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Accreditation of continuing education: the critical elements.

Accreditation in nursing continuing education (CNE) is central to professional values such as accountability, competence, and knowledgeable practice. Organizations choosing to participate in the accreditation/approval system make a commitment to quality. This article reviews the history of accreditation, defines the language, describes the system and process, and discusses agency/institution characteristics that should be in place before beginning an accreditation application process. The American Nurses Credentialing Center Commission on Accreditation model is used as the prototype.

Accreditation↗

A nursing partnership: the forces of magnetism guiding evidence-based practice in the Republic of Armenia.

A team of nurses at North Shore University Hospital in Manhasset, New York, has been participating in a global collaboration with nurses at Erebouni Medical Center in Yerevan, Armenia. During this collaboration, they have built on work initiated by representatives of the American International Health Alliance and the American Nurses Credentialing Center (ANCC) to develop application of evidence-based practice in the Armenian nurse's work environment. Their collective efforts have resulted in initiating nursing assessments and plans of care, position descriptions and performance appraisals, competency assessment tools, and performance improvement tools. Overall, the respect for nurses at Erebouni Medical Center has significantly improved. In October 2004, nurses at Erebouni Medical Center were recognized by the ANCC with the Journey to Nursing Excellence Award.

Armenia↗

Demographic characteristics of RN and generic students: implications for curriculum.

The overwhelming majority of nurses today continue to be prepared at the diploma or associate degree level despite the call of nursing leadership to make the BSN degree the minimum credential for entry into practice. Substantial numbers of registered nurses return to school for a BSN. The purpose of the study was to compare and contrast certain demographic characteristics of RN students with the generic BSN student enrolled in the same program. All junior and senior baccalaureate nursing students enrolled in California colleges and universities which admit RN students to NLN-accredited generic baccalaureate nursing degree programs comprised the study population. There were 3,421 students in the total designated population available for sampling. Of these, 251 actually participated in the study. Findings and implications for Nursing Educators are discussed within the context of the manuscript.

Adult↗

What are our priorities? Addressing the looming shortage of nursing faculty.

Let's get our priorities straight. As we continue the essential educational upgrading of the profession through research-focused doctoral programs, and through the new CNL and DNP programs, let's be sure that at least some of these programs attend to the critical need for well-prepared nursing faculty (i.e., provide opportunities for and encourage students to take advanced coursework in nursing education). Let's also pay attention to the reality of limited capacity in our research-focused doctoral programs and look to other viable approaches to having a cadre of well-prepared faculty. For example, let's recognize, value, and reward the important role master's-prepared nurses, especially those with advanced coursework in nursing education, can and must play in our basic programs. And let's be sure that we have faculty in our ranks who have the training, aptitude, and credentials to conduct the research so critical to progress in nursing education.

Curriculum↗

Implementation strategies for an inpatient women's support group.

The authors believe an inpatient women's group to be a supportive and educative nursing intervention that, when adjunctively combined with other inpatient therapy forms, assists women to resolve sex-role conflicts. Use of the nursing audit, review of relevant literature, development of a group philosophy, objectives, and appropriate credentialing of nurse group facilitators are strategies that maximize group effectiveness. Moreover, group content, which is determined from the client's perspectives of need, and evaluated by behavioral changes among client participants, insures sustained program relevancy.

Adult↗

Mental health care reform: a historic town meeting of psychiatric nurses.

1. Inspired by the 1992 presidential candidates' town meetings, the conveners of the American Psychiatric Nurses' Association Invitational Conference decided to stage a town meeting for psychiatric nurses. Forty psychiatric nursing leaders came together to share their professional expertise and experiences by giving "testimony" about the role psychiatric nurses play in mental health care reform. 2. The town meeting participants discussed many timely topics, such as practice, education, titling and credentialing issues, and the future of the psychiatric/mental health nursing profession. 3. The participants left the town meeting energized with a common sense of purpose--and a promise to commit themselves to creating the strategies necessary for reform of the mental health care system.

Curriculum↗

Leadership: a means of empowering the nursing profession.

For too long now, nurses have assumed an obsequious role in their working relationship with other health professionals. The nursing profession holds the majority membership in the field of health care professions yet nurses continue to be cast into subordinate roles within professional relationships, failing to be recognised as peers. This is despite many nurses possessing unique but analogous knowledge, credentials and professionalism. It is time nurses were agitated to reflect upon their position and be reminded nursing is also a profession. Some suggestions and motivation are offered.

Health Knowledge, Attitudes, Practice↗

Integrating complementary therapies into mainstream cancer care: which way forward?

Although viewed with scepticism by the medical and scientific community, complementary and alternative medicine (CAM) is being used by about 50% of Australians. Integrative medicine is a holistic approach to cancer care, with some CAM of proven effectiveness being used as adjuvants to conventional medical treatments. However, there is little evidence of a systematic process of evaluation or dialogue between mainstream cancer medicine and CAM providers in Australia. Collaboration, guidance and support for relevant research in this area are needed. The key elements of a process of furthering integrative medicine include improving knowledge about CAM; addressing uncertainties about CAM efficacy and safety; improving communication about CAM between medical practitioners and patients, and between medical practitioners and CAM practitioners; introducing regulatory frameworks and credentialing of CAM practitioners; and addressing ethical issues.

Australia↗

Working conditions and supervision for residents in internal medicine programs: recommendations. American College of Physicians.

Changes intended to improve resident working conditions and supervision must take into account the complex realities governing teaching services. The American College of Physicians supports the ongoing reexamination of these issues, and recommends the following: 1) change be systematic and coordinated, balancing patient care and teaching needs; 2) changes in the medical care system itself are necessary in this process; 3) efforts be continued to reduce preventable medical error on teaching services within the limits of uncertainty intrinsic to medical practice; 4) reasonable restriction be placed on total continuous duty hours, but residents not disengage themselves prematurely from care of their patients; 5) residency training specifically teach techniques for balancing patient service, education, and personal life; 6) the issue of resident workload be addressed; and 7) formal evaluation of supervisory competence, explicit attention to the spirit of resident-supervisor relationships, respect for the principle of meaningful patient responsibility, and formal resident credentialing all be taken into account in improving resident supervision.

Internal Medicine↗

Certification and recertification: one approach to professional accountability.

Professional accountability requires a self-regulating profession to set and maintain credible, useful standards for its members. Voluntary certification and recertification--evaluation by peers--serves the responsibility of the profession to establish and enforce its own standards. The goal of certification by the American Board of Internal Medicine is to improve the quality of medical care by ensuring that the certified internist and subspecialist possess the knowledge, skills, and attitudes essential to the provision of excellent care. Without a true constituency and with a valid certification process, the Board provides a credential sought by nearly every graduate resident and acceptable both to the profession and patients. Recertification now presents the opportunity to foster continuing scholarship and self-improvement throughout the career of an internist.

Certification↗

Team physician preferences at National Collegiate Athletic Association Division I universities.

Virtually all National Collegiate Athletic Association (NCAA) Division I universities have physicians who evaluate and treat athletic injuries and other medical conditions. The relationship of these physicians to these institutions ranges from a very loose arrangement to full-time employment. The specialties of the physicians working with the athletes of NCAA Division I universities vary as well. This study attempts to determine the specialty of current team physicians at NCAA Division I universities and their qualifications as well as the preferences of athletic directors when they are seeking to employ a team physician for their university. By comparing IA and non-IA Division I institutions, an attempt is made to determine the possible reasons for differences. This information will then be useful both for physicians-in-training who aspire to be team physicians at the university level and for administrators at these institutions who will be recruiting physicians with the most desirable credentials in the future.

Athletic Injuries↗

Forensic (medico-legal) necropsy of wildlife.

Post-mortem examination of wild animals for legal purposes has become increasingly common. Special procedures are necessary during such necropsies to ensure that the information collected is suitable for use in a court of law. Forensic necropsies should be performed by pathologists with formal training and experience, because these credentials will be examined if a case reaches court. There must be strict attention to maintaining a chain of custody when specimens are received from the field and in all subsequent procedures, so that the identity of specimens and information resulting from the necropsy is beyond question. A complete record must be kept of all procedures and observations. The necropsy report must be detailed, clear and, as far as possible, written in non-technical language. Photography should be used to preserve visual evidence. Special precautions are required for collecting specimens, such as bullets, suspected toxins, and material for DNA analysis, and for sending these specimens to other laboratories.

Animals↗

Detection of soft tissue foreign bodies in the presence of soft tissue gas.

OBJECTIVE: To determine the effect of soft tissue gas on the accuracy of foreign body detection by realtime sonography. METHODS: This was a prospective randomized study using glass, metal, and bone inserted into turkey breasts to simulate human soft tissue foreign bodies. Air was subsequently injected around a random selection of the foreign bodies to simulate soft tissue gas that can accompany a blast or high-force injury. Using a linear transducer, physicians credentialed in the use of sonography were each asked to scan the breasts, identify the location of any foreign body, and describe whether the object located was bone, metal, or glass. They were also asked to describe the characteristics of the foreign body, including surface echogenicity, visibility, and artifacts, if any. RESULTS: The sensitivity for localization of each foreign body by each sonographer was 100% (48 of 48) and was unaffected by the presence of soft tissue gas. The accuracy of classifying the foreign body was poor except with bone. Glass and metal were often confused with each other. With the addition of soft tissue gas over the foreign bodies, the sensitivity of classifying the foreign body was decreased further from a combined 58% to 28%. The presence of soft tissue gas decreased the amount of reflection of the foreign body and obscured the subtle differences in the brightness of each foreign body, leading to a decrease in the accuracy of identification but not localization of the foreign body. CONCLUSIONS: In an experimental model, soft tissue gas does not affect the localization of soft tissue foreign bodies. However, correct identification of the type of foreign body is limited by soft tissue gas because of loss of the typical sonographic characteristics.

Animals↗

Balint seminar leaders: what do they do?

BACKGROUND: Balint seminars are part of the education of family practice residents in an estimated 30% of programs. Balint leaders are family physicians, psychiatrists, psychologists, and social workers with apprenticeship-type training. Balint leaders or Balint groups have never been formally evaluated. METHODS: We used multiple qualitative methods, including field observations, interviews, and focus groups. Field observations involved 12 Balint groups in 3 family practice residency programs. For comparison, we used videotaped seminars of 2 groups from the most recent Balint International meeting. In-person or telephone interviews were conducted with Balint leaders in a number of sites. We conducted focus groups with resident participants at each of the local sites. RESULTS: Although differences were seen among groups influenced by the group leader and the makeup of the group, there were consistencies across all of the groups. Contrary to the usual description of Balint leadership, these residency groups functioned partially as support groups, attempted to relieve or dampen anxiety, had a hierarchical system with the leader as the teacher/controller, and served an educational and a developmental purpose. CONCLUSIONS: Balint leaders and their groups in the program studied did not function as traditionally described by Balint. Further observations of more groups are needed to determine if this variation is unique to the programs studied or is a manifestation of the transfer of the Balint method from experienced practitioners to physicians in training. This information will be of benefit to the development of appropriate training for future Balint leaders and for the credentialing process now being developed by the American Balint Society.

Family Practice↗

A perspective on local-level governance in multiunit systems.

The traditional functions of the hospital board are affected significantly when the institution is part of a multiunit system. The local board in multiunit systems often does not have the unrestricted ability to define its mission and goals and typically does not have total responsibility and authority for selecting, appointing, and evaluating the performance of the hospital's CEO. Some type of system-level involvement in shaping and/or approving the local institution's strategic plan and budget is common. Local boards generally have retained the principal role in the appointment and credentialing of medical staff members. In general, the continuing growth of multiunit systems has profound implications for the present and future role of local-level governance, but that role continues to have great importance and must be defined carefully.

Budgets↗

Implementation of a multimodality program.

Economic changes in the health care system have presented a unique opportunity for radiographers and other imaging personnel. Hospital administrators are becoming aware of the advantages of employing multiskilled technologists. The single-skilled technologist must recognize the benefits of additional education and overcome the negative perceptions of the profession. A well-conceived educational program developed and managed by a continuing education department will provide not only the required didactic and clinical courses to ensure competency, but also recognized credentialing for each modality.

Clinical Competence↗

Soviet nurses help alleviate Baltimore hospital's shortage.

A pilot program is boosting a Baltimore hospital's nursing rolls while providing on-the-job training to immigrant Soviet nurses. For the short term, the Soviets fill important non-professional positions in the hospital's nursing department while working toward gaining their nursing credentials so they can become eligible to be hired by the hospital, easing its long-term nursing shortage.

Baltimore↗

Resource directory. Licensing/credentialing requirements in respiratory therapy.

Most call it licensing. Others say credentialing or certification. Whatever the terminology, you will have to meet certain requirements to practice your healthcare discipline in any given state. Because these qualifications differ throughout the nation, you should gather this information from the state in which you wish to practice as soon as possible. To help you become familiar with these qualifications, we have compiled a state-by-state summary of practice requirements. We start with respiratory therapy and will continue with occupational therapy, pharmacy, nursing and physical therapy in later issues. For more complete information, contact appropriate state licensing/credentialing agencies. Their phone numbers and addresses will be featured in HT&T's upcoming Resource Directories.

Licensure↗