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Increased demand for nurses worldwide has highlighted the need for a flexible nursing workforce eligible for licensure in multiple countries. Nursing's curricular innovation mirrors the call for reform within higher education including globalization of curricula (E. J. S. Hovenga, 2004; D. Nayyar, 2008; B. J. G. Wood, S. M. Tapsall, & G. N. Soutar, 2005), increased opportunities for student mobility exchanges, dialogue between different academic traditions, and mutual understanding and transparency between universities (J. González & R. Wagenaar, 2005). The European Union (EU) and United States have combined efforts to achieve these objectives by creating the Atlantis program in 2007 (U.S. Department of Education, 2011). This article describes experiences of four nursing programs participating in an Atlantis project to develop a double-degree baccalaureate program for undergraduate nursing students. Early learnings include increasing awareness and appreciation of essential curricular and performance competencies of the baccalaureate-prepared professional nurse. Challenges include language competency; variations in curriculum, cultural norms, student expectations, and learning assessment; and philosophical differences regarding first-level professional nurse preparation as specialist versus generalist. The Transatlantic Double Degree program has successfully implemented the double-degree program. Members have gained valuable insights into key issues surrounding the creation of a more uniform, yet flexible, educational standard between our countries., (© 2014.)

Heart failure is a chronic illness that poses a significant societal burden in the United States. Health care facilities are challenged to provide the most current treatment options available for patients with heart failure. Patient education focusing on self-management is recognized as essential. Nurses play a key role in the delivery of patient education. This article reviews the limited available evidence regarding nurses' knowledge of heart failure self-management principles. The key topics of symptom and weight management, dietary recommendations, medications, and activity are discussed.

Recurrent heart failure (HF) is the most common cause for readmission of elderly patients with HF. Patient education is an essential component of care for these patients. Healthcare providers must have a sufficient knowledge base to facilitate this education. This study aims to describe nurses' knowledge of HF self-management education principles. Fifty-one nurses working in a small Midwestern community hospital completed a 20-item true or false written survey developed by Albert et al (Heart Lung. 2002;31:102-112) to assess their knowledge of 5 areas of HF self-management. The sample included 14 nurses working in an intensive care unit and 41 nurses working on a general medical unit, all routinely providing care to patients with HF. The mean (+/-SD) HF self-care knowledge score was 14.6 +/- 2 (range = 9-19). There was no statistical difference in mean score between intensive care unit (14.7 +/- 1.6) and floor (14.5 +/- 2.1) nurses. Correct responses to individual survey items ranged from 20% to 100%; 6 questions resulted in mean scores >90% correct, 9 questions had mean scores between 70% and 90% correct, and 5 questions had mean scores <70% correct. Most respondents (90%) answered 6 questions correctly, but on 9 questions, 70% and 90% answered correctly. On 5 questions, less than 70% answered them correctly. Two questions (need for daily weight monitoring when asymptomatic and the importance of notifying the doctor of new onset or worsening of fatigue) were answered correctly by all participants. Subject areas of frequently missed questions were the use of nonsteroidal anti-inflammatory drugs, use of potassium-based salt substitutes, assessment of weight results, and physician notification of asymptomatic low blood pressure and momentary dizziness when rising. These results suggest that nurses working in a small community hospital may not be sufficiently knowledgeable in HF management principles. Additional emphasis on HF educational principles may improve the quality of patient education. One suggested intervention is to provide ongoing education for nurses regarding HF management.

Tobacco use is a major health risk that requires a comprehensive response by healthcare professionals. Nurse educators can contribute to the reduction of tobacco use by educating nursing students about tobacco use and smoking cessation strategies. The authors examine the breadth and depth of tobacco cessation content in Kansas registered nursing programs providing insight into the content and resources needed to teach nursing faculty and students how to assist individuals in tobacco use cessation.

The purpose of this study was to explore the process of implementing a new care coordinator role on a medical-surgical unit. Qualitative data were collected from employees and patients during a 3-month period; data analysis occurred concurrently. Using the constant comparative method, a grounded theory was developed to explain the initial process of implementation of the clinical nurse III (CNIII) role. The basic social psychological problem associated with implementation was role ambiguity. The basic social psychological process used to resolve this problem was "making the role of the CNIII". Making the role involves the following four strategies, which may occur simultaneously: communicating the vision, gaining new knowledge, accessing resources, and defining boundaries. Communicating the vision refers to efforts to articulate the role before and during the implementation process. Gaining new knowledge includes participating in educational workshops and acquiring new skills. Accessing resources refers to development of new relationships and acquisition of office space and equipment. Defining boundaries includes determining the scope of responsibilities and differentiating the role from other roles. This theory may be useful to researchers, educators, and administrators interested in role implementation.

Nurses can take a leadership role in the process of helping rural Americans to recognize and implement their vision of a healthy community. This necessitates an understanding of rural communities' perceptions of health and health care and allows nurses to more appropriately provide primary health care. As defined by the World Health Organization, primary health care is comprised of concepts of essentiality, community participation, intersectorial collaboration, access, and empowerment (Barnes et al., 1995). A focused ethnography involving 150 residents was conducted in a midwestern rural community and included 56 personal and 8 focus group interviews. A qualitative analysis of responses to the question, "What is your vision of a healthy community?" was conducted using Leininger's (1985) categories of economics, social-kinship, cultural, political-legal, religion, technology, and education. An eighth category of environmental concern emerged from the data. Responses were further assimilated into descriptive statements reflecting the community's vision of a healthy community, including issues of accessible and technologically adequate healthcare, job availability, strong community support by schools and churches, a caring community membership, and an attractive, pollution-free environment. This analysis demonstrates the need for application of primary health care at the level of community in designing services to achieve healthy rural communities.