Policy, Politics, and Nursing Practice最新文献

Lack of access to birth facilities and maternity care providers has contributed to rising US maternal mortality and morbidity rates, especially among women in rural areas. Evidence supports the increased use of midwives as a potential solution for access-to-care issues. This observational survey was conducted to identify the practice environment for Certified Nurse-Midwives® in Colorado for the purpose of informing future workforce expansion. Study results indicate that midwives provide services aligned with the midwifery model of care and have mostly autonomous practice in hospitals where midwifery practices are already established. However, there is limited use of midwives, as fewer than half of Colorado's 69 birthing hospitals have midwifery practices, and financial constraint created by low Medicaid reimbursement could be a limiting factor in establishing new midwifery practices. Policy recommendations based on survey results include (a) support for midwifery education and workforce development, (b) removal of hospital-level restrictions for privileges of midwives, and (c) consideration for public payment models that promote expansion of midwifery practices.

Missed nursing care is a multifaceted patient safety issue receiving increased attention among healthcare scholars worldwide. There is limited research on missed nursing care in the Jordanian healthcare context. The current study sought to examine the perceptions of Jordanian nurses toward the amount and types of missed nursing care in medical and surgical wards. We also examined the differences in missed care items between public, private, and university hospitals in Jordan. This was a cross-sectional study using the MISSCARE Survey tool. Data collection spanned 4 months between March and July 2021. The final study sample consisted of 672 registered nurses employed in five public, three private, and two university hospitals in Jordan. Data were analyzed using descriptive statistics, Analysis of variance, and Pearson correlation coefficent test. Of the 672 registered nurses who participated, the majority were females (n = 421; 62.6%). Most participants held a bachelor's degree in nursing (n = 577; 85.9%). The three most common missed nursing activities in the participating hospitals were: ambulation, oral care, and emotional support. Nurses working in public hospitals reported the highest missed nursing care. The age and number of patients under care significantly correlated with missed nursing care. The findings could help nursing managers develop plans to reduce missed nursing care in their healthcare institutions.

Aim: The aim of the study was to explore the perceived self-reported competence of nurses who worked in Kuwaiti hospitals and the predictors influencing the level of competence.

Background: Competence in nursing is found to affect patient safety and the quality of care provided to patients. The vast majority of nurses working in the health system are non-Kuwaitis. Thus, it is of the utmost importance to assess nurses' competences as the first step toward ensuring the best quality of care.

Methods: A cross-sectional, descriptive, correlational design was used. A non-random convenience sample of 220 practicing expatriate nurses working in public hospitals completed the NPC-35 scale and a demographic form. Data collection was done over a period of three weeks from January 26^th, 2020 to February 16^th, 2020.

Results: The findings of the study showed that nurses perceived their competence as good. The results also showed that years of experience, enrollment in a traditional program of study, exposure to training programs, working in accredited hospitals and nationality explained 56% of the variation in the level of Nursing Professional Competence (NPC).

Conclusion: The results indicate that nurse leaders and policy makers need to improve nursing orientation and training programs so that they are competence based. The results of the study also point to the importance of revisiting the nursing recruitment policy and managing expatriate nurses while making better investment in educating and producing Kuwaiti national nurses.

In Canada, nurse practitioners (NPs) have been recognized as advanced practice nurses (APNs) for two decades. During this time, the number of NP education programs has increased and transitioned from post-baccalaureate to graduate and post-graduate level. In 2018, the Canadian Association of Schools of Nursing's (CASN) board of directors passed a motion to provide a voluntary NP accreditation program. Three NP programs (one collaborative) volunteered to participate in an accreditation pilot study between 2019 and 2020. As part of quality improvement, a pilot study evaluation involving all NP stakeholders was completed by a post-doctoral nursing fellow who led structured virtual focus groups. These groups focused on the NP accreditation standards and key elements, developed by CASN, as well as the accreditation process. The purpose of the evaluation study was to ensure the accreditation process was relevant, responsive to the needs of the discipline and promoted high-quality NP education. The data was analyzed and synthesized using content analysis. Several areas of improvement were identified to avoid duplication and to provide consistency in communication and collection of accreditation data. The recommendations led to revisions of the accreditation standards, to strengthen them and resulted in the standards and accreditation manual being published earlier than expected. The three NP programs involved in the pilot study received accreditation. The new standards will be utilized in Canada to improve the consistency and quality of NP education programs in Canada and abroad in the coming years.

Aims: To determine what extent are workplace empowerment, New Graduate Nurses' (NGN) perceptions of nurse leaders, trust in management, and areas of worklife predict coworker incivility experiences?

Background: NGNs' perceptions of nursing leaderships' control over workload contribute to coworker incivility experiences were tested. The relationship between workplace empowerment, authentic leadership, and areas of work life (workload control and fair resource allocation) to coworker incivility experiences were examined.

Design: Secondary analysis of Starting Out, national survey, Time 1 dataset. Select factors of workplace empowerment, authentic leadership, areas of worklife, trust in management and NGNs' co- worker incivility experiences were situated within an ecological approach. Multiple linear regression was used to test whether a negative relationship of workplace empowerment, areas of worklife and authentic leadership to NGNs co-worker incivility experiences and important new findings were discovered.

Results: First, NGNs' perceptions of workplace empowerment predict coworker incivility experiences when controlling for authentic leadership and trust in management. Second, NGNs' perceptions of areas of worklife predict coworker incivility experiences when controlling for authentic leadership, trust in management, and workplace empowerment. Third, NGNs' perceptions of authentic leadership do not predict coworker incivility experiences when controlling for workplace empowerment and trust in management. Finally, NGNs' perceptions of authentic leadership do predict coworker incivility experiences when trust in management and workplace empowerment are not controlled.

Conclusions: NGNs' perceptions of authentic leadership would benefit from workplace empowerment of the nurse leader in workplace environments to mitigate coworker incivility experiences.

In this study, we examine how full nurse practitioner (NP) practice authority affects racial and ethnic diversity of the NP workforce. Specifically, the purpose of our research is to understand the relationship between the racial and ethnic composition of the NP workforce, NP level of practice authority, and the communities they service. In this paper, we compare the ethnic and racial composition of the NP workforce to the composition of the state's population, and then observe if there are any noticeable differences in the patients served by NPs when we compare full practice authority (FPA) and non-FPA states. We also estimate how FPA affects the race and ethnicity of Medicare patients served by NPs.

People aging with disability and people of retirement age depend upon their respective states to follow the philosophical tenets of independent living (IL) to remain self-sufficient in their communities with a high quality of life. Independent living services are specified, programmatic sets of services funded by the Administration for Community Living (ACL) in line with expressly stated goals for implementation by state agencies for their state indepdent living centers (SILCSs) to implement through a State Plan for Independent Living (SPIL). Designated state agencies are required to submit their SPIL every three years to maintain funding through the ACL. This policy analysis of funded state plans for inclusion of people with disability aimed to determine which SPILs promote the IL philosophies of consumer choice and control. To this end, qualitative and quantitative content analyses were done to evaluate SPIL's inclusion of IL philosophies. Specifically, the consumer choice and control philosophy, involvement of people with disability, as well as the coherency of IL services from state to state were reviewed. The results of this paper indicate disparities in consumer choice and control initiatives across states, with approximately half of all states clearly promoting consumer control initiatives in their plans. Only three states made it clear that people with disability were involved in the SPIL development. The results give direction for nursing organizations who wish to work with and support SILCs as they advocate for person-centered approaches for people with disability.