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In March 2021, the American Association of Colleges of Nursing (AACN) endorsed and published a report that included a reenvisioned framework for nursing education. This report introduced innovative and bold ideas for transforming nursing education and pedagogy from a concept-based model to a competency-based model of nursing education. This new model of nursing education establishes a core set of expectations and standards of competency-based nursing curricula common to all nursing educational programs moving forward. Before this transformative change can occur, nurse educators must first understand what is expected of them before they can adapt current nursing curricula to meet the future needs of our communities and employers. This article will dissect the Re-envisioned Essentials and provide the reader with new terminology introduced by the Essentials document, as well as the core expectations and standards established by the AACN for future nursing education and curricula. With this new understanding, we will introduce and discuss strategies supporting the transitional process of moving from concept-based educational models to competency-based models using a think-backward approach to change that begins with an alignment of program-level learning outcomes with national standards and working backwards to build assessments.

Determinants of health (DOH) are key predictors of health, wellness, morbidity, and mortality. The more familiar social DOH are not the only DOH. By themselves, the social DOH do not adequately explain how individuals and populations achieve and maintain health equity or inequity. Other DOH also exert political, economic, and institutional forces at all levels of the socioecological systems in which humans interact with their environment.According to the American Nurses Association, the Nursing Code of Ethics is a "non-negotiable moral standard for the profession" (Fowler, 2015a, p. viii). Provision 9 of the Code of Ethics states that social justice is of primary concern for social ethics (p. 159) and that professional nurses are obligated to advocate for and integrate principles of social justice into nursing practice and health policy (p. 151).In search of conceptual explanations for these phenomena, and to locate health equity/inequity within a wide array of upstream DOH, a comprehensive review of the interdisciplinary professional literature and conceptual analysis were conducted. A new conceptual framework that acknowledges nursing's collective responsibility for ethical action for transformative change was developed. The framework addresses both "further upstream" antioppression efforts and "farther downstream" efforts to remediate the impacts of health inequity.The purpose of this Policy Watch column was to introduce a new "Expanded Conceptual Framework for Ethical Action by Nurses on the 'Further Upstream and Farther Downstream' Determinants of Health Equity" (Fornili, 2022).

In the nursing professional development (NPD) specialty, the NPD practice model visually represents the NPD scope of practice and reflects a growing, vibrant specialty. It delineates the who, what, when, why, where, and how of the specialty practice and is approved by the American Nurses Association. This column reflects upon the evolution of the NPD practice model and delineates its updates in the fourth edition of the Nursing Professional Development: Scope and Standards of Practice.

The Nephrology Nursing Scope and Standards of Practice, 9th Edition, published by the American Nephrology Nurses Association, defines the scope of nephrology nursing and provides standards of practice, standards of professional performance, and competencies for registered nurses and graduate-level prepared registered nurses (e.g., advanced practice registered nurses, clinical nurse specialists) in an approach consistent with the American Nurses Association's Nursing Scope and Standards of Practice, published in 2021. Discussions addressing respect, equity, inclusion, and social justice have been included in the 9th edition. A new section related to altered/crisis standards has been added to assist nephrology nurses in developing strategies for implementing those standards. The section on how to use the standards has been updated with forms that organizations can download and individualize. This article provides an overview of the scope, standards, competencies, and strategies for implementing them in clinical practice.

Nursing leaders continue to struggle with capacity issues in both clinical and academic settings-particularly those related to aging patient and nurse populations and the increasing complexity of health care in general. Programs and resources for formal mentoring have primarily focused on mid- and advanced-career RNs, but there is an imperative to develop methods of expertly mentoring "professionally younger" RNs across all settings and roles. In 2017, the American Nurses Association (ANA) conducted an extensive member needs assessment with more than 15,000 respondents. Three distinct career-stage categories were identified: early-career nurses, up-and-comers, and nursing leaders. The early-career nurses and up-and-comers listed "being mentored" among their top two member benefit requests. In response, the ANA launched a national virtual mentorship program in September 2018. The program aligned with criteria, recommendations, and charges from the American Nurses Credentialing Center's 2019 Magnet Recognition Program; the landmark 2010 report from the Institute of Medicine (IOM), The Future of Nursing: Leading Change, Advancing Health; and a 2019 IOM consensus study, The Future of Nursing 2020-2030. This article provides a general overview of the program, including evaluation and modifications, and discusses implications of using the ANA's career-stage categories in virtual mentoring.

In November, the American Nurses Credentialing Center (ANCC) released its revised 2023 Magnet Application Manual®, the 13th manual in the program's 31-year history. This month's "Magnet Perspectives" takes a deep dive into the new edition of the manual, examining the rigorous, multistep review process, the modernized standards, and the coalition of experts that contributed insights to inform the latest edition. Each edition raises the bar to promote the highest levels of nursing excellence, and the 2023 manual is no exception. Learn how this forward-looking edition addresses emerging challenges and changes to reflect what is happening in healthcare today.

A qualitative study was conducted with 10 nursing students to evaluate how students respond to breaches of standards of practice by clinical nurses. Statements were identified and analyzed with Colaizzi's method. Three main themes emerged: 1) Violations of the ANA Code of Ethics were witnessed by students (handling medications/equipment incorrectly, failing to comply with infection control, violating patient privacy). 2) Students were upset and felt they should have responded differently when witnessing a violation. 3) Students need preparation on how to react to violations of practice, with proper enforcement of practice within the clinical.

This study yielded a map of the alignment of American Association of Colleges of Nursing Graduate-Level Nursing Informatics Competencies with American Medical Informatics Association Health Informatics Core Competencies in an effort to understand graduate-level accreditation and certification opportunities in nursing informatics. Nursing Informatics Program Directors from the American Medical Informatics Association and a health informatics expert independently mapped the American Association of Colleges of Nursing competencies to the American Medical Informatics Association Health Informatics knowledge, skills, and attitudes. The Nursing Informatics Program Directors' map connected an average of 4.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency, whereas the health informatics expert's map connected an average of 5.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency. Agreement across the two maps ranged from 14% to 60% per American Association of Colleges of Nursing competency, revealing alignment between the two groups' competencies according to knowledge, skills, and attitudes. These findings suggest that graduates of master's degree programs in nursing, especially those specializing in nursing informatics, will likely be prepared to sit for the proposed Advanced Health Informatics Certification in addition to the American Nurses Credentialing Center bachelor's-level Informatics Nursing Certification. This preliminary map sets the stage for further in-depth mapping of nursing informatics curricula with American Medical Informatics Association Core Competencies and will enable interprofessional conversations around nursing informatics specialty program accreditation, nursing workforce preparation, and nursing informatics advanced certification. Nursing informaticists should examine their need for credentials as key contributors who will address critical health informatics needs.

The objective of this project was to use and evaluate the American Nurses Credentialing Center (ANCC) accreditation program in the context of registered nurse practice remediation using Just Culture. The quality improvement project intervention was aimed at educating nursing professional development educators about the accreditation program for registered nurse remedial education and implementing this program for remediation. It compared pre- and postintervention data for nurse educators using the nine key elements.

This article describes how a national nursing association and a major academic medical center responded to the coronavirus disease-2019 (COVID-19) pandemic during the first wave of the outbreak in the United States (January to August 2020). The organizations share their lived experiences as they quickly found themselves at the forefront of the crisis. The article discusses how early warning signs from a world away sparked collaboration, innovation, and action that grew to a coordinated, organization-wide response. It also explores how leaders in 2 distinct but interrelated environments rose to the challenge to leverage the best their organizations had to offer, relying on the expertise of each to navigate changes that were made to almost every aspect of work. From tentative first steps to rapid implementation of innovative policies and procedures, the organizations share lessons learned and benefits reaped. The article includes practical crisis response strategies for the nursing profession and health care systems moving forward.

As the American Nurses Credentialing Center (ANCC) marks its 30th anniversary in 2021, the world's largest and most prestigious nurse credentialing organization has unveiled a new Credentialing Framework for Nursing Excellence. In this month's "Magnet Perspectives," the directors of the ANCC's 6 credentialing programs introduce a new conceptual framework, outline the key concepts for exceptional nursing practice, and describe how ANCC's programs interconnect to invoke a powerful model that healthcare organizations can use to develop and sustain nursing excellence.

In 2015, the American Nurses Association issued a position statement on workplace violence. An authoritative, disciplinary position is critically important to inform policies and recommendations addressing this significant issue in nursing. Position statements and policies should reflect disciplinary values. A discourse analysis of this position statement was performed through the lens of nursing ethics. The position statement endorses a zero-tolerance response, which is moralist, punitive, and questionably effective. It problematically presents patient and coworker violence as equivalent. Promotion of this position has the potential to erode public trust and lead us down a path of criminalizing illness behaviors.

The article focuses on the presidential election which may be the most important of modern times Topics discussed include the numbers show a dismal accounting of the failure of the richest country in the world to protect its populace;and according to the Johns Hopkins Coronavirus Resource Center, as of September 4, the U S data on positive cases and fatalities is the worst in the world

This article presents the discussion that occurred during a policy dialogue on aid in dying (AID) presented at the American Academy of Nursing's annual conference in October 2016. Panelists explored the arguments for and against the growing state expansion of AID legislation, and the role for nurses in assisting patients who request AID. Recommendations are offered and four expert commentaries respond to the points raised.

This article addresses how nurse planners, nursing professional development practitioners, and any individual who is responsible for the facilitation of learning and professional development in health care can use a competency-based education framework as a methodology to design and evaluate outcome-based continuing education. [ J Contin Educ Nurs. 2019;50(3):100–102.]

APRNs remain guided, first of all, by the ANA Code of Ethics.

How does and should the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, with foundations from the late 1800s, impact today's nursing practice? How can the Code help you? The earlier 2001 Code was revised and became effective January 2015. The nine provisions received modest revision, as did the corresponding interpretive statements. However, Provisions 8 and 9 and their interpretive statements received more substantial revision. This article explains the Code and summarizes the 2015 revisions, considering points of particular interest for nurses of faith.

Keeping a community healthy requires more than hospital care. Magnet® nurses go beyond the bedside to promote a culture of health through volunteer work. To mark the season of giving, this month's "Magnet Perspectives" column looks at the ways in which nurses from Magnet-recognized organizations care for their communities. What do they do? Why do they do it? How does the Magnet framework promote and support them? We explore the implications for larger issues, such as population health, and hear from the nurses themselves about why community involvement is important.

Innovation has enabled organizations to highlight and engage during the COVID -19 pandemic. The use of virtual site visits to assess the organizations 's culture and sustainability of the Magnet components during initial designation and redesignation allows for ongoing support of nursing excellence.

Objective Social inequities threaten the health of the global population. A superficial acknowledgement of social justice by nursing's foundational documents may limit the degree to which nurses view injustice as relevant to nursing practice and education. The purpose was to examine conceptualizations of social justice and connections to broader contexts in the most recent editions. Design Critical discourse analysis examines and uncovers dynamics related to power, language, and inequality within the American Nurses Association's Code of Ethics, Scope and Standards of Practice, and Social Policy Statement. Results This analysis found ongoing inconsistencies in conceptualizations of social justice. Although the Code of Ethics integrates concepts related to social justice far more than the other two, tension between professionalism and social change emerges. The discourse of professionalism renders interrelated cultural, social, economic, historical, and political contexts nearly invisible. Conclusion Greater consistency would provide a clearer path for nurses to mobilize and engage in the courageous work necessary to address social injustice. These findings also call for an examination of how nurses can critique and use the power and privilege of professionalism to amplify the connection between social institutions and health equity in nursing education, practice, and policy development.

Recognizing, addressing, and preventing incivility in the health care environment, including the perioperative area, requires an intentional and informed approach to foster healthy workplaces and protect patient safety. Several important foundational documents and position statements speak directly to the nurse's responsibility to protect patient, coworker, and personal safety and promote civility and respect. In the complex, fast-paced environment of the OR, the pressure to meet patient needs, performance outcomes, and patient safety standards can lead to conflict and incivility. In this article, we present a case-based scenario to illustrate a multilevel evidence-based response to an uncivil encounter that could negatively affect patient safety in the OR. After the scenario, we discuss the responses to the encounter from the organization, the nurse manager, and the individual nurse. When nurses speak up and resolve issues, they report better patient outcomes, greater satisfaction in the workplace, and heightened organizational commitment.

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.

Accreditation of transition to practice (TTP) programs are rapidly increasing. A review was completed on 13 TTP programs, accredited by the American Nurses Credentialing Center Practice Transition Accreditation Program. The review found six benefits of TTP accreditation that can translate into value for organizations. Nursing professional development practitioners should seek accreditation for TTP programs to elevate the potential for funding from national agencies.

The American Nurses Association (ANA)Code of Ethics for Nurses with Interpretive Statementsprovides guidance for all nurses, in all roles and in all settings. Familiarity with the provisions and the interpretive statements improves our ethical awareness and our ethical competence. Current events in our communities and across the globe require a response from nurses individually and collectively. Living in the Code enables us to form responses that are ethically sound. Advancing the profession through scholarly inquiry and establishing moral communities are other obligations that can be achieved by living in the Code.

Today there are many global volunteer opportunities for nurses and student nurses. While the intentions of volunteers may be good, the result may be harmful to the volunteer and/or the host, creating a situation of moral distress. An ethical code provides guidance and promotes moral agency. We discuss elements of the American Nurses AssociationCode of Ethics with Interpretive Statementsand apply them to the experience of global volunteering through a case study approach.

Substance use disorder is a serious problem in nursing that is often invisible and not well understood or well handled. It tears at the social contract between nursing and society and disrupts the trust so essential to that contract. The American Nurses Association

Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias.

Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession’s norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.

Background Pending revisions to the Common Rule include topics consistent with respect for persons, justice, and beneficence for research subjects in studies using omics technologies and are relevant to omics research. Purpose Synthesize trends in bioethics, precision health, and omics nursing science for novice and experienced nursing scholars from which to consider bioethics questions. Methods Review topics addressed in the National Institute of Nursing Research (NINR) strategic plan, Common Rule pending revisions, and publications regarding human subjects protection policies. Discussion Omics research involves decisions regarding understandable informed consent, broad consent, data sharing, trust, equal benefit, equal access, societal variables, privacy, data security, and return of findings to participants. Conclusion Principles of respect for persons, justice, and beneficence as articulated in the Belmont report and reflected in the American Nurses Association (ANA) Code of Ethics provide guidance for human subjects protection procedures to advance omics and nursing science.

The eighth edition of the Nephrology Nursing Scope and Standards of Practice, published by the American Nephrology Nurses Association (Gomez, 2017), defines the scope of nephrology nursing practice, and provides standards of practice and professional performance in an approach similar to the American Nurses Association (ANA) 2016 standards. ANNA's eighth edition of the Nephrology Nursing Scope and Standards of Practice incorporates competencies for graduate level-prepared nurses in addition to the registered nurse (RN) and advanced practice registered nurse (APRN). The section on how to use the standards in practice has been updated with user-friendly forms. This article provides an overview of the scope of practice, standards, competencies, and situations that require intervention by the nephrology nurse.

Nursing is the largest healthcare profession in the United States (U.S.). As principal frontline caregivers in the U.S. healthcare system, nurses have tremendous influence over a patient's healthcare experience. A growing body of evidence states that the nursing workforce has a direct impact on healthcare quality. A standardized approach to measuring nursing's contribution to patient care and safety using nursing-sensitive quality indicators assists in examining the extent to which nurses and nursing affect the quality and safety of health care. This article focuses on nursing-sensitive quality indicators and discusses healthcare quality indicators and nursing-sensitive indicators used in the U.S. A summary of the work of the American Nephrology Nurses' Association Task Force on Nephrology Nursing-Sensitive Quality Indicators (NNSQI) and an NNSQI exemplar are provided.

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.