phd in perioperative nursing

DNP and PhD options for perioperative nurses

• PMID: 23806591
• DOI: 10.1016/j.aorn.2013.05.010

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Nursing: Perioperative (MHSc/PDip)

Course overview, course outline, why choose this course, course fees.

• Find Out More

This programme is designed for registered nurses who wish to pursue a specialism in Perioperative Nursing. The full-time programme is offered full-time over two calendar years. Taught components of the programme are delivered in a blended learning format. Blended learning is an innovative teaching strategy which involves a combination of face-to-face and on-line learning. This means that most learning/teaching will be delivered on-line through Blackboard, an interactive learning system which connects directly to the University from your own home computer. Students are required to attend face to face workshops for a total of 12 days across the programme. The programme is comprised of six theory /practice modules. In all modules there is an emphasis on exploring the relevance of module content to practice, similarly, practice placements allow students to explore “new” knowledge in practice, enabling them an opportunity to integrate theory and practice.  

Students are required to undertake their clinical practice in an approved clinical practice setting within Ireland normally within the students own work setting. Where the environment does not provide sufficient opportunities to meet the learning outcomes of the programme additional placements will be required by the student in sites which will provide the experience needed. A  minimum of  500 clinical hours (reduced from previously-published 1,000 hours, on NMBI advice) needs to be completed in the specialist area while undertaking the programme.

GOOD REASONS TO STUDY THIS COURSE

• The course is approved by The Nursing and Midwifery Board of Ireland  (NMBI) and has a clinical focus, offering opportunities to develop specialist skills.
• The programme is offered through a blended learning format—a combination of online and face-to-face learning and teaching.
• Blended learning is an innovative and flexible approach to learning, making it possible and easier to combine  working full-time with studying.

Scholarships available Find out about our Postgraduate Scholarships  here .

Applications and Selections

Applicants apply online via the University of Galway  Postgraduate Applications System . 

Please note all applicants register for the 1-year postgraduate diploma, with the opportunity to transfer to the second year of the MSc programme at the end of the first year if they meet the relevant eligibility criteria.

Applications are put forward for review to the relevant Programme Director when they have been marked complete (application fee paid & requested supporting documents submitted). Applicants are required to submit a letter from their employer confirming financial and placement support.  Applicants are offered places and are required to accept their place on the programme within a specific timeline. Once they have accepted their place, applicants are invited to register online. Administration staff check that this has occurred on or in advance of the induction day (held in the week before the first week of teaching in semester one (usually first week in September).

Selection will be made by the Programme Director, in consultation with the Head of School, based on applicants’ written application.  Applications will be evaluated on the following:

• Meet the entry criteria (See above entry requirements ).
• Be working in the required specialist area, i.e., perioperative setting for the duration of the programme.
• Be supported to undertake any additional placement(s) that may be required as outlined in the curriculum document before completion of the programme.

Documentation required to complete application

• A copy of current NMBI registration.
• Copies of academic transcripts from completed educational courses.
• Copies of official awards (parchments) from completed educational courses.
• Written commitment/memo of understanding or equivalent from the director of nursing/employer to support the student during the clinical practicum.

Who Teaches this Course

Requirements and Assessment

A variety of assessment strategies are employed across the modules. These include engagement with on-line discussion boards/blogging, etivities, reflections, case studies, MCQs and assignments.

Students are required to attend all workshops and to participate in other academic activities, for example, e-tivities, discussion boards/ blogs, simulation, workshops etc. as required, unless prevented by some unavoidable cause of absence. Scheduled face-to-face workshops, discussion boards/blogs and e-tivities are important components of the programme, which are designed to help students develop a sense of group identity and engage with programme content. These activities are carefully selected to build students’ knowledge and skill. Students are expected to keep up a consistent rate of good attendance and participation so that their performance will not be adversely affected. Students who miss classes are responsible for updating themselves on any information provided during those sessions. Students’ attendance and participation at workshops and engagement in online work is monitored by the Programme Director.

Entry Requirements

All applicants must meet the following entry requirements:

• Be a registered nurse on the General division of the register maintained by the Nursing and Midwifery Board of Ireland (NMBI);
• Have a minimum of six months’ post-registration experience (exclusive of post-registration courses);
• Be currently working in the required specialist area, i.e., theatre (perioperative setting) and have as a minimum six months’ clinical experience in this specialist area;
• Provide written evidence of support from their Director of Nursing for the duration of the programme;
• Have an honours bachelor’s degree at NFQ Level 8 in nursing or a comparable qualification. Applicants who do not hold an honours degree or Higher Diploma (Level 8) must demonstrate that they have successfully completed (in the previous two years) a module at Level 9. Please consult the professional credit awards at Level 9 at: www.nuigalway.ie/pca/pca.html.

Additional Requirements

Recognition of prior learning (rpl).

2 years, full-time (Option to leave the programme with a Postgraduate Diploma after one year)

Next start date

September 2024

A Level Grades ()

Average intake, qqi/fet fetac entry routes, closing date.

31 May 2024

Mode of study

Ects weighting, course code.

Students complete three core and three specialist modules in the first year (60 ECTS) which is conducted over two semesters. There are two clinical competency assessments, one for each semester. Students’ clinical competency will be assessed by a designed preceptor and programme director (“pass/ fail”, submitted at the end of Semester 2). Eligible students will then complete a research dissertation (30 ECTS) in the second year.   All students are invited to a postgraduate Induction Day prior to commencing the programme. The Induction Day has many purposes. Students meet and get to know their classmates and lecturers, they are provided with information regarding programme content, the timetable, assessment schedule; programme Marks and Standards and the resources in place to support them while undertaking the programme. Students are taught how to access Blackboard use of Turnitin and an overview of plagiarism, overview of academic writing and how to contribute to discussion boards/blogs and submit assessments. Students are also orientated to the library on-line resources and other student support services. Students meet their programme director and module leaders in break out groups during the day. The roles of various key people are outlined i.e., programme director, module leader and clinical facilitator if relevant. Students are informed about the various apps they should download, role of the student union, role of Class representative, specific location of policies they may need access to over the course of the programme e.g., leave of absence, exemptions/recognition of prior learning (RPL). The clinical components of the programme and clinical assessments are discussed. The most important aspect of the day however is allowing students the time to meet and get to know one another. We find that peer support is extremely important for students attending blended learning programmes and ensure that there is plenty of time for students to get to know one another on the Induction Day.  

Year One is a blended learning programme and is delivered using a combination of on-line learning and face-to-face skills teaching.   In all modules, there is an emphasis on exploring the relevance of module content to practice. Each module runs over a minimum of 12 weeks. Modules are developed into guided learning packs comprising of multiple units. Each pack provides a study guide for the student and includes directed learning activities (both on-line and practice based), key reading and reflective points. Students will be supported on-line as they work through each unit, using the virtual learning environment Blackboard. Students will complete practice focused assessments throughout the programme. Students will be expected to engage in discussion boards/blogs and respond to posted questions or activities, and to complete e-tivities, case studies, MCQs and assignments. The methods of assessments provide students with the opportunity to clarify their understanding, debate key issues with peers and moderator, and consider how to apply their learning in their practice.   The moderator (a lecturer) will provide written feedback on assessments.  

The face-to-face teaching component (workshops/online) will take place at intervals throughout the semester. Workshops will focus on key skills and application. Online teaching will comprise of theoretical knowledge and provide an opportunity for engagement though group work and discussions. While undertaking the programme, students will continue to work in an approved perioperative clinical care setting. Programme assessments are structured in such a way allowing students to explore “new” knowledge in the reality of their practice, thus providing them with an opportunity to integrate theory and practice.    

To be eligible for the award of the Postgraduate Diploma in Nursing (Perioperative) students must pass each module at 40% and pass the clinical competency assessments. Students must also meet the clinical hours’ requirement of  500 hours (reduced from previously-published 1,000 hours, on NMBI advice).    

To be eligible to attend the Master’s of Health Sciences (Year Two), students must obtain an overall result of 60% or over in Year One.

Curriculum Information

Glossary of terms, year 1 (60 credits), required nu6618: specialist module 2 - prevention of anaesthetic complications, nu6618: specialist module 2 - prevention of anaesthetic complications, semester 1 | credits: 10.

This module will discuss the prevention, recognition and safe treatment of anaesthetic complications. It will address the care of the patient in relation to general anaesthesia, regional anaesthesia, peripheral nerve blocks, local anaesthesia and recovery from anaesthesia. (Language of instruction: English)

Learning Outcomes

• Critically appraise the assessment, intervention and evaluation of patients undergoing general anaesthesia.
• Critically evaluate the assessment, intervention and evaluation of patients undergoing regional/local anaesthesia and peripheral nerve blocks.
• Critically review the assessment, intervention and evaluation of patients undergoing emergency anaesthesia.
• Critically appraise the assessment, intervention and evaluation of patients recovering from anaesthesia
• Recognise the precursors to catastrophic anaesthetic events.

Assessments

• Continuous Assessment (100%)
• SINÉAD HAHESSY:   Research Profile  |   Email
• ELAINE O'HARA:   Research Profile  |   Email

Reading List

• "“ASPASN’s 2019-2020 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements. Cherry Hill, New Jersey: American Society of PeriAnaesthesia Nursing." by American Society of PeriAnaesthesia Nurses
• "Drains Perianesthesia Nursing A Critical Care Approach." by Odom-Forren, J. Publisher: Elsevier Saunders.
• "PeriAnesthesia Nursing Core Curriculum: Preprocedure, Phase 1 and Phase 11 PACU Nursing. ." by Schick, L. and Windle, P. Publisher: Saunders
• "Stat Pearls: Content is King. Treasure island (FL):" by Stat Pearls Publisher: Stat Pearls Publishing.

Required NU623: Clinical Governance: Supporting Safe Practice

Nu623: clinical governance: supporting safe practice.

Errors are inevitable in healthcare systems (Commission on Patient Safety and Quality Assurance, 2008). It is estimated that medical errors would rank 5 in the top 10 causes of death in the United States, ahead of accidents, diabetes, and Alzheimer’s disease, if included on the National Centre for Health Statistics’ list (Joint Commission, 2005 p.7). In Ireland, the Commission on Patient Safety and Quality Assurance (2008) acknowledge that healthcare will never be risk free but argue that it is critical that the systems in place are as safe as possible, that the right ‘checks and balances’ are in place and that learning results from mistakes. To ensure this happens it is important that programmes prepare nurses to promote and enhance clinical safety. The module is guided by the National Patient Safety Framework (The Australian Council for Safety and Quality in Health Care, 2005) and the WHO Patient Safety Curriculum Guide for Medical Schools (World Health Organisation, 2009). (Language of instruction: English)

• Critique the concepts of ‘safety’ and ‘risk’ in context of their practice setting.
• Examine the concept of ‘clinical governance’ in the Irish healthcare system
• Identify and evaluate the factors that determine the quality and safety of healthcare from the perspective of (i) the nurse or midwife (ii) the client (iii) the multidisciplinary team and (iv) the wider healthcare system
• Identify local policies and procedures to improve clinical safety and apply safety principles in practice.
• Debate the tensions between ‘managing risk’ and ‘client autonomy
• Explore their role in promoting and enhancing safety as a member of the multidisciplinary team
• Complete a risk assessment relevant to their practice setting.
• Evaluate their contribution to quality improvement in their practice setting
• EIMEAR BURKE:   Research Profile  |   Email
• FRANCES FARRELLY:   Research Profile  |   Email
• CATHERINE MEAGHER:   Research Profile  |   Email
• MARI MORAN:   Research Profile  |   Email
• CLAIRE O'TUATHAIL:   Research Profile  |   Email
• CLAIRE QUINN:   Research Profile  |   Email
• Katherine Pigott:   Research Profile  |   Email
• Ciara O'Meara:   Research Profile  |   Email

Required NU921: Clinical Competence 1

Nu921: clinical competence 1, semester 1 | credits: 0.

• MAURA DOWLING:   Research Profile  |   Email
• ANDREW HUNTER:   Research Profile  |   Email
• BRONA MOONEY:   Research Profile  |   Email
• MARCELLA HORRIGAN-KELLY:   Research Profile  |   Email
• Derek O'Keeffe:   Research Profile  |   Email
• Peter Carr:   Research Profile  |   Email

Required NU616: Specialist Module 1 - Physiological effects of surgery

Nu616: specialist module 1 - physiological effects of surgery.

This module will focus on the development of knowledge and skills required to work effectively and safely within the complex perioperative environment. There will be particular emphasis on the physiological effects of surgery. Application of the knowledge will relate to the assessment, intervention and evaluation of patient care in relation to respiratory, circulatory, cardiac, renal and endocrine function. The physiological effects of surgery are explored in the context of the effects on these systems to include the metabolic changes induced by surgery/trauma, fluid and electrolyte imbalance and the inflammatory response. (Language of instruction: English)

• Critically discuss the physiological effects of surgical trauma.
• Discuss the management of a patient undergoing general anaesthesia.
• Critically discuss the function and maintenance of cardiovascular integrity in relation to patient care intra operatively.
• Critically examine the role of the nurse in assessment, intervention and evaluation of the patients’ need for fluid balance to be maintained intra operatively.
• Critically discuss the management of clients with an endocrine dysfunction during the perioperative period.
• Critically articulate the prevention of injury related to positioning of the patient for surgical procedure.
• Critically discuss the care of patients requiring assistance with thermoregulation including prevention of malignant hypo/hyperthermia.
• Critically examine special considerations in Perianaesthesia care.
• Critically discuss the promotion of safety in the perioperative environment and analyse the potential of hazards to staff and patients and articulate the policies/procedures to minimise harm.
• Critically discuss the legal and procedural requirements related to safe perioperative care to include patient information and consent.
• Critically analyse the psychological impact of impending surgery on the adult and paediatric patient to include nursing assessment, interventions, and evaluation of nursing care to minimise psychological distress.
• "AFPP in your pocket- Perioperative Practice." by n/a Publisher: AFP
• "Standards & Recommendations for Safe Perioperative Practice." by n/a Publisher: AFPP
• "American Society of PeriAnaesthesia Nursing (2017) Standards of Perianaesthesia Nursing Practice 2017-2018. Cherry Hill, New Jersey: American Society of PeriAnaesthesia Nursing." by n/a
• "American Society of PeriAnaesthesia Nurses (2019) “ASPASN’s 2019-2020 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements. Cherry Hill, New York." by n/a
• "AORN (2019) AORN Guidelines for Perioperative Practice. Association of Perioperative Practice Registered Nurses: Denver." by n/a
• "Nursing the Surgical Patient." by Pudner, R. Publisher: Elsevier.

Required NU6439: Service Improvement

Nu6439: service improvement, semester 2 | credits: 10.

This module will allow the student the opportunity to plan and implement, with their manager, and an academic facilitator, a service improvement initiative. The project will focus on an issue of relevance to client care or service improvement and must be supported by the student’s line manager and/or clinical facilitator. Examples of the types of projects include: completion of a defined literature review supporting some aspect of unit work, preparation of a patient education leaflet (supported by an evidence based rationale presented separately), development of a patient education pack (supported by an evidence based rationale presented separately), development of a strategy to reduce waiting time, an initiative that will improve patient/staff safety, development/implementation of guidelines/policies, an initiative that improves the quality of patient services or the work environment, an initiative that saves time/money or any issue/problem/change that can be addressed through action. This work must be completed within a calendar year. (Language of instruction: English)

• Critically examine a practice issue and contribute to service improvement
• Integrate and apply learning from other modules
• Work collaboratively with peers and clients
• Become an autonomous and independent learner
• Develop the skills and knowledge needed to implement a change in clinical practice
• Develop their skills of analysis, critical thinking, problem-solving and reflection
• DEIRDRE FITZGERALD:   Research Profile  |   Email
• Duygu Sezgin:   Research Profile  |   Email
• Martina Giltenane:   Research Profile  |   Email

Required NU6619: Specialist Module 3 - Prevention of surgical complications

Nu6619: specialist module 3 - prevention of surgical complications.

• Critically discuss measures employed in the peri operative environment to reduce the risk of infection intra- operatively
• Critically analyse the aspects of infection controls employed in the perioperative environment
• Critically analyse the wound healing processes and factors that impede healing
• LO4 Critically articulate the care of instruments and equipment used in the perioperative area
• Critically discuss the management of the sterile field

Required NU502: Advanced Research Methods

Nu502: advanced research methods.

. This module is designed to enable students to explore the methodological and practical issues of research. It will help students determine the appropriate research design for research questions in their practice and provides an opportunity for students to debate, challenge and clarify research issues. This module will also help students understand the systematic review process and types of reviews, Finally, the module prepares students to develop a research protocol (Language of instruction: English)

• Demonstrate an understanding of what is meant by ‘evidence-based practice’
• Discuss theoretical perspectives on research methodology
• Formulate an answerable clinical question using the PICO approach
• Develop a database search strategy
• Explain clearly the key characteristics, strengths and weaknesses of the main qualitative and quantitative research methodologies
• Articulate a research problem and formulate a research question or hypothesis as appropriate to guide the conduct of a study
• Justify the use of appropriate data collection, sampling, and data analysis methods for qualitative and quantitative research
• Discuss rigour in the context of quantitative and qualitative research
• Discuss evidence synthesis of quantitative and qualitative research
• Create a plan with clear rationales for data collection, sampling, data analysis and rigour to be used when conducting a primary qualitative or quantitative study or evidence synthesis
• BERNARD MCCARTHY:   Research Profile  |   Email
• SIOBHÁIN SMYTH:   Research Profile  |   Email
• AMANDA WALSH:   Research Profile  |   Email
• DECLAN DEVANE:   Research Profile  |   Email
• FIONNUALA JORDAN:   Research Profile  |   Email
• STEPHEN KENNETH BRADLEY:   Research Profile  |   Email

Required NU922: Clinical Competence 2

Nu922: clinical competence 2, semester 2 | credits: 0, optional rpl010: recognised prior learning, rpl010: recognised prior learning, semester 1 and semester 2 | credits: 10, optional rpl020: recognised prior learning, rpl020: recognised prior learning, semester 1 and semester 2 | credits: 20, optional rpl030: recognised prior learning, rpl030: recognised prior learning, semester 1 and semester 2 | credits: 30, year 2 (30 credits), required nu6515: research dissertation, nu6515: research dissertation.

Students will be required to undertake a piece of primary research or an evidence synthesis on a topic relevant to their practice area. Students will be assigned a research supervisor who will support them in undertaking this work. (Language of instruction: English)

• Demonstrated knowledge of ethical requirements and procedures by negotiating access to research site/participants by securing ethical approval from the appropriate Research Ethics Committee in the case of primary research. Or in the case of evidence synthesis/secondary data analysis, demonstrate knowledge in the process of negotiating access to full text data not available in the library databases.
• Developed a research question(s) of significance to area of of significance to their specialist nursing/midwifery professional practice or a problem statement(s) based on a review of evidence-based literature.
• Identified and apply an appropriate method(s) to achieve the objectives of the research question (s)/ hypothesis for primary data collection, or in the case of secondary data analysis, employ valid and reliable method(s) for processing and analysing archived research data
• Critically discuss research findings with reference to the methods used, current literature and professional practice.
• Prepared a scholarly report (Option A) research article (Option B) ready for publication which will demonstrate accurate expression, analysis, and synthesis of the research subject.
• GLORIA AVALOS:   Research Profile  |   Email
• MIRIAM BRENNAN:   Research Profile  |   Email
• DYMPNA CASEY:   Research Profile  |   Email
• ANNE FALLON:   Research Profile  |   Email
• TERESA MEANEY:   Research Profile  |   Email
• PATRICIA HEALY:   Research Profile  |   Email
• GEORGINA GETHIN:   Research Profile  |   Email
• CATHERINE HOUGHTON:   Research Profile  |   Email
• MARION O'REGAN:   Research Profile  |   Email

Career Opportunities

The Postgraduate Diploma in Nursing (Perioperative), Major Award, is at Level 9 on the National Framework of Qualifications. It is informed and guided by NMBI criteria. It is aimed at Registered General Nurses working in the perioperative environment. This programme provides nurses with the specific theoretical knowledge, skills and clinical reasoning abilities required to provide safe and high-quality care in the perioperative specialism. The concepts of patient centred care, evidence-based practice, and promotion of safety are examined in this programme. The learners’ knowledge of physiology, anatomy, ethical and legal practice, and specific operative procedures are also included. It covers a multitude of theory relevant to perioperative nursing practice resulting in significant career opportunities. 

Upon completing this programme, students have the requisite knowledge and clinical skills to work in a wide variety of peri-operative care settings, both in Ireland and Internationally. Past Graduates have found employment and promotion opportunities nationally and internationally. 

Furthermore, the programme has shown to support and facilitate nursing at specialist and advanced nursing levels. The programme is designed to support the development of knowledge, skills, attributes, and competencies in preparation for specialist and advanced roles within nursing. Successful completion of the Masters in Perioperative Nursing will offer students opportunities to be considered for clinical nurse specialist posts and advanced nursing practice posts.

Who’s Suited to This Course

Transferable skills employers value, work placement, related student organisations, fees: tuition, fees: student levy, fees: non eu.

Student levy €140—payable by all students and is not covered by SUSI.  Further detail  here .

Find out More

E [email protected]  www.universityofgalway.ie/medicine-nursing-and-health-sciences/nursing/

Therese Davey |   Graduate

The Postgraduate Diploma in Perioperative Nursing has been a wonderful addition to my nursing career in the operating theatre. It has enhanced my practical ability with research knowledge relevant to practice. It has allowed me to complete a recent CNM2 interview with confidence in achieving a working environment the maintains patient safety all times, being an efficient and effective leader, good communicator, assists in clinical auditing, education training and showcasing my recent service improvement. I was successful in the recent interview and I do attribute this PDip as being an essential component with the success in securing this job. I really enjoyed the modules. Thank you to Elaine for the excellent introduction informing us about all aspects of the modules. The extensive reading list contributed to interesting discussions on the blog. The study days had excellent workshops on difficult airway, recovery, and ECGs. I found it extremely beneficial. Elaine, Thank you so much for all your help and assistance during the module. I certainly enjoyed it.

Rachel McLoughlin |   Graduate

The extensive use of materials covered a multitude of concepts which I believe has enhanced my practice. In my role as perioperative nurse, comprehending and anticipating complications is crucial. This programme specifically reviews the complex nature of perioperative nursing offering a comprehensive understanding of the nursing management required. The modules are organized in a way that promotes distant learning through the provision of blogs and online learning. The use of video presentations, PowerPoint videos, blackboard collaborate, and the varied learning methods used were stimulating. The workshops were a highlight for me. It covered a multitude of theory which was applicable to practice. I believe that because of this programme I have become a more competent in my role as perioperative nurse.

Suman Jossy |   Graduate

I would like to start by saying I am extremely grateful for being part of this programme. I work as a scrub nurse, so I had extremely limited experience in anesthetic care. I struggled with anesthetic emergencies as result of insufficient knowledge and practice until I started this programme. My ultimate motive for selecting this programme was to increase my knowledge in relation to anesthetic care, complications, and management. This programme has enhanced me theoretically and practically supporting my practice enabling me to provide safe perioperative nursing care. The programme provides relevant knowledge required to support the safe journey and care of the perioperative patient. I found the programme supportive and extremely helpful.

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Will Hospitals Finally Listen to Nurses?

• 1 School of Nursing, School of Public Health, University of Michigan, Ann Arbor
• 2 Division of Nursing Practice and Work Environment, American Nurses Association, Silver Spring, Maryland
• Original Investigation Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021 K. Jane Muir, PhD, RN, FNP-BC; Joshua Porat-Dahlerbruch, PhD, RN; Jacqueline Nikpour, PhD, RN; Kathryn Leep-Lazar, BSN, RN; Karen B. Lasater, PhD, RN JAMA Network Open
• Original Investigation Reasons Nurses Do Not Recommend Their Hospitals to Other Clinicians K. Jane Muir, PhD, RN, FNP-BC; Raina M. Merchant, MD, MSHP; Karen B. Lasater, PhD, RN; J. Margo Brooks Carthon, PhD, RN JAMA Network Open

While the US health care system is beginning to recover from the COVID-19 pandemic, hospitals are still operating with many unfilled nursing positions. The nurse vacancy rate has jumped from 8% prepandemic to 16% to 17% by 2022 and remains there. Even though overall hospital employment numbers may have bounced back to prepandemic levels, they are yet to reach their prepandemic growth trend. 1 According to the American Nurses Association (ANA), more than one-half of hospital-employed nurses feel their administration is not doing enough to retain and attract staff. Becker’s Hospital Review reports nursing and other healthcare worker strikes increased from approximately10 per year during the 2017 to 2021 period to 18 strikes in 2022, further rising to an unprecedented 27 strikes in 2023. 2

Two new studies from the University of Pennsylvania 3 , 4 focus on the challenges with recruitment and retention of registered nurses. Led by Dr Jane Muir, PhD, RN, FNP-BC, the studies 3 , 4 draw on data from the RN4CAST survey conducted in New York and Illinois between 2018 and 2021. Complementing each other, one of the studies 3 examines responses from nurses who recently ended health care employment, while the other includes emergency department (ED) nurses who are currently employed but may not consider their organization a good place to work. 4

In both studies, 3 , 4 not having enough staff was the key concern driving nurses away or causing dissatisfaction. Nurses who have left also cited burnout and family responsibilities, 3 while those still employed in the ED also pointed to workplace violence, safety concerns, and a lack of appreciation and job satisfaction as major issues. 4 Together, these studies send a strong message that increasing staff numbers, easing burnout, making the workplace safer, and balancing the demands of work and home life are essential actions employers can take to keep nurses working and attract new ones.

Muir and her team’s work 3 , 4 adds to the substantial evidence of the critical importance of adequate nurse staffing levels and a positive work environment for nurse retention and recruitment. In its 2021 letter to Secretary Xavier Becerra of the Department of Health and Human Services, the ANA declared a national nurse staffing crisis and called for immediate action to develop and implement solutions. The 2022 Nurse Staffing Task Force, a collaborative initiative by the ANA and other prominent national nursing and health care organizations, has developed and widely disseminated a set of recommendations for hospitals focusing on investing in nurse staffing, safe and supportive work environments, and competitive wages.

Yet hospitals have been reluctant to implement the recommendations, instead advocating for increasing the supply of new nursing school graduates and immigrant nurses. A consistent influx of new nurses is undoubtedly needed to grow the nursing workforce, yet without correcting the issues nurses face at the bedside and improving retention, it may not provide a long-term solution. Let us not forget that nursing turnover and retention is not a new problem. According to the ANA, a whopping 20% of new nurses have been leaving the profession in their first employment year for almost a decade prior to the COVID-19 pandemic. 5

Why are hospitals not listening to the voices of nurses? Why does it seem that the scales are tipped more toward profit than patient care? The answer may lie in the market dynamics driving the US health care system. In health care, like in any market-led industry, expenditure must be justified by corresponding revenue in reimbursements. In plain terms, for hospitals to rationalize financial investment in nursing, each additional dollar allocated to nursing must be offset by a commensurate increase in revenue. Conversely, every dollar saved on nursing staff appears, from a fiscal standpoint, as a dollar gained.

Underpinning this economic equation is the existing value-based hospital reimbursement model, where a maximum of 6% percent of a hospital’s revenue is linked to the quality of care through various hospital pay-for-performance programs, with the remaining 94% is largely determined by patient admission numbers. 6 Consequently, unless nursing shortages reach a critical point where they lead to bed closures and impede revenue from the volume of hospital admissions, the monetary returns to expenditures on the quality aspect of nursing care remain marginal at best.

Importantly, the crux of the problem is not necessarily that hospitals lack financial resources to invest in nursing, it is just that doing so is not always in their best immediate financial interest. One might expect that industry regulations or nurse-to-patient ratios could mandate improved nurse staffing levels and work environments. However, such regulations alone may not achieve their intended goal if they are not backed by an organization’s internal financial business case. For instance, California’s experience with mandated nurse staffing ratios showed mixed results. While the state accomplished higher staffing levels of registered nurses after the mandate compared with before, the expected sustained improvements in patient outcomes were not as substantial as hoped. Critics have suggested that hospitals find ways to cut nursing costs irrespective of the mandates, such as by reducing the hiring of unlicensed support staff. 7

Essentially, our health care economy is suffering from a market failure; the benefit of high-quality nursing care accrues largely to consumers (and payors), but the cost falls largely on the organizations that employ nurses. The current hospital payment model drives a wedge between what hospitals ought to spend on nursing for the benefit of the society and what they are drawn to do for their own financial benefit. 8 A market-based solution requires an alternative payment model for nursing care, one that directly aligns organizational reimbursement with the well-being of its clinical workforce.

Linking hospital reimbursement with the well-being of its clinicians is not a new idea. The introduction of the Quadruple Aim 9 of health care reform adds clinician well-being to the original Triple Aim—delivery of high-quality, cost-effective, and equitable care. The addition of a fourth aim was motivated by the notion that achieving the Triple Aim is hindered without a strong, supported, and accessible clinical workforce. Given the pressing concern of nurse burnout and an increasingly unstable nursing workforce, policymakers are now in a position where they must consider alternative payment methods for nursing that advance all 4 goals of the Quadruple Aim.

The research conducted by Muir and colleagues 3 , 4 highlights the critical elements that can inform the development of these alternative nursing payment models. For example, measures of nurse staffing, work environment, and job satisfaction could be integrated into the current, value-based purchasing (VBP) systems, as a new workforce outcomes domain. 8 Current VBP models incentivize health care organizations to align with the Triple Aim by including measures of health outcomes, cost, and patient experience. If a domain focused on workforce metrics was added, this could steer these financial incentives to also support the development and maintenance of a healthy and effective health care workforce, effectively helping to achieve the Quadruple Aim.

Nurses are calling for change, and it is imperative that nurses’ voices reverberate outside of health care delivery systems that employ them. Health systems are only a part of the larger problem that nests within our health care economy and behaviors that are incentivized therein. Creating sustainable solutions will take the broad engagement of payors, health care policymakers, and the public to secure the well-being of the nursing workforce and, consequently, the patients they care for.

Published: April 9, 2024. doi:10.1001/jamanetworkopen.2024.4104

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Yakusheva O et al. JAMA Network Open .

Corresponding Author: Olga Yakusheva, PhD, School of Nursing, School of Public Health, University of Michigan, 400 N Ingalls Building, Ann Arbor, MI 48109-5482 ( [email protected] ).

Conflict of Interest Disclosures: Dr Yakusheva reported receiving grants from the American Nurses Foundation and personal fees from the American Nurses Association outside the submitted work. No other disclosures were reported.

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Yakusheva O , Boston-Leary K. Will Hospitals Finally Listen to Nurses? JAMA Netw Open. 2024;7(4):e244104. doi:10.1001/jamanetworkopen.2024.4104

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Johns Hopkins graduate programs again ranked among nation's best

'u.s. news & world report' includes 38 jhu programs among the top 10 in the u.s. in its annual rankings, including no. 1 ranked programs in nursing and public health.

By Hub staff report

Johns Hopkins University has 38 graduate schools, academic programs, and specialties ranked among the top 10 in the nation, including nine with No. 1 rankings, according to the latest edition of "Best Graduate Schools" from U.S. News & World Report , published earlier today.

Two schools at Hopkins—the Bloomberg School of Public Health and the School of Nursing —earned No. 1 rankings overall, and the School of Education entered the top 10, according to U.S. News & World Report .

Portions of the publication's annual list were released today but rankings for schools of medicine and engineering were delayed and will be released at a later date.

Among the new rankings released today:

The School of Nursing's DNP program ranked No. 1 for the third year in a row. Its master's degree programs tied at No. 1, up from No. 2 last year. In gerontology, the school moved up two spots to No. 1 for primary care, and up one spot to No. 2 for acute care. In other specialty areas, the School of Nursing's doctoral programs ranked:

• Psychiatric/mental health: No. 1
• Family: No. 3 (tied)
• Leadership: No. 4 (tied)
• Nursing Anesthesia: No. 36 (tie)

Public Health

The Bloomberg School retained its longtime No. 1 overall ranking among public health programs—it has held the top spot since 1994, the year the rankings began. In specialty areas, the Bloomberg School ranked:

• Environmental Health Sciences: No. 1
• Epidemiology: No. 1
• Health Policy and Management (Public Health): No. 1
• Social and Behavioral Sciences: No. 1
• Biostatistics: No. 2

Johns Hopkins tied at No. 8 in the Education category, up from No. 13 last year. The school also tied at No. 23 in higher education administration programs.

Public Affairs

Overall, Johns Hopkins programs in public affairs tied at No. 39. In subcategories, Johns Hopkins tied at No. 6 in Health Policy and Management (Public Affairs), No. 11 in International/Global Policy and Administration, and tied at No. 35 in Public Policy Analysis.

U.S. News & World Report updates some of its rankings each year and republishes the most recent rankings in other areas. Among the republished rankings for Hopkins, which are still current:

Biological Sciences

Hopkins is tied for No. 6 overall with six top 10 specialty rankings:

• Molecular biology: No. 3 (tie)
• Cell biology: No. 4
• Neuroscience: No. 4 (tie)
• Immunology: No. 5
• Genetics, genomics, and bioinformatics: No. 6 (tie)
• Biochemistry, biophysics, and structural biology: No. 8

Biostatistics

Hopkins is ranked No. 1 (tie) for Biostatistics at the doctoral level. (Note: U.S. News & World Report also ranks biostatistics as a sub-category of public health, where Hopkins is No. 2.)

The university is tied at No. 20 in Chemistry and ranks No. 9 in the Biochemistry subcategory.

Computer Science

The university is tied for No. 24 overall and tied at No. 21 in the specialty of Artificial Intelligence.

Earth Sciences

The university is tied at No. 30 in Earth Sciences.

Johns Hopkins' program in economics is tied at No. 22.

English tied at No. 13 overall with the following specialty rankings:

• Literary criticism and theory: No. 3
• British literature: No. 10 (tie)
• American literature after 1865: No. 17

Health Care Management

The university is No. 7.

Johns Hopkins ranks No. 10 overall, with the following specialty rankings:

• African-American history: No. 3 (tie)
• Cultural history: No. 4 (tie)
• U.S. Colonial history: No. 5 (tie)
• Women's history: No. 6 (tie)
• African history: No. 7 (tie)
• European history: No. 7 (tie)
• Modern U.S. history: No. 16 (tie)

Mathematics

Johns Hopkins is tied at No. 20 in Mathematics with the following specialty rankings: + Analysis: No. 18 (tie) + Algebra: No. 23 (tie) + Applied Math: No. 25

Overall, the university is tied at No. 13 with the following specialty rankings: + Living Systems: No. 5 (tie) + Cosmology: No. 7 + Condensed Matter: No. 13 (tie)

Political science

Overall, political science is tied at No. 41. In sub-categories, Johns Hopkins ranked: + Political theory: No. 8 (tie) + International politics: No. 24 (tie)

The university's graduate program in psychology is tied at No. 12 overall and tied at No. 5 in the subcategory of behavioral neuroscience.

Overall, sociology is tied at No. 29. The sub-category of sociology of population is tied at No. 17.

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Uri college of nursing graduate programs ranked among nation’s best.

Doctor of Nursing Practice ranks 66 nationally; Master’s program remains in top 50

KINGSTON, R.I. — April 9, 2024 — The University of Rhode Island College of Nursing graduate programs are again ranked among the top of nursing colleges in the country, making an impressive year-over-year rise, according to the latest U.S. News & World Report rankings.

The College’s Doctor of Nursing Practice program is tied at number 66 of 354 nursing schools across the country with a DNP program, up from number 86 last year, according to the rankings released April 9. The College’s master’s program also continued its impressive performance in recent years. For the third year in a row, the program ranks among the top 50 in the nation, slotting in at number 48 among 603 nursing schools surveyed.

“We are committed to providing an excellent education to all our students, including our graduate students who benefit from our top-notch facilities and some of the best educators in their field,” said Dean Danny Willis . “Education is transformative, and students are not just a number to us. We get to know them and facilitate their professional and personal success. It is very rewarding to see the College’s efforts recognized on a national level.”

U.S. News & World Report , among the leading authorities in college and university rankings, surveyed 648 nursing schools with master’s or doctoral programs accredited by either the Accreditation Commission for Education in Nursing or the Commission on Collegiate Nursing Education. The publication determined each school’s overall rank using 15 distinct ranking factors, including faculty credentials, student-to-faculty ratio, faculty research prowess and nursing practice experience, assessment scores from peer institutions, and more.

The URI College of Nursing met and exceeded the standards as it continues to increase its offerings at the undergraduate and graduate level. About one-third of the URI College of Nursing’s faculty members are recognized Fellows in national nursing organizations, including the American Academy of Nursing, for their distinguished academic achievements. Dozens of URI students were inducted in the Sigma Theta Tau honor society for nursing last year, and a handful were inducted into the Honor Society of Phi Kappa Phi. The number of faculty publications, funded external grants and committed gifts to the College have all increased over the last five years as the College continues to have major impacts on health and health care.

The advancements the College has made are obvious not only in the graduate programs, but in its undergraduate offerings as well. The College’s B.S. in Nursing program tied at number 67 out of 656 programs in the country for the second year in a row, in rankings released Sept. 17. The College has made an impressive rise in the rankings, climbing from number 96 just two years ago, the first year the publication ranked undergraduate programs, to 67 last year. Visit the URI College of Nursing Academics website for more information on all educational offerings.

By Melanie Kieve  April 9, 2024

Master’s degree programs at the Emory University Nell Hodgson Woodruff School of Nursing are once again the best in the nation, according to U.S. News and World Report’s 2024-2025 ranking of graduate schools.

The school’s Master of Science in Nursing (MSN) and Master of Nursing (MN) programs claimed the No. 1 spot for the second consecutive year, and its Doctor of Nursing Practice (DNP) program retained its No. 6 standing from 2023. Last September,   U.S. News   ranked the school’s undergraduate programs No. 3 nationwide.

“It takes a team to achieve this level of excellence in consecutive years, and I’m grateful to our school community for the work that has brought us to this place,” says Dean Linda McCauley, PhD, RN, FAAN, FRCN. “While the rankings are gratifying, what they represent in terms of student preparation, research excellence, and clinical expertise is the most rewarding. We intend to keep raising the bar for our students, the nursing profession, and the patients and communities who benefit from our efforts.”

Multiple graduate specialties at the School of Nursing were also ranked nationally, including: 

• DNP Gerontology-Primary Care – No. 3
• MSN Adult Primary Care Nurse Practitioner – No. 3
• DNP Gerontology-Acute Care – No. 4
• MSN Acute Care Nurse Practitioner – No. 4
• MSN Family Nurse Practitioner – No. 4
• DNP Family Nurse Practitioner – No. 5

All specialties rose or maintained their ranking from last year, with the DNP gerontology-primary care program rising to No. 3 from No. 6.

The school’s rankings reflect tremendous growth, with enrollment increasing by 38% and total research funding growing from $12.8 million to $32.3 million over the past five years. The school has been in the top five among all nursing schools in National Institutes of Health grant funding for nine consecutive years and has amassed more than $8.6 million in Health Resources and Services Administration community partnership grants.

U.S. News assesses both nursing master’s programs and Doctor of Nursing Practice programs on their research activity, faculty resources, student excellence, and qualitative ratings from experts. Information on their ranking methodology can be found  here . 

About the Emory University Nell Hodgson Woodruff School of Nursing  

As one of the nation's top nursing schools, the Emory University Nell Hodgson Woodruff School of Nursing is committed to educating visionary nurse leaders and scholars. Home to the No. 1 master's, No. 3 BSN and No. 6 DNP programs nationwide, the school has been recognized as a Center of Excellence in Nursing Education by the National League of Nursing. The school offers undergraduate, master’s, doctoral and non-degree programs, bringing together cutting-edge resources, distinguished faculty, top clinical experiences and access to leading health care partners to shape the future of nursing and impact health and well-being.  Learn more here.

• School of Nursing
• Woodruff Health Sciences Center
• Health Sciences Research

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COVID-19: Initial Perioperative and Perianesthesia Nursing Response in a Military Medical Center

Christopher h. stucky.

a Center for Nursing Science and Clinical Inquiry, Womack Army Medical Center, Fort Bragg, NC

Marla J. De Jong

b Division of Acute and Chronic Care, University of Utah College of Nursing, Salt Lake City, UT

Adam W. Lowe

c Perioperative Nursing Services, Womack Army Medical Center, Fort Bragg, NC

Bruce Mathews

Nurses have historically led efforts to improve the health of populations while simultaneously and unselfishly providing care during pivotal moments of national need. The COVID-19 pandemic has placed an unprecedented strain on the US health care system, including severe shortages of hospital beds, supplies, equipment, pharmaceuticals, and healthy frontline clinicians. Perioperative and perianesthesia leaders and clinicians have unique opportunities to provide patient care during the COVID-19 crisis. In this manuscript, we describe the initial changing roles and contributions of perioperative and perianesthesia registered nurses during the COVID-19 pandemic and share recent experiences from a military medical center. Perioperative and perianesthesia nurses are vital to the overall nursing viability of the health care system, as they possess the requisite knowledge and skills to provide expert clinical care in many hospital settings and meet the demands of a global pandemic.

Throughout history, nurses have answered the call to lead and serve in times of great public need. With a lineage reaching back to the American Revolutionary War, nurses have courageously provided patient care during wartime, terrorist attacks, natural disasters, and global pandemics. 1 Nurses are essential in times of crisis because of their education and experience in triage, assessment, emergency care, ground and air patient evacuation, physical and psychosocial support and recovery, disaster management, disease prevention, and nursing surveillance. Thus, nursing care during epidemic and pandemic crises is one of the best predictors of patient outcome. 2

Military nursing has a storied and revered past, with military nurses providing life-saving care in response to virtually every United States (US) military conflict. During Operations Enduring Freedom and Iraqi Freedom, military nurses were a vital part of a joint military effort in which case-fatality rates were the lowest in US warfare history. 3 Additionally, military nurses have provided care during pandemic crises, including the 1918 influenza pandemic, during which more than 200 Army nurses died. 4

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. Common symptoms, which include cough, shortness of breath, fever, fatigue, body aches, loss of appetite, and sore throat, appear 2 to 14 days after exposure and range from mild to severe (see coronavirus.gov for updated information). 5

In November 2019, the first cases of COVID-19 were detected in Wuhan, China. By March 11, 2020, it had spread to 114 countries, prompting the World Health Organization to declare it a pandemic. By mid-April, at least 210 countries/regions had patients with COVID-19, and more than 610,000 people in the US, including 2,986 US military members, were infected. 6

Most patients with COVID-19 do not require hospitalization. Nonetheless, the COVID-19 pandemic has placed an unprecedented strain on the US, military, and VA health care systems, 7 including severe shortages of hospital beds, 8 supplies such as personal protective equipment (PPE) 9 and diagnostic testing kits, 10 equipment like ventilators, 11 pharmaceuticals such as chloroquine and remdesivir, sedatives and anesthetics such as propofol, ketamine, midazolam, 12 and healthy frontline clinicians. 13

Many hospitals are experiencing COVID-19–induced financial distress or crisis. 14 Widespread PPE use, frequent diagnostic imaging, stringent cleaning protocols, low nurse-to-patient staffing ratios, and overtime pay have increased costs. Conversely, revenue has declined due to a low census of non-COVID-19 patients, canceled elective surgeries and outpatient preventive health screening tests, and care for patients without medical insurance.

The rapid surge of inpatients with COVID-19 has overwhelmed some health care systems. Given the actual or potential demand for expanded intensive care unit (ICU) capacity, health care leaders have rapidly bolstered COVID-19 capabilities by converting regular hospital wards, postanesthesia care units (PACUs), and operating rooms (ORs) into contingency ICU beds. 15 Some created screening and treatment areas in tents, hospital cafeterias, and parking garages. Active duty, Reserve, and National Guard military members and two Navy hospital ships deployed to augment clinicians in cities such as Seattle and New York City.

Health care clinicians are on the front line battling COVID-19. The purpose of this manuscript is to describe the changing roles and contributions of perioperative and perianesthesia registered nurses during the COVID-19 pandemic and share recent experiences from a military medical center.

Changing Roles for Perioperative and Perianesthesia Nurses

Nationally, the US government relaxed regulations to, among other things, increase the workforce during the COVID-19 pandemic. 16 Registered nurses, advanced practice registered nurses such as certified perioperative clinical nurse specialists and certified registered nurse anesthetists, and other clinicians may practice to the fullest extent possible, in accordance with emergency preparedness plans.

Perioperative and perianesthesia leaders and clinicians have unique opportunities to provide patient care during the COVID-19 crisis. They know the nursing process and possess the clinical, critical thinking, and clinical judgment skills needed to provide competent patient-centered care in varied settings. Many have prior critical care or medical-surgical nursing experience. Nonetheless, some, especially those resuming employment after a leave of absence, may choose to supplement their previous education and experience and thus be better prepared to work outside perioperative settings. During the past 2 months, professional nursing organizations (eg, American Society of Perianesthesia Nurses, Association of perioperative Registered Nurses, and American Association of Critical-Care Nurses, Emergency Nurses Association, American Nurses Association), the Defense Health Agency, the US Army Medical Command, universities and colleges, and health care agencies began offering an abundance of online refresher courses, webinars, just-in-time training, and reference materials, most of which are self-paced, and either free or modestly priced.

Due to canceled elective surgeries and high demand for critical care services, perioperative and perianesthesia nurses are mobilizing from the PACU and OR to screen patients in triage tents outside the hospital, open temporary medical-surgical units in cafeterias or convention centers, and work in emergency departments and ICUs. Perianesthesia nurses who provide PACU Phase I care, for example, are particularly qualified to care for mechanically ventilated patients, administer vasoactive medications, and perform hemodynamic monitoring in a critical care environment. 17

Novel ICU staffing models may be required to ensure that all patients receive required care. The Society of Critical Care Medicine recommends a tiered staffing strategy where non-ICU nurses work in pairs or teams with experienced clinicians. 18 Perioperative and perianesthesia nurses can provide general patient care such as administering medications, monitoring laboratory results, delivering enteral nutrition, and providing psychosocial care, freeing skilled ICU clinicians to manage multiple patients who require advanced mechanical ventilation or extracorporeal membrane oxygenation. 19

According to the American College of Physicians, health care clinicians must treat patients and families with dignity and respect, and patients and families should actively partner in all aspects of their care. 20 There is increasing evidence demonstrating that patient and family engaged care is associated with improved health outcomes. 21 To hamper the spread of COVID-19, most hospitals either limited visitation to 1-2 family members or instituted a no visitation policy. Although limiting COVID-19 transmission, the policies distress both patients and family members and make it difficult for busy providers to communicate regularly and effectively with family members.

Recognizing the important need for clinicians to communicate with patients and families during the COVID-19 pandemic, the Department of Health and Human Services temporarily relaxed rules for sharing patient information with family members and for using nonpublic facing remote communications technologies. 22 Consequently, perianesthesia and perioperative nurses may now use popular applications such as Zoom, Skype, Google Hangouts, and FaceTime to communicate with family members of patients who require emergency or emergent surgery or are admitted for other reasons. 23

Experiences From a Military Medical Center

The 167-bed military medical center is located in the southeastern US and has an OR with 11 surgical suites, which performs more than 11,000 annual surgeries with 12 surgical specialties. As is standard for Department of Defense (DOD) facilities, the medical center has a Hospital Incident Command System which allows leaders to implement its Contingency and Crisis Standards of Care, expand or restrict critical resources, deliver just-in-time training, facilitate patient flow and movement of critical equipment, and liaise with the community regarding health care utilization. 24

Aligning with national recommendations, 25 the DOD directed military treatment facilities to postpone all nonessential surgeries and procedures, thereby enhancing the safety of medical personnel, prolonging supplies of PPE, and ensuring the availability of military medical personnel to provide care where needed. 26 Surgeons continued to perform emergency surgical procedures and operations necessary to sustain deployment readiness. Thus, some perioperative and perianesthesia nurses continued their usual work.

Medical center leadership directed changes to the physical layout of the OR and the PACU. A section of OR suites, with sterile core access, was converted to negative pressure. Temporary wall barriers were erected in the PACU to facilitate surgical cohorting by COVID-19 status.

Perioperative and perianesthesia nurse administrators focused on the flow of COVID-19 and non-COVID-19 patients through the perioperative environment and revised other patient care policies. For example, only two people are present in the room during airway manipulation, and other clinicians must wait outside the room for approximately seven room air exchange cycles (21 minutes) before re-entering the room. 27

Senior hospital executives consulted with perioperative and perianesthesia nurses to develop a Concept of Operations Plan that included a surge plan and interdisciplinary staffing model. Perioperative and perianesthesia nurse leaders converted OR suites to adjunct critical care rooms and developed a tiered staffing strategy, forming and scheduling teams of perioperative nurses, certified registered nurse anesthetists, and ICU nurses. Perioperative nurses can independently provide all care to lower acuity patients. Beyond the OR, a perioperative nurse led efforts to reopen previously used clinical space into a COVID-19 medical-surgical unit, expanding inpatient capacity.

To prepare for patients with COVID-19 and atypical health care operations, all perioperative and perianesthesia nurses attended “just-in-time training.” Given that military nurses must maintain competency in medical-surgical and emergency-trauma nursing, completing just-in-time training is natural for them. Experienced nurses assigned to the medical center's education department, including master's prepared clinical educators and clinical nurse specialists, reviewed the DOD COVID-19 Practice Management Guide (originally published on March 23, 2020), 24 published COVID-19 evidence, guidance from agencies such as the Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services and military guidance, developed the training curriculum and prepared lesson plans, and delivered training. Training re-familiarized perioperative and perianesthesia nurses about nursing care, such as medication administration, point-of-care testing, catheter care, antimicrobial stewardship, specimen collection, administration of oxygen, and documentation. Training also informed them about COVID-19-specific considerations such as basic room setup, enhanced droplet precautions, high-flow nasal cannula therapy, mechanical ventilation, neuromuscular blockade, and prone positioning. Educators used a variety of training delivery modalities, including instructor-led training, hands-on learning, and video-assisted learning. Instructors assessed learning efficacy through visual confirmation, return demonstration, teach-back, and written tests. The training feedback was predominately favorable, and nurses reported feeling comfortable providing care using a tiered staffing strategy.

As military members and federal service employees, perioperative, and perianesthesia nurses eagerly supported the COVID-19 response mission, and supervisors did not reduce their hours. Leadership selected clinicians for cross-training to other sections based on their level of experience, identified health risk factors, and desire to contribute. At military screening and testing sites, they used a questionnaire to screen and assess patients, measure body temperature, collect clinical specimens from persons who exhibited COVID-19 symptoms, and educate patients about COVID-19 self-care, and actions to take if symptoms worsened. Perianesthesia nurses cross-trained and provided care to both COVID-19 positive and negative patients in the inpatient medical-surgical, intensive care, stepdown, and medical telemetry units. Their skills complemented those of unit nurses and achieved optimal nurse staffing. In addition, perioperative and perianesthesia nurses helped sustain the 24-hour COVID-19 Nurse Advice Line and manage outpatients who were awaiting test results 28 by assessing patient symptoms, reinforcing quarantine and care instructions, informing persons under investigation of test results, determining return to work status, and referring patients for follow-up medical care.

Perioperative and anesthesia leadership were also involved in the decision to purchase two ultraviolet germicidal irradiation (UVGI) machines. The UVGI machines were primarily used to disinfect and terminally clean rooms that COVID-19 positive patients or patients under investigation for COVID-19 occupied and decontaminate N95 particulate filtering facepiece respirators so they could be reused. 29 , 30 , 31 In accordance with best practice guidelines 30 , 31 and scientific evidence, 29 perioperative nurses developed processes and policy regarding UVGI decontamination, trained staff, and implemented UVGI across the medical center. Additionally, perioperative nurses oversaw a program to plan and optimize PPE use for the medical center and the greater military community. Although not standard practice, during a crisis condition like the COVID-19 pandemic, decontamination and reuse of N95 masks prevented the medical center from exhausting its supply of this vital resource and enabled it to maintain its required level of wartime readiness materials.

Lessons Learned

The most powerful lesson learned is that perioperative and perianesthesia nurses have the requisite knowledge and skills to provide expert clinical care in many hospital settings and meet the demands of a global pandemic. Perioperative and perianesthesia nurses were affable to duty assignment changes, which sometimes required additional training, enabling them to work in different or higher levels of care. Nursing is a calling, 32 and it was refreshing to see perioperative and perianesthesia nurses rise to new challenges, adapt to changes outside of their norm, and meet the needs of the greater good. Although specialty trained to provide care to surgical patients, organizations should view perioperative and perianesthesia nurses as potent enablers to the overall nursing viability of the health system. Furthermore, we learned that for operational success, the hospital and nursing response must be flexible to policy changes, scientific advances, and increased demand. Hospital leadership instituted rapid changes across the medical center, based on the latest evidence, which potentially saved lives and reduced transmission of COVID-19. Finally, clear lines of communication between leadership and staff are essential to promote shared understanding, 33 increase engagement, and reduce clinician stress. Nursing leadership was very involved in the COVID-19 response, and steady communication with clinical staff helped influence a positive culture that embraced change and potentially improved care.

Nurses have historically led efforts to improve the health of populations while simultaneously and unselfishly providing care during pivotal moments of national need. In this manuscript, we described the changing roles and contributions of perioperative and perianesthesia registered nurses during the COVID-19 pandemic and shared recent experiences from a military medical center. Perioperative and perianesthesia nurses contributed to the overall response through planning and influencing policy, expanding critical services/bed capacity, training staff, introducing novel methods to reduce PPE burn rates, cross-training to other clinical areas, leveraging communication technology to communicate with family members, and continuing to provide expert surgical patient care. Although the national pandemic has changed routine health care operations, perioperative and perianesthesia nurses are vital to the overall nursing viability of the health system, as they possess the requisite knowledge and skills to provide expert clinical care in many hospital settings and meet the demands of a global pandemic.

The COVID-19 pandemic is a rapidly evolving situation requiring hospitals and health care agencies as well as clinicians to adjust strategies based on scientific developments, patient demand, health care capacity, and available resources. For the latest clinical information, we recommend the comprehensive COVID-19 tool kits that the American Society of Perianesthesia Nurses, 34 and the Association of Perioperative Registered Nurses 35 developed to support perioperative and perianesthesia nurses.

Conflict of interest: This manuscript did not receive funding. The authors have no conflicts of interest to declare.

Disclaimer: The views expressed are solely those of the authors and do not reflect the official policy or position of the US Army, US Air Force, the Department of Defense, or the US Government.

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Nursing Rises in 'US News’ Best Grad Schools Rankings

April 9, 2024    |   By Mary T. Phelan

Continuing its mission of shaping the nursing profession and the health care environment by developing leaders in education, research, and practice, the University of Maryland School of Nursing (UMSON) has once again ranked in the top 10 across the board for public schools of nursing – and moved up in all six categories in which the school is ranked – in the newly released 2024 edition of U.S. News & World Report ’s “ America’s Best Graduate Schools ,” out of 651 accredited nursing school surveyed.

Both UMSON’s Doctor of Nursing Practice (DNP) and its Master of Science in Nursing (MSN) programs climbed in the rankings among all schools surveyed, DNP tied at No. 8 (up from No. 15 last year) and MSN at No. 20 overall (up from 25 last year) . Among public schools of nursing, the DNP program is tied at No. 4 and the MSN is ranked No. 9.

Two UMSON specialties lead the way in the rankings, both ranked No. 1 (tied) nationwide among public schools of nursing:

• The DNP Adult-Gerontology Primary Care Nurse Practitioner specialty, tied at No. 4  among all ranked schools
• The MSN Health Services Leadership and Management specialty, No. 2 among all ranked schools.

UMSON is also ranked in the top 10 among public schools of nursing for its:

• Family Nurse Practitioner Doctor of Nursing Practice specialty (No. 3)
• DNP Nurse Anesthesia specialty (No. 7, tied)

“It is gratifying to continue to be recognized nationally for our Doctor of Nursing Practice program and our Master of Science in Nursing program,” said Yolanda Ogbolu, PhD, NNP, FNAP, FAAN, the Bill and Joanne Conway Dean of the University of Maryland School of Nursing. “The School of Nursing plays a vital role in our collective efforts in Maryland and nationally to increase the number of nurses with advanced education, particularly at the doctoral level. It is essential that we have nurses who are well prepared to meet the changing needs of patients, their families, and our communities at a time when we face increasing complexity in our health care system, growing diversity in our population, and persistent gaps in access to needed care.”

The U.S. News & World Report rankings are based on a variety of indicators, including student selectivity and program size, faculty resources, and research activity, and on survey data from deans of schools of nursing that are accredited by the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. In fall 2023 and early 2024, U.S. News surveyed 651 nursing schools with master’s or doctoral programs. In total, 292 nursing programs responded to the survey. Of those, 216 provided enough data to be included in the rankings of nursing master’s programs and 188 provided enough data to be eligible for inclusion in the ranking of DNP programs. Many institutions were ranked in both, using overlapping data.

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UR Nursing Lands at No. 21 in National Ranking of Master’s Programs

  By Nora Williamson   Monday, April 8, 2024

The University of Rochester School of Nursing has been ranked No. 21 among U.S. nursing schools for its master’s programs, according to the 2024-25 Best Graduate Schools guide produced by U.S. News and World Report. Designed for prospective students looking to advance their nursing education, the Best Graduate Schools rankings evaluate programs based on academic quality and research success.  

“We are incredibly proud of the recent rankings that highlight the excellence of our master’s programs,” said Dean Lisa Kitko, PhD, RN, FAHA, FAAN . “While we are pleased with these results, they are just one measure of our ongoing progress and dedication to shaping the future of nursing. We continue to focus our efforts on equipping our students with the skills, knowledge, and resources they need to thrive in their careers while providing flexible ways to study as practicing nurses.”  

The No. 1 program in Upstate New York for five years, the UR School of Nursing is one of only two institutions in the state — and the only one outside of New York City — ranked in the top 30 for its master’s programs. It features one of the oldest and most prominent nurse practitioner programs in the country and currently enrolls nearly 300 students across six NP specialties and degree concentrations in nursing education and leadership . 

The recent rankings feature an increased emphasis on program size, research activity, student excellence, and faculty resources while reducing emphasis on reputation from previous year’s rankings.   "Our faculty's expertise and the high quality clinical and experiential learning that our programs offer have been instrumental in the success of our master's nursing programs,” said Lydia Rotondo, DNP, RN, CNS, FNAP, associate dean for education and student affairs. “Our faculty’s commitment to educational excellence combined with strong academic-practice partnerships enriches our learning environment. Working closely with our students and an extensive network of clinical partners, we are redefining nursing education to prepare our master’s graduates for the challenges of tomorrow's health care." 

Other metrics considered in the rankings include student to faculty ratio and percentages of faculty with important academic achievements in the nursing profession and who are active in nursing practice. About 86 percent of faculty at the UR School of Nursing actively practice in various clinical settings.

In addition to smaller class sizes and guaranteed clinical placements – in the UR Medicine system and other health care facilities across New York – master’s students can access one-on-one faculty support on career planning, writing, or test-taking through the school’s Center for Academic & Professional Success. UR Nursing master’s students hold an average 3.74 GPA from their undergraduate program and, in 2022, more than 90 percent of students successfully passed their national certification exam on the first try.    Prospective students can review master's programs offered by the UR School of Nursing, and read how the school compares to other institutions and how the rankings are calculated on USNews.com .  

Categories: Nursing Education , Nursing Leadership , Accelerated Programs , Nurse Practitioner Programs , Outcomes

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Ellen Tilden, PhD, is featured speaker for nursing lectureship

• Written by Jeff Robb, UNMC strategic communications
• Published Apr 8, 2024

Ellen Tilden, PhD, of Oregon Health and Science University

Ellen Tilden, PhD, a clinical scientist in the area of nurse midwifery, will be the guest speaker for the 11th annual Anna Marie Jensen Cramer Memorial Lectureship in Women’s and Children’s Health and Family Nursing. 

Dr. Tilden, from Oregon Health and Science University, serves as both an associate professor in the school of nursing and associate professor of obstetrics and gynecology in the school of medicine.

She will speak April 30 on the subject of “Preventing Perinatal Depression: Public Health Impact and Emerging Interdisciplinary Solutions.”

The Anna Marie Jensen Cramer Lectureship was established by Berniece Cramer to commemorate the life of her mother, who believed art and science formed the foundation of professional nursing. Berniece Cramer, a graduate of the Mary Lanning School of Nursing in Hastings, was awarded the 1989 U.S. Public Health Service Nurse of the Year for her lifelong contributions toward improving the health status of mothers and children. 

The lecture is presented by the UNMC College of Nursing.

The in-person lecture will be held at the University of Nebraska at Omaha Thompson Alumni Center, 6705 Dodge Street in Omaha. Satellite locations will be available at the UNMC College of Nursing locations in Lincoln, Norfolk, Kearney and Scottsbluff. More information on those locations and online access to the lecture is available on this flyer .

Continuing education credit is available.

RSVP by April 18 to LaDonna Tworek  by email .

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USC College of Nursing MSN programs best in the state

Today, U.S. News and World Report released their 2024 Best Graduate Schools list, ranking USC’s College of Nursing #22 for Best Overall Master’s program in the nation. The college jumped 10 spots from last year, breaking into the Top 25 and earning the top ranking for nursing programs in the Palmetto State.  

Background: USC’s College of Nursing’s online graduate program has been ranked #1 nationally for four years in a row. The college is also in the top 1 percent of the country for pass rates on the NCLEX, the national exam for licensing nurses. The expansion of faculty scholars over the last 10 years has generated new research and grant awards, earning them #1 in the state in NIH funding.

Why it matters: South Carolina has long experienced a shortage of registered nurses. By 2030, our state could face 10,000 vacancies in nursing positions. Graduate programs prepare nurses to assume roles in primary care, acute care, long-term care, specialty practices and public health settings. Flexible programs accommodate the busy schedules of registered nurses and creative partnerships meet the needs of professionals already working in the field.

What they’re saying: "I have tremendous gratitude for our faculty, students, and staff for continuously raising the bar and aiming high in our pursuit of excellence. This new ranking is a testament to our national reputation and quality programs here at USC College of Nursing," says Dean Jennette O. Andrews.

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April 4, 2024, karen keady named system chief nursing officer.

Following an extensive national search, Karen Keady, PhD, RN, NEA-BC, Vice President and Chief Nurse Executive with the University of Rochester Medical Center, has been named System Chief Nursing Officer for Vanderbilt University Medical Center

Following an extensive national search, Karen Keady, PhD, RN, NEA-BC, Vice President and Chief Nurse Executive with the University of Rochester Medical Center, has been named System Chief Nursing Officer for Vanderbilt University Medical Center (VUMC). Keady will join VUMC on July 1.  

Keady succeeds VUMC’s Executive Chief Nursing Officer, Marilyn Dubree, MSN, RN, who is retiring from her responsibilities as Executive Chief Nursing Officer but will remain with VUMC in a part-time role.

Keady will report to C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer, and will be responsible for overseeing all nursing operations for the Vanderbilt Health system.

 “I am delighted to welcome Dr. Keady to VUMC to serve in this critical role. Karen joins us with an outstanding reputation of advocacy for the nurses she served at the University of Rochester,” said Pinson. “The contributions of our incredible, caring nurses are beyond measure. It was vital to select the right individual to succeed Marilyn. I want to express my gratitude to the members of the search committee for their wisdom and outstanding work to identify Dr. Keady.”

Jenny Slayton, MSN, RN, Senior Vice President for Quality, Safety and Risk Prevention, led the search committee who identified Keady from a number of distinguished candidates.

“Karen is an energetic, passionate leader committed to nursing and the continued advancement of Vanderbilt Health.  She has exceptional experience in leading nursing in the academic and community setting.  She uses innovative approaches to nursing and partnering with physicians and care teams across the patient continuum and in the community,” said Slayton.

Other members of the search committee include Megan Cockrum, RN, Jon Howell, RN, LaSheryl Brown, BSN, RN, Marilyn Smith, DNP, MSN. RN, Deonna Taylor, PhD, MSN, Laura Beth Brown, MSN, RN, Ronald Alvarez, MD, MBA, Donald Brady, MD, Cecelia Theobald, MD, MPH, Pamela Jeffries, PhD, RN, and Margaret Rush, MD, MMHC.

Keady is joining VUMC after six years as the University of Rochester Medical Center’s (URMC) nursing leader. At URMC, Keady led initiatives to redesign nursing care delivery models and wellness and resiliency programs. She also implemented creative incentive plans, as well as new nursing education and professional development opportunities. URMC’s Strong Memorial Hospital was just awarded its fifth consecutive Magnet designation. 

“The search committee reviewed a variety of strong candidates for the position of System Chief Nursing Officer. Dr. Keady stood out as a leader with experience and knowledge that will help VUMC grow as it addresses the opportunities and challenges of today’s health care environment,” said Pamela R. Jeffries, PhD, RN, FAAN, ANEF, FSSH, Dean of Vanderbilt University School of Nursing, who served on the search committee. “Her experience in the academic medical setting, collaborative style and support for nurses make her a great partner for the School of Nursing. I look forward to working with her on a variety of initiatives.”

Keady spent the majority of her career at Johns Hopkins University where she steadily advanced through the health system from her first role as a clinical nurse in the Neuroscience Critical Care Unit.  After a series of successive promotions Keady was serving as Vice President of Nursing and Chief Nursing Officer for Johns Hopkins’ Howard County General Hospital before joining URMC.

Keady earned a Bachelor of Science in Nursing from Towson State College of Nursing and later earned a Master of Science in Nursing and a Doctor of Philosophy in Nursing from Johns Hopkins University School of Nursing.  

“I am thrilled to be joining the Vanderbilt team. The organizational commitment to innovation in health care and dedication to providing excellence in nursing care is truly inspiring.  The Vanderbilt mission and priorities align perfectly with my own values. The opportunity to be part of a team that is constantly pushing the boundaries of health care while upholding the highest standards is very exciting. I am looking forward to working in such a dynamic environment with great people,” said Keady.

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