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Little research has been done to document the value of using nursing diagnosis in home care and the impact that increased acuity levels have had in diagnostic selection. Nursing diagnosis documentation in home care was examined to see whether it had a relation to select client and visit pattern variables. This retrospective chart audit, which piloted a newly developed instrument called the Home Care Audit Tool, utilized a sample of 199 closed records of a large midwestem Visiting Nurse Association. The mean age of the client population was 76 years, with 64% female. There were 269 initial nursing diagnoses cited in the sample records, averaging 1.75 diagnoses per case. The number of recorded visits increased when select nursing diagnoses were cited together in a single case. © 1994, Taylor & Francis Group, LLC. All rights reserved.

When establishing Nursing Ethics Committees (NECs), statewide nursing organizations play an important role in developing and disseminating resources. The Connecticut Nurses Association Ethics and Human Rights Committee surveyed 85 healthcare facilities to identify active NECs. Representatives facilitated other committees by providing guidelines and assistance to those agencies developing NECs — the ultimate goal. © 1994 by Springhouse Corporation.

Meeting students’ learning needs in acute care settings is challenging. The authors discuss dual assignment in the pediatric setting with beginning nursing students. © 1992 Lippincott-Raven Publishers.

Data from an open-ended questionnaire and the comments section of a structured questionnaire were combined and ana-lyzed to determine the challenges faced and alterations in usual daily activities required by mothers caring for a young child at home in a body cast. The sample consisted of 35 mothers who identified themselves as the primary care givers of a child in a body cast. The challenges of caring for a child in a body cast required major adjustments in almost every aspect of the mothers' lives, including household activities, social and community activities, child care activities, personal care activities, occupational activities, and educational activities. © 1995 National Association of Orthopaedic Nurses.

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.