Susan Dean‐Baar

Practice versus knowledge when it comes to pressure ulcer prevention.

Purpose This study was completed to determine the current knowledge and documentation patterns of nursing staff in the prevention of pressure ulcers and to identify the prevalence of pressure ulcers. Methods This pre‐post intervention study was carried out in three phases. In phase I, 67 nursing staff members completed a modified version of Bostroms Patient Skin Integrity Survey. A Braden Scale score, the presence of actual skin breakdown, and the presence of nursing documentation were collected for each patient (n = 43). Phase II consisted of a 20‐minute educational session to all staff. In phase III, 51 nursing staff completed a second questionnaire similar to that completed in phase I. Patient data (n = 49) were again collected using the same procedure as phase I. Results Twenty‐seven staff members completed questionnaires in both phase I and phase III of the study. No statistically significant differences were found in the knowledge of the staff before or after the educational session. The number of patients with a documented plan of care showed a statistically significant difference from phase I to phase III. The number of patients with pressure ulcers or at risk for pressure ulcer development (determined by a Braden Scale score of 16 or less) did not differ statistically from phase I to phase III. Conclusion Knowledge about pressure ulcers in this sample of staff nurses was for the most part current and consistent with the recommendations in the Agency for Health Care Policy and Research guideline. Documentation of pressure ulcer prevention and treatment improved after the educational session. Although a significant change was noted in documentation, it is unclear whether it reflected an actual change in practice.

Reshaping Clinical Nursing Education: An Academic-Service Partnership.

This article describes the conceptualization and implementation of an academic-service partnership for a baccalaureate nursing program. The partnership began its fifth year in the fall of 2002; 107 students have entered the partnership since its inception. The partnership goals were to develop and implement clinical training experiences that teach students key skills for community-based practice settings, and to develop and evaluate an innovative and collaborative model for community-based clinical education. Students in the partnership have a unique opportunity for learning the art and science of nursing in a complex, integrated health care system with a strong emphasis on quality of environment, providers, and care delivery. A longitudinal program evaluation is underway, based on an American Association of Colleges of Nursing publication, the vision and goals of the School of Nursing, and the construct of organizational socialization.

Closing the gap between research and clinical practice.

Abstract Evidence-based practice and the application of research findings to practice is a major focus of attention in health care today. The quantification of variations in service delivery and the economic implications of these variations contribute to the pressure on clinicians to provide evidence-based care whenever possible. Awareness of the development of evidence-based practice (EBP), the need for EBP, factors that affect EBP, the methods used to translate research into practice, EBP quality indicators, barriers to EBP, and benefits of EBP will assist clinicians in the effective use of evidence-based information in the care of their patients.

Nursing Shortages Affect All Levels of the Profession

Recent attention to the growing nursing shortage focuses predominantly on projections regarding nurses with entrylevel preparation who provide direct services to patients and clients in a variety of settings. The need for nurses with graduate preparation, who can respond to the increasing demands in advanced practice, faculty, administration, and research roles, is not receiving the same attention. A closer look shows dire projections for these nurses with advanced preparation. An additional 200,000 graduate-prepared nurses are projected to be needed by the end of this decade. We can anticipate that the shortage of nurses prepared at the graduate level will, in coming decades, be an even greater problem than the shortage of nurses with entry-level preparation. The responsibilities of nurse administrators and managers in today’s complex healthcare organizations increasingly require the knowledge and skills gained in graduate programs. The increasing complexity of health care, coupled with the increase in longevity and concomitant increase in chronic illness, is creating an increased demand for advanced practice Nursing Shortages Affect Levels of the Profession All