: The competing demands of caring for high-acuity patients, reducing health care costs, and improving access to specialty care are complex challenges facing all health care providers. One approach-empowering nurses to expand their scope of practice-has been successfully employed for two decades by the nurse and physician leadership of a neurology department in an urban academic medical center. This article discusses the department's implementation of a quality improvement initiative to enhance access to neurology services in an ambulatory clinic by extending nursing practice to include lumbar puncture. Outcomes data from 2005 to 2016 demonstrate that through the department's comprehensive instructional program, RNs have competently and safely acquired new skills that have led to an expansion of their traditional roles, improved patient access to specialty care, and reduced costs.
The rise in childhood obesity has led policymakers to target schools and school districts to take a leadership role in addressing this epidemic. As such, teachers must be prepared to address the complex nature of childhood obesity through nutrition and health education. This paper outlines how teachers have the potential to be agents of change in schools thereby creating a culture of health within the school environment. Through professional development workshops and employee wellness programs, teachers have the opportunity to learn the knowledge and skills needed to promote health resulting in teachers being role models of healthy behaviors and integrating health concepts into daily instruction. The purpose of this study was to assess the beliefs and self-efficacy of classroom teachers before and after a professional development program focused on aligning nutrition lessons with district learning standards in an urban middle school. The school faculty was exposed to a minimal intervention designed to align nutrition and health standards to core curriculum learning standards. As a result of this program, teachers showed significant changes in their beliefs in the intersection of health and learning and improved their self-efficacy for delivering health and nutrition education aligned to existing learning standards. This project presents the promise that teachers can develop the confidence and conviction to include health across the curriculum and positively impact student and teacher health outcomes.
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