Showing papers in "Nursing Forum in 2016"

Concept Analysis of Spirituality: An Evolutionary Approach.

Abstract: Aim The aim of this article is to clarify the concept of spirituality for future nursing research. Background Previous concept analyses of spirituality have mostly reviewed the conceptual literature with little consideration of the empirical literature. The literature reviewed in prior concept analyses extends from 1972 to 2005, with no analysis conducted in the past 9 years. Design Rodgers' evolutionary framework was used to review both the theoretical and empirical literature pertaining to spirituality. Evolutionary concept analysis is a formal method of philosophical inquiry, in which papers are analyzed to identify attributes, antecedents, and consequences of the concept. Data Source Empirical and conceptual literature. Results Three defining attributes of spirituality were identified: connectedness, transcendence, and meaning in life. A conceptual definition of spirituality was proposed based on the findings. Also, four antecedents and five primary consequences of spirituality were identified. Conclusions Spirituality is a complex concept. This concept analysis adds some clarification by proposing a definition of spirituality that is underpinned by both conceptual and empirical research. Furthermore, exemplars of spirituality, based on prior qualitative research, are presented to support the findings. Hence, the findings of this analysis could guide future nursing research on spirituality.

Decision Making in Nursing Practice: A Concept Analysis

Abstract: Purpose The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Methods Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Conclusion Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed.

Concept Analysis: Alzheimer's Caregiver Stress.

Abstract: By 2030, the number of U.S. adults aged 65 or older will more than double to nearly 71 million (Administration on Aging, 2012). As the number of older adults rises, so too will the number of new and existing cases of Alzheimer’s disease (AD), as age is one risk factor for developing AD (Alzheimer’s Association, 2013). Currently, 5.2 million Americans are diagnosed with AD; approximately half of persons 85 and older have some form of the disease (Alzheimer’s Association, 2013). This has far-reaching implications because the disease has long-term effects to the families and the society as a whole. The financial impact of caregiving for a person with AD and related dementias (ADRD) is approximately $216 billion dollars per year (Alzheimer’s Association, 2013). It has been found that caregivers of persons with dementia are at greater risk for hospitalization, which has implications on hospitals seeking to decrease readmission rates (Alzheimer’s Association, 2013; Schubert et al., 2008). Employers of businesses may see an increase in Family Medical Leave of Absence or an increased use of sick time as a result of their employees needing to care for the person with ADRD. These societal implications are inextricably linked to the person with ADRD and the 15.4 million caregivers who provide unpaid care to persons with ADRD (Alzheimer’s Association, 2013). Of these caregivers, 60–70% of ADRD caregiving takes place in the home and community-based setting (Alzheimer’s Association, 2013). The concept of caregiver stress is significant to nursing, nursing research, and clinical practice. Nurses are at the forefront of implementing interventions to maintain the mental and physical health of family caregivers and persons with ADRD. Due to the chronic stress of caring for a person with ADRD, caregivers are at high risk for burnout and chronic health problems (Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002). Developing a clear understanding regarding the concept of caregiver stress can help nurses utilize theoretical frameworks as a basis for developing new interventions to help caregivers cope with the stress they face in caring for a person with ADRD. This paper seeks to clarify the concept of caregiver stress of the ADRD caregiver through analyzing and discussing Wilson’s modified method of concept analysis, reviewing the literature, defining working definitions and attributes of the concept, determining antecedents and consequences, describing cases, and evaluating empirical referents of the concept of Alzheimer’s caregiver stress.

Reflective Practice: A Comparative Dimensional Analysis of the Concept in Nursing and Education Studies.

Abstract: Aim This paper reports on an analysis of the concept of reflective practice. Background Reflective practice, a concept borrowed from the field of education, is widely used in nursing. However, to date, no study has explored whether this appropriation has resulted in a definition of the concept specific to the nursing discipline. Data Sources A sample comprised of 42 articles in the field of nursing drawn from the CINAHL database and 35 articles in education from the ERIC database (1989–2013) was analyzed. Review Method A concept analysis using the method proposed by Bowers and Schatzman was conducted to explore the differing meanings of reflective practice in nursing and education. Results In nursing, the dimensions of the concept differ depending on context. In the clinical context, the dimensions may be summarized as theory–practice gap, development, and caring; in training, as learning, guided process, and development; and in research, as knowledge, method, and social change. In education, the concept is also used in the contexts of training (the dimensions being development, deliberate review, emotions, and evaluation) and research (knowledge, temporal distance, and method). The humanist dimension in nursing thus reflects a use of the concept more specific to the discipline. Conclusion The concept analysis helped clarify the meaning of reflective practice in nursing and its specific use in the discipline. This observation leads to a consideration of how the concept has developed since its appropriation by nursing; the adoption of a terminology particular to nursing may well be worth contemplating.

The Experience of Male Nursing Students.

Abstract: Purpose To explore the experience of male nursing students in a baccalaureate nursing program. Methods This study used a qualitative approach with content analysis. Written narratives in response to open-ended questions were analyzed. Lincoln and Guba's guidelines were followed. Setting and Population This study took two academic years to complete, at a baccalaureate nursing program in the northeast United States. It consisted of 23 male undergraduate nursing students who had completed three clinical nursing courses. Findings Five themes emerged from the data analysis: staying focused, opinions matter, I want to be “a nurse,” relationships, and looking ahead. Conclusions The male nursing students in this study were serious about entering the nursing profession. They wanted to be known as “nurses,” not “male nurses.” Additional findings from this study can provide educators and clinicians with a deeper understanding of the experiences of male nursing students and what they need to be successful.

Culture and Cultural Competence in Nursing Education and Practice: The State of the Art

Abstract: HarkessKaddouraProblem The concept of cultural competency has developed a substantial presence in nursing education and practice since first attracting widespread attention in the 1990s. While several theories and corresponding measures of cultural competency have been advanced and tried, much work remains, as many nursing professionals continue to call for greater evidence-based research and attention to patient perspectives and outcomes. Methods Using a method provided by Hawker et al. to appraise articles, this paper compares nine recent (2008–2013) studies (including two composite studies) related to cultural competency, undergraduate curricula, and teaching strategies in nursing to assess the state of the art in this important area of care. Findings The studies applied phenomenological, study abroad, online, and service learning strategies, four of which relied on some version of Campinha-Bacote's IAPCC© model. These studies reported a general improvement in competency among students, though generally only to a level of cultural awareness, and admitted being constrained by several common limitations. Conclusion Improved results and more realistic expectations in this area may require a closer understanding of the nature of the “culture” that underlies cultural competence. HarkessKaddoura

Promotion of Nursing Student Civility in Nursing Education: A Concept Analysis

Abstract: Purpose Substantive research into the development of civility within nursing education is long overdue. Behaviors learned by nursing students while in the school of nursing transfer to the work environment and culture of nursing. This paper reveals a concept analysis of civility within nursing education using Rodgers' evolutionary concept analysis method. Conclusion Civility is defined to provide clarity for the current terminology of civility within nursing education. Nurse educators must set socially acceptable behavioral expectations in the learning environment, establishing positive interpersonal relationships with students, maintaining moral and academic integrity, and role model civil behaviors. Suggestions are included to help nurse educators outline acceptable behaviors in the learning environment and promote the development of civility. Practice Implications The development of civil behaviors in nursing students will carry into professional practice after graduation. Civility is necessary to establish meaningful interpersonal relationships, supportive communication, and optimum learning environments to ensure quality patient care with optimum outcomes.

Veterans in Transition: Implications for Nurse Educators.

Abstract: Recently the United States military has begun strategic reductions in force and as a result many veterans are utilizing education benefits to transition from combat to classroom. During this transitional period, veterans entering nursing programs may struggle to transition from the combat experience to the college campus. Barriers to transition can include stigma, difficulty with peer relationships, differences in military and nursing education structure, and personal and financial responsibilities. Regardless of these barriers, this population, which may include highly trained combat medics and corpsmen, may also bring assets gained through military training and experience that can enhance the nursing profession. These strengths include teamwork, perseverance, ability to focus on assignments, global awareness, and increased self-efficacy. Nursing education research is lacking in the area of combat veterans transitioning into nursing programs, prompting the concern that nursing education is not prepared to meet the needs of this unique population. Gaining better understanding of the barriers to transition and strengths gained through combat can aid the nurse educator in better meeting the needs of this unique population of students. Dyar.

Writing Across the Curriculum: Strategies to Improve the Writing Skills of Nursing Students.

Abstract: Background Writing across the curriculum (WAC) is a strategy in which writing instruction occurs in classes outside of composition, literature, and other English courses. This literature review was conducted to identify and synthesize the peer-reviewed literature about WAC in nursing education. Methods The team performed searches of MEDLINE (PubMed), CINAHL Plus With Full Text, and ERIC for articles published between January 2003 and April 2014. A combination of Medical Subject Heading terms (or equivalent) and keywords were used to create the database search strategies. Results There were 48 articles that discussed WAC. Most of the papers described writing courses in nursing programs, strategies to teach writing to nursing students, and writing activities or assignments within nursing courses. High-level evidence examining the impact of writing strategies and exercises in courses and occurring across the curriculum was lacking. Only 18 (37.5%) of these papers were evaluative; most of the databased articles were either author observations or perceptions of changes in students' writing ability, or low-level research studies. Conclusions Strategies, assignments, and courses intended to promote writing skills of nursing students were documented in this literature review; however, further evaluation is needed to determine which are most effective. Hawks Turner Derouin Hueckel Leonardelli Oermann.

Eating Self-Regulation in Overweight and Obese Adults: A Concept Analysis

Abstract: Background Poor eating behaviors greatly influence the development of becoming overweight or obese. Learning to better self-regulate eating is one area in which individuals can positively influence their own health. Purpose The purpose of this concept analysis is to provide an in-depth analysis of the concept eating self-regulation as it pertains to overweight and obese adults using Walker and Avant's method. Results The definition for eating self-regulation formulated as a result of this concept analysis and based on the critical attributes is the ability to initiate goal-related behaviors, to consistently self-monitor dietary intake, to regularly apply willpower to resist temptations, to self-evaluate where one stands in relationship to goal attainment, and finally to maintain motivation to positively change eating behaviors. Cognitive restraint, moderation, mindfulness, disinhibition, delayed gratification, emotions and moods, self-efficacy, social support, the environment, and physical activity are the antecedents that may influence eating self-regulation. Conclusion Examining an individual's weight, body mass index, lipid levels, or blood pressure are some ways to determine if self-regulation of eating behavior is achieved. With a consistent definition of self-regulation and a better understanding of the critical factors that influence eating behaviors, research can better explore how to help individuals change their eating behaviors more effectively.

When Push Comes to Shove: A Comparative Concept Analysis of Motivation and Coercion in Nursing Education

Abstract: Background Understanding the fine line between motivation and coercion in nursing education may offer insight into satisfaction and autonomy in young nursing students, leading to increased retention, effectiveness, and professionalism in the workplace. Purpose To compare and analyze the concepts of motivation and coercion with application to nursing academia. Methods Using the Walker and Avant method for concept analyses, definitions and defining attributes of motivation and coercion were identified, along with antecedents, consequences, and model cases for each concept. Comparison of the concepts noting comparative terms and notable differences are presented. Conclusions The comparison of the concepts of motivation and coercion reveals the stark contrast in the consequences of motivational and coercive power interactions in creating professional, satisfied, and empowered nurses. Nurse educators should seek to identify the best ways to create autonomy, competence, and relatedness in their graduates while minimizing coercive power plays which foster distance and dependence.

Reproductive Life Planning: A Concept Analysis

Abstract: BACKGROUND: In 2006 the U.S. Centers for Disease Control and Prevention issued 10 recommendations on preconception care which included the statement that reproductive life planning should be considered an individuals responsibility across his or her life span. PURPOSE: The purpose of this article is to provide a concept analysis of reproductive life planning using Walker and Avants method as an organizing framework. METHODS: Search engines were employed to review the existing knowledge base of the concept of reproductive life planning. FINDINGS: The findings suggest that reproductive life planning is integral to preconception care and family planning. Attributes antecedents and consequences associated with reproductive life planning are discussed. Model borderline and contrary cases are also provided to illustrate the concept. PRACTICE IMPLICATIONS: A reproductive life plan can serve as a framework for promoting reproductive health across the life span of both men and women. Healthcare providers must assess the individuals ability to understand and utilize educational resources to ensure full and effective participation in reproductive life planning. (c) 2015 Wiley Periodicals Inc.

Understanding Transitions to Promote Student Success: A Concept Analysis.

Abstract: HartSwentyAim The purpose of this analysis is to provide an extensive exploration of the concept of transitions, specifically within the context of nursing students. Background Transitions are a universal part of life. The concept of transitions is rooted in disciplines such as anthropology, sociology, psychology, and business. Transitions are also a central theme in nursing. While various definitions of the concept exist, most agree that transitions involve a process, which over time results in transformation of self. Design Walker and Avant's eight-step method of concept analysis served as the framework for exploration of the concept. Review Methods The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Education Resources Information Center, ProQuest, and Academic Search Premiere were searched using the search terms transition, transitions, transformation, nursing students, anxiety, and clinical education. Quantitative and qualitative studies, published concept analysis, and transition theory articles were included. Conclusions During a transition, people experience stress and anxiety. This applies to nursing students as well, who often report much stress and anxiety upon entering the initial clinical experience. However, consequences of a successful transition include increased knowledge, attainment of new skills, and identify reformation. By understanding the concept, nurse educators can develop effective teaching strategies to facilitate successful transitions, which will improve the educational experience, support student retention, and promote graduation of competent practitioners. HartSwenty

Care Coordination Strategies in Reforming Health Care: A Concept Analysis.

Abstract: PROBLEM With the growing number of individuals with chronic conditions and the associated healthcare costs, there is a need to improve how health care is delivered from an individual provider standpoint as well as a systemwide perspective. Such delivery can be accomplished through improved care coordination. CONCLUSION Care coordination is a complex term that encompasses the full array of healthcare delivery activities across all systems of care. This includes organizing the care, improving quality of health care delivered, and achieving cost savings. In working to achieve this goal, the nurse is well suited to provide oversight in this process in assuring that the components of care coordination are conducted efficiently and effectively. PRACTICE IMPLICATIONS While the nurse is the optimal provider for this position, the nurse's defined role in this process is not always clear. This article focuses on the term care coordination, which includes the definitions of care coordination, impact on nursing, attributes, antecedents, consequences, and empirical referents for this term. Care coordination is also differentiated from case management to add clarity to the role.

Quality Pain Management in Adult Hospitalized Patients: A Concept Evaluation.

Abstract: Aim To explore the concept of quality pain management (QPM) in adult hospitalized patients. Background Pain is common in hospitalized patients, and pain management remains suboptimal in some settings. Design A concept evaluation based on Morse et al.'s method. Data Source Of more than 5,000 articles found, data were restricted to 37 selected key articles published in peer-reviewed journals. Review Methods Data were extracted from the selected articles and then synthesized according to the following: definition, characteristics, boundaries, preconditions, and outcomes. Results QPM relates to the Structure: organizationally supported evidence-based policies, competent staff, interprofessional and specialized care, and staff accountability; Process: screening, assessment/reassessment and communication of pain and its treatment, patient/family education, individualized evidence-based treatment, embedded in safe, effective, patient-centered, timely, efficient, and equitable services; and Outcomes: reduced pain severity and functional interference, decreased prevalence/severity of adverse consequences from pain or pain treatment, and increase in patient satisfaction. Conclusions QPM is a multifaceted concept that remains poorly defined in the literature. Studies should aim to develop valid, reliable, and operational measures of the pillars of QPM and to look at the relationship among these factors. Authors need to state how they define and what aspects of QPM they are measuring.

Reflections of the Veterans Administration Puget Sound Health Care System Regional Nurse Practitioner Residency Forum.

Abstract: Problem There is a proliferation of advanced practice residency programs. However, there is no uniform model of developing and evaluating program success. Methods An information forum was convened by Veterans Health Administration Puget Sound Health Care System's Center for Primary Care Education on September 17, 2013, in Seattle, Washington, to explore critical aspects of residency models. The three objectives of this forum were to develop a shared understanding of key elements needed to support nurse practitioner residencies; define the unique needs of nurse practitioner trainees who are interested in applying for a residency; and examine the viability of designing a replicable nurse practitioner residency model benchmarking stakeholder best practices. Findings This article describes the organization of the forum and summarizes the presentations during the program. The companion article explores key recommendations from the forum related to future development of residency “toolkits” to aid in future evaluation and accreditation. Conclusion As nurse practitioner residencies continue to develop and evolve, more is needed in the area of structure and alignment.

Looking Back to the Future: Current Issues Facing Nursing Education From the Reflections of a Member of the Silent Generation.

Abstract: KeatingProblem As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. Method The author looks “back to the future” and reviews current issues that surround four key nursing education milestones. Findings From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Conclusion Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating

A Concept Analysis of Personalized Health Care in Nursing

Abstract: Purpose The purpose of the study is to identify the concept of personalized health care in nursing and to address future direction in person-centered nursing care. Background Personalized health care has attracted increased attention in the twenty-first century. As more and more preclinical studies are focusing on cost-effective and patient-centered care, there also has been an identified need for a personalized health care in nursing. Yet the term lacks clear definition and interests among healthcare professionals. Review Methods Rodgers’ strategy for concept analysis was used in this analysis. A literature review for 1960–2014 was conducted for the following keywords: nursing care, personalized, and health care. Results The analysis demonstrates that personalized health care in nursing is an intangible asset, including explicit attributes (interprofessional collaboration and individualized care approach) and implicit attributes (managing personal vulnerabilities: molecular-based health information and self-health-seeking behaviors). The result of this analysis provides a guide for further conceptual and empirical research and clinical practice in the personalized healthcare era. Conclusion This concept analysis represents an effort to describe the attributes of a concept regarded as representing an important feature of nursing care and to promote discourse that will enhance maturation of the concept into one that is established with clearly delineated characteristics.

Situational Transitions and Military Nurses: A Concept Analysis Using the Evolutionary Method

Abstract: Background Situational transitions in nursing remain a significant issue for both new graduates and experienced nurses. Although frequently discussed in current nursing literature, nursing research has exclusively focused on the transition experience of civilian (nonmilitary) nurses. With differing role and practice expectations, altered practice environments, and the risk of deployment, the outcome of negative transition experiences for military nurses is significant. Purpose The purpose of this analysis is to clarify the concept of transition, in a situational context, as it relates to military nurses by investigating the attributes, antecedents, and consequences. Methods Rodgers’ evolutionary method served as the framework to this study. The sample included 41 studies, published in English, between 2000 and 2013. Data were retrieved from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, ProQuest, Ovid, and PsycINFO databases. Conclusion Antecedents of situational transitions include any change in work roles or work environments. Attributes of situational transitions include journey, disequilibrium, finding balance, conditional, and pervasive. Consequences of transition range from successful to unsuccessful. Additional research that investigates the specific needs and challenges unique to nurses practicing in a military environment is needed.

Advocating for Deployed Women Veterans' Health Differences, Difficulties, and Disparities.

Abstract: PROBLEM: The preceding article presented a glimpse of deployed women veterans, their military culture, and their experiences in the Global War on Terror (Iraq and Afghanistan) to assist civilian nurses to gain significant rapport and provide important culturally sensitive care. METHODS: Pertinent literary sources were reviewed to gather applicable data about the problem. FINDINGS: A confirmatory answer from the assessment question of "Have you served in the military?" and the use of the Military Health History Pocket Card for Clinicians (available at http://www.va.gov.oaa/pocketcard) will assist with revealing possible health risks from the increased amounts of military men and women veterans seeking (and/or returning to) a variety of community-based health services. This article about deployed women veterans examines their specific health differences (e.g., research literature, post-traumatic stress disorder, and military sexual trauma), difficulties (e.g., reproductive, gynecologic, urinary, suicide), and gender disparities (varied treatment patterns). CONCLUSION: Understanding these gender situations, civilian nurses can better advocate with increasing evidence-based decisions that their physical and behavioral responses were different from their male counterparts. Continual assessment, knowledgeable care, ongoing literature review, interdisciplinary health team development, and the presence of resourceful community agencies should be a significant part of their holistic care. Language: en

Ready or Not-Retirement Looms Near for Boomer Nurses.

Abstract: Problem Nursing has been identified as one of the top 20 occupations that will be affected by baby boomer retirements. Boomer nurses, born between 1946 and 1964, have begun leaving the profession at an alarming rate. This nursing exodus is occurring at a time when demand for nurses is very high, the nursing shortage continues throughout the country, and financial forecasts predict very difficult financial times ahead for boomer nurses. Methods A literature review was conducted on research on retirement planning, habits and beliefs of boomer nurses, and the market forces that affect retirement savings. Findings Boomer nurses will face an unprecedented retirement crisis because they simply have not saved enough for a secure financial future after their retirement from the profession. Conclusions The case studies and recommendations in this article suggest that there are actions nurses at all ages can take to improve their retirement savings.

Evaluating an Online Family Assessment Activity: A Focus on Diversity and Health Promotion.

Abstract: Problem A lack of exposure to diverse families and family interactions created a need to identify effective teaching strategies that emphasized diversity and health promotion in a Registered Nurse to Bachelor of Science in Nursing online transition course. Methods A family assessment activity was designed to emphasize diversity and health promotion utilizing the Family Health Systems approach to family assessment and Healthy People 2020 as a framework for family health promotion. The activity was evaluated through faculty observation and student feedback, which is discussed in the article. Findings Evaluation data indicated that students believed the activity provided a safe environment to practice assessment skills for working with diverse families, pushed them out of their comfort zones, enhanced their awareness of the need for health promotion, extended their definition of diversity, increased their cultural knowledge, expanded their personal perspectives on families, and provided them with a broader scope of nursing practice in the community. Conclusions Using constructivist strategies that emphasize active learning and the use of cinema to teach family assessment results in increased awareness of diversity and increased knowledge of opportunities for health promotion in families. Smith Jones.

How We Engage Graduating Professional Students in Interprofessional Patient Safety.

Abstract: Problem Interprofessional curricula on patient safety do not acknowledge the culture and vulnerabilities of the student experience and often do not engage students. Methods We describe a patient safety collaboration between graduating nursing and medical students during their Capstone courses that fostered conversations about the similarities and differences in professional school experiences around patient safety. Students wrote reflections about an unanticipated patient outcome. Qualitative content analysis was used to characterize themes within student reflections, and to create audience response system questions to highlight differences in each profession's reflections and to facilitate discussion about those differences during the collaboration. Findings Medical students identified events in which perceived patient outcomes were worse than events identified by nursing students. Nursing students identified more near-miss events. Nursing students positively impacted the event and attributed action to the presence of a clinical instructor and personal responsibility for patient care. Medical students described themselves as "only a witness" and attributed inaction to hierarchy and concern about grades. Conclusions Students felt the session would change their future attitudes and behaviors. Stevenson Chudgar Molloy Phillips Engle Clay.

Distracted Practice: A Concept Analysis

Abstract: D'EsmondProblem Distracted practice is a growing concern for all healthcare professionals working in today's complex, technology-rich, acute care hospital environment. Distractions are a threat to patient safety, frequently cited as a contributing factor when reporting an adverse event. The number of new technologies introduced to the healthcare environment has significantly increased the number of distractions. Shrinking resources and the resultant time pressure placed on all practitioners has added to the list of human factors known to be contributing to potential errors. Delivering safe, quality care in this environment has now become a daily challenge for all members of the healthcare team. Distracted practice was found to have no consistent definition in the healthcare literature. Method Walker and Avant's method of concept analysis was used to develop a preliminary definition and model of distracted practice. Findings This analysis includes a definition, characteristics, antecedents, and consequences of distracted practice. Conclusion More research is needed to fully understand this critical human experience of distracted practice. With additional knowledge we will be able to raise awareness and create interventions to reduce its occurrence among members of the healthcare team. This will positively contribute to the team's efforts to keep all our patients safe while in the hospital. D'Esmond

Optimum Function in Patients With Heart Failure

Abstract: Purpose The aim of this article is to use Walker and Avant's methodological approach to provide clarity and a definition of optimum function as it relates to patients with heart failure (HF). Background Understanding optimum function in patients with HF can help advanced practice nurses (APNs) identify clinical signs of deterioration. Interpreting patient descriptions of signs and symptoms may be the first cues prior to diagnosis. Data Source Literature searches included electronic scientific databases and a manual search. Literature from 2005 to 2013 was reviewed. Themes were searched for function. The text was limited to English language peer-reviewed articles, resulting in 43 articles and 3 books in the analysis. Conclusion A definition of optimum function was developed from a synthesis of the literature's common themes. The four defining attributes include: multidimensional aspect (physical, cognitive, psychosocial, physiological, and spiritual), achieving a desired goal, dynamic and relative change (compared with previous functioning), and most favorable level of functioning. Defining optimum function in patients with HF provides clarity of patient communication to and between APNs. The concept promotes patient-centered care, enabling goal adjustment by the patient and APN. The concept analysis facilitates a deeper understanding of communication during the patient encounter.

A Critical Evaluation on a Fulbright Experience.

Abstract: Problem Although many Fulbright awardees have detailed experiences in varied countries, there is less discussion on the impact on the host institution and efforts to sustain the change between both participants. Methods The critical evaluation examines professional and personal impact of a Fulbright U.S. Scholar Award at the University of Johannesburg in South Africa. Findings This work details the influence of the host faculty in the experience for both the host faculty in the Department of Nursing and the scholar receiving the awarded. Challenges to achieve a successful exchange are described, and activities to sustain connections and maximize impact are presented, with particular emphasis on midwifery. Conclusions Collaborative research and teaching activities strengthened through administrative endorsement support ongoing exchange.

Developing Students as Future Researchers Using QSEN Competencies as a Framework

Abstract: MonsivaisRobinsonPurpose This article discusses the development of students as future researchers within the context of carrying out an R-15-funded research project, and demonstrates the application of selected competencies from the Quality and Safety Education for Nursing project as a project framework. Operationally, the project had two parallel tracks; the first track was the research project itself, and the second track was the development of researchers through carrying out the research project. Objectives of the project The objectives of the research project were to (a) translate project documents into Spanish, (b) test the acceptability of the intervention in a Hispanic population along the Unites States–Mexico border, and (c) assess the feasibility of conducting a trial of the intervention in the same population. Method Development of future researchers was guided by selected pre-licensure Quality and Safety Education for Nursing competencies, which created a transparent link among research, education, and practice. Conclusion This framework is extremely useful for educators and research mentors who have the opportunity to mentor and develop students as researchers. MonsivaisRobinson

From Dissertation Defense to Dissemination: Jump Start Your Academic Career With a Scholar Mentor Group

Abstract: Problem The dissertation provides an excellent source of scholarly productivity for new doctoral faculty, yet is often neglected because of the demands inherent in the faculty role. Methods The purpose of this paper is to present a case study of a scholar mentor group composed of three graduates of a PhD nursing program and their shared dissertation chair, who acted as a senior scholar mentor to the group. Findings By working together, we have been able to enhance our scholarly productivity by disseminating our dissertations through presentations and publications. The paper will present the evolving process of this working group, summarize outcomes, analyze the challenges, and provide suggestions for future doctoral students and faculty who are working with them. Conclusions Our experience and scholar mentor model captures the best of both worlds—the benefits of interaction with academic peers and the benefits of having a senior scholar mentor. This was accomplished while all members were at different schools in different cities and states. Although other literatures that document successful collaborations using a peer-mentorship model are available, we were unable to locate any that documents a post-doctoral group with a senior scholar mentor who continued working together after graduation.

Nurses and Lifelong Learning: Creating “Makers and Shapers” or “Users and Choosers”?

Abstract: Problem How have the meaning and goals of lifelong learning for nurses shifted under neoliberal political policy? Methods This article critically scrutinizes the political undercurrents of lifelong learning. While the original intent of lifelong learning was to foster intellectual, critical, social, and political citizen engagement (creating “makers and shapers” of social policy), instrumental learning—learning to meet practical economic ends—has taken priority and is instead creating marketable workers (creating “users and choosers”). Findings International educational neoliberal policy reform has altered the very nature of education. Under pervasive neoliberal political influence, lifelong learning has become distorted as the goals of learning have shifted towards creating marketable workers who are expected, while unsupported, to engage in learning to ensure ongoing employability in an open market. Conclusions By examining new understandings of lifelong learning, nurses can make informed choices as to whether they aspire to be a “user and chooser” or “maker and shaper” of lifelong learning in their workplaces.

From Vulnerability to Dignity: The RN Declaration of Self‐Esteem

Abstract: JanzenMitchellRentonCurrieNordstromBackground Registered nurses (RNs) experience vulnerability from a variety of sources in today's healthcare organizations. While RN vulnerability can be associated with positive outcomes with patients and clients, vulnerability can also be dangerous to RNs as they struggle with outside forces that many feel they have no control over. Aims The study aims to maintain and enhance the dignity of RNs and provide a beacon to RNs who may have become wounded in the healthcare setting and/or their own profession. Setting The study was conducted in a conference entitled “Advancing Nursing Practice Through Change, Innovation and Creativity” held at a midsized university in western Canada. Participants The participants were 115 administrators, members of RN regulatory bodies, nursing faculty, nurse educators, and staff nurses. Methods An activity entitled “Wild Thinking” gave participants an opportunity to reflect upon the conference and their personal experiences of change, innovation, and creativity they wished to see within the workplace. All responses were collected at the end of the activity, transcribed verbatim, and analyzed for themes. Results Arising from 16 themes, the RN Declaration of Self-Esteem was created. Conclusion The RN Declaration of Self-Esteem may be helpful in promoting empowerment at the individual RN level as well as in the collective professional level. JanzenMitchellRentonCurrieNordstrom