Journal of Professional Nursing最新文献

Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.

Nurses play a crucial role in addressing human health influenced by global forces such as pandemics, and political conflicts that displace millions; in leading efforts to promote planetary health; and in achieving the United Nations (UN) Sustainable Development Agenda. Academic nursing programs have a significant role in actualizing nursing's impact on global health (GH) and planetary health (PH). This paper describes how nursing programs can actualize their GH and PH nursing perspectives to benefit students and society, thereby increasing nursing's effectiveness and improving health outcomes in local and global settings. Numerous strategies to actualize GH and PH perspectives were derived from current literature and an assessment of eleven nursing program websites. Nursing programs may adopt program-wide strategies such as reflecting GH and PH in their mission statement; through education, in courses; and through faculty or student scholarship, policy endeavors, and/or partnerships. Now is the time to take such action, recommitting to GH and PH nursing and deepening nursing's impact. Academic nursing programs' leadership role in society, and their role in preparing nurses to lead, educate, discover, and advocate is essential for the health of populations and the planet long into the future.

Background

The American Association of Colleges of Nursing (AACN, 2021) introduced “The Essentials: Core Competencies for Professional Nursing Education” (Essentials) in 2021. The AACN document necessitated a change in nursing curriculums, both undergraduate and graduate. To meet the revised standards, one college of nursing within a hierarchical organization used a Three-Step Model of Planned Change to guide curricular revisions. This article presents the lessons learned from using the Three-Step Model of Planned Change, which includes barriers, strategies, and a toolkit for implementing planned change.

Step One-Desire a Change

Lessons learned include embracing the unifying values of the guiding coalition to understand the motivation(s) and urgency for change. Suggested strategies include creating a cross-sectional organizational team, utilizing collaborative approaches that value members' time, and various communication methods.

Step Two-Make the Change

Lessons learned include understanding the larger hierarchical structure's process requirements and time allotment for approval. Suggested strategies include establishing a repository hub for templates and shared documents, implementing various communication channels, and repurposing standing meeting times.

Step Three-Live the Change

As this process is just beginning, anticipated lessons include an understanding of changes occurring circuitously within and between steps. Considerations include significant and purposeful actions to deliver the new curriculum.

Background

With the aging population, there is an increased need for nurses with competence in chronic illness and palliative care management particularly in long-term care settings. The incorporation of palliative care education in nursing curricula has been explored previously.

Purpose

This review aimed to appraise the current literature on the state of palliative care education in academia and how it impacts the preparedness of nurses to enter long-term care post-graduation. There has not been an integrative review exploring curriculum-based palliative care education for long-term care.

Method

This review was guided by the method of Whittemore and Knafl using critical appraisal tools. The CINAHL, Cochrane, EBSCO, ERIC, Journals@Ovid, Medline, PsycINFO, and ScienceDirect databases were searched for peer-reviewed literature from 2017 to 2022.

Results

Sixteen items met the search criteria for appraisal, and 11 items were retained for discussion.

Conclusion

There is a gap in nursing curricula in preparing nurses for the situations faced by long-term care nurses. Long-term care nurses develop strong bonds with residents and families and often lack time, space, and resources to cultivate the confidence and competence as palliative situations arise. More research is needed to determine the best placement in nursing programs for palliative-based long-term care education.

Background

Nursing shortages are occurring due to decreased student enrollment, nurse burnout, staffing deficits, nurse retirements, and increasingly low numbers of nursing faculty. Men are an untapped resource that can offset these crises. However, men's presence in nursing remains underwhelming. Changes aimed at improving diversity and inclusivity related to men's presence is needed in the nursing workforce.

Purpose

Explore men's experiences in modern nursing environments to identify barriers to men's presence in nursing faculty and clinical workforce roles.

Method

This study used interpretive description design. Data were collected through individual and group interviews. Interviews were video recorded. Interview questions were semi-structured and open ended. Data were analyzed using thematic analysis.

Results

Two themes were identified and reflected men's experiences in nursing: educational and professional change. Subthemes for educational change included increasing numbers of men in student and faculty roles; instructional change; admission, retention, and advising. Subthemes for professional change included inclusive hiring practices; healthy working environments; and leadership outcomes.

Conclusion

Findings constitute calls for action. Change implementation should address barriers to diversity and inclusivity related to men's presence in nursing. Recommendations and strategies presented can guide change implementation. Change implementation is expected to strengthen the nursing profession.

The 20th century began a period of reform in nursing education and practice, with more nurses receiving advanced degrees and serving in key leadership roles throughout healthcare organizations. During this period, the transformation of the healthcare delivery system encouraged innovation and collaboration between academic nursing programs and other healthcare entities to develop partnerships based on a shared vision and goals. As a result, nurses are negotiating academic-practice partnership agreements and leading interprofessional teams to meet the needs of collaborating organizations. This article describes a stepwise approach to building a research-focused academic practice partnership, from a needs assessment to an evaluation of the partnership.

Background

Caring for an increasingly older and multicultural patient population requires nurses and APNs who are able to integrate cultural competency in meeting the needs of their patients while decreasing health care disparities. A study-abroad immersion experience is one way to instill deep learning and cultural competency.

Purpose

The purpose of this study was to understand the lived experience of baccalaureate nursing students and APN students working together in a study-abroad, service-learning experience.

Method

Using Interpretive Phenomenological Analysis (IPA) (Smith & Osborn, 2003), we explored the lived experience of Baccalaureate and Advanced Practice Nursing Students in a service-learning, study-abroad experience in Belize.

Results

Emergent themes derived from students' journal transcripts were: (1) Allowing learning to take place; (2) Practicing nursing with limited resources (3) A different take on culture; and (4) Kinship with peers. From this theme two sub themes emerged: 1) students' connection with the people and the country, and 2) students' connection with each other.

Conclusion

Cultural immersion prepared students to work in Belize with different patient groups, having varied perspectives related to their health. Students learned that the core values of dignity and caring require that we, as nurses, go where the patient is-not where we want the patient to be. This is tested when students are confronted with a culture not their own.

Background

In 2011, the Institute of Medicine published a report on the future of nursing, which recommended nurse practitioner postgraduate training in the form of fellowships or residencies. Since then, the number of postgraduate programs has grown, but data is still scarce regarding their efficacy and benefits.

Aim

The goal of this integrative review is to synthesize available literature regarding the outcomes of nurse practitioner postgraduate fellowships and/or residencies on clinical competence and perceived readiness to practice.

Methods

CINAHL, PubMed, and citation searching were used to search relevant subject headings, MeSH headings, and keywords related to fellowships and residencies for nurse practitioners, resulting in 11 articles being included based on inclusion and exclusion criteria. Synthesis was completed using the Garrard Matrix method to identify common themes among the studies.

Results

Eight quasi-experimental and three cross-sectional studies were included in this review. Programs included multiple areas of focus, including primary care, critical care, and pediatric acute care. Common themes among the studies were an increased level of preparedness, reduced turnover, and greater job satisfaction.

Conclusions

The major theme found among the studies was an increased confidence and preparedness to practice. Minor themes include increased job satisfaction and decreased intent to quit.

More than 90,000 qualified applicants were rejected from nursing schools in 2021 due in part to the national shortage of nurse practitioner (NP) preceptors and clinical placements. One model that has the potential to address this shortage by enhancing and expanding NP clinical training sites is the academic-practice partnership. In this article, the authors describe the development of a novel academic-practice partnership between a college of nursing and a health department and report the outcomes of a partnership activity that provided wellness visits for adolescents. Through this partnership, the graduate nursing program increased adolescent-focused clinical experiences for family nurse practitioner students by 87.6 h; added one adolescent clinical site for nine NP students; and delivered a total of 34 school and sports physicals, 81 immunizations, and 65 screening tests for adolescent-aged clients. Through this feasible, mutually beneficial, and innovative academic-practice partnership, the graduate nursing program and health department successfully expanded clinical placement experiences for NP students and improved access to wellness care for adolescents. The partnership model can be utilized to not only expand clinical opportunities for NP students but also improve access to care and health outcomes for our local communities.

There has been a call for nursing programs to shift to Competency-based education (CBE). Competency-based education has numerous benefits in nursing education. A curriculum that includes both concepts and competencies helps students and stakeholders understand what new nurse graduates will be able to do with the knowledge they construct throughout the program. Competency-based education is student-centered, flexible, and dependent on students actively engaging in their learning. A small faculty team developed a new direct-entry MSN program, based on essential components of CBE. This article describes the process of incorporating CBE into the development of the program, as well as challenges and barriers to fully implementing CBE into the curriculum.