Roy A. Thompson PhD, MSN, RN, Susan G. Silva PhD, Kirsten N. Corazzini PhD, FGSA, Thomas R. Konrad PhD, Michael P. Cary, Jr PhD, RN, Eleanor S. McConnell PhD, RN
{"title":"Examining Human Capital Among Foreign- and U.S.-Educated Nurses in Long-term Care","authors":"Roy A. Thompson PhD, MSN, RN, Susan G. Silva PhD, Kirsten N. Corazzini PhD, FGSA, Thomas R. Konrad PhD, Michael P. Cary, Jr PhD, RN, Eleanor S. McConnell PhD, RN","doi":"10.1016/S2155-8256(23)00088-1","DOIUrl":"10.1016/S2155-8256(23)00088-1","url":null,"abstract":"<div><h3>Background</h3><p>Recruiting foreign-educated nurses (FENs) is a strategy to reduce staffing shortages of registered nurses (RNs) practicing in long-term care (LTC) in the United States. However, little is known about how FENs compare to U.S.-educated nurses (USENs) in their innate abilities and skills, also known as human capital.</p></div><div><h3>Purpose</h3><p>To compare human capital among FENs and USENs practicing in LTC.</p></div><div><h3>Methods</h3><p>This cross-sectional study used data from the 2018 National Sample Survey of Registered Nurses to compare human capital scores between FENs and USENs. Human capital scores consisting of highest nursing qualification, skill-based certifications, number of state licensures, years of experience, multi-state employment, and multilingual ability were constructed and compared using analysis of covariance. Covariates were race, ethnicity, marriage/partnership, adults at home, children at home, direct patient care, and practice scope.</p></div><div><h3>Results</h3><p><span>The sample included 1,887 RNs (92.8% USENs and 7.2% FENs). Most RNs were female (92.3%), were aged ≥50 years (56.4%), were non-Hispanic White (78.3%), were married/partnered (68.0%), provided direct care (44%), and had full practice scope (71.7%). FENs versus USENs had a higher proportion reporting full scope of practice (80.7% vs. 71.0%, </span><em>p</em> = .0155). The mean human capital score for the total sample was 9.8 ± 1.3. Human capital scores were higher among FENs (<em>M</em> = 11.3, <em>SD</em> = 1.2) than USENs (<em>M</em> = 9.6, <em>SD</em> = 1.3, <em>p</em> < .0001).</p></div><div><h3>Conclusion</h3><p>FENs bring a higher level of human capital to LTC settings, which suggests that they have an increased capacity to provide the needed person-centered care to positively impact care quality and improve outcomes in LTC.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 18-28"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44494473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna van der Gaag MSc, PhD, Robert Jago BA, MPhil (Cantab), Ann Gallagher SRN, MRN, BA, MA, PhD, Kostas Stathis PhD, Michelle Webster BA, MSc, PhD, Zubin Austin BScPhm, MBA, MISc, PhD, FCAHS
{"title":"Artificial Intelligence in Health Professions Regulation: An Exploratory Qualitative Study of Nurse Regulators in Three Jurisdictions","authors":"Anna van der Gaag MSc, PhD, Robert Jago BA, MPhil (Cantab), Ann Gallagher SRN, MRN, BA, MA, PhD, Kostas Stathis PhD, Michelle Webster BA, MSc, PhD, Zubin Austin BScPhm, MBA, MISc, PhD, FCAHS","doi":"10.1016/S2155-8256(23)00087-X","DOIUrl":"10.1016/S2155-8256(23)00087-X","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence (AI) refers to a broad group of technologies that are increasingly commonplace in everyday life; however, they have had only limited application in regulatory practice.</p></div><div><h3>Purpose</h3><p>The present study explored nursing regulators’ perceptions of the role and value of AI in regulation and potential barriers and facilitators to the uptake and implementation of AI.</p></div><div><h3>Methods</h3><p>Three facilitated focus group sessions with 28 representatives of regulators from Australia, the United Kingdom, and the United States were conducted. Content analysis of verbatim transcripts was completed.</p></div><div><h3>Results</h3><p>Key themes that emerged included (a) interest in how AI could enhance sustainability and improve cost-effectiveness of certain regulatory processes and (b) concerns regarding how the term “artificial intelligence” itself could be problematic. Specific barriers to the uptake of AI in regulation included concerns regarding codification of system bias, negative public perception, and lack of clarity around accountability for decision-making. Facilitators to implementation included enhancing the consistency of processes and improving the decision-making and utility in supporting trend analyses and audit functions.</p></div><div><h3>Conclusion</h3><p>Additional work in exploring how best to incorporate evolving AI technologies in regulatory practice—and what they should be named—is required, but these findings suggest that promising outcomes may lie ahead.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 10-17"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46801998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen Leslie PhD, JD, RN, Sophia Myles PhD, Sarah Stahlke PhD, Catharine J. Schiller PhD, JD, RN, Jacob J. Shelley SJD, Karen Cook PhD, MSc (A), BSN, Jennifer Stephens MA, PhD, RN, OCN, CCNE, Sioban Nelson PhD, RN, FAAN, FCAHS
{"title":"Regulating During Crisis: A Qualitative Comparative Case Study of Nursing Regulatory Responses to the COVID-19 Pandemic","authors":"Kathleen Leslie PhD, JD, RN, Sophia Myles PhD, Sarah Stahlke PhD, Catharine J. Schiller PhD, JD, RN, Jacob J. Shelley SJD, Karen Cook PhD, MSc (A), BSN, Jennifer Stephens MA, PhD, RN, OCN, CCNE, Sioban Nelson PhD, RN, FAAN, FCAHS","doi":"10.1016/S2155-8256(23)00066-2","DOIUrl":"10.1016/S2155-8256(23)00066-2","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic placed intense pressure on nursing regulatory bodies to ensure an adequate healthcare workforce while maintaining public safety.</p></div><div><h3>Purpose</h3><p>Our objectives were to analyze regulatory bodies’ responses during the pandemic, examine how nursing regulators conceptualize the public interest during a public health crisis, and explore the influence of a public health crisis on the balancing of regulatory principles. We aimed to develop a clearer understanding of regulating during a crisis by identifying themes within regulatory responses.</p></div><div><h3>Methods</h3><p>We conducted a qualitative comparative case study examining the pandemic responses of eight nursing regulators in three Canadian provinces and three U.S. states. Data were collected from semi-structured interviews with 19 representatives of nursing regulatory bodies and 206 publicly available documents and analyzed thematically.</p></div><div><h3>Results</h3><p>Five themes were constructed from the data: (1) risk-based responses to reduce regulatory burden; (2) agility and flexibility in regulatory pandemic responses; (3) working with stakeholders for a systems-based approach; (4) valuing consistency in regulatory approaches across jurisdictions; and (5) the pandemic as a catalyst for innovation. Specifically, we identified that the meaning of “public interest” in the context of high workforce demand was a key consideration for regulators.</p></div><div><h3>Conclusion</h3><p>Our results demonstrate the intensity of effort involved in nursing regulatory responses and the significant contribution of nursing regulation to the healthcare system’s pandemic response. Our results also indicate a shift in thinking around broader public interest issues, beyond the conduct and competence of individual nurses, to include pressing societal issues. Regulators are beginning to grapple with these longer-term issues and policy tensions.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 1","pages":"Pages 30-41"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9386850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele H. Talley PhD, ACNP-BC, FAANP, FNAP, FAAN, Penni Watts PhD, RN, CHSE-A, FSSH, FAAN, Jill Stewart DNP, RN, CNOR, LSSGB, Jennie R. Alspach DNP, CRNP, FNP-BC, Terri L. Poe DNP, RN, NE-BC, Linda Moneyham PhD, RN, FAAN, Peggy Sellers Benson MSN, RN, MSHA, NE-BC, Maria Shirey PhD, MBA, RN, NEA-BC, ANEF, FACHE, FNAP, FAAN, Doreen C. Harper PhD, RN, FAAN
{"title":"Innovations in Academic/Clinical Partnerships During COVID-19 to Prepare a Ready Nursing Workforce","authors":"Michele H. Talley PhD, ACNP-BC, FAANP, FNAP, FAAN, Penni Watts PhD, RN, CHSE-A, FSSH, FAAN, Jill Stewart DNP, RN, CNOR, LSSGB, Jennie R. Alspach DNP, CRNP, FNP-BC, Terri L. Poe DNP, RN, NE-BC, Linda Moneyham PhD, RN, FAAN, Peggy Sellers Benson MSN, RN, MSHA, NE-BC, Maria Shirey PhD, MBA, RN, NEA-BC, ANEF, FACHE, FNAP, FAAN, Doreen C. Harper PhD, RN, FAAN","doi":"10.1016/S2155-8256(23)00069-8","DOIUrl":"10.1016/S2155-8256(23)00069-8","url":null,"abstract":"<div><p>Management of the COVID-19 pandemic required healthcare leaders and frontline workers to rapidly innovate and adjust to a new reality that has forever transformed nursing education and practice. Throughout the pandemic, key stakeholders in Alabama lobbied for transformations in clinical training practice that ultimately improved students’ exposure to clinical environments and alleviated the pressure on practicing nurses and other healthcare workers during pandemic hospitalization surges. The present article highlights the key partners and regulatory innovations that led to these successes in Alabama.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 1","pages":"Pages 59-63"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard A. Smiley MS, MA, Richard L. Allgeyer PhD, Yetty Shobo PhD, Karen C. Lyons PhD, APRN, NEA, Rayna Letourneau PhD, RN, Elizabeth Zhong PhD, Nicole Kaminski-Ozturk PhD, Maryann Alexander PhD, RN, FAAN
{"title":"The 2022 National Nursing Workforce Survey","authors":"Richard A. Smiley MS, MA, Richard L. Allgeyer PhD, Yetty Shobo PhD, Karen C. Lyons PhD, APRN, NEA, Rayna Letourneau PhD, RN, Elizabeth Zhong PhD, Nicole Kaminski-Ozturk PhD, Maryann Alexander PhD, RN, FAAN","doi":"10.1016/S2155-8256(23)00047-9","DOIUrl":"https://doi.org/10.1016/S2155-8256(23)00047-9","url":null,"abstract":"<div><p><strong>Background:</strong><span> Every two years, the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers (Forum) conduct the only national-level survey focused on the entire U.S. nursing workforce. The survey generates data on the supply of registered nurses (RNs) and licensed practical nurses/licensed vocational nurses (LPNs/LVNs). These data are especially crucial in providing information on emerging nursing issues, which in 2022, was the impact of the (COVID-19) pandemic on the nursing workforce. </span><strong>Purpose:</strong> To provide data critical to planning for enough adequately prepared nurses and ensuring a safe, diverse, and effective healthcare system. <strong>Methods:</strong> This study used a mixed-mode approach, involving mailing a national, randomized sample survey to licensed RNs and LPNs/LVNs in most jurisdictions, supplemented by a national, randomized sample survey emailed to licensed RNs and LPNs/LVNs in four jurisdictions and data from the e-Notify nurse licensure notification system for five jurisdictions. Data from RN and LPN/LVN respondents were collected between April 11, 2022, and September 30, 2022. Data included nurse demographics, educational attainment, employment, practice characteristics, and trends. <strong>Results:</strong> The total number of active RN and LPN/LVN licenses in the United States were 5,239,499 and 973,788, respectively. The median age of RNs was 46 years and 47<!--> <span>years for LPNs/LVNs, which reflects a decrease of 6 years for each cohort from the 2020 data. This decline was associated with estimated losses to the workforce of at least 200,000 experienced RNs and 60,000 experienced LPNs/LVNs. An average of 89% of all nurses who maintain licensure are employed in nursing with roughly 70% working full-time. Hospitals and nursing/extended care facilities continue to be the primary practice setting for RNs and LPNs, respectively. Increased proportions of male and Hispanic/Latino nurses have introduced greater racial diversity in the nursing workforce. The nursing workforce is becoming increasingly more educated with more than 70% of RNs holding a baccalaureate degree or higher. More than one-quarter of all nurses report that they plan to leave nursing or retire over the next 5 years. Increased demand from the COVID-19 pandemic and inflation led nursing incomes to rise significantly across the country. Nurses were also specifically asked how the COVID-19 pandemic impacted them, and more than 60% of all nurses reported an increase in their workload because of the pandemic. </span><strong>Conclusion:</strong><span> In the wake of the COVID-19 pandemic, the nursing workforce has undergone a dramatic shift with the loss of hundreds of thousands of experienced RNs and LPNs/LVNs. The nursing workforce has become younger and more diverse with increases reflected for Hispanic/Latino and male nurses. An increasing proportion of the ","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 1","pages":"Pages S1-S90"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49879357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual Clinical Simulation Adoption and Use by Licensed Practical Nurse/Licensed Vocational Nurse Education Programs During the COVID-19 Pandemic","authors":"Nicole Kaminski-Ozturk PhD, Brendan Martin PhD","doi":"10.1016/S2155-8256(23)00065-0","DOIUrl":"10.1016/S2155-8256(23)00065-0","url":null,"abstract":"<div><h3>Background</h3><p>In the early stages of the COVID-19 pandemic, as clinical site restrictions were implemented, education programs leading to licensed practical nurse/licensed vocational nurse (LPN/LVN) degrees increasingly relied on virtual simulation-based experiences to provide clinical training to their students. However, scant evidence exists regarding the extent of this change and the various modalities employed by LPN/LVN programs across the United States.</p></div><div><h3>Purpose</h3><p>We sought to identify the degree to which virtual clinical simulation was adopted by LPN/LVN education programs during the early stages of the COVID-19 pandemic to address clinical site restrictions. In addition, we hoped to identify the practices and activities that educators included under the broad umbrella definition of virtual clinical simulation.</p></div><div><h3>Methods</h3><p>All active U.S. prelicensure LPN/LVN nursing education programs were contacted in September 2020. Program leaders were asked to estimate the proportion of clinical hours completed in virtual clinical simulation before the pandemic and the proportion anticipated for the fall 2020 term. Descriptive statistics were generated, with repeated measures analysis of covariance applied to evaluate the average change in virtual simulation within programs stratified by reported clinical restrictions.</p></div><div><h3>Results</h3><p>Representatives from 265 LPN/LVN programs in 44 U.S. jurisdictions responded to the survey. Responding programs significantly increased the proportion of clinical hours completed in virtual clinical simulation between fall 2019 (<em>M</em> = 10.7, <em>SD</em> = 15.3) and fall 2020 (<em>M</em> = 35.3, <em>SD</em> = 27.6, <em>p</em> < .001). Furthermore, there was an interaction between clinical site restrictions and term, with a more pronounced uptick in virtual simulation usage among programs that indicated they found identifying clinical sites “very difficult” (<em>M</em> = 41.1, <em>SD</em> = 28.9) relative to those who found it “somewhat more difficult” (<em>M</em> = 23.9, <em>SD</em> = 18.8, <em>p</em> < .001). Programs adopted a range of modalities, including simply watching videos and participating in virtual or augmented reality, online software packages, or other forms of screen-based learning.</p></div><div><h3>Conclusion</h3><p>As the adoption of virtual simulation increases, clear definitions of what constitutes clinical virtual simulation must be established. Additionally, rigorous inquiry to support evidence-based regulatory guidelines is needed.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 1","pages":"Pages 21-29"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9386847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brendan Martin PhD, Nicole Kaminski-Ozturk PhD, Richard Smiley MS, Nancy Spector PhD, RN, FAAN, Josephine Silvestre MSN, RN, Wendy Bowles PhD, APRN-CNP, CNE, Maryann Alexander PhD, RN, FAAN
{"title":"Assessing the Impact of the COVID-19 Pandemic on Nursing Education: A National Study of Prelicensure RN Programs","authors":"Brendan Martin PhD, Nicole Kaminski-Ozturk PhD, Richard Smiley MS, Nancy Spector PhD, RN, FAAN, Josephine Silvestre MSN, RN, Wendy Bowles PhD, APRN-CNP, CNE, Maryann Alexander PhD, RN, FAAN","doi":"10.1016/S2155-8256(23)00041-8","DOIUrl":"10.1016/S2155-8256(23)00041-8","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has had a profound impact on prelicensure nursing education, leading to widespread disruptions that may have implications for nursing students’ learning and engagement outcomes. Understanding how the rapid shift to online and simulation-based teaching methods has affected new graduates’ clinical preparedness is critical to ensure patient safety moving forward.</p></div><div><h3>Purpose</h3><p>To assess the impact of institutional, academic, and demographic characteristics on prelicensure nursing students’ academic, initial postgraduation, and early career outcomes during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>We conducted a mixed-methods longitudinal study focused on prelicensure registered nurse (RN) students entering the core of their didactic and clinical nursing coursework during the pandemic. This study uses a combination of real-time student and faculty self-report data, including externally validated instruments, within and end-of-program standardized test scores, and focus group findings. Various statistical methods, ranging from simpler descriptive and non-parametric methods to Generalized Estimating Equation (GEE) models and detailed textual analysis, are applied to assess student, faculty, and institution-level data.</p></div><div><h3>Results</h3><p>The final sample includes more than 1,100 student and faculty participants affiliated with 51 prelicensure RN programs located across 27 states. Leveraging more than 4,000 course observations collected from fall 2020 to spring 2022 and supplemented by the rich personal narratives of over 60 focus group participants, this study illuminates the breadth, scale, and ever-evolving nature of prelicensure RN programs’ efforts to maintain the continuity of nursing students’ education during the public health crisis. In doing so, it captures the many ways in which nursing administrators, faculty, and students sought to address the unparalleled challenges they confronted on a day-to-day basis. In particular, the findings provide critical insights into the efficacy of the changes nursing programs made to their course delivery formats to adjust to the confluence of rapidly evolving federal, state, and private restrictions to stem the spread of COVID-19.</p></div><div><h3>Conclusion</h3><p>This study stands as the most comprehensive assessment of prelicensure nursing education in the United States since the onset of COVID-19. It extends knowledge by linking potential deficiencies in students’ didactic and clinical education during the pandemic and their early career preparedness, clinical competence, and the patient safety implications therein.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 1","pages":"Pages S1-S67"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9240872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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