Implementing a Standardized Testing Program: Preparing Students for the NCLEX-RN

The undergraduate nursing faculty of a large Midwestern university initiated a program of standardized computerized testing for two purposes: to provide students experience with standardized computerized testing prior to taking the National Council Licensure Exam for Registered Nurses (NCLEX-RN) and to increase the students' NCLEX-RN passing rate. This article chronicles the process of implementing a comprehensive testing program developed by the Assessment Technologies Institute (Overland Park, KS). Although the first class of students to have taken the entire testing package has just graduated, midprogram results have demonstrated potential as key indicators for identifying at-risk students. The trends in scores on standardized computerized tests, grades in prerequisite science courses, and grades in medical-surgical courses are used to identify students who are at risk for failure in the program and on the NCLEX-RN. Faculty advisors meet with these students to develop individual plans of study and to provide additional resources. The testing process is going on smoothly, and faculty members are learning to use the extensive information on students' test scores to further assist them in passing the NCLEX-RN.     

Childbirth Education in the 1990s and Beyond

Childbirth education has been evolving for centuries. It has been a part of the experience of pregnancy and birth since the beginning of time, although it did not exist in the formal structure that exists today. It began in response to a need to improve prenatal care and maternal-infant outcomes. It experienced an awakening fueled by the women's movement and the grass roots consumer movement between 1960 and 1980 and had an impact on the development of family-centered maternity care. It has been influenced by institutional control in the 1980s and 1990s. Throughout these decades the goals of childbirth education have changed and evolved. As we near the year 2000, childbirth education approaches a crossroads and faces many challenges for the future. A number of factors will influence the direction that childbirth education takes in the next century. These factors include demographic trends, health care reform, the philosophy of health care providers, goals and responsibilities of consumers, goals of educational programs, consumer access to education programs, the philosophy and role of childbirth educators, research, and standards of practice.     

A New Paradigm for Postpartum Care

Shortened hospital stays have decreased women's access to postpartum nursing care. Providers and payers together must address clinical and cost issues to develop a model of maternity care that covers the postpartum period.
A short-stay maternity program was developed in 1989 by Professional Nurse Associates, Inc., in conjunction with Kaiser Permanente. The program includes prenatal preparation of families, a brief hospital stay, postpartum home visits, and postvisit case management. Readmission rates for mothers and newborns in the program have been less than 1%. The program has saved about $1 million a year since 1991, and consumer satisfaction has been measured at 99%.