Processes used by a university to reverse the downward spiral of NCLEX-RN pass rates are described. Reasons for poor pass rates were found to be multifaceted and included gaps in curriculum content, student attitudes toward taking the licensure exam, delays in taking the exam following graduation, inadequate student preparation for taking standardized exams, and inappropriate and ineffective exit examinations. Various strategies for reversing the trend of the NCLEX failure rate included: addressing areas of weakness in the curriculum; revising courses; engaging students; changing standardized exit exams; employing a midcurricular and other standardized exams; and implementing remedial courses for poor performance on standardized exams. Change was effected and pass rates on the NCLEX-RN improved dramatically. Future possibilities and proactive measure are described.
Problem & Background: Residents of an urban, ethnically & racial diverse & resource-limited community where the college of nursing is located are at high risk for stroke. Recognizing this as a major population health issue for our community & nursing’s essential role improving health outcomes, faculty engaged with stroke center leadership to determine concerns. In addition, a curricular audit revealed stroke care competencies (knowledge, skills & attitudes-KSAs) were not well reflected in the curriculum & thus, the need for enriched graduate and undergraduate stroke curriculum. Also, we needed to build our research & EBP capacity with relevant & meaningful activities. Purpose: To increase student KSA’s in stroke care & stroke related nursing research/EBP. Methods: Faculty leading the stroke initiative worked with the stroke center nursing & physician leaders to identify teaching content & clinical practice opportunities for undergraduate & graduate students to integrate into existing courses. Stroke was an exemplar for population health teaching & learning in several courses. Faculty also identified stroke related research & EBP topics for students in a graduate research course. Results: Faculty & students are involved in several inter-professional projects & are applying for grants to support their work. Other learning opportunities include: stroke nursing unit as a designated education unit; student-led stroke support groups; & reducing missed appointments & readmissions. Community health course undergrads are conducting a study to describe the organization & delivery of community stroke services. Graduate students developed 4 stroke EBP project proposals presented at graduate & nursing research days on campus. Faculty & students presented their research & EBP proposals at outside conferences & have been recognized as STTI Rising Stars. Conclusions: All involved have expressed excitement & satisfaction with the stroke initiative. Students have demonstrated significant learning about stroke, their role in care across the continuum & stroke related research & EBP. Thus, this effort contributes to nursing engagement in stroke research & practice that promises to improve stroke related outcomes in our at risk community.
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