Quality indicators for initial licensure and discipline in nursing laws in South Korea and North Carolina.

BACKGROUND: The Korean regulatory framework of nursing licensure reflects that of the USA, but its content differs in some of the powers related to quality assurance. AIM: This article compares regulatory quality indicators and describes core standards in nursing regulations that are related to both initial licensure and discipline for three groups: the National Council of State Boards of Nursing, the North Carolina and the South of Korea. METHODS: A descriptive, comparative law design is used to examine the differences and similarities in the quality indicators and core standards found in three documents: the National Council of State Boards of Nursing Model Act, the North Carolina Nursing Practice Act and the Korean Medical Service Act for registered nurses. RESULTS: The findings indicate that ten quality indicators and two standards appear in study objects. Although most of the quality indicators are common to all documents, some differences are found in terms of the scope of criminal background checks and the range of grounds for disciplinary action. LIMITATIONS: These findings cannot be generalized in the USA because although the North Carolina nursing act was selected as an example of US nursing laws, nursing laws differ somewhat across states. CONCLUSIONS: This comparative study shows a clear opportunity to develop indicators that acknowledge the important areas of competence and good moral character and how they can improve patient safety in Korea. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study provides recommendations for Korean nursing legislative redesign and pointers for other jurisdictions to consider.

Nurse responses to re-tooling practice, education, and management roles.

BACKGROUND: The purpose of this article is to report the results of a survey conducted by one of the nine Area Health Education Centers in North Carolina to inform regional work force planning by ascertaining nurses' views of the need to re-tool for practice, education, and management roles. METHOD: A work force planning group represented by nursing service and education surveyed 1,050 nurses. Four hundred thirty-two (41%) nurses responded: 87% believed they needed to re-tool and 92% were willing to do so. RESULTS: Critical thinking was rated as very important to nurse managers, staff RNs, and LPNs, and educators rated teaching as the area most in need of re-tooling. CONCLUSION: Nurses are clearly interested in re-tooling. Staff development, continuing education, and degree programs can respond to this willingness.

Legal considerations at the end of life.

Patients with end stage renal disease (ESRD) and their families face questions related to dying that are touched by legal mandates. This article addresses patients' legal rights and the nurse's role in advocating for these rights. Advance directives, competency to make health care decisions, assisted suicide, disability law, and the duty to provide reasonable and safe care are specific areas discussed in the article. Nurses must become familiar with legal requirements; communicate effectively with patients, families, and other caregivers; provide care that falls within the standard of care expected of nephrology nurses; and advocate for policies that enhance ESRD patient care.

A tool to assess the cognitively impaired elderly.

When elderly persons become cognitively impaired, decision-making and case management can be intensely frustrating for health care providers who must make provisions for both short-term and long-term care. Numerous barriers pose challenges to the case managers in addition to those that occur when health care terminology does not fit easily into the legal vocabulary of the judge who makes the ultimate decision naming a guardian or conservator. Ongoing research by the authors has been involved in identifying criteria to determine incompetency by both formal and informal caregivers of cognitively impaired elderly. A scale, currently consisting of 10 criteria, has been developed and continues to be refined by the authors.

Nurse attendee purchasing patterns.

Retention of nursing professionals is crucial in responding to the increasing demand for and complexity of nursing care. Augmenting the decision-making role of nurses is one important retention-related strategy. Purchasing patterns reflect one aspect of nurses' decision-making role. National meetings provide nurses with an opportunity to investigate educational and employment options, as well as to preview technological advances in patient care products and supplies. Yet, the purchasing patterns of nurses related to the marketing of patient care supplies, or educational material at national meetings have rarely been acknowledged or researched. This study investigated the purchasing patterns of nurse attendees as revealed at a national meeting and how attendance influenced purchasing input following the meeting. The study addressed differences in purchasing patterns between specific groups of nurse attendees, as well as the relationship between meeting attendance motivators and purchasing patterns. A descriptive methodology utilizing participant observation at four national nursing meetings and mail survey in four phases was used to determine if there were: (1) identifiable purchasing patterns for nurses attending specific nursing-organization sponsored national meetings, (2) differences in purchasing patterns between nurse attendees from these meetings, (3) differences in self-reported post-meeting purchase input, and (4) relationships between meeting attendance motivators and purchasing patterns. The findings demonstrate that nurse attendee purchasing patterns can be identified and do vary among nursing groups. Nurse attendees at specialty meetings were more likely to act as specifiers, have a more dominant role in purchasing and were more likely to influence product purchases than were nurse attendees from generalist meetings. Self-reports of post-meeting purchasing input demonstrated that nurse attendees utilized information gained at national meetings in subsequent patient care product selections, product utilization and specification of new products/equipment/protocols for trial within the practice site. Positive relationships between meeting attendance motivators and purchasing patterns were most evident for those nurse attendees with greater purchasing involvement and influence.

Retrospective analysis of guardians' perceptions of cognitively impaired elderly.

The increased number of elderly persons who will become cognitively impaired in the near future is a cause for concern to all in the health care professions. Even though the final determination of incapacity and incompetency is a legal decision, input from health care professionals is weighed heavily by courts. Health professionals can have influence at the clinical level and also at the level of influencing social policy. Nurses rely on input from the assessments of informal caregivers. This research was conducted to determine guardians' perceptions of important criteria on the Incompetency Assessment Scale. Eleven guardians, a majority of whom were daughters of the elderly wards, perceived 9 of the 22 criteria on the IAS as important or very important to the question of incompetency. All nine criteria are found in Minnesota's statutory definition of incompetency, and also appear in the first two levels of the Maslow hierarchy of needs. Further research is recommended to develop a weighting or clustering of criteria to more accurately ascertain the way that incompetency judgments are made by guardians and other caregivers.