This chapter focuses on the Advanced Practice Nurse (APN) educator as a source of leadership development for students in APN programs. Content relevant to leadership understanding and skills development is presented. Examples of learning experiences throughout the program are explored. In addition, content related to interprofessional education (IPE) is offered along with ideas of teaching throughout the curriculum. The challenges of integrating scholarly activity into a clinical curriculum to foster a lifelong commitment to adding new knowledge are considered. Finally, building alliances with clinical partners, other academic institutions, and professional organizations to enhance the educational experience is explored.

This article provides a historic view of the development and accomplishments of the National Organization of Nurse Practitioner Faculties (NONPF). The authors explore the history leading up to the formalization of NONPF, noting the major factors leading to the creation of NONPF. Since its inception in 1980, NONPF has led efforts to provide resources to nurse practitioner program faculty, create standards and guidelines for quality programs, and most recently work to develop measurable competencies. This article tracks the achievement of the organization by decade and provides an education, practice, and policy context that informed and inspired the activities of NONPF.

Objective. To examine the impact of state-granted nurse practitioner (NP) independence on patient-level quality, service utilization, and referrals.Data Sources/Study Setting. The National Ambulatory Medical Care Survey's community health center (HC) subsample (2006-2011). Primary analyses included approximately 6,500 patient visits to 350 NPs in 220HCs.Study Design. Propensity score matching and multivariate regression analysis were used to estimate the impact of state-granted NP independence on each outcome, separately. Estimates were adjusted for sampling weights and NAMCS's complex design.Data Collection/Extraction Methods. Every "NP-patient visit unit" was isolated using practitioner and patient visit codes and, using geographic identifiers, assigned to its state-year and that state-year's level of NP independence based on scope of practice policies. Nine outcomes were specified using ICD-9 codes, standardized drug classification codes, and NAMCS survey items.Principal Findings. After matching, no statistically significant differences in quality were detected by states' independence status, although NP visits in states with prescriptive independence received more educational services (aIRR 1.66; 95 percent CI 1.09-2.53; p =.02) and medications (aIRR 1.26; 95 percent CI 1.04-1.53; p =.02), and NP visits in states with practice independence had a higher odds of receiving physician referrals (AOR 1.88; 95 percent CI 1.10-3.22; p =.02) than those in restricted states.Conclusions. Findings do not support a quality-scope of practice relationship.

Background The Doctor of Nursing Practice (DNP) degree positions nurse practitioners (NPs) and other advanced practice registered nurses, with clinical competencies similar to other disciplines requiring doctoral education (medicine, physical therapy, psychology, and pharmacy). In addition, all these disciplines also offer residencies. However, nursing is the only discipline that does not require a doctoral degree and/or have a systematic approach to residency training for advanced practice roles. The authors posit that there are critical policy issues to resolve within the nursing profession to clarify the role that clinical residencies should play in transition to DNP practice specifically related to NPs. Purpose The purpose of this article was to (a) describe the context of NP residency models within NP curricula that strengthen the DNP Essentials with an emphasis on Essential VIII and a focus on distinctive clinical specialization, (b) describe the history and policy implications of NP residency programs as well as existing programs that assist transition to practice, and (c) recommend policies for consideration related to DNP NP residencies. Methods Literature on nurse practitioner residencies was reviewed. Discussion While nurse practitioner residencies continue to grow, research is needed regarding outcomes of job satisfaction, clinical competencies, and patient satisfaction. Conclusion The first year of practice for nurse practitioners is a critical period of professional development. It is important to further clarify the need, direction, and program standards. Academically affiliated residencies will facilitate the development and standardization of curricula and competencies to enhance clinical rigor. The partnership between academic units and clinical agencies will pool resources and strengthen nursing in both settings.

We have read with interest the article by Meleis, 2016Meleis A.O. The undeaning transition: Toward becoming a former dean.Nursing Outlook. 2016; 64: 186-196Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar concerning what she describes as the “undeaning” process. Meleis clearly has a substantial history of scholarship in the area of transition, but the focus of this article comes as a surprise to us as former nursing deans. What she describes is certainly not the experiences we have had. The proposed orderly progression through her five sequential phases with defined milestones and challenges embedded in each does not capture our lived experience. What seems to be missing is some additional background. Is this article presented as a theory piece? If so, then there are additional components that are missing. The idea of Dean of Nursing likely shares characteristics with other similarly named positions throughout the university. Yet, no data are presented to allow for accepting this assumption. The unique nature and heterogeneity of American universities could be expected to contribute multiple contexts, values, and cultural norms within which equally unique and diverse roles of nursing deans exist. Meleis argues this very point in the first part of the article. However, this assumption is not continued in the latter parts of the article. We have observed many different ways to enter, execute, and exit the role of dean of nursing in American universities. These differences are missing in this work, unless they are to be inferred as being “unhealthy” or “unsuccessful.” The question arises as to whether understanding the process of becoming a former dean is worthy of scholarly inquiry. We all go through many transitions in our lives. We are curious about why Meleis felt that leaving a dean position is worthy of such an article. While we have all felt honored to be in a leadership position, that position was not our entire lives. Change theory and human development theory are much more relevant to “undeaning” than creating five phases that provide little to understanding our unique experiences of change through life transitions. We would argue that this article be read as a case study rather than a theoretical piece. We would also argue that if proposed as a theoretical framework for characterizing a “healthy” or “successful” undeaning transition, scholars with expertise in the field need to conduct the investigations to support the propositions provided by Meleis. The undeaning transition: Toward becoming a former deanNursing OutlookVol. 64Issue 2PreviewStepping up from leadership is a protracted transition that involves a complex set of interactions with many constituents. It begins with making the personal decision to step up to integrating the role of the dean in existing repertoire of roles that the person enacts. Deliberate planning, awareness of phases, challenges, goals and strategies, clear communication, transparency, and supportive interactions enhance the potential of experiencing a smooth and a healthy transition for the dean who is stepping up, the incoming dean, and the organization. Full-Text PDF Response to letter to the editor regarding “undeaning” publicationNursing OutlookVol. 64Issue 5PreviewI want to thank my dean colleagues for taking the time to respond to my article, “The Undeaning Transition: Toward Becoming a Former Dean” from Volume 64, Issue 2 of Nursing Outlook. I have received many thoughtful comments about it via different media sources, but I particularly appreciate a letter to the editor as it promotes a more public dialogue. Full-Text PDF

The purpose of this article is to provide information about the efforts to educate faculty teaching in graduate programs about the Quality and Safety Education for Nurses (QSEN) competencies, provide examples of teaching strategies for each graduate competency, and finally provide information about the outcomes of the graduate-faculty QSEN project. Examples are given of the critical QSEN work that remains to be done to ensure that care for patients and communities is high quality, safe, and reliable.

Although nursing education pathways have expanded access to the profession, fragmentation accompanying these entry points has created uncertainty among students about the desired end point, questionable efficiency and effectiveness of reaching career goals, and unclear merging mechanisms to enable seamless, linear progression. In response to these challenges and in anticipation of greater demands on nurses due to health reform, the Institute of Medicine (IOM) examined the capacity of the nursing workforce and proposed a transformative blueprint for change that relies on an education system to promote seamless academic progression. Despite support for this recommendation, little research exists regarding the best way to achieve the IOM's vision. This study examined the most promising practices in design and implementation of alternative pathways for academic progression in nursing. Four case studies are presented that explore the challenges of designing alternative pathways and identify performance measures to assist with developing such programs.

The findings by Peterson et al. show that over half of all family physicians work with nurse practitioners, physician assistants, and certified nurse midwives. While tensions surrounding leadership of teams remain an issue, there are many systems problems that all primary care providers need to face together. This commentary presents the challenges we need to address in order to keep the focus of our care on the patient.

A series of regional Quality and Safety Education for Nurses (QSEN) Faculty Development Institutes were held in 2010 and 2011 to provide nursing faculty with strategies to integrate quality and safety content into their curricula. The interactive coursework focused on the 6 core QSEN competencies. Using a train-the-trainer approach, the QSEN Faculty Development Institute Directors enabled nursing faculty attendees to (a) lead their institution's faculty to incorporate quality and safety content into the curriculum for students; (b) teach and mentor students to deliver high quality and safe patient care; and (c) train other faculty to accomplish these goals. Over 1,100 nursing faculty from across the United States attended the institutes. All types of prelicensure programs were represented including diploma, associate, and baccalaureate degree. In a preinstitute survey, faculty identified multiple opportunities to improve the integration of quality and safety content into curricula including the need for specific content on quality improvement, teamwork and collaboration, and informatics and the need for interprofessional experiences and electronic health record access. Postinstitute evaluations indicated that participants found the content clear, specific, usable, and presented in a format that facilitated thought, reflection, and application. The regional institutes served as a very effective strategy for engaging large numbers of faculty across the country in the QSEN work and for disseminating vital tactics to improve the teaching of quality and safety content.

The findings by Peterson et al. show that over half of all family physicians work with nurse practitioners, physician assistants, and certified nurse midwives. While tensions surrounding leadership of teams remain an issue, there are many systems problems that all primary care providers need to face together. This commentary presents the challenges we need to address in order to keep the focus of our care on the patient.

Lewis Blackman was a 15-year-old boy who died 4 days after having surgery to correct a congenital deformity of the chest. The story of his death serves as a chilling reminder that quality and safety are not abstract ideals but rather tangible goals designed to prevent tragedies like the one experienced by Lewis Blackman's family. The authors sought to find an explanatory model for the events that transpired and posit that the answer lies at the intersection of several distinct yet interrelated phenomena: (a) the failure of dual process theory; (b) anchoring and belief perseverance; (c) the role of power and authority; and (d) the fragmented care delivery system in the hospital setting. To prevent similar tragedies in the future, the authors propose 5 strategies for nursing educators: incorporate "cognitive unmooring" questions into student assessments of patients; integrate information about System 1 and System 2 thinking into the didactic portion of the curriculum; include cases similar to Lewis Blackman's into simulation experiences; ensure that students learn how to recognize and address authority gradients with supervisors, physicians, and other members of the health care team; and provide students with experiences including the patient/family as members of the care team.

In 2004, The George Washington University received funding from the U.S. Department of Homeland Security to develop a web-based emergency preparedness course for nurses. The purpose of the course was to provide training that would be accessible regardless of work setting or location. In designing the course, the development team used algorithmic decision making as a conceptual framework to transcend the linear, didactic focus of traditional online preparedness training to provide learners with a learning experience crafted around the decision-making process. This article describes the design of the algorithmic practice maps underlying this course and provides a replicable structure for those interested in developing similar offerings for nurses.

We interviewed hospital leaders and unit nurses in twenty-five hospitals between June and October 2008 to explore the effect of performance-based incentives. Interviewees expressed favorable impressions of the impact that incentive policies have on quality and safety. However, they raised concerns about the policies’ effects on the nurse workforce. Their concerns included the belief that performance-based incentives would increase both the burden and the blame for nurses without corresponding improvements in staffing levels, work environment, salaries, or turnover. To maximize the intended policy impact without jeopardizing the workforce that holds the key to their adoption, we recommend that policy makers invest in implementation support, redesign hospital incentives to reward teamwork, and involve nursing leaders in the design of future incentive policies.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssueArchivesePub Ahead-of-Print Collections Acute/Critical CareContinuing EducationCOVID-19 Disaster and Emergency PreparednessEnvironmental Health and IssuesEthics Evidence-Based Practice, Step by StepFamily CaregiversFocus on DEIGeriatric NursingHolistic NursingIn The CommunityInfectious DiseaseInternational TopicsLegal ClinicMental HealthNurse WellbeingNursing Research, Step By StepNursing ResourcesPalliative CarePatient SafetyPolicy and PoliticsProfessional Development, Leadership and ScholarshipProfessional Partners Supporting Diverse Family Caregivers Across SettingsQI: Quality ImprovementResearchSocial Media and Information TechnologySpecial SupplementsStrip SavvySupporting Family Caregivers: No Longer Home AloneSystematic Reviews Step by StepTeaching For PracticeTransforming Care at the Bedside (TCAB)Uniforms (Nursing)Uniting States, Sharing StrategiesWomen's HealthWriting Resources Videos Videos WebinarsFor Authors Call for ManuscriptsSubmit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor PermissionsOpen AccessLippincott® Preprints Journal Info About the JournalAdvertising and BusinessAward WinnersBook of the Year AwardsContact InfoEditorial BoardInformation for FacultyInformation for MediaInformation for Peer ReviewersLetters to the EditorNurse Faculty Scholars / AJN Mentored Writing AwardReprintsRights and PermissionsSubscription ServicesNurses: Submit Your Photos! All Articles Images Videos Podcasts Blogs Advanced Search

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.

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.