Elizabeth C. Poster

Competency development in new registered nurse graduates: closing the gap between education and practice.

The gap between a new registered nurse graduates education for practice and actual practice requirements of new registered nurses has long been an accepted fact in nursing. This article describes the development of an intervention from the academic side of the gap to improve the competency of nursing students before graduation. The intervention is noteworthy because it was developed collaboratively between academia and practice. The three-pronged intervention included development of learning modules based on the top 10 high-risk, high-volume patient conditions; faculty and staff educator development in learning strategies to enhance competency development; and sharing of products with the 84 schools of nursing in Texas.

A Multinational study of psychiatric nursing staffs' beliefs and concerns about work safety and patient assault

In an effort to understand beliefs and concerns about work safety and patient assault, the author describes the results of a multinational survey of 999 nursing staff members working in psychiatric facilities across the United States, Canada, United Kindgom, and South Africa. Although the majority of the sample (75%) reported being physically assaulted at least once during their careers, 62% responded that they felt safe in their work environment most of the time. Significant differences were found among the nurses with regard to beliefs about adequacy of staffing, safety of the physical environment, admission of assaultive patients, expectations about being victims of assault, overall level of safety, and taking legal action against a patient. A significant difference in attitudes was also found among nursing staff members, who reported previous assaults. They believed that assaults are expected events in their work with psychiatric patients.

Advanced practice psychiatric nursing: A national profile

The results of a national survey of Advanced Practice Psychiatric Nurses (APPN) are presented. Results are based on the Society for Education and Research in Psychiatric/Mental Health Nursings (SERPN) Primary Mental Health and Advanced Practice Psychiatric Nursing monograph. Characteristics of the nurses, the clients they serve, and their practice patterns are described. Documenting the cost-effectiveness of these practitioners and increasing the number of younger APPNs is recommended.

THE TEXAS MODEL OF Differentiated Entry-Level Competencies of Graduates of Nursing Programs

The Board of Nurse Examiners and the Board of Vocational Nurse Examiners for the state of Texas updated the states competency-based education model in collaboration with stakeholders in nursing service, state nursing organizations, and the deans and directors of the states 82 board-accredited professional nursing programs. Based on this collaborative effort, 14 differentiated entry-level competencies with associated knowledge and clinical behaviors/judgments were identified that set standards for graduates of vocational, diploma, associate, and baccalaureate degree programs.

Survey of sibling and peer visitation policies in southern California hospitals.

A survey of southern California hospitals identified current visitation policies and the rationale for the restrictions of siblings and peers. Questionnaires mailed to the nursing administrators of 212 hospitals having designated pediatric beds indicated that the majority allowed some form of sibling visitation. The rationales for restriction most frequently given were prevention of infection and spread of communicable disease. The results indicate a gap between sibling visitation research and the theoretical rationale given to support restrictive policies.

Differentiated essential competencies: a view from practice.

This article describes the results of strategies to elicit views of practicing nurses by the Texas Board of Nursing regarding competencies expected of new graduate licensed vocational nursing/LPN, associate degree/diploma, and baccalaureate nurses. The implications of these perceptions regarding the competencies expected of new graduates in Texas are considered, with questions posed for future exploration.

Academic Partnerships to Increase Nursing Education Capacity: Centralized Faculty Resource and Clinical Placement Centers

The North Texas Consortium of Professional Nursing Programs and Practice Partners is a regional academic partnership of nursing education and practice organizational leaders working together to share innovative ideas and best practices and to improve efficiencies that impact nursing education. The regions 15 nursing schools produced 25% of the Texas graduates, or 1,782 graduates, in 2008-2009. Yet, 3,522 graduates are needed in 2013-2014 to meet the projected north Texas demand. Barriers to increasing enrollment and graduation numbers were the lack of sufficient faculty to meet demand and insufficient numbers of clinical placement sites. To increase the capacity for graduating the numbers of nurses needed, the region developed a three-pronged plan to overcome each of these barriers: expansion of partnership members and development of a regional computerized clinical placement center and faculty resource center. The academic partnership expanded its members to include the 15 schools of nursing, more than 50 hospitals, and the Dallas Fort Worth Hospital Council (DFWHC) Foundation for the purposes of governance of the two proposed computerized centers and strategic planning for increased capacity. The faculty resource center is a centralized, one-stop shop for those interested in teaching and those needing faculty. The Centralized Clinical Placement Center is expected to streamline the nursing student clinical placements process and monitor the numbers of students per site at a given time so as to ensure that placements are at capacity and that schools of nursing benefit fairly in placing students in specialty areas to meet course objectives.

Differentiated Essential Competencies for Graduates of Texas Nursing Programs

TheTexas Board of Nursing (TBON) substantially updated its competency standards for new vocational nurse (VN), diploma/ associate-degree nurse (DIP/ADN), and baccalaureate-degree nurse (BSN) graduates to make the competencies consistent with the changing health-care environment. Eleven essential competencies were added to the existing 14 to reflect the evolving role of the nurse. The new Differentiated Essential Competencies of New Graduates of VN, Diploma/ADN, and BSN Programs clarifies and adds consistency to educational outcomes and provides nurse educators, employers, and the community a more in-depth understanding of the role of the TBON in ensuring the safety of the public. The collaborative nature of the analysis and revision of the Differentiated Essential Competencies demonstrates the commitment of nurse educators, employers, and stakeholders to work together for the well-being of the citizens of the state.

Nursing-Led Group Modalities in a Psychiatric Inpatient Setting: A Program Evaluation

This examination of group practice activities conducted by nurses in an inpatient setting combined retrospective examination of practices and concurrent analysis of what is actually done on the units. The most striking finding of this evaluation of institutional nursing-led or co-led group activities was the significant decline in the number of groups. Second, and a related finding, was the need to standardize the format for documenting group activities and outlining the scope and function of these groups. And finally, the need for concise evaluation criteria and measures to document the achievement of stated patient outcomes was very apparent.

Incorporating Play into the Care of the Hospitalized Child

Play is a primary activity of childhood. It serves a variety of purposes that enhance both the physical growth and the psychosocial development of children. Just as the childs level of knowledge, social abilities, and physical capacities increase, so does the childs use of play. Knowledge of the therapeutic value of play is essential for pediatric nurses to incorporate it into their care plan to facilitate the childs adaptation to the illness and hospital experiences. The use of play during the hospital experience can be effective in reducing the childs anxiety and promoting a sense of mastery. This article explores these issues and provides selected clinical examples to illustrate how nurses can integrate therapeutic play experiences with the care of children.