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AAN News & Opinion
187 Results
- Practice Guidelines
At-Risk populations and public health emergency preparedness in the United States: Nursing leadership in communities
Nursing OutlookVol. 69Issue 4p699–703Published in issue: July, 2021- Mary Pat Couig
- Jasmine L. Travers
- Barbara Polivka
- Jessica Castner
- Tener Goodwin Veenema
- Liz Stokes
- and others
Cited in Scopus: 1Public health emergency preparedness is defined as: …the capability of the public health and health care systems, communities, and individuals, to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities. Preparedness involves a coordinated and continuous process of planning and implementation that relies on measuring performance and taking corrective action (Nelson et al, 2007, p. - Practice Guidelines
Opioid Crisis through the Lens of Social Justice
Nursing OutlookVol. 68Issue 5p678–681Published in issue: September, 2020- Madeline A. Naegle
- Deborah S. Finnell
- Louise Kaplan
- Keela Herr
- Richard Ricciardi
- Karin Reuter-Rice
- and others
Cited in Scopus: 4The United States opioid crisis brings into sharp focus the health inequities for persons dependent on opioids due to long-term use for chronic pain and persons with opioid use disorder (OUD). Disparate access to health-care services, however, is widespread for vulnerable populations like frail older adults, children, incarcerated individuals, and members of racial, ethnic and sexual minorities, groups for whom opioid use exacts a heavy burden. Stigma combined with few prevention services and limited access to healthcare for life-saving treatment are costly for the society and its citizens. - Practice Guidelines
The crucial role of all current and future nurses in addressing the continuum of substance use
Nursing OutlookVol. 68Issue 5p682–684Published in issue: September, 2020- Deborah S. Finnell
- Ann M. Mitchell
Cited in Scopus: 1The American Academy of Nursing believes necessary measures must be taken to address the negative consequences of substance use on the health, economy, productivity, and social aspects of individuals and communities. The burden of disease attributable to alcohol and drug use varies substantially across geographic locations, yet much of the burden is due to the effects of substance use on other health outcomes. Despite the existence of evidence-based strategies, including screening, brief intervention, and referral to treatment (SBIRT), and knowledge of the impact of substances on the brain and body systems, further education is needed to identify persons who are at risk because of substance use and provide interventions to prevent and reduce substance use disease burden. - Practice Guidelines
Policy brief on climate change and mental health/well-being
Nursing OutlookVol. 68Issue 4p517–522Published in issue: July, 2020- Jianghong Liu
- Teddie Potter
- Susan Zahner
Cited in Scopus: 10Climate change has a significant global impact on individuals’ mental health and well-being. However, global health systems are inadequately prepared to address this issue. Studies indicate that climate events such as floods, droughts, tornados, earthquakes, and fires not only exacerbate chronic mental illness, but also impact well-being causing anxiety, stress, and in the worst case, suicide. The World Health Organization estimates that 12.6 million preventable deaths per year can be attributed to environmental factors, all of which are exacerbated by climate change, and an additional 250,000 deaths per year are projected between 2030 and 2050. - Practice Guidelines
Improving the care and health of populations through optimal use of clinical nurse specialists
Nursing OutlookVol. 68Issue 4p523–527Published in issue: July, 2020- Mary Fran Tracy
- Sarah Oerther
- Cynthia Arslanian-Engoren
- Shirley Girouard
- Pamela Minarik
- Patricia Patrician
- and others
Cited in Scopus: 8Patients with complex and chronic illnesses and those who have significant needs related to care coordination and transitions of care are dependent on access to healthcare providers who are skilled at meeting the distinct needs of these populations and are current in the latest evidence-based practices and guidelines. Clinical nurse specialists (CNSs) are uniquely qualified to care for patients with complex illnesses as well as having the skills to optimize care for entire populations with complex needs. - Practice Guidelines
Improve nurses’ well-being and joy in work: Implement true interprofessional teams and address electronic health record usability issues
Nursing OutlookVol. 67Issue 6p791–797Published in issue: November, 2019- Diane K. Boyle
- Marianne Baernholdt
- Jeffrey M. Adams
- Susan McBride
- Ellen Harper
- Lusine Poghosyan
- and others
Cited in Scopus: 13The three components of the Triple Aim – enhancing the patient experience, improving population health, and reducing costs – have become the guide for optimizing healthcare system performance in the U.S. (Berwick, Nolan, & Whittington, 2008; Sikka, Morath, & Leape, 2015). The three aims are intrinsically intertwined and therefore need to be addressed simultaneously. However, constant efforts to maintain a harmonious balance of the Triple Aim is a challenge and often causes unintended consequences especially as it relates to a consistent change in clinician work processes, decreased joy in work, and burnout (Dyrbye et al., 2017; Shanafelt et al., 2016). - Practice Guidelines
Policy brief: Nurse fatigue, sleep, and health, and ensuring patient and public safety
Nursing OutlookVol. 67Issue 5p615–619Published in issue: September, 2019- Claire C. Caruso
- Carol M. Baldwin
- Ann Berger
- Eileen R. Chasens
- James Cole Edmonson
- Barbara Holmes Gobel
- and others
Cited in Scopus: 19Society needs critical nursing services around the clock and, as a result, nurses often work shift work and long work hours (SWLWH). These hours can prevent nurses from getting the seven or more hours of quality sleep each day that experts recommend (Watson, et al., 2015). Nurses on SWLWH are at risk for cardiovascular disease, gastrointestinal and psychological disorders, cancer, type 2 diabetes, injuries, musculoskeletal disorders, all-cause mortality, adverse reproductive outcomes, and difficulty managing chronic diseases (Caruso, et al., 2017; Caruso & Waters, 2008; Gan, et al. - Practice Guidelines
Preventing adverse health outcomes among children and adolescents by addressing screen media practices concomitant to sleep disturbance
Nursing OutlookVol. 67Issue 4p492–496Published in issue: July, 2019- Susan K. Riesch
- Jianghong Liu
- Peter G. Kaufmann
- Willa M. Doswell
- Sally Cohen
- Judith Vessey
Cited in Scopus: 7In today's digital age, screen media use is prevalent in the daily life and functioning of children and adolescents. Sleep disturbance and adverse health outcomes related to screen media practices are on the rise affecting physical, cognitive, and behavioral health outcomes. Mounting evidence from studies worldwide support the following recommendations addressing practice, research, and policy: (a) All practitioners are encouraged to assess youth and their families at each health encounter for screen media practices, sleep disruption and daytime sleepiness, and be able to refer to specialists or be trained on interventions to address problems; (b) Children and families are encouraged to seek information about and take responsibility for screen media use practices, effective sleep habits, and signs and symptoms of adverse health outcomes; (c) Policy makers are encouraged to promote public awareness and provide funding for further research into screen media practices, sleep disturbance, and adverse health outcomes. - Research Article
Comparing residential long-term care regulations between nursing homes and assisted living facilities
Nursing OutlookVol. 68Issue 1p114–122Published online: June 27, 2019- Alison M. Trinkoff
- Jung Min Yoon
- Carla L. Storr
- Nancy B. Lerner
- Bo Kyum Yang
- Kihye Han
Cited in Scopus: 18The long-term care (LTC) sector is a major component of the U.S. health care system that continues to grow (Bureau of Labor Statistics, 2014; Congressional Budget Office, 2013). Most of this increase is due to growth in the population of oldest adults (85+), a group with limited capacity for self-care due to health conditions (Congressional Budget Office, 2013; NIA, 2015). In 2014, there were over 46 million Americans 65+ years, and 6.2 million 85+ years old (Federal Interagency Forum on Aging-Related Statistics, 2016). - Practice Guidelines
Pregnant and Parenting Women with a Substance Use Disorder: Actions and Policy for Enduring Therapeutic Practice
Nursing OutlookVol. 67Issue 2p199–204Published in issue: March, 2019- Martha A. Jessup
- Sarah E. Oerther
- Bonnie Gance-Cleveland
- Lisa M. Cleveland
- Kim M. Czubaruk
- Mary W. Byrne
- and others
Cited in Scopus: 7The American Academy of Nursing (Academy) calls for an end to criminal prosecution and punitive civil actions against pregnant and parenting women based solely on their substance use or substance use disorder (SUD). The Academy supports a public health response to the needs of women and their children and families affected by SUDs that incorporates multi-disciplinary culturally- and trauma-responsive models of health care, child welfare, treatment and recovery supports and clinician practices that are in line with the accumulated scientific evidence. - Research Article
Nursing innovation: The joint effects of championship behaviors, project types, and initiation levels
Nursing OutlookVol. 67Issue 4p404–418Published online: February 8, 2019- Shirly Luz
- Efrat Shadmi
- Anat Drach-Zahavy
Cited in Scopus: 5Health care organizations worldwide strive to deliver safe, high-quality, patient-centered care while fostering a proficient nursing staff and maintaining fiscal accountability. To achieve these aims, these organizations promote innovation at various organizational levels and in various domains (Drach-Zahavy, Somech, Granot, & Spitzer, 2004; Kaya, Turan, & Aydın, 2015; Länsisalmi, Kivimäki, Aalto, & Ruoranen, 2006; Weng, Huang, Chen, & Chang, 2015). It is increasingly recognized that nurse champions, namely excellent front-line practitioners, come from within the organization and are passionate about improving quality of care, and serving as key agents in implementing innovation via self-developed or management-developed projects (Byers, 2017; McSherry & Douglas, 2011; White, 2011). - Practice Guidelines
American Academy of Nursing on Policy position statement: Disaster preparedness for older adults
Nursing OutlookVol. 67Issue 1p118–121Published in issue: January, 2019- Wanda R. Spurlock
- Karen Rose
- Tener Goodwin Veenema
- Samir K. Sinha
- Deanna Gray-Miceli
- Shionne Hitchman
- and others
Cited in Scopus: 6The American Academy of Nursing recognizes the significant impact of natural disasters on older adults. Unfortunately, despite decades of planning, deficiencies continue to exist in disaster preparedness for this population. While recent federal and state legislative efforts have attempted to address some of these issues, gaps in allowing for a consistent level of preparedness and disaster response across the U.S. continue to be exposed. This position statement outlines practical policy and organizational recommendations to enhance the ability of frontline providers, health care organizations and emergency planners in responding to disasters on the behalf of older Americans, the most rapidly growing sector of the United States (U.S.) population. - Practice Guidelines
Position statement: The American Academy of Nursing opposes prevention and limitation of transgender individuals from serving in the United States military
Nursing OutlookVol. 66Issue 5p508–511Published in issue: September, 2018- Laura C. Hein
- Felicia Stokes
- David M. Keepnews
- The LGBTQ Health Expert Panel
- William T. Bester
- The Military & Veterans Health Expert Panel
Cited in Scopus: 0There are an estimated 1,320 to 6,630 transgender active duty service members in the U.S. military (Schaefer et al., 2016). Notably, their ability to serve has been unaffected by changes in policy on lesbian, gay, and bisexual service members. - Practice Guidelines
Policy brief: Protecting vulnerable LGBTQ youth and advocating for ethical health care
Nursing OutlookVol. 66Issue 5p505–507Published in issue: September, 2018- Laura C. Hein
- Felicia Stokes
- Cindy Smith Greenberg
- Elizabeth M. Saewyc
Cited in Scopus: 3Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ) youth are at heightened risk for bullying, victimization, homelessness, and being subjected to harmful therapies and associated physical and mental health issues. Health disparities in these populations are strongly associated with increased vulnerability based on stigma and discrimination due to their sexual orientation, gender identity, and gender expression (United Nations, 2017). Additional threats to the health of LGBTQ youth include: expanded religious freedom exemptions of providers, permitting legal refusal to provide health care or other services to this population; a halt to Title IX enforcement for transgender persons by the Department of Education; and regular threats to repeal Section 1557 of the Affordable Care Act (ACA), thereby excluding coverage for transgender-related care and eliminating coverage for pre-existing conditions (U.S. - Practice Guidelines
American Academy of Nursing on policy: Reducing preterm births in the United States: Maternal infant health, child, adolescent and family, and women's health expert panels
Nursing OutlookVol. 66Issue 5p499–504Published in issue: September, 2018- Carole Kenner
- Kristin Ashford
- Lina Kurdahi Badr
- Beth Black
- Joan Bloch
- Rosalie Mainous
- and others
Cited in Scopus: 1The rising rates of preterm birth (PTB) (less than 37 completed weeks gestation) in the United States is an urgent population/public health issue. Education of the healthcare workforce, policy makers and the public on risk factors for prematurity, and identification of strategies to counter the rising rate of PTB is critical. This policy brief illustrates the problem and sets forth policy recommendations to reduce prematurity rates. - Practice Guidelines
The American Academy of Nursing on policy: Emerging role of baccalaureate registered nurses in primary care (August 20, 2018)
Nursing OutlookVol. 66Issue 5p512–517Published in issue: September, 2018- Patricia Vanhook
- Jordon Bosse
- Margaret Flinter
- Lusine Poghosyan
- Lynne Dunphy
- Debra Barksdale
Cited in Scopus: 8Increased access to health insurance and health care, increased complexity of patients in our aging society, and challenges in primary care team staffing are among many current challenges to providing high quality, effective, and satisfying care to all patients. At the same time, the team is expected to attend to the equally important need for prevention, health promotion, and care coordination and management of the population at large. The demand to manage multiple, comorbid complex chronic illnesses are overwhelming the primary care system and causing waits, delays, and a shifts toward receiving primary care in inappropriate settings such as the emergency room (ER). - Practice Guidelines
Supporting breastfeeding for infants born to opioid dependent mothers June 18, 2018
Nursing OutlookVol. 66Issue 5p496–498Published online: July 28, 2018- Maureen Groer
- Breastfeeding Expert Panel,
- Denise Maguire
- Breastfeeding Expert Panel,
- Kailey Taylor
Cited in Scopus: 1Infants exposed to opioids during gestation demonstrate signs of withdrawal within 3 to 5 days of birth. Maternal opioid dependency may be the result of prescribed, illicit or nonmedical drug use. Breastfeeding reduces the severity of withdrawal and the need for pharmacological management (Abdel-Latif et al., 2006; Dryden, Young, Hepburn, & Mactier, 2009; Hodgson & Abrahams, 2012; Isemann, Meinzen-Derr, & Akinbi, 2011; McQueen, Murphy-Oikonen, Gerlach, & Montelpare, 2011; O'Connor, Collett, Alto, & O'Brien, 2013; Welle-Strand, Skurtveir, & Jones, 2012). - American Academy of Nursing on Policy, Council for the Advancement of Nursing Sciences
Policy brief on the nursing response to human trafficking
Nursing OutlookVol. 66Issue 4p407–411Published online: July 2, 2018- Patricia M. Speck
- Stacey A. Mitchell
- Rachell A. Ekroos
- Rosario V. Sanchez
- DeAnne K. Hilfinger Messias
Cited in Scopus: 10Human trafficking is a public health emergency affecting an estimated 12 to 30 million people globally. Given that 85% of trafficked victims have contact with health care providers in any year, nurses are critical to: the identification of trafficked persons; effective promotion of their physical, mental, and cognitive health; development and implementation of practice guidelines; implementation of research to inform bestpractices globally; and championing public policy initiatives at local, state, and national levels. - Practice Guidelines
Sexual and Reproductive Health Rights, Access & Justice: Where Nursing Stands
Nursing OutlookVol. 66Issue 4p416–422Published in issue: July, 2018- Ellen Olshansky
- Diana Taylor
- Versie Johnson-Mallard
- Shannon Halloway
- Liz Stokes
Cited in Scopus: 4Although the American Academy of Nursing (Academy) has for decades played a major role in advocating to protect the sexual and reproductive health (SRH) of all women and men regardless of race, color, sexual orientation, or social economic status, many government officials are aggressively pursuing ways to create barriers to evidence-based SRH care access. The Academy continues to “resist and respond” to these tactics, in the form of statements, policy briefs, amicus briefs and coalition letters—raising the voice of Nursing against the dismantling of the Affordable Care Act (ACA) and longstanding national health goals, programs, and essential services. - Practice Guidelines
Expanding nursing's role in responding to global pandemics 5/14/2018
Nursing OutlookVol. 66Issue 4p412–415Published online: June 27, 2018- Inge B. Corless
- Deena Nardi
- Jeri A. Milstead
- Elaine Larson
- Kathleen M. Nokes
- Susan Orsega
- and others
Cited in Scopus: 23We know by now that the world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. - Practice Guidelines
Strengthen federal and local policies to advance precision health implementation and nurses’ impact on healthcare quality and safety
Nursing OutlookVol. 66Issue 4p401–406Published online: June 21, 2018- Angela R. Starkweather
- Bernice Coleman
- Veronica Barcelona de Mendoza
- Kathleen T. Hickey
- Victoria Menzies
- Mei R. Fu
- and others
Cited in Scopus: 13The American Academy of Nursing (The Academy) supports sustaining and building on institutional and regulatory policies to ensure that adequate infrastructure and workforce is in place for precision health implementation by nurses and other healthcare team members. In order to realize anticipated improvements in healthcare quality and safety, the Academy will continue to provide opportunities in the area of precision health policy development to Academy Fellows and nurses across the nation. In 2016, H.R. - Practice Guidelines
Position statement: Policies to support family caregivers
Nursing OutlookVol. 66Issue 3p337–340Published in issue: May, 2018- G. Adriana Perez
- Karen Moomaw Rose
- Billy A. Caceres
- Wanda Spurlock
- Barbara Bowers
- Barbara Lutz
- and others
Cited in Scopus: 13In 2013, an estimated 40 million family caregivers provided an average of 18 hours of care per week, reflecting approximately $470 billion in unpaid caregiving contributions (Reinhard, Feinberg, Choula, & Houser, 2015). Projected demographic shifts in the U.S., including the rapidly aging population (World Health Organization, 2015) and increase of individuals living with chronic conditions across the lifespan (American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians, 2011; Houtrow, Larson, Olson, Newacheck, & Halfon, 2014), will increase the demand for family caregivers. - Practice Guidelines
Requiring a nurse residency for newly licensed registered nurses
Nursing OutlookVol. 66Issue 3p329–332Published online: April 17, 2018- Colleen J. Goode
- Kimberly S. Glassman
- Patricia Reid Ponte
- Mary Krugman
- Tammy Peterman
Cited in Scopus: 26We recommend that a nurse residency for newly licensed registered nurses (RNs) be required for all new graduate RNs as a component of their employment. Requirement through mandate or incentives at federal or state levels would enable that 100% of all newly licensed RNs complete an accredited new graduate nurse residency program (NRP). Evidence demonstrates the benefit and need for all newly licensed RNs hired into acute care hospitals to complete a clinical NRP (Benner, Sutphen, Leonard, & Day, 2010). - Practice Guidelines
American Academy of Nursing on policy: Recommendations in response to mass shootings
Nursing OutlookVol. 66Issue 3p333–336Published online: April 16, 2018- Rosa M. Gonzalez-Guarda
- Elizabeth Burgess Dowdell
- Marie Ann Marino
- Jocelyn C. Anderson
- Kathryn Laughon
Cited in Scopus: 7When Americans gather in public places, schools, work, places of worship, and at home, they should feel safe and not afraid. The recent massacre at Marjory Stoneman Douglas High School in Parkland, Florida, where 17 individuals were murdered, has led to a public outcry for action by policymakers to address mass shootings. This call to action is similar to those made in response to the mass shootings in Columbine, Sandy Hook, Orlando, and Las Vegas, making a case for a lack of progress and apathy in addressing mass shootings. - Practice Guidelines
Assessing and addressing cardiovascular risk in young women
Nursing OutlookVol. 66Issue 3p325–328Published online: April 16, 2018- JoEllen Wilbur
- Lynne T. Braun
- Cynthia Arslanian-Engoren
- Diane R. Lauver
- Shannon Halloway
Cited in Scopus: 2Over the past 2 decades there has been an increase in cardiovascular disease (CVD) mortality for young women aged 35 to 54 years that corresponds with an increase in CVD risk factors. Yet, both young women and their providers underestimate CVD risk. Expert recommendations to provide patient education on CVD prevention and consider CVD risk factors in women have failed to detail the unique considerations in young women. The American Academy of Nursing (Academy) supports (a) increasing National Institutes of Health (NIH) funding for both basic research and clinical trials that focus on CVD risk in young women; (b) amplifying health-care system quality improvement initiatives to increase clinicians' rates of practice consistent with clinical guidelines for CVD risk; (c) partnering among primary care providers and specialists in women's health and cardiovascular health to assess and manage women's CVD risk; and (d) collaborating with public health and community organizations to lead initiatives for CVD risk reduction in young women. - Practice Guidelines
Achieving advance care planning in diverse, underserved populations
Nursing OutlookVol. 66Issue 3p311–315Published online: April 11, 2018- Mona Newsome Wicks
- Jose Alejandro
- Desiree Bertrand
- Carol J. Boyd
- Christopher Lance Coleman
- Emily Haozous
- and others
Cited in Scopus: 8There remains a gap in meeting the palliative and end-of-life (EOL) care needs, including advance care planning (ACP) needs of ethnic minority, under-resourced, veterans, and lesbian, gay, bisexual, transgender, and queer (LGBTQ) Americans, as well as persons with disabilities and residing in geographically isolated regions. Intersecting socially constructed characteristics influence the lived experience of marginalized communities, including their health-care experiences. These persistent gaps pose a serious barrier to achieving high-quality care, including palliative and EOL care, across the life span of members of these growing populations. - Practice Guidelines
African-American mothers' persistent excessive maternal death rates
Nursing OutlookVol. 66Issue 3p316–318Published online: March 22, 2018- Linda C. Amankwaa
- Kathie Records
- Carole Kenner
- Gayle Roux
- Susan E. Stone
- Deborah S. Walker
Cited in Scopus: 11“Maternal health has significantly improved in the 21st century, but too many women continue to die or suffer severe pregnancy complications every year” (Centers for Disease Control and Prevention, 2016). African-American mothers in the United States die more often than their counterparts during childbirth and delivery. Research findings highlight disparity among African-American mothers as it relates to childbearing (Research overview of maternal mortality and morbidity in the United States). A focus on disparities during childbearing has been a national priority with federal support programs directed toward improving the health disparities of Maternal and Infant Health (MIH) among disadvantaged populations ( https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm ). - Practice Guidelines
An effective human papillomavirus vaccination policy will reduce infection- and malignancy-related morbidity and mortality
Nursing OutlookVol. 66Issue 3p319–324Published online: March 19, 2018- Dorothy J. Wiley
- Kari A. Mastro
Cited in Scopus: 0Twelve human papillomaviruses (HPVs) are classified as strong human carcinogens, commonly referred to as high-risk HPVs (hrHPVs), and are responsible for nearly all cervical malignancies and 40% to 50% of all vaginal and vulvar cancers in women (Bouvard et al., 2009; International Agency for Research on Cancer, 2006; International Agency for Research on Cancer (IARC) Working Group on Evaluation of Carcinogenic Risks to Humans, 2007). Together these hrHPVs are the cause of ≥75% of anal and perianal cancers in male and female adults (Bosch & de Sanjose, 2003; Clifford, Smith, Plummer, Munoz, & Franceschi, 2003; Munoz, 2000; Walboomers et al., 1999). - Practice Guidelines
Nurses play essential roles in reducing health problems due to climate change
Nursing OutlookVol. 66Issue 2p210–213Published online: February 27, 2018- Jeanne Leffers
- Patricia Butterfield
Cited in Scopus: 47Climate change is endangering the stability of the planet's ecological systems and poses untoward risks to the continued survival of humans (Kurth, 2017; Landrigan et al., 2017; Melillo, Richmond, & Yohe, 2014; Watts et al., 2017). In our communities, climate change is experienced as increased frequency and intensity of wildfires, heat waves, winter storms, hurricanes, and floods, as well as changes in vector distribution. Climate- and weather-related conditions affect health conditions as diverse as asthma, sudden cardiac death, premature birth, gastrointestinal illness, depression, malnutrition, and vector-borne illness (Schifino, Lallo, De Sario, Davoli, & Michelozzi, 2013; Sheffield & Landrigan, 2011). - Practice Guidelines
Critical conversation: Toxic stress in children living in poverty
Nursing OutlookVol. 66Issue 2p204–209Published online: February 27, 2018- Karen S. Cox
- Cheryl G. Sullivan
- Ellen Olshansky
- Kim Czubaruk
- Bernardine Lacey
- Linda Scott
- and others
Cited in Scopus: 6On October 27, 2017, the American Academy of Nursing President and Executive Vice President/Chief Operating Officer Children's Mercy Kansas City Karen Cox, PhD, RN, FAAN, convened a critical conversation on Toxic Stress in Children Living in Poverty. An invitation-only event, the critical conversation was launched in response to the Robert Wood Johnson Foundation's Culture of Health working group that met in 2016 on eliminating childhood poverty. Among the approximately 100 participants who assembled at the National Press Club, Washington, DC, were representatives of 33 organizations and 15 universities including First Focus, the Child Welfare League of America, Zero to Three, the Association for the Education of Young Children, the Campaign for Grade-Level Reading, National Association of Social Workers, and the Coalition to Stop Gun Violence. - Practice Guidelines
Call for action: Nurses must play a critical role to enhance health literacy
Nursing OutlookVol. 66Issue 1p97–100Published online: November 27, 2017- Lori A. Loan
- Terri Ann Parnell
- Jaynelle F. Stichler
- Diane K. Boyle
- Patricia Allen
- Christopher A. VanFosson
- and others
Cited in Scopus: 38Health literacy is a precursor to health and achievement of a culture of health (Barton et al., 2017). Patient empowerment, engagement, activation, and maximized health outcomes will not be achieved unless assurance of health literacy is applied universally for every patient, every time, in every health care encounter, and across all environments of care. Organizations such as the Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) endorse the use of available resources such as the Health Literacy Universal Precaution Toolkit (Brega et al., 2015). - Practice Guidelines
The vital role of school nurses in ensuring the health of our nation's youth
Nursing OutlookVol. 66Issue 1p94–96Published online: November 24, 2017- Erin D. Maughan
- Julia Cowell
- Martha K. Engelke
- Ann Marie McCarthy
- Martha D. Bergren
- M. Kathleen Murphy
- and others
Cited in Scopus: 22The American Academy of Nursing believes all students must have daily access to a full-time, school nurse, who is part of a comprehensive health-care and education system, and is supported financially by health and education dollars. The health of our nation's youth affects the health of the nation now and in the future, and is a critical investment. Rates of chronic health conditions continue to increase and become more complex. The number of outbreaks of communicable diseases such as measles and pertussis has been increasing as a result of the increase in immunization exemptions that have caused decreased herd immunity for these and other conditions. - Article American Academy of Nursing on Policy
Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care
Nursing OutlookVol. 65Issue 6p761–765Published in issue: November, 2017- Jordon Bosse
- Katherine Simmonds
- Charlene Hanson
- Joyce Pulcini
- Lynne Dunphy
- Patricia Vanhook
- and others
Cited in Scopus: 12Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens (Agency for Healthcare Research and Quality, 2014; Buerhaus, DesRoches, Dittus, & Donelan, 2015; Pohl et al., 2010a; Seibert, Alexander, & Lupien, 2004). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care (National Center for Workforce Analysis Health Resources and Services Administration, 2013; Perloff, DesRoches, & Buerhaus, 2016). - Article American Academy of Nursing on Policy
Position statement: Reducing fatigue associated with sleep deficiency and work hours in nurses
Nursing OutlookVol. 65Issue 6p766–768Published in issue: November, 2017- Claire C. Caruso
- Carol M. Baldwin
- Ann Berger
- Eileen R. Chasens
- Carol Landis
- Nancy S. Redeker
- and others
Cited in Scopus: 40The American Academy of Nursing promotes management practices in health care organizations and strategies in the nurse's personal life to support sleep health in nurses and, as a result, an alert nursing workforce fit to perform their jobs and more able to live healthy lives. Society requires critical nursing services around the clock. Consequently, shift work and long work hours are common in health care organizations and negatively affect a significant percent of nurses. Working at night and irregular hours compromise human physiology dictated by the need for sleep and circadian rhythms. - Article American Academy of Nursing on Policy
Reduce noise: Improve the nation's health
Nursing OutlookVol. 65Issue 5p652–656Published in issue: September, 2017- Sally Lechlitner Lusk
- Marjorie McCullagh
- Victoria Vaughan Dickson
- Jiayun Xu
Cited in Scopus: 8Although noise as a cause of hearing loss and tinnitus among civilian (Hearing health care for adults: Priorities for improving access and affordability, 2016) and military populations (Noise and military service: Implications for hearing loss and tinnitus, 2006) is well known, studies conducted in the past 15 years document that noise exposures negatively affect health by contributing to many diseases, including cardiovascular diseases, obesity, developmental delays, mental illness, and reduced job and academic performance (Basner et al., 2015; Lusk, Gillespie, Hagerty, & Ziemba, 2004; Münzel, Gori, Babisch, & Basner, 2014; Pyko et al., 2015; Ristovska, Laszlo, & Hansell, 2014; Tzivian et al., 2015; Yoon, Hong, Roh, Kim, & Won, 2015). - Article American Academy of Nursing on Policy
Engaging communities in creating health: Leveraging community benefit
Nursing OutlookVol. 65Issue 5p657–660Published in issue: September, 2017- Susan M. Swider
- Bobbie Berkowitz
- Sarah Valentine-Maher
- Shannon N. Zenk
- Betty Bekemeier
Cited in Scopus: 5The academy supports sustaining and building on institutional and regulatory policies to realize the goals of improved population health and greater health equity. In 2010, the Patient Protection and Affordable Care Act (ACA) modified community benefit requirements for nonprofit hospitals to support hospitals taking a broader view of community benefits. The law, and its interpretation in final rules of Internal Revenue Service (IRS) regulations (IRS, 2014), requires nonprofit hospitals to complete a triennial community health needs assessment (CHNA) and strategic plan to address identified community health needs. - Article American Academy of Nursing on Policy
Increasing the capacity of public health nursing to strengthen the public health infrastructure and to promote and protect the health of communities and populations
Nursing OutlookVol. 65Issue 5p661–664Published in issue: September, 2017- Joan E. Kub
- Pamela A. Kulbok
- Sarah Miner
- Jacqueline A. Merrill
Cited in Scopus: 24The American Academy of Nursing recognizes the need for strengthening the U.S. public health workforce and supports efforts to increase the capacity of public health nursing (PHN) to promote and protect the health of communities and populations. PHN has distinguished itself as a nursing specialty by defining its practice as that of “promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences” (American Public Health Association, PHN Section, 2013). - Article American Academy of Nursing on Policy
Opioid misuse epidemic: Addressing opioid prescribing and organization initiatives for holistic, safe and compassionate care
Nursing OutlookVol. 65Issue 4p477–479Published in issue: July, 2017- Madeline Naegle
- Expert Panel Psychiatric, Mental Health & Substance Abuse
- Ann M. Mitchell
- Expert Panel Psychiatric, Mental Health & Substance Abuse
- Margaret Flinter
- Expert Panel Primary Care
- and others
Cited in Scopus: 6The U.S. Centers for Disease Control (CDC) (2016a) state that the misuse and illicit use of prescription analgesic drugs and use of heroin have skyrocketed to epidemic proportions. Former Surgeon General Vivek Murtha's report, Facing Addiction in America (2016) notes that 12.5 million Americans use opioid pain relievers in ways other than those intended by prescription (USHHS, 2016). Notably, about 61% of the US drug overdose deaths in 2014 involved an opiate (Rudd, Seth, David, & Scholl, 2016). - Article American Academy of Nursing on Policy
Policy brief: Improve coverage of newborn genetic screening to include the Recommended Uniform Screening Panel and newborn screening registry
Nursing OutlookVol. 65Issue 4p480–484Published online: May 8, 2017- Angela Starkweather
- Bernice Coleman
- Veronica Barcelona de Mendoza
- Mei Fu
- Jacquelyn Taylor
- Wendy Henderson
- and others
Cited in Scopus: 6A major goal of newborn screening is to reduce morbidity and mortality in infants and children by identifying heritable conditions in which early treatment may improve a child's long-term health and survival. However, the number and type of heritable disorders included in newborn screening currently vary from state to state. Expert recommendations to screen for 34 core conditions and report on 26 secondary conditions were issued by the U.S. Department of Health and Human Services. This panel, known as the Recommended Uniform Screening Panel (RUSP), has not been adopted by all states thereby creating a geographic disparity in opportunities to receive timely intervention for potentially life-threatening heritable conditions. - Corrigendum American Academy of Nursing on Policy
Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education [Nursing Outlook 65/2 (2017) 242–245]
Nursing OutlookVol. 65Issue 3p346–350Published in issue: May, 2017- Diana Taylor
- Ellen F. Olshansky
- Nancy Fugate Woods
- Versie Johnson-Mallard
- Barbara J. Safriet
- Teresa Hagan
Cited in Scopus: 2The authors regret that the printed version of the above article contained a number of errors. The correct and final version follows. The authors would like to apologise for any inconvenience caused. - Special Issue: Robert Wood Johnson Faculty Scholars Program American Academy of Nursing on Policy
Call for improved military policy to support breastfeeding among U.S. armed forces
Nursing OutlookVol. 65Issue 3p343–345Published online: April 18, 2017- Emily Drake
- Karin Cadwell
- Joan E. Dodgson
Cited in Scopus: 3Human milk saves lives, reduces health care costs, and improves the health of both mother and infant. For a small investment to support breastfeeding among active-duty women, the payoff for the U.S. military would be significant: retention of loyal and well-trained service personnel, improved health of women, and a reduction in Tricare costs. Providing breastfeeding support can help the U.S. armed forces retain valued servicewomen after childbirth. A model policy to support breastfeeding women would include on-site lactation support services and peer support, suitable areas available for milk expression and storage, reasonable break time, and a leave policy that incentivizes breastfeeding. - Article American Academy of Nursing on Policy
Improving maternal and infant outcomes by promoting normal physiologic birth on hospital birthing units
Nursing OutlookVol. 65Issue 2p240–241Published in issue: March, 2017- Linda J. Mayberry
- Melissa D. Avery
- Wendy Budin
- Shannon Perry
Cited in Scopus: 3Pregnancy, labor, and birth are normal physiologic processes in women's lives. Women should receive care that supports a physiologic approach, using medical interventions only when needed, and continuing to support normal aspects of pregnancy and birth in more complex situations when possible. The academy supports the normalcy of pregnancy and birth and a woman-centered physiologic approach to providing care on hospital birthing units. - Article American Academy of Nursing on Policy
Position statement: Political interference in sexual and reproductive health research and health professional education
Nursing OutlookVol. 65Issue 2p242–245Published in issue: March, 2017- Diana Taylor
- Ellen F. Olshansky
- Nancy Fugate Woods
- Versie Johnson-Mallard
- Barbara J. Safriet
- Teresa Hagan
Cited in Scopus: 2Political interference in sexual and reproductive health (SRH) research and health professional education threatens the health of women and men. The American Academy of Nursing (academy) strongly supports actions to prevent political interference by supporting academic freedom principles and policies in institutions of higher education generally and in those offering instruction in nursing particularly. - Article American Academy of Nursing on Policy
Admit to observation status: Policy brief
Nursing OutlookVol. 64Issue 6p604–606Published online: October 15, 2016- Cynthia Arslanian-Engoren
- Linda Laskowski-Jones
- Toby Bressler
- Ann Marie Kolanowski
- Adriana Perez
- Lori L. Popejoy
- and others
Cited in Scopus: 0The Centers for Medicare and Medicaid Services (CMS) has differential payment for inpatient and observation status patient services. Observational stays are not credited toward the admission criteria for a skilled nursing facility (SNF). This rule poses financial concerns and burdens for Medicare patients. The Academy supports efforts to amend and replace the current payment rules with a more equitable payment policy for observation status and to limit its financial liability on patients. - Article American Academy of Nursing on Policy
Critical workforce issues for registered and advanced practice nurses in integrated care models
Nursing OutlookVol. 64Issue 6p607–609Published online: October 11, 2016- Kathleen R. Delaney
- Madeline Naegle
- Margaret Flinter
- Joyce Pulcini
- Emily J. Hauenstein
Cited in Scopus: 3Team-based, integrated models of care are essential to meeting the behavioral health needs of patients, families, and communities. To broaden the reach of effective integrated behavioral health care, all health providers must act to remove financial barriers, promote implementation of models designed for a wider range of populations, and improve access to services. The American Academy of Nursing identifies several actions in which nursing can partner with state and federal agencies, advocacy groups, and professional organizations to achieve these goals. - Article American Academy of Nursing on Policy
Lesbian, gay, bisexual, and transgender health disparities are a global concern
Nursing OutlookVol. 64Issue 3p279–280Published online: March 19, 2016Cited in Scopus: 5Increasingly, initiatives by civil societies, governmental and nongovernmental agencies, and international partners have highlighted inequities in health care access and health outcomes for lesbian, gay, bisexual, and transgender (LGBT) people throughout the world. The United States Agency for International Development promotes LGBT human rights globally through its LGBT Global Development Partnership and has a vision that “…the basic and universal human rights of LGBT persons are respected and they are able to live with dignity, free from discrimination, persecution, and violence” (USAID, 2015). - Article American Academy of Nursing on Policy
Call to action: Nursing action necessary to prevent one million heart attacks and strokes by 2017
Nursing OutlookVol. 64Issue 2p197–199Published in issue: March, 2016Cited in Scopus: 0Despite repeated national attempts to prevent and manage cardiovascular disease (CVD), it remains a leading public health problem in the United States today with costs estimated to exceed $289 billion (Anonymous, 2014; Mozaffarian et al., 2015). Several risk factors contribute to the burden of CVD. One third of all Americans have hypertension, and approximately half of those affected do not have it controlled (Mozaffarian et al., 2015; Lloyd-Jones et al., 2009; Ong, Cheung, Man, Lau, & Lam, 2007). - American Academy of Nursing on Policy
Removing reimbursement barriers to increase the use of screening, brief intervention, and referral to treatment to prevent risky alcohol use
Nursing OutlookVol. 63Issue 6p703–705Published in issue: November, 2015Cited in Scopus: 0Better preparation and positioning of nurses to identify and address modifiable risks associated with preventable behavioral health care issues is one of the strongest and most feasible actions that can be taken by health care providers to reduce harm from alcohol use. (This recommendation was a product of the “Harm Reduction To Transform Health Care” Policy Dialogue presented at the 2013 American Academy of Nursing annual meeting.) One modifiable risk that affects the health of about 25% of the U.S. - American Academy of Nursing on Policy
Elder justice: Preventing and intervening in elder mistreatment
Nursing OutlookVol. 63Issue 5p610–613Published in issue: September, 2015Cited in Scopus: 1In the United States, as many as 1 in 10 older adults and 47% of persons with dementia living at home experience some form of mistreatment (IOM, 2014). Elder mistreatment results in diminished well-being and quality of life, and violates the rights of older adults to be safe and free from violence. Elder mistreatment can occur anywhere–in the home, in care and residential facilities and in the community. It can also be malignantly contagious within settings and families and across the lifespan (Dong, 2012). - American Academy of Nursing on Policy
Putting “health” in the electronic health record: A call for collective action
Nursing OutlookVol. 63Issue 5p614–616Published in issue: September, 2015Cited in Scopus: 5The American Academy of Nursing (Academy) endorses the capturing of social and behavioral determinants of health in the electronic health record (EHR). For this to happen, action must be taken to identify specific social and behavioral determinants of health (SBHD) to be included in a parsimonious panel to foster standardization and promote interoperability. - Article American Academy of Nursing on Policy
Policy agenda for nurse-led care coordination
Nursing OutlookVol. 63Issue 4p521–530Published in issue: July, 2015- Gerri Lamb
- Robin Newhouse
- Claudia Beverly
- Debra A. Toney
- Stacey Cropley
- Charlotte A. Weaver
- and others
Cited in Scopus: 24The Care Coordination Task Force (CCTF) was convened in mid-2014 by the leadership of the American Nurses Association (ANA) and the American Academy of Nursing (AAN) to review major position papers and policy briefs on care coordination published between 2012 and 2013 by expert panels of both organizations, and to recommend specific and actionable federal policy priorities to advance nursing's contributions to effective care coordination. Nurses have been and continue to be pivotal in the development and delivery of innovative care coordination practice models. - Article American Academy of Nursing on Policy
Position statement: Employment discrimination based on sexual orientation and gender identity
Nursing OutlookVol. 63Issue 3p366–367Published in issue: May, 2015Cited in Scopus: 0The American Academy of Nursing opposes discrimination based on sexual orientation and gender identity. This position is consistent with its support for diversity and efforts to eliminate health disparities. Employment discrimination adversely affects physical and mental health (Institute of Medicine, Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities, 2011; Sears & Mallory, 2011). By perpetuating social stigma and adding to minority stress, it contributes to health disparities among lesbian, gay, bisexual, and transgender (LGBT) people, including those who have not directly experienced workplace discrimination. - Article American Academy of Nursing on Policy
American Academy of Nursing position statement on reparative therapy
Nursing OutlookVol. 63Issue 3p368–369Published in issue: May, 2015Cited in Scopus: 0Reparative therapies, sometimes called conversion therapies or sexual orientation change interventions, have been widely discredited by most major health care professional organizations for their lack of scientific justification, failure to achieve intended results, questionable clinical practices, disregard and lack of respect for normal human differences, and inherently harmful effects on mental and physical health of individuals being pressured to change (APA, 2009; AMA, 2014). The American Psychological Association's Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009) carried out a systematic review of the literature and “concluded that efforts to change sexual orientation are unlikely to be successful and involve some risk of harm…” (pg. - Article American Academy of Nursing on Policy
Reconsideration of do not resuscitate orders in the surgical/procedural setting
Nursing OutlookVol. 63Issue 3p370–373Published in issue: May, 2015Cited in Scopus: 0The American Academy of Nursing has long endorsed advance care planning and end-of-life conversations as essential components in the care of all persons but especially for those with critical, chronic, or complex conditions (American Academy of Nursing, 2010; The Palliative and End of Life Care Expert Panel, 2013; Tilden et al., 2012). The Institute of Medicine affirms the importance and necessity of having such conversations with patients in their recent report titled Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life (Institute of Medicine, 2014). - Article American Academy of Nursing on Policy
Implementing culturally competent care
Nursing OutlookVol. 63Issue 2p227–229Published in issue: March, 2015Cited in Scopus: 0Today there are more migrants in the world than ever before — about 232 million international migrants in 2013 (United Nations, 2013). Nurses are one cohort of these migrants as countries increasingly employ immigration as a strategy to address their nursing shortages (International Centre for Nurse Migration, 2014). This movement of peoples across geographic borders and the transfer of nurses from one country to another challenges nurses to understand cultures different from their own in order to provide safe, quality care. - Article American Academy of Nursing on Policy
Same-sex partnership rights: Health care decision making and hospital visitation
Nursing OutlookVol. 63Issue 1p95Published in issue: January, 2015Cited in Scopus: 0Although progress toward ensuring the rights of same-sex partners to visit and make decisions regarding the care of a hospitalized partner or partner's child has been made, policies and guidelines are inconsistently applied and sometimes completely ignored. Denying these rights is a violation of human rights and is detrimental of to the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) people. - Article American Academy of Nursing on Policy
American Academy of Nursing announced engagement in National Choosing Wisely® Campaign
Nursing OutlookVol. 63Issue 1p96–98Published in issue: January, 2015Cited in Scopus: 0As Part of Campaign, The Academy Released the List of Five Commonly Used Treatment Approaches That Are Not Always Necessary or Advisable - Article American Academy of Nursing on Policy
American Academy of Nursing: Improving health and health care systems with advanced practice registered nurse practice in acute and critical care settings
Nursing OutlookVol. 62Issue 5p366–370Published in issue: September, 2014- American Academy of Nursing, Washington, DC
Cited in Scopus: 1Patients in acute care hospitals receive more than 18 million days of intensive care unit care annually at an estimated cost of nearly 1% of the gross domestic product (Health Research Services Administration [HRSA], 2006). A significant need for acute/critical care services remains, especially in the context of an aging American population. Advanced practice registered nurses (APRNs) working in acute care settings are well positioned and well prepared to reduce health care costs while improving access, addressing health systems issues, and providing high-quality care. - Article American Academy of Nursing on Policy
American Academy of Nursing: Hepatitis C testing in the birth cohort 1945-1965: Have you been tested?
Nursing OutlookVol. 62Issue 5p371–373Published in issue: September, 2014- American Academy of Nursing, Washington, DC
Cited in Scopus: 0In July 2012, the American Academy of Nursing endorsed the recommendations of the Expert Panel on Emerging Infectious Diseases to accelerate efforts to remove barriers for hepatitis C screening and testing (Zucker, 2012). One month later, the Centers for Disease Control and Prevention announced its “Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965.” These baby boomers account for 76.5% of HCV cases in the United States (MMWR, 2012). - Article American Academy of Nursing on Policy
American Academy of Nursing: Ethics Policy-Maintaining high standards
Nursing OutlookVol. 62Issue 5p374–375Published in issue: September, 2014- American Academy of Nursing, Washington, DC
Cited in Scopus: 0Ethics is a branch of philosophy concerned with moral principles that guide decisions on how to live and how to behave. It is also defined as an evaluation of a moral choice based on ideas about what is morally right or wrong (Beauchamp & Childress, 2013). Ethics provides an opportunity to describe and understand standards of conduct in nursing practice. The nursing profession has long held to high ethical standards with the most recent benchmark being the development of the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association [ANA], 2001). - Article American Academy of Nursing on Policy
Core competencies in human milk and breastfeeding: Policy and practice implications for nurses
Nursing OutlookVol. 62Issue 4p297–298Published online: May 28, 2014- Diane L. Spatz
Cited in Scopus: 4The American Academy of Nursing endorses human milk and breastfeeding as the preferred method of infant feeding and has a long history of policy work and publications from the Expert Panel on Breastfeeding of the Academy. The Academy has members who serve the United States Breastfeeding Committee (USBC), and our members actively participated in the development of the core competencies for health professionals. In 2013, the Academy endorsed these core competencies for health professionals, further underscoring our commitment to improving the landscape of breastfeeding in the United States. - American Academy of Nursing on Policy
The mechanics of writing a policy brief
Nursing OutlookVol. 62Issue 3p219–224Published in issue: May, 2014- Rosanna DeMarco
- Kimberly Adams Tufts
Cited in Scopus: 8According to Nannini and Houde (2010), reports addressing the interests and needs of policy makers are frequently referred to as policy briefs. These reports are intended to be short and easy to use, containing information that can be reviewed quickly by policy makers. The contents of these reports are based on systematic reviews of the literature addressing refereed, rigorously evaluated science to advance policy making based on the best evidence. In a very important way, policy briefs give policy makers context to the issues that are intended to be addressed in their roles. - American Academy of Nursing on Policy
Promoting the mental health of families
Nursing OutlookVol. 62Issue 3p225–227Published in issue: May, 2014- Geraldine S. Pearson
- Lois K. Evans
- Vicki P. Hines-Martin
- Edilma L. Yearwood
- Janet A. York
- Catherine F. Kane
Cited in Scopus: 3The American Academy of Nursing has identified the development of healthy families, particularly those that are underserved, as one of its priorities. This is a broad mandate that focuses on physical and mental health promotion, maintenance, and treatment, recognizing that physical and mental health is intertwined. Mental health status is particularly precarious in families living in poverty and those confronted with chronic health problems, limited access to care, and the stigma associated with mental health problems. - Article American Academy of Nursing on Policy
A call to action: Engage in big data science
Nursing OutlookVol. 62Issue 1p64–65Published in issue: January, 2014- Thomas R. Clancy
- Kathryn H. Bowles
- Lillee Gelinas
- Ida Androwich
- Connie Delaney
- Susan Matney
- and others
Cited in Scopus: 0Numerous landmark reports in recent years have described the core problems and challenges of health care access, quality, safety, efficiency, and effectiveness today (Committee on Patient Safety, 2012; Smith, Saunders, Stuckhardt, & McGinnis, 2013). The significance of these problems as measured by the annual cost of medical errors is estimated at $17.1 billion dollars (Van Den Bos, 2011); 63.1% of these errors were judged preventable (Landrigan et al., 2010). The Affordable Care Act, the anticipated influx of approximately 32 million newly insured Americans in 2014, and the need to show quality and meaningful use require action on these important challenges. - Article American Academy of Nursing on Policy
A call to action: Expanded research agenda for women's health
Nursing OutlookVol. 61Issue 4p252Published in issue: July, 2013- Judith A. Berg
- Joan Shaver
- Ellen Olshansky
- Nancy Fugate Woods
- Diana Taylor
Cited in Scopus: 4Recently, reports were released by the National Institutes of Health, Office of Research on Women's Health, and the Institute of Medicine suggesting women's health research agendas. These reports stimulated commentary from the American Academy of Nursing's Women's Health Expert Panel. This commentary identified the need for an expanded research agenda for women's health that was published in Nursing Outlook (Shaver, Olshansky, & Woods, 2013). The following call to action highlights the most critical areas that were not included in these reports. - Article Policy
Prescription drug abuse: Problem, policies, and implications
Nursing OutlookVol. 61Issue 2p78–84Published online: December 14, 2012- Janice Phillips
Cited in Scopus: 11This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation’s fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. - Article American Academy of Nursing on Policy
Advance care planning as an urgent public health concern
Nursing OutlookVol. 60Issue 6p417Published in issue: November, 2012- Virginia Tilden
Cited in Scopus: 1The American Academy of Nursing extensively engages in the work of policy improvement for better end-of-life care for all Americans. The Academy's work is evident in at least three specific recent activities: - Article American Academy of Nursing on Policy
Advance care planning as an urgent public health concern
Nursing OutlookVol. 60Issue 6p418–419Published in issue: November, 2012- Virginia Tilden
- Inge Corless
- Constance Dahlin
- Betty Ferrell
- Rosemary Gibson
- Judy Lentz
Cited in Scopus: 2The American Academy of Nursing endorses end-of-life conversations as essential for the care of patients with life-limiting conditions so that patients’ values and preferences for their care and treatment are honored. These conversations, formally known as advance care planning, should rightfully occur among health professionals, patients, and patients’ families. - Article Policy
Global health diplomacy: An integrative review of the literature and implications for nursing
Nursing OutlookVol. 61Issue 2p85–92Published online: September 21, 2012- Anita Hunter
- Lynda Wilson
- Marcia Stanhope
- Barbara Hatcher
- Marianne Hattar
- DeAnne K. Hilfinger Messias
- and others
Cited in Scopus: 19The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. - Article American Academy of Nursing on Policy
The imperative for patient-, family-, and population-centered interprofessional approaches to care coordination and transitional care: A policy brief by the American Academy of Nursing’s Care Coordination Task Force
Nursing OutlookVol. 60Issue 5p330–333Published in issue: September, 2012- Pamela Cipriano
Cited in Scopus: 0The American Academy of Nursing (AAN), representing nurse policy leaders, scientists, and clinicians, applauds the Centers for Medicare and Medicaid Services’ (CMS) recognition and support of evidence-based care coordination and transitional care. As CMS moves forward with policies for care coordination under Medicare and Medicaid, the AAN urges the agency to consider the framework it uses for thinking about care coordination and the evidence to support that framework. The Academy seeks to share its perspectives on crucial elements of such a framework to support the integration of care coordination and transitional care into the U.S. - Article Policy
Conceptual models to guide best practices in organization and development of State Action Coalitions
Nursing OutlookVol. 61Issue 2p70–77Published online: August 24, 2012- Mary E. Cramer
- Linda Lazure
- Kathy J. Morris
- Marilyn Valerio
- Rosanna Morris
Cited in Scopus: 2The RWJF/AARP National Campaign for Action established a goal of establishing Action Coalitions in every state by 2012. Last year, a small Steering Committee formed in Nebraska and used two conceptual models to guide the organization and development of its Action Coalition. The purpose of this article is to present the Internal Coalition Outcome Hierarchy (ICOH) model that guided development of partnership and coalition building. The second model, Determining Program Feasibility, provided a framework for data collection and analysis to identify the opportunities and challenges for strategic program planning to accomplish identified key priorities for Nebraska. - Article Policy
Where we are today: Prioritizing women’s health services and health policy. A report by the Women's Health Expert Panel of the American Academy of Nursing
Nursing OutlookVol. 61Issue 1p5–15Published online: August 23, 2012- Judith A. Berg
- Diana Taylor
- Nancy Fugate Woods
- The Women's Health Expert Panel of the American Academy of Nursing
Cited in Scopus: 13There has been a recent resurgence of interest in women's health as evidenced by several federal and international policy-shaping reports that will impact women's health services. These reports include the 2010 Affordable Care Act, the formation of the National Prevention Council and Strategy, the 2011 IOM report on clinical preventives services for women, and the World Health Organization strategic plan for 2010-2015. In this paper, we summarize and discuss these reports and discuss implications of enacting the suggested health policies. - Article American Academy of Nursing on Policy
Expert panel on nursing theory guided practice position paper: Nursing knowledge and the impact on Nursing's Preferred Future a plan for enhancing Raise the Voice Phase II
Nursing OutlookVol. 60Issue 4p228Published in issue: July, 2012- Dorothy A. Jones
- Dorothy DeMaio
- Vivien Dee
- Callista Roy Sr
- Jean Watson
- Pamela Clark
- and others
Cited in Scopus: 0The American Academy of Nursing (AAN) strives to lead the nation and “… serve the public and nursing profession by advancing health policy and practices through the generation, synthesis and dissemination of nursing knowledge”.1 Still the story of how nurses everywhere are positioned to revolutionize our healthcare system remains untold. One strategy that the AAN can use to reveal this story and take the lead in advancing policy is to make explicit the disciplinary knowledge integral to the implementation of the innovative experiments of the AAN-led Edge Runners initiative. - Article American Academy of Nursing on Policy
Hepatitis C screening and testing: A call for a national response
Nursing OutlookVol. 60Issue 4p229–230Published in issue: July, 2012- Donna M. Zucker
- Submitted by the Emerging and Infectious Diseases Expert Panel
Cited in Scopus: 3The purpose of this brief is to convey the immediate need to coordinate and integrate hepatitus C virus (HCV) screening and testing for HIV co-infected and HCV-infected clients, into primary care. In 2000, 1.25 million persons were estimated to be chronically infected with hepatitus B virus (HBV), and 2.7 million are chronically infected with HCV.1 Furthermore, 55% to 85% of new HCV infections become chronic.2 Of the 1.0 million people chronically infected with HIV, 250,000 also have HBV, and ∼ 50,000 also have HCV, the leading cause of hepatocellular carcinoma. - Article American Academy of Nursing on Policy
Women’s health in jeopardy: Failure to curb unintended pregnancies: A statement from the AAN Women’s Health Expert Panel
Nursing OutlookVol. 60Issue 3p163–164.e1Published in issue: May, 2012- Judith A. Berg
- Ellen Olshansky
- Joan Shaver
- Diana Taylor
- Nancy Fugate Woods
Cited in Scopus: 4Care of and access to health care for women across the age span has always been at the forefront of nursing’s advocacy through education, practice, and research. One well-recognized method to improve the health status of women and children lies in managing unintended pregnancies; however, evidence shows that little progress has been made on this front. Threatening to roll back what little progress has been made, as well as the potential to achieve better management of unintended pregnancies, contemporary health policy fails to consistently ensure access to high-quality reproductive health care for all women in the United States. - Article American Academy of Nursing on Policy
The Fellow selection review process
Nursing OutlookVol. 60Issue 3p165–166.e1Published in issue: May, 2012- Susan A. Albrecht
- Margaret L. McClure
- Kelsey A. Buchanan
- Faye A. Gary
Cited in Scopus: 0The American Academy of Nursing (AAN) is an organization dedicated to serving the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge.1 - Article American Academy of Nursing on Policy
Carpe diem: Nursing making inroads to improve mental health for elders
Nursing OutlookVol. 60Issue 2p107–108Published online: February 10, 2012- Lois K. Evans
- Cornelia Beck
- Kathleen C. Buckwalter
Cited in Scopus: 8With 1 in every 5 adults over age 65 having mental illness, a projected 15 million will need services by 2030.1 Few nurses have specialized in geriatric mental health for a number of reasons: (1) The paucity of educational programs to prepare specialists, (2) the societal stigma associated with both aging and mental illness, (3) underpayment for services, and (4) lack of role models.2 Here we summarize the major accomplishments of the Academy’s Geropsychiatric Nursing Collaborative (GPNC), a Hartford-funded project designed to foster nursing’s contribution to the mental health of older Americans. - Article American Academy of Nursing on Policy
Leadership needed to address the global nursing and midwifery workforce shortage
Nursing OutlookVol. 60Issue 1p51–53Published in issue: January, 2012- Lynda Wilson
- Marsha Fowler
Cited in Scopus: 4An estimated 4.2 million health care workers are needed to address the global shortage of human resources for health (HRH) to achieve global health and development goals.1 Internationally, nurses and midwives comprise the majority of the global health care workforce,2 and the World Health Assembly has passed several resolutions over the past 20 years recognizing the importance of strengthening the nursing and midwifery (N&M) workforce. For example, in 2001, Resolution WHA54.12 recommended establishing mechanisms to address the global shortage of nurses and midwives, and to strengthen their contribution at all levels including within the WHO itself. - Article American Academy of Nursing on Policy
Performance measurement—A strategic imperative and a call to action: An overview of forthcoming papers from the American Academy of Nursing Expert Panel on Quality
Nursing OutlookVol. 59Issue 6p336–338Published in issue: November, 2011- Gerri Lamb
- Nancy Donaldson
Cited in Scopus: 6In 2010, the American Academy of Nursing Expert Panel on Health Care Quality identified performance measurement in the transforming health care delivery system as a strategic imperative and agreed that a synthesis of key concepts was needed to guide policy and provide direction for the Academy and nursing’s partners in health care. Envisioned as a “call to action,” the Expert Panel affirmed the foci of target papers, recruited members as lead authors and co-authors, and launched an ambitious effort to develop 6 substantive position papers in 2011. - Article American Academy of Nursing on Policy
The Future of Nursing Campaign for Action: State-level implementation efforts
Nursing OutlookVol. 59Issue 5p292–293Published in issue: September, 2011- Susan B. Hassmiller
Cited in Scopus: 0The Robert Wood Johnson Foundation (RWJF), in collaboration with AARP, has embarked on a national Campaign for Action that builds upon the findings in the landmark Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health. This Campaign seeks to advance comprehensive health care change by fully using the expertise and experience of all nurses. - Article American Academy of Nursing on Policy
The surgeon general’s call to breastfeeding action-policy and practice implications for nurses
Nursing OutlookVol. 59Issue 3p174–176Published in issue: May, 2011- Diane L. Spatz
Cited in Scopus: 0The lack of breastfeeding in the United States is a public health crisis. The World Health Organization, the American Academy of Pediatrics, and multiple other professional organizations all recommend that infants are exclusively breastfed for the first 6 months; in the United States, however, only 13.6% of infants receive exclusive human milk for this time period.1-3 A 2010 study in the United States reported that 911 infant deaths could be prevented if breastfeeding rates were improved.4 On January 20, 2010, with the release of the Surgeon General’s Call to Breastfeeding Action, the US government released the most comprehensive plan to date of what needs to occur to improve breastfeeding outcomes and the health of our nation. - AAN on Policy
Advance care planning as an urgent public health concern
Nursing OutlookVol. 59Issue 1p55–56Published in issue: January, 2011- Virginia Tilden
- Inge Corless
- Constance Dahlin
- Betty Ferrell
- Rosemary Gibson
- Judy Lentz
Cited in Scopus: 14The American Academy of Nursing endorses end-of-life conversations as essential for the care of patients with life-limiting conditions so that patients’ values and preferences for their care and treatment are honored. These conversations, formally known as advance care planning, should rightfully occur among health professionals, patients, and patients’ families. - Other
Implementing Health Care Reform: A Nursing Perspective
Nursing OutlookVol. 59Issue 1p57–58Published in issue: January, 2011Cited in Scopus: 0 - AAN News & Opinion
An update from the American Academy of Nursing's Workforce Commission
Nursing OutlookVol. 58Issue 5p272Published in issue: September, 2010- Pamela F. Cipriano
- Linda Burnes Bolton
Cited in Scopus: 0Since its inception in 2000, the American Academy of Nursing (AAN) Workforce Commission has focused on addressing the multiple factors that impede nursing workflow and the ability to achieve optimal clinical and operational outcomes. The Commission focused attention on ways technology could diminish demand on nurses' time by eliminating waste and enabling workflow, returning precious minutes of care to patients in acute care hospitals. Reducing demand is one strategy to abate cyclic nursing shortages. - AAN Guest Editorial
Guest Editorial: Intercontinental nursing
Nursing OutlookVol. 58Issue 3p167–168Published in issue: May, 2010- Roger Watson
Cited in Scopus: 0I regularly visit colleagues in Europe, North America, Australia, and South East Asia, and in my capacity as Editor-in-Chief of the Journal of Clinical Nursing, I process manuscripts from all of these parts of the world and more. Clearly, there would be little point in visiting other countries and continents if everything were the same as it was at home; it is the differences that draw us to travel and work in other countries and cultures, and the differences are apparent. For example, there could hardly be a greater contrast in cultures between Europe and South East Asia. - AAN News & Opinion
Guest Editorial: History Matters
Nursing OutlookVol. 58Issue 2p113–114Published in issue: March, 2010- Patricia D'Antonio
- Julie Fairman
Cited in Scopus: 0Washington is abuzz with history. Almost every commentator uses history to explain the foundations of critical issues and remind us how our modern problems and their solutions are shaped by historical perspectives. Thomas Freidman asks us to look back first to the Great Depression and later to the recession of the early 1970s to understand our current economic predicament and to develop useful strategies to overcome our own financial downturn. Our President, Barack Obama, has turned to economic historians Ben Bernanke and Christine Romer to chair, respectively, the Federal Reserve and the Council of Economic Advisors. - Abstract
Geospatial Linkage to Public Health Asthma Outcome
Nursing OutlookVol. 58Issue 2p115Published in issue: March, 2010- Helene J. Krouse
- Jason C. Booza
- Lawrence D. Lemke
- John J. Reiners Jr.
- Alice Grgicak-Mannion
- Richard J. Krajenta
- Xiaohong Xu
- Lois Lamerato
- Delbert M. Raymond
- Linda S. Weglicki
Cited in Scopus: 0Background: In 2003, Canada and the United States unveiled a joint strategy aimed at improving border air quality and addressing related health concerns. This proposed international, multi-disciplinary, and multi-institutional study builds upon geospatial models developed at the University of Windsor to identify and predict environmental influences on health outcomes in Detroit and Windsor. - Abstract
Sleep Disturbance among Low-Income Minority Teens
Nursing OutlookVol. 58Issue 2p115–116Published in issue: March, 2010- Mary Grace Umlauf
- John M. Bolland
- Bradley E. Lian
Cited in Scopus: 0Background: Sleep is particularly important for brain maturation and sleep deprivation in teens has a potent negative effect on behavior, emotion, and attention. Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, but teens from impoverished inner-city areas witness violence and experience stressors that are likely to affect sleep. - Abstract
Adolescent Use of Performance Enhancing Substances
Nursing OutlookVol. 58Issue 2p116Published in issue: March, 2010- Janet R. Thorlton
Cited in Scopus: 0Background: Consumer use of performance enhancing substances (PES) is a multi-billion dollar industry, fueling public health concerns regarding use in adolescents hoping to enhance athletic performance, body appearance, or fight obesity. PES may also be used for military, sexual, and intellectual performance enhancement. PES consumption can be viewed as a healthy fitness endeavor. Healthcare providers tend to be less familiar with PES than other forms of substance abuse. PES adverse effects can include violent behavior, suicide attempts, and premature deaths. - Abstract
Enhancing Diversity of Nursing Faculty Using Distance Technology
Nursing OutlookVol. 58Issue 2p116Published in issue: March, 2010- Ginette A. Pepper
- Susan Beck
- Kathi Mooney
- Lauren Clark
- Mauren Keefe
Cited in Scopus: 0Background: Recruitment of faculty to colleges of nursing who represent ethnic, racial, and geographic diversity is critical to preparation of a culturally competent nursing workforce and development of nurse scientists to address issues of health disparities. The lack of doctorally-prepared faculty from minority backgrounds and rural locations prevents realization of this goal. Barriers to pursuit of PhD education are prevalent in minority and rural nurses: family obligations that preclude long commutes or relocation, requirements for full time study, need to maintain employment during doctoral study, lack of geographic access to programs with the desired research focus, and reticence to commit to loan programs to finance doctoral study in light of the faculty salary levels that commonly are less than clinical salaries. - AAN News & Opinion
The Academy's work on healthcare reforms
Nursing OutlookVol. 57Issue 6p355–356Published in issue: November, 2009- Patricia Ford-Roegner
Cited in Scopus: 0For those of us in Washington, DC, the last few months of healthcare reform debate represent what we have been anxiously waiting for—an opportunity to reform healthcare delivery so that more people receive the care they need. And even more importantly for us, it is an opportunity to enhance the healthcare system so that it recognizes and utilizes the expertise and innovations that nurses can bring to healthcare delivery. To this end, the American Academy of Nursing (AAN) volunteers and staff have been working diligently to bring forward the messages of the value of nurse innovations to health care the importance of meaningful technology and high quality in healthcare delivery and nursing's contribution to cost-effective care. - AAN News & Opinion
Nurse Edge Runners—The hallmark of the Raise the Voice campaign
Nursing OutlookVol. 57Issue 5p296–297Published in issue: September, 2009- Patricia Ford-Roegner
- Liz Parry
Cited in Scopus: 0Nurse “Edge Runners”—the practical innovators who are leading the way in bringing new thinking and new methods to a wide range of healthcare challenges—are the hallmark of the American Academy of Nursing's Raise the Voice campaign. Edge Runners have developed options that help people stay healthy and cope better with illnesses, while producing exemplary financial and clinical outcomes. Furthermore, nurse-led innovations address people's needs and wants for a humane and effective health care system, reducing disparities while increasing efficiency and quality of patient care. - News from the American Academy of Nursing
AAN News
Nursing OutlookVol. 57Issue 4p232–233Published in issue: July, 2009- Patricia Ford-Roegner
Cited in Scopus: 0During his campaign and since taking office, President Barack Obama has made it clear that he wants major healthcare reform to happen as soon as possible. Learning from the 1990's healthcare reform debate, his team made the early decision that the White House would promote broad principles, not specific legislation. President Obama has, however, put the challenge to Congressional leaders to get the job done. And the Congressional leaders have taken up his challenge through direct action, unleashing years of pent-up energy to make healthcare reform a reality. - News from the American Academy of Nursing
An update from the American Academy of Nursing's Workforce Commission
Nursing OutlookVol. 57Issue 4p234Published in issue: July, 2009- Pamela F. Cipriano
Cited in Scopus: 0The American Academy of Nursing formed the Workforce Commission in 2000 to develop strategies for combating the nursing shortage by reducing the demand on nurses' time. Over the past 4 years, the Commission's work has focused on describing the benefits of deploying technology to enhance patient safety, enable efficient workflows, and improve nurse retention. They are currently disseminating the results of their Technology Targets Project with continued funding from the Robert Wood Johnson Foundation. - News From the American Academy of Nursing
American Academy of Nursing's Raise the Voice Campaign
Nursing OutlookVol. 57Issue 3p172Published in issue: May, 2009- Liz Parry
- Patricia Ford-Roegner
Cited in Scopus: 0We are all aware that America's healthcare system is in desperate need of repair. Health care is inaccessible to many, expensive for most, and fragmented for all. Enabling the system to deliver the best possible care at an acceptable cost requires not just reformation but transformation—moving American health care away from its current hospital-based, acuity-oriented paradigm toward a patient-centered, convenient, helpful, and affordable system. - News From the American Academy of Nursing
Translating nursing knowledge into practice: An uncommon partnership
Nursing OutlookVol. 57Issue 3p173–175Published in issue: May, 2009- Sally Lundeen
- Ellen Harper
- Karleen Kerfoot
Cited in Scopus: 4Evidence-Based Nursing Practice (EBNP) has the potential to transform and improve the quality of health care and the safety of patients. This will only occur to the extent that nursing research is made accessible and actionable for use by nurses at the bedside. The estimate that research can take up to 17 years to be translated into practice1 speaks to the enormous gap between academic and practice settings. Health information science and technology has been heralded as a significant factor in the translation of research and best evidence into the practice arena. - News From the American Academy of Nursing
Creating the context for technology: New realities for structure, media, space, and time
Nursing OutlookVol. 57Issue 2p116–118Published in issue: March, 2009- Kathy Malloch
Cited in Scopus: 0Context—circumstances in which an event occurs; a setting.1Technology—the use of scientific knowledge to solve practical problems; (Gr. tekhnologia—systematic treatment of an art or craft)1The newest and most exciting space—is where machines are actually in charge but have enough awareness to seek out people to help them when they get stuck. —Joe Flowers - News From the American Academy of Nursing
Participating in national standards initiatives: A call to action
Nursing OutlookVol. 57Issue 1p65–67Published in issue: January, 2009- Karen S. Martin
- Joyce E. Sensmeier
Cited in Scopus: 0Nearly 3 million nurses are practicing in this country and constitute the largest single group of healthcare workers. Increasingly, they use information and communication technology in the form of patient monitoring systems, computers, the Internet, email, cellular phones, and other devices. Such technology should enhance nurses' ability to provide high-quality care that is based on best practices/evidence-based practice, improve the education of students, and advance the research agenda. However, many nurses in front line and management positions are frustrated by a lack of coordination, integration, and standardization when they use healthcare information systems. - News From the American Academy of Nursing
Bringing nurses into the boardroom
Nursing OutlookVol. 56Issue 6p330–331Published in issue: November, 2008- Susan B. Hassmiller
Cited in Scopus: 2A large Midwest health system was implementing a new electronic health record (EHR) system expected to cost between $200 and $300 million. The board knew that other large health systems had phased in implementation of similar technology, requiring staff to come online first to allow any glitches to be worked out, with physicians coming on board after the initial training and testing. While acknowledging the need to be respectful of physicians' time, a nurse board member spoke out in strong support of shifting staff and physicians simultaneously – providing concrete, clinical examples of why this would be preferable – to eliminate the need for operating two different systems during the transition. - News From the American Academy of Nursing
Cognitive informatics: An essential component of nursing technology design
Nursing OutlookVol. 56Issue 6p332–333Published in issue: November, 2008- Kathleen Mastrian
- Dee McGonigle
Cited in Scopus: 5The implementation of various information technology (IT) systems designed to support, enhance and even transform healthcare delivery is inevitable. What is less certain, however, is whether or not these systems will be utilized to their greatest capacity and whether nurses will appreciate how IT systems can contribute to the knowledge base of nursing and to clinical practice. One might wonder why this seemingly counterintuitive discrepancy over information system usage and appreciation exists. The answer may very well lay behind the scenes in the infrastructure of the IT system and its user interfaces, especially in how closely the functions of the system resemble human cognition and practice patterns of the nurses utilizing them.