American Nurses Association Research Articles

Nursing advocacy and activism: A critical analysis of regulatory documents.

Background: Advocacy and activism are dynamic terms representing a spectrum of political action, aiming to achieve social or political change. The extent to which nursing advocacy and activism are legitimate nursing roles has been debated for around 50 years. Nursing regulatory documents, such as codes of conduct and professional standards, may provide direction to nurses on how they should act in the context of advocacy and activism.Aim: To explore what regulatory documents say about advocacy and activism, either explicitly or implicitly, and how they shape advocacy and activism.Research design: We used a Reflexive Qualitative Document Analysis approach with a Critical Feminist lens to analyse contemporary nursing regulatory documents from the USA, UK and Australia.Ethical considerations: This article has no human participants, and informed consent was not required.Findings: We identified eight nursing regulatory documents from the American Nurses Association, Nursing and Midwifery Council and Nursing and Midwifery Board of Australia. We constructed two major themes that reveal how nursing advocacy and activism are conceived and shaped in regulatory documents. Theme 1, Ideological arena describes the gendered and neoliberal subtexts influencing advocacy and activism. Theme 2, A five-pointed star, describes the shape of advocacy and activism in the regulatory documents.Conclusions: Regulatory documents from the USA, UK and Australia support diplomatic nursing advocacy and activism for people, equity, ourselves (nurses), the profession and systems change. However, more oppositional and disruptive advocacy and activism are potentially constrained by gendered and neoliberal subtexts that depoliticise nurses' roles.

Essentials of genomics in nursing undergraduate education: A discussion paper

AimTo map the 2021 American Association of Colleges of Nursing Essentials to the American Nurses Association Essentials of Genomic Nursing for all nurses and provide resources for nursing faculty to support the seamless integration of genomics into existing undergraduate curricula. BackgroundSince the completion of the Human Genome Project in 2003, rapid advancements in genomic science leading to practical applications of genomics have revolutionized all areas of healthcare. Nursing is built on foundational life sciences, including genomics. As the largest segment of the healthcare workforce, who spend the most time with patients and families, nurses play a critical role in healthcare teams integrating genomic knowledge into patient care to improve health and well-being. Consequently, nurses must be equipped with foundational genomic knowledge and skills during their undergraduate education. However, there is wide variability in whether and how nursing programs have incorporated genomics into their curricula. Additionally, nursing faculty may have limited knowledge of foundational genomic concepts and lack confidence in teaching genomics. DesignDiscussion paper MethodsWe aligned domains from the American Association of Colleges of Nursing Essentials and American Nurses Association Essentials of Genomic Nursing. ResultsA map illustrating alignment in multiple areas, which provide examples of ways to integrate genomics into existing nursing curricula. ConclusionAlthough based on domains developed in the United States, the map, curricular resources, example learning outcomes, and clinical vignettes can be used by nursing faculty globally to prepare future nurses who are competent in providing genomics-informed nursing care on entry-to-practice.

Precision health: Determining the capacity of practicing nurses across the United States.

Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental influences, and other social determinants of health (SDoH). However, the absence of a baseline assessment of knowledge, skills, and attitudes (KSAs) of practicing nurses' capacity for PH hinders its integration. The purpose of this study is to determine the capacity of practicing Registered Nurses (RNs) for PH across the United States and to assess the validity and reliability of a tool designed for this use-the Precision Health Nurse Capacity Scale (PHNCS). A descriptive exploratory study was conducted to evaluate the capacity of practicing RNs for this evolving phenomenon, PH, using a convenience sample. The survey was sent via email and made available to all members of the American Nurses Association (ANA) who work in a variety of practice environments. The ANA represents the over 4 million nurses practicing in the United States. The majority of nurse respondents felt it is important for nurses to become more educated about all aspects of PH including SDoH but they lack confidence in the integration of PH. The PHNCS was found to be a valid and reliable tool in measuring the capacity of nurses to practice PH. The incorporation of PH into nursing practice suffers an immediate impediment: the lack of know-how of the US nursing workforce. This inaugural data on KSAs for PH establishes a logical baseline from which the requisite education and training should commence. Precision Health is an emerging healthcare approach in the United States and globally. Enabling it will require a nursing workforce prepared with the requisite KSAs. Determining the capacity of the nursing workforce is a foundational step to begin this process.

Original Research: Exploring Black Nurses' Perceptions of Workplace Safety and Personal Health.

This study aimed to assess the perceptions of nurses who self-identify as Black or African American regarding their workplace health and safety and to explore how these perceptions are associated with their perceived personal health. Nurses practicing in unhealthy work environments can experience poorer physical and mental health. Recent civil unrest and ongoing dialogue about structural and systemic racism have prompted calls for greater efforts to understand the workplace perceptions and experiences of ethnic minority nurses, and how these influence nurses' personal well-being. But there is a dearth of relevant evidence concerning these nurses, including Black nurses. This cross-sectional, descriptive study involved analysis of secondary data collected from May 1, 2017, through December 31, 2019, by the American Nurses Association's HealthyNurse Survey (N = 19,131). We employed descriptive, bivariate, and multivariate analyses to examine the data for the 1,143 respondents who both self-identified as Black or African American and responded to all items concerning the major variable of personal health. Overall, respondents reported a slight tendency to agree or strongly agree that their practice environments were safe. When looking at various factors explaining personal health, the perception of workplace health and safety was found to be a significant contributing factor. The study findings suggest that, among Black nurses, perceptions about workplace health and safety are associated with perceived personal health. These findings underscore the importance of fostering healthy work environments.

The Role of Nursing Leadership in Dismantling Racism in Nursing: A Call to Action.

Racism is a structural determinant of health that affects mental health outcomes in the United States and globally. Nursing leaders must respond to a call to action to address racism in nursing. The purpose of the current article is to present evidence-based, race-conscious strategies for nurses in leadership roles to identify, challenge, and mitigate racism in nursing education and practice. Building on a theoretical framework, we share essential diversity, equity, and inclusion (DEI) strategies for dismantling racism in nursing. These DEI strategies include: (1) critical self-reflection, (2) mutual respect and recognition, (3) challenging White privilege, (4) leveraging available resources, (5) intentional advocacy/strategic planning, and (6) continuing education. The work of this American Nurses Association (ANA)-Illinois DEI Expert Panel is presented as an example of a statewide initiative to promote a greater understanding of the global history of racialization and challenge nursing leaders to act now to eliminate the contemporary effects of racism in the nursing profession. To truly challenge and mitigate racist practices, nursing leadership must be proactively engaged and have a strategic action plan in place to confront structural racism. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Nursing Professional Values Scale (NPVS-3) in an Austrian context: validation of a scale and reliability assessment

BackgroundThe Nurses Professional Values Scale-3 (NPVS-3) is a psychometric instrument derived from a set of values initially established by the American Nurses Association (ANA) Code of Ethics. The present study evaluates the reliability of the NPVS-3 scale for nursing students and nurses in Austria.MethodsA cross-sectional methodological study was conducted on 209 research participants, comprising 139 nursing students and 70 nurses, with the objective of determining the reliability of the Austrian version of the scale. A multilevel approach was employed in the study, encompassing cultural and linguistic validation, content validity, face validity, and construct validity. The scale translation was performed per the established translation stages of back-translation and was subsequently reviewed by an expert committee. The translated instrument was applied to the participants who completed an online survey between April and July 2023. Internal consistency was evaluated using Cronbach’s alpha, while construct validity was assessed using confirmatory factor analysis (CFA).ResultsThe Cronbach's alpha values obtained were deemed appropriate, with the following results: Caring (0.852), Activism (0.832), and Professionalism (0.676). Through factorial analysis, three factors were identified as original NPVS-3 and construct validity was verified.ConclusionThe Austrian version of the NPVS-3 demonstrated satisfactory validity, efficiently evaluating the professional values of nurses and nursing students in Austria.

Nursing vaccine mandates: Ethically justified, an infringement on autonomy, or both?

After almost a year and a half of the COVID-19 pandemic, many healthcare institutions in the United States announced that they would mandate COVID-19 vaccination, with medical and religious exceptions, as a term of employment. The mandates resulted in widely publicized protests from hospital staff, including some nurses, who argued that these medical institutions violated the ethical principle of autonomy. As the world enters the "post-pandemic period," decisions such as these, made during times of crisis, must be reviewed to provide clarity for when the next pandemic occurs. In this paper, we support the argument that such mandates are ethically justifiable. We explore the framework of objections that were brought forward by dissenters of this vaccine mandate. Next, we provide an analysis of conflicting ethical principles present when such mandates were deployed. Utilizing the American Nurses Association's Code of Ethics for Nurses, notably provisions 2, 3, and 6 we argue that it is an ethical duty of the nurse to be vaccinated. Specifically, we turn to provision two, which most explicitly underscores the necessity of vaccination as a function of the nurse's primary commitment to the patient. Next, we highlight the International Council of Nurses Code of Ethics which provides similar guidance internationally. Finally, we examine the applicability of the principles of public health, care ethics, and the nursing role as frameworks to underpin such mandates both for the current and for potential future pandemics, arguing that the nurse's ethical duty to be vaccinated spans these contexts.

Leading through difficult times: The oral histories of Drs. Barbara Nichols, Beverly Malone, and Ernest Grant

The nursing profession, along with its respective professional organizations, has transcended through the vicissitudes of time. This includes, but is not limited to, the evolution of the profession and integration of African American nurses into nursing organizations and leadership roles. The three past African American presidents of the American Nurses Association were invited to participate in an oral history about their leadership and presidencies. The interviews were visual/audio-recorded, digitally taped, and transcribed. The oral histories centered on their journeys to becoming the president of the ANA, experiences being the president, leading beyond their presidency, and respective insights about their presidency.

Update to the essential genomic nursing competencies and outcome indicators.

Genomic healthcare applications have relevance to all healthcare professionals including nursing, and most evidence-based clinical applications impact the quality and safety of healthcare. To guide nursing genomic competency initiatives, the Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were established through a process of consensus in 2005. A 2009 update incorporated outcome indicators consisting of specific areas of knowledge and clinical performance indicators, to help support academic integration. Almost 20 years have elapsed since these competencies were first established, yet incorporating the competencies into general and specialty scope and standards of nursing practice is inconsistent, competency integration into curricula is highly uneven, continuing education in genomics for nurses is limited, and the genomic capacity of the nursing workforce remains low. These deficits have persisted despite substantial advances in genomic technology which substantially reduced costs and increased evidence-based clinical applications, including direct to consumer genomic tests, the integration of genomics into evidence-based guidelines, and evidence that genomics impacts the quality and safety of healthcare. The aim of this project was to update and achieve consensus on genomic competencies applicable to all registered nurses. This was a mixed methods study. The update to the competencies was performed based first on a literature review to update the competencies based on the current state of the evidence. Using the updated content, a modified Delphi study was conducted with registered nurse panelists from clinical, academic, and research settings. Once consensus was achieved, the competencies were made available through the American Nurses Association for public comment. Public comments were then reviewed and integrated as needed. The literature review resulted in a transition from genetics to genomics, given the reduction in costs, which resulted in an expansion of the scope of testing in both the germline and somatic contexts. Two Delphi rounds were required to reach consensus prior to the public comment period. Public comments were solicited through the American Nurses Association, and each comment was reviewed by the authors and addressed as indicated. The Essentials of Genomic Nursing: Competencies and Outcome Indicators constitute the minimum competency in genomics required of all registered nurses regardless of the level of academic training, role, or specialty. Evidence-based genomic applications span the entire healthcare continuum and, therefore, are relevant for all registered nurses regardless of academic training, role, practice setting, or clinical expertise. These competencies serve as the guide for the minimum requirements for registered nurse practice as well as guide curricula and continuing education for all registered nurses, including but not limited to administrators, educators, nursing leaders, practicing nurses, and researchers.

Innovativeness and Transformational Leadership Among Nurse Leaders

Innovativeness and transformational leadership are characteristics that may enable nurse leaders to respond to today's rapidly changing healthcare landscape. This study was focused on describing innovativeness among nurse leaders and the relationship between innovativeness and transformational leadership. A descriptive, correlational, cross-sectional design was used; 97 nurse leaders participated. Contact was through a web-enabled survey posted to the American Nurses Association of New York website and social media platforms. A majority of the nurse leaders rated themselves as innovative and there was a significant relationship between innovativeness and transformational leadership. Programs to enhance both innovativeness and transformational leadership are recommended.

Evolving Nursing Research Priorities: A Unified Vision for Advancing the Nursing Profession.

The American Nurses Association Enterprise (ANA Enterprise) Research Advisory Council plays a vital role in bringing nursing voices together and shaping the dynamic landscape of nursing research. Historically, its priorities have revolved around 4 pivotal research priorities: advancing research capacity, promoting interprofessional collaboration, enhancing data structures and governance, and propelling practice-based nursing research. In a remarkable transition, the 2024 Research Priorities of the ANA Enterprise Research Advisory Council align with the vision and strategic goals of the ANA Enterprise. The Council now places emphasis on the intersection of the research priorities with 5 key areas crucial for "elevating the profession of nursing globally": workforce development; advancing nurse well-being practices; deepening understanding of diversity, equity, inclusion, and belonging; expanding scope of practice; and measuring the value of nursing. This approach provides clear guidance for nursing research efforts, demonstrating a dedicated effort to harmonize the diverse voices within the nursing community. The objective is to shape a future where nursing research not only serves to inform practice but also enhances the overall value and impact of the nursing profession globally.

Use and impact of the ANA Code: a scoping review.

Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses' codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses' Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses' codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses' ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed.

It's Time! The Path for Nursing Reimbursement Reform.

Since the COVID-19 pandemic, nurses and nurse leaders are increasingly vocal about chronic understaffing and the impact the staffing crisis continues to have on nurses' well-being and patient outcomes. The American Nurses Association's Nurse Staffing Task Force addressed the importance of staffing standards as a critically needed step toward improving patient and population health outcomes. Against the backdrop of ongoing nursing shortages, hospital leaders have been hesitant to embrace staffing ratios, expressing concerns about their ability to hire and retain sufficient nursing staff, as operational revenue margins remain thin and nursing labor is costly. This article explicates structural issues within the current nursing reimbursement model that harms hospitals' business case for investments in nurse staffing and work environments. We argue that nurses must advocate for nursing reimbursement reform to increase the nursing workforce and improve nurse staffing and work environments. Such reform is necessary to support sustained hospital investments, financial philosophies, and approaches to meaningfully address and improve nurse staffing.

Starting a New Revolution in Nursing.

The onset of COVID-19 and the murder of George Floyd shed light on social justice inequities, disparities in health care and the continuing rise of racism within society. Studies conducted by the American Nurses Foundation also revealed acts of racism within the nursing profession. The creation of the National Commission to Address Racism in Nursing and the American Nurses Association's issuance of an apology through its Racial Reckoning work have begun a revolution within the nursing profession to address this phenomenon. This commentary will provide a brief overview of collaborative initiatives currently underway and address ways in which nurses can do their part to obliterate racism from the nursing profession.

Transformational and Unifying Leadership: An Interview With Loressa Cole.

In this column, the recently retired American Nurses Association Enterprise Chief Executive Officer, Loressa Cole, DNP, MBA, RN, NEA-BC, FAAN, shares how her career journey shaped her into the healthcare executive she is today. As a transformational and unifying leader, she emphasizes the creation of cohesive environments that support nursing excellence and positively impact the profession. Dr Cole encourages nurse leaders to maintain a positive attitude, strong work ethic, and supportive networks while being patient-centered.

Creation of a Common Framework to Evaluate Initial Registered Nurse Role Competency.

Assessment of initial nursing competency is essential to safe nursing practice yet often focuses on psychomotor skill acquisition. A multistate health system created a competency strategy based on a comprehensive conceptualization of competency using the American Nursing Association scope and standards of nursing practice. This approach allows for the broad application of a standard competency assessment tool across diverse nursing specialties and provides a framework for nursing professional development practitioners to implement in their organizations.

An Evidence-based Practice Project to Evaluate Breathing Exercises on Dyspnea in Patients with Chronic Lung Disease

Introduction: Dyspnea, or difficulty breathing, is a common symptom that affects individuals with chronic lung diseases, such as Chronic Obstructive Pulmonary Disease (COPD), lung cancer, idiopathic pulmonary fibrosis, mesothelioma, and others. Nurses are the most frequently encountered providers at the bedside and have a unique obligation to treat the symptomology of these lung diseases. Nurses are charged with doing no harm and acting in the best interest of the patient; therefore, reducing dyspnea addresses these key ethical considerations (American Nurses Association, 2015).

Revisão da prevalência de diagnósticos de enfermagem em diferentes populações e cenários de cuidado à saúde

Abstract Objective To provide an overview of the prevalence of nursing diagnoses in different patient populations and healthcare settings, and on the methods identifying nursing diagnoses. Methods A descriptive review with a systematic method was applied according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies, in Medline and CINAHL databases from January 2007 to January 2020, reporting nursing diagnoses prevalence were included regardless of population and setting retrieving 1839 articles. Results After the screening, 328 articles were included for the analysis. Twenty different patient populations with their respective nursing diagnoses prevalence were identified. Most studies were conducted in inpatient settings (e.g., intensive, and surgical units). NANDA International was a widespread standard nursing language used, and risk for infection was the most frequently identified nursing diagnosis. Several gaps were identified regarding the methods used in the articles analyzed. Conclusion The most prevalent nursing diagnoses in different patient populations were identified. Moreover, the nursing diagnoses in the five standard nursing languages recognized by the American Nurses Association were summarized. Advances, gaps, and a call to action were identified.

Case Report: Evaluation of Patient Diagnosed Perianal Fistula According to Abdellah's 21 Nursing Problems Model

This case report aimed to provide nursing care to the patient diagnosed with Perianal Fistula for the nursing diagnoses in Faye Abdellah's "21 Nursing Problem Theory and North American Nurses Association (NANDA) classification system. Material and Methods: Verbal and written consent was obtained from the patient and the attending physician for the research. Results: He was married at the age of 62. The patient, who has four children and had perianal fistula surgery in 2002, was admitted to the Gastroenterohepatology Polyclinic of a training and research hospital due to increased rectal discharge and constipation recently. disease. There is no known disease in the family history. There is no known history of drug use and known allergy. Conclusion and Suggestions: The case was examined based on Faye Abdellah's "21 Nursing Problem Theory" and the North American Nurses Association (NANDA) Nursing care was given by using the nursing diagnoses in the classification system.

Patient Care Device Technology Transformation: Nurses Seek Partners to Achieve Patient Care Excellence

Nurses make up the largest segment of the health-care workforce worldwide (World Health Organization, 2020). Nursing is fundamentally a process of innovation, where creativity and problem-solving are leveraged to co-create optimal outcomes for each patient and family. Throughout history, nurse innovators have contributed significantly to health-care research, quality, safety, and improved outcomes. Unfortunately, nursing innovation is often not well recognized, respected, or utilized, and most patient care devices and technologies currently in use were not developed by or even with direct consultation with nurses. Nurses seek transdisciplinary partners to develop devices and technologies to transform health care and achieve optimal patient outcomes. This article highlights the experience of five nurses partnering with other disciplines to bring nursing innovations into practice, introducing a vision for patient care devices and technologies developed by a committee formed through the American Nurses Association. Sharing these experiences and vision is a call to interdisciplinary colleagues to recognize nurses’ needs, skills, and efforts - a call to partner with them to install devices and technologies into health care that can achieve patient care excellence.