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Health Care Delivery System Influences Changes in Nursing Educational Materials


  • Joan H. Baldwin DNSc, R.N.,

  • Cynthia O'Neill Conger Ph.D, R.N.,

  • Chloe Maycock B.S. R.N., and,

  • JoAnn C. Abegglen M.S., APRN, P.N.P.

Joan H. Baldwin is a Professor, Brigham Young University, Provo, Utah. Cynthia O'Neill Conger is an Assistant Professor of Clinical Nursing, University of Texas at Austin, Austin, Texas. Chloe Maycock is a Clinical Research Nurse, Intermountain Health Care, Salt Lake City, Utah. JoAnn C. Abegglen is an Assistant Professor, Brigham Young University, Provo, Utah.
  Address correspondence to Joan H. Baldwin, 30 E. School House Drive, Woodland Hills, Utah 84653. E-mail: and


The changing health care delivery system has affected nursing care delivery models. To meet the needs of these shifting sands, health-related professions must examine curricula preparing new graduates. An exploratory, descriptive survey design was employed to discover motivators for and types of curricular changes occurring in nursing programs and determine what supportive educational materials are needed. One hundred sixty-seven (26%) of the 651 surveys mailed to a sample of the whole of U.S. baccalaureate nursing programs were returned. Relationships between and among categories of nominal data culled from the participants' experiences were compared using nonparametric statistics. Findings demonstrated why and what changes were made and what educational materials are needed to support new curricula. Results also indicated that blurring of boundaries between community and general acute care nursing is necessary, and changes throughout curricula, including educational materials, must reflect the real-life community aspects of the health care needs of all individuals.