The AACN essentials: An intentional framework for successful implementation.

Nursing education is shifting toward competency-based education (CBE) in line with the American Association of Colleges of Nursing's (AACN) 2021 Essentials. This pedagogical shift from knowledge-based leaner outcomes to competency-based learner and program outcomes affects how faculty teach, how students learn, and how programs allocate resources to support this change. The initial move toward CBE necessitates scrutiny of current curricula and alignment of curriculum, teaching strategies, and assessment tactics framed within the ten domains of the Essentials. Drawing on the Donabedian quality improvement framework, one school of nursing's curricular revisions project team discusses their strategies and challenges in implementing the AACN Essentials, illustrating the structural, procedural, and initial outcomes of adopting the Essentials across programs and specialties. Key to this approach is engaging all relevant stakeholders and mapping current curricula to the Essentials' many competencies and subcompetencies. This work informs curricular revisions and fosters faculty engagement and creativity. Lessons learned highlight a critical need for ongoing faculty development and use of learner-centric pedagogies to achieve students' competency development and practice readiness. This article offers insights and guidance for nursing programs embracing CBE and aligning with AACN Essentials.

Developing Empathy in Emergency Nurses Using Hearing Voices Simulation.

Background: Many health professionals report feeling uncomfortable talking with patients who hear voices. Patients who hear voices report feeling a lack of support and empathy from emergency nurses. A local emergency department reported a need for training for nurses in the care of behavioral health patients. Objective: The aim of this study is to implement a quality improvement project using a hearing voices simulation. Empathy was measured using the Toronto Empathy Questionnaire, and a post-intervention survey was used to evaluate emergency nurses' perception of the professional development session. Methods: The quality improvement project included the implementation of a hearing voices simulation with emergency nurses. A paired t-test was used to determine the differences in the nurses empathy levels pre-and post-simulation. Qualitative data was collected on the nurses' experience during the simulation debriefing. A Likert-style questionnaire was used to collect data on the nurses' evaluation of the simulation. Results: The results of the hearing voices simulation were a statistically significant increase (p < .00) in empathy from baseline (M = 47.95, SD = 6.55) to post-intervention empathy scores (M = 48.93, SD = 6.89). The results of the post-simulation survey indicated that nurses felt that the hearing voices simulation was useful (n = 100; 98%) and helped them to feel more empathetic toward patients who hear voices (n = 98; 96%). Conclusions: Using a hearing voices simulation may help emergency nurses feel more empathetic toward the behavioral health patients who hear voices. Implications for Nursing: Through the implementation of a hearing voices simulation, clinical staff educators can provide support to staff nurses in the care of behavioral health patients.

Developing Nurse Practitioners for Hospitalist Roles: Lessons Learned From an Academic Practice Partnership.

Background: There are numerous benefits to academic practice partnerships. While there is great emphasis on the new graduate nurse transition to practice, there is less intention placed on the new nurse practitioner (NP) role transition. In a rural teaching hospital, leadership perceived a need for more support to successfully transition NPs into hospitalist practice roles. Objective: One academic practice partnership developed and implemented a grant-funded program to support advanced practice registered nurses (APRNs) transition to practice at a rural teaching hospital. Methods: Informed by the results of a needs assessment, faculty and practice partners delivered lecture content in a face-to-face setting during scheduled hours. Results: Although the content was well received, attendance to and engagement with the program were suboptimal. Conclusions: Upon reflection, the program team gained valuable lessons regarding role expectations, intentional interdisciplinary collaboration, timing, alignment, delivery format, and the need for a dedicated program coordinator. Implications for nursing: APRN transition programs can provide much-needed support with dedicated structure, clear communication, and individualized content. It can also be a recruitment and retention strategy for healthcare organizations.

Aromatherapy Blend for Postoperative Nausea in Ambulatory Surgery Patients.

PURPOSE: Postoperative nausea (PON) is one of the most common undesirable outcomes after surgery and increases patient dissatisfaction, hospital costs, and risk for postoperative complications. This quality-improvement project implemented and evaluated the effect of aromatherapy on nausea in adult postoperative patients. DESIGN: Quality improvement project evaluating the inhalation of a blend of essential oils through an individual stick via an aroma stick. METHODS: This quality-improvement project was implemented in a postanesthesia care unit (PACU) in the Northeastern United States that averages 300 adult patients per month. Over the course of 12 weeks in the Fall of 2019, the project sample included all PACU registered nurses and patients with PON without allergies to inhalation agents or nasal surgery. FINDINGS: One hundred percent of PACU registered nurses (n = 20) were educated and demonstrated competence in the aromatherapy intervention; 70.6% (n = 36) of patients with PON used an aroma stick for PON treatment. Of the patients receiving the aroma stick for PON, 94.4% (n = 34) had improved PON scores. CONCLUSIONS: Aromatherapy is an effective nonpharmacological treatment in reducing PON score for patients recovering from surgery. These results offer support for nursing practice to use aromatherapy as an additional method to enhance patient experience, improve outcomes, and reduce cost in recovery rooms.

Managing DNP projects in student/faculty groups to facilitate learning with large cohorts.

Despite the initial intent of the 2004 American Association of Colleges of Nursing (AACN) position statement to move all advanced nursing practice education to the doctoral level, many schools remain at the master's degree level. Many schools successfully transitioned their programs but struggled with adequate resources for the growing number of students and the faculty, staff, and preceptor workload associated with the Doctor of Nursing Practice (DNP) project courses. The AACN 2015 taskforce made many recommendations related to quality of DNP projects, but there is little in the literature on best operational practices. The goal of this paper is to describe how one school modified the DNP project courses from a traditional chair and committee driven format to a class driven format with multiple smaller sections to successfully manage large numbers of DNP students across nine specialties. Specifically, a new model with its successes and challenges is described as well as details regarding finances, course coordination, project advisors, project team, annual offerings and grouping of students.

Survey of Nursing Faculty Preparation for Guiding DNP Quality Improvement Projects.

BACKGROUND: Quality improvement (QI) projects comprise the majority of University of Maryland School of Nursing (UMSON) Doctor of Nursing Practice (DNP) projects. METHODS: An online survey was completed by 51% (n = 38) of faculty, who teach or mentor DNP students, and was analyzed using quantitative and descriptive methods. RESULTS: Faculty were somewhat or not familiar with developing a QI charter 68.4%, human error theory and error proofing 63.2%, driver diagrams 60.5%, characteristics of high-reliability organizations 60.5%, and Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines 55.3%. The faculty were most interested in learning more about (n = 97 responses) were human error theory and error proofing (28.9%), SQUIRE guidelines (26.3%), statistical process control (21.1%), and implementation strategies and tactics (21.1%). The most commonly identified challenges included identifying QI projects (24%), project time constraints (16%), keeping up-to-date on QI concepts, methods, and tools (12%), and balancing professional workload (10%). CONCLUSIONS: Gaps in self-reported QI knowledge indicate there is a need for further development of DNP and PhD prepared faculty at the UMSON.

Lessons Learned Using Logic Models to Design and Guide DNP Projects.

BACKGROUND: A final culminating project that is derived from a practice immersion experience is a critical part of a doctor of nursing practice (DNP) program. PROBLEM: Many schools use well-designed quality improvement (QI) projects to meet this requirement, but there is no consensus on which QI methods and tools are the most effective for DNP students to demonstrate before graduation. APPROACH: One Mid-Atlantic public university began using QI process models, one of which was a logic model, to guide their DNP projects. This led to subsequent changes in the curriculum, faculty preparation, and practice partner responsibilities. OUTCOME: Many benefits and challenges were identified during the logic model implementation that may benefit other schools seeking to increase consistency and rigor. Although the learning process for students and faculty may be challenging, the outcomes included improved project conceptualization, clarity, concision, and feasibility of goal attainment. CONCLUSIONS: Use of logic models expands DNP students' skills to develop and implement a successful project and supports clinical scholarship.

Structuring Doctor of Nursing Practice project courses to facilitate success and ensure rigor.

There is currently a lack of consensus on the best format for Doctor of Nursing Practice project deliverables. In this article the project course history, current format, and evaluation methods are described for a Doctor of Nursing Practice program during the transition from a sole post-master's option to one that also admitted post-baccalaureate students. The project course format shifted focus from one in which students independently implemented multiple types of projects under the direction of a chairperson and committee to one in which students carried out projects utilizing quality improvement methods and tools under the mentorship of a project faculty advisor and clinical site representative. The integration of quality improvement models is exemplified through course objectives and assignments. Lessons learned through this transition are provided in the hope that the work may benefit other nursing schools with similar programs.

New-to-Setting Nurse Transitions: A Concept Analysis.

New graduate nurses transitioning to practice have gained significant attention and dedicated resources. Less obvious are the transitions experienced nurses make to new settings or specialties during their careers. Experienced nurses still need support as they make these adjustments. This article explores the concept of nurse transition and specifically analyzes the concept of new-to-setting nurse transition. Nursing professional development practitioners and others can support experienced nurses through the challenges of new-to-setting transitions.

Nursing Professional Development's Spirit of Inquiry Focus Areas.

An Association for Nursing Professional Development (ANPD) task force was charged with redesigning the association's small research grant process. One step in this process included identifying focus areas for the specialty's spirit of inquiry. Using input from a round table discussion with ANPD annual convention attendees, the Journal for Nurses in Professional Development Editorial Board, and the convention evaluation query, 10 spirit of inquiry focus areas were identified that align with the Nursing Professional Development Practice Model.

Professional Development Strategies to Enhance Nurses' Knowledge and Maintain Safe Practice.

Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes.