Staying afloat: surviving curriculum change.

In response to calls for nursing education reform, a content-based curriculum was changed to a concept-based curriculum, using Kanter's 7 skills for effective change model. The skills include tuning in to the environment, challenging the prevailing organizational wisdom, communicating a compelling aspiration, building coalitions, transferring ownership to a working team, learning to persevere, and making everyone a hero. The authors describe the steps taken to successfully accomplish this arduous task.

A new curriculum for a new era of nursing education.

The need for curriculum reform, a common theme in the nursing and health sciences literature for a number of years, is becoming urgent. This article describes an innovative undergraduate nursing curriculum. Central to the curriculum revision were the adoption of a conceptual approach, the institution of clinical experiences driven by conceptually based learning, and a focus on experiences across population groups and practice settings. An innovative, Web-based community was developed as a platform for the curriculum.

The use of knee-length versus thigh-length compression stockings and sequential compression devices.

BACKGROUND: Nurses on an Acute Care Evidence Based Practice Committee, creating a policy to increase patient compliance with thromboembolic deterrent stockings (TEDS) and sequential compression devices (SCDs) for deep vein thrombosis prophylaxis, found limited literature on patient preference and response to this treatment. STUDY AIM: The study purpose was to determine whether knee-length or thigh-length TEDS and/or SCDs were more comfortable, correctly applied, and worn by patients, and to assess patient reasons for noncompliance. METHOD: A patient survey and observational data tool was designed. Six surveyors collected data (interrater reliability = 93%) from 137 randomly selected patients with orders for TEDS and/or SCDs admitted to acute care medical or surgical nursing units. RESULTS: Most patients wore thigh-length SCDs and TEDS. However, only 29.2% (n = 40) had SCDs on them at the time of survey, and 62.8% (n = 86) were compliant with TEDS. The most common reasons given for noncompliance with SCDs were that the devices were not reapplied after bathing or ambulating, or were removed because they were hot or itchy. Complaints of discomfort were highest among patients wearing thigh-length SCDs and TEDS. Problems with fit were 50% higher in those who wore thigh-length TEDS, and involved stockings that created restricting bands. Most patients understood the purpose of treatment, and older patients were more compliant than younger patients. IMPLICATIONS FOR PRACTICE: Knee-length TEDS and SCDs are more comfortable for patients, encourage higher levels of compliance with treatment, do not pose a risk for venous stasis to patients by creating restricting bands, and are less expensive. Patients need ongoing education to resume wearing TEDS and SCDs after activities of daily living, and knee-length stockings and devices would be easier to reapply. The policy in our institution was changed for the use of knee-length compression stockings and SCDs.

Rescuing nursing education from content saturation: the case for a concept-based curriculum.

Nursing education has been plagued with a saturation of content for many years. The multiple contributing factors underscore the complexity of the problem and validate the need for educational reform. The purpose of this article is to discuss various factors contributing to content saturation and propose a conceptual approach for curriculum development and teaching in nursing education.

Using the synergy of online education and simulation to inspire a new model for a community critical care course.

Advances in patient simulator technology, and the availability of online critical care orientation modules for nurses, provide nurse educators with a golden opportunity to create an innovative model for critical care orientation. Combining the advantages of online education with the benefits of simulation learning creates a course far superior to that produced by using the current educational approaches. This new model captures the flexibility and cost-effectiveness benefits of online learning while engaging the participants in active hands-on experiences to better prepare them for clinical practice. Simulation lab experiences allow the participant to experience a variety of emergent critical situations, take action, and review consequences of choices without jeopardizing patient safety. However, initiating and maintaining a simulator lab is an overwhelming expense for most hospitals. A collaborative education arrangement where hospitals partner to offer a community critical care course and share online and simulator lab costs would make this education model affordable, support national patient safety goals, and meet the need in our communities for highly qualified critical care nurses.

PDAs bring information competence to the point-of-care.

The ability of nursing faculty and students to efficiently obtain accurate information at the point-of-care is a critical aspect of providing quality patient care. Personalized Digital Assistants (PDAs) can provide instant access to entire textbooks of information where it is needed most, in the dynamic learning environment of the clinical setting. With a growing trend in higher education to include instruction on information competency in the curriculum, the use of PDAs in nursing education needs to be explored. This article discusses the use of PDAs by faculty and students within one nursing program. Results from a survey of faculty and students demonstrated a clear discrepancy in their use of PDAs. Although students recognized the benefits of PDA use in the clinical setting, they did not want owning a PDA to be a program requirement. Discussed are several approaches being used to overcome identified barriers to PDA use and ownership.