Readmissions to the hospital account for a significant number of all hospital admissions. Early discharge and inadequate care both during and after hospitalization are among the causes cited. Increasingly complex care and an aging population mandate that clinical nurse specialists (CNSs) in acute care settings assume more pivotal roles in discharge planning and care. Discharge program and intervention models, and ways to incorporate discharge interventions into advanced practice in acute care hospitals, are discussed. In addition, the effectiveness of CNSs and their required qualifications are presented.

Background: This quasi-experimental study explored full-time nurse faculty competency in genomics and genetics using a validated measure prior to and following educational sessions during one academic semester. The findings represent the researchers' efforts to educate nurse faculty and to support their competency in genomics and genetics as information shared with students is only as robust as faculty knowledge. Methods: Faculty who consented to participate completed the Genomic Nurse Concept Inventory (GNCI©) to measure their knowledge of the concepts surrounding genomics and genetics prior to the education intervention and then following all three education sessions. The education sessions were carried out over a semester using a lunch and learn forum. Results: Our first assumption was that 50% of faculty would score below 70% on the pretest. Eligible nurse faculty 29/48 (60%) completed the GNCI and scores show they had limited knowledge in three areas: nomenclature of genes and gene function, inheritance patterns, and the clinical application of genomics to human disease. Over half of nurse faculty 17/29 (59%) scored less than 70% on the GNCI© supporting our first assumption. The second assumption that over 85% of faculty would score at least 70% on the GNCI© after the education was not supported. The education sessions improved scores on the GNCI© in the 12/29 (41%) faculty who completed the measures prior to and after the intervention. Conclusion: Despite the growing knowledge about genomics/genetics and the application to clinical practice, health professionals like nurses are not competent in these concepts. Nursing faculty require competency in genomics and genetics in order to integrate these concepts in nursing curricula. Outcomes of this project show the need to provide education and support for nurse faculty in genomics and genetics.

The purpose of this article is to describe how a telemedicine system was used to complete a family and home assessment and to discuss issues facing advanced practice nurses (APNs) when they use such systems in practice. Incorporating discharge care into advanced practice is an increasingly important component of the nursing care given during acute illness. Telemedicine systems offer a mechanism for assessing the ways in which home situations impact on patient recovery. Telemedicine provides a method for early intervention that can ameliorate or prevent developing problems relatively inexpensively. The advantages and disadvantages of one such system, the Picasso, are described.