Increased adoption of smoke-free policies on campuses with schools of nursing.

BACKGROUND: In 2015, the majority of U.S. American Association of Colleges of Nursing (AACN)-accredited schools of nursing resided on campuses without smoke-free policies. PURPOSE: To determine the presence of smoke-free policies at AACN-accredited after resolutions from AACN and the American Academy of Nursing, and the creation of online resources. METHODS: Smoke-free policies (2015-2017) were determined through listings on the ANRF College Campus Policy Database© and survey responses from nursing deans. RESULTS: Smoke-free policies for 689 schools of nursing increased from 36% in 2015 to 91% in 2017. There were no significant differences by nursing program types or geographic area. Twenty percent of deans reported using the resources, with over 1700-page views. CONCLUSION: Smoke-free policies increased after support from two national nursing organizations. Learning in a smoke-free environment should be an expectation for nursing students to protect their own health, and to support their future critical role in tobacco control.

A group think tank as a discourse coalition to promote minority nursing faculty retention.

BACKGROUND: The nursing profession will need one million more nurses by 2024, yet nursing schools are turning away applicants due to insufficient numbers of nursing faculty. Likewise, minority nursing faculty are needed in order to attract diverse nursing students who can then address health care disparities. PURPOSE: The purpose of this paper is to describe the use of a group think tank (GTT) as a mentoring strategy for supporting the recruitment and retention of minority nursing faculty. METHOD: Guided by Kotter's theory of change, this paper describes the application of the GTT approach with 5 African American (AA) faculty, one AA doctoral student and a cross-cultural mentor. FINDINGS: Results are presented based upon the metrics typically used to support career advancement, promotion and/or tenure. DISCUSSION: The GTT is a promising mentoring model that can be used to integrate cross-cultural and peer mentoring into academic communities to support diversity in academia.

[Implementation of midwifery school accreditation mechanisms in Ivory Coast, Mali and Chad.] / Mise en place de mécanismes d'accréditation des écoles de sages-femmes en Côte d'Ivoire, au Mali et au Tchad.

One strategy to improve quality of care to eliminate preventable maternal and neonatal mortality and morbidity is to improve the training of health professionals, particularly midwives. Accreditation is a mechanism designed to reinforce education programmes and institutional capacities, using a situation analysis based on predefined criteria for decision-making. This paper describes the ongoing efforts of three Francophone African countries, Ivory Coast, Mali and Chad, to establish accreditation mechanisms of midwifery schools and to describe the necessary steps to implement these measures. Political will to support and regulate this sector, adoption of the License-Master-Doctorate (LMD) system, private sector support and an independent national accreditation commission are critical components.

Critical preparation and readiness to support future change.

The challenging nature of change is well documented and adequate preparation before implementing a change initiative is critical to reducing resistance and increasing its chances of success. This article describes a service review conducted in preparation for possible change and improvement at an internationally ranked school of nursing and midwifery in an Irish tertiary education institution. The purpose of the review was to examine organisational structures and work activities, including pressures facing the administrative team that supports the school, and to establish whether operations were fit for purpose and capable of continuing to support the international ranking. The article outlines the importance of change to maintain a competitive edge and the critical role of leadership during change. The background and rationale for the service review are discussed along with the methods used to prepare staff. The article also reports outcomes of the surveys and focus groups undertaken and discusses the main recommendations and changes implemented so far. It also suggests how the outcomes are relevant to clinical practice.

Rankings matter: nurse graduates from higher-ranked institutions have higher productivity.

BACKGROUND: Increasing demand for baccalaureate-prepared nurses has led to rapid growth in the number of baccalaureate-granting programs, and to concerns about educational quality and potential effects on productivity of the graduating nursing workforce. We examined the association of individual productivity of a baccalaureate-prepared nurse with the ranking of the degree-granting institution. METHODS: For a sample of 691 nurses from general medical-surgical units at a large magnet urban hospital between 6/1/2011-12/31/2011, we conducted multivariate regression analysis of nurse productivity on the ranking of the degree-granting institution, adjusted for age, hospital tenure, gender, and unit-specific effects. Nurse productivity was coded as "top"/"average"/"bottom" based on a computation of individual nurse value-added to patient outcomes. Ranking of the baccalaureate-granting institution was derived from the US News and World Report Best Colleges Rankings' categorization of the nurse's institution as the "first tier" or the "second tier", with diploma or associate degree as the reference category. RESULTS: Relative to diploma or associate degree nurses, nurses who had attended first-tier universities had three-times the odds of being in the top productivity category (OR = 3.18, p < 0.001), while second-tier education had a non-significant association with productivity (OR = 1.73, p = 0.11). Being in the bottom productivity category was not associated with having a baccalaureate degree or the quality tier. CONCLUSIONS: The productivity boost from a nursing baccalaureate degree depends on the quality of the educational institution. Recognizing differences in educational outcomes, initiatives to build a baccalaureate-educated nursing workforce should be accompanied by improved access to high-quality educational institutions.

Overburdened Systems and Dealing With Disaster: Nursing Administrators' Experiences and Nursing Leadership Recommendations From a State-Level Perspective.

Hurricane Katrina made landfall on the Louisiana coast on August 29, 2005. Since 2005, there has been a dramatic increase in natural, infectious, and man-made disasters. It is more evident that nursing leaders and administrators need to be prepared for all hazards. The purpose of this article is to provide nursing administrators with a perspective of state-level leadership during a natural disaster and to suggest recommendations based on lessons learned during Hurricanes Katrina, Rita, Gustav, and Ike in 2005. These come from a state governmental public health and a state nursing school within an academic health sciences center.

Intersection of Quality and Excellence: Characteristics of Redesignated National League for Nursing Centers of Excellence.

The purpose of this research was to identify characteristics of redesignated National League for Nursing Centers of Excellence in Nursing Education that represent the intersection between quality and excellence. A qualitative content analysis of six final applications submitted for redesignation disclosed essential resources that supported students, faculty, and staff and identified six characteristics: connections through relationships, communities of learning and service, support for students and faculty, connections through technology, use of innovation, and a systems focus. The systematic focus on excellence in teaching and learning identified in this research represents best practices from exemplary schools worthy of emulation by other nursing education programs.

Attitudes of nursing school deans toward interprofessional education in Western Pacific Region countries.

A previous survey distributed to medical school deans in the Western Pacific Region (WPR) showed positive attitudes toward collaborative practice and interprofessional education (IPE). This study aimed to clarify the present state of IPE and the attitudes of nursing school deans in the WPR. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) and the modified Readiness of healthcare students for Interprofessional Learning Scale (RIPLS) were used. Unexpectedly, the response rate was less than 20%. Deans of nursing schools with IPE courses showed significantly more positive attitudes than those of schools without IPE courses. The mean score of the modified ATHCTS and RIPLS of deans of nursing schools in rural areas were significantly higher than those in urban areas. Compared with medical schools, nursing schools in the WPR pay less attention to IPE and this may be one of the present characteristics of the region.

Informing the scale-up of Kenya's nursing workforce: a mixed methods study of factors affecting pre-service training capacity and production.

BACKGROUND: Given the global nursing shortage and investments to scale-up the workforce, this study evaluated trends in annual student nurse enrolment, pre-service attrition between enrolment and registration, and factors that influence nurse production in Kenya. METHODS: This study used a mixed methods approach with data from the Regulatory Human Resources Information System (tracks initial student enrolment through registration) and the Kenya Health Workforce Information System (tracks deployment and demographic information on licensed nurses) for the quantitative analyses and qualitative data from key informant interviews with nurse training institution educators and/or administrators. Trends in annual student nurse enrolment from 1999 to 2010 were analyzed using regulatory and demographic data. To assess pre-service attrition between training enrolment and registration with the nursing council, data for a cohort that enrolled in training from 1999 to 2004 and completed training by 2010 was analyzed. Multivariate logistic regression was used to test for factors that significantly affected attrition. To assess the capacity of nurse training institutions for scale-up, qualitative data was obtained through key informant interviews. RESULTS: From 1999 to 2010, 23,350 students enrolled in nurse training in Kenya. While annual new student enrolment doubled between 1999 (1,493) and 2010 (3,030), training institutions reported challenges in their capacity to accommodate the increased numbers. Key factors identified by the nursing faculty included congestion at clinical placement sites, limited clinical mentorship by qualified nurses, challenges with faculty recruitment and retention, and inadequate student housing, transportation and classroom space. Pre-service attrition among the cohort that enrolled between 1999 and 2004 and completed training by 2010 was found to be low (6%). CONCLUSION: To scale-up the nursing workforce in Kenya, concurrent investments in expanding the number of student nurse clinical placement sites, utilizing alternate forms of skills training, hiring more faculty and clinical instructors, and expanding the dormitory and classroom space to accommodate new students are needed to ensure that increases in student enrolment are not at the cost of quality nursing education. Student attrition does not appear to be a concern in Kenya compared to other African countries (10 to 40%).

The efficacy of integrating spirituality into undergraduate nursing curricula.

BACKGROUND: Attention to patients' spirituality, as a moral obligation of care, is now widely accepted in nursing practice. However, until recently, many nursing programs have paid little attention to spirituality. OBJECTIVE: The objective of this study was to identify the impact of two different curricula, used to teach undergraduate nursing students, on increasing nursing student awareness of spirituality in the care of patients. RESEARCH DESIGN: A quasi-experimental post-intervention two-group design was conducted in 2009-2010 and 2010-2011 academic years. PARTICIPANTS AND RESEARCH CONTEXT: The study included a total of 130 volunteer senior-year students. The students were assigned as "the intervention group/integrated system" that were informed about spirituality or as "the control group/traditional system" that received no information on spirituality. Data were collected via a personal information form and the Spirituality and Spiritual Care Rating Scale was used to assess responses. The study was conducted at the Department of Nursing of the Faculty of Health Sciences, Cumhuriyet University, in Central Anatolia/Turkey. ETHICAL CONSIDERATIONS: Permission to conduct the study at the nursing school was obtained from the schools' management teams. The rights of the participants were protected in this study by obtaining informed consent. FINDINGS: The results revealed that the intervention group had a higher mean score on the Spirituality and Spiritual Care Rating Scale than did the control group. The students in the intervention group defined the terms of spirituality and spiritual care more accurately than did the control group students. DISCUSSION: Nurses are professionally and ethically responsible for providing spiritual care. Nurses' competence in meeting the spiritual needs of their patients should be improved by undergraduate education on spiritual care. Nursing scholars reported a significant difference in the knowledge and attitudes toward spirituality of nursing students as a result of the integration of spirituality into the undergraduate nursing curriculum. CONCLUSION: Spirituality should be more widely included in nursing education.

International Federation of Nurse Anesthetists' anesthesia program approval process.

The International Federation of Nurse Anesthetists is improving anaesthesia patient care through a voluntary Anesthesia Program Approval Process (APAP) for schools and programmes. It is the result of a coordinated effort by anaesthesia leaders from many nations to implement a voluntary quality improvement system for education. These leaders firmly believe that meeting international education standards is an important way to improve anaesthesia, pain management and resuscitative care to patients worldwide. By 2013, 14 anaesthesia programmes from France, Iceland, Indonesia, Philippines, Sweden, Switzerland, Netherlands, Tunisia and the USA had successfully completed the process. Additional programmes were scheduled for review in 2014. Faculty from these programmes, who have successfully completed APAP, show how anaesthesia educators throughout the world seek to continually improve education and patient care by pledging to meet common education standards. As national governments, education ministers and heads of education institutions work to decrease shortages of healthcare workers, they would benefit from considering the value offered by quality improvement systems supported by professional organizations. When education programmes are measured against standards developed by experts in a profession, policy makers can be assured that the programmes have met certain standards of quality. They can also be confident that graduates of approved programmes are appropriately trained healthcare workers for their citizens.

Supporting neurodivergent nursing students in their practice placements.

Neurodivergent conditions such as autism, attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dyscalculia and Tourette's syndrome are common, and it is highly likely that practice assessors and supervisors will be asked to support neurodivergent nursing students in their practice learning environments. This article details the strengths that neurodivergent students can bring to nursing, as well as some of the challenges they may experience in practice settings. It outlines how practice assessors and supervisors can develop neuro-inclusive learning environments where neurodivergent students can thrive, as well as how to support them if they are not meeting their required proficiencies. The authors also discuss how appropriate reasonable adjustments can be implemented by using a collaborative approach with students.

[Implementation of reference frameworks at nursing schools - A qualitative study on beneficial and hindering factors]. / Implementierung der Rahmenpläne für die Pflegeausbildung ­ eine qualitative Studie zu förderlichen und hinderlichen Faktoren.

BACKGROUND: The reference frameworks that have been developed for the first time by the Specialist Committee in accordance with Sect. 53 of the German Nursing Professions Act follow a new didactic-curricular structure and are intended to support the nursing schools in creating their own curricular documents. RESEARCH QUESTION/OBJECTIVE: The commissioned study investigated hindering and promoting factors in the implementation of reference frameworks at nursing schools. METHODS: Expert interviews (n = 16 pair interviews) were conducted with teachers responsible for curriculum development (n = 32) at nursing schools and analysed deductively using qualitative content analysis. Internal school curricula (n = 15) were subjected to a criteria-based document analysis. The results were used to establish implementation types based on the degree of completion of the curricula and the implementation of the new didactic-curricular structure. RESULTS: Four implementation types were identified: reform-oriented implementation, partially reform-oriented implementation, traditional implementation and lack of implementation. The key factors for a reform-oriented, successful implementation include the supportive behaviour of the school administration & management, the acceptance of the novel vocational education & training in nursing and the opportunity to take part in further trainings. DISCUSSION: The implementation types identified are largely characterized by the supportive behaviour of the school administration & management as well as the acceptance and knowledge of the teaching staff. The opportunity to take part in further training courses in order to deal with the reformed vocational education and didactic-curricular recommendations is a central implementation factor. CONCLUSION: All federal German states should set up funding programs for the didactic and curricular requirements for the new vocational education & training in nursing in order to specifically promote the implementation of the reference frameworks.

Reimagining the Future of Clinical Nursing Education: A Cohort Partnership Model.

BACKGROUND: As the demand for registered nurses increases, innovative methods for stabilizing, improving, and ensuring the longevity of quality clinical nursing education should be considered. Traditionally, full-time nursing faculty teach nursing students in clinical settings. PROBLEM: Considering the impending nurse educator crisis, characterized by increasing demands on a dwindling nursing faculty, traditional approaches to clinical nursing education are no longer feasible. APPROACH: A new clinical cohort model (CCM), developed from an academic/health system partnership, is proposed as an innovative approach to future clinical nursing education. OUTCOMES: CCM implementation resulted in a significant reduction in the cost of educating nursing students. The health care system noted a 100% postgraduation 2-year retention rate among cohort students. Nursing students overwhelmingly expressed satisfaction, comfort, and new opportunities through participation in the CCM. CONCLUSIONS: This new CCM has significant benefits for schools of nursing, health care systems, and nursing students.

Predictor variables for NCLEX-RN readiness exam performance.

AIM: To understand the relationship among NLCLEX-RN readiness exam scores and influencing variables. BACKGROUND: First-time NCLEX-RN pass rates are a visible measure of program quality.Therefore, schools have adopted aggressive prediction and remediation measures to improve NCLEX-RN pass rate success and therefore the number of licensed and practicing nurses. METHOD: This descriptive correlational study used regression analysis to investigate multivariate relationship between NCLEX-RN readiness exam scores and predictors. RESULTS: This study's findings suggest that while the input variables measured by grades in prerequisites initially appear predictive, only the presence of transfer credits, a potential marker for age and motivation, remains significant. CONCLUSION: Most transfer students are nontraditional adult learners.Therefore, it can be theorized that student personal system has a significant impact on the outcome. The first nursing course, adult health nursing plus maternal-child health nursing, appears foundational for the NCLEX readiness exam.

Resource requirements for a quality Doctor of Nursing Practice program.

Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation's need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges.

[The nurse training reference framework in Ile-de-France]. / Le référentiel de formation en soins infirmiers en Ile-de-France.

In 2009, the changes introduced by the nurse training reference framework revolutionised the nursing curriculum. Partnerships were set up from the beginning of its implementation. The first three-year cycle has ended and the experience acquired opens up a new phase of further reflection and evolution.

[Reform of nursing studies, impact on the nurse training institutes]. / Réforme des etudes infirmières, impact dans les Ifsi.

The reengineering of nursing training led to the creation of a training reference framework in September 2009, which has considerably modified the reference pedagogical model, pedagogical practices and the monitoring of students. The notion of a partnership with the university has been created; pedagogical and technological innovations have been encouraged.

[Different perspectives on the reform of nursing studies]. / Regards croisés sur la réforme des etudes en soins infirmiers.

Two students and two recently qualified nurses describe their training within the new reference framework, and their reception by their course tutors and by their colleagues in their first jobs.