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The Magnet Recognition Program and evidence-based practice.

From the original Magnet study (1981) to now, health care organizations have begun to embrace the Magnet Recognition Program in record numbers. A visit to the Magnet web site (http://nursingworld.org/ancc/magnet.html) listed 186 Magnet hospitals, with many more healthcare facilities currently under review. As the Magnet Recognition Program has grown, so has the development of evidence-based practice (EBP). In fact, EBP is one of the cornerstones of the Magnet Recognition Program, as well as the involvement of staff nurses in research and/or EBP activities. This article will give a brief introduction of the Magnet Recognition Program and suggest activities that will involve staff nurses in EBP.

Accreditation↗

Supporting pre-registration students in practice: A review of current ICT use.

It is unclear how current healthcare students based in the United Kingdom (UK) use information and communication technology (ICT) to support their learning and care delivery in practice environments. This position reflects the dearth of current empirical evidence that needs development in this rapidly changing field. Using focus group interviews involving 16 students from nursing and the allied health professions, to reflect the interprofessional nature of healthcare education, this research explored how students employ technology in placement settings. The students drew on networked resources for personal learning and gave examples of use to meet patient and user needs. Technology also provided a vehicle for communication with the University, though use was complicated by a number of issues. Access to computers and the Internet whilst in placement environments proved problematic for some, with the culture not seeming to support ICT use. Lack of time, attitudes towards computers and ICT skills also affected student engagement. These findings provide information to guide the development of ICT use in placement settings.

Allied Health Personnel↗

The practice doctorate in nursing: approaches to transform nurse practitioner education and practice.

Ongoing challenges caused by increased complexity of care, changing patient demographics, and shifting health care delivery systems are necessitating a transformation of advanced practice. The practice doctorate has the potential to prepare graduates to meet these challenges now and in the future. This article conceptualizes the practice doctorate curriculum for nurse practitioners (NPs), with particular focus on how it will prepare NPs as expert clinicians with enhanced leadership and research skills. Nurse practitioner doctoral education and practice is articulated and differentiated from current NP education and practice, with distinguishing features clearly identified. A compelling argument is made for how this educational preparation will facilitate NPs in meeting future societal needs. The purpose of this article is to provide guidance for all advanced practice educational programs considering adoption of a practice doctorate, and to contribute to the advancement of thinking about the practice doctorate for clinicians as well as educators.

Certification↗

Advancing practice inquiry: research foundations of the practice doctorate in nursing.

The University of Washington Doctor of Nursing Practice program entails 3 curricular dimensions: advanced practice, leadership, and practice inquiry. In this article, the practice inquiry dimension is discussed and defined as a type of clinical investigation that closely aligns with the realities and complexities of everyday practice by advanced practice nurses (APNs). The advancement of APNs' practice inquiry competencies is timely for its interfaces with the national scientific agenda's emphasis on translating science to clinical practice, health care delivery systems and policy. A framework for conceptualizing a practice inquiry curriculum and competencies is proposed. In addition, the divergent and convergent comparisons with Doctor of Philosophy (PhD) nursing programs are discussed, with emphasis placed on potential collaborative clinical research endeavors.

Clinical Competence↗

Evidence-based resources and the role of librarians in developing evidence-based practice curricula.

The implementation of evidence-based practice (EBP) requires acquisition and use of a complex set of skills, including the ability to locate and critically evaluate clinically relevant research literature. In this article, we discuss information resources and tools that may be of value to educators faced with the task of teaching students to search for and evaluate research-based evidence. In addition, we discuss how health sciences librarians, with the use of new models of information instruction and delivery, can work with nursing faculty in developing curricula for training students in EBP.

Computer User Training↗

Computer literacy study: report of qualitative findings.

Computer literacy and information literacy are critical to the future of nursing. The very nature of health care is being transformed in response to environmental drivers such as the demands for cost-effective delivery of high quality services and enhanced patient safety. Facilitating the quality transformation depends on strategic changes such as implementing evidence-based practice (), promoting outcome research (), initiating interdisciplinary care coordination [Zwarenstein, M., Bryant, W. (2004). Interventions to promote collaboration between nurses and doctors. The Cochrane Library(I)], and implementing electronic health records (). Information management serves as a central premise of each of these strategies and is an essential tool to facilitate change. This report of the analysis of qualitative data from a national online survey of baccalaureate nursing education programs describes the current level of integration of the computer literacy and information literacy skills and competencies of nursing faculty, clinicians, and students in the United States. The outcomes of the study are important to guide curriculum development in meeting the changing health care environmental demands for quality, cost-effectiveness, and safety.

Anthropology, Cultural↗

Can technology improve intershift report? What the research reveals.

Shift report is a multifaceted process that serves to provide nurses with vital patient information to facilitate clinical decisions and patient care planning. A shift report also provides nurses with a forum for functions, such as patient problem solving and collaboration. The authors conducted a literature review, which indicates that current methodologies used to collect and convey patient information are ineffective and may contribute to negative patient outcomes. Data incongruence, legal implications, time constraints augmented by the nursing shortage, and the financial impact of shift report are also addressed. The literature reveals significant rationale for pioneering new and innovative methods of shift-to-shift communication. In the report To Err is Human: Building a Safe Health System, the Institute of Medicine attributes the deaths of up to 98,000 hospitalized Americans to medical errors, including communication failures [Institute of Medicine. (1999). To err is human: Building a safe health system. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. As a result, government policy makers and health care agencies have focused their attention on determining the root cause of errors to identify preventative measures, including the use of information technology [Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. Under these premises, the authors examined the process of nursing shift report and how it impacts patient outcomes. The use of computer technology and wireless modes of communication is explored as a means of improving the shift report process and, subsequently, health care outcomes and patient safety.

Causality↗

Fifteen best practice recommendations for bar-code medication administration in the Veterans Health Administration.

BACKGROUND: Since 2000, the Veterans Health Administration (VHA) has pioneered the development and deployment of a bar-code medication administration (BCMA) system. Based on VHA experience, 15 "best practices" for BCMA implementation, integration, and maintenance are recommended. METHODS: Data were collected on potential barriers to the effectiveness of BCMA to improve patient safety by direct observation of medication administration, simulated BCMA use in a laboratory setting, a survey of nursing informatics specialists regarding policies and procedures, and 30 unstructured interviews with diverse stakeholders. RECOMMENDATIONS: Fifteen practices were proposed, categorized by implementation and continuous improvement, training, troubleshooting, contingency planning, equipment maintenance, medication administration, and maintenance of paper patient wristbands. For example, Recommendation 15 ("Periodic replacement of wristbands") advises weekly bar-coded wristband replacement in long term care settings to improve the scanning reliability. DISCUSSION: Lessons learned about best practices to address challenges may offer insight to others considering implementation of bar-code technology.

Electronic Data Processing↗

New home telehealth toolkit available.

A new Home Telehealth Toolkit is available for those interested in establishing a new home telehealth program or improving an existing one. Developed by members of the American Telemedicine Association's (ATA) Home Telehealth Special Interest Group (SIG) contains guidelines, procedures, and sample protocols that can be adapted for all phases of a home care telehealth program.

Community Health Nursing↗

The impact of technology on the "older" nurse: findings of the study: part 2.

This article presents the results of a study identifying older nurses' response to using various technology in their practice. This study measured nurses working with wireless peripheral devices, such as blood pressure cuffs, pulse oximeters, scales, glucometers, and digital thermometers, and monitoring units that were placed in the patient's home. Findings have implications for both older and younger clinicians as these types of products and systems can affect productivity, visit time, and assessment accuracy.

Age Factors↗

Matching telehealth applications to the patient, clinician, and agency's needs.

Telehealth offers many opportunities to provide evidence-based, cost-effective home care practice. To ensure success administrators, managers, and clinicians must identify their agency's telehealth goals and compare these with technology manufacturers' recommendations. This article provides a list of considerations agencies can use to evaluate telehealth programs objectively. Successful telehealth applications are also presented.

Age Factors↗

Using telehealth to address the nursing shortage.

For years, government officials, health administrators, and others concerned about long-term care have been discussing the nursing shortage. As baby boomers age and fewer and fewer nurses enter the workforce, there is a growing concern about how to deliver health-care in the 21st Century.

Community Health Nursing↗

Managing congestive heart failure using home telehealth.

Congestive heart failure (CHF) is the leading cause of rehospitalization and loss of revenue for home care agencies and hospitals. This article outlines how an agency used telehealth to provide CHF patients quality care and improved outcomes while decreasing the number of skilled home nursing visits and reducing rehospitalization rates to 1.2%.

Durable Medical Equipment↗

Critical pathways: effectiveness in achieving patient outcomes.

Refining the clinical care process to produce high-quality patient outcomes is becoming increasingly important as health care administrators strive for success in a mature managed care environment. This study examines the effect of structuring interventions and the evaluation of patient response, inherent in the critical pathway process, on clinical, length-of-hospital-stay, and financial patient outcomes. This study differs from previous critical pathway trials in that an objective measure of quality was used and the critical pathways were not introduced concurrently with a case management delivery model. The results show that critical pathways may be a significant determinant of improved quality in a managed care environment. The findings also suggest ways to improve nursing practice, nursing education, and nursing informatics.

Critical Pathways↗