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PubMed2001

Statutory and regulatory issues for clinical nurse specialist (CNS) practice: ensuring the public's access to CNS services.

The practice environment of healthcare in the United States is fluid, dynamic, and sometimes chaotic. Statutory, regulatory, and credentialing requirements are critical elements of this changeable environment affecting clinical nurse specialists (CNSs) and other advanced practice nurses (APNs). CNSs are estimated to comprise approximately 54,000 APNs, based on the 2000 National Sample Survey of Registered Nurses. Although statutes and regulations related to APNs are reviewed regularly, there has not been a critical analysis of statutes and regulations specifically governing CNS practice in the United States. This lack is largely due to the absence of a national association devoted to CNSs before 1995. However, recently there has been a resurgence of interest and need for CNS services. Therefore, it is particularly important that any statutory and/or regulatory barriers to CNS practice be removed. In 1998, the National Association of Clinical Nurse Specialists Legislative and Regulatory Committee embarked on a critical analysis of state statutes and regulations governing CNS practice. All 50 state boards of nursing and the District of Columbia board of nursing were requested to send copies of their statutes and regulations governing CNS practice. Responses were received from 48 states. This article summarizes the state of regulation of CNS practice and identifies significant barriers to CNS practice that should be systematically addressed. The patchwork quilt of CNS regulation that varies from state to state results in over-restrictive and underinclusive provisions that preclude ease of reciprocity and deprive the public full access to CNS services. Recommendations for addressing the barriers are made.

Humans↗

PubMedDate not supplied

The practice of certified community health CNSs.

PURPOSE/OBJECTIVES: This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. METHODS: The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. ANALYSIS: Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. FINDINGS: The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25% for nurses/ nursing practice. CONCLUSIONS: Community Health CNS is a viable specialty practice with long-term career options. The subrole functions-described by ANA-of clinician, educator, administrator/leader, consultant, and to a lesser extent researcher apply to the role. The more intergraded updated model offered by NACNS also fits Community Health CNS practice with more emphasis on patient/client and organization/ network spheres than on nurses/nursing practice sphere. IMPLICATIONS: Schools of nursing should continue to offer the Community Health CNS programs and incorporate both the traditional functions and newer practice model into their curricula, with a greater emphasis on diversity of students to help ensure a more diverse CNS population. Further research is needed to explore the outcomes of Community Health CNS practice and the factors that contribute to role satisfaction.

Adult↗

PubMedDate not supplied

Technicians in critical care: training, supervisory, and legal aspects.

An extra pair of hands is a precious commodity because of today's nursing shortage. Should technicians without nursing credentials be assigned to fulfill the role of nurses in critical care areas? Many have already voiced their opinions against the Registered Care Technologist (RCT) proposal of the American Medical Association (AMA), but it is time to examine the larger issue: the broad use of technicians in critical care. This author clarifies important factors regarding the use of technicians in critical care.

Allied Health Personnel↗

PubMedDate not supplied

Why bother getting certified?

Certification is an important credential for the home healthcare nurse. Expertise in specific areas of nursing practice is documented by peers, thus attesting to the professional's expertise and qualifications. Home healthcare nurses should be encouraged to become certified in their area of practice and to educate their clients and colleagues about the importance of national certification.

American Nurses' Association↗

PubMed1998

Preparing for the home health nurse certification examination.

Becoming certified in an area of nursing practice is one way of demonstrating expertise and competency in that area. Proper preparation is the key to successfully become certified. Study hints and test-taking strategies are discussed in detail. Specific information is provided on preparation to take the American Nurses Credentialing Center (ANCC) Generalist Home Health Nurse certification examination.

Certification↗

PubMed2003

Magnet home care agencies: a professional way to impact quality and retention.

By 2009 the nursing shortage will reach a critical level with home care agencies seriously affected. Hospitals have begun to embrace one proven method for recruiting and retaining nurses: achieving magnet recognition from the American Nurses Credentialing Center. Although magnet recognition has been available to home health agencies since 2000, no agency has applied. This article outlines how agencies can take advantage of the program.

Home Care Agencies↗

PubMed1992

Job roles of assistive technology service providers in the United States.

The purpose of this study was to identify empirically the roles of assistive technology service providers in the United States. Via factor analysis, the following six job roles were identified: (a) Device Selection and Maintenance Activities, (b) Environmental Modification Activities, (c) Dissemination of Information on Assistive Technology Activities, (d) Evaluation of Suitability of Assistive Device Activities, (e) Administration Activities, and (f) Product Development Activities. The identified roles can provide a potential guide for the development of education or training curricula for assistive technology service providers. Those job role categories can be considered to be required areas of knowledge in a curriculum for assistive technology specialists. The identified roles can also be utilized to help define the profession of assistive technology. That definition could help guide the development of eligibility criterion and examination content for a credentialing programme for qualified assistive technology service providers in the future. A clear description of the job of assistive technology service providers can help administrators create needed positions within service delivery organizations such as state department of rehabilitation services and a rehabilitation hospital. The results could be valuable to the administrators responsible for setting job role criteria for assistive technology service providers. Such criteria are necessary for making effective hiring and employee evaluation decisions. In addition, the results can provide other professionals who utilize assistive technology services with an accurate picture of the services available from assistive technology service providers. When professionals on a rehabilitation team know what to expect of each other, clients are better served. Thus a better understanding of the roles of assistive technology service providers can contribute to better utilization of their services by a multidisciplinary team. This would in turn increase the chances of assistive technology services being offered to clients. Replication of the present study is encouraged to verify the obtained results. A future study should also focus on examining the roles of assistive technology service providers by directly observing their daily work activities. The task inventory used in the present study (ATTI) might be utilized to help guide such observations.

Allied Health Personnel↗

PubMed1987

Current and future policies regarding laboratory animal welfare.

Laboratory animal welfare has made tremendous strides in recent years. The first laboratory animal welfare law was not enacted until 1966, and laboratory animal medicine as a specialty did not even exist until the 1960s. The AAALAC accreditation program has stimulated improvements in accredited institutions, and the FDA and EPA Good Laboratory Practices Acts had a major impact on industry in the 1970s, but the most visible impact upon academic institutions was made by NIH enforcing their Policy in the 1980s by suspending funding to several programs and institutions. The Association of American Medical Colleges and the Association of American Universities jointly published Recommendations for Governance and Management of Institutional Animal Resources in October 1985, following very closely the provisions of NIH and the Guide. Animal rights groups have even contributed toward the improvement of animal welfare policies by their recent flurry of demonstrations, thefts, and vandalism. The end result has been an impressively rapid upgrading and standardization of animal care and use policies and programs at all types of institutions that use animals in their work. Most major institutions now have qualified and credentialed laboratory animal medicine specialists directing their programs, conscientious and responsive animal care and use committees overseeing and evaluating animal welfare, and qualified, well-trained animal care staff and investigators. Institutions that do not meet these standards undergo great pressure from the USDA, NIH, their peers, and the public to bring their programs into compliance quickly and appropriately.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Care Committees↗

PubMed1991

Pathways to improved radiologic research. An NIH workshop.

In summary, the workshop recommended two years of research training as being essential for radiologists to acquire the skills and knowledge necessary to begin a successful research career in today's funding and academic environment. Many pathways can combine two years of research training and provide fulfillment of existing requirements to achieve specialty certification and subspecialty credentialing. Departments of radiology supporting the beginning qualified investigator should allow him or her approximately 75% research time for the first three years of the academic appointment. Departmental research time accorded faculty members may best be concentrated on a few individuals, providing them sufficient time to be competitive for peer-reviewed grants and enabling research advances to provide a solid foundation for the future of radiologic imaging.

Humans↗

PubMed2000

The American College of Medical Practice Executives' competency study.

This article is the first of two studies conducted by the American College of Medical Practice Executives (ACMPE) that examines the perceived roles of medical practice executives. (Founded in 1956, the American College of Medical Practice Executives is the professional development and credentialing arm of the Medical Group Management Association (MGMA)). This study asked groups of physicians and nonphysician administrators to identify the competencies and associated skills and knowledge for administering group practices in today's changing environment. Those surveyed included administrators who are Fellows in ACMPE and 795 physicians who comprise the Society of Physician Administrators of the Medical Group Management Association. The responses were examined through a framework provided by the Managed Care Process Model. In this model, the focus is on the administrative and clinical processes required by different levels of managed care market penetration. The model progresses from a focus on relatively traditional practice management functions to those activities that are more complex with a greater focus on the integration of both clinical and business processes aimed at the health of populations. The analysis of the perceived competencies indicated that while both executive types perceived the importance of managing the health of populations, that task is not yet being incorporated into their professional roles.

Attitude of Health Personnel↗

PubMedDate not supplied

The holistic nurse's search for credibility.

This article, part of a larger qualitative naturalistic study, examined what motivates professional RNs to become certified holistic nurses and the knowledge, skills, and attitudes holistic nurses perceive they need to become competent practitioners. Two key findings were (1) disjuncture between the traditional nursing structure and the nurses' own personal and professional growth and development and (2) the need for credibility. For these participants, obtaining the HNC credential conveyed credibility and legitimacy.

Adult↗

PubMed1980

Extracting oblique planes from serial CT sections.

Although geometric principles describing planes oblique to an orthogonal image data set are well understood, no implementation has been offered for their practical specification, extraction, and display in a clinical environment. Fast image generation and ease of user specification-requisite credentials for successful clinical implementations-are handicapped by the large volume of data to process. Other difficulties further complicate an interactive solution. Once oblique planes are generated, their orientation is often difficult to perceive without visual cues that aid their registration with standard image formats. In addition, Moire patterns introduced by digital aliasing often currupt resultant views. In this paper, techniques are outlined for simplifying oblique plane specification, a methodology is presented for image construction, and an interactive approach is illustrated to register images for such general view planes. Finally, digital aliasing of oblique planes is discussed, and a solution is given for this application.

Computers↗

PubMedDate not supplied

Training and certifying gastroenterologists as physician nutrition specialists.

Because nutrition is an integral aspect of the science and practice of gastroenterology, all gastroenterology fellows should receive training in core aspects of nutrition (level 1 training). Some gastroenterologists also wish to train more extensively in nutrition (level 2) and become physician nutrition specialists. The Intersociety Professional Nutrition Education Consortium, composed of representatives from eight national societies with significant nutrition interests, including the American Gastroenterological Association, and three credentialing bodies, has developed a paradigm and training requirements for physician-nutrition specialists that recognizes their varied backgrounds and areas of interest. Opportunities exist for gastroenterology fellows to obtain physician nutrition specialist training within their gastroenterology fellowships and to be eligible to take the Certification Examination for Physician Nutrition Specialists offered by the new American Board of Physician Nutrition Specialists.* This article reviews the development of consensus on subspecialty training for physicians in nutrition; it also encourages directors of gastroenterology fellowships to develop training opportunities and gastroenterology fellows to consider identifying nutrition as an area of emphasis for their careers.

Certification↗

PubMed2000

Analysis of the nursing work force compared with national trends.

Nursing work force analysis gives crucial data for administrators, allowing them to anticipate employment opportunities and areas of limited growth. Using an economic model of supply and demand, this study examined the employment and educational needs for nurses. In many areas of data collection, the District of Columbia data paralleled national trends, indicating the nationwide relevance of the conclusions. Projected mismatches between the type of nurses (by educational preparation) entering the work force and the skills required for the job vacancies could lead to increased demand for nurses with certain credentials as well as shortages of nurses in certain types of facilities.

Ambulatory Care Facilities↗

PubMed2001

BSN by 2010. A California initiative.

The Association of California Nurse Leaders has developed an initiative to require the baccalaureate in nursing as the credential for entry into practice as a registered nurse by the year 2010 in the state of California. When nursing is compared to other healthcare professions, such as pharmacy, physical therapy, and occupational therapy, it becomes obvious that educational requirements for nurses must be updated. Nursing leaders have developed a 10-year action plan to change the entry-level educational requirements for California nurses.

California↗

PubMed2002

Using nursing research projects to meet Magnet Recognition Program standards.

The American Nurses Credentialing Center Magnet Recognition Program recognizes facilities that demonstrate excellence in nursing services, development of a professional milieu and growth and development of the nursing staff. The Magnet program is based on the American Nurses Association's which serves as the evaluation framework for determination of Magnet recognition. The role of research and its impact on nursing practice is an important criterion. The authors describe how one medical center successfully used ongoing nursing research projects to highlight how the institution met the Magnet standards.

Benchmarking↗

PubMed2003

The magnet application: pitfalls to avoid.

The process of seeking magnet designation through the American Nurses Credentialing Center begins with completion of a 1-page application. The second phase, the most tedious and time-consuming phase, consists of submitting written documentation. The written documentation must demonstrate implementation of the Scope and Standards for Nurse Administrators and how the "forces of magnetism" are incorporated within nursing services. Compiling the written documentation can be overwhelming and challenging. Getting started, developing an approach, and assigning responsibilities require time, creativity, and energy. The authors identify strategies to make the document preparation smooth and coordinated. Pitfalls to avoid and helpful tips are discussed.

Accreditation↗

PubMed2004

Achieving magnet hospital recognition: chief nurse executives and magnet coordinators tell their stories.

Organizational and management characteristics found in hospitals holding magnet hospital recognition are associated with professional nurse practice environments and positive patient and staff outcomes. However, while we know what works, we need a better understanding of "how to get there.'' The authors report the stories about "how we did it'' told by chief nurse executives and magnet project coordinators from hospitals that have achieved American Nurses Credentialing Center magnet hospital recognition. This article adds to the understanding of how to pursue magnet recognition.

Accreditation↗