Research Library

The research library contains a selection of research study articles that have been published in peer-reviewed journals for the purpose of advancing evidence-based regulation. The works listed here have been conducted by nurse educators, administrators, regulators and NCSBN staff. Find Research Briefs, NCLEX Practice Analyses and other published research in the Communications Library

 

Newly Licensed RN Retention

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Year
2017
Authors
Mary A. Blegen, PhD, RN, FAAN, Nancy Spector, PhD, RN, FAAN, Mary R. Lynn, PhD, RN, Jane Barnsteine, PhD, RN, FAAN, Beth T. Ulrich, EdD, RN, FAAN
Description

A Multisite Study on a New Graduate Registered Nurse Transition to Practice Program: Return on Investment

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Year
2017
Authors
Josephine H. Silvestre, MSN, RN, Beth T. Ulrich, EdD, RN, FACHE, FAAN, Tricia Johnson, PhD, Nancy Spector, PhD, RN, FAAN and Mary A. Blegen, PhD, RN, FAAN
Description

Do RNs in British Columbia Work Excessive Hours? A Registry Data Study

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Year
2017
Authors
Anne Logie, RN, MA, FRE and Jeanne Geiger-Brown, PhD, RN, FAAN
Description

Assessing Higher-Order Cognitive Constructs by Using an Information-Processing Framework

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Year
2016
Authors
Philip Dickison, PhD, Xiao Luo,PhD, Doyoung Kim, PhD, Ada Woo, PhD, William Muntean, PhD and Betty Bergstrom, PhD
Description

Using Response Time to Detect Item Preknowledge in Computer-Based Licensure Examinations

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Year
2016
Authors
Hong Qian, Dorota Staniewska, Mark Reckase, and Ada Woo, PhD
Description
This article addresses the issue of how to detect item preknowledge using item response time data in two computer-based large-scale licensure examinations. Item preknowledge is indicated by an unexpected short response time and a correct response. Two samples were used for detecting item preknowledge for each examination. The first sample was from the early stage of the operational test and was used for item calibration. The second sample was from the late stage of the operational test, which may feature item preknowledge. The purpose of this research was to explore whether there was evidence of item preknowledge and compromised items in the second sample using the parameters estimated from the first sample. The results showed that for one nonadaptive operational examination, two items (of 111) were potentially exposed, and two candidates (of 1,172) showed some indications of preknowledge on multiple items. For another licensure examination that featured computerized adaptive testing, there was no indication of item preknowledge or compromised items. Implications for detected aberrant examinees and compromised items are discussed in the article.

Canadian Nursing Supervisor's Perceptions of Monitoring Discipline Orders: Opportunities for Regulator-Employer Collaboration

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Year
2016
Authors
Farah Ismail, MScN, LLB, RN, FRE and Sean P. Clarke, PhD, RN, FAAN
Description

NCSBN Simulation Guidelines for Prelicensure Nursing Programs

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Year
2015
Authors
Maryann Alexander, PhD, RN, FAAN, Carol F. Durham, EdD, RN, ANEF, FAAN, Janice I. Hooper, PhD, RN, FRE, Pamela R. Jeffries, PhD, RN, FAAN, ANEF, Nathan Goldman, Suzan "Suzie" Kardong-Edgren, PhD, RN, ANEF, CHSE, Karen S. Kesten, DNP, APRN, CCRN, PCCN, CCNS, CNE, Nancy Spector, PhD, RN, FAAN, Elaine Tagliareni, EdD, RN, CNE, FAAN, Beth Radtke, and Crystal Tillman, DNP, RN, CPNP
Description
The National Council of State Boards of Nursing (NCSBN) published the results of the largest, most comprehensive study to date concerning the use of simulation as a substitute for traditional clinical experience. Results of the study, which were published in 2014, demonstrated that high-quality simulation experiences could be substituted for up to 50% of traditional clinical hours across the prelicensure nursing curriculum. An expert panel convened by NCSBN evaluated the data gathered through this study, examined previous research and the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice: SimulationSM, and used their collective knowledge to develop national simulation guidelines for prelicensure nursing programs. This article presents those guidelines, evidence to support the use of simulation, and information for faculty and program directors on preparation and planning for using simulation successfully in their nursing programs

Detecting Medication Order Discrepancies in Nursing Homes: How RNs and LPNs Differ

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Year
2015
Authors
Amy Vogelsmeier, PhD, RN, Allison Anbari, PhD(c), RN, Larry Ganong, PhD, Ruth A. Anderson, PhD, RN, FAAN, Lynda Oderda, PharmD, Amany Farag, PhD, RN, and Richard Madsen, PhD
Description

Developing a Multi-Regional Statewide Nursing Workforce Forecast Model Requires Innovation and Collaboration

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Year
2015
Authors
Cynthia Bienemy, PhD, RN
Description

Improving the Quality of Long-Term Care

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Year
2015
Authors
Josephine H. Silvestre, MSN, RN, Barbara J. Bowers, PhD, RN, FAAN, and Sue Gaard, MS, RN
Description
Many factors affect quality care in long-term care (LTC) settings. A supportive organizational culture, strong leadership, appropriate staff and staffing, and effective training and professional development of staff members are all fundamental elements necessary for influencing quality care in LTC settings. This article discusses challenging issues confronting LTC settings and provides strategies for managing the complexities of culture change, staffing, and education in LTC.

Perceptions of Nursing Practice: Capacity for High-Quality Nursing Home Care

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Year
2015
Authors
Kristen N. Corazzini, PhD, FGSA, Amy Vogelsmeier, PhD, RN, Eleanor S. McConnell, PhD, RN, GCNS-BS, Lisa Day, PhD, RN, CNE, Susan Kennerly, PhD, RN, Christine Mueller, PhD, RN, FAAN, FGSA, Jill T. Flanagan, MS, Karen Hawkins, BA, and Ruth A. Anderson, PhD, RN, FAAN
Description

Differentiating Scopes of Practice in Nursing Homes: Collaborating for Care

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Year
2015
Authors
Kristen N. Corazzini, PhD, FGSA, Eleanor S. McConnell, PhD, RN, GCNS-BC, Lisa Day, PhD, RN, CNE, Ruth A. Anderson, PhD, RN, FAAN, Christine Mueller, PhD, RN, FGSA, FAAN, Amy Vogelsmeier, PhD, RN, Susan Kennerly, PhD, RN, Bronda Walker, BSN, RN, Jill T. Flanagan, MS, and Maureen Haske-Palomino, MSN, GNP-BC
Description

Quality Care Outcomes in Nursing Homes: The Effects of a Nurse’s Country of Origin and Education

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Year
2015
Authors
Laura M. Wagner, PhD, RN, FAAN, Barbara L. Brush, PhD, ANP-BC, FAAN, John B. Engberg, PhD, Nicholas G. Castle, PhD, and Elizabeth Capezuti, PhD, RN, FAAN
Description

A Model for Advancing Professional Nursing Regulation: The African Health Profession Regulatory Collaborative

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Year
2015
Authors
Jessica M. Gross, MSN, MPH, Maureen Kelley, PhD, CNM, FACNM and Carey McCarthy, PhD, MPH, RN
Description

Transitioning the Virtual Nursing Care for School Children With Diabetes Study to a Sustainable Model of Nursing Care

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Year
2015
Authors
Linda Young, MS, RN, FRE, BC and Gloria Damgaard, MS, RN, FRE
Description

The National Council of State Boards of Nursing transition to practice study: Implications for educators

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Year
2015
Authors
Nancy Spector, PhD, RN, FAAN
Description
Citation
Spector, N. The National Council of State Boards of Nursing’s Transition to Practice Study: Implications for Educators. (2015). Editorial. J Nursing Education. 54(3);119-120.

Transition to Practice Study in Hospital Settings

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Year
2015
Authors
Nancy Spector, PhD, RN, FAAN, Mary A. Blegen, PhD, RN, FAAN, Josephine Silvestre, MSN, RN, Jane Barnsteiner, PhD, RN, FAAN, Mary R. Lynn, PhD, RN, FAAN, Beth Ulrich, EdD, RN, FACHE, FAAN, Lou Fogg, PhD, and Maryann Alexander, PhD, RN, FAAN 
Description
This multisite study of transition to practice included 105 hospitals in three states. Hospitals volunteered to participate and were randomly assigned to either the study group or the control group, and all new graduate registered nurses hired between July 1 and September 30, 2011, were invited to participate. The study hospitals adopted the National Council of State Boards of Nursing’s Transition to Practice model program; control hospitals continued using their existing onboarding programs, which ranged from simple orientation procedures to structured transition programs with preceptorships. The new graduate nurses who volunteered for the transition to practice study (n = 1,088) filled out surveys at baseline, 6, 9, and 12 months after beginning their first nursing position. Competence was reported by both the new nurses and their preceptors. New nurse self-reported data included the number of errors, safety practices, work stress, and job satisfaction. The hospitals provided retention data on the all the new graduates hired during the study period. Though the results showed few statistically significant differences between the two groups, when the hospitals in the control group were categorized as having established or limited programs, differences were detected. Hospitals using established programs had higher retention rates, and the nurses in these programs reported fewer patient care errors, employed fewer negative safety practices, and had higher competency levels, lower stress levels, and better job satisfaction. Structured transition programs that included at least six of the following elements were found to provide better support for newly graduated RNs: patient-centered care, communication and teamwork, quality improvement, evidence-based practice, informatics, safety, clinical reasoning, feedback, reflection, and specialty knowledge in an area of practice.
Citation
Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L., & Alexander, M. (2015). Transition to practice in hospital settings. Journal of Nursing Regulation, 5(4), 24-38.

Transition to Practice in Nonhospital Settings

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Year
2015
Authors
Nancy Spector, PhD, RN, FAAN, Mary A. Blegen, PhD, RN, FAAN, Josephine Silvestre, MSN, RN, Jane Barnsteiner, PhD, RN, FAAN, Mary R. Lynn, PhD, RN, FAAN, and Beth Ulrich, EdD, RN, FACHE, FAAN
Description

Faculty Development When Initiating Simulation Programs: Lessons Learned From the National Simulation Study

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Year
2015
Authors
Pamela R. Jeffries, PhD, RN, FAAN, ANEF, Kristina Thomas Dreifuerst, PhD, RN, CNE, ANEF, Suzie Kardon-Edgren, PhD, RN, ANEF, CHSE, and Jennifer Hayden, MSN, RN
Description
Nursing programs are seeking guidance from boards of nursing about how much simulation can be substituted for traditional clinical practice. To address this question and to assess educational outcomes when simulation is substituted for clinical time, the National Council of State Boards of Nursing (NCSBN) conducted a study using 10 nursing schools across the United States.This article focuses on the faculty development needed to maintain fidelity in the intervention, implementation, and evaluation processes of initiating simulation programs.

Preceptor Support in Hospital Transition to Practice Programs

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Year
2015
Authors
Mary A. Blegen, PhD, RN, FAAN, Nancy Spector, PhD, RN, FAAN, Beth T. Ulrich, EdD, RN, FAAN, Mary R. Lynn, PhD, RN, Jane Barnsteiner, PhD, RN, FAAN and Josephine Silvestre, MA, RN
Description

Comparing Medication Error Incidents Among Foreign-Educated Nurses and U.S.-Educated Nurses

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Year
2015
Authors
Jay J. Shen, PhD, Scott Neishi, MHA, Susan VanBeuge, DNP, APRN, FNP-BC, CNE, FAANP, Margaret Covelli, DNP, MHA, RN, Susan Adamek, MSN, RN, Janet Gallegos, CCRP, CCT, and Michelle Ricca Gardner, RN, MHA
Description

Simulation in Nursing Education: Current Regulations and Practices

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Year
2014
Authors
Jennifer K. Hayden, MSN, RN, Richard A. Smiley, MS, MA, and Lindsey Gross
Description
Regulators have been discussing the issue of allowing simulation to replace clinical time for years and are looking for evidence to guide their decision making. In anticipation of the National Council of State Boards of Nursing National Simulation Study results, a descriptive survey was conducted to document the current regulatory environment on simulation and serve as a benchmark for future regulatory comparisons. This article reports the results of the survey. 
Citation
Hayden, J.K., Smiley, R.A., & Gross, L. (2014). Simulation in nursing education: Current regulations and practices. Journal of Nursing Regulation, 5(2), 25-30.

RN-to-Population Ratio and Population Health: A Multifactorial Study

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Year
2014
Authors
Jeri L. Bigbee, PhD, RN, Sandra Evans, MA.Ed, RN, Bonnie Lind, PhD, Susan Perez, MPH, Lissette Jacobo, BS, & Estella M. Geraghty, MD, MS, MPH
Description
The purpose of this study was to explore the relationship between registered nurse (RN)-to-population ratio and population health indices. A cross-sectional secondary analysis of existing national data was conducted, using counties as the unit of analysis. Data based on 1,929,414 RNs in 33 states in 2012 were obtained from the National Council of State Boards of Nursing's Nursys® database, and county health data were obtained from 2,016 counties from the 2012 County Health Rankings database. Regression analysis indicated that the RN-to-population ratio along with nurse education (percentage of RNs with a BSN or higher degree) and experience (number of years since graduation) was significantly associated with the self-rated health (percentage of adults reporting fair or poor health), mammography screening rates, and teenage birth rates. The associations were all positive: Greater numbers of nurses per capita were associated with better population health indices. These results are consistent with the Nurse Dose concept and support the need for enhanced recognition and policy changes regarding the contribution of nurses to the health of the population. Implications for nursing regulation include the need for sustained and coordinated efforts to support the health of the population through the recruitment and maintenance of a well educated and experienced nursing workforce.
Citation
Bigbee, J.L., Evans, S., Lind, B., Perez, S., Jacobo, L., & Geraghty, E.M. (2014). RN-to-Population ratio and population health: A multifactorial study. Journal of Nursing Regulation, 5(1), 11-17.

Developing a Reporting and Tracking Tool for Nursing Student Errors and Near Misses

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Year
2014
Authors
Joanne Disch, PhD, RN, and Jane Barnsteiner, PhD, RN
Description
Little is known about the extent and types of errors and near misses (ENMs) made by nursing students. In nursing schools, the norm has been a culture of blame in which a student, a faculty member, or both are held accountable for ENMs regardless of the source. However, evidence suggests that a failure to track and trend ENMs and learn from them actually increases the likelihood of more ENMs. To help student nurses become competent nurses, educators need systems and structures that allow trending and analysis of ENMs. Key first steps include creating a mechanism for schools to use in reporting nursingstudent ENMs and creating a transparent and blame-free culture. In addition, it will be critical to establish a national database to reflect the occurrence and types of ENMs. The database will provide a baseline of information that will guide faculty members in designing interventions to reduce ENMs. This article describes the issues and challenges encountered in creating an occurrence reporting tool, testing the tool, and establishing a national database for tracking and trending ENMs encountered by nursing students. In addition, this article presents an adaptation of the tested occurrence reporting tool that schools can use while a national database is established.
Citation
Disch, J., & Barnsteiner, J. (2014). Developing a reporting and tracking tool for nursing student errors and near misses. Journal of Nursing Regulation, 5(1), 4-10. 

Introducing a New Competency Into Nursing Practice

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Year
2014
Authors
Kathleen A. Calzone, PhD, RN, Jean Jenkins, PhD, RN, Stacey Culp, PhD, Sarah Caskey, MS, & Laurie Badzek, LLM, JD, MS, RN
Description
As science advances, new competencies must be integrated into nursing practice to ensure the provision of safe, responsible, and accountable care. This article utilizes a model for integrating a new complex competency into nursing practice, using genomics as the exemplar competency. Nurses working at 23 Magnet® Recognition Program hospitals participated in a 1-year new competency integration effort. The aim of the study was to evaluate nursing workforce attitudes, receptivity, confidence, competency, knowledge, and practices regarding genomics. Results were analyzed using descriptive statistical techniques. Respondents were 7,798 licensed registered nurses. The majority (89%) said it was very or somewhat important for nurses to become more educated in the genetics of common diseases. Overall, the respondents felt genomics was important, but a genomic nursing competency deficit affecting all nurses regardless of academic preparation or role was observed. The study findings provide essential information to help guide the integration of a new competency into nursing practice.
Citation
Calzone, K.A., Jenkins, J., Culp, S., Caskey, S., & Badzek, L. (2014). Introducing a new competency into nursing practice.Journal of Nursing Regulation, 5(1), 40-47. 

Learning Nursing Practice: A Multisite, Multimethod Investigation of Clinical Education

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Year
2014
Authors
Angela M. McNelis, PhD, RN, Pamela M. Ironside, PhD, RN, Patricia R. Ebright, PhD, RN, Kristina T. Dreifuerst, PhD, RN, Sarah E. Zvonar, BSN, RN, & Susan C. Conner, BSN, RN
Description
Nurses agree that direct practice with actual patients is vital, but the teaching methodologies and faculty-student relationships that optimize students’ learning in clinical settings have not been documented. This study examined students’ thinking and their interactions with faculty during clinical experiences at three academic nursing programs. Findings suggest that missed opportunities for learning, inadequate measures for clinical progress and learning, and lack of interprofessional practice are failing to optimize student clinical learning experiences.
Citation
McNelis, A.M., Ironside, P.M., Ebright, P.R., Dreifuerst, K.T., Zvonar, S.E., & Conner, S.C. (2014). Learning nursing practice: A multisite, multimethod investigation of clinical education. Journal of Nursing Regulation, 4(4), 30-35. 

Virtual Nursing Care for School Children with Diabetes

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Year
2014
Authors
Gloria Damgaard, MS, RN & Linda Young, MS, RN
Description
Access to safe health care when a nurse is not present is a public protection issue facing many boards of nursing. This is especially true in schools where a nurse is not present to provide care for children with diabetes. This study examined the safety and effectiveness of a model of care that linked trained unlicensed school personnel to registered nurses (RNs) via telehealth technology to delegate and supervise diabetes care tasks, including insulin administration. The study took place from December 2010 to May 2013, and 5,568 doses of insulin were administered safely by unlicensed personnel. Surveys taken before and after implementation measured the perceptions of parents and school personnel regarding the safety and efficacy of the model of care. Statistical results showed large degrees of effectiveness. This study provides preliminary evidence supporting regulatory changes for the delegation of insulin administration and other diabetes care tasks by RNs.
Citation
Damgaard, G., & Young, L. (2014). Virtual nursing care for school children with diabetes. Journal of Nursing Regulation, 4(4), 15-24.

Preparation, Roles, and Perceived Effectiveness of Unlicensed Assistive Personnel

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Year
2013
Authors
Bonita Jenkins, EdD, RN and JoAnne Joyner, PhD, RN
Description
The use of unlicensed assistive personnel (UAP) in hospitals has increased over the last 20 years. In lieu of regulation of UAP by boards of nursing, many health care agencies and organizations have developed their own educational standards, role definitions, and scopes of practice for UAP in acute care. The purpose of this study was to explore how UAP are used in acute care settings and how their work is perceived by nurses who work with them and by themselves. The results of this mixed method design study showed many similarities among UAP titling; however, there were substantial variations in educational preparation and use of UAP, especially as they move into advanced or specialty areas. Nevertheless, both registered nurses and UAP perceive the work of UAP to be highly effective. Additional collaborative research by regulatory and health care agencies is recommended. This research should be used to inform the development of regulations for educational preparation and utilization of these providers.
Citation
Jenkins, B., & Joyner, J. (2013). Preparation, roles, and perceived effectiveness of unlicensed assistive personnel. Journal of Nursing Regulation, 4(3), 33-40.

Prelicensure RN Students With and Without Criminal Histories: A Comparative Analysis

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Year
2013
Authors
Danielle Smith, MSN, RN, Shana Corvers, PhD, William J. Wilson, MS, Dominique Douglas, MS, & Cynthia Bienemy, PhD, RN
Description
The purpose of this study was to determine whether certain key outcomes differ between preRN licensure students who have a criminal history and those who do not. Outcomes examined were program completion, NCLEX-RN ® passage, subsequent criminal acts, and subsequent professional misconduct. A retrospective descriptive-comparative research design was used. The sample consisted of 3,166 applicants from the 2006 cohort of preRN licensure students in Louisiana who met the criteria for inclusion in the study. Analysis of the data revealed 10% of participants with a criminal history had a subsequent criminal incident, whereas only 3.4% of the noncriminal history group had a subsequent criminal incident. Additionally, 4.5% of the criminal history group had subsequent professional misconduct compared with 1% of the noncriminal history group.
Citation
Smith, D., Corvers, S., Wilson, W.J., Douglas, D., & Bienemy, C. (2013). Prelicensure RN students with and without criminal histories: A comparative analysis. Journal of Nursing Regulation, 4(1), 34-38.

State Regulatory Oversight of Certified Nursing Assistants and Resident Outcomes

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Year
2013
Authors
Alison M. Trinkoff, ScD, RN, , Meg Johantgen, PhD, RN, Nancy Lerner, DNP, RN, Carla L. Storr, ScD, Kihye Han, PhD, RN, & Kathleen McElroy, MS, RN
Description
This study aimed to describe state regulatory certified nursing assistant (CNA) oversight in two domains—use of registry or licensing for credentialing and initial CNA training and continuing education (CE) requirements—and to evaluate whether CNA oversight is associated with resident outcomes in nursing homes. This cross-sectional secondary analysis combined 2004 data on state-level regulatory requirements for CNA oversight, training, and CE with nursing home resident outcomes data collected in 2004 from 16,125 U.S. facilities in 49 states. Though 26 states required CNAs to have more initial training hours than the federal requirement of 75 hours, only four states required additional yearly CE hours to maintain CNA certification. The combination of increased initial training and annual CE hours was significantly associated with nursing homes reporting lower antidepressant and antipsychotic use and lower average medication use. Use of a registry or licensing board for credentialing was significantly related to lower catheter use, and CNA licensure was significantly associated with lower odds of falls. Findings suggest that regulatory modifications could be beneficial to improve resident care outcomes in nursing homes.
Citation
Trinkoff, A.M., Johantgen, M., Lerner, N., Storr, C.L., Han, K., & McElroy, K. (2013). State regulatory oversight of certified nursing assistants and resident outcomes. Journal of Nursing Regulation, 3(4), 53-59. 

Foreign-Educated Nurses: Effects on Nurse, Quality of Care, and Patient-Safety-Indicator Outcomes

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Year
2013
Authors
Donna Felber Neff, PhD, RN, FNAP & Jeff Harman, PhD
Description
Approximately 8% of nurses in the United States were educated abroad, and in Florida and California, foreign-educated nurses (FENs) represent large percentages of the nurse labor force. It is important to know whether these nurses are prepared to care for patients who have complex needs; communicate successfully with other nurses, physicians, patients, and families; adapt to high technology in today's acute-care settings; and successfully transition to practice in the United States. It has been noted there is no comparative outcomes research on FENs and U.S.-educated nurses. The purpose of this study was to examine the effects of hospitals' proportions of FENs on nurse outcomes, hospital quality of care, perceptions of work environment, and patient-safety incidences.
Citation
Neff, D.F., & Harmon, J. (2013). Foreign-educated nurses: Effects on nurse, quality of care, and patient-safety-indicator outcomes. Journal of Nursing Regulation, 4(1), 19-24.

Highlights of the National Workforce Survey of Registered Nurses

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Year
2013
Authors
Jill S. Budden, PhD, Elizabeth H. Zhong, PhD, Patricia Moulton, PhD & Jeannie P. Cimiotti, DNSc, RN
Description
Over the past 3 decades the Health Resources and Services Administration has reported on the supply of registered nurses (RNs) through theNational Sample Survey of Registered Nurses (NSSRN). Data collection from the most recent, and final, NSSRN was completed in 2008; hence, there is no current data on the nationwide supply of RNs. This current project was conducted by the National Council of State Boards of Nursing and the Forum of State Nursing Workforce Centers to fill this ongoing need and is titled, The National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers 2013 National Workforce Survey of RNs. This article presents the highlights of the study and its results.
Citation
Budden, J., Zhong, E., Moulton, P., Cimiotti, J. (2013). Highlights of the national workforce survey of registered nurses. Journal of Nursing Regulation 4(2), 5-14.

A Multi-State Assessment of Employer-Sponsored Quality Improvement Education for Early-Career Registered Nurses

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Year
2013
Authors
Maja Djukic, Christine T. Kovner, Carol S. Brewer, Farida K. Fatehi, & Joanna R. Seltzer
Description
For RNs to participate effectively in hospital Quality Improvement, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 US states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Findings revealed the QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements.
Citation
Djukic, M., Kovner, C.T., Brewer, C.S., Fatehi, F.K., & Seltzer, J.R. (2013). A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses. Journal of Continuing Education in Nursing 44(1), 12-9.

Guidelines for Dual Certification in Acute-Care and Primary-Care Pediatric Nurse Practitioner Programs

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Year
2012
Authors
Elizabeth Hawkins-Walsh, PhD, CPNP-PC, Mary Berg, DNP, CPNP-PC, Michelle Beauchesne, DNSc, CPNP-PC, Nan Gaylord, PhD, CPNP-PC, Kristen Osborn, DNP(c), CPNP & Judy Verger, PhD, PNP BC & AC
Description
In increasing numbers, pediatric nurse practitioner (PNP) students seek educational programs that prepare them for dual certification in acute care and primary care. In 2008, an AFPNP research team of faculty experts was convened to examine areas of commonality and distinction between acute-care and primary-care PNP programs. Based on the results of surveys and interviews, an AFPNP task force created guidelines for combined educational programs that prepare students for dual certification as acute-care and primary-care PNPs.
Citation
Hawkins-Walsh, E., Berg, M., Beauchesne, M., Gaylord, N., Osborn, K., & Veger, J. (2011). Guidelines for dual certification in acute-care and primary-care pediatric nurse practitioner programs. Journal of Nursing Regulation 1(4), 1-4.

Measuring Post-Licensure Competence with Simulation: The Nursing Performance Profile

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Year
2012
Authors
Janine E. Hinton, PhD, RN, Mary Z. Mays, PhD, Debra Hagler, PhD, RN, Pamela Randolph, MS, RN, Ruth Brooks, MS, RN, Nick DeFalco, MSN, RN, Beatrice Kastenbaum, MSN, RN, Kathy Miller, MSN, RN & Dan Weberg, MHI, RN
Description
A valid, reliable practice assessment is needed to support intervention on the public's behalf when the pattern of a nurse's performance results in or is likely to result in patient harm. A collaborative multiagency research team developed and tested a criterion-referenced competency assessment process, using high-fidelity clinical simulation based on the Taxonomy of Error Root Cause Analysis and Practice Responsibility and the Clinical Competency Assessment of Newly Licensed Nurses. The 41-item instrument includes nine competency categories essential for safe practice. The instrument used with high-fidelity simulation testing shows promise as a reliable, valid method for identifying unsafe nursing practice.
Citation
Hinton, J.E., Mays, M.Z., Hagler, D., Randolph, P., Brooks, R., DeFalco, N., Kastenbaum, B., Miller, K., & Weberg,D. (2012). Measuring post-licensure competency with simulation: the nursing performance profile. Journal of Nursing Regulation 3(2), 45-53.

Licensed Nurse Responsibilities in Nursing Homes: A Scope-of-Practice Issue

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Year
2012
Authors
Christine Mueller, PhD, RN, Ruth A. Anderson, PhD, RN, Eleanor S. McConnell, PhD, RN & Kirsten Corazzini, PhD
Description
A mailed survey of licensed practical nurses (LPNs) employed in nursing homes in Minnesota and North Carolina examined their role and responsibilities as well as barriers to and facilitators for working within their scope of practice. The study focused on the nursing practice domains of assessment, care planning, evaluation, delegation, and supervision. BONs are encouraged to provide guidance to nurses and their nursing home employers who interpret RN and LPN scopes of practice as a means of promoting accountable, safe, quality care for nursing home residents.
Citation
Mueller, C., Anderson, R.A., McConnell, E.S., & Corazzini, K. (2012). Licensed nurse responsibilities in nursing homes: a scope-of-practice issue. Journal of Nursing Regulation, 3(1), 13-20.

Program Approval: Minnesota's Case for an Accreditation Requirement

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Year
2012
Authors
Ann Jones, PhD, RN, Jane Foote, MS, RN, & Sharon Ridgeway, PhD, RN
Description
Efforts to increase the number of accredited programs for practical nursing and associate-degree nursing and efforts to improve the BON rules for approving education programs led to a requirement that all programs in Minnesota must obtain national accreditation. This article describes the two distinct processes that produced this significant change.
Citation
Jones, A., Foote, J., & Ridgeway, S. (2012). Program approval: Minnesota's case for an accreditation requirement. Journal of Nursing Regulation, 2(4), 40-42.

Analyzing the Relationship Between Nursing Education and Patient Outcomes

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Year
2012
Authors
Dana Beth Weinberg, PhD, Dianne Cooney-Miner, PhD, RN, & Jennifer N. Perloff, PhD, MPA
Description
Hospital-based research links higher proportions of nurses with BSN degrees to lower patient mortality rates, but it does not explain the mechanism. This study explored mechanisms related to individuals and work groups that could explain the association between nurses' education and patient outcomes. Our findings suggest the need for a broadened regulatory focus that considers not only nurses' education but also the contribution of the work environment and interdisciplinary teams to the coproduction of high-quality safe care.
Citation
Weinberg, D.B., Cooney-Miner, D. & Perloff, J.N. (2012). Analyzing the relationship between nursing education and patient outcomes.Journal of Nursing Regulation, 3(3), 4-10.

The Initiative to Advance Innovations in Nursing Education: Three Years Later

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Year
2012
Authors
Nancy Spector, PhD, RN & Susan Odom, PhD, RN
Description
In 2009, the Innovations in Education Regulation Committee, convened by the NCSBN, worked collaboratively with other stakeholders to identify perceived and real barriers to innovation in nursing education and proposed model rules and statute language that boards of nursing could adapt to foster innovations in their state's nursing programs. The model language was unanimously adopted by NCSBN's Member Boards. Since then, NCSBN has conducted three surveys to determine the impact of NCSBN's initiative as well as the state of innovations in nursing education. Following a review of the committee's work, this article presents survey data on innovation in nursing education over the last 3 years.
Citation
Spector, N., & Odom, S. (2012). The initiative to advance innovations in nursing education: Three years later. Journal of Nursing Regulation, 3(2), 40-44.

Results of the National Council of State Boards of Nursing (NCSBN) National Simulation Survey: Part II

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Year
2012
Authors
Suzan Kardong-Edgren, PhD, RN, Janet Willhaus, MSN, RN, Deborah Bennett, MN, RN, & Jennifer Hayden, MSN, RN
Description
The purpose of this article is to report additional data gathered during the NCSBN 2010 nationwide simulation survey of 1,729 nursing programs in the US. It serves as a companion article to the initial survey data reported by Hayden in 2010.
Citation
Kardong-Edgren, S., Willhaus, J., Bennett, D., & Hayden, J. (2012). Results of the National Council of State Boards of Nursing (NCSBN) national simulation survey: Part II. Clinical Simulation in Nursing, 8(4), e117-e123.

Association Between Job History and Practice Error: An Analysis of Disciplinary Cases

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Year
2012
Authors
Elizabeth Zhong, PhD & Mary Beth Thomas, PhD, RN
Description
This study aimed to determine possible risk factors associated with error events or practice breakdowns for nurses that were reported to boards of nursing (BONs). We evaluated 861 cases submitted by BONs to the NCSBN’s Taxonomy of Error, Root Cause Analysis, and Practice-Responsibility database. Standard statistical analysis was used. A high percentage of nurses involved in practice breakdowns that were reported to BONs have a negative job history (discipline or termination for practice issues by their employers). Among the 725 nurses with complete job histories available, 60% (n = 437) had been disciplined or terminated by their employers in the past. A nurse's job history may serve as a useful index to identify a small group of nurses with a risk of being involved in a practice breakdown. In addition to conventional disciplinary actions, a tailored remediation program should be considered to prevent additional practice breakdowns.
Citation
Zhong, E.H., & Thomas, M.B. (2012). Association between job history and practice error: An analysis of disciplinary cases. Journal of Nursing Regulation, 2(4), 16-18.

Medication Aide Education, Supervision, and Work Role by Long-Term Care Setting

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Year
2012
Authors
Jill Budden, PhD
Description
Medication aides are unlicensed assistive personnel who administer medications. A survey was developed to provide insights into medication aide education, supervision, and work role. Items were derived by reviewing the literature and regulations. Data were analyzed by calculating percentages over all respondents, followed by breaking out data by type of work setting. In some cases, state regulations were incorporated to determine the percentage of responders who were performing tasks that regulations stated they should not perform. Study implications are discussed.
Citation
Budden, J. S. (2012). Medication aide education, supervision, and work role by long-term care setting. Geriatric Nursing, 33(6), 454-464.

Quality of Care and Patient Safety: The Evidence for Transition-to-Practice Programs

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Year
2011
Authors
Nancy Spector, PhD, RN & Josephine H. Silvestre, MSN, RN
Description
This article discusses the importance of developing a national, standardized program, implemented through regulation, for transitioning all newly licensed nursing graduates to practice. The background for establishing this evidence-based model in the context of today’s health-care arena is presented. A model for transition and the supporting evidence are described.
Citation
Spector, N., & Silvestre, J.H. (2011). Quality of care and patient safety: The evidence for transition-to-practice programs. In D. Molinari & A. Bushy (Eds.), Rural nurse: Transition to practice (35-46). New York: Springer.

Promoting and Regulating Safe Medication Administration in Nursing Homes

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Year
2011
Authors
Teresa Anderson, PhD, Carol A. Silveira, MS, RN, Rebecca Woodland, PhD, Steven Handler, PhD, MD & Michael Hutton, PhD
Description
The Massachusetts Board of Registration in Nursing and the University of Massachusetts Medical School Center for Health Policy and Research convened the Massachusetts Medication Safety Alliance, a 15-member collaborative of regulatory agencies and long-term care providers, to develop the Nurse-Employer Medication Safety Partnership Model to cultivate a safety culture in Massachusetts nursing homes that supports voluntary medication-event recognition and disclosure by nurses. To guide the model's development, the Alliance assessed the perceptions of 1,286 nurses working in 109 Massachusetts nursing homes, finding more than half rated their practice environment as punitive and identified fears of blame, disciplinary action, and lawsuits as barriers to medication-event reporting.
Citation
Anderson, T., Silveira, C.A., Woodland, R., Handler, S., & Hutton, M. (2011). Promoting and regulating safe medication administration in nursing homes. Journal of Nursing Regulation, 2(1), 56-61.

A Survey of Nurse Employers on the Professional and Practice Issues Affecting Nursing

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Year
2011
Authors
Jill Budden, PhD
Description
During 2009 and 2010, a survey was administered to hospital, home health, and nursing home nurse employers in the US to capture insights into the professional and practice issues affecting nursing. These key issues were identified: workforce, educational preparation, transition, and patient safety. The implications for regulators, researchers, educators, and employers are discussed.
Citation
Budden, J. S. (2011a). A survey of nurse employers on the professional and practice issues affecting nursing. Journal of Nursing Regulation, 1(4), 17-25.

The Safety and Regulation of Medication Aides

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Year
2011
Authors
Jill Budden, PhD
Description
A review of the literature on medication error rates among medication aides is presented, followed by an exploration of medication-aide regulations regarding oversight, applicant requirements, training, testing, continuing education, work setting and supervision, and role limitations. The results show the wide variability in the roles and regulations of medication aides. The issue of more uniformity in the regulation of medication aides is discussed.
Citation
Budden, J. S. (2011b). The safety and regulation of medication aides. Journal of Nursing Regulation, 2(2), 18-23.

The First National Survey of Medication Aides

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Year
2011
Authors
Jill Budden, PhD
Description
A survey was developed with the goal of providing insight into the work settings, education, supervision, and work roles of medication aides. Results of the survey and study implications are discussed.
Citation
Budden, J. S. (2011c). The first national survey of medication aides. Journal of Nursing Regulation, 2(3), 4-12.

Regulation of LPN Scope of Practice in Long-Term Care

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Year
2011
Authors
Kristen N. Corazzini, Ruth A. Anderson, Christine Mueller, Eleanor S. McConnell, Lawrence R. Landerman, Joshua M. Thorpe, & Nancy M. Short
Description
With changing staffing structures and persistent quality concerns in nursing homes, registered nurses are challenged to ensure that appropriate care is delivered. We describe differences in the nurse practice acts and related administrative code for all 50 states and DC for LPN delegation and supervision. Next, we explore relationships between these differences and quality measures from CMS for US nursing homes, using 2007 data. Findings indicate that how BONs regulate LPN scope of practice is directly related to care quality.
Citation
Corazzini, K.N., Anderson, R.A., Mueller, C., McConnell, E.S., Landerman, L.R., Thorpe, J.M., & Short, N.M. (2011). Regulation of LPN scope of practice in long-term care. Journal of Nursing Regulation 2(2), 30-36.

Linking Nursing Work Environment and Patient Outcomes

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Year
2011
Authors
Alison M. Trinkoff, ScD, RN, Meg Johantgen, PhD, RN, Carla L. Storr, ScD, Ayse P. Gurses, PhD, Yulan Liang, PhD & Kihye Han, MS, RN
Description
A cross-sectional secondary data analysis was conducted linking nursing work environment data from a 2004 survey of 633 nurses in 71 hospitals in North Carolina and Illinois to hospital-level patient outcomes data based on the Agency for Healthcare Research and Quality inpatient quality indicators and patient safety indicators. Nurses' job demands and schedules are associated with selected patient outcomes and should be considered as modifiable working conditions, along with staffing, to improve patient care.
Citation
Trinkoff, A.M., Johantgen, M., Storr, C.L., Gurses, A.P., Liang, Y., & Han, K. (2011). Linking nursing work environment and patient outcomes.Journal of Nursing Regulation, 2(1), 10-16.

Alabama Consumers' Views of Advanced Practice Registered Nurses

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Year
2011
Authors
Jean B. Lazarus, MSN, RN, Jerry J. Ingram, PhD, Kenneth W. Linna, PhD, & N. Genell Lee, JD, MSN, RN
Description
The primary purpose of boards of nursing is public protection, but few boards have conducted research with the public's input. This article provides results of a study conducted by the Alabama Board of Nursing regarding the views of 600 consumers on advanced practice registered nurses (APRNs). Less than 20% of participants knew the agency responsible for regulating APRNs, but the expectations for public safety were explicit regarding preparation for practice and competence.
Citation
Lazarus, J.B., Ingram, J.J., Linna, K.W., & Lee, N.G. (2011). Alabama consumers' views of advanced practice registered nurses. Journal of Nursing Regulation, 2(2), 24-29.

Graduate Nursing Programs for Non-Nurses: A National Perspective

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Year
2011
Authors
Judith Fitzgerald Miller, PhD, RN, & Karyn Holm, PhD, RN
Description
This study represents an initial attempt at exploring the characteristics of graduate programs in nursing for non-nurses (GPNNNs), their students, and real and potential regulatory concerns. The variability in the required number of credits alone is a prompt for educators to examine the most efficient path to a graduate degree for non-nurses. Further, those involved in the design, implementation, and regulation of these programs and the students need to consider the actual and potential regulatory issues that can surface when students without a nursing degree are permitted or required to take the NCLEX after completing pregraduate nursing courses.
Citation
Miller, J.F., & Holm, K. (2011). Graduate nursing programs for non-nurses: a national perspective. Journal of Nursing Regulation, 2(2), 4-9.

Nurse Practitioner Certification and Practice Settings: Implications for Education and Practice

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Year
2011
Authors
Vicki A. Keough, PhD, APRN-BC, Autumn Stevenson, Zoran Martinovich, PhD, Robert Young, MD, & Paula Tanabe, PhD, RN
Description
Nurse Practitioners (NPs) are certified within a population-focused specialty area, practice in a variety of settings, and treat a wide range of patients. Little is known about what agreement exists between certification obtained and actual site of practice. The purpose of this study was to examine NP practice sites as compared with their certification and examine additional education they received after employment.
Citation
Keough, V.A., Stevenson, A., Martinovich, Z., Young, R., & Tanabe, P. (2011). Nurse practitioner certification and practice settings: implications for education and practice. Journal of Nursing Scholarship, 43(2), 195-202.

Speak for Success: A Pilot Intervention Study on Communication Competence of Post-Hire International Nurses

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Year
2010
Authors
Yu Xu, PhD, RN, Anne L. Bolstad, BS, Jay Shen, PhD, Roseann Colosimo, PhD, RN, Margaret Covelli, MHA, RN, Miriam Torpey, MSN, RN, & Marcey Jorgenson,MSN, RN
Description
Speak for Success was a research study designed to test the effectiveness of an evidence-based, comprehensive communication training program for international nurses. This study indicated that a short-term linguistic intervention was effective in reducing phonologic errors of international nurses regardless of gender, age, country of origin, or length of residency in the US. Despite a tendency of improvement for some communication variables, differences in between-group and within-group comparisons were not significant.
Citation
Xu, Y., Bolstad, A.L., Shen, J., Colosimo, R., Covelli, M., Torpey, M., & Jorgenson, M. (2010). Speak for success: a pilot intervention study on communication competence of post-hire international nurses. Journal of Nursing Regulation, 1(2), 42-48.

Evidence-based Nursing Regulation: A Challenge for Regulators

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Year
2010
Authors
Nancy Spector, PhD, RN
Description
Learning objectives for this Continuing Education article: Describe evidence-based nursing regulation; Discuss the six steps of evidence-based nursing regulation; Identify at least three strategies for implementing evidence-based nursing regulation.
Citation
Spector, N. (2010). Evidence-based nursing regulation: A challenge for regulators. Journal of Nursing Regulation, 1(1), 30-36.

A Statewide Approach to a Just Culture for Patient Safety: The Missouri Story

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Year
2010
Authors
Rebecca Miller, MHA, CPHQ, FACHE, Scott Griffith, MS, & Amy Vogelsmeier, PhD, RN
Description
The Missouri Just Culture Collaborative brought together health-care providers, regulators, and other key stakeholders to learn and implement the principles of Just Culture. Under the leadership of the Missouri Center for Patient Safety, 67 health-care providers and regulatory agencies worked together to implement aspects of Just Culture. The collaborative led to an improved understanding between providers and regulators about barriers to implementing true Just Culture and how regulators can support provider efforts to improve the safety culture.
Citation
Miller, R., Griffith, S., & Vogelsmeier, A. (2010). A statewide approach to a just culture for patient safety: the Missouri story. Journal of Nursing Regulation, 1(1), 52-57.

Analyzing Nursing Regulation Worldwide

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Year
2010
Authors
Anne Morrison, MBA, RN & David C. Benton, MPhil, RGN, RMN
Description
Promoting clear communication and information sharing among nurse regulatory bodies is an essential step toward protecting patients worldwide. The research described in this article was intended to enhance global information sharing among nurse regulators, aid the development of a system that efficiently validates nurses' eligibility, and thus manage risk associated with increasing nurse migration, and allow recognition of best practices.
Citation
Morrison, A., & Benton, D. (2010). Analyzing nursing regulation worldwide. Journal of Nursing Regulation, 1(1), 44-47.

Using Multiple-Patient Simulation Experiences to Foster Clinical Judgment

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Year
2010
Authors
Pamela M. Ironside, PhD, RN & Pamela R. Jeffries, DNS, RN
Description
This multisite study examines the impact of multiple-patient simulation experiences on the development of students' abilities to make clinical judgments in evolving situations and the correlation between the design of the simulation and student outcome achievement in the final semester of their prelicensure nursing program.
Citation
Ironside, P.M., & Jeffries, P.R. (2010). Using multiple-patient simulation experiences to foster clinical judgment. Journal of Nursing Regulation, 1(2), 38-41.

Use of Simulation in Nursing Education: National Survey Results

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Year
2010
Authors
Jennifer Hayden, MSN, RN
Description
While simulation use in nursing programs continues to increase, it is important to understand the prevalence of this new technology in nursing education, how this technology is utilized, and how educators are preparing to teach with this educational tool. This article reports on the results of a survey conducted by NCSBN of 1,060 pre-licensure nursing programs in the US as a means of describing use of simulation.
Citation
Hayden, J. (2010). Use of simulation in nursing education: national survey results. Journal of Nursing Regulation, 1(3), 52-57.

Nurses' Competence Development During the First 5 Years of Practice

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Year
2010
Authors
Margaret H. Kearney, PhD, RN & Kevin Kenward, PhD, MA
Description
More than 2,000 practice anecdotes e-mailed by new nurses during their first 5 years of practice were analyzed to describe nurses’ definitions of competence and how it developed over time. Nurses defined competence as efficient care amid complex priorities; rapid response to subtle changes in patients’ conditions; seeing the big picture and working the system on patients’ behalf; interpersonal warmth, respect, and authority; and a committed desire to learn and improve. Support for development of these qualities may promote nursing care quality in high-acuity practice environments.
Citation
Kearney, M.H., & Kenward, K. (2010). Nurses’ competence development during the first 5 years of practice. Journal of Nursing Regulation, 1(1), 9-15.

A Regulatory Model on Transitioning Nurse from Education to Practice

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Year
2007
Authors
Nancy Spector, PhD, RN & Marcy Echternacht, MS, RN
Description
The NCSBN Board of Directors charged their Practice, Regulation, and Education Committee with developing a regulatory model for transitioning new nurses from education to practice. Because the mission of the BONs is to protect the public, they are responsible for ensuring that safe and competent nurses are entering the workforce. Therefore, the Board requested an evidence-based transition model that BONs could use as a resource for the transition issues that many states are facing.
Citation
Spector, N. & Echternacht, M. (2007). A regulatory model on transitioning nurse from education to practice. JONA’s Healthcare Law, Ethics, and Regulation, 9(1), 19-22.