Using new resources to teach evidence-based practice.

This article describes an innovative strategy used to teach evidence-based practice (EBP) concepts in an undergraduate research course and explains the underlying framework used to design the strategy. The strategy for the Evidence-Based Practice Project was based on new resources: undergraduate nursing student competencies for EBP, national health care improvement priorities, evidence rating systems, and a model of knowledge transformation for EBP. Groups of students selected a priority area, categorized and critically appraised the evidence supporting the recommendation for change in health care practice, and compared the recommendation to actual practice. An oral and poster presentation of the project provided the opportunity to discuss the significance, influence, and strength of the evidence supporting the recommendation to change health care practice. Student presentations and faculty perceptions of the project indicated beginning competencies in EBP were achieved.

Revitalizing Learning Outcomes for Adult Gerontology Advanced Practice Programs.

The implementation of the Consensus Model for Advanced Practice Registered Nurse Regulation has defined the model for advanced practice within the four recognized advanced practice nursing roles. The focus of graduate nursing program focus for care of the adult population has been broadened to include gerontology. The change toward increasing graduate program breadth and focus to a lifespan adult/gerontology population will result in the need for analysis and restructuring of advanced practice programs in order to incorporate gerontologic content. The purpose of this article is to describe a process for developing or revitalizing meaningful learning outcomes as an integral component in program revision and evaluation for advanced practice programs incorporating gerontologic content. Learning outcomes will be included with examples and definitions from the beginning basis of role-specific selected adult gerontology competencies through data collection and analysis for program improvement.

Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN role must integrate interprofessional competencies and interactions to prepare APRNs accordingly.

The American Society of Pain Management Nurses role-delineation study. National Association of Orthopaedic Nurses respondents.

PURPOSE: A role-delineation study was conducted by the American Society of Pain Management Nurses to examine the activities performed by nurses involved in pain management. DESIGN: A survey was sent to nurses involved in pain management. The role-delineation survey consisted of 92 activity statements and was based on the Nursing Intervention Classifications. Frequency of performing each activity and importance of the activity were rated by respondents, and a Mean Activity Index score was calculated for each item. SAMPLE: As part of the sampling strategy, a random sample of 200 nurse members of the National Association of Orthopaedic Nurses (NAON) were sent surveys. Forty-two (21%) NAON members returned completed surveys. FINDINGS: The activities with the highest Mean Activity Index were primarily those involving pain assessment and pharmacologic management and those relatively specific to orthopaedic patients, such as positioning to increase comfort and premedicating with analgesics before activity. CONCLUSION: Orthopaedic nurses were similar to other nursing specialty groups for assessment and pharmacologic management of pain but placed more emphasis on activity management than other groups. IMPLICATIONS: The results of the study will be used to refine standards of care develop nursing education curricula, develop research priorities, and develop a blueprint for a certification examination.

The American Society of Pain Management Nurses practice analysis: role delineation study.

A role delineation study was carried out by the American Society of Pain Management Nurses (ASPMN) to determine the activities performed by nurses involved in pain management. Demographic characteristics of pain management nurses and differences in practice based on educational preparation and specialty affiliation were identified. The role delineation survey was developed based on Nursing Intervention Classifications. The survey consisted of 91 activity statements. Respondents rated the frequency of performing each activity and the importance of the activity. A Mean Activity Index score was calculated for each item. All members of the ASPMN, the nursing special interest group (SIG) of the American Pain Society, and the pain SIG of the Oncology Nursing Society, as well as random samples of members of the National Association of Orthopaedic Nurses, Hospice and Palliative Nurses Association, American Association of Nurse Anesthetists, American Association of Critical Care Nurses, and American Academy of Nurse Practitioners were surveyed. Seven hundred and sixty-one questionnaires were analyzed (24.8% response rate). Demographic characteristics of the sample mirrored those of nursing as a whole in the United States. The activities with the highest Mean Activity Index were primarily those involving assessment of pain. Nurses with diploma and Associate Degree preparation rated assessment and nonpharmacologic management higher and communication and collaboration lower than nurses with higher educational preparation. Activities varied somewhat as a reflection of respondents' nursing specialty. The results of the study will be used to refine standards of care, develop nursing education curricula, develop research priorities, and develop a blueprint for a certification examination in pain management nursing.

A preoperative intervention for pain reduction, improved mobility, and self-efficacy.

The Foster Pain Intervention (FPI) is a 24-minute videotape of a nurse showing breathing and movement skills with four postoperative mobility activities to a patient. Its preoperative use incorporates self-efficacy concepts to teach techniques that can improve postoperative pain and mobility. This study compared the effects of the FPI on postoperative pain and mobility and the relationship with self-efficacy in 70 elective hysterectomy patients. The treatment group (n = 35) received the FPI and routine information, whereas the control group (n = 35) received routine information through videotaped instruction. The treatment group had significantly less pain (p <.0001), higher observed mobility (p <.0001), and higher preoperative self-efficacy and was ready to go home sooner than the control group (p <.0001). These results suggest that the FPI enhances self-efficacy, decreases pain associated with postoperative activities, and promotes earlier independent mobilization.