No abstract

OBJECTIVE: To investigate the relationship of locus of control, parental age, and state anxiety to parental coping and activities performed during hospitalization of a child in a pediatric critical care center. DESIGN: Cross-sectional. SETTING: Pediatric critical care center at a university medical center. PARTICIPANTS: A convenience sample of 47 parents of 47 children hospitalized in a critical care center. MAIN OUTCOME MEASURES: Parental coping strategies and activities performed during hospitalization in a critical care center. RESULTS: Older, more self-directed and less anxious parents were found to use coping strategies focusing on problem solving rather than on their emotional response to a child's hospitalization. Further, those who used the problem-focused coping modes were more likely to be involved in caring for the child, while parents who used emotion-focused coping modes participated less in care activities. CONCLUSIONS: Appropriate strategies to bolster coping and reduce stress of parents need to be constantly reassessed because coping mechanisms vary according to parental age, locus of control, anxiety level, and parental involvement in child-care activities. More research is needed in the changes of parental coping mechanisms with time and child-care activity, to assess the benefits of interventions planned to encourage a problem-focused approach.

Substitution of hospital staff performing concurrent utilization review (CUR) was evaluated using a production process framework. There were no differences in the number of reimbursement denials or denied days among 4 job classifications of hospital staff performing CUR, indicating that educational preparation of staff did not affect outcomes. The implications are that hospitals could substitute assistive staff in place of registered nurses to complete the CUR function, potentially increasing the availability of professional nurses.

As outlined by the Institute of Medicine's Future of Nursing, it is expected that nurses in direct care will be baccalaureate prepared. What then should be the expectation for educating nurse managers? This article compares the Baccalaureate Essentials with the American Nurses Credentialing Center and American Organization of Nurse Executives certification examination content for nurse managers to evaluate if baccalaureate education prepares these leaders for management roles in order to provide additional support for graduate education of nurse managers.

The previous CGEAN Perspectives column compared the Baccalaureate Essentials document with American Nurses Credentialing Center (ANCC) and American Organization of Nurse Executives (AONE) certification examination content for nurse managers and concluded that the baccalaureate curriculum lacks the depth of content needed for today's frontline nurse leaders. This article continues the discussion by comparing the Master's Essentials document with ANCC and AONE nurse manager-level certification content to evaluate if a master's graduate education prepares nurses for the competencies of these management roles.