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Representing A Globally Diverse Profession: Implementing A Holistic Interview Process for Applicants
No full textAs the national nursing shortage rises across the United States, educators continue to focus on providing quality education and producing competent bedside nurses. However, there remains a lack of diversity in the nursing profession (Breland, 2020). Ensuring a student body is representative of various experiences and personal attributes creates a nursing workforce that more closely reflects the population and is prepared to successfully lead and impact health outcomes equity (Wagner et al., 2020). Implementing holistic interview processes will allow for the evaluation of life experiences and core values demonstrating a more accurate representation of how individuals will practice as professionals (Thompson et al., 2021)A group of nursing faculty and leaders took a collaborative approach to create a holistic admission process for an Accelerated Bachelor of Science in Nursing (ABSN) Program. Moving away from a traditional question-and-answer interview process and a heavily weighted academic success model allows for a more comprehensive review of candidates and promotes a decrease in the unconscious bias of the interviewers (Murray, 2020; Noone et al., 2021). A pilot project was implemented using a multi-level interview process with a written essay, video essay, and role-play of the registered nurse for the 2023 cohort of applicants. The written essay portion consisted of questions covering the applicants\u27 hands-on healthcare experience, interactions with healthcare providers, and their community involvement. The video essay portion inquired about the applicant\u27s ability to manage difficult situations, how their core values connect to their purpose, and how they believe nursing will impact their identity. Lastly, the faculty incorporated role-play questions that ask the applicant to consider ethical and cultural awareness by communicating with a variety of patients and family members.Informal feedback from applicants revealed a positive experience with the revised interview process. Technical issues were not reported which suggested a seamless process. Additionally, surveys were sent to interviewers and revealed support for continuing the revised interview process for future cohorts. Suggestions for improvement for the overall scoring process were implemented for the 2024 cohort interviews. This interview process can be easily replicated across other programs and schools
Enhancing Nursing Student\u27s Communication Skills for Antimicrobial Stewardship Via Simulation
No full textThis pilot study evaluates the impact of high-fidelity pediatric simulation training on nursing students’ communication skills related to antimicrobial stewardship (AMS) with caregivers and families. The research focuses on developing and testing a simulation lab to enhance students’ decision-making, patient education, and therapeutic communication in AMS contexts. Using a quasi-experimental design, pre- and post-simulation surveys assessed effectiveness, with the Simulation Effectiveness Tool - Modified (SET-M) by Leighton et al. (2015) as the post-survey measure. Conducted over three months in the Northeastern United States, the study involved 103 pediatric prelicensure nursing students, with over 95% affirming enhanced communication abilities and confidence in discussing AMS. The findings underscore high-fidelity simulation as a valuable educational tool in nursing, helping future nurses address pediatric antimicrobial resistance. The realism of these simulations supports students in handling complex clinical situations. Further research should investigate the long-term effects of AMS-focused simulation training on clinical practice and patient outcomes
Australian Mental Health Nurses’ Attitudes Towards Consumers With Mental Illness: A Survey Analysis
No full textNegative attitudes towards mental illness are a global issue for discrimination towards people with mental illness. Literature has identified various dimensions of stigma. Among the different dimensions, professional stigma prevents people from seeking and accessing help, which further increases mental health-related suffering in the community. Despite providing professional care to consumers, negative attitudes towards mental health conditions are evident even among Mental Health Nurses [MHNs] working in acute inpatient psychiatric units. At the same time, there is a lack of research addressing Australian acute inpatient psychiatric units’ MHNs\u27 attitudes towards mental illness. Therefore, this study aims to assess Australian acute inpatient psychiatric units’ MHNs’ views towards mental ill health. This study used a survey design to assess MHNs’ attitudes using the Mental Illness Clinicians’ Attitude version-4 [MICA-v4] scale. The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement is used to report the quality of this survey. The results revealed that overall, MHNs showed positive views towards mental illness, with a requirement of an enhancement in the attitudes towards the recovery of people with mental illness, disclosure about mental illness and safety of the public from mentally unwell. Moreover, nurses’ qualifications, years of experience and gender positively correlated with items 2, 5 and 8 of the questionnaires. Future research is required to focus on the development of exemplary anti-stigma strategies to maintain positive attitudes as well as the enhancement of negative attitudes among MHNs. The results of this study may inform the policy makers and researchers to develop anti-stigma strategies to enhance or maintaining the positives attitudes of MHNs nationally
Psychiatric Observation Unit, Patient Outcomes, and Boarding
No full textBackground: The deinstitutionalization of mental health facilities occurred after the Community Mental Health Act, which aimed to transition mental health care from institutions to community centers to deliver psychiatric crisis intervention (Hung et al., 2020). Due to a lack of funding, the Acts\u27 goals were unmet, causing patients to seek care in emergency settings and creating the revolving door phenomenon (Stien et al., 2022). Emergency departments had an increase in patients with mental health conditions of 6.6% to 10.9% over ten years (Kim et al., 2022). Boarding is defined as patients in the emergency department requiring transfer to an outside facility, but no bed is available (Nordstrom et al., 2019).Purpose: This literature review aims to evaluate the impact of Psychiatric Observation Units (POUs) on boarding times for patients with mental health conditions.Methods: This literature review utilized PubMed and ProQuest databases to retrieve retrospective, before-and-after analyses, quantitative and qualitative studies published within the last five years. Keywords were related to boarding patients with mental health conditions in emergency departments.Results: The average boarding time of patients with mental health conditions is 60 hours. Patients boarding in the emergency department do not receive psychiatric treatment due to knowledge deficits related to mental health, extending boarding times up to 35 hours (Nordstrom et al., 2019). Patients with psychotic, neurodevelopmental, and neurocognitive disorders are more likely to board the emergency department (Kraft et al., 2021). Stabilizing patients and initiating treatment of underlying mental health conditions results in discharge from the emergency department and reduced boarding times from 212 to 152 hours (Stamy et al., 2021).Conclusions: Implementing POUs improves clinical outcomes, reducing recovery and boarding times. Patients with mental health conditions seek treatment in emergency departments due to limited options, limited upstream solutions, and fragmented healthcare. Mental health episodes can lead to emergencies, but leading someone experiencing a mental health episode to the emergency department decreases support and increases risks. Implementing POUs is a downstream solution; however, it gives access to upstream solutions that promote mental wellness and equity. Mental health is a state of mental well-being, not just the absence of a mental diagnosis
Insight into the Orientation Needs for a Sub-Specialty From the Preceptors Perspective
No full textNursing orientation has been noted to have long-term impacts on confidence, preparedness, and retention (Barrett, 2020). Preceptors play a key role of any orientation program and are vital to a successful orientation and transition to practice (Chu, 2023; Durkin et al., 2022). Nurses transitioning to the Neonatal Intensive Care (NICU) require additional education and training to gain competency caring for fragile newborns (Fiske, 2018; McDermott, 2023).
The overall aim of this IRB approved quality improvement initiative was to understand and improve the orientation experience from the preceptors’ perspectives. Surveys were provided to 42 nurses, 28 responded and 23 provided comments. Surveys were voluntary and anonymous. Comments from the survey were analyzed using thematic analysis.
Three major themes were found: the need for a shared mental model, necessity for a strong foundation for neonatal nursing and the desire for a supportive learning environment. Shared mental model was characterized by respondents’ desire for standardization. They expressed a need for consistency in the approach to orientation, specifically content and expectations. Respondents commented on meeting individual needs of each orientee including timeline of orientation, solidifying workflow and the progression of learning.
Nurses reflected on the necessity for a strong foundation for neonatal nursing. They addressed the need to have flexibility within a framework and a desire for orientees to have access to didactic learning.
The theme of supportive learning environment was characterized by systems support and attitudes that impacted the learning environment. Respondents recognized the need for assistance with prioritization of orientee assignments, support for redirecting orientation and development of learning goals. Respondents also reflected on meeting between the Clinical Nurse Educator and the preceptor orientee dyad referred to as ‘check-ins’ on our unit. Lastly, they commented on the impact of teamwork and the influence of the interdisciplinary team on the learning environment.
Providing an orientation experience for nurses caring for unique patient populations necessitates acquisition of foundational skills, identification of goals and a plan to assist learners in meeting these goals. Understanding preceptors experiences in sub-specialty settings will provide valuable insight into the specific professional development needs for orientees and preceptors
Enhancing Patient Safety: Nurses’ Perspectives on Barcode Point-of-Care Systems
No full textBackground: Barcode technology in healthcare has advanced significantly and has become essential for patient safety. Multifunctional devices, such as personal digital assistants (PDAs), are integrated with electronic health records, enabling real-time documentation through barcode scanning at the patient’s bedside.
Aim: This study aimed to explore nurses’ perspectives regarding the barcode point-of-care (POC) system using mobile PDAs, focusing on medication administration, blood transfusions, and specimen collection.
Methods: This qualitative descriptive study collected data through focus group interviews with 24 nurses between September and November 2023. The data were analyzed using content analysis.
Results: Participants acknowledged that although the barcode POC system enhances patient safety, it can also impede nursing workflow. They reported that the POC system improved accurate patient identification and increased their confidence in performing nursing tasks correctly. Additionally, they found the PDA convenient as it was connected to the electronic medical record, enabling them to look up and enter nursing information directly at the patient’s bedside. However, participants noted that work delays were primarily caused by issues such as unrecognized barcodes due to crumpling, slow or disconnected wireless internet connections, automatic logouts after a certain period, and the multiple steps required to log in. Concerns were also raised about the risk of infection from the shared use of the device and the protocols following its use with infected patients. Furthermore, participants identified several strategies that facilitated the effective use of this system, including providing feedback on individual nurses’ usage at the ward level and improving functions based on nurses’ requests at the institutional level.
Conclusion: To effectively implement and utilize the barcode POC system, it is crucial to emphasize its importance and ensure user compliance, identify challenges faced by users, and provide the necessary support. Additionally, it is essential to disseminate information on manuals and protocols and create an environment conducive to efficient system operation
Exploring Factors Affecting Global Health Nurse Partnerships: Rwanda Human Resources-Health Program
No full textBackground: Low- and lower-middle-income countries (LMICs) account for 89% of the global shortage of nurses and midwives,1,2 with inadequate training to address population health needs.3,4 Nurse leaders are vital in addressing this shortage through education and training.5 One approach to nurse leadership development is to foster partnerships between institutions and governments in high-income countries and LMICs through twinning.6 Twinning partnerships were exemplified by the Rwanda Human Resources for Health (HRH) program (2012-2019). While twinning partnerships are beneficial in training nurse leaders in LMICs,7,8,9 not enough is known about the factors that affect global health nurse leaders\u27 twinned partnerships.
Methods: A qualitative descriptive study was conducted to gain an in-depth understanding of factors that affected twinned partnerships between Rwandan and US. Faculty-nurse leaders (RNL/USFNL) in the HRH program. Purposeful sampling was used to recruit RNL and USFNL who participated in the HRH program (2013-2018). The study was conducted at two teaching and referral hospitals and the University of Rwanda. Data were gathered through semi-structured in-depth interviews, observations, and document analysis. The study was guided using Upvall and Leffers’s revised conceptual model of partnership and sustainability in global health.10
Results: The study included 10 RNL and 10 USNL (10 dyads) ranging from 30-80 years of age and associate to PhD degrees in education. Participants reported that language barriers considerably affected the effectiveness of twinning partnerships during the implementation of the HRH program. Participants felt a clear framework and guidelines were absent for program implementation. Consequently, the program\u27s initiatives were not systematically monitored or evaluated. RNLs and USFNLs were instrumental in improving Rwanda\u27s healthcare workforce. A key achievement was launching the first master’s program in 8 nursing specialties (2015), supported by the Ministry of Health, with the midwifery track added in 2022.
Conclusion: In this qualitative exploration, RNL and USFNL, in a twinning partnership, led innovative solutions to prepare the nursing workforce, including developing Rwanda’s first master\u27s nursing program. Future global health nurse leadership programs and partnerships should prioritize using frameworks for effective monitoring & evaluation and address language barriers by considering culture and linguistic history
Beyond Borders: Sustainable Development Goals as a Nursing Education Framework
No full textIntroduction: Nurse educators prepare graduates as effective and compassionate clinicians. Global conditions demand sustainable health solutions centered within cultural contexts. The United Nations Sustainable Development Goals (SDGs) that intersect with health are a vital framework for education. The impacts of Covid on learning and infrastructure losses have long term consequences on quality education, and loss of human capital (UN, 2024; ICN 2023).The SDGs and social determinants of health framed educational project goals between two schools in different countries: (1) to engage students and faculty in collaborative learning experiences, and (2) to collectively explore social determinants of health and care delivery that impact the community. Common values in school mission statements grounded learning.Implementation: Students and faculty acquired insights and rich learning experiences within the Bwindi Uganda hospital and community through:
●Participation in morning prayer with the healthcare team●Student pairings for patient care guided by Bwindi nursing staff or faculty●Rotations in patient care services—adults, pediatrics, neonatal intensive care, and family planning clinic●Attendance at physician-led rounds of patients admitted with preventable diseases--malaria, malnutrition, HIV/AIDS, and maternal and child conditions●Participation in community outreach in HIV prevention, testing, and counseling at a local parish●Home health visits to inquire about health concerns, and to promote health teaching●Tracing hospital water sources in the environment and observing water quality testing with a sanitation engineer highlighting access to clean waterA live demonstration garden growing local sustainable foods taught patients, families, and students about nutrition. As participant-observers in hospital wide planning students gained insights into proactive approaches to real or potential issues.Evaluation: Faculty evaluated students in their respective programs. A project limitation was inattention to co-evaluation of long-term student learning outcomes. Alumni follow-up is needed for future projects.Implications: Implications focus on SDG integration in nursing curriculum. Lived experiences of students in real time and place in cultural and healthcare contexts are an invaluable learning tool. Partnership plans are ongoing and include cloud based video communication technology for new educational projects
Relationships Between Maternal Employment, Breastfeeding Relationships, and Maternal Emotions
No full textObjective: The COVID-19 pandemic changed maternal employment (e.g., telework options) and caregiving infrastructure in the US (Bauer & Yu Want, 2023). The purpose of this study was to examine the impact of maternal employment on breastfeeding relationships, i.e., mutual responsiveness during direct breastfeeding in response to perceived adequate milk supply (Wood et al., 2022 & 2023) and its relation to maternal emotions (Watson et al., 1988). Additionally, breastfeeding experiences were explored qualitatively.
Methods: A prospective, mixed methods, between groups repeated measures design was used (N = 81). Data were obtained between June 2022 and August 2023 through online surveys at 4, 12, 20, and 24 weeks after birth from mothers who had initiated their healthy term singleton infants into direct breastfeeding. Three groups represented mothers who: 1) stayed at home with their infant full-time (SAH); 2) returned to work from home/telework (WFH); and 3) returned to work outside of the home (WOH). Data were analyzed using generalized linear mixed models, Kaplan-Meier time-to-event analysis, and inductive content analysis.
Results: SAH mothers had a slower decrease in breastfeeding relationships (β = -0.85, p = 0.047) as well as perceived adequate milk supply (β = -0.28, p \u3c 0.001) over time than mothers who returned to WOH. Mothers who returned to WFH slightly increased negative emotions over time compared to mothers who returned to WOH (β = 0.72, p = 0.043). Mothers who returned to WOH were more likely to discontinue exclusive direct breastfeeding at 24 weeks. Qualitative results showed that mothers who were committed to direct breastfeeding achieved emotional well-being (e.g., feeling relaxed) (Wood et al., 2024). In contrast, mothers who had less frequent direct breastfeeding experienced low milk supply, slow infant weight gain, or maternal distress. Unrestricted direct breastfeeding was the reported strategy mothers who returned to WFH and WOH used to restore breastfeeding relationships.
Nursing implications: Mothers who returned to WFH and WOH were more likely to struggle with keeping breastfeeding relationships with their infants compared to SAH mothers. Nurses need to discuss with employed mothers that the engagement of work might affect breastfeeding challenges regardless of WFH or WOH. Unrestricted direct breastfeeding is the strategy mothers can use to restore breastfeeding relationships upon reunion after they return to WFH or WOH
Enhancing Nursing Curriculum With AI: Integrating Generative Technology in Nursing Education
No full textPurpose: This presentation aims to explore integrating generative AI technology, such as ChatGPT, into nursing education to support curriculum development, enhance student engagement, and improve learning outcomes. This study examines how AI can be incorporated to enrich pedagogical approaches in nursing, ensuring that students are well-prepared for complex, evolving healthcare environments.
Background: As healthcare settings become increasingly technologically advanced, nursing education must evolve to prepare students for ever-changing clinical practice. AI technologies, particularly generative AI models, present significant potential for transforming nursing education by promoting active learning, fostering critical thinking, and enabling personalized learning pathways. However, AI in education poses challenges related to ethical use, clinical judgment development, and dependency concerns.
Methods: This abstract presents a literature review and case studies on the implementation of generative AI in nursing curricula. It covers its role in interactive simulations, case study generation, ethical decision-making exercises, and real-time feedback. We also outline pilot program outcomes, where AI was used to facilitate student engagement, adapt content to individual learning needs, and assess critical thinking.
Findings: The integration of AI-enhanced student engagement, as evidenced by increased participation in simulations and case-based learning activities. It also fostered higher critical thinking as students analyzed AI-generated responses for clinical accuracy. However, ethical considerations around data privacy, dependency on AI, and accuracy of AI responses were noted as areas for improvement.Implications: AI in nursing education is promising to enhance curriculum delivery, but it requires careful, responsible integration. Nurse educators are encouraged to incorporate AI thoughtfully to improve learning experiences while upholding ethical standards and promoting independent clinical judgment. Future research should focus on the long-term impacts of AI on clinical readiness and best practices for effective, ethically sound AI integration in nursing education