Moving toward the 21st century: American Association of Colleges of Nursing guidelines and baccalaureate nursing education

This study investigated current use of American Association of Colleges of Nursing guidelines in preparing the baccalaureate nurse graduate to practice nursing in the community health sector of the healthcare delivery system and use of community based healthcare delivery sites by baccalaureate programs located in non-urbanized and urbanized areas. The extent of guidelines adoption, plans by colleges not currently using them to do so in the future, and impact of accreditation visits on the adoption of the guidelines were also explored.; A qualitative survey design was used to describe the use of AACN guidelines in the development of baccalaureate nursing education.; Subjects included 387 Deans and Program Coordinators of baccalaureate nursing programs in the contiguous United States. A researcher developed questionnaire instrument was completed by all participants.; Both null hypotheses were retained. Baccalaureate nursing programs located in urbanized and non-urbanized areas used greater than 20% of community sites made available to them for clinical education. The majority of baccalaureate nursing programs include all topics stated by the AACN guidelines as important and necessary for teaching the baccalaureate prepared registered nurse.; Application of the guidelines has occurred in various ways since their inception, appearing to have dropped off in more recent years. Programs facing accreditation are less likely to use the guidelines in designing curriculum than those programs accredited between 1993 and 1995. Programs not currently using the guidelines indicated a desire to do so in the future.; Baccalaureate nursing educators have recognized the need to educate nurses to care for patients in non-traditional settings. AACN guidelines were valued early on. Programs using the guidelines are closer to meeting AACN requirements for accreditation.; Nurse educators should increase teaching the clinical application of critical thinking, multi-disciplinary team work, communication, and economic management of care over all semesters thus leading to a well prepared nurse who can give care in the changing healthcare delivery system.