Evaluation of a six-week professional education curriculum designed to retain registered psychiatric nurses

During the past few years there has been a drastic shortage of registered nurses in the field. The shortage appears to have affected the field of psychiatric mental health nursing most intensely. The psychiatric nursing shortage is a multifaceted problem grounded in decreasing federal funds for advanced clinical training, inadequate undergraduate psychiatric experiences, lack of a well prepared articulate role model, the integrated curriculum and the confusion and blurring associated with the roles and functions of the psychiatric mental health nurse.^ This dissertation will describe the current nursing shortage; the decline in enrollment to nursing programs; the history of psychiatric nursing as a discipline; the shortage of psychiatric mental health nurses; factors contributing to the psychiatric nursing shortage and a plan for a solution to the nursing shortage in psychiatry.^ The paper focuses on an evaluation conducted on an internship curriculum designed to facilitate effective nursing care in the treatment of clients who exhibit emotional problems. The purpose of this study was to attract and retain nurses to employment opportunities in four Hospital Corporation of America (HCA) facilities, using a six week internship program.^ The study will yield an analysis of the effect of combining psychodynamic principles and knowledge with skills in the clinical area. The demands of educational practice have been merged with the discipline of psychiatric nursing in the development of this curriculum. ^

A study of state and trait anxiety and perceived causes of anxiety identified by licensed practical nurses returning to an associate degree nursing program

The purpose of this study was to identify the state and trait anxiety and the perceived causes of anxiety in licensed practical nurses (LPNs) returning to an associate degree nursing program in order to become registered nurses (RNs). The subjects for this study were 98 students enrolled in a transitional LPN/RN associate degree nursing program in two community colleges in the state of Florida. The State-Trait Anxiety Inventory (STAI) developed by Spielberger (1983), was used as the measuring instrument for this study.^ In addition, a Q-sort technique was used to obtain information from the subjects regarding perceived causes of anxiety. Anxiety causes for the Q-sort cards used in the study were developed from the themes identified by a sample of LPN/RN students in a pilot study. The state and trait anxiety levels were obtained using the STAI for college students scoring key and scales. Descriptive statistics were used to determine the state and trait anxiety of the students. Correlational statistics were used to determine if relationships existed between the state and trait anxiety levels and perceived causes of anxiety identified by LPN students returning to an associate degree nursing program.^ The analysis of the Q-sort was performed by computing the means, standard deviations, and frequencies of each cause. The mean trait anxiety level of the students was 57.56, $SD=29.69.$ The mean state anxiety level of the students was 68.21, $SD=25.78.$ Higher percentile scores of trait anxiety were associated with higher ranks of the Q-sort category, "failing out of the program," $\rm r\sb{s}=.27,\ p=.008.$ Implications for future nursing research and application of the findings to nursing education are presented. ^

Performance accountability in the federal-state transportation program: Factors affecting successful implementation

Governmental accountability is the requirement of government entities to be accountable to the citizenry in order to justify the raising and expenditure of public resources. The concept of service efforts and accomplishments measurement for government programs was introduced by the Governmental Accounting Standards Board (GASB) in Service Efforts and Accomplishments Reporting: Its Time Has Come (1990). This research tested the feasibility of implementing the concept for the Federal-aid highway construction program and identified factors affecting implementation with a case study of the District of Columbia. Changes in condition and performance ratings for specific highway segments in 15 projects, before and after construction expenditures, were evaluated using data provided by the Federal Highway Administration. The results of the evaluation indicated difficulty in drawing conclusions on the state program performance, as a whole. The state program reflects problems within the Federally administered program that severely limit implementation of outcome-oriented performance measurement. Major problems identified with data acquisition are: data reliability, availability, compatibility and consistency among states. Other significant factors affecting implementation are institutional barriers and political barriers. Institutional issues in the Federal Highway Administration include the lack of integration of the fiscal project specific database with the Highway Performance Monitoring System database. The Federal Highway Administration has the ability to resolve both of the data problems, however interviews with key Federal informants indicate this will not occur without external directives and changes to the Federal “stewardship” approach to program administration. ^ The findings indicate many issues must be resolved for successful implementation of outcome-oriented performance measures in the Federal-aid construction program. The issues are organizational and political in nature, however in the current environment resolution is possible. Additional research is desirable and would be useful in overcoming the obstacles to successful implementation. ^