Unhealthy institutional workplaces.
* Workplace violence. Incidents of violence against nurses and other clinical workers continue at hospitals and nursing homes. An American Nurses Association (ANA) survey found that in the past year, 62% of nurses "have personally experienced physical and verbal abuse on the job." In response, the ANA announced plans to convene an expert panel to "address barriers to reporting abuse against nurses" and also launched the hashtag #EndNurseAbuse to increase awareness of violence against nurses through social media. The American Hospital Association, meanwhile, continued a campaign to combat hospital-based violence (http://www.AHA.org/PreventViolence), including holding its second national Hospitals Against Violence Day of Awareness in June.
* Staffing issues. The trend of new graduates working at the hospital bedside for only a few years before leaving to pursue advanced degrees and practice has created increased turnover among nurses, leaving fewer experienced nurses at the bedside as older, more experienced nurses retire.
* The 12-hour shift. It's well documented that both harm to nurses and patient-related medical errors result from 12-hour nursing shifts, leading many to wonder why they persist. Washington State University College of Nursing is leading a new federally funded study to evaluate the impact of consecutive 12-hour shifts on patient care skills, nurse fatigue, and other issues. The study will also compare the influence of day and night shifts.
Nursing practice and education trends.
* Practice models. An aging population has spurred the development of new care models, such as Age-Friendly Health Systems, which is being tested at five large health systems in the United States. The goal is to ensure that older adults receive optimal care across health care settings.The global telehealth market is projected to expand by 13% by 2025, a growth rate driven in part by the increasing prevalence of chronic illness-especially cardiovascular disease-and the growing number of older adults. This expansion is creating new practice opportunities for nurses, as well as benefits to patients. One skilled nursing facility saw a nearly 50% drop in ED transfers as a result of facility nurses utilizing telehealth consults. In 2018, the Centers for Medicare and Medicaid Services expanded coverage for telehealth services to Medicare Advantage enrollees, and the American Association of Critical-Care Nurses announced updated teleICU nursing practice and standards.
* Education trends. To increase the proportion of nurses with a bachelor of science in nursing (BSN) to 80% by 2020, as recommended by the Institute of Medicine, many community colleges are pairing up with baccalaureate programs to facilitate academic pathways for RNs to earn BSN degrees. The Academic Progression in Nursing program, a four-year initiative to study best practices, released its findings (read a summary in the February 2018 AJN) and will now continue work as the National Education Progression in Nursing Collaborative (http://www.nepincollaborative.org).-Elizabeth Mechcatie, MA, BSN