Babette Biesecker

Abstract

Purpose: The purpose of this study was to analyze the national practice of fulfilling 500 clinical hours as a requirement for graduation from nurse practitioner (NP) programs at the master's level and to compare this standard to a comprehensive approach of evaluating attainment of clinical competencies. Data sources: The National Organization of NP Faculties (NONPF) and specialty accreditation bodies publications were used for references to clinical hour and core competency requirements for graduation from NP programs. Data from one university from student documentation on a commercial electronic tracking system were also analyzed. Conclusions: Data analysis revealed that the 500 clinical hours correlated to populations, skills performed, required levels of decision making, and expected diagnoses. However, assurance that these clinical hour requirements translated to exposure to all core competencies for entry into practice could not be established. Implications for practice: A more comprehensive approach to the evaluation of student core competencies by implementing one or more performance-based assessments, such as case-based evaluations, simulations, or objective structured clinical examinations (OSCEs), as a strategic part of NP evaluation prior to graduation is proposed. This change is viewed as critical to the continued success of NP programs as master's level education transitions to direct BS to DNP educational preparation for advanced nursing practice.

Abstract

PURPOSE: To develop a profile of common nutritional patterns among pregnant African American women that will assist healthcare providers in identifying areas for improvement and change. STUDY DESIGN: This study was part of a larger NIH-funded (R03NR008548-01) study that examined risk factors associated with preterm labor and birth in high- and low-risk African American women. Data were collected on high-risk mothers (women experiencing preterm labor) before 34 weeks gestation and every 4 weeks until birth. Data were also collected on the low-risk mothers beginning at 28 weeks and then every 4 weeks until birth. For this study, high- and low-risk groups were collapsed to examine food choices over time in all participants (n ≤ 58). METHODS: Nutrition intake was examined by conducting one 24-hour diet recall at each time point. Food models and portion size pictures were used to improve accuracy. RESULTS: Overall, dietary intake was suboptimal, and micro- and macronutrient intake during the third trimester did not vary. Energy (caloric) intake was inadequate with the time-averaged probability of having inadequate caloric intake 64.4%. Protein intake was the most likely nutritional factor to be inadequate with a time-averaged estimated probability of inadequate intake 25.1%. Micronutrient intake from food was also inadequate. CLINICAL IMPLICATIONS: The persistence of suboptimal nutritional intake during the third trimester supports the importance of continually assessing nutritional status throughout pregnancy, with a focus on caloric requirements and protein intake.

Abstract

New evidence has prompted changes in our national cardiopulmonary resuscitation guidelines for both neonates and adult patients. The purpose of this article is to provide an overview of the changes recommended by the American Heart Association, Academy of American Pediatrics, and the American College of Obstetrics and Gynecology. In addition, a strategy for implementing these guidelines into practice is suggested.