Leveling EBP content for undergraduate nursing students.

Integration of evidence into practice is an essential outcome for baccalaureate nursing students in this era of health care reform. Cultivation of a spirit of inquiry and appreciation for the role of evidence in shaping nursing practice is central to the development of requisite knowledge and skills. A baccalaureate nursing program curricular redesign placed a higher emphasis on evidence-based practice. The evidence-based practice focus of the undergraduate curriculum is a sequence of 3 undergraduate research courses designed to prepare the graduate to identify, locate, read, and critically appraise evidence at the individual study, systematic review, and clinical practice guideline levels. This curriculum lays the foundation for evidence-based practice in the clinical arena and in graduate nursing programs.

School nurses who only care for children with special needs: working in a teacher's world.

Published qualitative studies have not focused on nurses who solely care for children with special health care needs. The purpose of this study was to explore and describe (a) the work of school nurses who care exclusively for these children, (b) nurses' interaction with parents, staff, or providers, and (c) the challenges, benefits, and support for their role. Data from on-site observation and in-depth interviews with experienced, long-term employed nurses (n = 13) were analyzed using qualitative descriptive inquiry. Performing a personally satisfying clinical role, school nurses adapted to a "teachers world" by working alone, feeling responsible; begging, bartering, and subsidizing; and embracing school as family. They bridged home and school by doing for children, building relationships with parents, and knowing the child. Nurses need to be supported through peer supervision and adequate resources to provide family-centered care to students in a setting dominated by education professionals.

School nursing for children with special needs: does number of schools make a difference?

BACKGROUND: Few recent studies have focused on the role of school nurses who predominantly care for children with special health care needs (CSHCN). The primary aim of this study was to explore differences related to (a) child health conditions covered, (b) direct care procedures, (c) care management functions, and (c) consultation sources used among nurses who spent the majority of their time caring for CSHCN compared to a mixed student population and among nurses who covered a single school versus multiple schools. METHODS: A community-based interdisciplinary team developed a 28-item survey which was completed by 50 nurses (48.5% response) employed by health departments and school districts. Descriptive and comparative statistics and thematic coding were used to analyze data. RESULTS: Nurses who covered a single school (n = 23) or who were primarily assigned to CSHCN (n = 13) had a lower number of students, and more frequently (a) encountered complex child conditions, (b) performed direct care procedures, (c) participated in Individualized Education Plan (IEP) development, (d) collaborated with the Title V-CSHCN agency, and e) communicated with physicians, compared to nurses who covered multiple schools or a general child population. Benefits centered on the children, scope of work, school environment, and family relationships. Challenges included high caseloads, school district priorities, and families who did not follow up. CONCLUSION: The number of schools that the nurses covered, percent of time caring for CSHCN, and employer type (school district or health department) affected the scope of school nurse practice. Recommendations are for lower student-to-nurse ratios, improved nursing supervision, and educational support.

Development of an observational instrument to measure mother-infant separation post birth.

The importance of the timing, quality, and quantity of early maternal-infant contact has gained prominence over the years. However, no researcher has adequately documented the nature of maternal-infant contact and separation. This study assessed the psychometric properties of the Index of Mother-Infant Separation (IMIS), pronounced "I miss," which is a 37-item observational measure of the process of mother-infant contact or separation post birth. Assessment of reliability and validity of the IMIS was conducted using data collected in a randomized clinical trial with 224 healthy newborn infants assigned at 1 hour post birth to self-regulatory or routine nursery care (control) groups. Time-sampled observations occurred every 15 minutes. Content validity indices of the IMIS, determined by nine nationally known perinatal experts, were 77% to 100% for instrument items. Construct validity was supported through known-groups hypothesis testing (p < .0001). Interrater reliability was from 86% to 90%. The IMIS is a valid observational measure of maternal contact when raters are trained to score it reliably.