Journal of professional nursing : official journal of the American Association of Colleges of Nursing
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Political participation is an opportunity for individuals to give their time and energy in such a way that it benefits others and advances relevant agendas. Political participation is a key issue for nurses because they are familiar with clinical issues that directly impact health care policies instituted at the local, state, and federal levels. ⋯ The purpose of this exploratory review is to identify modifiable factors that support political participation among nurses. A review of the extant literature revealed three primary factors that promote civic engagement among nurses: (a) integration of political education in the nursing curriculum; (b) value of active psychological engagement, including a personal interest in political knowledge and information; and (c) value of collective influence such as membership in professional organizations.
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The purpose of this article was to address the call for evidence-based practice through the development of clinical pathways and to assert the role of the clinical nurse specialist (CNS) as a champion in clinical pathway implementation. In the current health care system, providing quality of care while maintaining cost-effectiveness is an ever-growing battle that institutions face. The CNS's role is central to meeting these demands. ⋯ Execution of clinical pathways should include a clinical expert, who has the ability to look at the system as a whole and can facilitate learning and change by employing a multitude of competencies while maintaining a sphere of influence over patient and families, nurses, and the system. The CNS plays a pivotal role in influencing effective clinical pathway development, implementation, utilization, and ongoing evaluation to ensure improved patient outcomes and reduced costs. This article expands upon the call for evidence-based practice through the utilization of clinical pathways to improve patient outcomes and reduce costs and stresses the importance of the CNS as a primary figure for ensuring proper pathway development, implementation, and ongoing evaluation.
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Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
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Cultural competence has become an important concern for contemporary health care delivery, with ethical and legal implications. Numerous educational approaches have been developed to orient clinicians, and standards and position statements promoting cultural competence have been published by both the American Medical Association and the American Nurses Association. Although a number of health care regulatory agencies have developed standards or recommendations, clinical application to patient care has been challenging. ⋯ To make cultural competence relevant to clinical practice, we linked a cultural competency continuum that identifies the levels of cultural competency (cultural destructiveness, cultural incapacity, cultural blindness, cultural precompetence, and cultural proficiency) to well-established values in health care. This situates cultural competence and proficiency in alignment with patient-centered care. A model integrating the cultural competency continuum with the components of evidence-based care (i.e., best research practice, clinical expertise, and patient's values and circumstances) is presented.
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Review Comparative Study
The journey to the DNP program and beyond: what can we learn from pharmacy?
Advanced practice nursing has been elevated to a new level with the introduction of the DNP (Doctorate of Nursing Practice). One of the justifications for its implementation is the promotion of parity between nurses and other health care providers who require a practice doctorate. ⋯ The purpose of this analysis is to explore these issues using pharmacy as an example for implementing a practice doctorate. Similarities and differences between the professions are examined, and lessons that nursing can learn from pharmacy are discussed.