The Future of Nursing Institute of Medicine; Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine
National Academies Press,
10/2010
eBook, Book
Open access
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.
While vast numbers of nurses across the globe contribute in all areas of healthcare delivery from primary care to acute and long-term care in community settings, there are significant differences in ...how they are educated, as well as the precise nature of their practice. This comprehensive handbook provides a research-informed and international perspective on the critical issues in contemporary nurse education.
As an applied discipline, nursing is implemented differently depending on the social, political and cultural climate in any given context. These factors impact on education, as much as on practice, and are reflected in debates around the value of accredited programmes, and on-the-job training, apprenticeship, undergraduate and postgraduate pathways into nursing. Engaging with these debates amongst others, the authors collected here discuss how, through careful design and delivery of nursing curricula, nurses can be prepared to understand complex care processes, complex healthcare technologies, complex patient needs and responses to therapeutic interventions, and complex organizations. The book discusses historical perspectives on how nurses should be educated; contemporary issues facing educators; teaching and learning strategies; the politics of nurse education; education for advanced nursing practice; global approaches; and educating for the future.
Bringing together leading authorities from across the world to reflect on past, present and future approaches to nurse education and nursing pedagogy, this handbook provides a cutting-edge overview for all educators, researchers and policy-makers concerned with nurse education.
Research has indicated that a range of adult psychiatric disorders and mental health problems originate at an early age, yet the psychiatric symptoms of an increasing number of children and ...adolescents are going unrecognized and untreated-there are simply not enough child psychiatric providers to meet this steadily rising demand. It is vital that advanced practice registered nurses (APRNs) in psychiatry and primary care take active roles in assessing behavioral health presentations and work collaboratively with families and other healthcare professionals to ensure that all children and adolescents receive appropriate treatment. Child and Adolescent Behavioral Health helps APRNs address the mental health needs of this vulnerable population, providing practical guidance on assessment, intervention and treatment strategies; indications for consultation, collaboration, and referral; and more. Now in its second edition, this comprehensive and timely resource has been fully updated to include DSM-5 diagnostic criteria for common behavioral health issues of infants to adolescents. New and expanded chapters cover bullying and victimization, child sexual development, adolescent sexual identity, managing the needs of LGBTQ youth, and adverse childhood events. Edited and written by a team of accomplished child psychiatric and primary care practitioners in nursing, this authoritative volume: Provides state-of-the-art evidence-based knowledge about specific psychiatric and behavioral health issues across multiple care settings Reviews the clinical manifestation and etiology of behavioral disorders, risk and management issues, and implications for practice, research, and education Offers approaches for interviewing children and adolescents, and strategies for integrating physical and psychiatric screening Discusses special topics such as legal and ethical issues, cultural influences and the needs of immigrant children, and child and adolescent mental health policy Features a new companion website containing clinical case studies for each chapter, downloadable figures and tables, further reading lists, and links to additional resources Designed to specifically address the issues faced by APRNs, Child and Adolescent Behavioral Health is essential reading for nurse practitioners and clinical nurse specialists, particularly those working in family, pediatric, community health, psychiatric, and mental health settings.
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.
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