"The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to ...advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles--including limits on nurses' scope of practice--should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing. The following are appended: (1) Methods and Information Sources; (2) Committee Biographical Sketches; (3) Highlights from the Forums on the Future of Nursing; (4) APRN Consensus Model; (5) Undergraduate Nursing Education; (6) Health Care System Reform and the Nursing Workforce: Matching Nursing Practice and Skills to Future Needs, Not Past Demands; (7) Transformational Models of Nursing Across Different Care Settings; (8) Federal Options for Maximizing the Value of Advanced Practice Nurses in Providing Quality, Cost-Effective Health Care; (9) The Future of Nursing Education; and (10) International Models of Nursing. An index is also included. (Individual chapters contain references.) The content of this document was prepared by the Committee on the Robert Wood Johnson Foundation, Initiative on the Future of Nursing at the Institute of Medicine.
This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines, real-life case studies, and evidence-based protocols ...developed by master educators and practitioners. With a focus on improving quality of care, cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issues in older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care, palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easy information retrieval. Protocols-systematically tested by more than 300 participating NICHE (Nurses Improving Care for Healthsystem Elders) hospitals-are organized in a consistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references, and evidence ratings for each protocol are provided along with resources for additional study.
Der Pflege-Report, der in Buchform und als Open-Access-Publikation erscheint, nimmt jährlich relevante Themen der Versorgung von Pflegebedürftigen unter die Lupe. Schwerpunkt des Jahres 2019 ist die ...Frage „Mehr Personal in der Langzeitpflege – aber woher?“ Es werden unterschiedliche Maßnahmen analysiert, die ein quantitativ wie qualitativ ausreichendes Angebot an Pflegepersonal sicherstellen sollen. Die Beiträge beleuchten Ursachen der Personalnot, zeigen Lösungswege auf und diskutieren hierbei bestehende Herausforderungen und zu erwartende Auswirkungen. Zudem präsentiert der Pflege-Report empirische Analysen zur Entwicklung der Pflegebedürftigkeit in Deutschland sowie zur Inanspruchnahme der Pflegeinfrastruktur und verschiedener Pflegeformen. Ein besonderer Fokus gilt der gesundheitlichen Versorgung in der ambulanten Pflege und im Pflegeheim.
The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit and consequently, on workload.
To assess the nurse-patient ratio required by COVID-19 patients and to ...identify the factors that influence nursing in this context.
This study was a retrospective observational study that evaluated the ratio using the Nursing Activities Score (NAS).
Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients.
The study included 95 COVID-19 patients and 1604 non-COVID-19 patients (control group) resulting in 905 and 5453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p = <0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2 = 457.60, p = <0.0001), mobilisation (χ2 = 161.21, p = <0.0001), and hygiene (χ2 = 557.77, p = <0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age <65 years old (p = 0.23), the use of continuous venovenous hemofiltration (p = 0.002), a high APACHE II score (p = 0.006) and patient death (p = 0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR = 4.8, 95% CI:3.6–6.4).
Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average ratio of almost 1:1.
•Paper explores barriers to a universal DNP requirement for advanced practice nurses•Includes cost analysis and perceptions of the DNP in today's professional environment•Offers insight to help ...facilitate the implementation of a universal DNP standard
In 2004, the American Association of Colleges of Nursing (AACN) called for all nursing schools to phase out master's-level preparation for advanced practice registered nurses (APRNs) and transition to doctor of nursing practice (DNP) preparation only by 2015. Today, five years after the AACN's deadline, nursing has not yet adopted a universal DNP standard for APRN practice entry.
The purpose of this paper is to examine the factors influencing the ability of nursing schools to implement a universal DNP standard for APRNs.
Deans from top-ranked nursing schools explore the current state of the DNP degree in the US. The authors draw upon their collective experience as national leaders in academic nursing, long-time influencers on this debate, and heads of DNP programs themselves. This insight is combined with a synthesis of the literature and analysis of previously unpublished data from the AACN on trends in nursing doctoral education.
This paper highlights issues such as the long history of inconsistency (in messaging, curricula, etc.) surrounding the DNP, certification and accreditation challenges, cost barriers, and more. The authors apply COVID-19 as a case study to help place DNP graduates within a real-world context for health system stakeholders whose buy-in is essential for the success of this professional transition.
This paper describes the DNP's standing in today's professional environment and advances the conversation on key barriers to its adoption. Insights are shared regarding critical next steps to ensure national acceptance of the DNP as nursing's terminal practice degree.
"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' ...Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions."-from the Introduction
In a series of provocative essays,The Complexities of Carerejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.
A Nurse's Step-by-Step Guide to Transitioning to an Academic Role gives you a detailed road map for a successful transition to academia, offering guidance in how to balance competing priorities and ...avoid burnout.
This open access book offers an overview of theories related to simulation and describes different simulation areas within nursing. It illustrates how simulation may be used in different levels in ...professional education. The book deals with the role of the Simulation Facilitator, peer learning and the use of Virtual Reality in simulation. It provides new insights and paths to the development of the use of simulation within nursing and healthcare and contributes with new knowledge from research and experiences of implementation of different simulating scenarios within nursing and midwifery. It is intended to teachers in nursing and other healthcare professionals with an interest in the use of active learning methods.
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