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The gap between a new registered nurse graduate's education for practice and actual practice requirements of new registered nurses has long been an accepted fact in nursing. This article describes the development of an intervention from the academic side of the gap to improve the competency of nursing students before graduation. The intervention is noteworthy because it was developed collaboratively between academia and practice. The three-pronged intervention included development of learning modules based on the top 10 high-risk, high-volume patient conditions; faculty and staff educator development in learning strategies to enhance competency development; and sharing of products with the 84 schools of nursing in Texas.

Older adults use more prescription and OTC medications than any other age group. Because their medication regimens often are complicated by many medications and different doses, times, and administration methods, older adults are at high risk for medication mismanagement. The most common errors associated with medication mismanagement include mixing OTC and prescription medications, discontinuing prescriptions, taking wrong dosages, using incorrect techniques, and consuming inappropriate foods with specific medications. Both human and environmental factors contribute to medication mismanagement among older adults. Human factors include faulty communication between the health care provider and the patient; the patient's lack of knowledge; ADRs; alcohol-drug interactions; use of OTC medications and herbal products; cognitive, sensory, and motor impairments; and polypharmacy. Environmental factors include high cost of prescribed medications, improper medication storage, and absence of clearly marked expiration dates. Nurses need to take advantage of both formal and informal teaching opportunities in all settings to prepare a patient for medication self-management. Teaching should be individualized and based on a thorough assessment of the patient's abilities to administer medication safely and the specific medication regimen. By involving older adults as active partners in their health care, many errors and medication-related health problems can be prevented. New technologies and devices have the potential for improving the patient's self-management of medications. The role of nurses in educating older adults and their families about proper medication management is vital.

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Assessing urban Native American (NA) parenting remains a challenge for public health nurses. This study explored the effectiveness of using the NCATS and HOME instruments with urban NA mothers and their children. Scores for 63 sets of mothers and their children age 3 months to 3 years on the home observation for measurement of the environment (HOME) and nursing child assessment teaching scale (NCATS) instruments were compared with norms for those instruments. Scores were lower than the norms on the play and involvement subscales of the HOME, and higher than the norms on the total parent, clarity of cues, response to parent, and total child subscales of the NCATS. Analysis of responses to specific items indicated that these mothers were unlikely to structure and intervene in children's activities and likely to use nonverbal parenting techniques. Findings supported the usefulness of these instruments with NA parents when accompanied by discussion of findings with them, and nurse awareness of common family structures and traditional values.