Nursing Outlook RSS feed: Articles in Press. Nursing Outlook , a bi-monthly journal, provides innovative ideas for nursing leaders through peer-reviewed articles and timely reports. Each issue examines current issues and trends in nursing practice, education and research, offering progressive solutions to the challenges facing the profession. Nursing Outlook is the official journal of the American Academy of Nursing and supports it mission to serve the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The journal is included in MEDLINE, CINAHL and the Journal Citation Reports published by Thomson Reuters. http://www.nursingoutlook.org//inpress?rss=yesElsevier Inc.en © 2012 Elsevier Inc. All rights reserved. Nursing Outlook0029-65542012-01-19 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.nursingoutlook.org/article/PIIS0029655411003563/abstract?rss=yesAbstract: Behavior change interventions to promote colorectal cancer (CRC) screening have targeted people in community and primary care settings, health care providers, and health systems. Randomized controlled trials provide the strongest evidence of intervention efficacy. The purpose of this integrative review was to evaluate trials of CRC screening interventions published between 1997 and 2007 and to identify knowledge gaps and future directions for research. Thirty-three randomized trials that met inclusion criteria were evaluated using a modified version of the TREND criteria. Significant intervention effects were reported in 6 of 10 trials focused on increasing fecal occult blood testing, 4 of 7 trials focused on sigmoidoscopy or colonoscopy completion, and 9 of 16 trials focused on completion of any screening test. Several effective interventions to promote CRC screening were identified. Future trials need to use theory to guide interventions, examine moderators and mediators, consistently report results, and use comparable outcome measures.Interventions to promote colorectal cancer screening: An integrative review - Corrected ProofSusan M. Rawl, Usha Menon, Allison Burness, Erica S. Breslau10.1016/j.outlook.2011.11.003Nursing Outlook (2012)2012-01-19Nursing Outlook2012-01-19http://www.nursingoutlook.org/article/PIIS0029655411003575/abstract?rss=yesAbstract: Social justice is asserted as a responsibility of the nursing profession. However, a reliable conception of social justice that can undergird practice, research, education, and policy endeavors has proved elusive. We discuss this as a problem for the profession and propose Powers and Faden’s model of social justice as useful for nursing purposes because of its focus on exploring and rectifying underlying causes of injustice as they lie within the fabric of society. Their model asserts 6 essential dimensions of well-being as universal human needs. These dimensions are interrelated and nonhierarchical. A serious deficiency in any one affects other dimensions and interferes with the ability to experience “a minimally decent life.”9 The model is applied to the problem of child abuse and the effects of its aftermath on well-being as an example of its potential for structuring nursing knowledge development, practice, and policy initiatives.Nursing responsibilities and social justice: An analysis in support of disciplinary goals - Corrected ProofPamela J. Grace, Danny G. Willis10.1016/j.outlook.2011.11.004Nursing Outlook (2012)2012-01-19Nursing Outlook2012-01-19http://www.nursingoutlook.org/article/PIIS0029655411003599/abstract?rss=yesAbstract: Background: Nursing is the largest health care profession, and Institute of Medicine (IOM) nurse members have the potential to contribute to health policy through IOM activities. We studied reported activities of IOM nurse members.Purpose: To describe activities of IOM nurse members within the IOM.Method: An e-mail survey was conducted that asked nurse IOM members to assess self-reported IOM activities. Of 57 members, 47 had functioning e-mail addresses, and 33 usable responses were received. The survey consisted of 9 questions dealing with roles and responsibilities undertaken in the previous 5 years. Data analyses were descriptive.Discussion: The data suggest that nurses have made considerable contributions to the IOM and their participation seems to be as high, or higher, than other disciplines.Conclusions: In an era of health care reform, there is additional opportunity for nurse IOM members to enhance their work in the IOM.Nurse IOM members’ contributions to the Institute of Medicine - Corrected ProofMargaret Grey, William L. Holzemer, Elaine Larson10.1016/j.outlook.2011.11.006Nursing Outlook (2012)2012-01-19Nursing Outlook2012-01-19http://www.nursingoutlook.org/article/PIIS0029655411003927/abstract?rss=yesNearly 18 months after the release of the Institute of Medicine (IOM) report “The Future of Nursing: Leading Change, Advancing Health,” it makes sense to ask: what changes are occurring? how can we make the most difference? and where can the report’s recommendations take us toward improving patient care?The nurse education imperative - Corrected ProofRisa Lavizzo-Mourey10.1016/j.outlook.2011.12.001Nursing Outlook (2012)2012-01-16Nursing Outlook2012-01-16GUEST EDITORIALhttp://www.nursingoutlook.org/article/PIIS0029655411003538/abstract?rss=yesAbstract: Emerging adulthood, a developmental period from late adolescence to the late twenties, is a critical transition for youths with type 1 diabetes. This article proposes a framework for emerging adults with diabetes during this transitional time, integrating theoretical writings on transitions and emerging adulthood with empirical findings from younger adolescents with diabetes, about whom more is known. Key health, developmental, and behavioral outcomes are proposed, as well as key influential personal and environmental characteristics. Influential transitional events for this age group are also discussed relative to these outcomes and to personal and environmental characteristics. This framework provides a guide for longitudinal studies on the transition to young adulthood among emerging adults with type 1 diabetes. Identifying key times and influential factors will provide information for designing future effective interventions to improve glycemic control and quality of life for these youths as they transition to adulthood.A framework for the youth with type 1 diabetes during the emerging adulthood transition - Corrected ProofKathleen M. Hanna10.1016/j.outlook.2011.10.005Nursing Outlook (2012)2012-01-06Nursing Outlook2012-01-06http://www.nursingoutlook.org/article/PIIS0029655411003587/abstract?rss=yesAbstract: The availability of health information on the Internet has equalized opportunities for knowledge between patients and their health care providers, creating a new phenomenon called the e-patient. E-patients use technology to actively participate in their health care and assume higher levels of responsibility for their own health and wellness. This phenomenon has implications for nursing informatics research related to e-patients and potential collaboration with practitioners in developing a collective wisdom. Nursing informatics can use the data, information, knowledge, and wisdom (DIKW) framework to understand how e-patients and clinicians may achieve this collective wisdom. Nurse informaticists can use constructivism and Gadamerian hermeneutics to bridge each stage of this framework to illustrate the fundamentals of patient and clinician interactions and commonality of language to achieve a collective wisdom. Examining the e-patient phenomenon will help nurse informaticists evaluate, design, develop, and determine the effectiveness of information systems used by e-patients. The Internet can facilitate a partnership between the patient and clinician and cultivate a collective wisdom, enhanced by collaboration between nurse informatics and e-patients.Exploration of the e-patient phenomenon in nursing informatics - Corrected ProofPerry M. Gee, Deborah A. Greenwood, Katherine K. Kim, Susan L. Perez, Nancy Staggers, Holli A. DeVon10.1016/j.outlook.2011.11.005Nursing Outlook (2012)2012-01-06Nursing Outlook2012-01-06http://www.nursingoutlook.org/article/PIIS0029655411003526/abstract?rss=yesAbstract: Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one’s own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care.1 The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model.Evaluation of an academic service partnership using a strategic alliance framework - Corrected ProofTeri A. Murray, Dorothy C. James10.1016/j.outlook.2011.10.004Nursing Outlook (2011)2011-12-19Nursing Outlook2011-12-19http://www.nursingoutlook.org/article/PIIS0029655411003514/abstract?rss=yesAbstract: Translational clinical research has emerged as an important priority for the national research enterprise, with a clearly stated mandate to more quickly deliver prevention strategies, treatments and cures based on scientific innovations to the public. Within this national effort, a lack of consensus persists concerning the need for clinical nurses with expertise and specialized training in study implementation and the delivery of care to research participants. This paper reviews efforts to define and document the role of practicing nurses in implementing studies and coordinating clinical research in a variety of clinical settings, and differentiates this clinical role from the role of nurses as scientists and principal investigators. We propose an agenda for building evidence that having nurses provide and coordinate study treatments and procedures can potentially improve research efficiency, participant safety, and the quality of research data. We also provide recommendations for the development of the emerging specialty of clinical research nursing.Clinical research nursing: A critical resource in the national research enterprise - Corrected ProofClare E. Hastings, Cheryl A. Fisher, Margaret A. McCabe, The National Clinical Research Nursing Consortium10.1016/j.outlook.2011.10.003Nursing Outlook (2011)2011-12-15Nursing Outlook2011-12-15http://www.nursingoutlook.org/article/PIIS0029655411003071/abstract?rss=yesAbstract: Objective: Research coordinators have significant responsibilities in clinical trials that often require them to find unique ways to manage their jobs, thus reshaping their professional identities. The purpose of this study was to identify how research coordinators manage role and ethical conflicts within clinical research trials.Methods: A qualitative study combining observation and 63 semistructured interviews at 25 research organizations was used.Results: Altruism is a recurring theme in how research coordinators define and view their work.Conclusion: Altruism is adopted by research coordinators to: (1) Teach patient-subjects the appropriate reasons to participate in clinical research, (2) minimize the conflict between research and care, and (3) contest the undervaluation of coordinating. Altruism is a strategy used to handle the various conflicts they experience in a difficult job, and it has become part of the professional identity of clinical research coordinators.Altruism in clinical research: Coordinators’ orientation to their professional roles - Corrected ProofJill A. Fisher, Corey A. Kalbaugh10.1016/j.outlook.2011.10.002Nursing Outlook (2011)2011-11-15Nursing Outlook2011-11-15http://www.nursingoutlook.org/article/PIIS0029655411002892/abstract?rss=yesAbstract: Despite wide disparities of political support, material resources, and systems of initial education, there exists an increasing global recognition that the level of nursing education has a close relationship with access to and quality of care. Still, individual nations also maintain alternative ways of educating nurses that are rooted in strong traditions. This paper explores the systems in China and Egypt. These countries have important differences. Education in China, for example, has been more heavily influenced by models from the United States, whereas Egypt has looked to those from Britain and France. Most striking, however, is what they now share. Both countries’ systems of nursing education are now clearly located in an increasingly global world of health, and health care that recognizes that a more educated nursing workforce remains the critical component of any initiative to better meet health care needs.The education of nurses in China and Egypt - Corrected ProofChenjuan Ma, Howieda Fouly, Jing Li, Patricia D’Antonio10.1016/j.outlook.2011.08.002Nursing Outlook (2011)2011-10-14Nursing Outlook2011-10-14http://www.nursingoutlook.org/article/PIIS0029655411002909/abstract?rss=yesAbstract: Background: The first year of nursing practice is critical to developing new graduate nurses into safe practitioners. Many new graduate nurses leave the profession because of job stress, lack of organizational support, poor nurse-physician relations, unreasonable workloads, uncivil work environments, and difficulty transitioning into practice. In response, Nurse Residency programs reflect an organizational commitment to support new nurses, allowing them time and support to become competent professional nurses.Purpose and method: Thirty-seven new graduate nurses employed in a hospital in a northwestern state participated in a descriptive qualitative study to examine the “lived experience” as new nurses and to assess the level of job satisfaction during the first year of their nursing practice.Results: New graduate nurses described themes related to their first year of nursing practice including rhythm in the chaos, feeling valued, stress from ‘not knowing’, life-long learning, and preserving the profession.Conclusions: Having supportive preceptors and nursing staff, feeling valued by the health care team, and being perceived as a vital member of the organization contributed to job satisfaction and overall commitment to the profession.Nurse residents’ first-hand accounts on transition to practice - Corrected ProofCynthia M. Clark, Pamela J. Springer10.1016/j.outlook.2011.08.003Nursing Outlook (2011)2011-10-14Nursing Outlook2011-10-14http://www.nursingoutlook.org/article/PIIS0029655411002910/abstract?rss=yesAbstract: Background: Foreclosure rates have risen rapidly since 2005, reaching historically high levels. The purpose of this study was to examine the health implications of the current housing crisis.Methods: We conducted a cross-sectional online consumer panel survey including residents of California, Arizona, Nevada, and Florida (n = 798) to determine the feasibility of contacting distressed homeowners via the Internet and to assess mental and physical health among respondents across the spectrum from those having no housing strain to those in loan default or home foreclosure.Results: Homeowners in default or foreclosure exhibited poorer mental health and more physical symptoms than renters, homeowners with moderate strain, and homeowners with no strain—following a gradient that was consistent across multiple health indicators.Conclusions: Internet panel sampling was an efficient method of contacting distressed homeowners. Record-high foreclosure rates may have broad implications for nursing and public health. Homeowners in default or foreclosure represent an identifiable high-risk group that may benefit from coordinated, affordable health and social services.Housing strain, mortgage foreclosure, and health - Corrected ProofCarolyn C. Cannuscio, Dawn E. Alley, José A. Pagán, Beth Soldo, Sarah Krasny, Michelle Shardell, David A. Asch, Terri H. Lipman10.1016/j.outlook.2011.08.004Nursing Outlook (2011)2011-10-14Nursing Outlook2011-10-14http://www.nursingoutlook.org/article/PIIS0029655411002946/abstract?rss=yesAbstract: Background: Although there is an abundance of research on nurses’ job satisfaction, there is a paucity of publications on the regional differences that impact on nurses’ job satisfaction.Purpose: To compare the differences between northern and southern hospitals in Mainland China with respect to nurses’ job satisfaction.Methods: A cross-sectional survey design was selected. Data were analyzed using descriptive statistics, independent t test, chi-square test, correlation, and linear regression.Results: Nurses in northern hospitals were older, had higher educational levels yet received lower pay in comparison with their counterparts in the southern region. Despite these salary differences, those in the north consistently rated their job satisfaction greater in all areas except professional opportunities.Conclusion: Regional differences were related to nurses’ job satisfaction. Potential contributing factors included philosophical, cultural, and economic differences between the 2 regions. The noteworthy regional differences that potentially related to nurse’ job satisfaction should be investigated in future studies.Regional differences in job satisfaction for mainland Chinese nurses - Corrected ProofHong Tao, Aihua Zhang, Jingchao Hu, Yaqing Zhang10.1016/j.outlook.2011.08.007Nursing Outlook (2011)2011-10-14Nursing Outlook2011-10-14http://www.nursingoutlook.org/article/PIIS0029655411002934/abstract?rss=yesThe authors provide a blueprint for developing the Advanced Practice Psychiatric Nurse (APRN-PMH) workforce that it is incumbent on all of us to take seriously, even if we are not in that specialty, because behavioral health is one of the most all-encompassing areas of health care. The need for a professional workforce skilled in addressing behavioral health is enormous—nearly 96% of U.S. counties have an unmet need for prescribers—and there simply are not enough providers prepared to meet demand for such services. Current efforts to reform health care by creating accountable care organizations provide us with an exceptional opportunity for insinuating APRN-PMHs more forcefully than ever before into mainstream health care services, because the emphasis will increasingly be on prevention, rehabilitation, and management of chronic conditions.Commentary on blueprint for developing the advanced practice psychiatric nurse workforce - Corrected ProofAngela Barron McBride10.1016/j.outlook.2011.08.006Nursing Outlook (2011)2011-10-10Nursing Outlook2011-10-10http://www.nursingoutlook.org/article/PIIS0029655411002181/abstract?rss=yesAbstract: Although evidence supports safe patient handling practices, nurses are not always involved in the process of evaluating and selecting lifting equipment. This study used a descriptive design to: (1) assess staff’s perceived barriers and attitudes toward safe patient handling, (2) identify staff needs for equipment and education concerning safe patient handling, and (3) involve staff in the equipment selection process before implementing a safe patient handling program. Overall, staff on all units indicated that they wanted more equipment and education. Major barriers identified by staff were lack of: a “no lift” policy, adequate lifting equipment, and adequate space on patient care units. Staff had the opportunity to participate in a vendor fair and select equipment for trial. An appraisal was conducted with 2 vendors for trialing and evaluating the equipment. Nursing staff had the ability to participate in research and change practice for safe patient handling.Empowering staff nurses to use research to change practice for safe patient handling - Corrected ProofCandice Krill, Beth A. Staffileno, Claudette Raven10.1016/j.outlook.2011.06.005Nursing Outlook (2011)2011-08-29Nursing Outlook2011-08-29http://www.nursingoutlook.org/article/PIIS0029655411002193/abstract?rss=yesAbstract: Nurse overtime has been used to handle normal variations in patient census and to control chronic understaffing. By 2010, 16 states had regulations to limit nurse overtime. We examined mandatory overtime regulations and their association with mandatory and voluntary overtime and total hours worked by newly licensed registered nurses (NLRNs). For this secondary data analysis, we used a panel survey of NLRNs; the final dataset consisted of 1,706 NLRNs. Nurses working in states that instituted overtime regulations after 2003 or in states that restricted any type of mandatory overtime had a lower probability of experiencing mandatory overtime than those nurses working in states without regulations. Nurses who worked in states with mandatory overtime regulations reported fewer total hours worked per week. The findings of this study provided insight into how mandatory overtime regulations were related to nurse mandatory and voluntary overtime and the total number of hours worked. Future research should investigate institutions’ compliance with regulations and the impact of regulations on nurse and patient outcomes.State mandatory overtime regulations and newly licensed nurses’ mandatory and voluntary overtime and total work hours - Corrected ProofSung-Heui Bae, Carol S. Brewer, Christine T. Kovner10.1016/j.outlook.2011.06.006Nursing Outlook (2011)2011-08-29Nursing Outlook2011-08-29http://www.nursingoutlook.org/article/PIIS0029655411002144/abstract?rss=yesAbstract: Academic incivility remains a problem on college campuses. Nursing research has refocused from student impropriety to aberrant faculty behaviors. Our original study using the Nursing Education Environment Survey showed that 94 of 152 (88%) student participants experienced uncivil treatment. Latent, inductive content analysis was undertaken to analyze narratives about their “worst experience” of negative faculty behavior. Four categories were identified: “In front of someone,” “Talked to others about me,” “Made me feel stupid,” and “I felt belittled.” Incivility had a profound effect on students and is problematic because it increases already significant academic pressure; it interferes with learning and safe clinical performance; it is contrary to caring, a central nursing concept; and it decreases program satisfaction and retention. Few nursing schools have civility policies for faculty behavior. Formal procedures that promote professional interaction should be crafted and implemented. Equally important is creating ways for nursing students to document incivility without fear of retaliation.Student narratives of faculty incivility - Corrected ProofSue Lasiter, Lisa Marchiondo, Kathleen Marchiondo10.1016/j.outlook.2011.06.001Nursing Outlook (2011)2011-08-16Nursing Outlook2011-08-16http://www.nursingoutlook.org/article/PIIS0029655411002156/abstract?rss=yesAbstract: In 2006, the Centers for Diseases Control and Prevention (CDC) released recommendations calling for routine HIV testing to be offered to those ages 13 to 64 as a standard of general health care. This recommendation included a plan to conduct HIV testing as part of a general consent. The reasoning and evidence for this recommendation is supported by experts, patients, and sponsored screenings by the CDC. The rationale behind this approach includes that knowledge of one’s HIV status helps (1) infected individuals adopt risk-reduction behaviors and access to life-prolonging treatment and (2) uninfected individuals maintain behaviors that reduce their risk of becoming infected. This article discusses the perceived patient, provider, and policy barriers to implementing routine HIV screening and proposed solutions that can be part of a nurse-led contribution to develop and adopt innovative, patient-centered care models that can address the need for screening.Recommendations and reality: Perceived patient, provider, and policy barriers to implementing routine HIV screening and proposed solutions - Corrected ProofRosanna F. DeMarco, Donna Gallagher, Lucy Bradley-Springer, Sande Gracia Jones, Julie Visk10.1016/j.outlook.2011.06.002Nursing Outlook (2011)2011-08-16Nursing Outlook2011-08-16http://www.nursingoutlook.org/article/PIIS002965541100217X/abstract?rss=yesAcross the nation, the behavioral health workforce crisis continues to worsen. Although the economic downturn has slowed staff turnover, it is still difficult to find and keep qualified mental health and substance abuse professionals. Regardless of the discipline, the content of both preservice and continuing education lags woefully behind changes in the field that are driven by the rapidly evolving evidence base, the financing of health care, and state and federal policy. Despite the compelling data on the aging of the workforce and the gulf in leadership that this will create over the next decade, systematic efforts at succession planning and the development of future leaders are meager at best. The behavioral health workforce has been trained to work principally with urban and suburban white adults, and is much less capable of responding to the needs of children and adolescents, older adults, and persons from culturally diverse backgrounds. Most rural counties in America lack a single behavioral health professional from any discipline.Commentary on a “Blueprint for developing the advanced practice psychiatric nurse workforce” - Corrected ProofMichael A. Hoge10.1016/j.outlook.2011.06.004Nursing Outlook (2011)2011-08-16Nursing Outlook2011-08-16http://www.nursingoutlook.org/article/PIIS0029655411001680/abstract?rss=yesAbstract: Nearly 80% of associate’s degree–prepared nurses do not return to school for a more advanced degree in nursing, which is an issue of concern to many nursing leaders. This interpretive phenomenological study investigates what influences associate’s degree–prepared nurses to refrain from continuing their professional education and obtain a baccalaureate or higher-level degree. Although these nurses generally wished they had a higher degree, they did not feel pursuing one was necessary. They did not perceive that their standard of patient care would change with further professional training involved in obtaining a higher educational degree. Furthermore, they did not perceive any distinctions in professional ability between themselves and colleagues with more advanced nursing degrees. The culture of service health care organizations in which associate’s degree–prepared nurses are employed, as well as other factors, are likely directly responsible for the practicing nurses’ lack of appreciation for the relevancy and rewards of returning to school.Mixed messages: Hospital practices that serve as disincentives for associate degree–prepared nurses to return to school - Corrected ProofLiana Orsolini-Hain10.1016/j.outlook.2011.05.007Nursing Outlook (2011)2011-07-11Nursing Outlook2011-07-11http://www.nursingoutlook.org/article/PIIS0029655411001321/abstract?rss=yesAbstract: The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a significant opportunity for advanced practice psychiatric nurses–psychiatric mental health (APRN-PMH) to develop action-oriented recommendations for developing their workforce and thereby increasing access to high-quality and full-spectrum behavioral health care services. If endorsed by the professional nursing associations and the APRN-PMH workforce, the strategies presented in this paper provide a blueprint for developing the APRN-PMH workforce. Achieving these goals will significantly reform the APRN-PMH workforce, thereby contributing to the overall goal of supporting an integrated model of behavioral health care. No change has as much potential to influence the APRN-PMH workforce as the uniting of all APRN-PMHs in a “Blueprint for APRN-PMH Workforce Development.”Blueprint for development of the advanced practice psychiatric nurse workforce - Corrected ProofNancy P. Hanrahan, Kathleen R. Delaney, Gail W. Stuart10.1016/j.outlook.2011.04.007Nursing Outlook (2011)2011-06-24Nursing Outlook2011-06-24http://www.nursingoutlook.org/article/PIIS0029655411000972/abstract?rss=yesAbstract: Despite the relatively long history of nursing education, the development of graduate nursing education in the People’s Republic of China is slow compared to western countries. Yet, rapid social changes call for higher quality nursing care. Consequently, the Chinese government has acknowledged the need to upgrade nursing education in China. The first master of nursing program was established in 1992. Since then graduate programs have grown dramatically in the past 17 years and this growth has had a vital impact on nursing development. However, a number of issues have been raised concerning the focus of graduate programs. This article presents a comprehensive description on the current status, problems, and strategies used in graduate nursing education in mainland China.Graduate nursing education in China - Corrected ProofHaiou Zou, Zheng Li, David Arthur10.1016/j.outlook.2011.04.001Nursing Outlook (2011)2011-06-20Nursing Outlook2011-06-20