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The first installment of a new column looks at some of the many things nurses can do to get involved.

Maintaining the integrity of record keeping and retrievable information related to the provision of continuing education credit creates challenges for a large organization. Accurate educational program documentation is vital to support the knowledge and professional development of nursing staff. Quality review and accurate documentation of programs for nursing staff development occurred at one institution through the use of continuous improvement principles. Integration of the new process into the current system maintains the process of providing quality record keeping.

Review six well-known credentialing processes sought by healthcare facilities, and identify success indicators that emerge as common themes among these processes.

For any discipline with a practice component, value priorities are a reflection of choices on what it means to be a member of the discipline. For the recipients of professional nursing services, values reflect owning individual priorities for what is most important in living health and quality of life. In the context of global healthcare, priority has been afforded to disciplinary practices whose values are consistent with those of normative, empirical science. This column begins a discussion of what values guide and ought to guide the discipline and practice of nursing from a nursing theoretical perspective.

Holistic nurses believe that the human being, composed of a mind, body and soul integrated into an inseparable whole that is greater than the sum of the parts, is in constant interaction with the universe and all that it contains. Health and well-being depend on attaining harmony in these relationships. Healing is the journey toward holism. Using presence, intent, unconditional acceptance, love, and compassion, holistic nurses can facilitate growth and healing and help their clients to find meaning in their life experiences, life purpose, and reason for being.

In the fall of 2013, the American Nurses Association began the process of redesigning the scope and standards for the nurse administrator. This article provides a synthesis of the top 10 changes in the new Scope and Standards for Nurse Administrators that are being reviewed for approval. These changes reflect the continuing evolution of practice for nurses serving as leaders across the United States.

The purpose of this study was to begin to develop a consensus as to the essential content and methods of ethics education for advanced practice nurses. An online Delphi technique was used to survey ethics experts to determine whether items were essential, desirable, or unnecessary to ethics education for students in doctor of nursing practice programs. Only the American Nurses Association Code of Ethics and ethics terminology were deemed essential foundational knowledge.

In this article, I argue that professional healthcare organizations such as the AMA and ANA ought not to take controversial stances on professional ethics. I address the best putative arguments in favor of taking such stances, and argue that none are convincing. I then argue that the sort of stance-taking at issue has pernicious consequences: it stands to curb critical thought in social, political, and legal debates, increase moral distress among clinicians, and alienate clinicians from their professional societies. Thus, because there are no good arguments in favor of stance-taking and at least some risks in doing so, professional organizations should refrain from adopting the sort of ethically controversial positions at issue.

How six hospitals in northern New Jersey helped each other achieve and maintain Magnet recognition.

To practice competently and with integrity, today's nurses must have in place several key elements that guide the profession, such as an accreditation process for education, a rigorous system for licensure and certification, and a relevant code of ethics. The American Nurses Association has guided and supported nursing practice through creation and implementation of a nationally accepted Code of Ethics for Nurses with Interpretive Statements. This article will discuss ethics in society, professions, and nursing and illustrate how a professional code of ethics can guide nursing practice in a variety of settings. We also offer a brief history of the Code of Ethics, discuss the modern Code of Ethics, and describe the importance of periodic revision, including the inclusive and thorough process used to develop the 2015 Code and a summary of recent changes. Finally, the article provides implications for practicing nurses to assure that this document is a dynamic, useful resource in a variety of healthcare settings.

A cohort of holistic nurses, recognizing opportunities inherent in health care transformation, organized and worked together from 2009 to 2012. The goal was to hold space for holistic nursing by developing a health and wellness coaching role and certification program for holistic nurses. The intent was to ensure that holistic nurses could work to the fullest of their ability within the evolving health care system, and others could discover the merit of holistic nursing as they explored the possibilities of nurse coaching. Challenges emerged that required the cohort plan strategies that would hold the space for nursing while also moving toward the intended goal. As they worked, this cohort demonstrated leadership skills, knowledge, values, and attitudes of holistic nursing that provide an example for others who follow in the wake of health care transformation. The American Holistic Credentialing Corporation’s perspective of the events that unfolded and of the related decisions made by the coalition provides a record of the evolution of holistic nursing.

In 2010, the American Nurses Association (ANA) added an environmental health standard to the ANA Scope and Standards of Practice requiring that nurses implement environmental health strategies in nursing practice. To prepare nurse educators to integrate environmental health at all educational levels, nursing faculty members from the Alliance of Nurses for Healthy Environments developed environmental health competencies and curricular recommendations that address this need. Internet URLs are included for environmental health curricula for each level of nursing education.

The application of theory to practice is multifaceted. It requires a nursing theory that is compatible with an institution's values and mission and that is easily understood and simple enough to guide practice. Comfort Theory was chosen because of its universality. The authors describe how Kolcaba's Comfort Theory was used by a not-for-profit New England hospital to provide a coherent and consistent pattern for enhancing care and promoting professional practice, as well as to serve as a unifying framework for applying for Magnet Recognition Status.

Objective To identify the barriers to research utilization for nurses within a Magnet community hospital. Design A descriptive, quantitative design was used. Methods The instrument used was the BARRIERS scale, a 29-item Likert-type questionnaire, regarding perceived obstacles to research utilization. It included 3 open-ended questions. In all, 584 packets containing the BARRIERS tool and a demographic survey were successfully distributed. A total of 275 (47%) completed questionnaires were returned. Results The questions were categorized into 4 domains: Nurse, Setting, Research, and Presentation. The Setting domain was found to be the greatest barrier for nurses. Four of the top 5 barriers related to the Setting. Facilitators to implementing research fell within 4 distinct themes: access and availability, education and communication, practical application, and supportive environment. A statistically significant difference was found in the Nurse domain based on the education level (F = 2.932) (P = .034). Conclusions The results of this study will be useful in determining strategies for improving the nurse practice setting to facilitate the use of research by nurses. Suggested changes should encourage the reading of research; discussion of research; risk taking to implement new ideas; mentoring; and education of nursing staff, hospital administration, and physicians. Implementation of the Magnet standards is likely to diminish the barriers to research use by nurses within that facility.

Whether the goal is to generate new knowledge through basic research or to effectively use existing knowledge in evidence-based clinical practice, collaborative exchange between service and academia is essential. The authors describe 2 successful strategies that have been mutually beneficial to a clinical agency and a school of nursing in fostering research and evidence-based practice. These strategies can be used by other institutions as they strive to meet standards for excellence in academia and service.

The use of antibiotics in agriculture is considered a contributing factor to the problem of antibiotic resistance. A majority of antibiotics and related drugs produced in the United States are not used to treat the infirm, but rather are used as feed additives for agricultural animals to promote growth and compensate for stressful and crowded growing conditions. Significant efforts must be made to decrease inappropriate overuse in animals and agriculture. Several leading health and political organizations have begun to address the issue. The American Nurses Association has established policies that call on Congress, the U.S. Food and Drug Administration, and meat producers to promptly phase out the agricultural practices that promote antibiotic resistance.

The prevalence of substance abuse in the nurse population is believed to parallel that in the general population (i.e. approximately 10%). Nurses with substance abuse problems need help. They are in danger of harming patients, the facility's reputation, the nursing profession, and themselves. The consequences of not reporting concerns can be far worse than those of reporting the issue. Part one of this two-part series discusses how society views addiction and the nursing profession, signs and symptoms of substance abuse, reasons nurses should report an impaired colleague, the code of silence that exists among nurses, and board of nursing jurisdiction.

The potential to have a unit based on excellence is within every manager's reach. The ability to submit for the Beacon Award and Magnet hospital designation are two avenues to fulfill that potential. Successes from University of California Davis Medical Center are shared in this article in the hope of inspiring other managers and their staff.

As new informational technologies emerge and ever more innovative applications of existing technologies are found, new circumstances will also evolve. The ethical issues involved in these situations will challenge forward-looking nurse leaders to become aware of the matters in question and to employ critical thinking to ensure that information technology serves all stakeholders well.

Nurses must frequently make ethical decisions. These decisions require judgment, knowledge, and skills. This article will provide one framework for ethical decision making and provide several examples of the process.

Review a progressive framework for operationalizing an integrated evidence-based nursing practice culture.

As chief nursing officers partner with physician colleagues to create collaborative models of practice across the care continuum, the role of peer review in achieving quality outcomes cannot be overlooked. This article describes how an integrated healthcare system approached the creation of a unique integrative model for physician/nurse practitioner peer review.

The process of seeking magnet designation through the American Nurses Credentialing Center begins with completion of a 1-page application. The second phase, the most tedious and time-consuming phase, consists of submitting written documentation. The written documentation must demonstrate implementation of the Scope and Standards for Nurse Administrators and how the "forces of magnetism" are incorporated within nursing services. Compiling the written documentation can be overwhelming and challenging. Getting started, developing an approach, and assigning responsibilities require time, creativity, and energy. The authors identify strategies to make the document preparation smooth and coordinated. Pitfalls to avoid and helpful tips are discussed.

(2003). Nurse-Assisted Suicide: Not an Answer in End-of-Life Care. Issues in Mental Health Nursing: Vol. 24, No. 1, pp. 45-57.

This article is an overview of the development of the revised Scope and Standards of Practice for Nursing Professional Development, published by the American Nurses Association in 2000. It provides some background information about the standards, and discusses implications for staff development educators. The framework for these revised standards is continuing competence, which is essential to promote evidence-based practice.

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this fourth of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the second statement, which emphasizes commitment to the patient.

Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this third of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the fourth provision statement, which addresses nurses' accountability and responsibility. AORN J 75 (June 2002) 1094-1099.

The purpose of this study was to assess the feasibility and conduct a pilot study of the ANA Nursing Care Report Card Study in one state. Clinical indicators studied include agency data, skin integrity, patient falls, and nurse (n = 217) and patient (n = 924) satisfaction. Patients were well satisfied with their care. Nurses were less satisfied, with a significant difference between what was important to their satisfaction and their current level of satisfaction. Important information is included for hospital and nursing service administrators, as well as for nurses.

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.