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Research Findings Describing Home-Based Nurses’ International Scope and Standards of Practice
No full textBackground. The International Home Care Nurses Organization and the American Nurses Association (ANA) are collaborating to develop the International Scope and Standards of Home-Based Nursing Practice. The first step was to conduct research with home-based nurses (HBNs; nurses who provide care for patients in their homes) to develop an evidence-base for the international scope and standards document.
Methodology. This IRB-reviewed study consisted of a literature review to locate key documents (e.g.; ICN, 2021; Narayan et al., 2017; Nursing and Midwifery Council, 2024; Rusli et al., 2021, Saari et al., 2024) and four surveys: 1) status of country’s Home-Based Nursing (HBN) practice, 2) HBNs\u27 perspectives about scope of practice, 3) HBN standards for practice, and 4) basic competencies for HBNs. The surveys were developed sequentially, using data from each previous survey to develop the next survey. Each survey captured quantitative and qualitative data on a secure web-based platform in 2024. Convenience, purposive, and snowball sampling recruited over 100 HBN participants from six geographic world regions. Potential participants were sent an e-mail invitation to participate in the study and were asked to forward the invitation to their HBN colleagues. ANA’s online research platform was used for consent, anonymous data collection, and initial analysis. Data were transferred to SPSS for further analysis.
Findings. HBNs’ opinions about the status and preferred scope, standards and competencies of HBN practice by country and geographic region will be reported
Measuring Hospital Case Management Practice Environment: Adaption and Validation of the PES-NWI
No full textThe Practice Environment Scale of the Nursing Work Index (PES-NWI) has been used to measure the work environment across diverse nursing populations for over two decades (Lake, 2002; Lake et al., 2023). Case management, a specialty nursing practice centered around care coordination, aims to meet the clinical and financial goals of medically and socially complex individuals across the care continuum (Luther et al., 2019). Hospital case management practice is complex, and case managers often face work barriers, including unclear scope of practice and insufficient training upon entering the specialty (Anderson & Hewner, 2021; McLaughlin Davis & Morley, 2022). There is limited knowledge of the case management practice environment, and no instrument exists to measure the concept in the hospital setting. This study aims to test the psychometric properties of the hospital case management version of the PES-NWI.Based on expert panel feedback, the PES-NWI was adapted for hospital case managers and shortened to 23 items. Convenience sampling was used to recruit 156 hospital case managers in the United States through social media and professional networks. Data analysis for psychometric properties included Cronbach’s alpha for reliability and factor analysis for validity.The study sample included hospital case managers working in 34 states. Most respondents were female (92%) and from the discipline of nursing (79%). Nearly 60% of the case managers were nationally certified, and 40% had over ten years of experience in case management. The adapted instrument demonstrates internal consistency with an overall Cronbach’s alpha of 0.92 and item-to-total correlations from 0.38-0.76. Sampling adequacy was met for factor analysis with Kasier-Meyer-Olkin of 0.895 and a statistically significant Bartlett’s Test of Sphericity (p\u3c 0.001). Results yielded a similar five-factor solution to the original PES-NWI with items cleanly loading to factors (0.45-0.73).The hospital case management version of the PES-NWI demonstrates excellent reliability and validity. The nursing implications of establishing this instrument include the ability to measure the hospital case management practice environment accurately and identify areas for improvement. This knowledge will support the specialty practice\u27s workforce and professional development and foster advancements in practice
COVID-19 Vaccine Acceptance and Hesitancy Among People Living with HIV in Kenya: Lessons Learned
No full textThe roll out of the Covid 19 vaccine encountered vaccine hesitancy globally (Rahbeni et al., 2024). In East Africa approximately four out of ten people expressed hesitancy towards vaccination (Alie, Abebe, Negesse, Adugna, & Girma, 2024). By the end of 2023, only 21% of Kenyans had received the complete Covid primary series and only 4% had received at least one Covid dose booster vaccine (WHO, 2023). Although Covid 19 is no longer a threat, some variants may emerge (UN, 2023). People living with HIV (PLHV) are more vulnerable to COVID 19 infection and experienced worse clinical outcomes than others. Therefore, it is recommended that PLHV should be prioritized for Covid 19 vaccination (Liu, et al., 2024). Yet, a large proportion of them remain hesitant to be vaccinated (Shrestha et al., 2022). Although several studies have highlighted reasons for vaccine hesitancy among various groups in Kenya, such as refugees among others, most were quantitative and there are limited studies on vaccine hesitancy among PLHV (Orangi et al., 2024). There is need for more in-depth exploration of vaccine hesitancy.
Methods: An exploratory qualitative design was used to explore the barriers and facilitators of Covid 19 vaccine among 20 PLWH in an urban setting. Face to face in-depth interviews were used to collect data from consenting participants. Data were transcribed verbatim and analyzed using thematic analysis.
Findings: Four themes emerged from the data depicting the barriers and facilitators of the Covid 19 uptake. These include: Perceptions of vaccines, Vaccine acceptance, Vaccine hesitancy and Booster uptake. The variations in the acceptance of the vaccine as well as hesitancy reflects the complex tapestry of perceptions, variations in knowledge, misinformation, and social pressures that influenced the decision making of PLHV. Booster uptake was very limited, illustrating the lack of knowledge of the importance of vaccines.
Conclusion: Although Covid 19 no longer threatens people’s lives, health education on the role of vaccinations for Covid 19 and other vaccine preventable diseases is essential for PLHV to understand the importance of prevention in vaccine preventable diseases. This is key in health promotion and can inform the roll out of vaccines in future pandemics.
Recommendations: Policy makers should develop health promotion programs that address different groups of people in communities
Global Goals, Local Impact: Advancing Nursing Education through SDG Integration
No full textUndergraduate nursing students are future healthcare leaders who not only provide direct patient care but also influence community and global health outcomes. The United Nations Sustainable Development Goals (SDGs) provide a comprehensive framework to address pressing health and social challenges, including reducing inequalities, promoting well-being, ensuring access to quality education, and combating climate-related health threats. Integrating SDGs into nursing education equips students with the knowledge, skills, and advocacy mindset to address these challenges at local, national, and global levels.
Nurses are pivotal in achieving SDG-related outcomes such as health equity, disease prevention, and sustainable community interventions. Currently, nursing curricula often emphasize clinical skills and patient care but provide limited structured exposure to global health frameworks like the SDGs. Early exposure to SDGs fosters awareness, critical thinking, and action-oriented skills that prepare students to advocate for policy change, health promotion, and sustainable practices.
Integrating the SDGs into undergraduate nursing programs empowers students to see beyond traditional clinical care, fostering a generation of nurses prepared to address complex health challenges globally. This initiative aligns with the vision of nursing as a profession that promotes health equity, sustainability, and social responsibility
Beyond the Basics: Next Steps to Achieve Work-Life Harmony for Healthcare Professionals
No full textNow, more than ever before, it is important to intentionally create and cultivate healthy work environments to enhance professional well-being within the highly dynamic and demanding field of healthcare. Since the onset of the COVID-19 pandemic, workplace and personal demands have increased. In addition, the prevalence of mental health challenges and symptoms have also increased (Ayar et al., 2022; Chutiyami et al., 2022). One common strategy to achieve healthy work environments and professional well-being centers on work-life balance. Work-life balance simply means striking a healthy balance in prioritizing your personal and professional life. The concept of work-life balance is often depicted as a perfectly balanced scale and in most cases true balance is not realistic or achievable (Gragnano et al., 2020). Instead, we invite individuals to consider the concept of work-life balance as more similar to a sensible budget. In this model, items (e.g., tasks, to-dos, & commitments) are assigned and allocated based on the individual\u27s current needs and resources. Additionally, the authors propose that redefining work-life balance in terms of work-life harmony can be useful. The concept of work-life harmony refers to a state where an individual can achieve both professional and personal goals, while acknowledging that neither set of goals may be equally balanced. This novel view of work-life balance emphasizes the dynamic nature of an individual\u27s work and personal life and lends itself to a more practical approach to cultivating professional well-being. Greater work-life harmony is positively associated with more employee motivation and productivity in the workplace. Other notable benefits may include: improved retention rates, job satisfaction, efficiency, higher levels of engagement, lower absenteeism or sick leave, and organizational commitment (Žnidaršič & Bernik, 2021; Rodríguez-Sánchez et al., 2020). In this presentation, there will be a discussion of the significance of work-life balance and practical strategies to realize work-life harmony. Factors influencing work-life balance and barriers to success are also outlined including key issues with time management, stress, and burnout. Self-compassion, radical acceptance, and a gratitude practice are also explored as possible mediators to the highly stressful healthcare environment. The goal of this presentation is to inform and inspire the cultivation of Work-Life Harmony for a more fulfilling personal and professional experience, while fostering health and well-being for overburdened Healthcare Professionals
Wisdom, Wellbeing, and Peer Support Program: Addressing System-Based and Individual Job Stress
No full textThe presented program is an evidenced-based and evidence-informed program to help the health care workforce be their best together. Full health system implementation followed a pilot-test and program evaluation in a high-stress unit. The program is constructed on three pillars that address and integrate individual, team, and organizational factors: (1) Peer support; (2) Resilience; and (3) Optimization of the systems in which people work.
Detailed abstract is attached to this item record
Sparking Professional Well-being Through the Development of a Holistic Health and End-of-Life Course
No full textIn response to the profound impact of the pandemic on the population and healthcare providers’ health and wellness, a new undergraduate nursing course was developed to educate future nurses about holistic health, self-care, and end-of-life nursing.
Detailed abstract attached
Creating Healthy Work Environment for Nurse Managers
No full textNurse Managers are charged with the task of creating healthy work environments for the clinical nursing staff. What is being done to create a healthy work environment for Nurse Managers? This presentation will share what one organization is doing to help Nurse Managers embrace a work-life balance.
Detailed abstract attached
Transcendental Meditation® Improves Clinical Nurses’ Well-Being, Conscious Awareness, and Authentic Presence
No full textA mixed-method research study (RCT and qualitative) was conducted to evaluate the impact of Transcendental Meditation (TM®) on clinical nurses’ well-being, and explore the relationship between nurses’ well-being, conscious awareness, and authentic presence. Findings demonstrate the value of TM on development of self-care and authentic presence for self and others.
Detailed abstract attached
Volume-Based Feeding Protocol in Metropolitan Medical ICU
No full textOptimal nutritional support is a fundamental aspect of the recovery process for critically ill patients (Compher et al., 2022). It plays a crucial role in mitigating the catabolic effects of severe illness and trauma (Bharal et al., 2019). In the intensive care unit (ICU), enteral feeding (EF) is the preferred nutrition delivery method (Holyk et al., 2020). However, traditional EF protocols such as Rate-Based Feeding (RBF) fail to meet patients’ nutritional requirements. RBF protocol provides only 60% of the prescribed daily caloric intake (Wang et al., 2023). An evaluation of our Medical ICU (MICU) has revealed that the EF was held for 3 to 3.5 hours per day, depriving a caloric intake of 15%, which accounts for 12,150kcal of missed nutrition to the patients. The inadequacy exposes critically ill patients to an increased risk of iatrogenic malnutrition, prolonging ICU length of stay, increasing the risk of infection, extending the duration of mechanical ventilation, and contributing to higher mortality rates (Smith et al., 2024).
Volume-based Feeding (VBF) is designed to mitigate the problem of underfeeding by providing an average of 90% of the recommended nutrition. This project describes a clinical practice improvement and advancement by implementing a VBF protocol that will improve nutrition practice in the ICU