William Beaumont Army Medical Center conducted quantitative modeling with FluSurge 2.0 (Centers for Disease Control and Prevention) to determine hospital capabilities in responding to patient arrival surges of the Fort Bliss population in mild 1968-type and severe 1918-type influenza pandemics. Model predictions showed that William Beaumont Army Medical Center could adequately care for all intensive care unit (ICU) and non-ICU patients during a mild pandemic, particularly if hospital capacity was expanded using the emergency management plan, excess surge plan, or activation of a contagious disease outbreak facility. For a severe influenza pandemic, model predictions showed that hospital beds, ventilators, and other resources would be exceeded within 2 or 3 weeks. Even at maximal hospital expansion, for a 12-week severe pandemic with a 35% attack rate there would be peak demand for 214% of available non-ICU beds, 785% of ICU beds, and 392% of ventilators. Health care planners and decision-makers should prepare for resource challenges when developing plans for the next influenza pandemic.

Purpose-Integrated transitions of care for rural older persons are key issues in policy and practice. Interdisciplinary partnerships are suggested as ways to improve rural-care transitions by blending complementary skills of disciplines to increase care's holistic nature. Yet, only multidisciplinary efforts are frequently used in practice and often lack synergy and collaboration. The purpose of this paper is to present a case of a partnership model using nursing, gerontology and public health integration to support rural-residing elders as a part of building an Adult-Gerontology Acute Care Nurse Practitioner program. Design/methodology/approach-This paper uses the Centre for Ageing Research and Development in Ireland/O'Sullivan framework to examine the creation of an interdisciplinary team. Two examples of interdisciplinary work are discussed. They are the creation of an interdisciplinary public health course and its team-based on-campus live simulations with a panel and site visit. Findings-With team-building successes and challenges, outcomes show the need for knowledge exchange among practitioners to enhance population-centered and person-centered care to improve health care services to older persons in rural areas. Practical implications-There is a need to educate providers about the importance of developing interdisciplinary partnerships. Educational programming illustrates ways to move team building through the interdisciplinary continuum. Dependent upon the needs of the community, other similarly integrated partnership models can be developed. Originality/value-Transitions of care work for older people tends to be multi-or cross-disciplinary. A model for interdisciplinary training of gerontological practitioners in rural and frontier settings broadens the scope of care and improves the health of the rural older persons served.

Objective: The purpose of the study was to explore student and faculty perspectives regarding what constitutes incivility in the online learning environment (OLE). Online learning is increasingly prevalent in nursing education. Scant research describes characteristics of OLEs contributing to, or inhibiting, learning or affecting civility among learners/faculty. Educators must effectively manage uncivil behavior to reduce incivility in learning and work environments. Attribution theory is helpful in examining issues related to incivility. Methods and Results: Faculty (n = 34) and students (n = 44) reported perceptions of what constitutes incivility via an online survey, the Incivility in the Online Learning Environment (IOLE), an instrument described by Clark and colleagues. The groups reported somewhat different perceptions of the extent of incivility experienced but agreed on identification of uncivil behaviors. Both groups agreed that rude comments and name calling were definitely uncivil, however, several areas of disagreement existed between faculty and student groups as to other types of behaviors. For example, lack of timely feedback on assignments and an unclear syllabus were seen as incivility by students. High internal consistency (Cronbach's alpha of .98 on the faculty scale, and .96 on the student scale) was obtained for the IOLE in this sample. Qualitative comments regarding suggested ways to promote civility were similar from both groups, including role modeling and penalizing incivility; students emphasize the need for clearly stated course requirements. Conclusions: Best practices are essential for developing/delivering online courses and in orienting faculty and students regarding expectations for professional behavior online. Faculty development should focus on using best practices to ensure online courses incorporate essential components enabling accessibility and efficiency for students navigating through them. Attention to this unique and increasingly typical learning environment is essential to the goal of prevention of incivility in both learning environments and subsequently in workplaces.

Healthcare resources are stretched perilously thin and the demand for primary healthcare services has never been greater. Despite this demand for service, relatively little is known about the practice environment of primary healthcare providers, particularly certified nurse-midwives (CNMs), where workforce surveys frequently include these specialists within the broader nurse practitioner category. A distinct professional discipline, nurse-midwives are one type of primary care provider recommended to enhance access to services. The objective of this study was to understand the nature of the nurse-midwifery practice environment in the state of Colorado. Online survey of Colorado CNMs (N = 328) found little ethnic/racial diversity and an aging workforce, with most providing care in an urban, hospital/medical center environment. Several key legislative issues were identified though respondents felt ill prepared to engage in legislative change. Overall, CNMs were optimistic about the future of midwifery and were largely satisfied with their practice.

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