Reflecting on two distinct leadership roles during the pandemic.

ABSTRACT: For more than a year, the COVID-19 pandemic has caused unprecedented stress, anxiety, sadness, and fear, but it has also allowed people to reflect, learn, self-improve, and change. In this article, the author demonstrates how reflective practice enabled her to improve in two distinctly different leadership roles.

Development of a Medication Safety Science Curriculum for Nursing Students.

BACKGROUND: Medication errors, now thought to be 4 times greater than previous estimates, harm patients, families, health care institutions, and nurses themselves, who are second victims of their mistakes. PROBLEM: Current nursing education may lack coherent medication safety frameworks other than the classic Five Rights construct. APPROACH: This project piloted an educational intervention with senior associate degree nursing students based on high-reliability organization (HRO) safety principles. OUTCOMES: Subjects evaluated the HRO safety concepts learning experience positively and improved pretest to posttest scores by 74%. CONCLUSIONS: This study demonstrates subjects' ready acceptance and comprehension of HRO safety theory as applied to medication safety, an alternative to the Five Rights construct.

Nonacademic Factors That Influence Nontraditional Nursing Student Retention.

The purpose of this study is to identify the most supportive and restrictive factors contributing to students' ability to persist through nursing program course completion as perceived by 59 nontraditional students enrolled in a nursing associate degree program. The Student Perception Appraisal-Revised tool was used. Results include that encouragement by friends within school is the top supportive factor, while financial status was found to be the most restrictive factor. Students' perceptions of why they are not successful in staying in school may help nurse educators to plan and implement changes for improvement based on changing student needs.

Implementation of a Dedicated Education Unit Model for ADN Students in a Rural Primary Care Setting.

BACKGROUND: Dedicated education unit (DEU) clinical education models are an innovative, evidence-based approach to create effective learning environments for students. These models have been implemented primarily in acute care settings. PROBLEM: The gap between nursing education and clinical practice in rural health care settings is a growing concern, compounded by a nursing faculty shortage and decreased availability of clinical sites. APPROACH: A descriptive study design was used to assess the outcomes of a DEU model of clinical practice with associate degree nursing students in a rural primary care clinic, using registered nurses (RNs) who were prepared as clinical nurse teachers. OUTCOMES: Associate degree nursing students experienced the RN role in primary care, worked with nurses who wanted to teach them, and improved their nursing skills. CONCLUSIONS: The DEU model is a positive clinical teaching pedagogy for students and staff nurses.

ADN-to-BSN Articulation, Academic Progression, and Transition: A Proactive, Holistic Approach.

BACKGROUND: Although improvements have been made in articulation agreements, credit transfers, and concurrent enrollments, meeting the 80% BSN by 2020 goal falls short. PROBLEM: Nursing students at key transitional points (such as first- and last-semester students) are faced with numerous academic and career path challenges and opportunities simultaneously, often leaving them overwhelmed and in need of additional support and resources. APPROACH: Guided by Jeffreys' Nursing Universal Retention and Success model, a proactive, holistic approach for facilitating articulation, academic progression, and transition is presented. OUTCOMES: Implementation with fourth/last-semester associate degree nursing students and newly admitted RN-BSN students yielded positive student feedback and survey data. CONCLUSIONS: Nurse educators can make a positive difference in students' transitional experiences, career path planning, and educational mobility via a coordinated, connected, proactive, holistic approach guided by an evidence-based theoretical framework.

Systems Thinking Education in RN-BSN Programs: A Regional Study.

BACKGROUND: Nurses need to take a lead in reducing medical errors. Formal education of systems thinking (ST) can be a catalyst for error prevention. PROBLEM: Integration of ST in RN-BSN education has not been studied. APPROACH: A descriptive, cross-sectional design using survey methods was used. OUTCOMES: Deans of accredited RN-BSN programs across the Midwest reported on ST integration across their RN-BSN programs. Gaps in ST integration were identified as (1) a lack of evaluation tools to determine mastery of systems theory, thinking and awareness, and the application of quality and safety competencies for systems-level synthesis and (2) program outcomes emphasizing autonomy of systems-level decisions. CONCLUSIONS: Systems thinking was integrated across curricula among most accredited RN-BSN programs in the Midwest. Recommendations are to integrate systems theory into program outcomes and to develop evaluation tools that validate ST mastery.

Associate Degree in Nursing-to-Bachelor of Science in Nursing Graduates' Education and Their Perceived Ability to Keep Patients Safe.

BACKGROUND: Associate Degree in Nursing (ADN)-to-Bachelor of Science in Nursing (BSN) programs are designed to advance the ADN-prepared RNs' clinical reasoning and analytical skills. However, little is known about exactly how their BSN education may improve their clinical practice, specifically in the area of patient safety. METHOD: During semi-structured one-to-one interviews, ADN-to-BSN graduates were asked about their educational process and the perceived affect their education made on their ability to keep patients safe. Content analysis were used to identify emerging themes and categories. RESULTS: Three themes emerged from the data: (a) an unaltered approach to keeping patients safe, (b) experience as an ADN matters, and (c) BSN degree as a stepping stone. CONCLUSION: The call to increase the number of BSN-prepared nurses at the bedside is supported in the evidence and noteworthy of pursuit. However, as ADN-to-BSN programs increase in numbers to meet this demand, the outcomes of graduates need to be considered. [J Nurs Educ. 2018;57(5):300-303.].

Top-of-License Nursing Practice, Part 2: Differentiating BSN and ADN Perceptions of Top-of-License Activities.

OBJECTIVE: The aim of this study was to describe differences in associate degree (ADN) and baccalaureate degree-prepared (BSN) nurses' perceptions of top-of-license (TOL) practice. BACKGROUND: To date, no empirical work has examined whether ADN and BSN nurses approach TOL practice nursing activities differently. METHODS: We conducted a qualitative pilot study with focus groups to explore the perceptions of a group of ADN- and BSN-prepared nurses concerning nursing activities and their relation to TOL practice. RESULTS: Subthemes emerged differentiating how ADN and BSN nurses perceived their responsibilities related to critical thinking, communication, and patient education. For professional nursing care, 5 subthemes further emerged: (a) approaches to assessment, (b) chart review, (c) psychosocial patient care, (d) documentation, and (e) handoff. CONCLUSIONS: The differences identified in approaches to TOL practice activities by educational preparation have implications for staffing patterns that can optimize the contribution of ADN- and BSN-prepared nurses. Further research is indicated.

Dual Enrollment Nursing Partnerships: Steps to Successful Implementation.

This article discusses the planning and implementation of a dual enrollment initiative between an associate degree and baccalaureate nursing program. This type of endeavor offers an advantage to nursing students by allowing them to enroll concurrently in both academic programs, avoiding academic breaks and creating a streamlined educational progression toward the BSN degree. Dual enrollment programs are a transformational way to meet Institute of Medicine recommendations for increasing the number of BSN-prepared nurses while strengthening ties between associate degree and baccalaureate nursing programs.

Teaching Informatics to Prelicensure, RN-to-BSN, and Graduate Level Students.

Teaching nursing informatics to students in associate, baccalaureate, RN-BSN, and graduate nursing programs poses challenges for curriculum design, as well as developing appropriate instruction and assessment methods. The current state of nursing informatics education provides opportunities for unique instructional design and assessment techniques. Key course content is provided with suggestions for teaching informatics that focus on leveling for prelicensure, RN-BSN, and graduate nursing programs.

An Innovative Academic Progression in Nursing Model in New York State.

BACKGROUND: The Dual Degree Partnership in Nursing (DDPN) is a unique articulation model created in 2005 between two nursing programs that provides a seamless pathway for students to earn both an associate's degree and a bachelor's degree in nursing while benefiting from the strengths of each program. METHOD: Archival data has been systematically collected for a decade on admission, progression, retention, satisfaction, graduation, and NCLEX-RN pass rates to measure the reliability, validity, and integrity of this DDPN model for nursing education. RESULTS: The findings demonstrate consistent performance and positive outcomes on all factors measured, which have been benchmarked against available state and national results. CONCLUSION: This innovative approach to academic progression in nursing is replicable and serves as a prototype to educate more nurses at the baccalaureate level, which directly contributes to the Institute of Medicine's goal of 80% of RNs having a minimum of a bachelor's degree by 2020. [J Nurs Educ. 2017;56(5):266-273.].

Adjunct Nurse Faculty Demographics and Intent to Stay Teaching.

Adjunct nurse educators have become a primary facilitator of students' clinical learning in nursing education. However, studies are lacking as to variables that correlate with their intent to stay teaching. This study examined demographic variables that had an impact on adjunct clinical educators' decisions about whether to leave a teaching position in an associate degree nursing program. Full-time employment in addition to teaching as an adjunct faculty member predicted intent to leave the role. Measures to improve adjunct nurse faculty intent to stay are included.

Integrative Review of Admission Factors Related to Associate Degree Nursing Program Success.

BACKGROUND: High attrition in associate degree nursing (ADN) programs contributes to the nursing shortage and causes hardship for students, families, faculty, colleges, and taxpayers. The purpose of this integrative literature review is to identify admission criteria related to ADN program success to inform evidence-based admission policies and reduce attrition. METHOD: Integrative review methodology, suggested by Whittemore and Knafl, was used. A systematic search of existing professional literature was conducted using five databases and key word searches. The final sample included 26 documents that were analyzed and synthesized with the matrix method. RESULTS: Five categories of admission criteria and factors related to success in ADN programs were revealed from the analysis of findings: academic aptitude, demographic factors, psychological hardiness, specialty skills and experience, and socioeconomic support. CONCLUSION: ADN programs with a goal of decreasing attrition may want to implement admission selection guidelines that consider applicant criteria and attributes across all five dimensions. [J Nurs Educ. 2017;56(2):85-93.].

Foundational Courses for the Baccalaureate Nursing Degree: Enhancing Efficiency for Academic Progression.

BACKGROUND: The Institute of Medicine recommendation for a more educated nursing workforce has triggered significant activity in the area of academic profession, particularly in pre- and postlicensure baccalaureate nursing education. Many innovative academic progression models involving universities and community colleges have emerged. Among the most common barriers to this effort are inconsistent prerequisite course requirements. METHOD: A workgroup convened to discuss commonalities and differences of general education and prerequisite course work and propose core prerequisite coursework for the baccalaureate nursing degree. RESULTS: A course menu strategy for foundational baccalaureate nursing courses was proposed that includes four general course categories with credit ranges and common courses or content for each category. The four proposed foundational course categories are general education, basic sciences, social sciences, and human sciences. CONCLUSION: A need exists to reduce barriers affecting academic progression. The foundational course approach proposed has potential to reduce some of these barriers. [J Nurs Educ. 2016;55(7):373-378.].

Effects of Associate Degree Nursing Students' Characteristics on Perceptions and Experiences of Mentoring.

BACKGROUND: Mentoring has been identified as a key education program support structure to facilitate student success. METHOD: A cross-sectional study was conducted to investigate how associate degree nursing program students experience mentoring and persistence. Mentoring perceptions were evaluated using the College Student Mentoring Scale. Associate degree nursing students throughout the state of Michigan were recruited for an online survey. RESULTS: Sample characteristics (N = 283) resembled those compiled by the National League for Nursing. The study found that men met with a mentor more frequently and perceived greater psychological, emotional, and academic support than women. Part-time students and students who had never failed a nursing course also reported they met more frequently with a mentor than full-time students and those who had failed a nursing course. CONCLUSION: The findings contribute to an evidence base to support the further development and evaluation of mentoring programs for nursing students. [J Nurs Educ. 2016;55(5):258-265.].

Variability of Passing Grades in Undergraduate Nursing Education Programs in New York State.

AIM: The purpose of this descriptive study was to provide information about passing grades and their corresponding numeric grades for undergraduate nursing programs in New York State. An additional purpose was to report on differences in grading between faculty teaching in associate versus baccalaureate nursing programs, full-time versus adjunct faculty, and tenured versus nontenured faculty. BACKGROUND: There is a paucity of research on grade variability in undergraduate nursing programs. METHOD: Three hundred eighty-four full-time and 96 adjunct faculty responded to an invitation to complete an online survey. RESULTS: Grades are not uniformly awarded across institutions. Passing grades ranged from 70 to 85 percent (C- to B+, respectively), with a mean of 74.79 percent. CONCLUSION: Wide variations in grades in different institutions across the country may undermine grade point average as a reliable measure of education, making it difficult to evaluate individual student performance.