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Ross, Cheryl, and Cath Rogers. "RN? Registered or rubber nurse?" Collegian 24, no. 6 (December 2017): 551–55. http://dx.doi.org/10.1016/j.colegn.2017.02.001.
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Wilkinson, Jill. "Proposals for registered nurse prescribing: perceptions and intentions of nurses working in primary health care settings." Journal of Primary Health Care 7, no. 4 (2015): 299. http://dx.doi.org/10.1071/hc15299.
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INTRODUCTION: In 2013, the Nursing Council of New Zealand consulted on a proposal for introduction of registered nurse (RN) prescribing at two levels (specialist and community) within the designated class of prescriber. The proposal builds on the success of the diabetes nurse specialist prescribing project and the experience of other countries where RN prescribing is well established. AIM: To describe the views and intentions of nurses who work in primary health care (PHC) settings about the two levels of RN prescribing proposed. METHODS: The study involved a self-reported survey using a non-probability sample of RNs working in PHC settings (N=305). Quantitative and qualitative data were analysed descriptively. RESULTS: The respondents were experienced nurses. Overall, 82.3% expressed interest in becoming a community nurse prescriber, and 62.6% expressed interest in the specialist prescriber level. RN prescribing was expected to improve efficiency and access to medicines for high-needs populations, clarify accountability and improve nurses' autonomy. The education requirements for the specialist level were viewed as appropriate but too onerous for many. Requirements were viewed as inadequate for the community level. Concerns were raised about funding for education and support for RN prescribing roles. DISCUSSION: Nurses were positive about the proposals and see a potential to meet significant unmet health need. Nurses are already engaged in the provision of medicines to patients and prescribing authority would ensure they are suitably qualified to engage in these tasks. A clear policy platform will be needed if the proposed levels of RN prescribing are to be successfully implemented. KEYWORDS: New Zealand; prescribing; primary health care; registered nurses
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Juraschek, Stephen P., Xiaoming Zhang, Vinoth Ranganathan, and Vernon W. Lin. "United States Registered Nurse Workforce Report Card and Shortage Forecast." American Journal of Medical Quality 27, no. 3 (November 19, 2011): 241–49. http://dx.doi.org/10.1177/1062860611416634.
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Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted.
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Russell, Anne F., Abigail J. Tarr Cooke, Olga Kagan, and Elisabeth S. Stieb. "Multifaceted role of the registered nurse on an oral immunotherapy clinical team." Journal of Food Allergy 4, no. 2 (July 1, 2022): 78–85. http://dx.doi.org/10.2500/jfa.2022.4.220014.
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Oral immunotherapy (OIT) emerged into clinical practice, and its delivery highlights the multifaceted expertise of registered nurses (RN) as central to allergy/immunology interprofessional collaborative teams. The allergist‐RN model of clinical evidenced‐based OIT provision is presented. RN competencies, role components, and intervention examples are included to assist RNs and allergists in maximizing RN capabilities. RNs’ patient-centered focus, and the ability to evaluate and incorporate physical, psychological, and sociological patient aspects are assets to OIT teams. RNs can establish best practices, initiate scholarly inquiry, and disseminate new knowledge to interdisciplinary colleagues. RNs also implement allergist-prescribed standing protocols within their legal practice scope by using their clinical judgment during evaluation of a patient receiving OIT. The same RN may serve as a nurse clinician, patient and family educator, case manager, research collaborator, and OIT program manager. Allergy/immunology practices use diverse staffing models, which thus require adaptation of presented descriptions per clinical team needs and resources.
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Lindley, Lisa C., and Melanie J. Cozad. "Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care." American Journal of Hospice and Palliative Medicine® 34, no. 6 (May 17, 2016): 577–83. http://dx.doi.org/10.1177/1049909116649415.
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Objective: To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. Methods: Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Results: Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = −.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = −.041, P < .05) and rural areas (β = −.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05). Conclusion: The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.
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Juraschek, Stephen P., Xiaoming Zhang, Vinoth Ranganathan, and Vernon W. Lin. "Republished: United States Registered Nurse Workforce Report Card and Shortage Forecast." American Journal of Medical Quality 34, no. 5 (September 2019): 473–81. http://dx.doi.org/10.1177/1062860619873217.
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Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted.
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Puskar, Kathryn, Melissa Rudolph, and Xiaojun Shi. "NCLEX RN Exam: A university school of nursing case study of preparation strategies." Journal of Nursing Education and Practice 7, no. 11 (June 19, 2017): 37. http://dx.doi.org/10.5430/jnep.v7n11p37.
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The NCLEX-RN (National Council Licensure Examination—Registered Nurse) is the exam taken at the end of a U.S. nursing student’s education to enable him or her to become a licensed registered nurse. The purpose of this article is twofold (1) to discuss NCLEX-RN preparation strategies provided by several U.S schools of nursing; and (2) to describe a case study focusing on a university school of nursing’s preparation strategies implemented to improve NCLEX RN pass rate. Specific actions and results from case study may be useful to other nurse educators teaching in baccalaureate school of nursing.
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Knecht, Linda D’Appolonia, Beverly W. Dabney, Lauren E. Cook, and Gregory E. Gilbert. "Exploring the development of professional values in an online RN-to-BSN program." Nursing Ethics 27, no. 2 (July 8, 2019): 470–79. http://dx.doi.org/10.1177/0969733019850237.
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Background: Development of professional nursing values is critical within registered nurse–to–bachelor of science in nursing programs to prepare nurses for increasingly complex and diverse work environments. The results of previous studies have been inconsistent, with few studies focusing on online registered nurse–to–bachelor of science in nursing programs. In addition, little is known regarding the effectiveness of the educational methods used to support advancement of professional values and ethical practice. Objective: The object of this study was to gain an understanding of nursing students’ attitudes and beliefs about professional values at entry and exit of an online registered nurse–to–bachelor of science in nursing program that includes a standalone ethics course and integrates American Nurses Association Code of Ethics provisions throughout the curriculum. Research design: For this one-group pretest–posttest, quasi-experimental design, longitudinal matched-pair data were gathered at program entry and exit using the Nurses Professional Values Scale–Revised. Participants and research context: In all, 119 students of an online registered nurse–to–bachelor of science in nursing program at a Midwest public university who completed entry and exit surveys between spring 2015 and spring 2018 were included in this study. Ethical considerations: This study was reviewed and determined to be exempt by the university’s institutional review board. Findings: The results showed a significant increase in total posttest scores when considering all participants. However, students who took the ethics course after the pretest demonstrated a significant increase in posttest scores, while students who took the ethics course prior to the pretest demonstrated a small increase that was not statistically significant. Significant increases were also found in the professionalism, activism, and trust factors. Discussion: This study supports previous study findings where students scored higher on caring and lower on activism and professionalism factors. The largest gains were made after completing the ethics course. Conclusion: The results suggest that requiring a standalone ethics course in the registered nurse–to–bachelor of science in nursing curriculum had a positive impact on self-reported professional values.
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Hawthorne-Spears, Nina, and Mary Shepherd. "Bedside clinicians retain nurses through turnover analysis and best practices." Journal of Nursing Education and Practice 9, no. 12 (August 21, 2019): 27. http://dx.doi.org/10.5430/jnep.v9n12p27.
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The nursing shortage is projected to grow to well over 500,000 by 2020. Health care organizations are faced with increasing vacancies, mandating that strategic initiatives be developed to address the imperative of retaining their registered nurses (RNs). The implications for reducing RN turnover include improved safety and quality outcomes for patients. RN turnover also has financial implications. The average annual hospital cost of RN turnover is between $5.2 and $8.1 million dollars. Houston Methodist Hospital in the Texas Medical Center is a large, 1,200-bed metropolitan facility that employs over 3,000 nurses. By using shared governance to engage bedside clinicians and the ADKAR change model, nurse leaders were able to reduce organizational RN turnover from 16.39% to 10.57%, outperforming the national average and the American Nurses Credentialing Center’s benchmark for Magnet facilities with greater than or equal to 700 beds. This article will discuss the role of nurse leaders in creating a culture of retention, methods that were implemented at Houston Methodist Hospital to engage and empower beside clinicians to assume a lead role in reducing RN turnover, and the best practices discovered and implemented by bedside clinicians to improve RN turnover.
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Christensen, Diane. "Effects of a Registered Nurse (RN) Transition Course on Preparedness and Performance on the National Council Licensure Examination - Registered Nurse (NCLEX-RN)." Practical and Professional Nursing 2, no. 1 (September 13, 2018): 01–06. http://dx.doi.org/10.24966/ppn-5681/100006.
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Womack, Dana M., Michelle R. Hribar, Linsey M. Steege, Nancy H. Vuckovic, Deborah H. Eldredge, and Paul N. Gorman. "Registered Nurse Strain Detection Using Ambient Data: An Exploratory Study of Underutilized Operational Data Streams in the Hospital Workplace." Applied Clinical Informatics 11, no. 04 (August 2020): 598–605. http://dx.doi.org/10.1055/s-0040-1715829.
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Abstract Background Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. Dynamic monitoring of RN strain could identify when intervention is needed, but comprehensive views of RN work demands are not readily available. Electronic care delivery tools such as nurse call systems produce ambient data that illuminate workplace activity, but little is known about the ability of these data to predict RN strain. Objectives The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain. Methods In this exploratory retrospective study, ambient data for a 1-year time period were exported from electronic nurse call, medication dispensing, time and attendance, and staff communication systems. Feature sets were derived from these data for supervised machine learning models that classified work shifts by unplanned overtime. Models for three timeframes —8, 10, and 12 hours—were created to assess each model's ability to predict unplanned overtime at various points across the work shift. Results Classification accuracy ranged from 57 to 64% across three analysis timeframes. Accuracy was lowest at 10 hours and highest at shift end. Features with the highest importance include minutes spent using a communication device and percent of medications delivered via a syringe. Conclusion Ambient data streams can serve as information channels that contain signals related to unplanned overtime as a proxy indicator of RN strain as early as 8 hours into a work shift. This study represents an initial step toward enhanced detection of RN strain and proactive prevention of missed or delayed patient care.
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Romanowski, Alison, Patricia Allen, and April Martin. "Educational Revolution: Integrating Concept-Based Curriculum and Active Learning for Mental Health Nursing Students." Journal of the American Psychiatric Nurses Association 27, no. 1 (November 29, 2019): 83–87. http://dx.doi.org/10.1177/1078390319890031.
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OBJECTIVE: To disseminate knowledge to mental health nurse educators regarding a course that is successfully preparing registered nurse (RN) students to pass the psychosocial integrity portion of the National Council Licensing Exam for Registered Nurses (NCLEX-RN). METHOD: Following the implementation of a new concept-based nursing program curricular design, faculty teaching in a psychiatric mental health nursing course embarked on converting lecture-based, content-saturated teaching strategies into active learning strategies. In this article, the overall conceptual framework for the course and specific examples of active learning teaching strategies related to nursing concepts in mental health are described. Information on objectives, clinical placements, testing, class organization, and curricular content are provided. Outcomes are shared revealing success in helping students pass the psychosocial integrity section of the NCLEX-RN. RESULTS: Predictive scores on the HESI RN Psychiatric Mental Health Specialty Exam have been consistently higher than the national average for the United States, and the NCLEX-RN pass rate for the cohort of 90 students was 97%. The majority of student evaluations of the course were positive. CONCLUSIONS: Results suggest that the integration of conceptual and active learning in a psychiatric mental health nursing course may increase the likelihood of student success.
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Needleman, Jack, Jianfang Liu, Jinjing Shang, Elaine L. Larson, and Patricia W. Stone. "Association of registered nurse and nursing support staffing with inpatient hospital mortality." BMJ Quality & Safety 29, no. 1 (August 7, 2019): 10–18. http://dx.doi.org/10.1136/bmjqs-2018-009219.
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BackgroundThe association of nursing staffing with patient outcomes has primarily been studied by comparing high to low staffed hospitals, raising concern other factors may account for observed differences. We examine the association of inpatient mortality with patients’ cumulative exposure to shifts with low registered nurse (RN) staffing, low nursing support staffing and high patient turnover.MethodsCumulative counts of exposure to shifts with low staffing and high patient turnover were used as time-varying covariates in survival analysis of data from a three-campus US academic medical centre for 2007–2012. Staffing below 75% of annual median unit staffing for each staff category and shift type was characterised as low. High patient turnover per day was defined as admissions, discharges and transfers 1 SD above unit annual daily averages.ResultsModels included cumulative counts of patient exposure to shifts with low RN staffing, low nursing support staffing, both concurrently and high patient turnover. The HR for exposure to shifts with low RN staffing only was 1.027 (95% CI 1.002 to 1.053, p<0.001), low nursing support only, 1.030 (95% CI 1.017 to 1.042, p<0.001) and shifts with both low, 1.025 (95% CI 1.008 to 1.043, p=0.035). For a model examining cumulative exposure over the second to fifth days of an admission, the HR for exposure to shifts with low RN staffing only was 1.048 (95% CI 0.998 to 1.100, p=0.061), low nursing support only, 1.032 (95% CI 1.008 to 1.057, p<0.01) and for shifts with both low,1.136 (95% CI 1.089 to 1.185, p<0.001). No relationship was observed for high patient turnover and mortality.ConclusionLow RN and nursing support staffing were associated with increased mortality. The results should encourage hospital leadership to assure both adequate RN and nursing support staffing.
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Ziegler, Erin, Sarah Kalvoda, Elyse Ancrum-Lee, and Erin Charnish. "I Have Never Felt so Novice: Using Narrative Reflection to Explore the Transition from Expert RN to Novice NP Student." Nurse Practitioner Open Journal 1, no. 1 (May 7, 2021): 1–8. http://dx.doi.org/10.28984/npoj.v1i1.342.
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Aim: To explore the experiences of nurse practitioner students moving from expert registered nurses to novice nurse practitioner program students.
Background: Moving from registered nurse to nurse practitioner can be a time filled with mixed emotions, lack of confidence, adaptation, and competency development. Learning about and navigating the advanced practice nursing role can be challenging. Students in the nurse practitioner program are encouraged to engage in regular reflective writing to foster role development and learning. This paper aims to reflectively explore the experiences of transition from registered nurse to nurse practitioner student.
Methods: Inspired by Benner’s Novice to Expert Theory and Carper’s ways of knowing, the authors personally reflected on their transition experiences during NP schooling and then collectively developed a composite reflection of the shared experience. From this exercise common themes were identified.
Conclusion: This unique reflective paper identified common themes in the experience of transitioning to the student role. Potential areas for future research-based exploration of the nurse practitioner student experience were identified. By understanding these experiences, students can be better prepared in advance and faculty can design both formal and informal support measures to better support the student experience.
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Walker, Rachel, Marie Cooke, and Margaret McAllister. "The meaningful experiences of being an Registered Nurse (RN) Buddy." Nurse Education Today 28, no. 6 (August 2008): 760–67. http://dx.doi.org/10.1016/j.nedt.2007.12.001.
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Jones, Michaela, and Amy Rose Taylor. "Exploring Nursing Students, Registered Nurses, and Advanced Practice Registered Nurses’ Interest in Doctor of Nursing Practice Degree Programs." Clinical Scholars Review 8, no. 1 (2015): 66–69. http://dx.doi.org/10.1891/1939-2095.8.1.66.
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This pilot study explored nursing students, registered nurses (RN), RNs enrolled in master’s degree programs focused on advanced practice registered nurse roles, and master’s prepared nurse practitioners’ interest in attending a Doctor of Nursing Practice (DNP) degree program. There were 666 persons who responded to the 23-item web-based, multiple-choice questionnaire. Of those who responded to specific questions, 76% of participants were aware of the different types of DNP programs, and 73% were considering a DNP degree. More than half of all respondents were considering the degree to advance their careers. Of those who were considering pursuing the degree, 74% were most interested in a clinically focused program to expand or improve their clinical diagnosis and management skills. Overall cost and school reputation were the most important factors for choosing a program. Further research is needed to understand reasons and influencing factors that are associated with potential applicants’ interest in pursuing this degree and the types of programs they would choose to attend.
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McGinty, Melinda, Betty Poot, and Jane Clarke. "Registered nurse prescribing: A descriptive survey of prescribing practices in a single district health board in Aotearoa New Zealand." Nursing Praxis Aotearoa New Zealand 36, no. 3 (November 2020): 61–72. http://dx.doi.org/10.36951/27034542.2020.014.
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The expansion of prescribing rights in Aotearoa New Zealand has enabled registered nurse prescribers (RN prescribers) working in primary care and specialty teams, to enhance nursing care, by prescribing medicines to their patient population. This widening of prescribing rights was to improve the population’s access to medicines and health care; however, little is known about the medications prescribed by RN prescribers. This paper reports on a descriptive survey of self-reported RN prescribers prescribing in a single district health board. The survey tool used was a Microsoft Excel spreadsheet to record nurse’s area of practice, patient demographic details, health conditions seen, and medicines prescribed and deprescribed. Simple data descriptions and tabulations were used to report the data. Eleven RN prescribers consented to take part in the survey and these nurses worked in speciality areas of cardiology, respiratory, diabetes, and primary care. Findings from the survey demonstrated that RN prescribers prescribe medicines within their area of practice and within the limits of the list of medicines for RN prescribers. Those working in primary care saw a wider range of health conditions and therefore prescribed a broader range of medications. This survey revealed that the list of medications available for RN prescribers needs to be updated regularly to align with the release of evidence-based medications on the New Zealand Pharmaceutical Schedule. It is also a useful record for both educational and clinical settings of the types of medications prescribed by RN prescribers.
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Moore, Jane, Dawn Prentice, and Jenn Salfi. "A mixed-methods pilot study of the factors that influence collaboration among registered nurses and registered practical nurses in acute care." Clinical Nursing Studies 5, no. 4 (July 17, 2017): 1. http://dx.doi.org/10.5430/cns.v5n4p1.
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Objective: Staffing models employing registered nurses (RNs) and registered practical nurses (RPN) have created the opportunity for enhanced collaboration in acute care settings. However, little is understood about how these nurses collaborate and the factors that influence their collaboration. The purpose of this pilot study was to examine the factors that influenced collaboration among RNs and RPNs at one acute care hospital in Canada in order to understand and improve nursing collaborative practice.Methods: Using an explanatory, sequential mixed methods design, data were collected over several months in 2016 from the nurses using a questionnaire and individual telephone interviews. Sixty-five RNs and RPNs working on medical, surgical and emergency units completed the “Nurse-Nurse Collaboration Scale” survey and ten RNs and RPNs participated in the telephone interviews.Results: Quantitative analysis showed lower scores among younger nurses across most domains of the survey: conflict management, communication, shared processes, coordination and professionalism. Qualitative analysis revealed working to full scope of practice was a facilitator of RN-RPN collaboration, and older age and poor interpersonal skills were barriers to successful collaboration.Conclusions: The results provide discussion for identification of strategies to improve collaborative practice among nurses such as establishing joint education programs for RNs and RPNs, and the use of models or frameworks to guide collaborative practice in healthcare organizations.
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Spetz, Joanne. "The Importance of Good Data." Annual Review of Nursing Research 28, no. 1 (December 2010): 1–18. http://dx.doi.org/10.1891/0739-6686.28.1.
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In 1977, the federal government launched the nation's largest and most significant program to collect data on the registered nurse (RN) workforce of the United States—the National Sample Survey of Registered Nurses (NSSRN). This survey is conducted by the U.S. Health Resources and Services Administration, first in 1977 and then every 4 years since 1980. This article offers the history of the NSSRN and a review of the ways in which the NSSRN data have been used to examine education, demographics, employment, shortages, and other aspects of the RN workforce. The influence this body of research has had on policymaking is explored. Recommendations for future research are offered, in the hope that future waves of the NSSRN will continue to be used to their fullest potential.
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Huynh, Nathan, Rita Snyder, José M. Vidal, Omor Sharif, Bo Cai, Bridgette Parsons, and Kevin Bennett. "Assessment of the Nurse Medication Administration Workflow Process." Journal of Healthcare Engineering 2016 (2016): 1–14. http://dx.doi.org/10.1155/2016/6823185.
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This paper presents findings of an observational study of the Registered Nurse (RN) Medication Administration Process (MAP) conducted on two comparable medical units in a large urban tertiary care medical center in Columbia, South Carolina. A total of 305 individual MAP observations were recorded over a 6-week period with an average of 5 MAP observations per RN participant for both clinical units. A key MAP variation was identified in terms of unbundled versus bundled MAP performance. In the unbundled workflow, an RN engages in the MAP by performing only MAP tasks during a care episode. In the bundled workflow, an RN completes medication administration along with other patient care responsibilities during the care episode. Using a discrete-event simulation model, this paper addresses the difference between unbundled and bundled workflow and their effects on simulated redesign interventions.
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Claudette, Mc Farquhar. "Lived Experiences of Failure on the National Council Licensure Examination - Registered Nurse (NCLEX-RN): Perceptions of Registered Nurses." International Journal of Nursing Education 6, no. 1 (2014): 10. http://dx.doi.org/10.5958/j.0974-9357.6.1.003.
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Shin, Juh Hyun, Rosemary Anne Renaut, Mark Reiser, Ji Yeon Lee, and Ty Yi Tang. "Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents’ Outcomes Using a Longitudinal Study." International Journal of Environmental Research and Public Health 18, no. 2 (January 6, 2021): 402. http://dx.doi.org/10.3390/ijerph18020402.
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The purpose of this study was to estimate how much resident outcomes can improve with an increase in hours per resident day (HPRD) of registered nurses (RNs) staffing. Nursing home (NH) staff in Korea have serious problems with inappropriate nurse staffing standards and poor working conditions, which lead to poor quality of care for NH residents. This study used a longitudinal survey design. A quota sampling was used with a total of several repeated survey measurement from 2017 to 2020 (n = 74). The independent variable was the amount of nurse staffing HPRD and the outcome variable was the compiled outcome of 15 quality-of-care indicators. Data were directly collected from all participating NHs. A longitudinal, multilevel model was used for analysis. An increase of one unit of RN HPRD (60 min) corresponded to a decrease of about 10.5% of residents with deteriorated quality of care outcomes. This study emphasized that increasing RN HPRD decreased residents’ deteriorated outcomes in NHs. This suggests that professional RNs must be secured to an appropriate level to improve the quality of care for NH residents.
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McGregor, Margaret J., Janice M. Murphy, Jeffrey W. Poss, Kimberlyn M. McGrail, Lisa Kuramoto, Huei-Chung Huang, and Stirling Bryan. "24/7 Registered Nurse Staffing Coverage in Saskatchewan Nursing Homes and Acute Hospital Use." Canadian Journal on Aging / La Revue canadienne du vieillissement 34, no. 4 (November 16, 2015): 492–505. http://dx.doi.org/10.1017/s0714980815000434.
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RÉSUMÉLa législation, dans de nombreuses juridictions, nécessite les établissements des soins de longue durée (SLD) d'avoir une infirmière en service 24 heures par jour, 7 jours par semaine. Bien que la recherche considérable existe sur l'intensité SLD de la dotation en personnel infirmier, il n'existe pas de la recherche empirique relative à cette exigence. Notre étude rétrospectif d'observation a comparé des installations en Saskatchewan avec 24/7 RN couverture aux établissements offrant moins de couverture, complétées par divers modèles de dotation des postes de nuit. Les ratios de risque associés à moins de 24/7 couverture RN complété de la dotation infirmière autorisé de nuit, ajusté pour l'intensité de dotation en personnel infirmier et d'autres facteurs de confusion potentiels, étaient de 1,17, IC 95% [0,91, 1,50] et 1.00, IC à 95% [0,72, 1,39], et avec moins de couverture 24/7 RN complété avec soin par aides personnels de nuit, les ratios de risque étaient de 1,46, IC 95% [1,11, 1,91] et 1,11, IC 95% [0,78, 1,58], pour les patients hospitalisés et de visites aux services d'urgence, respectivement. Ces résultats suggèrent que l'utilisation des soins de courte durée peut être influencée négativement par l'absence de la couverture 24/7 RN.
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Bloomer, Melissa J., Paul Fulbrook, Sandra Goldsworthy, Sarah L. Livesay, Marion L. Mitchell, Ged Williams, and Adriano Friganovic. "World Federation of Critical Care Nurses 2019 Position Statement: Provision of a Critical Care Nursing Workforce." Connect: The World of Critical Care Nursing 13, no. 1 (March 1, 2019): 3–7. http://dx.doi.org/10.1891/1748-6254.13.1.3.
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BackgroundDue to changes in critical care worldwide, the World Federation of Critical Care Nurses Board of Directors commissioned a review of its 2005 Declaration of Buenos Aires: Position Statement on the Provision of a Critical Care Nursing Workforce.AimTo provide international recommendations to inform and assist critical care nursing associations, health services, governments, and other interested stakeholders in the development and provision of an appropriate critical care nursing workforce.MethodsAn international review group was established, comprised of critical care nurse clinicians, leaders, and researchers. A literature search was undertaken, which informed the revision of the 2005 Declaration, which is contained in the 2019 Position Statement.PositionThe position is supported by six central principles, and is comprised of eight key statements: A critical care unit should have a dedicated nurse leader; Each shift should have at least one registered nurse (RN) designated as the team leader; The majority of RNs providing patient care should hold a recognized post-registration qualification or certification in critical care; Critical care RN staffing should be assessed on a shift-by-shift basis according to patient acuity, the staffing profile, and unit need; An additional critical care RN, not counted in RN-to-patient ratios or allocated a patient load, may provide additional hands-on assistance in patient care, and coordinate other patient-related activities; Support staff (such as nursing and allied health assistants, nursing aides, and care assistants) should work only under the direct supervision of a critical care RN, and never in place of a critical care RN; Where institutionally supported, and in accordance with local legislation, a critical care RN may provide expert critical care consultancy; A critical care unit should be staffed to provide at least one senior nurse, who holds a recognized post-registration critical care qualification or certification, and ideally further qualifications in education.
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McCullough, J. Mac, Rebecca Sunenshine, Ramona Rusinak, Patty Mead, and Bob England. "Association of Presence of a School Nurse With Increased Sixth-Grade Immunization Rates in Low-Income Arizona Schools in 2014–2015." Journal of School Nursing 36, no. 5 (January 22, 2019): 360–68. http://dx.doi.org/10.1177/1059840518824639.
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School nurses often play large roles in implementation of school vaccination requirements aimed at controlling the spread of communicable disease. We analyzed the association between the presence of a school nurse and school-level vaccination rates in Arizona. Using school-level data from Arizona sixth-grade schools ( n = 749), we regressed average sixth-grade school-level immunization rates on presence of a school nurse (registered nurse [RN] or licensed practical nurse [LPN]) and school-level socioeconomic status (SES), controlling for other school- and district-level characteristics. Schools with a nurse had higher overall vaccination rates than those without a nurse (96.1% vs. 95.0%, p < .01). For schools in the lowest SES quartile, the presence of a school nurse was associated with approximately 2 percentage point higher immunization rates. These findings add to the growing literature that defines the impact of school nurses on student health status and outcomes, emphasizing the value of school nurses, especially in lower SES schools.
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Quelly, Susan B. "Reliability and Validity of a Tool to Measure School Nurse Perceptions and Practices Associated With Childhood Obesity Prevention." Journal of Nursing Measurement 23, no. 2 (2015): 239–54. http://dx.doi.org/10.1891/1061-3749.23.2.239.
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Background and Purpose: Childhood obesity prevention (COP) should include increasing school nurse involvement. Measurements of school nurse perceptions influencing COP practices are limited. The purpose of this study is to evaluate the reliability and validity of 5 measures of school nurse COP practices and perceptions. Methods: A 70-item anonymous survey was completed by 171 Florida registered nurse (RN) school nurses and tested for reliability and validity. Results: Internal reliability was acceptable with Cronbach’s alphas ranging from .81 to .94. Uncertain to adequate test–retest reliability was determined by correlation coefficients (r = .55–.78). Significant correlations (p < .05) based on hypothesized relationships provided moderate support for construct validity. Conclusions: Results support use of these scales in research with targeted school nurse populations to promote COP practices.
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J*, Berryman. "Use of EBP as a Problem Solving Approach to Improve Patient Satisfaction, while Overcoming the COVID Pandemic Barrier." Nursing & Healthcare International Journal 6, no. 1 (2022): 1–3. http://dx.doi.org/10.23880/nhij-16000258.
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Background: The Centers for Medicare & Medicaid Services requires hospitals to meet rigorous patient satisfaction requirements for reimbursement. One metric used for patient satisfaction is call light responsiveness within a unit. Aims: To meet target call light responsiveness benchmarks at a 45- bed telemetry, medical– surgical nursing unit within a Magnet ® designated hospital. Methods: An evidence- based practice (EBP) project model was utilized. The chief nursing officer worked with an EBP nurse mentor. A PICOT (Population, Intervention, Comparison, Outcome, and Time) question was developed to guide the literature search. Literature was critically appraised, and a resulting intervention was established. Nurse educators taught the unit nurses how to perform the intervention, and intervention integration was assessed via direct observation. Call light responsiveness data were collected to assess whether targets were met. Results: Five articles were deemed as applicable to the PICOT question, and the best evidence determined that using the 4Ps (pain, presence, “potty,” and positioning) during structured registered nurse (RN) care rounding every 2 hours improved patient outcomes. After RN education and implementation, hospital call light responsiveness began to improve. Linking Evidence to Action: Rounding without intention increases RN workload and does not result in improved patient outcomes or a satisfied patient. RN rounding every 2 h is effective and efficient when done with intention (i.e., adhering to the 4Ps). RN patient rounds had done every 2 hours with intention improved patient satisfaction and other patient outcomes such as a decrease in call light usage.
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Brown, Robin, Heidi Mennenga, Alham Abuatiq, Linda Burdette, Leann Horsley, and Christina Plemmons. "Collaborating with Rural Practice Patners to Address the Need for RNs in Primary Care." Online Journal of Rural Nursing and Health Care 20, no. 2 (December 11, 2020): 179–93. http://dx.doi.org/10.14574/ojrnhc.v20i2.618.
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Abstract
Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care.
Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey in December 2018.
Methods: This descriptive exploratory study utilized an online needs assessment survey to gather information from 13 rural clinical practice partners regarding their knowledge, interest, and use of RNs in primary care.
Results: Twelve of the 13 rural clinical practice partners completed the needs assessment survey. A majority of the clinical partners indicated they felt knowledgeable about the RN full scope of license and expressed a high interest in the expanded role of the RN in primary care. The clinical practice partners reported interest in providing independent RN chronic and acute care visits, care management, medication management, and collaborative provider and RN visits.
Conclusion: Conducting a needs assessment and collaborating with rural primary care practice partners to address the need for RNs in primary care is the first step in developing policies and utilizing RNs to the full scope of their license.
Keywords: primary care, rural, registered nurses
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Wasarhaley, Nesa E., Theresa A. Simcic, and Jonathan M. Golding. "Mock Juror Perception of Sexual Assault Nurse Examiner Testimony." Violence and Victims 27, no. 4 (2012): 500–511. http://dx.doi.org/10.1891/0886-6708.27.4.500.
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The perception of a sexual assault nurse examiner’s (SANE) testimony in a criminal rape trial was investigated. Men and women undergraduates (N = 138) read a fictional criminal trial summary of a rape case in which medical testimony from a SANE or a registered nurse (RN) was presented, or no medical testimony was presented. Results indicated that mock jurors were more likely to render guilty verdicts when a SANE testified than when an RN testified, and this relationship was fully mediated by perceived credibility of the nurse as well as provictim perceptions. Results are discussed in terms of the impact of SANE involvement in legal proceedings.
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Santa Mina, Elaine Elizabeth, Carol Eifert, Martha Ireland, Carol Fine, Gail Wilson, Vaska Micevski, Ruth Wojtiuk, and Martha Valderrama. "The development of an online instrument for prior learning assessment and recognition of internationally educated nurses: A pilot study." International Review of Research in Open and Distributed Learning 12, no. 1 (January 31, 2011): 128. http://dx.doi.org/10.19173/irrodl.v12i1.896.
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A fully online prior learning assessment and recognition (PLAR) tool for internationally educated nurses (IENs) was developed and tested by an inter-professional team at Ryerson University. The tool consisted of two stages: a self-assessment component followed by a multiple-choice examination and narrative (vignette) evaluation. The purposes of the study were to describe the demographic profile of the IEN registered nurse (RN), to develop the benchmark responses that demonstrate competency at the entry-to-practice level of the typical IEN RN, and to describe the experience of completing an online PLAR tool. A mixed-method approach was used. Findings demonstrated that IEN RNs who immigrate to Ontario, Canada, are of various ages and come from a wide spectrum of countries. The PLAR process holds promise for an objective assessment of IEN’s eligibility to write the Canadian Registered Nurses Examination (CRNE) and to meet a global need. Further testing of the tool across a broader sample is required.
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Bridges, Jackie, Peter Griffiths, Emily Oliver, and Ruth M. Pickering. "Hospital nurse staffing and staff–patient interactions: an observational study." BMJ Quality & Safety 28, no. 9 (March 27, 2019): 706–13. http://dx.doi.org/10.1136/bmjqs-2018-008948.
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BackgroundExisting evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nurse staffing and staff–patient interactions.SettingSix wards at two English National Health Service hospitals.MethodsWe observed 238 hours of care (n=270 patients). Staff–patient interactions were rated using the Quality of Interactions Schedule. RN, healthcare assistant (HCA) and patient numbers were used to calculate patient-to-staff ratios. Multilevel regression models explored the association between staffing levels, skill mix and the chance of an interaction being rated as ‘negative’ quality, rate at which patients experienced interactions and total amount of time patients spent interacting with staff per observed hour.Results10% of the 3076 observed interactions were rated as negative. The odds of a negative interaction increased significantly as the number of patients per RN increased (p=0.035, OR of 2.82 for ≥8 patients/RN compared with >6 to <8 patients/RN). A similar pattern was observed for HCA staffing but the relationship was not significant (p=0.056). When RN staffing was low, the odds of a negative interaction increased with higher HCA staffing. Rate of interactions per patient hour, but not total amount of interaction time, was related to RN and HCA staffing levels.ConclusionLow RN staffing levels are associated with changes in quality and quantity of staff–patient interactions. When RN staffing is low, increases in assistant staff levels are not associated with improved quality of staff–patient interactions. Beneficial effects from adding assistant staff are likely to be dependent on having sufficient RNs to supervise, limiting the scope for substitution.
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Mazurenko, Olena, Gouri Gupte, and Guogen Shan. "Analyzing U.S. nurse turnover: Are nurses leaving their jobs or the profession itself?" Journal of Hospital Administration 4, no. 4 (May 12, 2015): 48. http://dx.doi.org/10.5430/jha.v4n4p48.
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Objective: To examine and compare factors associated with making the decision to vacate a job (organizational turnover) versus leaving the profession (professional turnover) among registered nurses (RN) in the United States (U.S.).Methods: Nationally representative data from the 2008 National Sample Survey of Registered Nurses was used. The sample consisted of 8,796 RNs who held an active RN license as of March 10, 2008, but changed a place of work or left the profession entirely. The analysis has been performed using SAS, version 9.3.Results: The results of binary logistic regression revealed that RNs who reported work-related disability (OR = 14.51; p-value: < .001), illness (OR = 3.32; p-value: < .001), experienced high physical demands (OR = 1.57; p-value: < .001) or burnout (OR = 1.39; p-value: < .001), were unsatisfied with their schedule (OR = 2.16; p-value: < .001), or staffing arrangements (OR = 1.41; p-value: < .001) were more likely to leave the profession. Whereas RNs who reported high levels of stress (OR = 0.59; p-value: < .001) were unsatisfied with the organization’s leadership (OR = 0.22; p-value: < .001), unsatisfied with their opportunity to advance their career (OR = 0.56; p-value: < .001), or were not adequately compensated (OR = 0.63; p-value: < .001), were more likely to leave the organization.Conclusions: Policy makers and health care managers should be aware of the different factors that are associated with RNs’ decision to leave the profession or an organization. Health care managers involved in the development of nurse retention strategies should address organizational leadership and consider development of comprehensive career development programs. Policy makers should consider allocating additional resources to ensure that RN workforce is of adequate size, is qualified, and is able to provide high quality care in the U.S..
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Skillen, D. Lynn, Marjorie C. Anderson, JoAnne Seglie, and Julie Gilbert. "Toward a Model for Effectiveness." AAOHN Journal 50, no. 2 (February 2002): 75–82. http://dx.doi.org/10.1177/216507990205000207.
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Effectiveness is difficult to define or measure, but is frequently associated with cost. A two phase study conducted with occupational health nurses in Alberta, Canada resulted in a beginning model for effectiveness. In 1997, Phase One of an exploratory descriptive study focused on physical assessment by occupational health nurses ( N = 137) and perceptions of effectiveness in practice ( n = 104). In 2001, Phase Two used focus groups ( n = 7) to determine occupational health nurses' reactions to the preliminary analysis of questionnaire responses on effectiveness. The focus groups confirmed and expanded categories, and reconfigured the developing model. The model makes explicit the foundations, functions, relationships, and goals for effectiveness in occupational health nursing practice. The foundation includes registered nurse (RN) experience and baseline competence comprising occupational health nursing education, RN and occupational health nurse experience, and multidisciplinary knowledge. Ten specific functions and nine relationships describe the occupational health nursing specialty practice and promote achievement of five goals: balance, communication, continuing competence, leadership, and trust. The goal of balance needs articulation in the nursing literature.
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Prentice, Dawn, Jane Moore, Joanne Crawford, Sara Lankshear, and Jacqueline Limoges. "Collaboration among Registered Nurses and Licensed Practical Nurses: A Scoping Review of Practice Guidelines." Nursing Research and Practice 2020 (June 2, 2020): 1–7. http://dx.doi.org/10.1155/2020/5057084.
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Professional associations, nurse scholars, and practicing nurses suggest that intraprofessional collaboration between nurses is essential for the provision of quality patient care. However, there is a paucity of evidence describing collaboration among nurses, including the outcomes of collaboration to support these claims. The aim of this scoping review was to examine nursing practice guidelines that inform the registered nurse (RN) and registered/licensed practical nurse (R/LPN) collaborative practice in acute care, summarize and disseminate the findings, and identify gaps in the literature. Ten practice guidelines, all published in Canada, were included in the final scoping review. The findings indicate that many of the guidelines were not evidence informed, which was a major gap. Although the guidelines discussed the structures needed to support intraprofessional collaboration, and most of the guidelines mention that quality patient care is the desired outcome of intraprofessional collaboration, outcome indicators for measuring successful collaborative practice were missing in many of the guidelines. Conflict resolution is an important process component of collaborative practice; yet, it was only mentioned in a few of the guidelines. Future guidelines should be evidence informed and provide outcome indicators in order to measure if the collaborative practice is occurring in the practice setting.
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Melrose, Sherri, Jean Miller, Kathryn Gordon, and Katherine J. Janzen. "Becoming Socialized into a New Professional Role: LPN to BN Student Nurses' Experiences with Legitimation." Nursing Research and Practice 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/946063.
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This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs) who attended an online university to earn a Baccalaureate degree in nursing (BN), a prerequisite to writing the Canadian Registered Nurse (RN) qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir’s theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs). First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as “nurse.” Second, practicum interactions with instructors and new clinical experiences are key socializing agents.
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Baik, Dawon, and Brenda Zierler. "RN Job Satisfaction and Retention After an Interprofessional Team Intervention." Western Journal of Nursing Research 41, no. 4 (April 24, 2018): 615–30. http://dx.doi.org/10.1177/0193945918770815.
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Despite continuing interest in interprofessional teamwork to improve nurse outcomes and quality of care, there is little research that focuses on nurse job satisfaction and retention after an interprofessional team intervention. This study explored registered nurse (RN) job satisfaction and retention after a purposeful interprofessional team training and structured interprofessional bedside rounds were implemented. As part of a larger study, in this comparative cross-sectional study, pre- and post-intervention data on RN job satisfaction and turnover rate were collected and analyzed. It was found that RNs had significantly higher job satisfaction after the interprofessional team intervention. The 6-month period turnover rate in the post-intervention period was slightly lower than the 6-month period turnover rate in pre-intervention period; however, the rate was too low to provide statistical evidence. Ongoing coaching and supportive work environments to improve RN outcomes should be considered to enhance quality of care and patient safety in healthcare.
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Curry, Sabra, Ellen Mallard, Elizabeth Marrero, Melinda Walker, Robin Weeks, H. Allen Harrison, Melany Temple, Cara Holland, and Katherine Brandon. "The Impact of a Dedicated Nurse on the Prevention of Central Line-Associated Bloodstream Infections in the NICU." Neonatal Network 40, no. 2 (March 1, 2021): 88–97. http://dx.doi.org/10.1891/0730-0832/11-t-658.
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BackgroundThe neonatal population is at increased risk for central line-associated bloodstream infections (CLABSIs) related to prematurity, critical illness, and compromised immune function.1,4,5MethodsTo address a 30 percent CLABSI rate increase, a quality improvement (QI) project in a Level IV NICU was developed and implemented by the NICU CLABSI team in 2018. The project trialed a dedicated CLABSI prevention-registered nurse (DCP-RN) role with select responsibilities aimed at rate reduction. The DCP-RN spearheaded an RN education plan, addressed prevention bundle compliance, and aided in establishing a reliable apparent cause analysis (ACA) process.ResultsThe outcome resulted in an over 50% reduction in the CLABSI rate and permanent adoption of the DCP-RN role in the NICU.
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Choi, Seonhwa, Eunhee Cho, Eunkyo Kim, Kyoungeun Lee, and Soo Jung Chang. "Effects of Nurse Staffing, Work Environment, Education on Adverse Events in Nursing Homes." Innovation in Aging 4, Supplement_1 (December 1, 2020): 84. http://dx.doi.org/10.1093/geroni/igaa057.276.
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Abstract This study examined the effect of registered nurse (RN) staffing level, work environment, and education on adverse events experienced by residents in nursing homes. A cross-sectional study was conducted with 216 RNs working in nursing homes who were selected using random stratified sampling by location and bed size. Self-reported questionnaires regarding staffing level, work environment, education level, adverse events, and nurse characteristics were administered. Data from the National Health Insurance Service were used to describe nursing home characteristics. Both multiple and multinomial logistic regressions were used to control for the characteristics of nurses and nursing homes, and investigate the effects of nursing staffing level (number of older adults assigned to a nurse), work environment (Practice Environment Scale of the Nursing Working Index), and level of nursing education on the adverse events experienced by residents. An increase of one resident per RN was significantly associated with a higher incidence of pressure ulcers (OR= 1.019, 95% CI=1.004-1.035). Poor work environment increased the incidence of adverse events such as pressure ulcers (OR= 3.732, 95% CI=1.155-12.056) and sepsis (OR=3.871, 95%CI=1.086-13.800). Compared to RNs with a baccalaureate or higher, RNs with diplomas reported increased incidence rates of pressure ulcers (OR=2.772, 95%CI= 1.173-6.549). RN staffing, work environment, and education level affect the incidence of pressure ulcers, and the work environment affects the incidence of sepsis among residents in nursing homes. Policy-wise, improving the level of nurse staffing, nursing work environment, and nursing education will improve health outcomes of residents.
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Saccomano, Scott J., and Genevieve Pinto Zipp. "Integrating Delegation Into the Undergraduate Curriculum." Creative Nursing 20, no. 2 (2014): 106–15. http://dx.doi.org/10.1891/1078-4535.20.2.106.
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One of the essential practice skills for registered nurses (RNs) is the delegation of tasks. However, few experiences in RN educational programs directly address the development of delegation skills. Many RNs report not feeling confident in their ability to delegate appropriately upon completing their educational programs. Nurse educators must respond to the need to address delegation in undergraduate nursing curricula. This article describes research evaluating levels of knowledge of and confidence in the delegation process among newly graduated RNs, and explores options for teachable moments about delegation.
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Griffiths, Peter, Antonello Maruotti, Alejandra Recio Saucedo, Oliver C. Redfern, Jane E. Ball, Jim Briggs, Chiara Dall'Ora, Paul E. Schmidt, and Gary B. Smith. "Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study." BMJ Quality & Safety 28, no. 8 (December 4, 2018): 609–17. http://dx.doi.org/10.1136/bmjqs-2018-008043.
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ObjectiveTo determine the association between daily levels of registered nurse (RN) and nursing assistant staffing and hospital mortality.DesignThis is a retrospective longitudinal observational study using routinely collected data. We used multilevel/hierarchical mixed-effects regression models to explore the association between patient outcomes and daily variation in RN and nursing assistant staffing, measured as hours per patient per day relative to ward mean. Analyses were controlled for ward and patient risk.Participants138 133 adult patients spending >1 days on general wards between 1 April 2012 and 31 March 2015.OutcomesIn-hospital deaths.ResultsHospital mortality was 4.1%. The hazard of death was increased by 3% for every day a patient experienced RN staffing below ward mean (adjusted HR (aHR) 1.03, 95% CI 1.01 to 1.05). Relative to ward mean, each additional hour of RN care available over the first 5 days of a patient’s stay was associated with 3% reduction in the hazard of death (aHR 0.97, 95% CI 0.94 to 1.0). Days where admissions per RN exceeded 125% of the ward mean were associated with an increased hazard of death (aHR 1.05, 95% CI 1.01 1.09). Although low nursing assistant staffing was associated with increases in mortality, high nursing assistant staffing was also associated with increased mortality.ConclusionLower RN staffing and higher levels of admissions per RN are associated with increased risk of death during an admission to hospital. These findings highlight the possible consequences of reduced nurse staffing and do not give support to policies that encourage the use of nursing assistants to compensate for shortages of RNs.
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Yoon, Jung Min, Alison Trinkoff, Carla Storr, and Elizabeth Galik. "Nurse Staffing and Nursing Home Deficiency of Care for Inappropriate Psychotropics Use in Residents With Dementia." Innovation in Aging 4, Supplement_1 (December 1, 2020): 207–8. http://dx.doi.org/10.1093/geroni/igaa057.671.
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Abstract Psychotropics use to manage behavioral and psychological symptoms of dementia (BPSD) in nursing homes (NHs) has been the focus of policy attention due to their adverse effects. We hypothesized that NHs with lower nursing staffing would have greater reliance on psychotropics use to control BPSD. A NH deficiency of care can be cited for inappropriate psychotropics use (F-tag 758). The association between the occurrence of F-758 tags and nurse staffing in residents with dementia was examined using the 2017-18 Certification and Survey Provider Enhanced Reporting data (n=14,548 NHs). Staffing measures included nursing hours per resident day (HPRD) and registered nurse (RN) skill-mix. Generalized linear mixed models that included covariates (NH location, bed size, ownership, proportion of residents with dementia/depression/psychiatric disorders and with Medicare/Medicaid) estimated the magnitude of the associations. There were 1,872 NHs with F-758 tags indicating inappropriate psychotropics use for NH residents with dementia. NHs with greater RN and certified nurse assistant (CNA) HPRD had significantly lower odds of F-758 tags (OR=0.59 54, 95% CI=0.47 44-0.73 66; OR=0.87, 95% CI=0.77-0.99, respectively) and similar findings were found in NHs with greater RN skill-mix (OR=0.14 10, 95% CI=0.05 04-0.37 25). There were no significant associations between the occurrence of F-758 tags and licensed practice nurse and unlicensed nurse aide HPRD. This study found that RN and CNA staffing had inverse associations with inappropriate psychotropic use citations among residents with dementia. NHs with higher RN staffing ratios may be better able to implement alternatives to pharmacological approaches for BPSD. It is suggested that NHs be equipped with adequate nurse staffing levels to reduce unnecessary psychotropics use.
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Schlepp, Susan. "RN first assistant legislation reintroduced; certified registered nurse anesthetists to receive Medicare reimbursement." AORN Journal 49, no. 4 (April 1989): 966–72. http://dx.doi.org/10.1016/s0001-2092(07)66804-5.
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Kash, Bita A., George S. Naufal, Leslie Cortés, and Christopher E. Johnson. "Exploring Factors Associated With Turnover Among Registered Nurse (RN) Supervisors in Nursing Homes." Journal of Applied Gerontology 29, no. 1 (June 4, 2009): 107–27. http://dx.doi.org/10.1177/0733464809335243.
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Diaconis, Linda K. "The Labyrinth: A Transformative Path for RN to BSN Education." International Journal of Human Caring 14, no. 3 (April 2010): 42–47. http://dx.doi.org/10.20467/1091-5710.14.3.42.
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The labyrinth as a tool for meditation is explored as registered nurse (RN) to Bachelor of Science in Nursing (BSN) students walk a labyrinth together. Students’ journeys of returning to school become transformative as they experience this archetypal tool as a metaphor for their lives. Interpretive themes from a hermeneutic phenomenological inquiry (Diaconis, 2001) are reflected as patterns of the labyrinth and places on the path. Walking the labyrinth leads to questioning ways of developing curriculum and being with students in RN to BSN education.
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Ruby, Karen L., Carol A. Blainey, Linda B. Haas, and Maxine Patrick. "The Knowledge and Practices of Registered Nurse, Certified Diabetes Educators: Teaching Elderly Clients About Exercise." Diabetes Educator 19, no. 4 (August 1993): 299–306. http://dx.doi.org/10.1177/014572179301900409.
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This study identified the knowledge base and practices of Registered Nurse,. Certified Diabetes Educators (RN, CDEs) regarding their exercise teaching programs for elderly clients who have non-insulin-dependent diabetes mellitus (NIDDM). The random sample of 197 AADE members surveyed by questionnaire was a highly educated and experienced group. RN, CDEs who worked 30 or more hours per week in diabetes education or attended four or more continuing education (CE) programs per year had significantly more comprehensive exercise teaching program designs and instructional techniques to enhance elderly NIDDM clients' learning (P<.05). However; many CDEs do not teach their elderly clients about exercise due to lack of resources, lack of specific knowledge to prescribe exercise, and negative stereotypes of elderly clients' ability to exercise. Greater availability of educational programs for CDEs to explore curriculum development, program planning, evaluation, and exercise prescription for elderly clients with multisystem disease is recommended.
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Maslowski, Julia. "STUDENT PAPER: Patient Participation." International Journal of Human Caring 16, no. 4 (June 2012): 74–78. http://dx.doi.org/10.20467/1091-5710.16.4.74.
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To ensure effective management of Canadian healthcare system resources, increasing demands are placed on patients to become further engaged in their health. The registered nurse (RN) must understand the complex factors that influence the provision of meaningful care to successfully work in partnership with patients. ray’s (1989) theory of bureaucratic caring provides a valuable framework through which patient participation may be explored utilizing the social, ethical, and political variables from this theory. The importance of patient engagement with implications for the patient, RN, healthcare team, and larger healthcare system are examined.
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Limoges, Jacqueline, Kim Jagos, Sara Lankshear, Sandy Madorin, and Deb Witmer. "Getting to the root of it: How do faculty address professional boundaries, role expansion, and intra-professional collaboration?" Journal of Nursing Education and Practice 8, no. 9 (May 2, 2018): 113. http://dx.doi.org/10.5430/jnep.v8n9p113.
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Background: Little research exists to guide nursing faculty to respond to the most recent entry-to-practice education changes and subsequent practice and knowledge expansion for nurses. The purpose of this study was to explore the experiences of faculty as they teach about professional boundaries and role clarity to college and university nursing students and how this teaching is connected to in intra-professional collaboration.Methods: This qualitative research study used a critical feminist sociology to analyze interviews and relevant documents. Twenty-five nursing faculty from an Ontario, Canada school were interviewed.Results: Through our analysis we detected two main findings. The first was the activation of hierarchies positioning the university program with more status and legitimacy than the college program, and how this established power relations and impeded nursing education for role clarity. The second was the struggle to articulate the actual differences between the roles and contributions of the Registered Practical Nurse (RPN) and the Registered Nurse (RN) and how this struggle impeded education for effective collaboration and role clarity.Conclusions: Supporting faculty to recognize the distinct and overlapping contributions of each type of nurse can support educational reform that promotes competencies in collaborative care.
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Harrington, Charlene, Leslie Ross, Susan Chapman, Elizabeth Halifax, Bruce Spurlock, and Debra Bakerjian. "Nurse Staffing and Coronavirus Infections in California Nursing Homes." Policy, Politics, & Nursing Practice 21, no. 3 (July 7, 2020): 174–86. http://dx.doi.org/10.1177/1527154420938707.
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In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.
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Mardiros, Marilyn. "Preparing Native Indian RNs in British Columbia." Practicing Anthropology 10, no. 2 (April 1, 1988): 8–9. http://dx.doi.org/10.17730/praa.10.2.q36316234501h246.
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In 1981 the Nisga'a Tribal Council in New Aiyansh and North Coast Tribal Council in Prince Rupert commissioned a feasibility study to determine whether there was interest among Indian people of coastal British Columbia in pursuing registered nurse (RN) education. The study resulted in a three year project, the Northern Native Indian Professional Nursing Program (NNIPNP) offering RN preparation which addressed the personal, social and cultural needs of prospective students, their families and communities, while ensuring quality education at par with provincial standards. This article discusses the project as a community-based initiative and my roles as program coordinator, cultural broker, advocate, and liaison between communities, students and the educational institutions offering the RN program.
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Kosheleva, Ludmila, and Irene Ngune. "Registered Nurses’ Decisions Around Referral of Residents With Urinary Tract Infections: A Retrospective Cohort Study." Journal of Primary Care & Community Health 11 (January 2020): 215013272095744. http://dx.doi.org/10.1177/2150132720957441.
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Background Referral of residents with urinary tract infections (UTIs) in residential aged care facilities (RACFs) to hospital are common. However, there is limited information on what influences Registered Nurses’ (RN) decision-making process. Aim To investigate resident factors that influence RN’s decisions to escalate care. Design A retrospective cohort approach audited electronic clinical records of residents with UTIs. Methods Data were extracted from the electronic database and analyzed using descriptive and regression analysis. Approval was obtained from both the RACFs and University Human Research Ethics Committee. Results There was a higher likelihood of being referred to hospital if residents were female, had had a past fall, had related comorbidity, or had abnormal vital signs. However, being older and having a urinary catheter were protective factors for referral by the RN. Conclusion Referral of residents with UTIs by RNs to hospital is common in RACFs. Resident characteristics such as abnormal vital signs, past falls, and presence of comorbidity influence referrals by RNs. Nurse Practitioners dedicated to the RACFs could complement the role of a general practitioner. UTI-specific escalation protocols can assist RNs to make decisions about referrals. RNs’ related risk factors also need to be examined to understand other influencing factors.