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Beyond The Specious Present: Workplace Bullying Victimization's Roots In Lived Experience, Laura Cox Dzurec
Beyond The Specious Present: Workplace Bullying Victimization's Roots In Lived Experience, Laura Cox Dzurec
International Nursing Research Congress (INRC)
Session presented on Friday, July 22, 2016:
Purpose: The purpose of this presentation is to begin to unravel features inherent in workplace bullying victimization so that targets--the intended objects of workplace bullies' assaults--can be differentiated from victims--those parties actually injured by workplace bullies' assaults. The face-to-face encounters that overtly characterize workplace bullying often are brief in duration and puerile (Dzurec, Kennison, & Albataineh, 2014). Some who are targeted by workplace bullies are able to walk away, literally or figuratively, from bullying encounters. For others, the influence of the typically childish and immature content of bullying assaults is devastating, resulting, paradoxically, …
Attitudes And Behaviors Of Caribbean Women And Men Toward Partner Violence And Sexual Relationships, Doris W. Campbell, Jacquelyn C. Campbell, Kamila A. Alexander, Gloria B. Callwood, Desiree Bertrand, Phyllis Sharps, Noelle M. St. Vil
Attitudes And Behaviors Of Caribbean Women And Men Toward Partner Violence And Sexual Relationships, Doris W. Campbell, Jacquelyn C. Campbell, Kamila A. Alexander, Gloria B. Callwood, Desiree Bertrand, Phyllis Sharps, Noelle M. St. Vil
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: The United States Virgin Islands (USVI) has the 2nd highest HIV/AIDS incidence rate in the United States and its territories (US Virgin Islands, 2010). Additionally, one-third of USVI women reports physical and/or sexual abuse in their lifetime and experiences of coercive, unprotected sex and other behaviors that increase risks for HIV/AIDS (Draughon JE1, 2015; Stockman JK, 2013; Stockman, 2014). There is scant research that aims to understand USVI women and men's perceptions of heterosexual relationship dynamics or implications for HIV/AIDS risks and intimate partner violence. The purpose of this study was to …
Towards Clinical Teaching And Learning Excellence Using A Formative Assessment Framework In The Skills Laboratory, Annie N. Msosa
Towards Clinical Teaching And Learning Excellence Using A Formative Assessment Framework In The Skills Laboratory, Annie N. Msosa
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016;
Background: Nursing education institutions in Malawi adopted the use of the skills laboratory through benchmarking from the developed countries. In view of this, the skills laboratories have been operational at the Kamuzu College of Nursing for a number of years. However, upon the evaluation of teaching and learning in the skills laboratories, the findings show that demonstrations and return demonstrations are the practical necessities of clinical teaching that enrich clinical teaching experiences. The OSCE method of evaluation is in use and both students and nurse educators expressed that it is a good method …
Visual Thinking Strategies: A Mixed Method Study In Bachelor Of Science Nursing Students, Desiree Hensel, Meg Moorman
Visual Thinking Strategies: A Mixed Method Study In Bachelor Of Science Nursing Students, Desiree Hensel, Meg Moorman
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
The development of broad cognitive skills is imperative as nurse educators prepare students for practice in a complex healthcare setting. Developing and honing these skills in creative ways can be challenging for nurse educators, especially as class sizes increase. These broad skills include interpersonal communication, critical thinking, problem solving, collaboration, tolerance of ambiguity, and information literacy, which are often referred to as transferable skills. Visual Thinking Strategies (VTS) is a teaching method that uses art to foster discussions and help students use visual evidence to support their findings. VTS has been studied in …
Symptoms And Health-Related Quality Of Life In Idiopathic And Associated Pulmonary Arterial Hypertension, Lea Ann Matura, Annette Mcdonough, Diane L. Carroll
Symptoms And Health-Related Quality Of Life In Idiopathic And Associated Pulmonary Arterial Hypertension, Lea Ann Matura, Annette Mcdonough, Diane L. Carroll
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Introduction: Pulmonary arterial hypertension (PAH) is a chronic illness affecting primarily young and middle age women. Elevated pulmonary pressures lead to right heart failure and premature death. Patients with PAH report multiple symptoms (e.g. dyspnea, fatigue) that can be severe and impair health-related quality of life (HRQOL). PAH etiology is varied with approximately half being idiopathic PAH. Associated PAH includes those with PAH caused by other disorders such as: connective tissue disease, congenital heart disease, portopulmonary hypertension and anorexigens.
Purpose: The purpose of this study was to determine if there were differences between …
Minding The Gap: Improving Mental Health Access In African-American Communities, Catherine Alicia Georges, Kermit Payne
Minding The Gap: Improving Mental Health Access In African-American Communities, Catherine Alicia Georges, Kermit Payne
International Nursing Research Congress (INRC)
Session presented on Saturday, July 23, 2016:
Purpose: This national initiative was developed to bring African American communities together with clinicians, policy makers, as well as faith and community leaders to discuss mental health disparities and mental health issues. This campaign focused on the development of a community level 'safety net' to enhance mental health and related services. This campaign discussed the role of health policy in improving equity in mental health while providing resources information for mental health services. The goals of the initiative : Develop a national network for mental health awareness, through community interaction; Encourage political activism …
Content-Analysis Of Social Networks And Mobile Phone Text Messages Among Hiv Patients In Tanzania, Soson Jong, Lisa M. Thompson
Content-Analysis Of Social Networks And Mobile Phone Text Messages Among Hiv Patients In Tanzania, Soson Jong, Lisa M. Thompson
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Purpose: The study aimed to explore and understand HIV patients' social networks and support in relation to their use of mobile text messages (SMS). This study also presents HIV patients' perspectives on use of SMS for HIV care and management. Mobile technology has become a promising communication and educational platform for both health care providers and patients. Mobile phone messages have been used to provide reminders to patients about medication adherence, medical appointments, and to encourage physical activities. The mobile technology appears to have more potential to improve health service delivery where health …
Conceptualising Adolescent Hiv Self-Management In A South African Context, Talitha Crowley, Anita Van Der Merwe, Donald Skinner
Conceptualising Adolescent Hiv Self-Management In A South African Context, Talitha Crowley, Anita Van Der Merwe, Donald Skinner
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Background: Many adolescents are living with HIV globally and in South Africa (UNICEF 2013; De Wet et al. 2014). Challenges in clinical management of adolescents include managing HIV related problems and motivating them to adhere to a lifelong treatment regime, which are compounded by the physical and psychological changes which occur during adolescence (Mofenson & Cotton 2013). Little is known about the healthcare needs of adolescents living with HIV in low resource, high HIV burden settings. These settings have contextual specific issues such as poverty, family and community violence, altered family structures and …
International Collaboration And Partnership: A Pilot Program Developing Roles Of Advanced Practice Nurses In Israel, Caryn Andrews, Julie Vosit-Steller, Dorit Goldman, Barbara M. Cohen, Judy A. Beal
International Collaboration And Partnership: A Pilot Program Developing Roles Of Advanced Practice Nurses In Israel, Caryn Andrews, Julie Vosit-Steller, Dorit Goldman, Barbara M. Cohen, Judy A. Beal
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: Advanced practice nursing (APN), in particular nurse practitioners (NPs), have well-established roles in many countries, especially the US and Canada. They have become integral members of the health care team (Pulchini, Jelic, Gul, & Loke, 2010). Nurse practitioner education programs moved into university settings in the early 1990?s and NPs eaRN academic graduate degrees and clinical NP licenses. The concept of nurse practitioners health care systems in the Middle East, and in particular, Israel has been explored but remains in an early stage (Kleinpell, Scanlon, Hibbert, Ganz, East, Fraser, Wong & Beauchesne, …
Making A Match: Impact Of Rn Education, Certification, And Experience On Quality Outcomes And Safety, Martha A. O'Neill
Making A Match: Impact Of Rn Education, Certification, And Experience On Quality Outcomes And Safety, Martha A. O'Neill
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Registered Nurses (RN) comprise the largest health care professional group in the United States estimated at 3 million licensed RNs (AACN, 2015). As many as 1.3 million RNs work in the acute care setting as frontline clinicians having direct influence on safe, efficacious care provided to patients. Despite the large RN workforce and pivotal position in patient care, there remains a need to quantify the RN contribution to quality care outcomes. Education, national nurse certification, and years of experience are variables that are thought to contribute to the nurse's ability to provide quality …
Improving Interdisciplinary Relationships In Primary Care With The Implementation Of Teamstepps, Nicole M. Siddons
Improving Interdisciplinary Relationships In Primary Care With The Implementation Of Teamstepps, Nicole M. Siddons
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016:
Healthcare organizations face many diverse challenges, perhaps one of the most problematic of these is the lack of interdisciplinary collaboration plaguing healthcare. This issue results in serious complications with the safety and quality of care (IOM, 1999). One example depicting ineffective collaboration among healthcare teams occurred in an urban Midwest United States city, where a Native American community clinic recently transformed their care model by adding registered nurses to their team. As a result, issues with interprofessional collaboration and teamwork arose threatening healthcare outcomes and employee engagement. The Institute of Medicine (IOM) report, …
Innovative Evidence-Based Practice Education: Battling Dr. Google And Nurse Jackie, Melanie C. Neumeier, Leah Adeline Phillips
Innovative Evidence-Based Practice Education: Battling Dr. Google And Nurse Jackie, Melanie C. Neumeier, Leah Adeline Phillips
International Nursing Research Congress (INRC)
Session presented on Saturday, July 23, 2016:
In Canada, Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) are required to engage in evidence-based practice (EBP) as an entry to practice competency (CCNRN, 2012, CCPNR 2013). However, despite this expectation, and research findings that nurses generally have a positive attitude toward evidence-based practice (Yoder, Kirkley, McFall, Kirkey, StalBaum, & Sellers, 2014) globally there is poor uptake in the application of this process. Thiel and Ghosh (2008) conducted a cross-sectional survey of 121 practicing nurses in the Midwestern United States to determine how they accessed information and their readiness to engage in …
Pain, Gut Microbiome And Neurodevelopment In Preterm Infants, Xiaomei Cong
Pain, Gut Microbiome And Neurodevelopment In Preterm Infants, Xiaomei Cong
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016:
Purpose: The purpose of this presentation is to discuss the state-of-the-science of recent research for the importance of the brain-gut-microbiota axis in regulation of pain/stress in early life and the use of advanced technologies of microbiome genomic sequencing in predicting pain/stress responses and neurodevelopmental outcomes in high risk preterm infants.
Methods: A prospective longitudinal study was conducted. Sixty preterm infants (26 0/7 - 32 6/7 weeks gestational age) were recruited at birth and followed-up for 3 weeks. Outcome measurements are gut microbiota (16S rRNA and metagenomic sequencing), early life pain/stress experience, and neurodevelopmental …
A Systematic Review Of Screening Instruments For Depression In Antenatal Services In Low Resource Settings, Genesis Chorwe Sungani, Jennifer A. Chipps
A Systematic Review Of Screening Instruments For Depression In Antenatal Services In Low Resource Settings, Genesis Chorwe Sungani, Jennifer A. Chipps
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016: Purpose: A review of screening instruments for depression for use in antenatal services in low resource settings was conducted. It is important to assess methodological quality of articles which reported psychometrics of an instrument because gives insight in quality of study designs. A good instrument should have high sensitivity and specificity which makes it effective in ruling in pregnant women with depression and ruling out those who do not have. The aim of the review was to appraise the evidence on sensitivity and specificity of screening instruments for depression and recommend a suitable …
Curriculum Development And Transcultural Service Learning In Post Earthquake Haiti, Margarett Alexandre
Curriculum Development And Transcultural Service Learning In Post Earthquake Haiti, Margarett Alexandre
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Haiti remains the poorest country in the Western Hemisphere. After the earthquake of January 12, 2010, Haiti is in even greater need of healthcare support. In an effort to provide our students with an opportunity to provide much needed healthcare services in two underserved areas in rural Haiti; an elective course was developed incorporating the Student learning Outcomes; which included the need to advocate for health policies that address local and global health issues, effectively communicate with diverse client populations and disciplines using a variety of strategies and respecting client's cultural beliefs and …
Development Of Client Care Needs Assessment Tool To Support Workforce Transformation In Mental Health, Rani Hajela Srivastava, Kristin Cleverley
Development Of Client Care Needs Assessment Tool To Support Workforce Transformation In Mental Health, Rani Hajela Srivastava, Kristin Cleverley
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Purpose: The purpose of our research was to develop a evidenced-based methodology that could be applied to define how clinical services were staffed to deliver care of the highest quality and built around clients' needs. Development of the Client Care Needs Assessment Tool (CCNA) appropriate for inpatient mental health was the cornerstone of this methodology. Commitment to evidence based care requires evidence based decision making. Staffing decisions are critical to achieving quality care. The aim of skill-mix review endeavors is to optimize efficiency and effectiveness (http://www.who.int/management/determining_skill_mix.pdf), that is have the right care by …
A Comparison Of Innovative Oral Health Educational Programs For Caregivers Of Preschool Children, Audrey P. Miller, Gabriella M. Riccio, Chanadra T. Young-Whiting
A Comparison Of Innovative Oral Health Educational Programs For Caregivers Of Preschool Children, Audrey P. Miller, Gabriella M. Riccio, Chanadra T. Young-Whiting
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016:
Background: Oral health care is the primary preventive method of tooth decay (caries or cavities) and infection in children below the age of five. However, poor oral health (OH) in preschool children can have several detrimental outcomes. Nonetheless, many children still suffer with multiple infectious tooth decay, unnecessary sedative extractions, and tooth loss; resulting in pain, nutritional concerns and weight loss. These outcomes can lead to speech delays and impairments, growth and developmental delays, and eventually negative systemic effects. The gap in the literature as it relates to caregiver knowledge towards oral health …
Emancipatory Nursing Praxis: A Theory Of Social Justice In Nursing, Robin R. Walter
Emancipatory Nursing Praxis: A Theory Of Social Justice In Nursing, Robin R. Walter
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Purpose: The purpose of this international qualitative, constructivist grounded theory study was to generate a middle-range theory of social justice specific to the discipline of nursing. The primary research question was, "What are the critical factors shaping nurse professionals' perceptions and attitudes about their role in social justice?" Related questions included, "How do nurse professionals come to know and practice social justice?" and, "What processes do nurse professionals use to identify the contexts in which they will engage in social justice?"
Methods: The methods employed in the study were consistent with the constructivist, …
Transformative Partnership: Creating An Inter-Professional Environment, Jessie M. Colin, John Mcfadden
Transformative Partnership: Creating An Inter-Professional Environment, Jessie M. Colin, John Mcfadden
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016:
Novice and experienced nursing faculty often find it challenging to balance and fulfill the academic tripartite mission of teaching, service and scholarship while staying clinically relevant. Faculty members who excel at teaching and service may struggle to find the time to engage in scholarship. Additionally, the movement to the practice doctorate as the terminal degree for advanced practice nurses poses yet another challenge for faculty members who have not been educated as nurse scientists. Scholarly contributions, however, are essential to academic life, nursing practice, and the continuous evolution of the nursing profession. Boyers …
Data Based Conceptual Model Of Gbv And Women's Risk For Hiv Contraction And Progression, Jacquelyn C. Campbell
Data Based Conceptual Model Of Gbv And Women's Risk For Hiv Contraction And Progression, Jacquelyn C. Campbell
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: Construct a biobehavioral model of the linkages of Gender Based Violence and HIV acquisition and progression through biological and behavioral risk factors including the physiological stress and immune system dysfunction linkages, STI and vaginal wall physiology, forced anal sex, mental health (depression, PTSD, suicidality), and behavioral risks resulting from violence such as substance abuse, inconsistent condom use, and multiple partners.
Methods: Deductive processes from systematic reviews along with data from a large Case (N = 543 abused) Control (N = 358) study of women in the US Virgin Islands and the US …
The Association Of Perceived Stress To Physical And Affective Health Outcomes In Sickle Cell Disease, Miriam O. Ezenwa
The Association Of Perceived Stress To Physical And Affective Health Outcomes In Sickle Cell Disease, Miriam O. Ezenwa
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: Pain is a major complication of sickle cell disease (SCD). Stress is known to trigger acute pain crisis or intensify chronic pain in patients with SCD.De, 2005, 1 Serjeant, 1994, 2. There is insufficient evidence about the effects of stress on fatigue, a ubiquitous symptom of SCD or on affective (anger, anxiety, and depression) symptoms in adults with SCD. Because SCD is marked by repeated ischemic attacks and chronic inflammation, which predisposes patients to the differential expressions of genes implicated in stress responses, Jison, 2004, 3, the SCD population is prime for …
Advancing Nursing Migration Research: Observations And Opportunities, Franklin A. Shaffer, Janice Phillips
Advancing Nursing Migration Research: Observations And Opportunities, Franklin A. Shaffer, Janice Phillips
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016:
Purpose: The purposes of this umbrella review were to identify the state of nursing research focused on the experiences of nurses who migrate globally and identify implications for advancing the global nursing research agenda.
Methods: The body of research examining the migration experiences of nurses has grown during the past two decades resulting in a number of knowledge synthesis studies. While the breadth and focus of these studies is quite diverse, an umbrella review or synthesis of these studies was undertaken to summarize what is known about the migratory experiences of nurses worldwide. …
Perceived Barriers To Research Utilization Among Registered Nurses In An Urban Hospital In Jamaica, Pauline Anderson-Johnson, Andrea Norman-Mcpherson, Stacey Foster-Jackson
Perceived Barriers To Research Utilization Among Registered Nurses In An Urban Hospital In Jamaica, Pauline Anderson-Johnson, Andrea Norman-Mcpherson, Stacey Foster-Jackson
International Nursing Research Congress (INRC)
Session presented on Friday, July 22, 2016:
Background: Applying research-based evidence into the clinical practice reflects the gold standard of quality and cost effective patient-centered care. Practicing without evidence-based knowledge limits nurses in providing competent care. The international Council of Nurses (ICN) has stipulated that nurses globally use research evidence in the clinical practice in order to close the existing gap between research and practice in nursing. However despite these directives, routine practices still persist (ICN, 2012).While there are numerous clinically pertinent research-based knowledge available as well as an increase in access, the pace of adopting the evidence to provide …
Ehealth: Using Healthcare Information From The Internet In The Classroom, Indra Hershorin
Ehealth: Using Healthcare Information From The Internet In The Classroom, Indra Hershorin
International Nursing Research Congress (INRC)
Session presented on Saturday, July 23, 2016:
The current 'Millennial Generation' of college students majoring in the health professions has unprecedented access to the Internet. Eight out of 10 Internet users look online for health information, making it the third most popular Web activity next to checking email and using search engines (Stellefson, Hanik, Chaney, & Tennant, 2012). The Internet continues to be widely used to facilitate research and learning for health and medical information. eHealth emerged early in the 21st century and is an all-encompassing term for the combined use of electronic information and communication technology in the health …
Nurse Faculty Leadership Development: Prospects, Progress, And Perspectives, Fidelindo Lim, Larry Z. Slater, Karla G. Rodriguez
Nurse Faculty Leadership Development: Prospects, Progress, And Perspectives, Fidelindo Lim, Larry Z. Slater, Karla G. Rodriguez
International Nursing Research Congress (INRC)
Session presented on Saturday, July 23, 2016: The confluence of the nursing faculty shortage, faculty retirement, changing nursing students' demographics, and the demand to make nurses full partners in health care delivery have all highlighted the need for building greater capacity for nurse faculty leadership development. Academic nursing leadership demands unique knowledge, skills, and competencies not fully addressed in entry-level and advanced nursing education. The need to support and sustain faculty leadership development has been called for by nursing education stakeholders such as the American Association of Colleges of Nursing (AACN), National League for Nursing (NLN), Sigma Theta Tau international …
A Food Label Literacy Intervention Tool To Fight Childhood Obesity Among Vulnerable Populations, Susan Allen
A Food Label Literacy Intervention Tool To Fight Childhood Obesity Among Vulnerable Populations, Susan Allen
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: This research was conducted by a school nurse in a school setting who recognized childhood obesity as an epidemic globally and specifically in the United States (Burke & Wang, 2011) and set out to identify and conduct research with a Food Label Literacy Intervention Tool. This was done to advocate for a vulnerable population of poor, minority students who grow up to be chronically ill adults. At least one fourth of all the children globally (Abela, Bagnasco, Arpesella, Vandoni, & Sasso, 2014), and approximately one third of all children and adolescents within …
Teaching Interprofessional Practice Utilizing Video Conferencing And Virtual Environment, Jean Beatson, Mary Val Palumbo
Teaching Interprofessional Practice Utilizing Video Conferencing And Virtual Environment, Jean Beatson, Mary Val Palumbo
International Nursing Research Congress (INRC)
Session presented on Monday, July 25, 2016:
Purpose: The purpose of this study was to explore student experiences in utilizing the virtual environment and videoconferencing in interprofessional education and practice through qualitative analysis. The goal of this presentation is to present these findings, discuss interprofessional education, and lessons learned including issues of applicability.
Methods: A virtual environment and video conferencing was used for teaching interprofessional practice (IPP) when caring for the elderly with students from eight healthcare professions. Students from nursing, physical therapy, speech and language therapy, social work, nutrition, medicine, exercise science, and pharmacy collaboratively developed a plan of …
Transformation Of Nursing Education In South Africa Through Strategic Collaborative Partnerships, J. N. Makhanya
Transformation Of Nursing Education In South Africa Through Strategic Collaborative Partnerships, J. N. Makhanya
International Nursing Research Congress (INRC)
Session presented on Friday, July 22, 2016:
Cognizance of the depth of challenges facing the nursing profession in south Africa, in 2011 the Minister of health convened a national summit for nursing with the aim of reconstruction and revitalization of nursing of the nursing profession for a long and healthy life for all south Africans. The consultative summit culminated in a nursing compact providing of resolutions taken collectively by the summit. The National Strategic Plan for Nurse Education, Training and Practice (Nursing Strategy) 2012/2013-2016/2017, provides a roadmap in generic terms for addressing the resolutions taken by the summit. The purpose …
Prevalence And Use Of Simulation In Undergraduate Nursing Education Institutions In South Africa, Catherine Hilary Thurling
Prevalence And Use Of Simulation In Undergraduate Nursing Education Institutions In South Africa, Catherine Hilary Thurling
International Nursing Research Congress (INRC)
Session presented on Sunday, July 24, 2016:
Purpose: The purpose of this presentation is to assess the prevalence, uses and practices of simulation as a teaching methodology in undergraduate nursing curricula in South Africa.
Methods: A survey of the prevalence and practices of simulation in South Africa was carried out as part of a situational analysis for the development of a simulation programme. The validated 2010 Simulation in Nursing Education Survey (Hayden, 2010) was used with permission from the original authors. The researcher received ethics approval from the relevant university's Human Ethics Research Committee to conduct the study, prior to …
Advancing Advanced Practice Nurses In Illinois: Challenges In The Land Of The American Medical Association, Nancy M. Valentine
Advancing Advanced Practice Nurses In Illinois: Challenges In The Land Of The American Medical Association, Nancy M. Valentine
International Nursing Research Congress (INRC)
Session presented on Thursday, July 21, 2016: This presentation will utilize the case study of the Illinois House Bill 421 (2015) which introduced the legislated changes entailed in eliminating the requirement of nurses to have a legislated physician collaborative practice agreement. Alternatively, granting the ability for nurses to not have to have a legislated collaborative agreement with a physician would give more independent freedom for APNs to practice independently. Although this bill did not pass as fully written in the last legislative session, the steps utilized to push this concept further in incremental steps illustrates the key elements in the …