{"title":"Geriatric Nurse Practitioner Supply and State Scope-of-Practice Laws","authors":"Ying Xue DNSc, RN, Xueya Cai PhD, Lusine Poghosyan PhD, MPH, RN, FAAN","doi":"10.1016/S2155-8256(23)00108-4","DOIUrl":"https://doi.org/10.1016/S2155-8256(23)00108-4","url":null,"abstract":"<div><h3>Background</h3><p><span>The population of adults aged 65 years or older in the United States has continued to expand, reaching 17% of the total population in 2020. This increase has consequently led to a growing demand for geriatric care and a corresponding need for more geriatric clinicians. Given these demographic trends, it is essential to understand the relationship between state nurse practitioner (NP) scope-of-practice (SOP) laws and </span>geriatric nurse practitioner (GNP) supply.</p></div><div><h3>Purpose</h3><p>To investigate the relationship between SOP laws and GNP supply in the United States.</p></div><div><h3>Methods</h3><p>We constructed a county-level national dataset that included data from 2009 to 2019. We explored trends in SOP laws as well as trends in GNP supply by type of SOP laws. To assess the relationship between state SOP laws and GNP supply, we performed a random effect repeated measures zero-inflated Poisson regression.</p></div><div><h3>Results</h3><p>Twelve states and the District of Columbia had full SOP for NPs in 2009, and 10 additional states adopted full SOP laws for NPs between 2009 and 2019. Although the GNP supply increased nationwide, a considerable proportion of counties did not have any GNPs during the study period. Among counties with any GNPs, we found that states with full SOP laws experienced higher growth in GNP supply during the study period. However, we did not find that adoption of a full SOP law was significantly associated with a decrease in the number of counties without GNPs over time, particularly among small, nonmetropolitan counties.</p></div><div><h3>Conclusion</h3><p>The growing GNP supply is an encouraging trend. Our findings highlight the potential benefits of supportive SOP laws in expanding GNP supply, which can enhance the geriatric workforce and improve access to care for the aging population.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 3","pages":"Pages 4-13"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49868574","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}
Tracey K. Dick PhD, RN, Lori A. Loan PhD, RN, FAAN, Kathleen A. Ladner PhD, RN, FACHE(R), David J. Becker PhD, Peng Li PhD, Patricia A. Patrician PhD, RN, FAAN
{"title":"Alabama’s Acute Care Registered Nurse Workforce Demand: A Descriptive Survey-Based Study","authors":"Tracey K. Dick PhD, RN, Lori A. Loan PhD, RN, FAAN, Kathleen A. Ladner PhD, RN, FACHE(R), David J. Becker PhD, Peng Li PhD, Patricia A. Patrician PhD, RN, FAAN","doi":"10.1016/S2155-8256(23)00111-4","DOIUrl":"https://doi.org/10.1016/S2155-8256(23)00111-4","url":null,"abstract":"<div><p><strong>Background:</strong><span> State-level nursing workforce data are important because national-level data cannot account for the local conditions that affect workforce distributions across states. The Alabama Board of Nursing collects licensure and survey data that inform registered nurse (RN) supply. However, little is known about the demand for acute care RNs in the state. </span><strong>Purpose:</strong> The purpose of this study was to characterize the demand for acute care RNs in Alabama. <strong>Methods:</strong> An exploratory, descriptive design was employed. Demand for acute care RNs was determined using a voluntary <em>Survey of Acute Care Registered Nurse Employers in Alabama 2019</em>. Chief nursing officers (CNOs) in Alabama were invited to complete the survey between July 2019 and April 2020. <strong>Results:</strong> Twenty-five CNOs representing Alabama’s acute care hospitals completed the survey, 68% of whom reported an overall high demand with difficulty filling open acute care RN positions. That proportion increased to 80% when CNOs were queried about the demand for experienced RNs. <strong>Conclusion:</strong><span> This study provides evidence of the increasing demand for acute care RNs in Alabama even prior to the COVID-19 pandemic. To ensure patient safety and quality care in Alabama, the development of structures and processes for ongoing data collection regarding Alabama’s acute care RN workforce supply and demand should be a legislative and regulatory priority.</span></p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 3","pages":"Pages 33-43"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49868571","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":"Racial Disparities in Lipid Screening Among Patients With Coronary Artery Disease Narrowed in Primary Care Settings Supportive of Nurse Practitioners","authors":"Heather Brom PhD, RN, Lusine Poghosyan PhD, MPH, RN, FAAN, Jacqueline Nikpour PhD, RN, Barbara Todd DNP, CRNP, FAANP, Kathy Sliwinski BSN, Tresa Franz BS, MS, Jesse Chitta MS, Linda Aiken PhD, RN, FAAN, Margo Brooks Carthon PhD, APRN, FAAN","doi":"10.1016/S2155-8256(23)00110-2","DOIUrl":"https://doi.org/10.1016/S2155-8256(23)00110-2","url":null,"abstract":"<div><h3>Background</h3><p><span>Coronary artery disease (CAD) is the most prevalent heart disease in the United States, and it disproportionately affects Black compared to White patients. Regular </span>primary care<span> and dyslipidemia screening and management are essential for optimal CAD care. Nurse practitioners (NPs) increasingly provide primary care services, though unsupportive practice environments may constrain their ability to do so.</span></p></div><div><h3>Purpose</h3><p>To examine whether disparities<span> in lipid screening between Black and White patients with CAD were associated with the NP practice environment scores.</span></p></div><div><h3>Methods</h3><p>Cross-sectional survey data from NPs in primary care practices and Medicare claims were linked to evaluate outcomes among 111,911 CAD patients (94% White, 6% Black) across 456 primary care practices in four states (California, Florida, New Jersey, and Pennsylvania) in 2016. The NP-Primary Care Organizational Climate Questionnaire, which provides a score on the supportiveness of a respondent’s practice, was used to evaluate the NP practice environment. Multilevel regression models that accounted for patient and practice characteristics were used to evaluate the study aim.</p></div><div><h3>Results</h3><p>Compared to White patients with CAD, Black patients with CAD less frequently received annual lipid screening (77.0% vs. 70.6%; <em>p</em><span> < .001). In logistic regression models accounting for patient and practice characteristics, for every standard deviation increase in the practice environment score, Black patients experienced a 5% increase in odds of receiving lipid screening.</span></p></div><div><h3>Conclusion</h3><p><span>Investing in the NP practice environment, including increasing NP role visibility and strengthening relationships with physicians and administrators, may narrow </span>racial disparities in CAD management.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 3","pages":"Pages 20-32"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49868573","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}
Yetty Shobo PhD, Robin Hills RN, DNP, WHNP, Jay Douglas MS M, RN, CSAC, FRE, Elizabeth Carter PhD
{"title":"The Impact of COVID-19 on Nurse Aide Education Programs","authors":"Yetty Shobo PhD, Robin Hills RN, DNP, WHNP, Jay Douglas MS M, RN, CSAC, FRE, Elizabeth Carter PhD","doi":"10.1016/S2155-8256(23)00092-3","DOIUrl":"10.1016/S2155-8256(23)00092-3","url":null,"abstract":"<div><h3>Background</h3><p><span>The COVID-19 pandemic impacted various aspects of life. One of its most deleterious effects was on educational programs preparing the health workforce needed to care for patients infected by the virus and other </span>diseases.</p></div><div><h3>Purpose</h3><p>To examine self-reported difficulties precipitated by and programmatic changes made secondary to the COVID-19 pandemic by nurse aide education programs (NAEPs) in Virginia across four different settings: nursing homes and hospitals, community colleges, high schools, and proprietary programs.</p></div><div><h3>Methods</h3><p>In this exploratory study, both quantitative and qualitative data were collected through online surveys. The quantitative results were examined by setting and included the frequencies of difficulties faced and changes made. For open-ended responses, inductive thematic analysis was conducted.</p></div><div><h3>Results</h3><p><span>Of the 202 programs that participated in the study, 92% reported at least one difficulty, and several NAEPs reported multiple difficulties. The most common reported difficulties were clinical site closures among community college and proprietary NAEPs, transitioning to virtual instruction among high school NAEPs, and </span>social distancing in skills laboratories among hospital and nursing home NAEPs. In response to these COVID-19–induced difficulties, the most-reported changes were clinical training sites among community college and proprietary NAEPs, instructors and clinical training sites among high school NAEPs, and program length and primary instructor among NAEPs in nursing homes and hospitals. However, only half of the programs that reported difficulties reported making any resultant changes.</p></div><div><h3>Conclusion</h3><p>The COVID-19 pandemic led to various difficulties for NAEPs, which gives urgency to designing setting-specific regulatory guidance that would help NAEPs overcome such impacts and engender recommendations for NAEPs and researchers. The ability of NAEPs to respond to future nurse aide workforce needs depends on their urgent response.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 49-56"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48013938","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":"SHARE Act Introduced to Streamline Implementation of State Licensure Compacts","authors":"Kaitlynn Ward MIA","doi":"10.1016/S2155-8256(23)00094-7","DOIUrl":"10.1016/S2155-8256(23)00094-7","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 63-64"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44744446","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}
Rebecca Durcan BA (Hons.), LLB, LLM, Erica Richler BA (Hons.), LLB, Richard Steinecke BA, LLB
{"title":"Major Regulatory Reform Comes to Canada","authors":"Rebecca Durcan BA (Hons.), LLB, LLM, Erica Richler BA (Hons.), LLB, Richard Steinecke BA, LLB","doi":"10.1016/S2155-8256(23)00091-1","DOIUrl":"10.1016/S2155-8256(23)00091-1","url":null,"abstract":"<div><p>The <span><em>Health </em><em>Professions</em><em> and Occupations Act</em></span> of British Columbia is likely the most significant reform in the regulation of health professions, including nursing, ever enacted in Canada. It ends self-regulation for the health professions and creates an entirely new governance regime for regulators in this Canadian province. This act also expands the mandate of health regulators to include extensive and detailed requirements to foster cultural humility, to promote reconciliation with Indigenous peoples, and to actively address discrimination. Furthermore, it modifies the way in which regulatory activities are performed. This legislation will likely be closely monitored by nursing regulators throughout Canada. The present article highlights the more significant changes, particularly those consistent with regulatory reform initiatives elsewhere in Canada and the United Kingdom.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 43-48"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43748942","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":"Prelicensure Nursing Clinical Simulation and Regulation During the COVID-19 Pandemic","authors":"Nicole Kaminski-Ozturk PhD, Brendan Martin PhD","doi":"10.1016/S2155-8256(23)00090-X","DOIUrl":"10.1016/S2155-8256(23)00090-X","url":null,"abstract":"<div><h3>Background</h3><p>During the COVID-19 pandemic, many boards of nursing (BONs) in the United States issued emergency orders to allow prelicensure RN nursing programs greater flexibility regarding simulation use.</p></div><div><h3>Purpose</h3><p>To understand how state BONs adjusted their simulation regulations to support prelicensure nursing programs and how prelicensure nursing programs in turn drew upon this revised guidance to safely deliver clinical education during the early stages of the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Simulation-related BON regulations were reviewed before and during the pandemic and classified by the degree of change. All active U.S. prelicensure RN programs were then surveyed in the summer of 2020 about prior and anticipated (fall 2020) simulation usage. Data from each phase were then merged to determine how jurisdictional changes informed simulation substitution levels at the program level. Wilcoxon signed-rank tests were used to determine the significance of identified trends.</p></div><div><h3>Results</h3><p>Early in the pandemic, nearly half (<em>n</em> = 24) of states issued emergency orders to allow for the expanded use of simulation-based education (SBE) in prelicensure nursing programs. A total of 526 prelicensure RN programs participated in the survey, yielding a 32.8% response rate. Most programs increased their use of SBE, with the most pronounced changes occurring in jurisdictions in which emergency orders modified or waived existing clinical substitution thresholds.</p></div><div><h3>Conclusion</h3><p>Proactive BON emergency orders and policies provided the necessary flexibility for prelicensure RN programs to maintain the continuity of prelicensure RN students’ education early in the pandemic when many clinical sites imposed significant onsite restrictions.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 36-42"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49397570","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}
Brenda Moore PhD, RN-BC, CNE, Fadwa N. Alhalaiqa CNS, PhD, Ahlam Al-Zahrani PhD, Hoda Mohammed Sayed PhD
{"title":"Exploratory Survey of Simulation Use in Middle East and North African Prelicensure Nursing Programs","authors":"Brenda Moore PhD, RN-BC, CNE, Fadwa N. Alhalaiqa CNS, PhD, Ahlam Al-Zahrani PhD, Hoda Mohammed Sayed PhD","doi":"10.1016/S2155-8256(23)00089-3","DOIUrl":"10.1016/S2155-8256(23)00089-3","url":null,"abstract":"<div><h3>Background</h3><p>The National Council of State Boards of Nursing (NCSBN) Survey of Simulation Use in Prelicensure Nursing Programs tool was employed to gather descriptive information from nursing programs in the Middle East and North Africa (MENA). A total of 39 nursing programs from 10 countries participated.</p></div><div><h3>Purpose</h3><p>To benchmark the prevalence, use, and regulation of simulation in MENA nursing programs.</p></div><div><h3>Methods</h3><p>The NCSBN Survey of Simulation Use in Prelicensure Nursing Programs tool was communicated either electronically or in person to multiple nursing programs in the MENA region. Descriptive data, ideas, and opinions were collected.</p></div><div><h3>Results</h3><p>Of the 93 MENA programs contacted, 39 returned a completed survey. According to survey responses, simulation use in nursing programs is widespread. Simulation is commonly used to enhance instruction, to support skill acquisition, and as a substitute for clinical hours. Respondents viewed therapeutic communication, patient education, compassion, and demonstration of critical thinking as unsuitable for simulation.</p></div><div><h3>Conclusion</h3><p>Simulation is appreciated as a critical tool in nursing education in the MENA region. Limitations in clinical space, time, and complex patient situations and opposite gender care are driving factors for simulation use. Challenges related to space, funding, and training limit the availability of simulation in a region where more simulation is both needed and desired.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"14 2","pages":"Pages 29-35"},"PeriodicalIF":2.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41410673","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}