Redesigning Nursing Education to Build Healthier Communities: An Innovative Cross-Sector Collaboration.

Today's health care environment requires registered nurses to be prepared for an array of practice settings, providing care outside the hospital and directly in the community. There is increasing focus on wellness, prevention, access to care, and mental health services for an aging and more diverse population. To improve alignment of education with increasingly complex needs, donor-advised funding supported four prelicensure nursing schools to transform their curricula. Selected schools were guided through a curriculum redesign process emphasizing community and continuum of care. This innovation was consistent with meeting challenges to realize the Institute of Medicine's 2011 Future of Nursing recommendations.

High occurrence of antihistamine resistance in patients with recurrent idiopathic angioedema.

Antihistamines are the most prescribed therapy in recurrent idiopathic angioedema, yet little is known about their efficacy. Herein, we report on clinical improvement with antihistamine therapy in 120 patients evaluating angioedema attack frequency. A high incidence (36%) of antihistamine refractory cases was observed. Forty percent of patients on antihistamine prophylaxis suffered from 1 or more angioedema attacks per month. Our findings stress the need for additional treatment options for recurrent idiopathic angioedema.

Academic-Practice Partnerships for Unemployed New Graduates in California.

In California, academic-practice partnerships offer innovative transition programs to new registered nurse (RN) graduates who have not yet found positions in nursing. This report describes the formation of 4 partnerships between 1 or more schools of nursing and clinical practice sites that included hospitals and nonacute care settings, such as hospice, clinics, school districts, and skilled nursing facilities. Factors facilitating the partnerships included relationships established as nurse leaders from practice and academia came together to address previous workforce issues, positive interpersonal experiences, an independent convening and coordinating organization, a shared understanding of the employment challenge faced by new RN graduates, and a shared vision for its solution. Partnerships face continuing challenges that include sustaining engagement, resource constraints, and insufficient nursing leadership succession planning. Partnership benefits include improved relationships between academia and practice, a forum to address contemporary issues in nursing education and practice advances, and stimulation of a reassessment of how to integrate ambulatory, transitional, and community-based nursing into prelicensure education.

Preceptor and Self-Evaluation Competencies Among New RN Graduates.

Four transition-to-practice programs for new RN graduates who had not yet found employment in nursing were based on the Quality and Safety Education for Nurses (QSEN) competencies of knowledge, skills, and attitudes (KSAs). To support consistent evaluation of participants by preceptors, a 35-item tool was developed that used a 4-point scale to assess selected behaviors. This article describes the initial reliability and validity testing of the tool, which had good internal consistency, with a Cronbach's alpha of 0.92 for preceptor evaluation of participants and 0.82 when used as a self-evaluation tool. Six content experts evaluated the tool's face validity; it successfully discriminated between junior-level baccalaureate nursing students and nursing faculty. Although the tool does not exhaustively reflect the QSEN KSAs, it provides a way to assess competencies among new nurse graduates.

Economic aspects of community-based academic-practice transition programs for unemployed new nursing graduates.

Four partnerships between schools of nursing and practice sites provided grant-funded 12- to 16-week transition programs to increase confidence, competence, and employability among new RN graduates who had not yet found employment in nursing. Per capita program costs were $2,721. Eighty-four percent of participants completing a postprogram employment survey became employed within 3 months; 55% of participants became employed at their program practice site. Staff development educators may find this model a useful adjunct to in-house nurse residency programs for new RN graduates.

Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence.

Collaborative academic-practice transition program for new graduate RNs in community settings: lessons learned.

In 2010-2011, leaders from California academic and practice settings and additional community partners collaboratively developed four 12- to 16-week transition programs for 345 new registered nurse (RN) graduates who had not yet found employment as nurses. Program goals were to increase participants' confidence, competence, and employability and expand the employment landscape to nontraditional new graduate settings. One program focused exclusively on community-based settings and was completed by 40 participants at clinics and school sites; all participants secured RN jobs. Key lessons learned go beyond the impact for participants and relate to changing the nursing culture about career path models for new graduates, troubleshooting regulatory issues, the potential for new graduates to help transform nursing, and advancing academic-practice partnerships and supporting practice sites. The community-based transition program continues to provide opportunities for new RN graduates and model an approach for transforming nursing practice.

Competence gaps among unemployed new nursing graduates entering a community-based transition-to-practice program.

Multiple reports document competence gaps among employed new RN graduates. Less is known about the competence and confidence of new RN graduates who have not yet found employment in nursing. As part of an academic/practice partnership model, 4 collaboratives provided transition-to-practice programs for newly graduated and licensed, but unemployed, RNs. The authors describe the new nurses' characteristics on program entry and discuss implications for nursing education and practice.