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Journal ArticleDOI

The future of nursing: leading change, advancing health.

01 Mar 2013-Journal for nurses in professional development (J Nurses Prof Dev)-Vol. 29, Iss: 2, pp 51
TL;DR: Three recommendations for transforming nursing education are offered: create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials, and invest in a national initiative to develop and evaluate new approaches to pre-licensing clinical education.
Abstract: Evidence is accumulating that nurses completing pre-licensure programs are not equipped with the essential knowledge and skills for today’s nursing practice, nor prepared to continue learning for tomorrow’s nursing. Citing the need to improve quality and increase capacity, this paper offers three recommendations for transforming nursing education: (1) Create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials. (2) Convene one or more expert panels to develop model pre-licensure curricula which: (a) can be used as a framework by faculty in community college-university partnerships for development of their local curriculum; (b) are based on emerging health care needs and widely accepted nursing competencies as interpreted for new care delivery models; (c) incorporate best practices in teaching and learning. (3) Invest in a national initiative to develop and evaluate new approaches to pre-licensure clinical education, including a required post-graduate residency under a restricted license. The author notes that these changes will require significant investment in the reforms, as well as in nursing education research and faculty development. The return on investment would be improved educational capacity and a better prepared nursing workforce, responsive to emerging health care needs and rapidly changing health care delivery systems. TRANSFORMING PRE-LICENSURE NURSING EDUCATION: PREPARING THE NEW NURSE TO MEET EMERGING HEALTH CARE NEEDS The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of pre-licensure nursing education (Benner et al., 2009b). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as increasing complexity of community based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today’s practice nor prepared to continue learning for tomorrow’s nursing (p. 31). They found (1) weak curricula in natural sciences, technology, social sciences and humanities, and in developing cultural competency; (2) weak classroom instruction and limited integration between classroom and clinical experiences; (3) limited strategies in helping
Citations
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Journal ArticleDOI
20 Oct 1916-Science
TL;DR: A: The Carnegie Foundation for the Advancement of Teaching’s current mission is to support needed transformations in American education through tighter connections between teaching practice, evidence of student learning, the communication and use of this evidence, and structured opportunities to build knowledge.
Abstract: A: The Carnegie Foundation for the Advancement of Teaching was established in 1905 and is an “independent policy and research center. Its current mission is to support needed transformations in American education through tighter connections between teaching practice, evidence of student learning, the communication and use of this evidence, and structured opportunities to build knowledge.” (http://www.carnegiefoundation.org/about-us/about-carnegie)

353 citations

22 Feb 2016
TL;DR: Three recommendations for transforming nursing education are offered: create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials, and invest in a national initiative to develop and evaluate new approaches to pre-licensing clinical education.
Abstract: Evidence is accumulating that nurses completing pre-licensure programs are not equipped with the essential knowledge and skills for today’s nursing practice, nor prepared to continue learning for tomorrow’s nursing. Citing the need to improve quality and increase capacity, this paper offers three recommendations for transforming nursing education: (1) Create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials. (2) Convene one or more expert panels to develop model pre-licensure curricula which: (a) can be used as a framework by faculty in community college-university partnerships for development of their local curriculum; (b) are based on emerging health care needs and widely accepted nursing competencies as interpreted for new care delivery models; (c) incorporate best practices in teaching and learning. (3) Invest in a national initiative to develop and evaluate new approaches to pre-licensure clinical education, including a required post-graduate residency under a restricted license. The author notes that these changes will require significant investment in the reforms, as well as in nursing education research and faculty development. The return on investment would be improved educational capacity and a better prepared nursing workforce, responsive to emerging health care needs and rapidly changing health care delivery systems. TRANSFORMING PRE-LICENSURE NURSING EDUCATION: PREPARING THE NEW NURSE TO MEET EMERGING HEALTH CARE NEEDS The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of pre-licensure nursing education (Benner et al., 2009b). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as increasing complexity of community based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today’s practice nor prepared to continue learning for tomorrow’s nursing (p. 31). They found (1) weak curricula in natural sciences, technology, social sciences and humanities, and in developing cultural competency; (2) weak classroom instruction and limited integration between classroom and clinical experiences; (3) limited strategies in helping The Future of Nursing: Leading Change, Advancing Health Copyright National Academy of Sciences. All rights reserved.

336 citations


Cites background or result from "The future of nursing: leading chan..."

  • ...To support this collaborative effort, the IOM welcomed staff from RWJF, as loaned employees, to provide specific content expertise in nursing, research, and communications....

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  • ...In this partnership, the IOM and RWJF were in agreement that accessible, high-quality care cannot be achieved without exceptional nursing care and leadership....

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  • ...FON The Future of Nursing: Leading Change, Advancing Health (IOM, 2011) FQHC federally qualified health center FTC Federal Trade Commission...

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  • ...The cornerstone of the initiative is the work of this IOM committee....

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  • ...Suggested citation: IOM (Institute of Medicine)....

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Journal ArticleDOI
TL;DR: Overall, the data showed that nursing students can become more confident in EOL care through online education and knowledge gains and continued fears about the same topics suggest EOL confidence lies along a continuum and may require ongoing education.
Abstract: This study describes nursing students' reflections on taking an online course on death and dying. In a semistructured paper, students described fears of caring for clients at end of life (EOL), important content learned, and remaining discomforts. Data were analyzed using directed content analysis. Consistent themes were noted among the papers. Student reflections on the knowledge they gained closely followed initial fears. Several students appreciated the ability to reflect on their experiences in a nonjudgmental setting. Overall, the data showed that nursing students can become more confident in EOL care through online education. Knowledge gains and continued fears about the same topics suggest EOL confidence lies along a continuum and may require ongoing education. Future research should focus on offering online continuing education on EOL to practicing nurses.

316 citations


Cites background from "The future of nursing: leading chan..."

  • ...Recently, the Institute of Medicine’s Future of Nursing report recommended that the role of nurses in palliative and EOL care be enhanced.(3) As care coordinators, patient advocates, and navigators of the health care system, nurses are a critical component in ensuring quality of life and a good death for all patients across disease trajectories and the life span....

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  • ...As care coordinators, patient advocates, and navigators of the health care system, nurses are a critical component in ensuring quality of life and a good death for all patients across disease trajectories and the life span.(3)...

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  • ...However, integration into most undergraduate nursing curricula of an entire course dedicated to care of the dying is the exception, rather than the rule.(3,4,14)...

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References
More filters
Book
01 Jan 1991
TL;DR: This work has shown that legitimate peripheral participation in communities of practice is not confined to midwives, tailors, quartermasters, butchers, non-drinking alcoholics and the like.
Abstract: In this important theoretical treatist, Jean Lave, anthropologist, and Etienne Wenger, computer scientist, push forward the notion of situated learning - that learning is fundamentally a social process. The authors maintain that learning viewed as situated activity has as its central defining characteristic a process they call legitimate peripheral participation (LPP). Learners participate in communities of practitioners, moving toward full participation in the sociocultural practices of a community. LPP provides a way to speak about crucial relations between newcomers and old-timers and about their activities, identities, artefacts, knowledge and practice. The communities discussed in the book are midwives, tailors, quartermasters, butchers, and recovering alcoholics, however, the process by which participants in those communities learn can be generalised to other social groups.

43,846 citations

Journal ArticleDOI
17 Nov 2001-BMJ
TL;DR: Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Abstract: Crossing the Quality Chasm identifies and recommends improvements in six dimensions of health care in the U.S.: patient safety, care effectiveness, patient-centeredness, timeliness, care efficiency, and equity. Safety looks at reducing the likelihood that patients are harmed by medical errors. Effectiveness describes avoiding over and underuse of resources and services. Patient-centeredness relates both to customer service and to considering and accommodating individual patient needs when making care decisions. Timeliness emphasizes reducing wait times. Efficiency focuses on reducing waste and, as a result, total cost of care. Equity looks at closing racial and income gaps in health care.

15,046 citations

Book
01 Jan 1999
TL;DR: New developments in the science of learning as mentioned in this paper overview mind and brain how experts differ from novices how children learn learning and transfer the learning environment curriculum, instruction and commnity effective teaching.
Abstract: New developments in the science of learning science of learning overview mind and brain how experts differ from novices how children learn learning and transfer the learning environment curriculum, instruction and commnity effective teaching - examples in history, mathematics and science teacher learning technology to support learning conclusions from new developments in the science of learning.

13,889 citations

Journal ArticleDOI
TL;DR: Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care.
Abstract: Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health car...

4,276 citations

Journal ArticleDOI
24 Sep 2003-JAMA
TL;DR: In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.
Abstract: ContextGrowing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes.ObjectiveTo examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications).Design, Setting, and PopulationCross-sectional analyses of outcomes data for 232 342 general, orthopedic, and vascular surgery patients discharged from 168 nonfederal adult general Pennsylvania hospitals between April 1, 1998, and November 30, 1999, linked to administrative and survey data providing information on educational composition, staffing, and other characteristics.Main Outcome MeasuresRisk-adjusted patient mortality and failure to rescue within 30 days of admission associated with nurse educational level.ResultsThe proportion of hospital RNs holding a bachelor's degree or higher ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics and hospital structural characteristics (size, teaching status, level of technology), as well as for nurse staffing, nurse experience, and whether the patient's surgeon was board certified, a 10% increase in the proportion of nurses holding a bachelor's degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue (odds ratio, 0.95; 95% confidence interval, 0.91-0.99 in both cases).ConclusionIn hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.

1,694 citations


"The future of nursing: leading chan..." refers background in this paper

  • ...gests that the percentage of nurses prepared at the BSN level on hospital units is positively correlated with better patient outcomes (Aiken et al., 2003), and during times when no shortage of nurses exists, the baccalaureate graduate is now the preferred new graduate hire....

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  • ...1-1 Employment settings of registered nurses, 24 1-2 Employment settings of RNs, by highest nursing or nursing-related education, 25 3-1 Map of the number of NPs per primary care MD by county, 2009, 89 3-2 Map of the number of physician assistants per primary care MD by county, 2009, 89 3-3 Requirements for physician−nurse collaboration, by state, as a barrier to access to primary care, 99 3-4 Physician opinions about the impact of allowing nurse practitioners to practice independently, 113 3-5 Patient satisfaction with retail-based health clinics, 113 3-6 Reasons cited for not working in nursing, by age group, 118 3-7 Age distribution of registered nurses, 1980−2008, 126 3-8 Average age of nurses at various levels of education and of MDs, 127 3-9 Distribution of registered nurses and the U.S. population by racial/ ethnic background, 129 4-1 Trends in graduations from basic RN programs, by type, 2002−2008, 167 4-2 Highest nursing or nursing-related education by urban/rural residence, 178 4-3 Distance between nursing education program and workplace for earlycareer nurses (graduated 2007−2008), 178 4-4 Numbers of qualified applicants not accepted in ADN and BSN programs, 182 4-5 Age distribution of nurses who work as faculty, 183 Copyright © National Academy of Sciences....

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  • ...Acronyms and Abbreviations* AACN American Association of Colleges of Nursing AAI Arkansas Aging Initiative AAMC Association of American Medical Colleges AARP American Association of Retired Persons ACA Affordable Care Act ACO accountable care organization ADN associate’s degree in nursing AIDS acquired immune deficiency syndrome AMA American Medical Association ANA American Nurses Association ANCC American Nurses Credentialing Center AONE American Organization of Nurse Executives APRN advanced practice registered nurse ARRA American Recovery and Reinvestment Act BSN bachelor’s of science in nursing CBO Congressional Budget Office CCNE Commission on Collegiate Nursing Education CHC community health center CMA California Medical Association CMS Centers for Medicare and Medicaid Services *The acronyms and abbreviations used in the Summary and Chapters 1–7 appear in this list. xxv Copyright © National Academy of Sciences....

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  • ...presented to show that the mortality rates were the same for hospitals in which nurses cared for 8 patients each, on average, and 60 percent had a BSN and for hospitals in which nurses cared for only 4 patients each but only 20 percent had a BSN (Aiken, 2008; Aiken et al., 2003)....

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  • ...All rights reserved. xxii TABLES, FIGURES, AND BOXES 3-1 Variation in State Licensure Regulations, 100 3-2 Case Study: Advanced Practice Registered Nurses, 108 3-3 Case Study: The Patient-Centered Medical Home, 134 3-4 Case Study: 11th Street Family Health Services of Drexel University, 138 3-5 Case Study: Technology at Cedars-Sinai Medical Center, 146 4-1 Costs of Health Professional Education, 169 4-2 Case Study: The Oregon Consortium for Nursing Education (OCNE), 174 4-3 Case Study: Community Colleges Offering the BSN, 180 4-4 Nurse Profile: Jennifer Wenzel*, 184 4-5 Case Study: The Dedicated Education Unit, 192 4-6 Case Study: Nursing for Life—...

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