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Two northeast nursing schools piloted an innovative curriculum to teach The Conversation Project (TCP) to the next generation of nurses. The goal was to educate 26 graduate nursing students about how to have end-of-life and advance care planning conversations with people before they experience a crisis. The focus of assignments was on communicating newly learned TCP information. Postreflections demonstrated that participants felt their communication skills had been enhanced while their anxieties were reduced. The students' abilities to have end-of-life conversations increased. © Lippincott Williams & Wilkins.

The United States is in the midst of an opioid epidemic. The numbers of opioid-related deaths have been steadily climbing, magnifying the need for innovative intervention. Stigma is a set of preconceived, negative assumptions about a patient population or group. Stigma is a known deterrent to communication and the delivery of healthcare. Nurses serve as a primary contact for many marginalized patients within the healthcare system. The purpose of this scoping review is to gather known data on the use of educational interventions with nursing students to reduce stigmatizing tendencies. Inclusion criteria constituted an educational intervention involving student nurses and an effort to reduce stigmatizing attitudes toward patients who misuse opioids. The intervention must have taken place in an institute of higher learning between the years of 2003 and 2018. Exclusion criteria included community-wide studies. A single study was identified addressing nursing student reduction of stigmatization of the individual who uses opioids, and so, the search was expanded to include any student nursing intervention developed to reduce stigma toward any marginalized population. The following electronic databases were utilized in the search process: Cumulative Index of Nursing and Allied Health Literature, Google Scholar, Journal Storage, Microsoft Academic, and ScienceDirect. Reference pages of selected or related articles were reviewed in an attempt to identify additional pertinent literature through citation mapping. Fifteen studies were identified, each of which utilized a variable methodology for stigma reduction with varying levels of success. © Lippincott Williams & Wilkins.

Nurses conduct physical and psychosocial assessments during admissions to healthcare facilities. Patients rely upon nurses to provide support and education during their journey, from periods of health decline to states of optimal wellness. Therefore, nurses are an ideal population to assess spiritual health. The value and necessity of spiritual assessment were explored on an inpatient unit providing medical and palliative care to patients. Two spiritual assessment tools, comprised each of five items, were evaluated by nursing staff and patients. Spiritual Assessment Tool 1 used language that was unaffiliated with religion, nor a belief in God, and Spiritual Assessment Tool 2 used language affiliated with faith and belief in God. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Technologic advances are changing hospice home care. A case study explores the clinical dilemmas and illustrates the educational and research agendas required to resolve them.

Hospice providers and policy makers are currently evaluating the emerging patterns of hospice care, especially regarding cost containment considerations. This study compared patterns of care for two groups of hospice homecare clients–one group, which received only homecare services for the duration of the hospice career; the other, which received both hospice homecare and inpatient services. The groups were significantly different on clinical parameters, number of homecare episodes, survival rate, and place of death. The impact of policy structures on continuity of care and service equity are discussed. Copyright © 1986, Wiley Blackwell. All rights reserved

Most nurse educators would agree that critical thinking is an essential competency for the professional nurse in today's ever-changing health care environment. In fact, critical thinking has been identified as an integral component of professional nursing practice and has been incorporated in accreditation guidelines (1-3). As a result of this imperative, professional programs of nursing must explicate a clear definition of critical thinking, identify specific learning outcomes reflective of critical thinking abilities, and select appropriate ways to measure the achievement of these outcomes in graduating students. Although much has been written about the need for critical thinking skills, the concept and measurement of critical thinking within the context of nursing education has not yet been clearly defined (4-6). As a result, nursing programs are developing their own conceptual definitions of critical thinking and using a variety of methods to measure outcomes (5). The authors caution that to ensure validity of findings, the instruments used must reflect the individual program's definition of the concept. In most cases, outcomes have been assessed using a cross-sectional design that compares students at different levels or types of programs or are measured as an end-of-program outcome. While such designs can provide educators with knowledge of students' critical thinking abilities at a particular point in the educational process, longitudinal data are needed to assess the effects of the educational program.

In response to public criticisms about the outcomes of higher education, colleges and universities have implemented comprehensive assessment programs. In nursing education, outcomes assessment has become a criteria for accreditation. Yet, currently no guidelines exist describing “best practices” in nursing education outcomes assessment. Experts in educational assessment provide helpful guidelines for nurse educators as they establish comprehensive assessment plans. The authors provide a review of the literature in the field of assessment and offer strategies for developing successful assessment programs in nursing education.

Nurses are challenged to advance the theoretical foundations of community practice. This paper offers ideas on what-has been done and what needs to be done to meet this challenge. Within a community health nursing perspective, the paper defines community, proposes an integrated knowledge development framework that focuses on community, analyses contemporary theoretical and philosophical foundations of community in nursing, considers three worldviews in which nursing can be framed, and examines parameters for knowledge development for the future.

The primary purposes of this study were to identify the best teaching practices for adult baccalaureate (BSN) nursing students and to examine if adult students' teaching preferences differed from those of traditional BSN students. The sample consisted of 206 adult and traditional students in four BSN programs. The adult nursing student sample was further subdivided into two groups: adults with no prior nursing education (adult non-nurses) and adults with prior nursing education (RN'S). Using a two-part, self-administered questionnaire, respondents were asked to rate the frequency with which 41 teaching strategies were used in their best and in their worst classroom learning experiences in nursing. In most cases, adult non-nurses' teaching preferences did not vary significantly from the preferences of traditional students. However, adults with no prior nursing education did show a preference for knowledgeable and organized instructors. In contrast RNs' preferred classroom situations were where time on task was emphasized, cooperative learning was encouraged, and expectations for learning were high. Results indicate that classroom teaching preferences vary as a function of prior experience with the subject matter and are not attributable to age itself. Findings suggest that prior experience with course content is a more important consideration in planning programs than generalized adult experience.

The alleged synthesis of nursing and public health has not produced the expected community-as-client emphasis. Public health is characterized as disease-focused, with masculine domination, using a causal model. The explanatory model of chaos challenges nurses to reexamine nursing's theoretical base by questioning assumptions associated with linear thinking. The selected chaotic concepts of aperiodicity, attractors, sensitive dependence on initial conditions, phase space, and fractals are discussed here. Each concept's connection to physics and mathematics is cited and considerations for nursing science are outlined. Conclusions include redefining health, nursing, and community in chaotic terms and renaming nursing practice, which has this aperiodic and holistic paradigm, as ecologic health nursing.

An individual's social support system comprises multiple networks. A lack in one system may cause an increased need for support in another. Social support has been found to be of vital impor tance to the health of the older adult client and caregiver. It has been found to have a significant influence on health outcomes, acting as a buffer and altering recovery patterns. This article de scribes the concept of social support and relates how the home health care nurse can assess this dimension and use the findings to better plan patient care in the home setting. Key words: social support, home care, older adult. © 1994, Sage Publications. All rights reserved.

A recent malpractice case involved public health nurses. Given the legal issues based on this case, recommendations can be made to help ensure legal accountability, improve practice, and minimize liability risk. Areas of concern include doctor's orders and communication relating to telephone orders, the nurse's accountability to the client, documentation and patient teaching, the physician's duty to supervise the nurse, and corporate negligence. The court's analysis of the facts in finding areas of liability can guide nurses in avoiding malpractice litigation.

We assessed the beliefs of 49 college students regarding the acquired immunodeficiency syndrome (AIDS), condom use, and sexual behaviors related to AIDS prevention. Roy's modes of self-concept, interdependence, and role function were used as a framework to find psychosocial determinants that influence safer sex practices. Interdependence was measured by a sexual regard scale. Beliefs regarding both AIDS beliefs and condom were very positive. Students were selectively using safer sex practices; most reported avoiding high-risk partners, but only 39% were using condoms. No significant associations were found among the four independent measures of AIDS beliefs, condom beliefs, self-esteem, and sexual regard or with the dependent measure, AIDS safer sex practices. A two-hour safer sex educational module did change several beliefs but did not increase safer sex practices. Most participating students stated they had a good understanding of how AIDS was spread, they knew how to use condoms correctly, and they discussed AIDS with friends and parents.

Social support has a significant effect on the response to illness and treatment. The au thors present some of the findings and practical applications originating from a collaborative study, including a clinical indicator tool for the diabetic patient. This information gives the home health care professional an expanded knowledgebase to use in developing individualized care plans for the elder home care diabetic. © 1992, Sage Publications. All rights reserved.