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The American Association of Colleges of Nursing asserted the position that the practice doctorate should be the graduate degree for advanced nursing practice preparation. To maintain professional standards for military advanced practice registered nurses (APRN) and remain competitive for high-quality students, the Daniel K. Inouye Graduate School of Nursing at the Uniformed Services University of the Health Sciences transitioned its APRN programs to the Doctor of Nursing Practice degree. This article describes a model graduate curriculum that incorporates clinical partnerships to prepare APRNs for their future roles in the federal health care system. Background, stakeholders, program aims, implementation strategies, curriculum design, accreditation, challenges, and lessons learned are discussed.

Purpose: This article reports on recommendations arising from an invitational workshop series held at the National Institutes of Health for the purposes of identifying critical genomics problems important to the health of the public that can be addressed through nursing science. The overall purpose of the Genomic Nursing State of the Science Initiative is to establish a nursing research blueprint based on gaps in the evidence and expert evaluation of the current state of the science and through public comment. Organizing Constructs: A Genomic Nursing State of the Science Advisory Panel was convened in 2012 to develop the nursing research blueprint. The Advisory Panel, which met via two webinars and two in-person meetings, considered existing evidence from evidence reviews, testimony from key stakeholder groups, presentations from experts in research synthesis, and public comment. Findings: The genomic nursing science blueprint arising from the Genomic Nursing State of Science Advisory Panel focuses on biologic plausibility studies as well as interventions likely to improve a variety of outcomes (e.g., clinical, economic, environmental). It also includes all care settings and diverse populations. The focus is on (a) the client, defined as person, family, community, or population; (b) the context, targeting informatics support systems, capacity building, education, and environmental influences; and (c) cross-cutting themes. It was agreed that building capacity to measure the impact of nursing actions on costs, quality, and outcomes of patient care is a strategic and

Translating the recommendations from the Institute of Medicine's landmark report, Keeping Patients Safe: Transforming the Work Environment of Nurses, into practice and healthcare policy will require an extensive collaboration among nurse administrators and nurse researchers. The insights and skills of both groups are critical for evaluating the recommendations and their implications for practice, for filling gaps in research, and for influencing significant health system change.

The U.S. health care system is facing a projected nursing shortage of unprecedented magnitude. Although military nursing services recently have been able to meet their nursing recruitment quotas, national studies have predicted a long-term nursing shortage that may affect future recruitment for the Nurse Corps of the three military services. Data are needed to plan for recruitment incentives and the impact of those incentives on targeted populations of likely future nurses.Data are drawn from three online surveys conducted in 2011-2012, including surveys of 1,302 Army, Navy, and Air Force personnel serving on major military bases, 914 nursing students at colleges with entry Bachelor of Science in Nursing programs located nearby major military bases, and a qualitative survey of 1,200 young adults, age 18-39, in the general public.The three populations are different in several demographic characteristics. We explored perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. Perceptions differ among the groups.The results of this study may help to inform strategies for reaching out to specific populations with targeted messages that focus on barriers and facilitators relevant to each to successfully recruit a diverse Nurse Corps for the future.

A proposed multiyear plan of funding mechanisms by the National Center for Nursing Research (NCNR) to increase the use of biological theory and measurements in nursing research has been developed for both research training and research programs. The objectives of the research training programs are (a) to develop a cadre of nurse scientists with solid research training in the biological sciences, (b) to upgrade to state-of-the-art biological research for midcareer nurse scientists, and (c) to ensure adequate highly trained biological-nurse manpower will be available to accomplish the nation's nursing research agenda. The objectives of the research programs are (a) to stimulate nurse scientists to undertake novel, innovative research using state-of-the-art biological technology, (b) to link the behavioral and biological underpinnings of nursing science in specified areas of biomedical clinical research, and (c) to ensure that, in the coming decade, nursing science and behavioral research will be inextricably interwoven with biological research. The research training programs include: targeted predoctoral-postdoctoral transitional training, targeted predoctoral or postdoctoral fellowships, training awards for existing institutional training grants in other disciplines, mid-career awards, the Nurse Scientist award, and institutional training grants for biological nursing. The research programs include: small grants programs, augmentation of existing projects in other Institutes, Requests For Applications (RFA) in biobehavioral nursing, cluster studies, and clinical trials. © 1993 John Wiley & Sons, Inc.

Title. Missed nursing care: a concept analysis. Aim. This paper is a report of the analysis of the concept of missed nursing care. Background. According to patient safety literature, missed nursing care is an error of omission. This concept has been conspicuously absent in quality and patient safety literature, with individual aspects of nursing care left undone given only occasional mention. Method. An 8-step method of concept analysis – select concept, determine purpose, identify uses, define attributes, identify model case, describe related and contrary cases, identify antecedents and consequences and define empirical referents – was used to examine the concept of missed nursing care. The sources for the analysis were identified by systematic searches of the World Wide Web, MEDLINE, CINAHL and reference lists of related journal articles with a timeline of 1970 to April 2008. Findings. Missed nursing care, conceptualized within the Missed Nursing Care Model, is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Various attribute categories reported by nurses in acute care settings contribute to missed nursing care: (1) antecedents that catalyse the need for a decision about priorities; (2) elements of the nursing process and (3) internal perceptions and values of the nurse. Multiple elements in the nursing environment and internal to nurses influence whether needed nursing care is provided. Conclusion. Missed care as conceptualized within the Missed Care Model is a universal phenomenon. The concept is expected to occur across all cultures and countries, thus being international in scope.

> Balancing the development of cultures of safety with nursing workforce challenges is similar to navigating the perfect storm. The perfect storm is characterized as a tempest of extreme intensity that happens rarely, maybe once every 100 years, as a result of multiple factors that end in a situation worse than people have ever seen. Such a storm is currently evident when attempting to ensure patient safety while being confronted with a shortage of nurses and nursing faculty unlike any other shortage experienced in over a number of decades. Based on research, the threats to patient safety from healthcare system and health professional errors have become of paramount concern. The prevention of such errors is the focus of healthcare organizations as they create cultures of safety. A major aspect of cultures of safety is nurses with their many roles in caring for patients and families, especially the constant surveillance they provide, which often prevents complications and deaths secondary to failure to rescue. However, providing such surveillance requires adequate numbers of well-prepared nurses in attendance. The perfect storm is created because of the existence of a steadily worsening shortage oi nurses and nursing faculty. Multiple factors have converged to develop and sustain such a shortage. A blueprint for healthcare organizations is proposed, with examples of numerous innovative strategies that are being developed and studied for handling the major challenges posed by this perfect storm.

Purpose: This article is part of the series regarding genomics and nursing practice, science, education, and policy. Issues in genetic testing, genetic information and the lessons learned through applications of genetic and genomic science are analyzed and discussed. Framework: Scientists, scholars, and members of the public have articulated a vision to guide genomics research and scholarship. The three overarching themes of this conceptual framework are genomes to biology, genomes to health, and genomes to society. Conclusions: Nurses can promote the use of genomic research technologies and information in the context of health, biology, and society, as well as in nursing research, practice, education, and policy.

Concern, indeed growing alarm, over the declining quality of health care in America has been a recurring topic over the last 2 decades. Reports from many sectors conclude that poorer quality can affect the health of the public and that widespread problems in the quality of care exist throughout the nation. Recommendations call for coordinated efforts among providers, consumers, purchasers, researchers, and regulators of healthcare services.

Objective. —To develop a consensus on the use of antenatal corticosteroids for fetal maturation in preterm infants. Participants. —A nonfederal, nonadvocate, 16-member consensus panel including representatives from neonatology, obstetrics, family medicine, behavioral medicine, psychology, biostatistics, and the public; 19 experts in neonatology, obstetrics, and pharmacology presented data to the consensus panel and a conference audience of approximately 500. Evidence. —An extensive bibliography of references was produced for the consensus panel and the conference audience using a variety of on-line databases including MEDLINE. The consensus panel met several times prior to the conference to review the literature. It also commissioned an updated meta-analysis, a neonatal registry review, and an economic analysis that were presented at the conference. The experts prepared abstracts for distribution at the conference, presented data, and answered questions from the panel and audience. The panel evaluated the strength of the scientific evidence using the grading system developed by the Canadian Task Force on the Periodic Health Examination and adapted by the US Preventive Services Task Force. Consensus. —The consensus panel, answering predefined consensus questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. Consensus Statement. —The consensus panel composed a draft statement that was read in its entirety at the conference for comment. The panel released a revised statement at the end of the conference and finalized the revisions a few weeks after the conference. Conclusions. —Antenatal corticosteroid therapy is indicated for women at risk of premature delivery with few exceptions and will result in a substantial decrease in neonatal morbidity and mortality, as well as substantial savings in health care costs. The use of antenatal corticosteroids for fetal maturation is a rare example of a technology that yields substantial cost savings in addition to improving health. (JAMA. 1995;273:413-418)

Summary statements from the Nursing Research Study Section, Division of Research Grants, NIH, between October, 1986 and June, 1988 were used to identify reasons for recommending approval or disapproval of grant applications with RO1 and R29 activity codes. The 917 comments (25 +/- 4 per critique), sorted into one of nine categories (Aims, Significance, Investigator, Budget, Resources, Design, Sample, Techniques, Data Analysis) for analysis, were classified as Strengths (positive comments) or Weaknesses (negative comments). The weaknesses of approved applications were confined mostly to the categories of Design and Techniques. Disapproved applications had few strengths and many weaknesses in Design, Sample, Techniques, and Data Analysis. Critiques of First Award (R29) and traditional research project grant applications (RO1) were similar. The approved applications addressed meaningful problems, had well-synthesized literature reviews, and were solvable by available techniques. The research plans were consonant with stated aims, and the methods sections reflected understanding of the principles underlying the techniques to be used. A supportive environment and adequate research resources, including access to the study population were common to these applications. Disapproved applications provided poor synthesis of the literature, methods inconsistent with the aims, and often reflected inadequate understanding of techniques to be used.