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Biomedical subjects

Dana N Rutledge

Publications and source records attributed to Dana N Rutledge.

9 recordsLinked to original sources

Ensuring cultural diversity among California nurses.

The California Strategic Planning Committee for Nursing cultural diversity work group surveyed deans and directors from RN prelicensure and vocational nurse education programs in California in 1998. With a 49% response rate, key survey findings were that 48% of programs were actively recruiting ethnically diverse students using a variety of strategies; various approaches were being used to retain students; barriers to student success were primarily financial and educational; and most programs included curricular content and programming designed to ensure culturally competent and sensitive graduates.

California↗

Testing the model for testing competency.

The pilot study to demonstrate the utility of the CBRDM in the practice setting was successful. Using a matrix evaluation tool based on the model's competencies, evaluators were able to observe specific performance behaviors of senior nursing students and new graduates at either the novice or competent levels. The study faced the usual perils of pilot studies, including small sample size, a limited number of items from the total CBRDM, restricted financial resources, inexperienced researchers, unexpected barriers, and untested evaluation tools. It was understood from the beginning of the study that the research would be based on a program evaluation model, analyzing both processes and outcomes. However, the meager data findings led to the desire to continue to study use of the model for practice setting job expectations, career planning for nurses, and curriculum development for educators. Although the California Strategic Planning Committee for Nursing no longer has funding, we hope that others interested in role differentiation issues will take the results of this study and test the model in other practice settings. Its ability to measure higher levels of competency as well as novice and competent should be studied, i.e., proficient, expert, and advanced practice. The CBRDM may be useful in evaluating student and nurse performance, defining role expectations, and identifying the preparation necessary for the roles. The initial findings related to the two functions as leader and teacher in the care provider and care coordinator roles led to much discussion about helping students and nurses develop competence. Additional discussion focused on the roles as they apply to settings such as critical care or primary health care. The model is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and career planning.

California↗

A test of the California competency-based differentiated role model.

To address the incongruence between the expectations of nursing service and education in California, the Education Industry Interface Task Force of the California Strategic Planning Committee for Nursing developed descriptions to assist employers and educators in clearly differentiating practice and educational competencies. The completion of the Competency-Based Role Differentiation Model resulted in the need to test the model for its utility in the service setting, in education, and for career planning for nurses. Three alpha demonstration sites were selected based on representative geographical regions of California. The sites were composed of tri-partnerships consisting of a medical center, an associate degree in nursing program, and a baccalaureate nursing program. Observers rated senior students and new graduates in medical-surgical units on their behaviors in teacher and leadership care provider and care coordinator roles. The alpha demonstration study results were as expected. That is, senior students practice predominantly at a novice level in teacher and management/leadership care provider functions and new graduates practice predominately at the competent level. New graduates are more likely to take on novice and competent care coordinator roles. The CBRDM may be useful for practice and education settings to evaluate student and nurse performance, to define role expectations, and to identify the preparation necessary for the roles. It is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and carrier planning.

California↗

Processes and outcomes of evidence-based practice.

OBJECTIVES: To describe knowledge utilization, the models created to apply knowledge and promote evidence-based practice, and outcomes of integrating evidence into practice. DATA SOURCES: Textbooks, research and review articles, and professional experience. CONCLUSIONS: Evidence-based practice is both a process, which requires activities to evaluate evidence, and a product, which is the translation of evidence into a practice change. IMPLICATIONS FOR NURSING PRACTICE: The integration of evidence into nursing practice will strengthen nursing's theoretical base, decrease the variation in processes of care, improve patient outcomes, empower nurses, and help identify areas for research.

Evidence-Based Medicine↗

Osteoporosis in men treated with androgen suppression therapy for prostate cancer.

Men with advanced or metastatic prostate cancer commonly receive long-term treatment with luteinizing hormone-releasing hormone (LHRH) agonist therapy. This prolonged treatment causes a hypogonadal state of chronic testosterone deficiency. Similar to estrogen deficiency in postmenopausal women, testosterone deficiency among these men negatively affects bone metabolism through a complex self-regulating, negative feedback system and subsequent reduction in bone formation. If left undetected or untreated, the risk for osteoporosis rises. Osteoporosis increases the likelihood of fracture, especially of the hips. Researchers are studying the effects of LHRH agonist therapy on osteoporosis and other related conditions to determine whether interventions, such as pharmacologic agents (e.g., bisphosphonates), dietary supplements (e.g., calcium, vitamin D), and exercise, can slow or prevent the process and assist healthcare providers in knowing how to counsel patients. Current recommendations are found in the literature on glucocorticoid-induced and menopausal osteoporosis. Nurses need to stay abreast of current knowledge in this area, as it is expanding rapidly.

Antineoplastic Agents, Hormonal↗