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BACKGROUND - Continuing concerns over the diverse degree names and the quality and quantity of doctoral nursing programs make it essential that nursing leadership take consensus-driven action on the basis of today's educational realities.
PURPOSE - To explore the state of US doctoral nursing education to determine what leadership initiatives are needed in program definition, scope, and resources.
METHOD - The researchers used a mailed survey (63.4% response rate) and Web site review (all remaining progress) to gather data on all US doctoral nursing education programs (n = 87). The survey included 12 items pertaining to each degree program and 11 institutional environmental questions.
DISCUSSION - The doctor of philosophy was the most common degree title (n = 71). Degree title was not consistently associated with requirements (eg, dissertation and practica requirements) or stated degree purposes. Reports of program resources, as defined by faculty rank and research experience, indicated fiscal and educational threats to program integrity in many schools.
CONCLUSIONS - Although individual schools should continue efforts to increase educational quality, consensus and action by all doctoral programs is needed. Five recommendations for immediate action are proposed.
This analysis of workforce projections confirms that early employment withdrawal by registered nurse baby boomers could have a profound effect on US health care. The available policy mechanisms to encourage or discourage any early withdrawal require several years to implement, which makes timely decisions imperative.
BACKGROUND - Because AIDS is increasing in rural areas and small cities of the United States, we sought to further describe the epidemiology of HIV/AIDS in nonurban Alabama.
METHODS - Extensive interviews of HIV-infected residents of Alabama living outside of urban Birmingham were conducted at clinics throughout the state.
RESULTS - Of the 417 HIV-infected persons interviewed from January 1995 through January 1997, 310 (74%) were male, 229 (55%) were white, and 179 (43%) were black. Over time, increasing proportions of HIV infections have likely been acquired in nonurban areas. Of the 417 subjects, 43 (10%) had visited an STD clinic in the past year, and 31 (7%) had smoked crack-cocaine during the past month. Of the 166 persons who had been sexually active in the past month, 59 (36%) had used alcohol before sex and 56 (34%) used condoms inconsistently. Of the 417 subjects, 161 (39%) currently had no health insurance, and 68 (16%) had lost medical insurance since becoming HIV-infected.
CONCLUSION - HIV-infected persons in nonurban Alabama are likely to have practiced high-risk behavior, to have acquired HIV in nonurban settings, and to have inadequate health insurance.
A key part of resource allocation decisions is determining the impact of staffing on clinical outcomes. A national study involving eight hospitals and 77 units lends support for a previously identified labor assignment phenomena that may contribute to an underestimation of the impact of nursing labor on outcomes if only traditional labor measurement methods are used. The authors suggest actions for nurse administrators and researchers who must address frequent queries as to the adequacy of nursing staffing.