Tuesday, October 30, 2007

5 Little-Known Giant Health Care Issues Facing the United States

While many people in the United States agree that some sort of health care reform is in order, those same individuals may be unaware of the specific problems within the system. Those who are engaged in current events may stay on top of all the following issues affecting patients and health care workers, but this is sadly not the case where the average citizen is concerned. With the 2008 presidential election on the horizon, it is more important than ever for casual observers to learn more about the following five little-known giant health care issues that individuals in the United States face.
1. Uninsured Millions Are Affecting Everyone

Many individuals complain about the shortcomings of our insurance policies, but do you know how many people are living without any kind of medical insurance? It is estimated that over 46 million Americans are currently uninsured. This is a testament to the many problems within the system. Most uninsured people go without insurance because of the initial cost, while others feel that outrageous premiums make insurance policies futile. In essence, many Americans have simply given up on health care insurance.

Without health insurance, people often neglect "well" visits to the doctor. Preventative medicine is essential for good health and longevity. Without regular checkups and childhood vaccinations, individuals and society as a whole may suffer. The individuals who avoid the doctor's office will experience more serious illnesses and conditions, while contagious diseases will spread throughout the public more readily when proper vaccinations and care are not administered.
2. Obesity Is Dangerously On the Rise

We hear it in the news all the time: "America is getting fatter." However, many of us dismiss how devastating this epidemic is to our health. Reports from 2005 indicated that 64.5% of American adults were overweight, possibly obese. Today, obesity rates are even higher and projected to grow exponentially. The health risks involved with obesity are numerous, though high blood pressure, stroke, diabetes and heart disease are the most concerning. According to a 2005 article in the Journal of the American Medical Association (JAMA), obesity-related illnesses kill over 112,000 Americans each year. The CDC, however, links obesity with over 300,000 deaths per year. A large discrepancy, but both numbers are alarming.

Why are Americans getting so fat? Experts are attributing this to many factors. For one, workplaces are far less strenuous than they used to be. Our bodies, once built for hunting and gathering, are often sedentary through most of the day. Another large contributor to the nation's expanding waistline is the television. Both television programming and video games park people on their couches. The biggest factor in obesity, however, is overeating. Americans eat larger portions than necessary and are offered many delicious, albeit fatty, processed foods.
3. Pharmaceutical Companies Control More Than You Realize

Comparison shop between your local pharmacies all you like, your sticker shock can only be blamed on greedy pharmaceutical companies. Yes, we have them to thank for medicinal breakthroughs, and scientific research certainly isn't cheap; however, when the goal of a pharmaceutical company turns from profit to excess profit, everyone suffers.

The rising costs of prescription drugs have been devastating on Medicaid and Medicare programs, leading many doctors to stop accepting patients with such coverage. Also, high prices have gravely affected AIDS Drug Assistance Programs (ADAP), leaving many HIV/AIDS patients without life-saving medications. Doctors are continuously wined and dined by pharmaceutical representatives, which certainly can bias physicians to use certain prescriptions that may not be the cheapest or most effective options. Even some of the most respected medical journals, which are presumed to be unbiased, have been bankrolled by high-dollar drug advertisements.
4. Hospital Staff Shortages Are Killing People

Says Marge Sampson, a former hospital nurse, stated to the Chicago Tribune, "It's so scary to spend eight hours, flying by the seat of your pants and just praying. In my day, they taught you never to give a drug until you looked it up and verified the proper doses. But you can't do that. There's no time. You're just dumped into this. It's so nightmarish I can't even explain."

A nationwide shortage of hospital personnel has left many health care workers overworked and exhausted. The result? Mistakes occur, sometimes with deadly consequences. Many hospital workers are asked to cover areas where they have little experience, while others simply make mistakes due to stress and/or sleep deprivation. It is hard to say how many medical errors occur in American hospitals each year. Ironically, this lack of adequate documentation is also due to staff shortages. However, the Institute of Medicine estimates that 7000 people die each year in America from medication errors alone.
5. Veterans Are Being Neglected

A Harvard / Public Citizen report found that, as of 2003, 1.69 million veterans were without medical insurance or regular care from Veterans Health Administration (VHA) facilities. Those who earn too much to qualify for VHA services, yet not enough to afford private insurance, find themselves in a helpless situation. Others that do qualify for free VHA services may sit on long waiting lists while suffering from a chronic condition or disease or, upon acceptance, will receive inadequate care from an understaffed facility.

In 2005, it was acknowledged by U.S. government that the Department of Veterans Affairs was lacking $1 billion to operate with maximum efficiency. Since that time, organizations like the American Legion and the Paralyzed Veterans of America have been working overtime to make changes on Capitol Hill. However, the fact remains that many veterans, even those maimed in combat, have been all but abandoned by this health care system.

There are obviously no easy answers for the health care problems that face the United States today. However, the public needs to be aware of what is happening to the health care system, as all of these issues affect society as a whole. Even if you are content with your particular insurance policy or health care provider, you should still be concerned about hospital shortages. Even if you are of a healthy weight, obesity is undoubtedly a problem for someone you care about and is certainly on the rise for children. In short, the above "little-known" health care issues should be familiar to us all.


http://noedb.org/library/features/5-little-known-giant-health-care-issues-facing-the-united-states

The Ultimate Guide to the NCLEX Exam

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) and the National Council Licensure Examination for Practical Nurses (NCLEX-PN) are test plans used by state and territorial boards of nursing to assist in determining licensure decisions. In order to become a nurse, you must pass one of those two exams. While the pressure is on to pass the test, the following information might make the whole process much easier for you.

If you realize that one organization, National Council of State Boards of Nursing (NCSBN), develops both licensure examinations, you might then understand that this is the source for all your research into the NCLEX. Beyond this, some simple requirements include registration, as you must apply for a nursing license from your state board of nursing. That board will determine whether or not you meet their criteria for NCLEX exam eligibility. Once you've passed eligibility, you must register to take the exam - or, in other words - apply for a license to practice nursing.

Once you register, you'll receive an NCLEX Examination Candidate Bulletin in the mail or by email. This bulletin allows you to register with the NCSBN's testing service (see instructions below). You'll also receive an ATT (Authorization to Take the Test), along with a list of testing centers and instructions for how to schedule a time to take the exam. From this point, the only thing you need to do is pass the exam! That's where we come in, to help you simplify this otherwise stressful event.
NCLEX Test Plan Structures

The National Council of State Boards of Nursing (NCSBN) develops the two licensure examinations mentioned in the introduction. Therefore, it might behoove you to look to this agency for guidance in taking these exams. As explained in the link provided for NCSBN, their committees, subcommittees and staff prepare the items for the tests and contracts with Pearson VUE for test development and administration of the NCLEX examinations. This is a fairly new partnership and it will extend through 2014.

The link for Pearson VUE above will take you directly to the page where you can schedule your NCLEX exam. This page also contains an online tutorial for both NCLEX test plans. This tutorial is the same for both the NCLEX-RN and NCLEX-PN, and you will need a Windows PC to operate this tutorial. When you click "Play Tutorial," a "File Download" box will appear. Click "Open" and the windows application will download to your PC. Once the installation completes, the guided tour and tutorial will open automatically and you may begin to practice for your exams.

According to the NCSBN, the NCLEX-RN test plan [PDF] categories all reflect client needs across the life span in a variety of settings. Under this broad topic, you'll find four major categories of Client Needs that organize the content within the test plan. Two of the four categories are further divided into a total of six subcategories. The Client Needs categories and subcategories that define the content of the NCLEX-RN Test Plan include ("Health promotion and maintenance" and "Psychosocial Integrity" categories do not have subcategories):

Safe Effective Care Environment

* Management of Care: 13% - 19%
* Safety and Infection Control: 8% - 14%

Health promotion and maintenance: 6% - 12%

Paychosocial Integrity: 6% - 12%

Physiological Integrity

* Basic Care and Comfort: 6% - 12%
* Pharmacological and Parenteral Therapies: 13% - 19%
* Reduction of Risk Potential: 13% - 19%
* Physiological Adaptation: 11% - 17%

Now that you know the basic percentages that each topic consumes within the test plan, you can judge how to portion your time for test study. For instance, if you're weak in "Safety and Infection Control," you know that you risk blowing from 13% to 19% of that test if you don't study that subcategory. If you read further into the PDF file offered by the NCSBN, you'll discover that there are thirteen topics listed within that "Safety and Infection Control" subcategory:

1. Accident Prevention
2. Disaster Planning
3. Emergency Response Plan
4. Error Prevention
5. Handling Hazardous and Infectious Materials
6. Home Safety
7. Injury Prevention
8. Medical and Surgical Asepsis
9. Reporting of Incident/Event/Irregular Occurrence/Variance
10. Safe Use of Equipment
11. Security Plan
12. Standard/Transmission-Based/Other Precautions
13. Use of Restraints/Safety Devices

The NCSBN warns that the topics above are included in the "Safety and Infection Control" subcategory, but they may not be limited to those thirteen topics. Still, these topics can provide you with guidance in how to study for that subcategory. If you know these topics, then you can bring that 13% to 19% of the test plan score up to par and you won't fail that section.

After you preview what's expected from you for both tests from that PDF, you'll want to visit the NCSBN Learning Extension, where you can find various tips, courses, and reviews for the test plans. Not all the information on this site is free, but you are free to make the choice between paying for materials here or - with the test subjects under your belt - use free online materials to study for the exams. Another resource is the NCSBN PDF file, "Candidate Bulletin" for 2007, which outlines every question you might have about these exams.
About Registering (or Re-registering)

A 365-day time period during which a board of nursing may determine the candidate's eligibility begins when the board of nursing receives the candidate's registration from the test service. Once a candidate is made eligible, he or she must test within the validity dates printed on the Authorization to Test (ATT).

If a candidate's board of nursing is unable to make that candidate eligible within the 365-day time period, the candidate must wait until his or her current registration expires before re-registering. If a candidate re-registers before a current registration expires, the second registration will be processed and denied and the fee collected for the application will be non-refundable. Additionally, candidates who are not made eligible by their board of nursing within 365 days will forfeit registration, including the fee. Candidates then must re-register and re-pay the examination fee.

As a candidate, you can register online at Pearson VUE (www.pearsonvue.com/nclex), by mail (see instructions at https://www.ncsbn.org/1202.htm), or by phone (instructions also at https://www.ncsbn.org/1202.htm). The fee for taking the NCLEX examination currently is $200. Candidates may also have to pay other fees for licensure required by the board of nursing in the application jurisdiction. There will be no refund of registration fees (mail, telephone, or via the Internet) for any reason. This policy also applies to the current international scheduling fee of $150.

If you apply by Internet or if you supply an email address, you will receive information from Pearson VUE by email. If, however, you don't provide an email address for communications, all correspondence from Pearson VUE will arrive only through U.S. mail.
NCLEX Test Time

The current NCLEX examination is a four-option, multiple-choice examination that includes "alternate items" [PDF]. Alternate items will allow candidates to demonstrate their entry-level nursing competence in ways that are different from the standard multiple-choice items. Follow the link to learn more about these items so you'll be prepared for those questions.

The NCLEX multiple-choice exam uses an interactive system called Computerized Adaptive Testing (CAT) to gauge your level of competence. After you've answered the minimum number of questions (75 out of 265 questions for RN candidates, 85 out of 205 questions for LPN candidates), the computer will attempt to access your level of competence. The questions that follow may vary from that point for each candidate. To read more about how the CAT system works, take some time to review NCSBN's PowerPoint explanation about CAT.

At the point of minimum answers to questions, you can basically determine if you will pass or fail. If you are clearly above the passing standard at the minimum questions, you'll pass. If you are clearly below the standard, you'll probably fail. If you fall too close to the standard to allow a definitive result, you'll continue to answer questions until a final assessment can be determined. Read more about how the answers to the questions are determined at NCSBN's FAQ.

You have five hours to complete the exam, and this time includes the introductory computer tutorial and two ten-minute breaks. The NCLEX examination is scored once by the computer on which you take the test, and a second time by the National Council's testing service. It will take about a month for your state board of nursing to send the results of your exam to you.

If you fail the test, it's not the end of the world. In fact, you're somewhat at an advantage if you need to retake the exam, as your state board of nursing will mail a diagnostic profile to you that outlines both the areas of knowledge where you performed well and areas where you performed poorly. You can retake the test as many times as you need to pass. The National Council's policy dictates that you wait at least 91 days before retaking the test, but individual state boards may impose other requirements. Check with your state board to learn about your local restrictions.
Testing Tools

You can find many online tools that are designed for both the NCLEX-RN and the NCLEX -PN. Some companies offer their materials for a fee. Some of these companies, listed in alphabetical order, include:

* InternetExam Online Practice Exams
* Kaplan Nursing
* Measure Up
* NCLEX Excel
* NCLEX-Practice
* Peterson's
* Test Prep Research
* Thomsen Delmar Learning

You can also purchase review books and sample tests in book form, such as the books at InformIT, eBookMall, and Amazon (do search for NCLEX). And, you can also take NCLEX prep courses in a traditional classroom setting through the following companies:

* Kaplan
* NCLEX Excel
* Nursing Education Consultants
* Rineheart and Associates

You may not be able to afford all the help offered above, but you can find resources online for free including a Google book search for NCLEX (beware of outdated documents for many topics). Other sites you might peruse include the following:

* 4Tests
* Caring4You
* Delmar's Online NCLEX Review
* Exam Cram
* NCLEX & HESI Online Course
* NCLEX Course Review
* Nursing Study
* Study Guide Zone

Test Preparation

Now that you know most of the basics about the NCLEX, we want to pass on some tips about how you can prepare for this test. If you took the SAT or ACT in high school, you may soon realize that the NCLEX isn't much different in its style (or in its pressure or stress!). The major difference is that the NCLEX is necessary for you to pursue a nursing career. With that said, you can take the pressure off a bit by reminding yourself that you can retake this test if you fail.

To increase your odds for success, you need to plan ahead. Here are some tips that may help you pass the test with ease:

1. Learn How to Learn: Before you begin to cram for these exams, read the tips listed at OEDb's article about memory and learning. There are 75 tips listed here, but they're all sorted into categories that you can tackle easily. For instance, you'll need to set aside a place at home where you can study quietly, and you'll need to know whether you truly need flashcards to learn or not. You might not be a visual learner!
2. Practice Testing: Tests often make people very nervous, and this is a huge source of stress. To help eliminate some of this stress, try to simulate a testing atmosphere at home. Use the resources listed below to develop tests, and spend a good hour taking the test in a quiet atmosphere without a break. You'll develop endurance, and you'll also learn your weaknesses as well as your strengths with these 'tests.' Practice with online testing, as this exercise will reduce stress over taking the test online during the actual exam.
3. Get Plenty of Rest: Sleep is one cure to stress, and sleep will also help you to improve your memory. If at all possible, try to get a good night's rest not just the night before the exam, but for the entire week prior to the exam.
4. Take a Deep Breathe and Read Each Test Question Slowly: One way to understand a question on the test is to rephrase it. This way you can pick out all the verbs, nouns, and any other grammatical directives that will turn a 'trick' question into a reasonable query.
5. Be Confident: Fear is a big stress factor. But, if you've learned your material and you know it (not just memorized it), then why worry? Your confidence in what you know will help you to ride through this stressful exam. If you pass, then that score will validate your confidence. If you fail, then you have all the tools at your fingertips to try the test again. Just because you fail the exam does not mean that you are a weak, bad, or otherwise worthless individual.

If you heed the tips listed above and the all the material listed at NCSBN, you may end up enjoying the whole testing process. Good luck!



http://noedb.org/library/nursing-education/the-ultimate-guide-to-the-nclex-exam

Nursing School Rankings: What Are the Best Nursing Programs?

A high demand for nurses in the United States has led to the creation of many nursing school programs. As professionals and students would attest, however, not all programs and schools are created equally. Indeed, you should thoroughly research a school before you begin to pursue a nursing degree.

If you are looking for the "best" nursing programs in the country, you will find that certain organizations have ranked schools based on important factors. However, no two lists are exactly alike, as said organizations use slightly different criteria for each list. Below, we will examine the two most widely recognized nursing school rankings from U.S. News & World Report and the National Institutes of Health (NIH), as well as other resources. Each will shed more light on what makes a school noteworthy and how you should decide on which nursing program to pursue.
U.S. News & World Report

Each year, U.S. News & World Report releases a special set of college and university rankings. Entitled "America's Best Colleges", it collects many Top 100 lists. From "Best National Universities" to "Best Black Colleges", each list is created using a different set of criteria. Nursing students can look to this collection of rankings for nursing school-specific lists.

U.S. News & World Report offers several annual rankings for nursing programs, including a general list for "Best Nursing Graduate Schools". Other lists are more specific, ranking the best colleges for various nursing specialties. These specializations include nursing service administration, family nursing, adult nursing, pediatric nursing, geriatric nursing, surgical nursing and psychiatric nursing.

U.S. News & World Report compiles college and university rankings through a unique process. The publication uses peer reviews to determine which schools have the best reputation. Also considered is how students scored on standardized tests, as well as how many students were accepted to a given college. Other factors include available faculty resources, tuition fees, alumni donation rates and graduation rates.

The latest edition of U.S. News & World Report's "America's Best Colleges" should be available at all major bookstores and your local library. You can also purchase an online edition through the publication's official Web site, which will grant you instant access to the many rankings from your home computer.
National Institutes of Health

The National Institutes of Health, or NIH, regularly contributes funds to hospitals, schools, businesses and other organizations in order to promote important medical research. Money is extended to schools and universities that have proven to be effective and reputable institutions. Each year, the NIH releases nursing school rankings, reflecting which schools received the most funding from the NIH.

The NIH extends millions of dollars to nursing programs each year. It is an unbiased, peer-review process that leads to approval for funding, which is why the annual school rankings are held in such high regard. To be given medical research funds by the NIH indicates that a college or university is making great strides within the medical community. Naturally, such schools should be worth consideration by potential students.

The organization's official Web site offers specific data in regards to annual award trends. There, you will be able to view rankings that are organized by state, hospital, medical school and more.
OEDb

For those of you who are seeking an online undergraduate nursing degree, you should consult the college rankings at Online Education Database (OEDb). OEDb, an exhaustive guide to the nation's top accredited online schools, features colleges with online nursing programs on their well-executed rankings list.

The combination of factors used to compile OEDb's college rankings is unique and unbiased. The qualifying criteria includes acceptance rate, financial aid, graduation rate, peer Web citations, retention rate, scholarly citations, student-faculty ratio and years accredited. U.S. News & World Report combines similar metrics, though their process is more simplified.
The Princeton Review

The Princeton Review (TPR), not unlike U.S. News & World Report, publishes an annual guide to America's top colleges. Entitled "Best 366 Colleges", this guide offers rankings in many different categories, from "Best Classroom Experience" to "Best College Newspaper". These lists are compiled less scientifically than U.S. News & World Report's rankings, as TPR's annual guide is based on student feedback.

If you are in search of a more personable guide to America's best nursing schools, you should consult this annual collection of rankings. TPR has found that nursing is one of the top 10 most popular college majors amongst today's students and, accordingly, includes many colleges and universities with nursing programs in their annual guide. The latest edition of TPR's "Best 366 Colleges" can be purchased online or found locally at a major bookstore or library.
StudentsReview.com

The rankings offered by StudentsReview.com are compiled from surveys taken by undergraduate and graduate students who have attended the schools in question. The site aims to provide "answers to the questions college students wish they had known to ask". By simply specifying a college major, state, degree level or social interest, users will have instant access to personalized college rankings.

Prospective nursing students, by selecting "nursing" as their major of choice, will be provided with a ranking list of the site's top-reviewed nursing schools. Though the methodology behind the site isn't as scientific as OEDb or U.S. News & World Report rankings, it will afford you the chance to really know how students feel about their alma mater. Detailed reviews are available on the site and a simple grading system allows students to vote on a school's overall performance, specific departments and campus social life.
Community College Week

Community College Week (CCW) is bi-weekly news source that focuses on two-year community, technical and junior colleges. Each year, CCW publishes a special report on the "Top 100 Associate Degree Producers". Also included with this report are specific rankings for popular college majors. The "Top 50 Associate Degrees: Nursing" [PDF] should be of interest to prospective nursing students who wish to earn a two-year degree.

The rankings offered by CCW are compiled using only one set of metrics — the total number of degrees awarded by each college. Though degree conferral is important when considering a school, you may wish to use these lists in conjunction with another resource, as you will want to know additional details about a college before enrolling. However, these rankings are important in that they uniquely focus on associate degrees and they break down numbers according to gender, which may be of great importance so some students.
Conclusion

Determining which nursing school to attend involves more than just referring to cold statistics. However, the rankings above should assist your search for the best nursing program. Naturally, the "best" program will differ from one student to the next, as each person will have different needs. No two colleges offer the same programs, amenities and atmospheres.

Before you use any college rankings to determine which school you attend, you should always research how the rankings were compiled. For example, a school's financial aid program may be of more important to you than student-faculty ratio. In that case, you may wish to rely on a list that favors financial aid data. Comparing several lists side-by-side may give you the best perspective on nursing programs, which is why we have offered a variety of resources above.


http://noedb.org/library/nursing-education/nursing-school-rankings