Nursing: Addressing substance use in the 21st century.

Over the past two decades, there has shift from focusing on the most severe end of the substance use continuum to earlier detection of persons who are at risk given the consequences associated with alcohol and other drug use. In 2017, the Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) undertook the development of core competencies for specific disciplines addressing substance use in the 21st century. This article presents the core competencies for nursing in accord with the 16 standards of practice and performance for nursing. The competencies for the registered nurse and the advanced practice nurse are intended to inform and guide nursing practice with a focus on prevention, intervention, treatment, and recovery supports for persons who are affected by substance.

Quality of nursing schools in the Philippines: Trends and evidence from the 2010-2016 Nurse Licensure Examination results.

BACKGROUND: The quality of undergraduate nursing programs offered by higher education institutions (HEIs) in the Philippines is usually evaluated using Nurse Licensure Examination (NLE) results. PURPOSE: To describe NLE trends in 2010 to 2016, compare low- and high-performing HEIs, and examine the association of HEIs' characteristics with NLE passing rate. METHODS: NLE and HEI data were collected from two Philippine government agencies. Descriptive statistics were used to present NLE trends, while multiple linear regression was used to determine the association of HEI characteristics with NLE passing rate. DISCUSSION: There was a downward trend for NLE takers and passers from 2010 to 2016. Regression results showed that location, size, type, year of establishment, and student-faculty ratio were associated with NLE passing rate. CONCLUSION: HEIs should consider decreasing their student-faculty ratio to improve NLE performance. Relevant government agencies should take measures to improve most HEIs' NLE performance in the Philippines.

Integrative review of studies about nurses who have been disciplined by their professional regulatory bodies.

AIM: To synthesize knowledge in studies about nurses who had been disciplined by their professional regulatory bodies. BACKGROUND: Unprofessional conduct that violates patient safety, nursing standards or legislation can result in disciplinary action that affects nurse's professional rights to practice. However, research on disciplinary procedures in nursing is fragmented. METHODS: An integrative review was carried out with systematic searches between January 2006 and November 2018, using the CINAHL, PubMed, Scopus and Web of Science databases and manual searches. The quality of the 17 included studies was evaluated with the Mixed Method Appraisal Tool. RESULTS: The evidence in the included studies focused on various databases. Disciplined nurses were described in relation to their characteristics and disciplined because of numerous patients, practice and behaviour related violations. Similar disciplinary actions against nurses were reported. CONCLUSION: This review provides knowledge on contributory risk factors that can be used to develop professional standards and early interventions in nursing management. More systematic research is needed, together with clear definitions of disciplinary procedures. IMPLICATION FOR NURSING MANAGEMENT: This knowledge could strengthen the abilities of nurse managers to recognize and prevent events that seldom occur but seriously threaten the safety of patients and nurses when they do.

Diversity and education of the nursing workforce 2006-2016.

BACKGROUND: The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. PURPOSE: The purpose of this paper is to report the progress toward achievement of these recommendations. METHODS: We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. FINDING: The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. DISCUSSION: The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations.

Trends in geographic distribution of nursing staff in Japan from 2000 to 2010: a multilevel analysis.

The aim of this study was to examine trends in the geographic distribution of nursing staff in Japan from 2000 to 2010. We examined time trends in the rates of nursing staff per 100,000 population across 349 secondary health service areas. Using the Gini coefficient as a measure of inequality, we separately analyzed the data of 4 nursing staff types:public health nurses (PHN), midwives (MW), nurses (NS), and associate nurses (AN). Then, using multilevel Poisson regression models, we calculated the rate ratios (RRs) and their 95% confidence intervals (CIs) for each type of nursing staff per 1-year change. Overall, the distribution of PHN, MW, and NS improved slightly in terms of the Gini coefficient. After adjusting for prefectural capital and population density, PHN, MW, and NS significantly increased;the RRs per 1-year increment were 1.022 (95% CI:1.020-1.023), 1.021 (95% CI:1.019-1.022), and 1.037 (95% CI:1.037-1.038), respectively. In contrast, AN significantly decreased;the RR per 1-year increment was 0.993 (95% CI:0.993-0.994). Despite the considerable increase in the absolute number of nursing staff in Japan (excluding AN), this increase did not lead to a sufficient improvement in distribution over the last decade.

Preparing the nursing workforce of the future.

Nurse shortages coupled with the need for national healthcare reform present a challenge. We are not preparing enough nurses nor are we preparing nurses with the right skills to fully participate in a reformed healthcare system. Historical forces in nursing education have resulted in multiple levels of entry into nursing practice and an inadequate nursing workforce. Today's environment of expanding knowledge, the call for interdisciplinary healthcare delivery teams, and evidence of the relationship between nurse education and improved patient outcomes strongly indicate the need for nurses prepared at the baccalaureate level. Requiring a baccalaureate degree for entry into nursing practice, and as the initial degree of nursing education would prepare nurses earlier for graduate education and the much needed roles of educator, researcher and advanced practice nurse. The nursing profession should take the lead in advocating for educational policies that would adequately prepare the nurse workforce of the future.

Implementing graduate entry registration for nursing in England: a scope review.

AIMS: A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. BACKGROUND: Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. METHOD: In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. RESULTS: The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. CONCLUSIONS: Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

Holistic nurses' examinations: past, present, future.

Social and professional paradigm shifts of the 1990s moved holistic nursing into the mainstream of health care, resulting in the need for national certification of Holistic Nurses. Given the assumptions that certification examinations are based on the knowledge, skills, and abilities prerequisite for competent practice in a given specialty, and that the certification credential tells the public and peers that the certificant has such knowledge, The American Holistic Nurses Association's Leadership Council (AHNA-LC) initiated certification processes in 1994. On the request of AHNA-LC, the American Holistic Nurses' Certification Corporation (AHNCC) assumed these responsibilities in April, 1997. Since then, AHNCC has overseen the revision of the first certification process for holistic nursing prepared at the baccalaureate level and development of a second one designed for holistic nurses prepared in graduate nursing programs. This article describe these developmental processes.

The Australian nurse and midwifery workforce: issues, developments and the future.

The paper is concerned with data, concepts and analyses necessary for understanding the nurse and midwifery workforces at a macro-level, and for developing policies and plans that can best assure the quality and sufficiency of those workforces in the future. The size, composition and age profile of the nurse workforce are set out first. This is followed by an outline of the notions of 'attachment' to and 'separation' from a profession. Data on the population with professional nurse qualifications, whether working in the profession, in another occupation, or not working illustrates the patterns of 'attachment' and 'separation' over the working age range. Historical developments since the 1960s are then considered, including the workforce size and age profile, the nurse labour market, pre-registration course completions, and movement in and out of Australian of nursing professionals. The nature and impact of the 'oversupply' of nurses in the early- to mid-1990s is discussed. Six matters are outlined that need to be taken into account when estimating future requirements. A discussion of the potential for quantitative impact on the overall nurse labour market from work redesign and role extension concludes that there is no easy solution for macro-level nurse workforce shortages, and that some otherwise very positive initiatives may exacerbate shortages. It is clear that further increases in pre-registration (and pre-enrolment) intakes and completions will be necessary, as least for a further 8-12 years. Some of the barriers to such increases are noted and suggestions for the future made.

The Canadian Nurses Association: Reflections on the NCLEX-RN through the Lens of Nursing History and Evolution.

Decades of work by professional associations, regulators and educators have produced an ethical, reliable, robustly educated and regulated nursing workforce that enjoys high levels of respect in Canada and around the world. The officers of the Canadian Nurses Association comment here on the organization's history and changing role in regulatory policy over the past decade during the introduction of the American NCLEX-RN examination as the assessment tool for entry-to-practice for Canadian registered nurses. Facing forward, to maintain a strong, trusted nursing workforce the association remains committed to meaningful collaboration among nursing's professional, regulatory, education and union sectors.

Getting Comfortable with "It Depends": Embracing the Impermanence of Scope of Practice.

Scope of practice of nursing roles is continually evolving to meet the ever-changing needs of patient populations and the healthcare system and to reflect changes in legislation, regulation and education requirements. As such, leaders must embrace the impermanence of scope of practice rather than constructing mental models, policies and practices as if the foundation will never change. Impermanence is the only constant, as the complexities within healthcare require that nurses be knowledgeable and flexible to fully leverage our individual and collective contributions to not only our patients but also our profession.

Transition to NCLEX-RN: Reflections from a CASN Past President.

Each president of CASN has one "issue" on which he or she focuses most during the presidency - for me, it was the NCLEX. Canadian nursing graduates first wrote the NCLEX for entry to practice in 2015. Failure rates were significantly higher than for the previous exam - the CRNE. Although the pass rates have improved, this is likely a result of better practice for writing this type of test. Apprehensions remain about the negative impact of the Americanization of our Canadian nursing curriculum and the damage that this examination appears to be doing to present and future francophone nurses.

Promoting Quality in Nursing Education in Canada through a Canadian Examination for Baccalaureate Nurses.

Since its creation in 1942, the Canadian Association of Schools of Nursing's mandate has been to foster high-quality nursing education in Canada in the interest of healthier Canadians. To this end, the Canadian Examination for Baccalaureate Nurses/l'examen canadien du baccalauréat en sciences infirmières (CEBN/ECBSI) has been developed and will be launched in 2020. Its purpose, what the Canadian Examination for Baccalaureate Nurses designation signifies and the development of the examination are described.

A Closer Look at the Introduction of the NCLEX-RN in Canada.

In 2015, the nursing faculty across most of Canada were informed by provincial nursing regulators that the America-based National Council Licensure Examination-Registered Nurse (NCLEX-RN) was going to replace the Canadian Registered Nurse Examination for our nursing students to become registered as nurses. This change in the exam has presented a number of challenges to both faculty and students as they transitioned from a Canadian exam for the Canadian context to an exam that was originally formulated for nursing registration in the United States. This manuscript examines the differences in the Canadian and American healthcare systems; explores the variations in Canadian and American nursing practice and education; outlines concerns surrounding the use of standardized testing that panders to corporate interests, encourages "teaching to the test" and is costing nursing programs and nursing students considerable resources; and explores the controversy surrounding the validity of the NCLEX-RN in both Canada and the United States. This manuscript asks Canadian nursing leaders, educators, clinicians and researchers to question why Canadians have taken on this exam when Americans themselves state that this exam "gives a false and incomplete picture of practice readiness."

The Adoption of NCLEX-RN in Canada: A Failure of Leadership at the Intersection of Nursing Regulation, Education and Practice.

This commentary presents perspectives of two senior nursing professors who have extensive faculty and leadership experience in both Canada and the United States. To understand more about how the adoption of the National Council Licensure Examination-Registered Nurses (NCLEX-RN) examination in Canada came to be, the authors conducted conversations with 29 Canadian nurse educators and nursing education and practice leaders. Based on these conversations as well as a review of published materials on the topic, the authors conclude that regulatory leaders failed to involve key leaders and stakeholders from nursing education and practice in this decision, and the resulting negative consequences have been borne primarily by the education and practice sectors. The authors argue that the NCLEX-RN adoption has introduced a misalignment into what had been a well-aligned model of education, regulation and practice in Canada and invite readers to consider the following discussion points. First, the NCLEX-RN has been designed to operate within a healthcare system that should not, by any reasonable argument, be replicated elsewhere; therefore, what are the contextual factors that led to the Canadian adoption of the NCLEX-RN? Second, American regulators stipulate that the examination must fit associate degree graduate competencies and that the additional knowledge and competencies gained at the baccalaureate level are irrelevant for licensure purposes; however, is this a fit for Canadian nursing licensure that requires the baccalaureate degree as an entry for practice? In conclusion, as American higher education in nursing now begins to move toward a competency-based model, further changes will have to be implemented to shape and frame the future of nursing education in the United States, and by extension, the future development of the NCLEX-RN within Canada's distinct historical, social, political and institutional context.