ASPMN Position Statement: Authorized Agent Controlled Analgesia.

The American Society for Pain Management Nursing (ASPMN) has reviewed and updated its position statement on the use of authorized agent controlled analgesia (AACA) for patients who are unable to independently utilize a self-dosing analgesic infusion pump, commonly known as patient-controlled analgesia (PCA). ASPMN continues to support the use of AACA to provide timely and effective pain management while promoting equitable care for vulnerable patient populations who are unable to use PCA. ASPMN does not support the use of "PCA by Proxy" in which unauthorized individuals activate PCA for a patient. This position statement includes an updated review of the evidence related to AACA. Clinical practice recommendations for authorized agents, nurses, prescribers, and organizations are provided with an emphasis on the importance of appropriate authorized agent selection, education, diligent patient assessment and medication management.

Centering diversity, equity, and inclusion in a regional professional nursing organization.

BACKGROUND: Professional nursing organizations can respond to threats to social justice by strengthening structures to support diversity, equity, and inclusion (DEI). PURPOSE: Describe implementation strategies and outcomes to advance DEI from the Western Institute of Nursing (WIN). METHODS: In 2019, WIN committed to prioritizing DEI by updating its vision and mission. A taskforce was assembled to conduct member surveys, focus groups, and open forums to generate recommendations on developing and implementing organizational change. DISCUSSION: These initiatives culminated in centralized efforts that include the formation of a standing committee, ongoing member surveys, selection of diverse conference topics and speakers, adoption of inclusive practices, and ongoing assessments to make recommendations to the Board to advance DEI. CONCLUSION: The work of the Committee ensures the organization remains committed to DEI. These strategies inform other nursing organizations as they advance DEI to impact research, education, policy, and practice.

The Status of Nephrology Nursing - Views from Nephrology Nurse Leaders.

To better understand the current status of nephrology nursing in the United States, nephrology nurse leaders from the American Nephrology Nurses Association and the leading nephrology care provider organizations were asked their perceptions of pressing issues facing nephrology nurses. Each described their experiences and how they are handling the challenges and opportunities in their respective organizations.

Lessons from professional nursing associations' policy advocacy responses to the COVID-19 pandemic: An interpretive description.

BACKGROUND: Professional nursing associations across jurisdictions engaged in significant policy advocacy during the COVID-19 pandemic to support nurses, the public and health systems. While professional nursing associations have a long history of engaging in policy advocacy, scholars have rarely critically examined this important function. PURPOSE: The purpose of this study was twofold: (a) to examine how professional nursing associations engage in the process of policy advocacy and (b) to develop knowledge specific to policy advocacy in the context of a global pandemic. METHODS: This study was conducted using interpretive description. A total of eight individuals from four professional nursing associations (two local, one national and one international) participated. Data sources included semi-structured interviews conducted between October 2021 and December 2021 and internal and external documents produced by organizations. Data collection and analysis occurred concurrently. Within-case analysis was conducted prior to cross-case comparisons. FINDINGS: Six key themes were developed to illustrate the lessons learned from these organizations including their organization's role in supporting a wide audience (professional nursing associations as a compass); the scope of their policy priorities (bridging the gaps between issues and solutions), the breadth of their advocacy strategies (top down, bottom up and everything in between), the factors influencing their decision-making (looking in and looking out), their evaluation practices (focus on contribution, not attribution) and the importance of capitalizing on windows of opportunity. CONCLUSIONS: This study provides insight into the nature of policy advocacy carried out by professional nursing associations. IMPACT: The findings suggest the need for those leading this important function to think critically about their role in supporting a wide range of audiences, the breadth and depth of their policy priorities and advocacy strategies, the factors that influence their decision-making, and the ways in which their policy advocacy work can be evaluated to move towards greater influence and impact.

Position Statement: Acute Perioperative Pain Management Among Patients Undergoing Orthopedic Surgery by the American Society for Pain Management Nursing and The National Association of Orthopaedic Nurses.

Patients undergoing elective orthopaedic surgery may experience pain that is acute, chronic or a combination of the two, with less than half of all surgical patients reporting adequate pain relief. The National Association of Orthopaedic Nurses (NAON) and the American Society for Pain Management Nursing (ASPMN) have partnered to provide evidence-informed guidance to empower nurses to employ effective pain management. Understanding and applying ethical, evidence-informed, patient-focused, interprofessional interventions will improve outcomes for patients, clinicians, and healthcare organizations. Together, we encourage nurses to embrace the guiding principles presented in this Position Statement to provide optimal pain management for the orthopaedic patient.

Procedural Pain Management: Clinical Practice Recommendations American Society for Pain Management Nursing.

Throughout the life span procedures are common within health care and have the potential to cause pain. Nurses have an ethical responsibility involving the care of people with pain. The American Society for Pain Management Nursing holds the position that all patients undergoing painful procedures have the right to safe and effective pain management throughout the phases of care and that the interprofessional health care team ensures such ethical obligation is fulfilled within a framework of patients or their designees' goals and preferences. It is recommended that nurses, other health care providers, and health care organizations offer the use of integrative intervention for managing pain during procedures.

AONL Foundation Innovates to Bridge Science and Practice.

In this column, leaders from AONL discuss the AONL Foundation and its charitable mission of providing resources that create opportunities to bridge science and practice to shape the future of nursing.

ALSN 2021 Conference: Nursing Science for Leadership in the New Decade.

The Association for Leadership Science in Nursing's 2021 conference provided an opportunity to further enhance professional understanding of the difficulties facing nurse leaders as the COVID-19 pandemic continues to create unimaginable challenges. Presentations provided evidence in support of courageous caring leadership interventions.

Defining the social determinants of health for nursing action to achieve health equity: A consensus paper from the American Academy of Nursing.

BACKGROUND: The 2019-2020 American Academy of Nursing (Academy, 2019) policy priorities document states that "they have a clear and distinct focus on social determinants of health and uses this lens to advance policies and solutions within each of the three overarching priorities" PURPOSE: This consensus paper seeks to establish conceptual clarity and consensus for what social determinants of health mean for nursing, with emphasis on examples of health policies that advance planetary health equity and improve planetary health-related quality of life. METHODS: Volunteers from five Expert Panels of the Academy met via videoconference to determine roles and refine the focus of the paper. After the initial discussion, the first draft of the conceptual framework was written by the first three authors of the paper and, after discussion via videoconference with all the co-authors, successive drafts were developed and circulated for feedback. Consensus was reached when all authors indicated acceptance of what became the final version of the conceptual framework. FINDINGS: A conceptual framework was developed that describes how the social determinants of health can be addressed through nursing roles and actions at the individual, family, and population levels with a particular focus on the role of health policy. The paper provides a specific health policy example for each of the six key areas of the social determinants of health to illustrate how nurses can act to improve population health. DISCUSSION: Nursing actions can support timely health policy changes that focus on upstream factors in the six key areas of the social determinants of health and thus improve population health. The urgent need to eliminate systematic and structural racism must be central to such policy change if equity in planetary health-related quality of life is to be attained.

Ethics in nursing: Progress on national nursing ethics summit.

BACKGROUND: In 2014 a National Nursing Ethics Summit was undertaken to chart a future for nursing ethics in the United States. PURPOSE: The purpose of this study was to understand changes in the field over a 5-year period as a measure of longitudinal impact and identify recommendations for education, practice, research and scholarship, and policy. METHODS: This cross-sectional study used a mixed method design. FINDINGS: Nineteen participants from 15 institutions participated in the survey. The majority of respondents agreed or strongly agreed on their effort in promoting education (84%), contributing to scholarship (74%), creating a sustained environment for ethical practice (63%) and developing new initiatives (58%) in nursing ethics. DISCUSSION: Further investment is needed to establish a more broadly funded research agenda for ethical issues in nursing, improvement in evidence-based practice, and development of policy initiatives to promote ethical practice and infrastructure for sustainability and responsiveness to contemporary challenges.

International consensus-based policy recommendations to advance universal palliative care access from the American Academy of Nursing Expert Panels.

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.

Who Advances Nursing Science in Practice Settings and How?

Nurse scientist (NS) roles in clinical practice settings are key components of The Future of Nursing and ANCC Magnet® recognition. Despite increased opportunities for NS roles, leveraging these roles to advance nursing science remains at an early stage. We describe opportunities and challenges for NSs in clinical practice settings, highlighting the value of a strong partnership with chief nurse officers as critical for the success of NSs and outcomes associated with these roles.

Preparing Nurse Leaders for Value-Based Care: A Toolkit to Guide Practice Transformation.

Organizations across the country are redesigning care delivery to improve quality and outcomes, enhance the patient experience, reduce costs, and, ultimately, produce better population health. Leaders from the American Organization for Nursing Leadership engaged key stakeholders to discuss the role nursing can play and the toolkit that will be introduced this year to guide nurse leaders in striving for value.

Celebrating Magnet® Nursing Excellence: Meet the Recipients of the 2020 National Magnet Nurse of the Year® Awards and ANCC Magnet Prize®.

This month's Magnet® Perspectives column spotlights the recipients of the 2020 American Nurses Credentialing Center (ANCC) Magnet Program® National Magnet Nurse of the Year Awards and the ANCC Magnet Prize®, sponsored by Cerner, who were recognized during the ANCC National Awards virtual event on May 14, 2021.

Leveraging Academic-Clinical Partnerships to Create an Operating Room Nurse Pipeline.

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®- and National Cancer Institute-designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.

American Academy of Nursing Expert Panel consensus statement on nursing's roles in ensuring universal palliative care access.

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

"Moms and babies first"-A historical overview of the Association of Women's Health Obstetric and Neonatal Nurses.

Professional nursing bodies have had a well-established, collective history of advancing the nursing profession through career development, advocacy, and continuing education. The purpose of this review paper is to provide a historical overview of these entities, leading up to the formation of specialty nursing associations and the emergence of the Association of Women's Health Obstetric and Neonatal Nurses (AWHONN). The Association of Women's Health Obstetric and Neonatal Nurses is a leader in research, education, and advocacy in the field of women's health, obstetric, and neonatal nursing that has focused on promoting the health and well-being of women, newborns, and their families for the past fifty years.

Giving while grieving: Racism-related stress and psychological resilience in Black/African American registered nurses.

BACKGROUND: Studies have found race-related stress psychologically and physiologically harms members of stigmatized racial groups. However, the stressor is racism, not race. PURPOSE: This study examined the relationship between racism-related stress and psychological resilience in Black/African American nurses. METHOD: This study used a cross-sectional, quantitative, correlational design with two instruments, an investigator-developed demographic questionnaire and a convenience sample. FINDINGS: Participants perceived they have low psychological resilience in stressful situations. With racism-related stress, in particular, participants perceived they are affected by both lived and vicarious racism - ruminating over past occurrences, and expecting/worrying that racism will happen to them or other Black/African American people. There was a significant positive correlation between participants' perceived psychological resilience, their ability to assess the nature of the racism-related stressor and their ability to mitigate its harmful effects by identifying and utilizing their coping resources. There was a negative correlation between racism-related stress and psychological resilience. DISCUSSION: There is a need for continued research on racism-related stress among Black/African American nurses. Further, healthcare organizations, advisably through their diversity, equity and inclusion (DEI) programs, must develop systemic approaches to meeting the unique needs of the Black/African American workforce.

Development and Implementation of a Simple Wound Care Guideline for Minor Skin Lesions: A Quality Improvement Project.

PURPOSE: The purpose of this quality improvement project was to use the best available evidence and expert opinion to develop and implement a simple inpatient nursing care guideline ("The Guideline") for patients with minor skin lesions, including candidiasis, skin tears, incontinence-associated dermatitis, and stage 1 and stage 2 pressure injuries that would not require a WOC nurse consultation. PARTICIPANTS AND SETTING: The Guideline was developed for nurses working on inpatient adult acute care units in a large community hospital in southwest Minnesota. APPROACH: The Guideline was validated for its clarity and appropriateness by internal and external hospital-based wound care nurses and implemented through in-person rounding on the nursing units and distribution of badge cards and required completing an online education module. Surveys and wound documentation audits were conducted to measure changes in knowledge and skin care pre- and postimplementation of The Guideline. OUTCOMES: We conducted wound documentation audits of approximately 491 records that assessed whether patients received appropriate treatment and found an improvement from 45% (104 of 231) to 80% (209 of 260). Nurses' self-rating of their knowledge about which dressings and topical treatment to use improved from 18% (16 of 89) agreement to 57% (55 of 96). Nurses' self-rating of their knowledge about when to change dressings and reapply topical treatments improved from 27% (24 of 89) agreement to 65% (62 of 96). IMPLICATIONS FOR PRACTICE: Although there is evidence for a variety of dressings or products to treat wounds, this quality improvement project demonstrated increased adherence with providing appropriate care when fewer treatment options were recommended to nursing staff through our structured guideline. The Guideline continues to be used at the project site and is now being implemented at affiliate hospitals.

The Emergency Nurses Association: 50 Years of Advocacy and Advancement.

To commemorate the 50th anniversary of the Emergency Nurses Association, this article describes the 3 most enduring and impactful policy initiatives in the organization's history. These initiatives were identified through a comprehensive review of the articles published in the Journal of Emergency Nursing as well as in other publications of the Emergency Nurses Association, including position statements and press releases. The top 3 policy issues throughout the Emergency Nurses Association's history were identified as provision of care for vulnerable populations, trauma and injury prevention, and patient quality and safety. The Emergency Nurses Association also worked hard to professionalize emergency nursing within the realms of nursing and emergency services during the first half of its history, and since then the Emergency Nurses Association has promoted issues related to the emergency nursing workforce and to ensuring a safe and sustainable environment in which nurses practice. This article includes critical constructs such as the professionalization of emergency nursing; advocating for vulnerable populations such as children, older adults, and people experiencing sexual violence or human trafficking; improvements in trauma care and injury prevention; promoting quality and safety through nursing certifications, efficient and accurate nurse triage, and disseminating best practices in evidence-based care; and supporting the nursing workforce by championing issues such as workplace violence, ED crowding, and healthy work environments.