8 apply to all DNPs and 5 defi ne specialty roles of advanced practice. One thousand postbaccalaureate clinical hours also are rec- ommended (AACN, 2006).
SYNOPSIS
In 2002, the AACN established a task force to evaluate the practice-focused doctorate degree to meet the need for curriculum changes. In 2004, the AACN voted that the educational requirement for advanced practice nurses be at the doctoral level by 2015. A task force was established for creating guidelines for curriculum, and in 2006, The Essentials for Doctoral Education for Advanced Nursing Practice was adopted and nursing education began its transformation.
RECOMMENDATIONS
AACN recommends that educational insti- tutions offering DNP programs should have faculty with doctoral preparation once there is a larger population of DNP-prepared nurses.
DNP-prepared faculty, through their practice experience, will exemplify rapid translation of new knowledge into practice and demon- strate to students the process of knowledge dissemination (AACN, 2006, p. 21). Nursing education will continue to evolve as the health care system changes with the contin- ued implementation of the Affordable Health Care Act. DNP leaders need to continue to pursue policies that remove practice barriers, and allow the DNP graduates to practice to the full extent of their preparation (Glazer &
Fitzpatrick, 2013) online nursing students’ experiences with
technology-delivered instruction. Journal of Nursing Education, 46(6), 252–260.
Moore, J. C. (2011). The Sloan Consortium quality framework and the fi ve pillars.
Retrieved from http://sloanconsortium.
org/publications/books/qualityframe- work.pdf
Schmidt, B., & Stewart, S. (2010). Implementing the virtual world of Second Life into community nursing theory and clinical courses. Nurse Educator, 35(2), 74–78.
Western Interstate Commission for Higher Education (WICHE). (2011). Principles of good practice. Retrieved from http://
wcet.wiche.edu/wcet/docs/tbd/TbD_
PrinciplesofGoodPractice.pdf
Diane M. Billings
D
OCTOR OFN
URSINGP
RACTICEDEFINITION
Doctor of nursing practice (DNP) is defi ned by the American Association of Colleges of Nursing (AACN) as the terminal academic degree for nursing practice (AACN, 2006, p. 8).
APPLICATION
Enrollment of DNP students has increased to 95% from 2006 to 2011 (Eglehart, 2013, p. 1937). Graduates of the DNP program are expert clinicians who can assess evi- dence and translate it into practice (Reed &
Crawford, 2011, p. 37). The rapidly chang- ing health care system requires the DNP student to be educated in leadership, cli- ent-centered care, quality improvement, multidisciplinary care provision, scientifi c inquiry, and evidence-based care (AACN, 2006, p. 6). The goal of DNP programs is to educate advanced practice nurses to be academic leaders and educators who also
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the outside in (pp. 1–5). New York, NY:
Springer Publishing.
Mason, D. J., Leavitt, J. K., & Chaffee, M.
W. (2012). Policy & politics in nursing and healthcare (6th ed.). St. Louis, MO:
Elsevier.
Reed, P., & Crawford, N. (2011). Nursing knowl- edge and theory innovation: Advancing the science of practice. New York, NY: Springer Publishing.
Therese Hulme American Association of Colleges of
Nursing (AACN). (2006). The essentials for doctoral education for advanced nurs- ing practice. Retrieved from http://www .aacn.nche.edu/publications/position/
DNPEssentials.pdf
Eglehart, J. (2013). Expanding the role of advanced nurse practitioners’ risks and rewards. The New England Journal of Medicine, 368(20), 195.
Glazer, G., & Fitzpatrick, J. (Eds.). (2013).
Introduction. Nursing leadership from
E
E
LECTRONICH
EALTHR
ECORDDEFINITION
Traditionally, patients’ health records were paper based, and nursing students learned documentation skills by entering informa- tion under the supervision of the clinical faculty (Baillie, Chadwick, Mann, & Brooke- Read, 2013). The move to electronic-based health records was legislated in the United States in the Health Information Technology for Economic and Clinical Health Act (2009).
According to this legislation, a qualifi ed elec- tronic health record (EHR) includes patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to support clinical deci- sions; support physician order entry; capture and query information relevant to health care quality; and exchange electronic health infor- mation with, and integrate such information from, other sources. The goal of the federal legislation was to have an EHR used for each person in the United States by 2014. Nursing students need information about different EHR systems including their strengths and limitations in accessing essential information at the point of care, communicating across disciplines and settings, coordinating care, and guiding patients through the many tran- sitions that comprise the health care experi- ence (Mahon, Nickitas, & Nokes, 2010). Some nursing education programs are purchasing academic EHRs that have the characteristics of a qualifi ed EHR along with an educational component that enables assessment of the student’s documentation and feedback to the student through comments and grading in the electronic format (Hanson, 2013).
APPLICATION
There are many EHRs being developed and sold in the health care marketplace. As nurs- ing students rotate through different clini- cal sites during their educational program, they are exposed to different EHR systems;
however, there are a number of barriers that impact on whether students are able to docu- ment using the clinical agency’s EHR. Rather than being given opportunities to experi- ence in simulated settings the mistakes and frustrations inherent in using EHRs, health professional students often embark on a haphazard and variable learning curve in patient care settings, where their EHR education is directed by faculty with differ- ing skill levels (Milano, Hardman, Plesiu, Rdesinski, & Biagioli, 2014).
Educators have responded to the need for students to have electronic documentation skills by using academic EHR during simu- lation experiences that encourage critical thinking while allowing for error. Vendors supplying academic EHR include SimChart by Elsevier, Neehr Perfect®, and Cerner’s Academic Education Solution (AES). Borycki, Joe, Armstrong, Bellwood, and Campbell (2011) described an open-source system, the University of Victoria Interdisciplinary Electronic Health Record Educational Portal, which allows access to a number of EHR sys- tems for health professional students. Anest (2013) described how pre-licensure nursing students were taught medication admin- istration using barcode technology, while interprofessional students (pharmacy, nurs- ing, physical therapy, and physician assis- tant) used the MEDITECH software package (Medical Information Technology, Inc., Westwood, MA) to simulate the medication administration and documentation (Kirwin,
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Baillie, L., Chadwick, S., Mann, R., & Brooke- Read, M. (2013). A survey of student nurses’ and midwives’ experiences of learning to use electronic health record systems in practice. Nurse Education in Practice, 13(5), 437–441.
Borycki, E., Joe, R., Armstrong, B., Bellwood, P., & Campbell, R. (2011). Educating health professionals about the electronic health record (EHR): Removing the barriers to adoption. Knowledge Management &
E-Learning: An International Journal, 3(1), 51–62.
Hanson, D. (2013). Nurse educators’ consensus opinion on using an academic electronic health record: A Delphi study (doctoral dissertation).
The University of North Dakota. Retrieved f rom ht t p://gateway.proquest.com/
openurl%3furl_ver=Z39.88–2004%26res_
dat=xri:pqdiss%26rft_val_fmt=info:ofi/
f m t : k e v : m t x : d i s s e r t a t i o n% 2 6 r f t _ dat=xri:pqdiss:3596698
Health Information Technology for Economic and Clinical Health Act.
(2009). Retrieved from http://www .healthit.gov/sites/default/files/hitech_
act_excerpt_from_arra_with_index.pdf, 112–164
Hoyt, R., Adler, K., Ziesemer, B., & Palombo, G. (2013). Evaluating the usability of a free electronic health record for train- ing. Perspectives in Health Information Management, 10(Spring), 1b. Published online April 1, 2013.
Kirwin, J., DiVall, M., Guerra, C., & Brown, T. (2013). A simulated hospital pharmacy module using an electronic medical record in a pharmaceutical care skills laboratory course. American Journal of Pharmaceutical Education, 77(3). Article 62. doi:10.5688/
ajpe77362
Mahon, P., Nickitas, D., & Nokes, K. (2010).
Faculty perceptions of student documen- tation skills during the transition from paper-based to electronic health records systems. Journal of Nursing Education, 49(11), 615–621.
Meyer, L., Sternberger, C., & Toscos, T.
(2011). How to implement the electronic health record in undergraduate nursing DiVall, Guerra, & Brown, 2013). Meyer,
Sternberger, and Toscos (2011) described experiences with AES, while, to avoid the cost associated with purchasing an EHR system, Rubbelke, Keenan, and Haycraft (2014) used Google Drive, a cloud storage device that stores documents and can be synced with a free Google account. Another strategy that faculty have used is to partner with the EHR system used in the clinical setting in order to have access to the same EHR system for student practice.
SYNOPSIS
The transition from paper-based record to EHRs is a worldwide phenomenon. Use of EHR has been associated with better care coordination, continuous access to evi- dence, information exchange between pro- viders, and improved client engagement in health and self-care processes (Topaz, Rao, Creber, & Bowles, 2013). The cost of using an academic EHR has been estimated to be at an expense to each student of at least US$35 to US$49 per semester (Rubbelke, Keenan, & Haycraft, 2014). Not only do fac- ulty need to learn skills associated with using EHR, they need to communicate these skills to students who are novices in clinical practice.
RECOMMENDATIONS
Nursing faculty and students must develop competence in EHR documentation skills and establish clear systems for authorized access so that students can document during clinical placements (Baillie et al., 2013).
Health professional educational pro- grams should collaborate as they choose academic EHR systems and develop curri- cula modules so that not only documenta- tion skills are taught but also the importance of communication between members of the health care team.
Anest, R. (2013). Teaching patient safety with a functional electronic medication record.
Journal of Nursing Education, 52(5), 303.
EMOTIONAL INTELLIGENCE ■ 121
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teaching strategy to increase EI skills in part because this approach actively involves learn- ers in critical refl ection and discussion to question assumptions. This model involves refl ective learning experiences such as jour- nal writing, which enhances self-awareness;
interpersonal understanding; critical analy- sis; cognitive learning; and clinical reason- ing skills. The process of journal writing allows students to refl ect on attitudes and feelings, and expand the cognitive and affec- tive dimension of learning. Other examples of this type of learning include using the arts like drama, art, poetry, and music to express nursing students’ experiences. These expres- sive modalities demonstrate the notion of caring in a creative way.
The Carnegie Foundation for the Advancement of Teaching is calling for changes in how nurses are educated. One of the recommendations includes using active learning strategies such as case studies. Case studies are more effective than traditional lectures because they show nursing stu- dents the ways of using nursing science and knowledge to solve patient problems. The clinical setting provides a perfect opportu- nity for students to present case studies in postconference discussions following clini- cal experiences. This format gives faculty an opportunity to not only link theory and prac- tice but also enhances EI skills of students.
Role modeling and mentoring by fac- ulty are imperative to foster development and growth of nurses’ EI skills. Faculty must possess these EI skills themselves in order to develop their students’ EI skills. Enhancing EI skills among nurses enables them to create a caring environment and implement effec- tive coping strategies when faced with stress- ful situations (Evans & Allen, 2002).
Hospitals are beginning to implement health and well-being programs for staff in an attempt to help employees improve and maintain their health and overall well-being.
One New York hospital is engaging employ- ees in their own well-being and supporting them in achieving individual health goals.
This hospital is offering innovative, inte- grated, and easily accessible programs to education. American Nurse Today, 6(5),
40–44.
Milano, C., Hardman, J., Plesiu, A., Rdesinski, R., & Biagioli, F. (2014). Simulated Electronic Health Record (Sim-EHR) curriculum:
Teaching EHR skills and use of the EHR for disease management and prevention.
Academic Medicine, 89(3), 399–403.
Rubbelke, C. S., Keenan, S. C., & Haycraft, L. L.
(2014). An interactive simulated electronic health record using Google drive. CIN:
Computers, Informatics, Nursing, 32(1), 1–6.
Topaz, M., Rao, A., Creber, R., & Bowles, K.
(2013). Educating clinicians on new ele- ments incorporated into the Electronic Health Record: Theories, evidence, and one educational project. CIN: Computers, Informatics, Nursing, 31(8), 375–379.
Kathleen M. Nokes
E
MOTIONALI
NTELLIGENCEDEFINITION
Emotional intelligence (EI) is the ability to perceive and understand one’s own and oth- ers’ emotions and use this information to guide one’s thinking and actions (Salovey &
Mayer, 1990).
APPLICATION
EI is integral to every interaction nurses have with patients and families. In order to provide compassionate and quality care, nurses need to have the skills to understand, interpret, man- age, and respond to not only their own emo- tions, but to emotions of patients and families.
Research indicates that EI skills and knowl- edge can be increased with training (Chang, 2007). Thus, information about EI needs to be well integrated into every aspect of nursing education; it should not be an addendum, a learning module, or a didactic class.
Freshwater and Stickley (2004) described transformatory learning as an effective
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into one’s emotions, strengths, and weak- nesses and to see how one’s feelings affect others. Self-regulation, the second attribute, involves controlling one’s impulses and not making judgments until enough informa- tion is gathered. People with a high degree of self- regulation are more capable of facing change. The third attribute, motivation, can be described as passion, a quest for chal- lenges, a desire to learn, and pride in one’s work. People who are motivated actively search for solutions to problems and pur- sue goals with energy and commitment.
Highly motivated people consistently raise performance expectations for themselves, their team, and their organization. Social awareness, the fourth attribute, is the abil- ity to understand others’ feelings and emo- tions when making decisions. People with empathy have acute organizational aware- ness, possess a service orientation, and are attentive to others. The fi nal attribute, rela- tionship management, involves the ability to manage and forge relationships with others (Goleman, 1998).
There has been a vast amount of research on EI outside of nursing. Articles and books have touted the relationship between suc- cessful business leaders and high levels of EI. Akerjordet and Severinsson (2008) found that nurses who displayed high EI enhanced organizational, staff, and patient outcomes.
RECOMMENDATIONS
Nursing’s newest generation learns differ- ently. Millennials (those born after 1981) prefer interactive activities and are most comfortable with technology and multi- tasking. Journaling, postconference discus- sions, blogging, and posting questions and instructing students to respond through creating threads on an electronic platform are ways for the faculty to learn more about students and the talents the students bring to the learning environment. Discussions between faculty and students about prior life experiences in an authentic manner build a trusting relationship and enable faculty to foster employee health and well-being such
as meditation classes, relaxation techniques, cooking tips, blood pressure screening, and walking clubs. The goal is to create a cul- ture of caring, health, and well-being in the workplace. This approach might work well in other settings as well.
SYNOPSIS
Three main theories regarding EI are addressed in the literature: the ability model, the trait model, and the mixed model. The abil- ity model was developed by Salovey and Mayer, who introduced the term “EI” into mainstream American psychology in their landmark article “Emotional intelligence.”
This model identifi ed four factors of EI: per- ceiving emotion, reasoning with emotion, understanding emotion, and managing emo- tion. In addition, Salovey and Mayer devel- oped the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) to measure EI.
The trait model is defi ned as a constella- tion of self-perceptions located at the lower levels of personality hierarchies (Petrides, Pita, & Kokkinaki, 2007). This model is the self-perceived ability to identify, assess, and control the emotions of oneself, of others, and of groups.
The mixed model was introduced by Goleman (1995) in his book, Emotional Intelligence: Why It Can Matter More Than IQ. Goleman argued that the current defi ni- tion of human intelligence was far too nar- row and showed that people with high IQs were not necessarily successful. Goleman proposed that emotional factors such as self- awareness, self-discipline, and empathy con- tributed to a different way of being smart.
He indicated that the previous factors are not fi xed at birth; they are shaped by childhood experiences and can be nurtured and shaped throughout adulthood with immediate ben- efi ts to health, relationships, and work.
According to Goleman, EI consists of fi ve attributes: self-awareness, self-regula- tion, motivation, social awareness, and rela- tionship management. The fi rst attribute, self-awareness, is the ability to have insight