Advancing Nursing Practice: The Evolution and Impact of Continuing Professional Development.

American Nurses Credentialing Center (ANCC) Accreditation in Nursing Continuing Professional Development (NCPD) emphasizes the importance of maintaining competence, ensuring patient safety, and supporting career advancement in nursing through learning and development. It underscores the shift toward competency-based and outcome-oriented education models, addressing challenges such as misconceptions about the demands of NCPD and focusing more on the impact. This column provides the "why" for organizations, leaders, and nurses to engage in ANCC accredited NCPD educational programs. It further explores a future where NCPD fosters a skilled, equitable, and diverse health care workforce, promoting transformational learning experiences. [J Contin Educ Nurs. 2024;55(4):153-156.].

Celebrating Magnet® Nursing Excellence-Meet the Recipients of the 2023 National Magnet Nurse of the Year® Awards and ANCC Magnet Prize®.

ABSTRACT: This month's Magnet® Perspectives column spotlights the recipients of the 2023 American Nurses Credentialing Center (ANCC) Magnet Program® National Magnet Nurse of the Year® (MNOY) awards and the ANCC Magnet Prize®, sponsored by Press Ganey, recognized during the colocated ANCC National Magnet Conference® and the ANCC Pathway to Excellence Conference® in Chicago, Illinois, October 12 to 14, 2023. The MNOY awards recognize 5 clinical nurses in Magnet designated organizations who demonstrate outstanding contributions in innovation, consultation, leadership, and professional risk taking. The ANCC Magnet Prize, sponsored by Press Ganey, recognizes a Magnet organization whose nursing team spearheaded exemplary achievements including initiative(s) in healthcare delivery and research leading to innovations in patient care services. Press Ganey sponsors the Magnet Prize by providing a $125 000 purse to further develop and advance its innovative program/project.

The association of nursing home infection preventionists' training and credentialing with resident COVID 19 deaths.

BACKGROUND: Nursing home (NH) residents' vulnerability to COVID-19 underscores the importance of infection preventionists (IPs) within NHs. Our study aimed to determine whether training and credentialing of NH IPs were associated with resident COVID-19 deaths. METHODS: This retrospective observational study utilized data from the Centers for Disease Control and Prevention's National Healthcare Safety Network NH COVID-19 Module and USAFacts, from May 2020 to February 2021, linked to a 2018 national NH survey. We categorized IP personnel training and credentialing into four groups: (1) LPN without training; (2) RN/advanced clinician without training; (3) LPN with training; and (4) RN/advanced clinician with training. Multivariable linear regression models of facility-level weekly deaths per 1000 residents as a function of facility characteristics, and county-level COVID-19 burden (i.e., weekly cases or deaths per 10,000 population) were estimated. RESULTS: Our study included 857 NHs (weighted n = 14,840) across 489 counties and 50 states. Most NHs had over 100 beds, were for profit, part of chain organizations, and located in urban areas. Approximately 53% of NH IPs had infection control training and 82% were RNs/advanced clinicians. Compared with NHs employing IPs who were LPNs without training, NHs employing IPs who were RNs/advanced clinicians without training had lower weekly COVID-19 death rates (-1.04 deaths per 1000 residents; 95% CI -1.90, -0.18), and NHs employing IPs who were LPNs with training had lower COVID-19 death rates (-1.09 deaths per 1000 residents; 95% CI -2.07, -0.11) in adjusted models. CONCLUSIONS: NHs with LPN IPs without training in infection control had higher death rates than NHs with LPN IPs with training in infection control, or NHs with RN/advanced clinicians in the IP role, regardless of IP training. IP training of RN/advanced clinician IPs was not associated with death rates. These findings suggest that efforts to standardize and improve IP training may be warranted.

Magnet Recognition® and Pathway to Excellence®, Complementary Programs.

The American Nurses Credentialing Center® (ANCC) provides healthcare organizations with 2 complementary programs: Magnet Recognition Program® and Pathway to Excellence®. Both programs support nurses in providing the best care. Understanding each program's framework and focus allows organizations to choose which program is the best fit. Nursing is searching for solutions, the ANCC's Magnet Recognition®, and the Pathway to Excellence® programs offer evidence-based frameworks to support professional nursing practice. The frameworks result in improved nurse engagement, retention, interprofessional collaboration, nurse and patient safety, and patient outcomes.

Electroconvulsive Therapy Credentialing for Psychiatrists-Review of Required Standards Across States and Territories in Australia.

ABSTRACT: Electroconvulsive therapy (ECT) is a complex medical procedure, the delivery of which requires specialist knowledge and skills. We reviewed the standards required for ECT credentialing in different jurisdictions in Australia. We reviewed the Chief Psychiatrist guidelines and statewide policy standards on ECT and focused on standards required for initial credentialing and ongoing privileging in ECT. We compared the credentialing requirements within these documents with the standards specified in the Royal Australian and New Zealand College of Psychiatrists professional practice guideline for ECT. Most of the jurisdictions had specific standards for initial credentialing and maintenance of this credentialing; however, there was significant variance in the credentialing process and standards required. It would be useful to have a minimum standard for credentialing for ECT psychiatrists and prescribers. This standard would be relevant for practice of ECT internationally. States and territories would have the responsibility for implementation of these standards. Appropriate training and establishing good clinical governance processes are essential to the provision of high quality ECT.

Do clinical and communication skills scores on credentialing exams predict potentially inappropriate antibiotic prescribing?

BACKGROUND: There is considerable variation among physicians in inappropriate antibiotic prescribing, which is hypothesized to be attributable to diagnostic uncertainty and ineffective communication. The objective of this study was to evaluate whether clinical and communication skills are associated with antibiotic prescribing for upper respiratory infections and sinusitis. METHODS: A cohort study of 2,526 international medical graduates and 48,394 U.S. Medicare patients diagnosed by study physicians with an upper respiratory infection or sinusitis between July 2014 and November 2015 was conducted. Clinical and communication skills were measured by scores achieved on the Clinical Skills Assessment examination administered by the Educational Commission for Foreign Medical Graduates (ECFMG) as a requirement for entry into U.S residency programs. Medicare Part D data were used to determine whether patients were dispensed an antibiotic following an outpatient evaluation and management visit with the study physician. Physician age, sex, specialty and practice region were retrieved from the ECFMG databased and American Medical Association (AMA) Masterfile. Multivariate GEE logistic regression was used to evaluate the association between clinical and communication skills and antibiotic prescribing, adjusting for other physician and patient characteristics. RESULTS: Physicians prescribed an antibiotic in 71.1% of encounters in which a patient was diagnosed with sinusitis, and 50.5% of encounters for upper respiratory infections. Better interpersonal skills scores were associated with a significant reduction in the odds of antibiotic prescribing (OR per score decile 0.93, 95% CI 0.87-0.99), while greater proficiency in clinical skills and English proficiency were not. Female physicians, those practicing internal medicine compared to family medicine, those with citizenship from the US compared to all other countries, and those practicing in southern of the US were also more likely to prescribe potentially unnecessary antibiotics. CONCLUSIONS: Based on this study, physicians with better interpersonal skills are less likely to prescribe antibiotics for acute sinusitis and upper respiratory infections. Future research should examine whether tailored interpersonal skills training to help physicians manage patient expectations for antibiotics could reduce unnecessary antibiotic prescribing.

2023: A Year in Review.

In 2023, the American Nurses Credentialing Center (ANCC) Nursing Continuing Professional Development (NCPD) and Transition to Practice Directors highlighted the ever-changing professional development environment. This column highlights this year's key topics: academic and practice partnerships, workforce development, updated accreditation standards, and mentoring. [J Contin Educ Nurs. 2023;54(12):545-547.].

Identifying commonalities in definition and governance of point-of-care ultrasound within statements from medical organizations in the United States: A scoping review for a shared understanding.

This scoping review analyzed statements from 22 medical organizations in the United States to identify commonalities in the definition and governance of point-of-care ultrasound (POCUS). A total of 41 statements were included. The review found that the most commonly used elements in defining POCUS were "focused," "bedside," and "patient care." In terms of governance, consistent requirements included specific training programs, documentation in medical records, continuous quality assurance, and standards for credentialing and privileging. These findings suggest the existence of essential commonalities that could facilitate communication and the development of standardized POCUS programs in the future.

Exploring Nurses' Perceptions of Specialty Certification.

BACKGROUND: The strategic nursing plan for a large Midwestern health care system includes achievement of the American Nurses Credentialing Center's Magnet® recognition for all their hospitals. This study explored the barriers to and perceived value of certification among nurses employed by the same health care system across eight facilities in a metropolitan region. One of these facilities holds Magnet® recognition. METHOD: Subjects were recruited by direct email to collect demographic data and complete a barrier to certification survey and the Perceived Value of Certification Tool-12. RESULTS: There were statistically significant differences in the perception that lack of institutional support is a barrier to certification both in aggregate and when comparing the Magnet® hospital with the others. CONCLUSION: As an initial exploration into barriers and perceived value, this study provides data for this health care system to plan strategies to promote certification. This study also serves as an exemplar for other organizations considering evaluation of certification barriers and value among their nursing staff. [J Contin Educ Nurs. 2023;54(12):567-573.].

Intergenerational mobility through inhabited meritocracy: Evidence from civil service examinations of the early- and mid-Ming dynasty.

The civil service examination system emerged to strengthen the emperor's power by recruiting political elites through open examinations. Did it, during the early- and mid-Ming dynasty, facilitate intergenerational mobility? Rather than oversimplifying it as a single-stage system of meritocracy, we propose a two-stage evaluation framework. In the first stage, the Metropolitan Exam featured merit-based evaluations and generated credentials necessary for becoming political elites. The subsequent non-eliminating Palace Exam then functioned to assess the students' organizational fit in line with an emperor's political calculations. In particular, those whose families served in the bureaucracy were favored, while those from affluent families were discriminated against. We test this two-stage framework using the records of 12,427 students who passed 46 exams between 1400 and 1580, a period characterizing the heyday of this system. Our empirical findings from the mixed-effect regression models confirm this argument and suggest promising directions for future research.

Le système d'examen de la fonction publique est apparu pour renforcer le pouvoir de l'empereur en recrutant des élites politiques par le biais d'examens ouverts. A-t-il, au début et au milieu de la dynastie Ming, facilité la mobilité intergénérationnelle ? Plutôt que de le simplifier à l'extrême comme un système de méritocratie à une seule étape, nous proposons un cadre d'évaluation en deux étapes. Au premier stade, l'examen métropolitain comportait une évaluation fondée sur le mérite et permettait d'obtenir les qualifications nécessaires pour devenir des élites politiques. L'examen du palais, non éliminatoire, permettait ensuite d'évaluer l'aptitude organisationnelle des étudiants en fonction des calculs politiques de l'empereur. En particulier, ceux dont les familles travaillaient dans la bureaucratie étaient favorisés, tandis que ceux issus de familles aisées étaient discriminés. Nous testons ce cadre en deux étapes en utilisant les dossiers de 12 427 étudiants qui ont passé 46 examens entre 1400 et 1580, une période qui caractérise l'apogée de ce système. Les résultats empiriques de nos modèles de régression à effets mixtes confirment cet argument et suggèrent des directions prometteuses pour la recherche future.

Will the End of the X-Waiver Expand Access to Buprenorphine Treatment? Achieving the Full Potential of the 2023 Consolidated Appropriations Act.

The 2023 Consolidated Appropriations Act repealed the special waiver for prescribing buprenorphine to patients with opioid use disorder, a bipartisan goal long sought by advocates. The change has symbolic importance in recognizing that buprenorphine is a mainstream medical treatment. We argue that the maximum potential of the law can be achieved by addressing three bottlenecks. First, it is important that new training requirements for all controlled substances prescribers be grounded in scientific principles of addiction treatment and are robustly evaluated to ensure they meet quality standards. Second, even with the elimination of the waiver, there are potential constraints from state law such as state-specific requirements that practitioners require counseling or obtain a separate credential, and many states also have limiting scope of practice regulations. We recommend that these requirements are eased wherever possible to improve treatment access. Third, it is critical to build onramps to treatment in settings such as primary care, hospitals, and correctional facilities. While we anticipate that buprenorphine prescribing will primarily occur in high-volume practices, there is the potential to activate a broader workforce to serve as entry points to care. We conclude that the stage is set for significant increases in lifesaving treatment but the difficult task ahead is ensuring that the resources and training are available to build strong capacity.

The Future of Magnet®.

The Magnet Recognition Program® is built on the results of a study. Magnet® has continued to be evidence-based and forward reaching with each new manual requirement. The foundation of the Forces of Magnetism combined with current future-facing evidence continues to promote a culture of excellence. While it is nursing recognition, Magnet is an organizational credential from which an entire organization benefits.

Formulas of oath and licensing of pharmacists during the Napoleonic Italian Republic and the Napoleonic Kingdom of Italy / Fórmulas de juramento y habilitación de los farmacéuticos durante la República Italiana Napoleónica y el Reino de Italia Napoleónico

This study presents selected unpublished documents that concern the completion of the pharmacy degree programme and its corresponding qualifying exam, in accordance with the reforms of the Napoleonic Italian Republic (1802-1805) and the Napoleonic Kingdom of Italy (1805-1814). The Law on Public Education of 4 September 1802 and the Study and Discipline Plans for National Universities of 1803 stated that pharmacists had to study for three years at one of the national universities in order to obtain an academic degree. These reforms also declared that, after graduating, a further exam was required before pharmacists could freely exercise their profession.The first remarkable document is the one containing the oath taken by pharmacy students upon obtaining their academic degree. The oath is very detailed and accurately describes the expectations that the new Italian Government placed on pharmacists, as well as all the duties that they had to fulfil.Among the documents of the Ufficio Centrale Medico, Chirurgico, Farmaceutico (Central Medical, Surgical and Pharmaceutical Office) – the body that at the time was responsible for qualifying health professionals – there are the Office regulations, with all the rules concerning the pharmacists’ qualifying exam and their proclamation. There is also the oath formula that pharmacists read aloud at the end of their final exam. This oath was more concise than the oath taken at the end of university studies and, in this case, it was the same as the one taken by physicians and surgeons. What is also remarkable in these documents is the special qualification that was granted to those most deserving pharmacists who passed the exam with excellent marks: the possibility of producing and selling large quantities of chemical-pharmaceutical compounds to other pharmacists.(AU)

Este estudio presenta una selección de documentos inéditos relativos a la obtención del grado académico de farmacia y su correspondiente examen de habilitación, de acuerdo con las reformas de la República Italiana Napoleónica (1802-1805) y del Reino Napoleónico de Italia (1805-1814). La Ley de Instrucción Pública de 4 de septiembre de 1802 y los Planes de Estudio y Disciplina de las Universidades Nacionales de 1803 establecían que los farmacéuticos debían estudiar tres años en una de las universidades nacionales para obtener un título académico. Estas reformas también declaraban que, después de graduarse, se requería otro examen antes de que los farmacéuticos pudieran ejercer libremente su profesión.El primer documento destacable es el que contiene el juramento prestado por los estudiantes de farmacia al obtener su título académico. El juramento es muy detallado y describe con precisión las expectativas que el nuevo Gobierno italiano depositaba en los farmacéuticos, así como todas las obligaciones que debían cumplir.Entre los documentos del Ufficio Centrale Medico, Chirurgico, Farmaceutico (Oficina Central Médica, Quirúrgica y Farmacéutica), organismo que en aquella época se encargaba de habilitar a los profesionales sanitarios, se encuentra el reglamento del Ufficio, con todas las normas relativas al examen de habilitación de los farmacéuticos y su proclamación. También está la fórmula del juramento que los farmacéuticos leen al final de su examen final. Este juramento era más conciso que el que se prestaba al final de los estudios universitarios y, en este caso, era el mismo que el de los médicos y cirujanos. Lo que también llama la atención en estos documentos es la cualificación especial que se concedía a los farmacéuticos más meritorios que aprobaban el examen con excelentes notas: la posibilidad de producir y vender grandes cantidades de compuestos químico-farmacéuticos a otros farmacéuticos.(AU)

Using Innovation in Credentialing to Foster Meaningful Transitions to Practice and Support Continuing Professional Development.

Certification within specialized areas in nursing has long been an avenue by which nurses demonstrate competence and dedication toward professional development. Because of innovation within the credentialing arena, certification also can serve as an avenue that supports nursing professional development practitioners who are assisting nurses transitioning into new roles or new practices. [J Contin Educ Nurs. 2023;54(9):413-420.].

Credentialed and Privileged Clinical Nurse Specialists.

PURPOSE/OBJECTIVES: The purpose of this article is to illustrate, using exemplars, the practice of clinical nurse specialists (CNSs) in Michigan who are credentialed and privileged as providers by hospital/healthcare agencies to practice in acute inpatient and ambulatory settings. DESCRIPTION: The CNS provides expert specialty direct patient care to improve patient outcomes. They hold a graduate degree as a CNS, are professionally certified as a CNS in a specialty practice population, and are licensed or otherwise recognized to practice as an advanced practice nurse by the state nursing practice regulatory agency. OUTCOME: The exemplars illustrate CNS practice as an independent provider within a health system. CONCLUSION: Hospital-based credentialing and privileging facilitates CNS practice within the full scope of practice authority that consists of education, certification, and licensure and is a valuable contribution to cost-effective, high-quality clinical care for specialty populations.