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Many factors affect quality care in long-term care (LTC) settings. A supportive organizational culture, strong leadership, appropriate staff and staffing, and effective training and professional development of staff members are all fundamental elements necessary for influencing quality care in LTC settings. This article discusses challenging issues confronting LTC settings and provides strategies for managing the complexities of culture change, staffing, and education in LTC.

From December 1, 2010, through May 31, 2013, the South Dakota Board of Nursing conducted a pilot study, “Virtual Nursing Care for Children with Diabetes in the School Setting.” The findings from the study supported the use of the virtual nurse model of care as a safe and effective method of supervising and delegating diabetes nursing care tasks to unlicensed assistive personnel (UAP), including insulin administration. This article provides an update describing the 2014 changes made to the nursing delegation rules, the protocol established for registered nurses using the virtual nurse model of care, and the training program for UAP providing diabetes nursing care.

Despite a growing number of foreign-educated nurses (FENs) joining the health care workforce, scientifically based evidence comparing FENs to U.S.-educated nurses on quality of care, including medication errors, is lacking. Hypotheses tested were related to differences in frequencies and consequences of medication error incidents between FENs and U.S.-educated nurses. The case and control groups were randomly selected from 2006 and 2010 risk management files and medication files at five Southwestern hospitals. The sample included 2,178 observations. In 2006, there were comparable percentages of FENs in the case group (34.7%) and in the control group (31.2%). In 2010, the percentages were again comparable (30.7% of FENs in the case group and 28.6% in the control group). In 2006, FENs were less likely to make medication errors not reaching patients (4.5% for FENs and 13.3% for U.S.-educated nurses), but tended to make errors reaching patients without harm (85.8% for FENs and 75.1% for U.S.-educated nurses); however, the difference disappeared in 2010. The authors’ comparison demonstrates that FENs provide quality of care comparable to that of U.S.-educated nurses with regard to medication errors, which may be attributed to the rigorous registered nurse licensure exam; FENs’ relatively higher educational background; the hospital’s recruitment, mentoring, and training programs; and the implementation of health information systems.

The National Council of State Boards of Nursing (NCSBN) published the results of the largest, most comprehensive study to date concerning the use of simulation as a substitute for traditional clinical experience. Results of the study, which were published in 2014, demonstrated that high-quality simulation experiences could be substituted for up to 50% of traditional clinical hours across the prelicensure nursing curriculum. An expert panel convened by NCSBN evaluated the data gathered through this study, examined previous research and the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice: SimulationSM, and used their collective knowledge to develop national simulation guidelines for prelicensure nursing programs. This article presents those guidelines, evidence to support the use of simulation, and information for faculty and program directors on preparation and planning for using simulation successfully in their nursing programs.

NCSBN's Transition to Practice (TTP) study: implications for educators.

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The basic NCLEX-RN test plan includes an overview of the content categories along with details about the administration of the exam.

Summary data for multiple categories of candidates, U.S. and international, is provided for performance on NCSBN's two nurse licensure examinations, the NCLEX-PN and NCLEX-RN.

A practice analysis study aims to investigate the applicability of the 2013 NCLEX-RN Test Plan. This periodic performance of practice analyses (i.e., job analysis) studies assists NCSBN in evaluating the validity of the test plan that guides content distribution of the licensure examination. Because changes can occur in registered nurse (RN) practice, practice analyses are conducted on a three-year cycle. This publication analyzes both the U.S. and Canadian nurse testing populations.

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