the first 7 months of 1996. Any attempt to cite a reference source was considered a citation. Each citation was coded for type and placement in relation to the text of the sample journals. The content of each…

  17. 20 CFR 655.5 - Purpose and scope of subpart A.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Labor Certification Process and Enforcement of Attestations for Temporary Employment in Occupations Other Than Agriculture or Registered Nursing in the United... certification process for the temporary employment of nonimmigrant foreign workers in the U.S. in occupations...

  18. A comparison of policies on nurse faculty workload in the United States.

    PubMed

    Ellis, Peggy A

    2013-01-01

    This article describes nurse faculty workload policies from across the nation in order to assess current practice. There is a well-documented shortage of nursing faculty leading to an increase in workload demands. Increases in faculty workload results in difficulties with work-life balance and dissatisfaction threatening to make nursing education less attractive to young faculty. In order to begin an examination of faculty workload in nursing, existing workloads must be known. Faculty workload data were solicited from nursing programs nationwide and analyzed to determine the current workloads. The most common faculty teaching workload reported overall for nursing is 12 credit hours per semester; however, some variations exist. Consideration should be given to the multiple components of the faculty workload. Research is needed to address the most effective and efficient workload allocation for nursing faculty.

  19. Barriers to work-life balance for hospital nurses.

    PubMed

    Mullen, Kathleen

    2015-03-01

    Nurses are loyal to their patients and coworkers. They often put the needs of others before their own and sometimes even before the needs of their families. This concern for others can cause conflicts that manifest as stress. Of the more than 2 million nurses in the United States, more than 62% work in hospitals. Hospitals are known to be both rewarding and stressful places to work. Like most workers, nurses face the challenge of balancing demands and achievements of work with those in their private lives. Hospital leaders can facilitate improved work-life balance (WLB) for hospital nurses by using tools already in place. Equally important, nurses can use their knowledge and resources to nurse the nurse within, which can greatly improve their experience of WLB, independent of the demands of their work environment. © 2015 The Author(s).

  20. The effects of RN staffing hours on nursing home quality: a two-stage model.

    PubMed

    Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene

    2014-03-01

    Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. International Nursing: Constructing an Advanced Practice Registered Nurse Practice Model in the UAE: Using Innovation to Address Cultural Implications and Challenges in an International Enterprise.

    PubMed

    Behrens, Sue A

    Despite utilization of the advanced practice registered nurse (APRN) in the United States health care system, there is little information about the introduction, utilization, and challenges of the APRN role globally, especially in the Middle East. This article will look at how one hospital in the United Arab Emirates introduced the APRN role to a health care environment of a country where it has not been recognized historically. Cultural challenges and barriers for the implementation of the role include regulatory, societal, and institutional. Innovation and collaboration are necessary to address these challenges and barriers and to pave the way for a successful advanced practice model pilot, as well as for the future use of the role. Innovation is also one of the key performance indicators for the country's health care. However, the idea of advanced practice is a new concept that has been outside the mainstream health care practice for the United Arab Emirates. To help with the implementation, a road map was developed to outline the steps necessary to provide a safe practice environment. The plan included aligning with the ministry of health nursing and midwifery council, as well as the Health Authority of Abu Dhabi, to help them learn more about the US model of advanced practice, along with benefits, and outcomes of the role. Developing the role of the APRN will benefit the future state of the health care infrastructure for not only the United Arab Emirates but throughout the Middle East.

  2. Violence against female student nurses in the workplace.

    PubMed

    Hinchberger, Patricia A

    2009-01-01

    Violence, harassment, and bullying in the workplace are not new phenomena. However, the growing epidemic of violence in the health sector workplace is raising great concern among workers, employers, and governmental agencies across Australia, Canada, the United Kingdom, and the United States. National and international literature reveals that the prevalence of violence experienced by graduate and undergraduate female nursing students in the college and workplace settings is largely unknown. Moreover, the prevalence of violence is now recognized as a major health priority by the World Health Organization, the International Council of Nurses, and Public Services International. Even so, the number of nursing personnel affected by this problem continues to rise. A modified self-report online survey was used to ascertain the level of violence experienced by nursing students in their clinical placements. One hundred percent of those surveyed had experienced some type of workplace violence and the perpetrators were most often other staff members followed closely by patients. The American Association of Colleges of Nursing Position Statement recommends that all faculty prepare nurses to recognize and prevent all forms of violence in the workplace. This research seeks to develop practical approaches to better understand and prevent this global public health issue.

  3. Social networking in nursing education: integrative literature review

    PubMed Central

    Kakushi, Luciana Emi; Évora, Yolanda Dora Martinez

    2016-01-01

    Abstract Objective: to identify the use of social networking in nursing education. Method: integrative literature review in the databases: LILACS, IBECS, Cochrane, BDENF, SciELO, CINAHL, Scopus, PubMed, CAPES Periodicals Portal and Web of Science, using the descriptors: social networking and nursing education and the keywords: social networking sites and nursing education, carried out in April 2015. Results: of the 489 articles found, only 14 met the inclusion and exclusion criteria. Most studies were published after 2013 (57%), originating from the United States and United Kingdom (77.8%). It was observed the use of social networking among nursing students, postgraduate students, mentors and nurses, in undergraduate programmes, hybrid education (blended-learning) and in interprofessional education. The social networking sites used in the teaching and learning process were Facebook (42.8%), Ning (28.5%), Twitter (21.4%) and MySpace (7.1%), by means of audios, videos, quizzes, animations, forums, guidance, support, discussions and research group. Conclusion: few experiences of the use of social networking in nursing education were found and their contributions show the numerous benefits and difficulties faced, providing resourses for the improvement and revaluation of their use in the teaching and learning process. PMID:27384465

  4. [Decisive factors relating to workload in a primary healthcare unit].

    PubMed

    da Silva, Nilson Rogério

    2011-08-01

    Work-related diseases o either physical or emotional origin have been on the increase in contemporary society in the different work sectors. They have had a profound impact on health professionals, such as physicians, dentists, nurses, nursing assistants and administrative assistants in the primary healthcare units. This study aimed to establish the decisive factors relating to workload, seeking to identify possible relations between the working conditions and their potential impact on worker health. Thirty-one individuals comprised the sample, namely 12 physicians, 3 dentists, 1 nurse, 9 nursing assistants, 3 dental assistants and 3 business assistants at a PHU (Primary Healthcare Unit) in a city in the interior of the State of São Paulo. For the data collection, structured interviews were conducted through meetings with the specific groups of workers, such that a detailed description of the activities performed by each group could be drafted, as well as a survey of the problems and desirable features involved. The results indicated the presence of physical, cognitive and psychological demands; inadequate communication processes; obsolete equipment; excessive number of users and an inefficient structure to deal with absenteeism.

  5. Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

    PubMed

    Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

    2014-08-01

    To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Medical history and epidemiology: their contribution to the development of public health nursing.

    PubMed

    Earl, Catherine E

    2009-01-01

    The nursing profession historically has been involved in data collection in research efforts notably from the time of the Framingham Tuberculosis Project (1914-1923). Over the past century, nurses have become more sophisticated in their abilities to design, conduct, and analyze data. This article discusses the contributions of medicine and epidemiology to the development of public health nursing and the use of statistical methods by nurses in the United States in the 19th and 20th centuries. Knowledge acquired from this article will inform educators and researchers about the importance of using quantitative analysis, evidenced-based knowledge, and statistical methods when teaching students in all health professions.

  7. Development and testing of an instrument to measure holistic nursing values in nurse practitioner care.

    PubMed

    Kinchen, Elizabeth

    2015-01-01

    As primary care delivery evolves in the United States with nurse practitioners (NPs) as key providers, exploring the patient's perception of the nature and quality of NPs' care is of critical importance to healthcare consumers, providers, educators, policy makers, and underwriters. The aim of this study was to describe the development and testing of the Nurse Practitioner Holistic Caring Instrument, a new, investigator-developed measure of the preservation of holistic nursing values in NP care. Results suggest that NPs provide patient-centered, comprehensive, and clinically competent care, rendering them ideally suited to leading primary health care delivery. However, further testing in more diverse populations and settings is needed to strengthen preliminary findings.

  8. DEVELOPMENT OF AN EMERGENCY NURSING TRAINING CURRICULUM IN GHANA

    PubMed Central

    Bell, Sue Anne; Oteng, Rockefeller; Redman, Richard; Lapham, Jeremy; Bam, Victoria; Dzomecku, Veronica; Yakubu, Jamila; Tagoe, Nadia; Donkor, Peter

    2014-01-01

    The formal provision of emergency health care is a developing specialty in many sub-Saharan African countries, including Ghana. While emergency medicine training programs for physicians are on the rise, there are few established training programs for emergency nurses. The results of a unique collaboration are described between a university in the United States, a Ghanaian university and a Ghanaian teaching hospital that has developed an emergency nursing diploma program. The expected outcomes of this training program include: a) an innovative, interdisciplinary, team-based clinical training model b) a unique and low-resource emergency nursing curriculum and c) a comprehensive and sustainable training program to increase in-country retention of nurses. PMID:24631161

  9. Preparing for disasters: Enhancing the role of pediatric nurses in wartime.

    PubMed

    Ferguson, Stephanie L

    2002-08-01

    During the tragic terrorist attacks that occurred against the United States on September 11, 2001, nurses were on the front lines making a difference for patients, families, and children. As noted in the American Nurse, the official publication of the American Nurses Association, "September 11, 2001, is no longer just a day gone by. It now takes the place alongside other infamous dates like December 7, 1941, the attack on Pearl Harbor by Japan" (Trossman, 2001, p. 1). This article will focus on resources available for pediatric nurses to use when working with children and families who are either preparing for or responding to disasters. Copyright 2002, Elsevier Science (USA). All rights reserved.

  10. The impact of market and organizational characteristics on nursing care facility service innovation: a resource dependency perspective.

    PubMed

    Banaszak-Holl, J; Zinn, J S; Mor, V

    1996-04-01

    Using resource dependency theory as a conceptual framework, this study investigates both the organizational and environmental factors associated with an emerging health care service delivery innovation, the provision of specialty care in designated units in nursing care facilities. We consider two types of specialty units, Alzheimer's Disease and subacute care. The Medicare/Medicaid Automated Certification Survey (MMACS) data file was merged with local market area data obtained from the 1992 Area Resource File and with state level regulatory data. The likelihood of providing Alzheimer's Disease or subacute care in dedicated units was estimated by separate logistic regressions. Results indicate that facilities with fewer Medicare patients are more likely to operate a dedicated Alzheimer's care unit, while facilities located in markets with a large HMO population and greater hospital supply are more likely to operate a subacute care unit. While competition among nursing homes, for the most part, is an incentive to innovate, greater regulatory stringency appears to constrain the development of specialty care units of both types. Finally, organizational characteristics (e.g., size and proprietary status) appear to be important enabling factors influencing the propensity to provide specialty care in dedicated units. Nursing care facilities are moving toward providing specialty care units partly as a response to a growing demand by resource providers and to maintain a competitive edge in tighter markets. Loosening regulation directed at cost containment would further encourage the development of specialty care but should be preceded by some evaluation of population needs for specialty care and the effectiveness of specialty care units.

  11. Results of an Oncology Clinical Trial Nurse Role Delineation Study.

    PubMed

    Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

    2017-09-01

    To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

  12. Effective implementation of work-hour limits and systemic improvements.

    PubMed

    Landrigan, Christopher P; Czeisler, Charles A; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Lockley, Steven W

    2007-11-01

    Sleep deprivation, ubiquitous among nurses and physicians, recently has been shown to greatly increase rates of serious medical errors and occupational injuries among health care workers in the United States. The Accreditation Council for Graduate Medical Education's current work-hour limits for physicians-in-training allow work hours well in excess of those proven safe. No regulations limit the work hours of other groups of health care providers in the United States. Consequently, nursing work shifts exceeding 12 hours remain common. Physician-in-training shifts of 30 consecutive hours continue to be endorsed officially, and data demonstrate that even the 30-hour limit is exceeded routinely. By contrast, European health care workers are limited by law to 13 consecutive hours of work and to 48-56 hours of work per week. Except for a few institutions that have eliminated 24-hour shifts, as a whole, the United States lags far behind other industrialized nations in ensuring safe work hours. Preventing health care provider sleep deprivation could be an extremely powerful means of addressing the epidemic of medical errors in the United States. Implementation of evidence-based work-hour limits, scientifically designed work schedules, and infrastructural changes, such as the development of standardized handoff systems, are urgently needed.

  13. A consistent course of events or a series of coincidences: nursing in Poland from the 19(th) to the 21(st) century.

    PubMed

    Majda, Anna; Ziarko, Ewa; Zalewska-Puchała, Joanna

    2015-12-01

    The development of nursing began in Poland much later than it did elsewhere, for instance in the United Kingdom, the United States, or Germany, and it came up against difficult conditions. After a brief twenty-year period of development between 1918 and 1939, it almost stalled during the war (1939-45), only to be followed by nearly twenty years of chaos. Nursing started to come out of this difficult period at the beginning of the 1960s. The turn of the 21st century saw the emergence of extensive professional development and training opportunities for nurses. This change was brought about as much by political, social and economic issues, health care requirements, and the advancement of science, medicine, the birth of humanitarism, the growth of the feminist movement, the European Agreement on the Instruction and Education of Nurses, the WHO European Strategy for Nursing and Midwifery Education, the Bologna declaration, as well as the activities undertaken by the European Union, the International Council of Nurses, the American and Polish Red Cross, the Rockefeller Foundation, the Polish Association of Nurses, and the professional self-governing body. The transformation of nursing into an independent profession was further boosted by physicians deeply involved in the issue and female pioneers of nursing. © 2015 John Wiley & Sons Ltd.

  14. 42 CFR 460.96 - Excluded services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... nursing services (unless medically necessary), and nonmedical items for personal convenience such as... procedures. (e) Services furnished outside of the United States, except as follows: (1) In accordance with...

  15. 42 CFR 460.96 - Excluded services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... nursing services (unless medically necessary), and nonmedical items for personal convenience such as... procedures. (e) Services furnished outside of the United States, except as follows: (1) In accordance with...

  16. 42 CFR 460.96 - Excluded services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... nursing services (unless medically necessary), and nonmedical items for personal convenience such as... procedures. (e) Services furnished outside of the United States, except as follows: (1) In accordance with...

  17. Challenge of assessing symptoms in seriously ill intensive care unit patients: can proxy reporters help?

    PubMed

    Puntillo, Kathleen A; Neuhaus, John; Arai, Shoshana; Paul, Steven M; Gropper, Michael A; Cohen, Neal H; Miaskowski, Christine

    2012-10-01

    Determine levels of agreement among intensive care unit patients and their family members, nurses, and physicians (proxies) regarding patients' symptoms and compare levels of mean intensity (i.e., the magnitude of a symptom sensation) and distress (i.e., the degree of emotionality that a symptom engenders) of symptoms among patients and proxy reporters. Prospective study of proxy reporters of symptoms in seriously ill patients. Two intensive care units in a tertiary medical center in the Western United States. Two hundred and forty-five intensive care unit patients, 243 family members, 103 nurses, and 92 physicians. None. On the basis of the magnitude of intraclass correlation coefficients, where coefficients from .35 to .78 are considered to be appropriately robust, correlation coefficients between patients' and family members' ratings met this criterion (≥.35) for intensity in six of ten symptoms. No intensity ratings between patients and nurses had intraclass correlation coefficients >.32. Three symptoms had intensity correlation coefficients of ≥.36 between patients' and physicians' ratings. Correlation coefficients between patients and family members were >.40 for five symptom-distress ratings. No symptoms had distress correlation coefficients of ≥.28 between patients' and nurses' ratings. Two symptoms had symptom-distress correlation coefficients between patients' and physicians' ratings at >.39. Family members, nurses, and physicians reported higher symptom-intensity scores than patients did for 80%, 60%, and 60% of the symptoms, respectively. Family members, nurses, and physicians reported higher symptom-distress scores than patients did for 90%, 70%, and 80% of the symptoms, respectively. Patient-family intraclass correlation coefficients were sufficiently close for us to consider using family members to help assess intensive care unit patients' symptoms. Relatively low intraclass correlation coefficients between intensive care unit clinicians' and patients' symptom ratings indicate that some proxy raters overestimate whereas others underestimate patients' symptoms. Proxy overestimation of patients' symptom scores warrants further study because this may influence decisions about treating patients' symptoms.

  18. The role of nurse practitioners in health sector reform in Iran (2011).

    PubMed

    Vatankhah, Soudabe; Khalesi, Nader; Ebadifardazar, Farbod; Ferdousi, Masoud; Naji, Homayon; Farahabadi, Seyed Mohammad Ehsaan

    2013-09-01

    Most countries use educated nurses called "nurse practitioners" (NPs) besides the family physicians for diagnosis, treatment, and specifically health education of the family. The main goal of this study was to redefine the role of NPs for better use of their capabilities in the so-called "family physician reform" in Iran. This is a qualitative and comparative study carried out in three stages (triangulation method) in 2011. In the first stage, we conducted a literature review to design a conceptual framework. The second stage was a comparative study on four countries. In this study, we focused on the role of NPs, which in turn helped to redefine this role in the health sector reform of Iran. In the third stage, two expert panels were involved and the suggested roles were confirmed. In the United States, NPs are licensed by the state in which they practice and have a national board certification. In Canada, nurses involved in clinics should participate in specific training course of diagnosis and management of health care after registration. In Austria, nurses in Nursing homes and maternity do some of the medical procedures under the supervision of the physicians. In the United Kingdom, NPs increasingly substitute for GPs in the care of minor illness and routine management of chronic diseases. There is still debate in nursing and medical circles about what the focus of the NP roles should be. In Iran, whereas a noticeable reform toward "family physician" is ongoing, redefining the nurses' role is essential. They can perform more active roles in associating with GPs in the clinics of family physicians, both in urban and rural areas, even with higher degrees of autonomy.

  19. Measuring Nursing Value from the Electronic Health Record.

    PubMed

    Welton, John M; Harper, Ellen M

    2016-01-01

    We report the findings of a big data nursing value expert group made up of 14 members of the nursing informatics, leadership, academic and research communities within the United States tasked with 1. Defining nursing value, 2. Developing a common data model and metrics for nursing care value, and 3. Developing nursing business intelligence tools using the nursing value data set. This work is a component of the Big Data and Nursing Knowledge Development conference series sponsored by the University Of Minnesota School Of Nursing. The panel met by conference calls for fourteen 1.5 hour sessions for a total of 21 total hours of interaction from August 2014 through May 2015. Primary deliverables from the bit data expert group were: development and publication of definitions and metrics for nursing value; construction of a common data model to extract key data from electronic health records; and measures of nursing costs and finance to provide a basis for developing nursing business intelligence and analysis systems.

  20. Intermittent auscultation versus continuous fetal monitoring: exploring factors that influence birthing unit nurses' fetal surveillance practice using theoretical domains framework.

    PubMed

    Patey, Andrea M; Curran, Janet A; Sprague, Ann E; Francis, Jill J; Driedger, S Michelle; Légaré, France; Lemyre, Louise; Pomey, Marie-Pascale A; Grimshaw, Jeremy M

    2017-09-25

    Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA. We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social influences; Behavioural regulation). We identified potential influences on birthing unit nurses' use of IA as their primary method of fetal surveillance. These beliefs suggest potential targets for behaviour change interventions to promote IA use.

  1. Creating a brand image for public health nursing.

    PubMed

    Baldwin, Kathleen A; Lyons, Roberta L; Issel, L Michele

    2011-01-01

    Public health nurses (PHNs) have declined as a proportion of both the nursing and the public health workforces in the past 2 decades. This decline comes as 30 states report public health nursing as the sector most affected in the overall public health shortage. Taken together, these data point to a need for renewed recruitment efforts. However, the current public images of nurses are primarily those of professionals employed in hospital settings. Therefore, this paper describes the development of a marketable image aimed at increasing the visibility and public awareness of PHNs and their work. Such a brand image was seen as a precursor to increasing applications for PHN positions. A multimethod qualitative sequential approach guided the branding endeavor. From the thoughts of public health nursing students, faculty, and practitioners came artists' renditions of four award-winning posters. These posters portray public health nursing-incorporating its image, location of practice, and levels of protection afforded the community. Since their initial unveiling, these posters have been distributed by request throughout the United States and Canada. The overwhelming response serves to underline the previous void of current professional images of public health nursing and the need for brand images to aid with recruitment. © 2010 Wiley Periodicals, Inc.

  2. Risk Factors for Pressure Ulcers Including Suspected Deep Tissue Injury in Nursing Home Facility Residents: Analysis of National Minimum Data Set 3.0.

    PubMed

    Ahn, Hyochol; Cowan, Linda; Garvan, Cynthia; Lyon, Debra; Stechmiller, Joyce

    2016-04-01

    To provide information on risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home residents in the United States. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Examine the literature related to risk factors for the development of PrUs.2. Compare risk factors associated with the prevalence of PrUs and sDTI from the revised Minimum Data Set 3.0 2012 using a modified Defloor's conceptual model of PrUs as a theoretical framework. This study aims to characterize and compare risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home (NH) residents in the United States. Secondary analysis of the 2012 Minimum Data Set (MDS 3.0). Medicare- or Medicaid-certified NHs in the United States. Nursing home residents (n = 2,936,146) 18 years or older with complete PrU data, who received comprehensive assessments from January to December 2012. Pressure ulcer by stage was the outcome variable. Explanatory variables (age, gender, race and ethnicity, body mass index, skin integrity, system failure, disease, infection, mobility, and cognition) from the MDS 3.0 were aligned with the 4 elements of Defloor's conceptual model: compressive forces, shearing forces, tissue tolerance for pressure, and tissue tolerance for oxygen. Of 2,936,146 NH residents who had complete data for PrU, 89.9% had no PrU; 8.4% had a Stage 2, 3, or 4 or unstagable PrU; and 1.7% had an sDTI. The MDS variables corresponding to the 4 elements of Defloor's model were significantly predictive of both PrU and sDTI. Black residents had the highest risk of any-stage PrU, and Hispanic residents had the highest risk of sDTI. Skin integrity, system failure, infection, and disease risk factors had larger effect sizes for sDTI than for other PrU stages. The MDS data support Defloor's model and inform clinicians, educators, researchers, and policymakers on risk factors associated with PrUs and sDTI in NH residents in the United States participating in Medicare and Medicaid.

  3. Smoking behavior and patient education practices of oncology nurses in six countries.

    PubMed

    Lally, Robin M; Chalmers, Karen I; Johnson, Judith; Kojima, Misako; Endo, Emiko; Suzuki, Shizue; Lai, Yeur-Hur; Yang, Young-Hee; Degner, Lesley; Anderson, Elsie; Molassiotis, Alexander

    2008-09-01

    Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States. A 27-item structured survey, designed for this study in English and translated and reverse translated by the Asian countries, was distributed to a convenience sample of nurses attending oncology meetings in each country. Totally 759 surveys were completed and analyzed using descriptive statistics. Principle findings indicate that 4.5% of these nurses currently smoke, although 23.3% reported smoking previously. While many nurses (74%) reported frequently assessing the smoking status of patients, only 50% reported discussing cessation with their patients that smoke. Although the majority (80%) reported feeling comfortable with asking their patients about smoking, only 23% felt it was the nurse's role. The findings indicate that while internationally oncology nurses recognize the importance of smoking cessation, significant room for improvement exists in translating this into practice.

  4. Effective promotion of breastfeeding among Latin American women newly immigrated to the United States.

    PubMed

    Denman-Vitale, S; Murillo, E K

    1999-07-01

    Across the United States, advance practice nurses (APNs) are increasingly encountering recently immigrated Latin American populations. This article provides an overview of the situation of Latin Americans in the United States and discusses aspects of Latin American culture such as, respeto (respect), confianza (confidence), the importance of family, and the value of a personal connection. Strategies that will assist practitioners to incorporate culturally holistic principles in the promotion of breastfeeding among Latin American women who are new arrivals in the United States are described. If practitioners are to respond to the increasing numbers of Latin American women who need health care services, and also provide thorough, holistic health care then health care activities must be integrated with cultural competence.

  5. Certified School Nurse Perspectives on State-Mandated Hearing Screens

    ERIC Educational Resources Information Center

    Sekhar, Deepa L.; Beiler, Jessica S.; Schaefer, Eric W.; Henning, Antoinette; Dillon, Judith F.; Czarnecki, Beth; Zalewski, Thomas R.

    2016-01-01

    Background: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs…

  6. The effect of hospital unit layout on nurse walking behavior.

    PubMed

    Yi, Lu; Seo, Hyun-Bo

    2012-01-01

    To confirm a new method for the research question, "How do different hospital unit layouts affect nurses' walking behavior and distance?" Concern is renewed regarding nurses' long walking distances because of the trend toward larger patient rooms with family areas inside, resulting in a larger overall unit size. Studies have found unit design characteristics that support nurses' efficient walking, but few have done it in units designed for patient- and family-centered care. To examine the effect of unit design on nurses' walking behavior, the authors propose a new method of observing a specific task. The authors observed nurses during the task of medication administration. Contrary to their hypotheses, results showed: (1) Experienced nurses had more unnecessary stops and longer walking distances than new nurses because of interactions; and (2) nurses in the smaller wing of the unit walked more than those in the larger wing of the same unit. The authors posit that the closeness between the nurses' path to the medication supply room and the central nurses' station affected the frequency of interactions and prompted a deviation from the shortest and most efficient path during medication administration. Observing a specific task to identify the effect of unit layout was effective, determining that overall unit shape or unit layout type might not be a good predictor of nurses' walking behavior; instead the characteristics of the path that connects functional spaces such as patient room and medication area might better predict nurses' walking behavior.

  7. Contraceptive care of adolescents: overview, tips, strategies, and implications for school nurses.

    PubMed

    Gabzdyl, Elizabeth Mary

    2010-08-01

    The United States has one of the highest unintended pregnancy rates of all industrialized nations in the world, with 13% of those occurring among the adolescent population. In 2005, the adolescent birthrate in the United States was 40.5 per 1,000 women and increased 3% in 2006 (Martin et al., 2009). Unintended pregnancy and motherhood can have a tremendous impact and lifelong implications for adolescents and their children as well as financial and societal costs. Helping make contraception accessible to adolescents is one area where school nurses are able to have an impact. Various contraceptive methods are described. Advantages and disadvantages are summarized along with considerations relative to adolescents. General strategies for counseling and caring for adolescents to encourage successful initiation, use, and continuation of contraception also reviewed.

  8. Caring for Young Children Exposed to Marijuana.

    PubMed

    Ruiz, Natasha M; Shapiro, Susan E

    This article reviews the research report, Marijuana Exposure Among Children Younger Than Six Years in the United States (), and, using a case study approach, applies the findings to advanced practice registered nurses. B. extracted data from the National Poison Data System showing an increasing trend in marijuana exposure in children, especially in states where marijuana has been legalized for either medicinal use or recreational use. Advanced practice registered nurses need to be comfortable recognizing and managing marijuana intoxication in the pediatric population, as well as educating parents in providing safe environments for their children.

  9. Nursing shaping and influencing health and social care policy.

    PubMed

    Fyffe, Theresa

    2009-09-01

    This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.

  10. Associations between nursing home performance and hospital 30-day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States.

    PubMed

    Pandolfi, Michelle M; Wang, Yun; Spenard, Ann; Johnson, Florence; Bonner, Alice; Ho, Shih-Yieh; Elwell, Timothy; Bakullari, Anila; Galusha, Deron; Leifheit-Limson, Erica; Lichtman, Judith H; Krumholz, Harlan M

    2017-12-01

    To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. Medicare-certified nursing homes and acute care hospitals. 12,542 nursing homes and 3,039 hospitals treating 30 or more Medicare fee-for-service patients for all three conditions across 2,032 hospital service areas in the United States. Community-specific hospital 30-day risk-standardised readmission rates. Community-specific nursing home performance measures: health inspection, staffing, Registered Nurses and quality performance; and an aggregated performance score. Mixed-effects models evaluated associations between nursing home performance and hospital 30-day risk-standardised readmission rates for all three conditions. The relationship between community-specific hospital risk-standardised readmission rates and community-specific overall nursing home performance was statistically significant for all three conditions. Increasing nursing home performance by one star resulted in decreases of 0.29% point (95% CI: 0.12-0.47), 0.78% point (95% CI: 0.60-0.95) and 0.46% point (95% CI: 0.33-0.59) of risk-standardised readmission rates for AMI, HF and pneumonia, respectively. Among the specific measures, higher performance in nursing home overall staffing and Registered Nurse staffing measures was statistically significantly associated with lower hospital readmission rates for all three conditions. Notable geographic variation in the community-specific nursing home performance was observed. Community-specific nursing home performance is associated with community-specific hospital 30-day readmission rates for Medicare fee-for-service patients for acute myocardial infarction, heart failure or pneumonia. Coordinated care between hospitals and nursing homes is essential to reduce readmissions. Nursing homes can improve performance and reduce readmissions by increasing registered nursing homes. Further, communities can work together to create cross-continuum care teams comprised of hospitals, nursing homes, patients and their families, and other community-based service providers to reduce unplanned readmissions. © 2017 John Wiley & Sons Ltd.

  11. Where Does Your State Stand on Shackling of Pregnant Incarcerated Women?

    PubMed

    Ferszt, Ginette G; Palmer, Michelle; McGrane, Christine

    2018-02-01

    Pregnant incarcerated women have been identified as a particularly high-risk group and among the most vulnerable women in the United States. The use of shackling or restraints poses health risks to pregnant women and their fetuses. Currently, only 22 states have legislation prohibiting or limiting the shackling of pregnant women. Here we provide an overview of the potential negative health outcomes that can result from shackling pregnant women, especially during labor and birth, and suggest strategies for nurses who wish to promote optimal health care for incarcerated women and to advocate for anti-shackling legislation in their states. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  12. Expanding the Role of Psychiatric Mental Health Nurse Practitioners in a State Psychiatric System: The New Hampshire Experience.

    PubMed

    de Nesnera, Alexander; Allen, Diane E

    2016-05-01

    Psychiatric mental health nurse practitioners (PMHNPs) are assuming increasing clinical responsibilities in the treatment of individuals with mental illness as the shortage of psychiatrists and their maldistribution continues to persist in the United States. States vary widely in their statutes and administrative rules delineating PMHNP's scope of practice. This column describes the legislative process of incremental changes in New Hampshire statute and rules changes over the past 15 years that have significantly expanded PMHNP's ability to treat individuals with mental illnesses in the state mental health system. PMHNPs have worked closely with physician leaders and policy makers to allow this to occur.

  13. The influence of nursing care integration services on nurses' work satisfaction and quality of nursing care.

    PubMed

    Ryu, Jeong-Im; Kim, Kisook

    2018-06-20

    To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.

  14. The Mediating Effects of Basic Psychological Needs at Work on the Relationship between the Dimensions of the Learning Organization and Organizational Commitment in Registered Nurses

    ERIC Educational Resources Information Center

    Baird, Bonni Lynn

    2012-01-01

    The purpose of this study was to determine the mediating effects of the Basic Psychological Needs at Work, comprised of competence, autonomy and relatedness, on the relationship between the Dimensions of the Learning Organization and affective and normative organizational commitment in the United States nursing population. The study incorporated…

  15. Applying Resource Utilization Groups (RUG-III) in Hong Kong Nursing Homes

    ERIC Educational Resources Information Center

    Chou, Kee-Lee; Chi, Iris; Leung, Joe C. B.

    2008-01-01

    Resource Utilization Groups III (RUG-III) is a case-mix system developed in the United States for categorization of nursing home residents and the financing of residential care services. In Hong Kong, RUG-III is based on several board groups of residents. The aim of this study was to examine the reliability and validity of the RUG-III in Hong Kong…

  16. Discrimination against the Poor and Disabled in Nursing Homes. Hearing before the Special Committee on Aging, United States Senate, Ninety-Eighth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    This Congressional oversight hearing was convened to examine evidence that many of the nation's nursing homes restrict or deny access to the elderly poor and disabled, leaving the 18 million Americans dependent on Medicaid especially vulnerable to neglect and exploitation. Evidence was heard on discriminatory admissions, on the practice of…

  17. Does therapeutic touch help reduce pain and anxiety in patients with cancer?

    PubMed

    Jackson, Emily; Kelley, Megan; McNeil, Patrick; Meyer, Eileen; Schlegel, Lauren; Eaton, Melody

    2008-02-01

    With more than 10 million patients with cancer in the United States, pain and symptom management is an important topic for oncology nurses. Complementary therapies, such as therapeutic touch, may offer nurses a nonpharmacologic method to ease patients' pain. Using 12 research studies, the authors examined the evidence concerning the effectiveness of this type of treatment in reducing pain and anxiety.

  18. Problem Solving for Better Health Nursing: a working approach to the development and dissemination of applied research in developing countries.

    PubMed

    Hoyt, Pamela

    2006-05-01

    This article describes the international component of the Problem Solving for Better Health Nursing (PSBHN) program initiated by the Dreyfus Health Foundation (DHF) in 2002. PSBHN is operational in 14 countries in addition to the United States. A PSBHN initiative is described, and attention is given to lessons learned and plans for the future.

  19. Healthy, Hunger-Free Kids Act of 2010: An Opportunity for School Nurses to Make a Difference

    ERIC Educational Resources Information Center

    Prokop, Jessica L.; Galon, Patricia

    2011-01-01

    Implementation of the Healthy Hunger-Free Kids Act of 2010 will provide an opportunity for school nurses to intervene in the serious childhood obesity problem in the United States. Major changes in the management of the National School Lunch Program (NSLP) will likely challenge schools yet may provide the impetus for a collaborative effort by the…

  20. The Number of Students Sent Home by School Nurses Compared to Unlicensed Personnel

    ERIC Educational Resources Information Center

    Pennington, Nicole; Delaney, Elizabeth

    2008-01-01

    Many schools across the United States do not have a full-time school nurse, resulting in care being provided by unlicensed school employees when children are sick or injured at school. The purpose of this study was to determine if there was a difference in the number of students sent home when ill or injured based on who assessed the student in…

  1. An Analysis of Navy Nurse Corps Accession Sources

    DTIC Science & Technology

    2014-03-01

    1 I. INTRODUCTION A. BACKGROUND Since 1998, the United States has experienced a nationwide nursing shortage (Juraschek, Zhang, Ranganathan ...supply of RNs in the civilian workforce (Juraschek, Zhang, Ranganathan , & Lin, 2012). A study by Juraschek, Zhang, Ranganathan , & Lin (2012...Postgraduate School, Monterey, CA. Retrieved from www.dtic.mil/cgi- bin/GetTRDoc?AD=ADA344570 Juraschek, S. P., Zhang, X., Ranganathan , V. K., & Lin, V

  2. [Nursing care systematization according to the nurses' view: a methodological approach based on grounded theory].

    PubMed

    de Medeiros, Ana Lúcia; dos Santos, Sérgio Ribeiro; de Cabral, Rômulo Wanderley Lima

    2012-09-01

    This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of nursing care (SNC) in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon. "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff" The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as well as considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.

  3. [Parents and nursing staff's expectations regarding the nurse's work in a NICU].

    PubMed

    Kamada, Ivone; Rocha, Semíramis Melani Melo

    2006-09-01

    The general purpose of this investigation was to identify parent and nursing staff expectations regarding the nurse's role in Neonatal Intensive Care Units (NICU). A descriptive study was carried out using a qualitative approach and interviews were conducted at a NICU in the interior of the State of São Paulo. Results showed new expectations on the part of parents and professionals regarding the role of NICU nurses. The knowledge identified as necessary were a family-centered approach, interpersonal relations techniques, and differentiation between technology and scientific knowledge. The conclusion is that NICU nurses need to play a more incisive role in the nursing care process, adjusting the use of technological advances to human knowledge, particularly in the area of interpersonal relationships between family members and staff, which includes activities of continuing education, such as specialization courses.

  4. Nursing informatics competencies: bibliometric analysis.

    PubMed

    Kokol, Peter; Blažun, Helena; Vošner, Janez; Saranto, Kaija

    2014-01-01

    Information and communication technology is developing rapidly and it is incorporated in many health care processes, but in spite of that fact we can still notice that nursing informatics competencies had received limited attention in basic nursing education curricula in Europe and especially in Eastern European countries. The purpose of the present paper is to present the results of a bibliometric analysis of the nursing informatics competencies scientific literature production. We applied the bibliometrics analysis to the corpus of 332 papers found in SCOPUS, related to nursing informatics competencies. The results showed that there is a positive trend in the number of published papers per year, indicating the increased research interest in nursing informatics competencies. Despite the fact that the first paper was published in Denmark, the most prolific country regarding the research in nursing informatics competencies is United States as are their institutions and authors.

  5. Incidence and risk factors of workplace violence on psychiatric staff

    PubMed Central

    Ridenour, Marilyn; Lanza, Marilyn; Hendricks, Scott; Hartley, Dan; Rierdan, Jill; Zeiss, Robert; Amandus, Harlan

    2015-01-01

    BACKGROUND A study by Hesketh et al. found that 20% of psychiatric nurses were physically assaulted, 43% were threatened with physical assault, and 55% were verbally assaulted at least once during the equivalent of a single work week. From 2005 through 2009, the U.S. Department of Justice reported that mental health occupations had the second highest average annual rate of workplace violence, 21 violent crimes per 1,000 employed persons aged 16 or older. OBJECTIVE An evaluation of risk factors associated with patient aggression towards nursing staff at eight locked psychiatric units. PARTICIPANTS Two-hundred eighty-four nurses in eight acute locked psychiatric units of the Veterans Health Administration throughout the United States between September 2007 and September 2010. METHODS Rates were calculated by dividing the number of incidents by the total number of hours worked by all nurses, then multiplying by 40 (units of incidents per nurse per 40-hour work week). Risk factors associated with these rates were analyzed using generalized estimating equations with a Poisson model. RESULTS Combining the data across all hospitals and weeks, the overall rate was 0.60 for verbal aggression incidents and 0.19 for physical aggression, per nurse per week. For physical incidents, the evening shift (3 pm – 11 pm) demonstrated a significantly higher rate of aggression than the day shift (7 am – 3 pm). Weeks that had a case-mix with a higher percentage of patients with personality disorders were significantly associated with a higher risk of verbal and physical aggression. CONCLUSION Healthcare workers in psychiatric settings are at high risk for aggression from patients. PMID:24894691

  6. Evolution of a Nursing Model for Identifying Client Needs in a Disaster Shelter: A Case Study with the American Red Cross.

    PubMed

    Springer, Janice; Casey-Lockyer, Mary

    2016-12-01

    From the time of Clara Barton, Red Cross nursing has had a key role in the care and support of persons affected by disasters in the United States. Hurricane Katrina and other events brought to light the need for a shelter model that was inclusive of the whole community, including persons with disabilities, at-risk and vulnerable populations, and children. From an intake process to a nursing model for assessment, an evidence-guided process informed a systematic approach for a registered nurse-led model of care. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.

    PubMed

    Dykes, Patricia C; Hurley, Ann C; Brown, Suzanne; Carr, Robyn; Cashen, Margaret; Collins, Rita; Cook, Robyn; Currie, Leanne; Docherty, Charles; Ensio, Anneli; Foster, Joanne; Hardiker, Nicholas R; Honey, Michelle L L; Killalea, Rosaleen; Murphy, Judy; Saranto, Kaija; Sensmeier, Joyce; Weaver, Charlotte

    2009-01-01

    In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.

  8. Occupational health and safety issues among nurses in the Philippines.

    PubMed

    de Castro, A B; Cabrera, Suzanne L; Gee, Gilbert C; Fujishiro, Kaori; Tagalog, Eularito A

    2009-04-01

    Nursing is a hazardous occupation in the United States, but little is known about workplace health and safety issues facing the nursing work force in the Philippines. In this article, work-related problems among a sample of nurses in the Philippines are described. Cross-sectional data were collected through a self-administered survey during the Philippine Nurses Association 2007 convention. Measures included four categories: work-related demographics, occupational injury/illness, reporting behavior, and safety concerns. Approximately 40% of nurses had experienced at least one injury or illness in the past year, and 80% had experienced back pain. Most who had an injury did not report it. The top ranking concerns were stress and overwork. Filipino nurses encounter considerable health and safety concerns that are similar to those encountered by nurses in other countries. Future research should examine the work organization factors that contribute to these concerns and strengthen policies to promote health and safety.

  9. Physical Assessment Techniques in Nursing Education: A Replicated Study.

    PubMed

    Kohtz, Cindy; Brown, Suzanne C; Williams, Ryan; O'Connor, Patricia A

    2017-05-01

    It has been nearly a decade since findings revealed that a sample of U.S. nurses routinely used only 30 physical assessment techniques in clinical practice. In a time of differentiating nice-to-know from need-to-know knowledge and skills, what has changed in nursing education? This cross-sectional, descriptive study examines the physical assessment skills taught and used among nursing students at one baccalaureate nursing education program located in the midwestern United States. Findings highlight the similarities and differences from previous studies and offer insight as to how closely nursing education mirrors the skills needed for clinical practice. Nurse educators must continue to discriminate content taught in prelicensure nursing education programs and should consider the attainment of competency of those essential skills that most lend to optimal patient outcomes. [J Nurs Educ. 2017;56(5):287-291.]. Copyright 2017, SLACK Incorporated.

  10. Adjustment of inpatient care reimbursement for nursing intensity.

    PubMed

    Welton, John M; Zone-Smith, Laurie; Fischer, Mary H

    2006-11-01

    The Centers for Medicare and Medicaid Services has begun an ambitious recalibration of the inpatient prospective payment system, the first since its introduction in 1983. Unfortunately, inpatient nursing care has been overlooked in the new payment system and continues to be treated as a fixed cost and billed at a set per-diem "room and board" fee despite the known variability of nursing intensity across different care settings and diagnoses. This article outlines the historical influences regarding costing, billing, and reimbursement of inpatient nursing care and provides contemporary evidence about the variability of nursing intensity and costs at acute care hospitals in the United States. A remedy is proposed to overcome the existing limitations of the Inpatient Prospective Payment System by creating a new nursing cost center and nursing intensity adjustment by DRG for each routine-and intensive-care day of stay to allow independent costing, billing, and reimbursement of inpatient nursing care.

  11. Occupational Health and Safety Issues Among Nurses in the Philippines

    PubMed Central

    de Castro, A. B.; Cabrera, Suzanne L.; Gee, Gilbert C.; Fujishiro, Kaori; Tagalog, Eularito A.

    2009-01-01

    Nursing is a hazardous occupation in the United States, but little is known about workplace health and safety issues facing the nursing work force in the Philippines. In this article, work-related problems among a sample of nurses in the Philippines are described. Cross-sectional data were collected through a self-administered survey during the Philippine Nurses Association 2007 convention. Measures included four categories: work-related demographics, occupational injury/illness, reporting behavior, and safety concerns. Approximately 40% of nurses had experienced at least one injury or illness in the past year, and 80% had experienced back pain. Most who had an injury did not report it. The top ranking concerns were stress and overwork. Filipino nurses encounter considerable health and safety concerns that are similar to those encountered by nurses in other countries. Future research should examine the work organization factors that contribute to these concerns and strengthen policies to promote health and safety. PMID:19438081

  12. Media images of physicians and nurses in the United States.

    PubMed

    Krantzler, N J

    1986-01-01

    This paper analyzes images of physicians and nurses presented in advertisements in the medical and nursing journals JAMA (Journal of the American Medical Association) and AJN (American Journal of Nursing). Advertisements are viewed as hyper-ritualized displays of symbols and rituals associated with medical and nursing practice, both reflecting and reaffirming stereotypes and beliefs that are widely held in the society at large. Trends over the past few decades show that medical advertisements are dropping some traditional symbols (such as the white coat and stethoscope) in favor of depicting science-in-action and high technology. Nursing advertisements, however, are more frequently utilizing the symbols formerly reserved for physicians. Both physicians and nurses are depicted in their respective journals as existing largely independent of one another. While these advertisements clearly do not depict social reality, they present a fictionalized version which reflects and reproduces some of the expressed ideals in medical and nursing practice.

  13. Comparison of nurse staffing based on changes in unit-level workload associated with patient churn.

    PubMed

    Hughes, Ronda G; Bobay, Kathleen L; Jolly, Nicholas A; Suby, Chrysmarie

    2015-04-01

    This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers. Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes. Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical. Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts. Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn. Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements. © 2013 John Wiley & Sons Ltd.

  14. The Certified Clinical Nurse Leader in Critical Care.

    PubMed

    L'Ecuyer, Kristine M; Shatto, Bobbi J; Hoffmann, Rosemary L; Crecelius, Matthew L

    2016-01-01

    Challenges of the current health system in the United States call for collaboration of health care professionals, careful utilization of resources, and greater efficiency of system processes. Innovations to the delivery of care include the introduction of the clinical nurse leader role to provide leadership at the point of care, where it is needed most. Clinical nurse leaders have demonstrated their ability to address needed changes and implement improvements in processes that impact the efficiency and quality of patient care across the continuum and in a variety of settings, including critical care. This article describes the role of the certified clinical nurse leader, their education and skill set, and outlines outcomes that have been realized by their efforts. Specific examples of how clinical nurse leaders impact critical care nursing are discussed.

  15. Nurses with Undiagnosed Hearing Loss: Implications for Practice.

    PubMed

    Spencer, Cara S; Pennington, Karen

    2015-01-05

    Hearing loss affects 36 million people in the United States of America, including 17% of the adult population. This suggests some nurses will have hearing losses that affect their communication skills and their ability to perform auscultation assessments, potentially compromising patient care and safety. In this article, the authors begin by reviewing the hearing process, describing various types of hearing loss, and discussing noise-induced hearing loss and noise levels in hospitals. Next, they consider the role of hearing in nursing practice, review resources for hearing-impaired nurses, identify the many costs associated with untreated hearing loss, and note nurses' responsibility for maintaining their hearing health. The authors conclude that nurses need to be aware of their risk for hearing loss and have their hearing screened every five years.

  16. Principle-based ethics and nurses' attitudes towards artificial feeding.

    PubMed

    Day, L; Drought, T; Davis, A J

    1995-02-01

    Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.

  17. Hospital Administration and Nursing Leadership in Disasters: An Exploratory Study Using Concept Mapping.

    PubMed

    Veenema, Tener Goodwin; Deruggiero, Katherine; Losinski, Sarah; Barnett, Daniel

    Strong leadership is critical in disaster situations when "patient surge" challenges a hospital's capacity to respond and normally acceptable patterns of care are disrupted. Activation of the emergency operations plan triggers an incident command system structure for leadership decision making. Yet, implementation of the emergency operations plan and incident command system protocols is ultimately subject to nursing and hospital leadership at the service- and unit level. The results of these service-/unit-based leadership decisions have the potential to directly impact staff and patient safety, quality of care, and ultimately, patient outcomes. Despite the critical nature of these events, nurse leaders and administrators receive little education regarding leadership and decision making during disaster events. The purpose of this study is to identify essential competencies of nursing and hospital administrators' leadership during disaster events. An integrative mixed-methods design combining qualitative and quantitative approaches to data collection and analysis was used. Five focus groups were conducted with nurse leaders and hospital administrators at a large urban hospital in the Northeastern United States in a collaborative group process to generate relevant leadership competencies. Concept Systems Incorporated was used to sort, prioritize, and analyze the data (http://conceptsystemsinc.com/). The results suggest that participants' institutional knowledge (of existing resources, communications, processes) and prior disaster experience increase leadership competence.

  18. United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit.

    PubMed

    Zhang, Xiaoming; Tai, Daniel; Pforsich, Hugh; Lin, Vernon W

    This is a reevaluation of registered nurse (RN) supply and demand from 2016 to 2030 using a previously published work forecast model and grading methodology with more recent workforce data. There will be a shortage of 154 018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions. This reflects a nearly 50% overall improvement when compared with the authors' prior study, and the low-performing states have improved from 18 "D" and 12 "F" grades as published earlier to 13 "D" and 1 "F" in this study. Although progress has been made, efforts to foster the pipelines for improving the nursing workforce need to be continued.

  19. Managed Migration: The Caribbean Approach to Addressing Nursing Services Capacity

    PubMed Central

    Salmon, Marla E; Yan, Jean; Hewitt, Hermi; Guisinger, Victoria

    2007-01-01

    Objective To (1) provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; (2) discuss country-specific case(s) within the Caribbean; and (3) describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. Principal Findings The Caribbean is in the midst of a crisis of shortages of nurses with an average vacancy rate of 42 percent. Low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Many of these nurses look outside the region for job opportunities in the United Kingdom, Canada, the United States, and other countries. Compounding the situation is the lack of resources to train nurses to fill the vacancies. The Managed Migration Program of the Caribbean is a multilateral, cross-sector, multi-interventional, long-term strategy for developing and maintaining an adequate supply of nurses for the region. Conclusions The Managed Migration Program of the Caribbean has made progress in establishing regional support for addressing the nursing shortage crisis and developing a number of interesting initiatives such as training for export and temporary migration. Recommendations to move the Managed Migration Program of the Caribbean forward focus on advocacy, integration of the program into regional policy decisions, and integration of the program with regional health programming. PMID:17489919

  20. [Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].

    PubMed

    Kim, Se Young; Kim, Eun Kyung; Kim, Byungsoo; Lee, Eunpyo

    2016-06-01

    The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.

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