The role of a nursing home administrator's education in influencing quality of care in US nursing homes

Nursing home literature links poor management practices to poor quality of care and resident outcomes. Since Nursing Home Administrators (NHAs) require an array of skills to perform their role, it is important to explore what makes a NHA effective. This research fills a gap in the literature and provides a possible option to improve the quality of care in nursing homes. Purpose of the study. The study examines whether NHAs with advanced education (defined as a Masters degree or more) are associated with better quality of care in licensed nursing homes (NHs). Design and Methods. Data was derived from the CDC’s 2004 National Nursing Home Survey, which is a representative sample of NHs across the US. A Donabedian- inspired structure-process-outcomes study model was created to explain how education relates to quality of care. Quality of care was defined as onsite oral care, employee influenza vaccination rates and staff recognition programs. Statistical analyses included multivariate logistic regression; covariates included facility-level variables used in similar peer-reviewed research but also included select measures from the Area Resource File to control for county-level factors. Results. Descriptive and analytical analyses confirm that NHAs with a Bachelor’s degree, Associate degree or high school diploma perform less well than NHAs with a Masters degree or more. NHAs with advanced education are more likely to have onsite dental care and recognition programs for staff than NHAs with a Bachelor’s degree (or less). Also NHAs with less than graduate education are more likely to provide off-site dental care. Employee vaccination rates are not impacted by education. Adding certification, tenure or years of experience to a NHA with advanced education gives them an advantage. In fact, certification and experience alone do not have a positive relationship to care indicators; however adding these to advanced education produces a significant result. Implications. This research provides preliminary evidence that advanced education for the NHA is associated with better quality of care. If future research can confirm these findings, there is merit in revisiting the qualifications. Education can be a legitimate option to support quality improvement efforts in US nursing homes. ^

The Role of the Clinical Educator in Evaluating Nursing Competency

INTRODUCTION: Evaluation of nursing competency is critical to assuring patient safety and maintaining high professional standards in the practice of nursing. All nurses must graduate from an approved nursing program and successfully pass the national board exam before receiving initial licensure. State boards of nursing fulfill the role of gatekeeper, seeking to assure the public that nurses provide safe, competent care. In turn, high public awareness and patient advocacy initiatives require close monitoring of nursing competency. [See PDF for complete abstract]

The organizations transcomplejas from the perspective of the nursing

El propósito del artículo es el análisis de las organizaciones transcomplejas desde la perspectiva de la Enfermería, en el contexto del paradigma de la complejidad. Todos los cuestionamientos realizados a las ciencias de la modernidad fueron necesarios para dar al mundo desarrollos de enorme significación, como es el paradigma de la complejidad donde se rescata la idea de la totalidad universal y con ella el holismo dentro de las organizaciones, si se consideran estas como organismos vivo; y este aplicado al campo de la salud donde los profesionales del cuidado de la salud entre ellos la enfermería ha aceptado la perspectiva de salud holística como, más que la ausencia de enfermedad, como la realización individual. La humanidad vive una crisis de fragmentación que conduce a sentimientos y emociones destructivas de la armonía y del arte de vivir en equilibrio. La perspectiva holistica se preocupa de promover la salud mediante la prevención y se aplica a las personas que se recuperan de una enfermedad y desean aprender a prevenir su repetición y mejorar su estatus de salud futura. Así, la enfermería estudia la totalidad o la salud de los humanos, reconociendo que los humanos están en continua interacción con su medio ambiente

Oxytocin is required for nursing but is not essential for parturition or reproductive behavior.

Oxytocin, a neurohypophyseal hormone, has been traditionally considered essential for mammalian reproduction. In addition to uterine contractions during labor and milk ejection during nursing, oxytocin has been implicated in anterior pituitary function, paracrine effects in the testis and ovary and the neural control of maternal and sexual behaviors. To determine the essential role(s) of oxytocin in mammalian reproductive function, mice deficient in oxytocin have been generated using embryonic stem cell technology. A deletion of exon 1 encoding the oxytocin peptide was generated in embryonic stem cells at a high frequency and was successfully transmitted in the germ line. Southern blot analysis of genomic DNA from homozygote offspring and in situ hybridization with an exonic probe 3' of the deletion failed to detect any oxytocin or neurophysin sequences, respectively, confirming that the mutation was a null mutation. Mice lacking oxytocin are both viable and fertile. Males do not have any reproductive behavioral or functional defects in the absence of oxytocin. Similarly, females lacking oxytocin have no obvious deficits in fertility or reproduction, including gestation and parturition. However, although oxytocin-deficient females demonstrate normal maternal behavior, all offspring die shortly after birth because of the dam's inability to nurse. Postpartum injections of oxytocin to the oxytocin deficient mothers restore milk ejection and rescue the offspring. Thus, despite the multiple reproductive activities that have been attributed to oxytocin, oxytocin plays an essential role only in milk ejection in the mouse.

Simultaneous implementation of the Bachelor, Masters and PhD degrees in nursing in the Universidad Jaume I. Castellón de la Plana, Spain

We present an experience in Nursing Education, accredited and implemented under the Spanish University System Reform in a Public University (Jaume I, Castellón) which had no previous nursing studies. The academics offered included all three educational levels (Bachelor, Master's and Doctorate), with an integrated theoretical-practical-clinical teaching methodology for the Bachelor Degree, competence acquisition in research in the Master's degree, and a doctorate formed by lines of research in the field of Nursing. Studies are accredited by the National Agency for Quality Assessment, which were authorized by the Spanish Ministry of Education and implanted between 2009 and 2011.

Mentors’ implication in clinical learning and assessment of nursing students

Nursing Education in Europe is regulated by law from 2005. Clinical learning comprises at least 50% of the total degree program in nursing. It is necessary rely on professionals nurses involved in the learning process and skills development assessment. The level of implication in learning processes of these professional nurses is very important to ensure good results.

The nurses´ experience on nursing students and their clinical learning process in hospital

Nursing studies program, and relationships between University academic program and Hospitals, all influence bedsides nurses´ experience on nursing clinical learning process.

Integrating Evidence-Based Practice in the Training Programme Bachelor’s Degree in Nursing, University Jaume I

The Evidence-Based Practice (EBP) aims to combine a form methodological process of professional experience in health with the most current information on the clinical situation. The professional novice can make better decisions despite lacking sufficient years in clinical practice. We then train the student in correct habits within the methodological process by which you can strengthen both their knowledge and their attitude and ability, allowing secure customs, where all of your work is based on PBE.

Level of involvement of clinical nurses in the evaluation of competence of nursing students

Objective. To determine the level of involvement of clinical nurses accredited by the Universitat Jaume I (Spain) as mentors of practice (Reference Nurses) in the evaluation of competence of nursing students. Methodolgy. Cross-sectional study, in which the “Clinical Practice Assessment Manual” (CPAM) reported by reference 41 nurses (n=55) were analyzed. Four quality criteria for completion were established: with information at least 80% of the required data, the presence of the signature and final grade in the right place. Verification of learning activities was also conducted. Data collection was performed concurrently reference for nurses and teachers of the subjects in the formative evaluations of clinical clerkship period in the matter “Nursing Care in Healthcare Processes “, from March to June 2013. Results. 63% of CPAM were completed correctly, without reaching the quality threshold established (80%). The absence of the signature is the main criteria of incorrect completion (21%). Nine learning activities do not meet the quality threshold set (80%) (p < 0.05). There are significant differences according to clinical units p < 0.05. From the 30 learning activities evaluated in the CPAM, it can be stated that nine of them do not reach the verification threshold established (80%), therefore it cannot be assumed that these activities had been completed by students and evaluated by the RefN throughout the clinical clerkship period. Conclusion. The level of involvement of Reference Nurse cannot be considered adequate, although strategies to encourage involvement through collaboration and training must be developed.

An electronic record system in nursing education: evaluation and utilization

The main objective of the present work is to analyze the results of the utilization and evaluation of the LORETO Record System (LRS), providing improvement areas in the teaching-learning process and technology, in second year nursing students. A descriptive, prospective, cross sectional study using inferential statics has been carried out on all electronic records reported by 55 nursing students during clinical internships (April 1º-June 26º, 2013). Electronic record average rated 7.22 points (s=0.6; CV=0.083), with differences based on the clinical practice units (p<0,05). Three items assessed did not exceed the quality threshold set at 0.7 (p<0.05). Record Rate exceeds the quality threshold set at 80% for the overall sample, with differences based on the practice units. Only two clinical practice units rated above the minimum threshold (p <0.05). Record of care provision every 3 days did not reach the estimated quality threshold (p <0.05). There is a dichotomy between qualitative and quantitative results of LRS. Improvement areas in theoretical education have been identified. The LRS seems an appropriate learning and assessment tool, although the development of a new APP version and the application of principles of gamification should be explored.