Nursing information technology knowledge,skills, and preparation of student nurses,nursing faculty,and clinicians: a U.S. survey

Because health care delivery increasingly requires timely information for effective decision making, information technology must be integrated into nursing education curricula for all future nurse clinicians and educators. This article reports findings from an online survey of deans and directors of 266 baccalaureate and higher nursing programs in the United States. Approximately half of the programs reported requiring word processing and e-mail skill competency for students entering nursing undergraduate programs. Less than one third of the programs addressed the use of standardized languages or terminologies in nursing and telehealth applications of nursing. One third of the programs cited inclusion of evidence-based practice as part of graduate curricula. Program faculty, who were rated at the "novice" or "advanced beginner" level for teaching information technology content and using information technology tools, are teaching information literacy skills. The southeastern central and Pacific regions of the United States projected the greatest future need for information technology-prepared nurses. Implications for nurse educators and program directors are discussed.     

Family nursing education and family nursing practice in Nigeria

A survey of six Nigerian nursing program curricula was conducted to determine the extent to which family nursing theory was used as a reference for conceptualizing nursing care in Nigeria. In addition, 25 nurse clinicians were purposely selected from three levels of primary, secondary, and tertiary health care units in Ile-Ife, Nigeria, and were interviewed to determine the extent to which nurses in practice reported using family assessment tools in their practice. The survey of the postgraduate curricula showed that master's and doctorally prepared nurses specializing in community health nursing have a theoretical base in family nursing theory. The limited focus on family nursing theory in basic, postbasic, and first-degree nursing curricula was deemed inadequate to develop the knowledge and skills necessary for all practicing nurses to embrace family-focused care in Nigeria. In nursing practice, families were seen to be involved in nursing care only to the extent of meeting financial and physical care needs of their family members. Findings from this study point to the need for a reorientation of the nursing curricula in Nigeria to include more family nursing theory. Specialized education of family nurse practitioners who would function at all levels of care also is a desirable goal to provide holistic health care to Nigerian families.     

Quality and safety curricula in nursing education: matching practice realities

Health care delivery settings are redesigning in the wake of staggering reports of severe quality and safety issues. Sweeping changes underway in health care to address quality and safety outcomes lend urgency to the call to transform nursing curricula so new graduate competencies more closely match practice needs. Emerging views of quality and safety and related competencies as applied in practice have corresponding implications for the redesign of nursing education programs. Nurse executives and nurse educators are called to address the need for faculty development through strategic partnerships.     

Emergency preparedness curriculum in nursing schools in the United States

With concern about bioterrorism and inadequacies in responding to mass casualty events, health care professionals have been placed in the category of first responders. The International Nursing Coalition for Mass Casualty Education (INCMCE) was established to plan strategically to address the educational needs of the nation's nurses. This study sought to determine the types and levels of disaster preparedness curricula being delivered or in development in nursing programs at all levels. INCMCE surveyed 2,013 deans or directors of nursing schools as to curricula for emergency preparedness prior to September 11, 2001, and during the two following academic years. Initial requests were sent via email and the US postal service. Respondents were invited to answer the online survey so data could be directly entered into a database for purposes of data analysis. Responses were received from 348 schools of nursing. Curriculum plans, followed by competency lists, were selected as most helpful for teaching content in disaster preparedness. The survey results validated the general assumption that nursing programs provide limited curricula in this area. The mean number of hours of disaster preparedness content provided, approximately four hours, did not change significantly over three academic years. The study also showed that 75 percent of respondents thought that nurse faculty were inadequately prepared in the area of disaster management. The study established a baseline for future curricular growth.     

A critical lens on culture in nursing practice

Increasing evidence demonstrates that the Aboriginal population experience greater health disparities and receive a lower quality of health care services. The Canadian Nurses Association (CNA) code of ethics states that nurses are required to incorporate culture into all domains of their nursing practice and ethical care. The aim of this article is to examine the concepts of cultural competency and cultural safety by way of relational ethics. To address these disparities in health care, cultural competency training programs are being widely advised. Recent research into cultural safety has not only recognized the importance of culture in nursing practice and organizational structures, but also extended the concepts to the culture of the client. In recognizing this diversity, nurses must pay close attention to their relationships with their clients. It is argued that the answers lie in relational ethics, which honors indigenous people's connection to self, others, the environment, and the universe.     

Diversity in emergency medicine education: expanding the horizon

An emergency medicine (EM)-based curriculum on diversity, inclusion, and cultural competency can also serve as a mechanism to introduce topics on health care disparities. Although the objectives of such curricula and the potential benefits to EM trainees are apparent, there are relatively few resources available for EM program directors to use to develop these specialized curricula. The object of this article is to 1) broadly discuss the current state of curricula of diversity, inclusion, and cultural competency in EM training programs; 2) identify tools and disseminate strategies to embed issues of disparities in health care in the creation of the curriculum; and 3) provide resources for program directors to develop their own curricula. A group of EM program directors with an interest in cultural competency distributed a preworkshop survey through the Council of Emergency Medicine Residency Directors (CORD) e-mail list to EM program directors to assess the current state of diversity and cultural competency training in EM programs. Approximately 50 members attended a workshop during the 2011 CORD Academic Assembly as part of the Best Practices track, where the results of the survey were disseminated and discussed. In addition to the objectives listed above, the presenters reviewed the literature regarding the rationale for a cultural competency curriculum and its relationship to addressing health care disparities, the relationship to unconscious physician bias, and the Tool for Assessing Cultural Competence Training (TACCT) model for curriculum development.     

An education-service partnership to achieve safety and quality improvement competencies in nursing

The Institute of Medicine recommends that educational and service organizations develop partnerships to promote and prioritize competency development for nurses. This article describes a collaborative project between a college of nursing and a regional health care system. The project's aim was to foster the development of safety and quality by creating a curriculum based on the 10 core competencies identified by the Massachusetts Department of Higher Education Nurse of the Future Competency Committee. To accomplish this goal, learning experiences were created to address competency development. Competency-based education will help ensure that nursing graduates are adequately prepared to meet the current and future health care needs of our population.     

Development of an international comorbidity education framework

ContextThe increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions.AimOur aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education.MethodsWe surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing clinical frameworks and the student survey data. This list was used to develop the International Comorbidity Education Framework.ResultsThe survey sample consisted of 917 students from England (42%), India (48%), Italy (8%) and Sweden (2%). The majority of students across all disciplines said that they lacked knowledge, training and confidence in comorbidity care and were unable to identify specific teaching on comorbidities. All student groups wanted further comorbidity training. The health education institution representatives found no specific references to comorbidity in current health education curricula. Current clinical frameworks were used to develop an agreed list of core comorbidity content and hence an International Comorbidity Education Framework.ConclusionsBased on consultation with academics and clinicians and on student feedback we developed an International Comorbidity Education Framework to promote the integration of comorbidity concepts into current healthcare curricula.     

5 competencies needed by new baccalaureate graduates

As nurse educators prepare new graduates for practice, part of the challenge is to ensure that these nurses are capable of functioning in a broad continuum of care with increased responsibilities. To identify competencies needed by new baccalaureate graduates in today's health care environment and determine whether these competencies fall into particular dimensions, a cross-sectional survey design was used to query 363 nurse administrators from three health care settings. Nurse administrators rated the importance of 45 nursing competencies. Factor analysis was conducted on the competency items, and factor scores were calculated to determine the importance ratings by work setting groups. Findings revealed a simple six-factor competency structure (Health Promotion Competency, Supervision Competency, Interpersonal Communication Competency, Direct Care Competency, Computer Competency, and Caseload Management Competency). MANOVA indicated significant differences in the importance of these competence factors by work setting. The findings are an important beginning for evidence-based decision-making about nursing curriculum reform, both in the classroom and clinical practice areas. The study also provides a foundation for further measurement of nursing competencies.     

Quality and Safety Education for Nurses

Quality and Safety Education for Nurses (QSEN) addresses the challenge of preparing nurses with the competencies necessary to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine(1) competencies for nursing (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), proposing definitions that could describe essential features of what it means to be a competent and respected nurse. Using the competency definitions, the authors propose statements of the knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing education. Quality and Safety Education for Nurses (QSEN) faculty and advisory board members invite the profession to comment on the competencies and their definitions and on whether the KSAs for pre-licensure education are appropriate goals for students preparing for basic practice as a registered nurse.     

National comparative curriculum evaluation of baccalaureate nursing degrees: a framework for the practice based professions

The primary aim of the study was to determine whether Australian undergraduate nursing curricula incorporate the necessary skills and knowledge to prepare graduates for the current health care environment in Australia. The eligibility criteria for inclusion in this evaluation included Australian university undergraduate pre-registration nursing programs. All of the 29 universities offering such programs in Australia were contacted by letter to the Deans of Nursing and their current curriculum document requested. Twenty six of 29 (90%) eligible Australian curricula were included in the curriculum evaluation. A comprehensive and flexible curriculum evaluation framework was developed for the analysis of the 26 curricula. The evaluation revealed the ways in which nursing curricula balance various aspects of courses, respond to changes in society, education and health care industries. Overall it was found that graduates are well prepared for practice. However questions of quality and coordination of clinical learning were highlighted for future focus and major challenges lie in addressing excessive workload and assessment. Also work needs to be done in improving the inclusion of issues around the health of Aboriginal and Torres Strait Islander (ATSI) peoples, people living in remote or rural Australia and older people.     

Public policy on competency: how will nursing address this complex issue?

The evolving contexts in which nursing care is provided and the complexity of clients being served are raising new questions about the nature of nursing practice, the ways in which nurses can best be prepared for such practice settings, and how current staff can continually update their knowledge, skills, and abilities to provide competent care. It is imperative that the profession be forward looking as it reassesses the implications of assuring the public of a competent nursing work force. The mandate to prepare nurses differently to practice competently in future health care systems also suggests a different system for competency assessment. This article provides an overview of international, national, and state perspectives and approaches in addressing the issue of assuring competency from a public policy perspective, including one state's experience to date.     

What is a comprehensive mental health nursing assessment? A review of the literature

Assessment is the foundation on which nursing care is delivered. The aim of this paper is to better understand the content (what information nurses seek about consumers) and the process (how they go about gathering that information) of a comprehensive mental health nursing assessment in practice. Using terms, such as 'nursing', 'mental health', and 'assessment', the CINAHL, Medline, and PsycINFO databases were searched for studies that describe the content and process of a comprehensive mental health nursing assessment. Although studies of aspects of mental health nursing assessment, such as the assessment of risk or carer burden, were found, no single study described both the content and process of a comprehensive mental health nursing assessment in practice. In Australia, a comprehensive assessment is codified as a competency to practice nursing; however, the standards of practice set for mental health nurses are less clear on what constitutes a comprehensive assessment or how this should be undertaken. The peer-reviewed literature describes assessment as both an independent and interdependent activity. It is described as informal, and there is evidence that comprehensive mental health nursing assessments are not well documented. The credibility of training and research into mental health nursing requires that the content and the process of a comprehensive mental health nursing assessment needs to be clearly defined.     

“Oh,older people,it's boring”: Nurse academics’ reflections on the challenges in teaching older person's care in Australian undergraduate nursing curricula

BackgroundNursing students encounter older people in all health care sectors; however, few choose a career primarily focused on older person's care.AimTo explore the challenges to teaching older person's care to Bachelor of Nursing students and how pre-registration nursing students are prepared to care for older people, part of a large study investigating content on care of older people in Australian nursing curricula.MethodsA purposive sample of Australian nurse academics involved in Bachelor of Nursing curriculum development or delivery completed a telephone-assisted survey. Qualitative content analysis of two open-ended questions was undertaken.ResultsAll Australian schools of nursing participated, and 45 nurse academics were interviewed. Reflecting on the challenges of teaching older person's care to nursing students, most participants felt the curriculum was too crowded and some called for a 4 year degree. In addition, students’ ageist attitudes, fuelled by unrealistic portrayals of nursing in popular culture, were reinforced by curricula being acute care focused and the ageist attitudes of some nurse academics.ConclusionsTeaching older person's care in Australian nursing curricula is challenged by insufficient time and ageism among students and academics. Regulatory bodies need to urgently provide direction so that nursing curricula content aligns with emerging Australian health care priorities, in particular the health care needs of older people.     

Patient safety competence for final-year health professional students: Perceptions of effectiveness of an interprofessional education course

As final-year medical and nursing students will soon play key roles in frontline patient care, their preparedness for safe, reliable care provision is of special importance. We assessed patient safety competencies of final-year health profession students, and the effect of a 1-day patient safety education programme on these competencies. A cross-sectional survey was conducted with 233 students in three colleges of medicine, nursing, and traditional medicine in Seoul. A before-and-after study followed to evaluate the effectiveness of the curriculum. Patient safety competency was measured using the Health-Professional Education for Patients Safety Survey (H-PEPSS) and an objective patient safety knowledge test. The mean scores were 3.4 and 1.7 out of 5.0, respectively. The communication domain was rated the highest and the teamwork domain was rated the lowest. H-PEPSS scores significantly differed between the students from three colleges. The 1-day patient safety education curriculum significantly improved H-PEPSS and knowledge test scores. These results indicated that strengthening patient safety competencies, especially teamwork, of students is required in undergraduate healthcare curricula. A 1-day interprofessional patient safety education programme may be a promising strategy. The findings suggest that interprofessional patient safety education needs to be implemented as a core undergraduate course to improve students’ safety competence.     

Australian nursing students’ clinical experiences in residential aged care: Reports from nurse academics

BackgroundNurses are the largest group of registered healthcare professionals and are fundamental to delivering health and aged care in Australia.AimTo explore how nursing students report clinical experiences when caring for older people as part of a larger study investigating how care of the older person content is included in Australian undergraduate nursing curricula.MethodsA population sample of all Australian nursing schools that offered a Bachelor of Nursing degree (n = 35) in 2019. Nurse academics involved in curriculum development or delivery were recruited. A telephone-assisted survey was used, and qualitative content analysis undertaken.ResultsAll schools of nursing participated in the survey, representing a response rate of 100%. The acute care focus of nursing curricula meant clinical experiences for nursing students related to older person's care commonly occurred in residential aged care facilities in the first year of the degree. Student reports of these experiences varied, with a majority of respondents reporting mixed or negative feedback associated with a lack of preparation and inadequate supervision.ConclusionsThis study highlights the: significance of the timing of nursing students’ clinical placements in residential aged care; the selection of appropriate care homes; and the need for the right clinical teaching staff who can supervise high quality learning experiences for students.