Organizational Commitment of Nurse Faculty Teaching in Accelerated Baccalaureate Nursing Programs.

AIM: The aim of the study was to examine organizational commitment by exploring experiences of faculty in Accelerated Bachelor of Science in Nursing (ABSN) programs. BACKGROUND: ABSN faculty report that the curriculum is intense and fast-paced. METHOD: A cross-sectional survey design was used to examine faculty organizational commitment. A 53-item self-reported survey with closed questions measured organizational commitment, global job satisfaction, and work conditions. ABSN programs were recruited using cluster random sampling from a five-region list of programs; 62 programs were recruited with total faculty participation of 104. RESULTS: ABSN faculty were found to be affectively and normatively committed to their organizations. Significant predictor variables of work environment conditions were stress and experiences of shortcomings, professional development, managerial support, and global job satisfaction. CONCLUSION: As ABSN programs continue to flourish, it is important to identify strategies for faculty success within the fast-paced curricula.

Successful Advance Care Planning in a Rural Nursing Home.

BACKGROUND:: Advance care planning (ACP) often culminates in the completion of advance care directives (ACD), which is a written record of informed decisions specifying the type and extent of desired medical treatment. Documentation of ACD in nursing homes in the United States indicates a 60% to 70% completion rate. There are little data on the time at which ACD are completed in relation to when the resident was admitted to the nursing home facility. OBJECTIVE:: To explore the success of advanced care planning at a large, rural long-term care (LTC) facility. METHODS:: A descriptive approach, using a retrospective chart review, of 167 residents was used to examine resident completion of health-care system documents, legal documents, predisposing factors (resident demographics and psychosocial characteristics), and the actual process of ACP as defined by the rural LTC facility. RESULTS:: This nursing home utilizes a document entitled resident preference for life-sustaining treatment (RPLST). For residents who do not have formal prepared advance directive documents, the RPLST serves to define resident and family choices for resuscitation and implementation of fluids, nutrition, medications, and antibiotics. The most striking finding was the completion rate of the RPLST within 100 days of being admitted to the nursing home. CONCLUSION:: Documentation of end-of-life preferences within 10 days of admission was achieved through the incorporation of RPLST during the resident admission process.

Revitalizing Learning Outcomes for Adult Gerontology Advanced Practice Programs.

The implementation of the Consensus Model for Advanced Practice Registered Nurse Regulation has defined the model for advanced practice within the four recognized advanced practice nursing roles. The focus of graduate nursing program focus for care of the adult population has been broadened to include gerontology. The change toward increasing graduate program breadth and focus to a lifespan adult/gerontology population will result in the need for analysis and restructuring of advanced practice programs in order to incorporate gerontologic content. The purpose of this article is to describe a process for developing or revitalizing meaningful learning outcomes as an integral component in program revision and evaluation for advanced practice programs incorporating gerontologic content. Learning outcomes will be included with examples and definitions from the beginning basis of role-specific selected adult gerontology competencies through data collection and analysis for program improvement.

Transitions into practice: First patient care experiences of baccalaureate nursing students.

An essential component of the learning process for nursing and other disciplines in health professions education is the structuring of successful clinical experiences for beginning students. The purpose of this research study was to explore and describe first patient care experiences of baccalaureate nursing students in order to better understand student perspectives and perceptions. Data were collected from three cohorts of baccalaureate nursing in two university settings in the first semester following completion of first patient care experiences. A basic, exploratory qualitative approach with overtones of grounded theory was used for data collection and analysis. Three clear themes emerged from the data analysis. Participants experienced emotional responses of Anticipation, including fear, nervousness, and anxiety. The clinical experiences allowed Processing ∼ Working Through, which was impacted by actions of instructors, nurses and patients. Participants developed Awareness as a result of their experiences.

Balancing Ethical Uncertainty: The Dance of Interprofessional Roles.

Interprofessional (IP) education has emerged globally as a means of improving overall healthcare quality, and to increase healthcare provider understanding of other roles. However, in situations of moral uncertainly, there are not clear procedures to address IP role interactions when tension and conflict emerge. This study reports secondary analysis findings from data in a large study related to moral distress in IP ethics consultations and collaborations. A basic qualitative, exploratory approach was utilized for data analysis with overtones of grounded theory. Eleven IP participants representing five disciplines comprised the sample. A model of IP role interaction was constructed from themes which were revealed to identify distinct facilitating actions and barriers as components of IP interactions serving to balance ethical decision making in the context of patient care. Specific role boundaries of the professions identified uncertainty as they interacted with multiple healthcare roles in patient care dilemmas.

Implementation of Mock Competency Skill Assessments to Improve Student Outcomes.

A primary responsibility for nurse educators is to provide students with theoretical knowledge and clinical skills for professional nursing. In this study, laboratory faculty developed a creative pedagogical strategy to reduce nursing student stress during assessment of skill performance. Mock competencies were structured so that students participated in peer-to-peer evaluations in simulated competency assessments. The purpose of this study was to determine whether this pedagogical strategy had an impact on first-round pass rates for skills competency assessments.

Transitioning the complex trauma patient from the ICU: acute care nurses' perceptions of readiness.

Trauma centers improve patient outcomes through the provision of expert care by trauma surgeons and nurses. While the American College of Surgeons stipulates that trauma centers must have qualified nurses, there is no clear definition of qualified, nor is there a recommendation for trauma nurse readiness beyond the emergency department or intensive care. In a newly designated level II trauma center, it was recognized that nurses were unprepared to provide care to complex trauma patients. This study explored nurses' perceptions of their knowledge, skills and confidence in complex trauma care utilizing a novel transitional care model.

Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN role must integrate interprofessional competencies and interactions to prepare APRNs accordingly.

The doctorate in nursing practice: moving advanced practice nursing even closer to excellence.

One of the most significant events to affect advanced practice nursing is the practice doctorate. The doctor of nursing practice (DNP) is firmly established as an educational alternative to the traditional academic research doctoral degree. This option empowers nurses to advance knowledge and skills in clinical practice. This article reviews the historical context that led to the introduction of the DNP and the proposal of the DNP as entry into practice for advanced practice nurses, DNP program parameters, and some of the evolving issues related to nursing's practice doctorate.