A large healthcare system was challenged to develop a nursing professional practice model that would apply to and be understood by nurses at all levels and across all entities of the organization. A team was convened, composed of direct care nurses, educators, clinical nurse specialists, Magnet program directors, managers, and directors, representing 5 hospitals, the organization institute for nursing, and system support services. The group drafted a model describing nursing across the organization. The draft model was vetted in nursing governance councils across the entity. The model includes a theoretical framework; a mission, vision, and values; elements of professional practice; internal accountabilities; and nursing outcomes. Nurses learned about the model through Web-based and face-to-face training, through participation in a professional practice model blog and group discussions.
Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome.
School health is a specialty practice of nursing positioned at the intersection of public health and population health. This article discusses the redesign of a program's curriculum with the hope of advancing and elevating the practice of school nursing. The redesign is based on NASN's Framework for 21st Century School Nursing Practice and is the result of a New Jersey Nursing Initiative grant awarded to a trio of adjunct faculty from Rutgers University Camden in July 2016.
The July 2018 issue of the NASN School Nurse, featured the first in a series of articles exploring the history, examining the present, and visioning the future of our organization in celebration of NASN's 50th anniversary. Part 2 of our historical account reflects on the leadership of a new generation of clinicians, reviewing the major emphases and accomplishments of NASN presidents serving from 1993 to today.
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