International nursing: the past 25 years and beyond

What the Joint Commission Medication Management Titration Standards Mean to Quality Care for Complex Patients

ABSTRACT

The Joint Commission (TJC), the nation's largest healthcare accreditor, was founded in the 1950s. Its Standards for Medication Management (MM) of titratable medications focused on prescriptive ordering practices versus reliance on nurse clinical decision making. The use of measurable endpoints to guide nurse decision making regarding medication titration has been the standard of care since the inception of TJC. Evidence to support altering these practice patterns is lacking. Using the 6 aims for the healthcare system (safe, timely, effective, efficient, equitable, and patient-centered) from the National Academy of Medicine, formerly the Institute of Medicine, and the American Association of Critical-Care Nurses Healthy Work Environment essential standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, authentic leadership), this article examines the impact of TJC MM standards on system design in critical care environments.

Merging time zones: promoting international communication through videoconferencing

Nursing is viewed increasingly from an international perspective. Communication between nurses from different countries and cultures is becoming an important feature of nurses' education as well as their professional lives. While it is often not possible for nurse educators and students to visit their counterparts in other countries, it is possible for them to engage in personal contact and discussion through videoconferencing technology. An exploratory international videoconferencing case-study project, which was undertaken to enable educators to further their knowledge of videoconferencing as a teaching method, and enable students to meet in a videoconference class and discuss common issues in nursing education and practice with their counterparts in another country is presented. Two groups of registered nurse students, one undergraduate and one graduate, from the Department of Nursing, University of Scranton, Pennsylvania, USA and the School of Nursing and Midwifery, University College Dublin, Ireland were brought together for one class each. This article presents these case studies in the context of videoconferencing in higher education, describes the practical and pedagogical considerations in implementation and makes recommendations for further use of videoconferencing to foster communication and help students in different countries to develop greater international awareness of nursing practice and health care.

Community transformation through culturally competent nursing leadership: application of theory of culture care diversity and universality and tri-dimensional leader effectiveness model

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.

Collaborative International Research

The current age of globalization poses challenges as to how to promote professional interaction to further international scholarly efforts in nursing. Models of global research are defined. Global health priorities are explicated, with recommendations for the conduct of outcomes-focused research leading to the generation of cost-effective interventions that contribute to the health and well-being of individuals, families, communities, and nations throughout the world. The challenges and opportunities in international collaborative nursing research are described based on the experiences of the authors during nearly two decades of collaborative work. International partnerships in globally relevant research, which respect and value equity between nurse researchers practicing in developed and developing countries, are essential.

Global nurse leaders: lessons from the sages

Globalization changes the benchmarking of excellence from national to "world class" standards. A synthesis of literature about global leadership was used to guide interviews with 17 nurse leaders from 8 countries in 5 continents. The leaders demonstrated leadership from early school years, learned from their mentors, had productive and sustained results in their work with peers and students, and realized their potential in becoming leaders in global health and nursing. The leadership development of future nurses requires formal and informal education, and training for global competencies, international experiences at home and abroad, and promoting and rewarding international work.

Creating a Context for Professional Dialogue Between United States and Russian Nurses: Design of an International Conference

This age of globalization challenges nurses to find effective ways to promote interaction to further scholarly efforts across cultural boundaries. This article describes critical conference design elements necessary to create a context for transnational professional dialogue. Collaborative efforts such as study exchanges and workshops resulting from this conference have fostered dialogue on ways to strengthen nursing practice to improve patient and family outcomes in the United States and Russia. The design of such a conference can serve as a model for promoting joint scholarly efforts to increase understanding among nurses across the globe.

Development of situation-specific theories: an integrative approach

One type of "ready-to-wear" theories that can bring about better nursing care outcomes regardless of their philosophical bases is situation-specific theories proposed by Im and Meleis in 1999. In this paper, some propositions for an integrative approach to the development of situation-specific theories are made. First, situation-specific theories are described as practice theories while they are compared with middle-range theories. Then the integrative approach is detailed, which includes (a) checking assumptions for theory development; (b) exploring through multiple sources; (c) theorizing; and (d) reporting, sharing, and validating. Finally, the paper concludes with suggestions for further development of the integrative approach.