American Nurses Credentialing Center Research Articles

Does Prehabilitation Improve Pain Outcomes in Surgical Patients?

Dr. Starkweather is Professor and Director of the Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Rd, Storrs, CT 06269; E-mail: [email protected]. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.CME AccreditationLippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on January 31, 2019.CNE AccreditationLippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 1.0 contact hours for this continuing nursing education activity. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This CNE activity expires on February 29, 2020.

Identifying the Underlying Educational Needs That Contribute to the Professional Practice Gap.

This article addresses how nursing professional development practitioners and nurse planners can meet the educational design process criterion 2 in the American Nurses Credentialing Center Primary Accreditation process that also corresponds with the Association for Nursing Professional Development's Scope and Standards of Practice. J Contin Educ Nurs. 2018;49(2):52-54.

Correlation of hospital magnet status with the quality of physicians performing neurosurgical procedures in New York State

Purpose: The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures.Materials and methods: We performed a cohort study of patients undergoing neurosurgical procedures from 2009–2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database. Propensity score adjusted multivariable regression models were used to adjust for known confounders, with mixed effects methods to control for clustering at the facility level. An instrumental variable analysis was used to control for unmeasured confounding and simulate the effect of a randomized trial.Results: During the study period, 185,277 patients underwent neurosurgical procedures, and met the inclusion criteria. Of these, 66,607 (35.6%) were hospitalized in Magnet hospitals, and 118,670 (64.4%) in non-Magnet institutions. Instrumental variable analysis demonstrated that undergoing neurosurgical operations in Magnet hospitals was associated with a 13.6% higher chance of being treated by a physician with superior performance in terms of mortality (95% CI, 13.2% to 14.1%), and a 4.3% higher chance of being treated by a physician with superior performance in terms of length-of-stay (LOS) (95% CI, 3.8% to 4.7%) in comparison to non-Magnet institutions. The same associations were present in propensity score adjusted mixed effects models.Conclusions: Using a comprehensive all-payer cohort of neurosurgical patients in New York State we identified an association of Magnet hospital recognition with superior physician performance.

Using the Magnet® Criteria to Document New Graduate Nurses' Transition to Practice.

Nursing professional development practitioners are partners in practice transitions for new graduate nurses. Organizations seeking Magnet® designation need to demonstrate how new graduate nurses transition in the written documentation submitted to the American Nurses Credentialing Center. This article explores current strategies used by Magnet®-designated organizations and connects the strategies to the six new elements of the new 2019 Magnet® criterion, Structural Empowerment 9.

Analyzing Gaps to Design Educational Interventions.

This article addresses how nursing professional development practitioners can meet educational design criterion 1 in the American Nurses Credentialing Center Primary Accreditation process and standards 1 and 2 in the Association for Nursing Professional Development Scope and Standards of Practice. J Contin Educ Nurs. 2018;49(1):4-6.

Charting the course for American Nurses Credentialing Center–Approved perioperative nurse-sensitive indicators

The current health care environment, with increasing public awareness of and attention to patient safety, mandates the delivery of exceptional quality care. To meet the health care requisites of the perioperative patient population, clinical nurses have identified the need for nurse-sensitive clinical indicators for this setting. We describe the strategies used to identify, obtain American Nurses Credentialing Center approval for, and integrate nurse-sensitive indicators into the perioperative setting to advance a Magnet culture. Prior to this, nurse-sensitive indicators for the perioperative setting that enabled nurses to monitor and improve patient care outcomes, in accordance with the standards of a Magnet-recognized hospital, had not been formally established. A review of the literature yielded a list of potential metrics, which included normothermia, patient falls with harm, and retained surgical items. Methodology and data collection processes for these metrics were established, facilitating quarterly Nursing Dashboards and collaboration among nurses to improve patient outcomes. This groundbreaking initiative enables nurses to routinely evaluate whether the structures and processes of care effectively yield quality outcomes. This foundational work has broader implications for nursing practice, because these quality metrics can easily be translated into perioperative settings in other health care organizations.

A culture of nursing excellence: A community hospital’s journey from Pathway to Excellence® to Magnet® recognition

Creating a culture of nursing excellence requires strategic planning, transformational leadership, and effective change management. The American Nurses Credentialing Center (ANCC) provides 2 programs that recognize nursing practice. The Pathway to Excellence Program® recognizes health care organizations that provide nurses with positive and safe practice environments. The ANCC Magnet Recognition Program®, the highest level of recognition for nursing, recognizes health care organizations that demonstrate excellence in nursing and quality patient outcomes. Both of these programs promulgate the valuable contributions of nurses to influence the practice environment and ultimately enhance patient outcomes. ANCC recognition, as either a Pathway to Excellence® or a Magnet® recognized facility, is a significant achievement for both the nursing enterprise and the organization. The transition from achieving Pathway to Excellence® recognition to Magnet® recognition requires organizational change management through transformational leadership and employee engagement at multiple levels. This article addresses one community hospital’s strategy to advance a culture of nursing excellence through integration of the Pathway to Excellence® 12 Practice Standards and enculturation of the Magnet® Model to achieve Magnet® recognition. The ADKAR® Model of change management was applied throughout this journey in a systematic approach that created awareness, desire, knowledge, ability, and reinforcement. Key strategies were implemented to engage employees and resources were provided to advance the culture of nursing excellence within the health care organization.

Professor in Residence: An Innovative Academic-Practice Partnership.

This article describes an academic-practice partnership between an American Nurses Credentialing Center Magnet®-designated hospital and an academic nurse educator that has increased the hospital's capacity for research, evidence-based practice, and support for nurses continuing their education. Through close collaboration with the full-time nurse researcher and members of the nursing education department, the professor in residence consults with clinical staff to support completion of research and evidence-based practice projects. The collaboration also has resulted in the development of a formal year-long mentoring program for clinical nurses in the area of evidence-based practice. Individual support and academic consults are offered to nurses enrolled in school to promote advancement of nurses' educational level. This collaboration has been beneficial for both the hospital and the university, increasing the capacity for scholarly activities for nurses in the hospital and serving as a forum for ongoing faculty practice and scholarship. J Contin Educ Nurs. 2017;48(12):552-556.

Should Radiofrequency Denervation Be Dropped From the Clinical Arsenal for Chronic Back Pain?

Mr. Schoene is the Editor of The BackLetter, 25 Storey Ave, Ste 154, Newburyport, MA 01950; E-mail: [email protected]. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.This article was published originally in The BackLetter, 2017;32(9):97-107.CME AccreditationLippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on October 31, 2018.CNE AccreditationLippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 1.0 contact hours for this continuing nursing education activity. Instructions for earning ANCC contact hours are included on page 12 of the newsletter. This CNE activity expires on November 30, 2019.

The 2019 Magnet® Application Manual: Nursing Excellence Standards Evolving With Practice.

The American Nurses Credentialing Center's Magnet Recognition Program® released the 2019 Magnet® Application Manual () in October. The 2019 manual is the 12th application manual in the 27-year history of the program. The manual builds upon the foundation of seminal research conducted in the early 1980s that led to the creation of the program yet incorporates contemporary standards that address challenges faced globally by healthcare organizations today.

Using the ARCC Model to Implement the 2015 ANCC COA Criteria: A North Carolina Public Health Nursing Project.

In July 2015, the American Nurses Credentialing Center's Commission on Accreditation released updated criteria for continuing nursing education, including updates to the Education Design Process. The primary nurse planner in the Public Health Nursing Approved Provider Unit in North Carolina's Division of Public Health applied the advancing research and clinical practice through close collaboration model and quality improvement strategies to facilitate the adoption and implementation of the 2015 criteria. This article describes an innovative approach to implementation using an evidence-based practice model and quality improvement tools and provides data regarding nurse planners' knowledge of accreditation criteria and role comfort during the first 6 months of implementation. J Contin Educ Nurs. 2017;48(11):501-507.

From the Field: A Panel on Leadership in Continuing Education.

In July 2017, the American Nurses Credentialing Center held their annual continuing nursing education symposium. The focus was on leadership development for nursing professional development practitioners in continuing nursing education. This article is an overview of the panel discussion from national experts in the field. J Contin Nurs Educ. 2017;48(11):489-491.

Meet ANCC's New Executive Leaders.

In October 2016, the American Nurses Credentialing Center (ANCC) announced the appointment of Loressa Cole, DNP, MBA, RN, FACHE, NEA-BC, as its new executive director and executive vice president and Jeffrey Doucette, DNP, RN, CENP, FACHE, NEA-BC, LNHA, as its new vice president of the Magnet Recognition® and Pathway to Excellence® Programs. In this Magnet® Perspectives column, we learn more about these 2 dynamic leaders at the helm of ANCC.

Acute Pain Management for Patients on Medication-Assisted Treatment for Opioid-Use Disorder

Dr. Mayerson is Advanced Practice Registered Nurse and Associate Director for Advanced Practice, Hartford Healthcare Medical Group, Vernon, Connecticut, and Mr. Julian is Doctoral Student, Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Rd, Storrs, CT 06269; E-mail: [email protected]. The authors, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.CME AccreditationLippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on September 30, 2018.CNE AccreditationLippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 1.0 contact hours for this continuing nursing education activity. This activity has been assigned 0.5 pharmacology credits. Instructions for earning ANCC contact hours are included on page 12 of the newsletter. This CNE activity expires on October 31, 2019.

The Emergency Nurse Practitioner Board Certification Examination: The Purpose, Process, and Eligibility

In January 2017, the American Academy of Nurse Practitioners Certification Board (AANPCB), in collaboration with the American Academy of Emergency Nurse Practitioners (AAENP), began to offer a new board certification examination for the emergency nurse practitioner (ENP). This new certification examination provides a standardized evaluation of ENP knowledge base across the lifespan. The certification examination was developed in accordance with the APRN Consensus Model. Prior to this board certification examination, the only certification option for ENPs was a portfolio review process offered through the American Nurses Credentialing Center (ANCC) in August 2013. 1 Certification Through Portfolio Application Requirements. American Nurses Credentialing Center website. http://www.nursecredentialing.org/CertificationPortfolioRequirements.pdf Google Scholar Courtney J. Cook is Assistant Professor, Vanderbilt School of Nursing, Nashville, TN

Treatment of Acute Herpes Zoster Pain and Postherpetic Neuralgia

Dr. Starkweather is Professor and Director of the Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Rd, Storrs, CT 06269; E-mail: [email protected]. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.The author has disclosed that the use of tricyclic antidepressants for treatment of chronic neuropathic pain, as discussed in this article, has not been approved by the US Food and Drug Administration. Please consult the product labeling for approved uses.CME AccreditationLippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on July 31, 2018.CNE AccreditationLippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. LWW, publisher of Topics in Pain Management, will award 1.0 contact hours for this continuing nursing education activity. This activity has been assigned 0.5 pharmacology credits. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This CNE activity expires on August 31, 2019.

Using Science to Improve the Art of Staffing

Nurse executives are required each day to balance the costs of human resources against the anticipated clinical outcomes produced by those resources. Using sophisticated analyses, landmark studies have repeatedly demonstrated the impact of nurse staffing on clinical outcomes. 1–8 Other studies establish the business case for a value-based nursing model that produces better outcomes with fewer adverse effects while minimizing total costs of care. 9–11 One author notes: This is more than a staffing-level or nurse:patient ratio discussion. 11 The American Nurses Credentialing Center has identified that staffing levels, recognition of nurse competency and experience, and flexible care delivery systems are foundational components of a work environment in organizations that achieve Magnet® recognition. 12

System-Level Shared Governance Structures and Processes in Healthcare Systems With Magnet®-Designated Hospitals: A Descriptive Study.

The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.

Effect of Cognitive Demand on Functional Mobility in Ambulatory Individuals with Multiple Sclerosis.

As disease progresses, cognitive demands may affect functional mobility in individuals with multiple sclerosis (MS). The Timed Up and Go (TUG) test assesses functional mobilityin populationssuch as MS. A cognitive-demanding task can be added to the TUG test to assess its effect on functional mobility. People with MS (n = 52) and controls (n = 57) performed three versions of the TUG test: TUG alone (TUG-alone), TUG plus reciting the alphabet (TUG-alpha), and TUG plus subtracting numbers by 3s (TUG-3s). Times to complete the TUG tests were compared among controls and three groups of participants with MS created using Expanded Disability Status Scale (EDSS) scores 0 to 3.5, 4.0 to 5.5, and 6. Differences among groups were analyzed using split-plot analysis of variance. Group and TUG type were significant (P < .001 for both), with no interaction effect of group × TUG type (P = .21). Mean times were 8.7, 9.4, and 11.1 seconds to perform the TUG-alone, TUG-alpha, and TUG-3s, respectively. Mean times for groups were 8.0, 8.2, 11.1, and 11.6 seconds for controls and individuals with MS and EDSS 0 to 3.5, 4.0 to 5.5, and 6, respectively. People with MS with an EDSS score greater than 3.5 had a statistically significant reduction in performance of the TUG test even with the addition of a simple cognitive task, which might have implications for a person's more complex everyday activities.

American Nurses Credentialing Center Practice Transition Accreditation Program Update

American Nurses Credentialing Center Practice Transition Accreditation Program Update