Using computer simulations and focus groups for planned change in prenatal clinics.

The Colleges of Nursing and Engineering in a southwest Florida university combined efforts to design a project to use time/motion techniques and focus groups to assess patent flow and effective and efficient use of human resources in public health clinics. Data for 877 observations were entered into a computer simulation program that displayed alternative configurations for health resource management. Information from focus groups was used to plan for ways to use clinic wait time more effectively. This article describes data collection and findings.

Assessing critical thinking in baccalaureate nursing students: a longitudinal study.

The purpose of this study was to evaluate the attainment of critical thinking skills of students before and after curriculum revision of a baccalaureate nursing program. The California Critical Thinking Skills Test (CCTST) was used to measure the critical thinking ability of the students at program entry, midpoint, and at exist. The sample consisted of three cohorts of students: cohort 1 (n = 55) was the baseline class before curriculum revision, whereas cohorts 2 (n = 55) and 3 (n = 73) were the first two classes to experience the revised curriculum. The results revealed that cohort 2 achieved significantly higher critical thinking scores than the baseline cohort. Cohort 2 also improved dramatically on all subscales from test 1 to test 3. However, cohort 3 failed to demonstrate improved critical thinking scores over time. Findings have implications for measuring critical thinking.

Compete or complement? An interdisciplinary approach to training health professionals.

The recommendation that future practitioners have the competency to work effectively in interdisciplinary teams is not new, but educating students for this type of practice remains a challenge for the health care professions (1-4). Early interdisciplinary teams usually worked in parallel. There were no common goals, but each group's goals stemmed from its professional education (5). In the traditional model, medical doctors were the "team leaders." Current recommendations challenge health professions educators "to move beyond traditional discipline-bound educational models to future-oriented interdisciplinary teaching/learning models" (6). Taking this recommendation seriously, educators from the University of South Florida (USF) formed a team to develop a model to guide the education of students from four health professions. Our goal was to model, by our philosophy, actions, and words, the art of teaching as an interdisciplinary team. This article describes the first phase of the process and four critical steps--establishing a common goal, developing a team process, creating a model to guide our interactions, and developing support networks within the community.

Baccalaureate nursing education and home health: a collaborative alliance.

Nursing educators are challenged to prepare practitioners to move out of acute care and perform competently in nontraditional settings. Faculty from a university college of nursing and registered nurse preceptors from 13 home health agencies formed an alliance to serve as co-educators for junior-level baccalaureate nursing students in a 35-hour, two-semester home health clinical rotation. The outcomes of this alliance were evaluated with a qualitative descriptive study that evaluated the effectiveness of the model. Content analysis of students' journal reflections revealed that the collaborative alliance in home health enabled students to integrate practice with theory and to view the new practice environment as a meaningful learning experience. Nurse preceptors serving as co-educators in the home setting were viewed as valuable role models who provided opportunities for active participation of students. In addition, this collaborative alliance enhanced students' assimilation of the principles of nontraditional practice and facilitated the personal and professional growth they needed to prepare them for nursing practice in the future.

Effect of comprehensive care on pregnancy outcomes.

The purpose of the study was to compare pregnancy outcomes of low socioeconomic pregnant women receiving prenatal care at a prototype, comprehensive, multidisciplinary tertiary clinic with outcomes of a matched sample who received prenatal care from a variety of area public health clinics. Multidisciplinary clinic subjects were matched by age, race, and parity to 175 control subjects selected from labor and delivery logs of the general hospital that services the entire community. There were significant differences between groups on the measures of gestational age (t[174] = 2.50, p < .01), maternal risk factors (t[174] = 11.12, p < .0), and infant complications (t[174] = 5.86, p < .01). Infant birthweight and APGAR scores were not significantly different between the multidisciplinary clinic subjects and the matched sample. This study showed the importance of comprehensive prenatal care for low socioeconomic women at high risk for obstetrical and medical complications.

Logbook data as a source of birth information. Are they valid?

OBJECTIVE: To determine if the data recorded in the labor and delivery logbook in two hospitals are complete and consistent with the information in the patient's medical record. STUDY DESIGN: We performed a retrospective comparison of the information in the labor and delivery logbook to the content of 110 patients' hospital charts in each of two hospitals. RESULTS: The logbooks of both hospitals had erroneous entries and missing data as compared to the antepartum complications, intrapartum events and immediate newborn care recorded in the patients' medical records. The range of error in these three categories was 61%, 31% and 60% in one hospital and 37%, 29% and 30% in the other hospital. CONCLUSION: The results of this study do not support the use of logbooks as a source of data for individual or collated departmental, hospital or agency reports containing antepartum, intrapartum and newborn information.

Client satisfaction with prenatal care and pregnancy outcomes.

Client satisfaction and pregnancy outcomes of two groups of low socioeconomic women were compared. One group received prenatal care from a public health clinic, the other from a prototype tertiary multidisciplinary clinic. Sixty-two women from each clinic completed the Risser Patient Satisfaction instrument, after no less than three clinic visits. Clients from the multidisciplinary clinic were significantly more satisfied on three variables related to nursing care (technical skills, teaching, and interpersonal relationships), and one variable related to setting. Postdelivery log reviews revealed that infant birth weights, Apgar scores, and gestational ages were not significantly different between the two groups. Nurse case managed care and removal of barriers contributed to more satisfied consumers. Continuity of prenatal care was associated with healthy infants regardless of client perceptions of satisfaction.

Innovative teaching of developmental themes of the elderly and the young.

The authors demonstrate how faculty members creatively designed an undergraduate course in which students learned developmental similarities and differences across the life span. Student-client interaction, involvement in practice, and inquiry strategies are used to enhance teaching and learning. Practice informed theory for students resulting ina meaningful synthesis of content.

Neuman's framework and ventilator dependency: a pilot study.

The purpose of this article is to illustrate how the Neuman systems model guided a pilot study with ventilator-dependent patients. Mechanical ventilation was the external stressor to which these subjects reacted. The interaction of Neuman's client system variables was investigated to see which variables most influenced the weaning process. The pilot served to link model concepts with research variables and to identify appropriate procedures and tools for data collection.

Is a baccalaureate in nursing worth it?

This study investigated economic costs and benefits of generic BSN and BS degrees from students' points of view. Economic benefits from the baccalaureate degree exceeded benefits from an RN-credential only, after a lifetime of employment. The net present value of a BSN degree discounted at 5% was four times greater than the net present value of a BSRN/diploma and three times greater than a BSN/associate degree.

Spirituality: integral to quality care.

Caring is the medium through which nursing knowledge, skill, and touch are operationalized. Caring is a profound act of hope (White T. 1986. Unpublished data) that contributes to the spiritual well-being of others. In order to assure quality care, the impact of identifying and meeting patient spiritual needs must be taken into account.

Nursing shortage. Catalyst for administrative/educational partnership.

A nurse administrator and a nurse educator, already linked in collaborative efforts, developed a creative response to their concerns of recruitment and retention of nursing staff and nursing students. The result was a program of academically sound registered nursing education for a specific full-time employed population. This link between service and education benefitted the health care agency by recruiting and retaining employees, the college by increasing enrollments in the nursing program, and the employees by providing convenient, low cost, accessible education. The phases of assessing, planning, implementing, and evaluating the on-site RN program are reported, and the information of interest and use to other persons in similar situations is presented.

Intergenerational education in human sexuality.

Our primary goal is to bring parents and their teens together in a relaxed, nonjudgmental atmosphere and get them talking to each other about sexuality.