Transforming prelicensure 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 prelicensure nursing education (Benner, Sutphen, Leonard, & Day, 2009). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as the 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: a) weak curricula in natural sciences, technology, social sciences, and humanities, and in developing cultural competency; b) weak classroom instruction and limited integration between classroom and clinical experiences; c) limited strategies in helping students develop habits of inquiry, raising clinical questions, seeking evidence for practices; d) faculty and student perception that students are ill prepared for their first job and dissatisfaction with the teaching preparation of current nursing faculty; and e) multiple pathways to eligibility for the licensure examination, with tremendous variability in prerequisites, curricular requirements, and the quality of offerings.     

Transforming organizational culture through nursing shared governance

Nursing shared governance (NSG) provides a framework for the professionalization of nursing, provides a broader distribution of decision making across the profession, and allocates decisions based on accountability and role expectations. Shared governance defines staff-based decisions, accountability, roles, and ownership of staff in those activities that directly affect nurses' lives and practice. Although NSG is a somewhat ambiguous concept with a vast application, examining it from the perspective of structure, process, and outcomes can more clearly outline a successful strategy for implementation and growth.     

The nursing case management computerized system: meeting the challenge of health care delivery through technology.

Does nursing case management compute? In this article, the author attempts to explain how computerizing the team plan of care and critical pathways decreases paperwork, makes it easier to develop standardized team care plans, enhances quality improvement trending, and is flexible enough to update the plan of care according to the patient's changing needs. The Nurse Case Management Computerized System puts the patient care team plan into an interactive computer program. The computer does the work of presenting the nurse with care plan options and printing a hard copy ready to implement. Use of the computer program enhances the health care team's ability to individualize the team plan of care while maintaining patient care standards. The system is also used to collect patient care data automatically and to trend for quality improvement.     

Improving the quality of care and reducing health care costs through a point-of-service health care information system

Health care information systems will become critical to the success of health care providers. These systems must make the process of health care delivery more effective and more efficient, assisting the provider in improving the quality of care while maximizing cost reduction through more appropriate care and reduction in administrative costs. The system must be able to capture accurate encounter data for outcomes analyses and capable of use by multiple health plans for their unique policies or programs such as disease management. The most effective means of achieving all of the above will be to re-empower the physicians through software placed in a mobile computing environment with full integration among all participants.     

Transforming assertive community treatment into an integrated care system: the role of nursing and primary care partnerships

Despite the high rate of co-occurring medical conditions experienced by individuals receiving assertive community treatment (ACT), this comprehensive service model continues to be considered primarily a mental health intervention. Without compromising fidelity to the model, ACT can serve as an ideal platform from which to provide both primary and behavioral health care to those with complex service needs. Using a case example, this article considers the transformation of the ACT mental health care model into an integrated health care delivery system through establishing nursing and primary care partnerships. Specifically, by expanding and explicitly redefining the role of the ACT nurse, well-developed care models, such as Guided Care, can provide additional guidelines and training to ACT nurses who are uniquely trained and oriented to serve as the leader and coordinator of health integration efforts.