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Characterizing Prenatal Substance Use: A Leading Cause of Maternal Mortality
No full textIntroduction: Prenatal substance use is of global concern due to its contributions to adverse maternal and child health outcomes and maternal mortality.1 Substance use disorder (SUD) and other mental health concerns are the leading cause of maternal mortality in the U.S.,2,3 where overall rates of maternal mortality are two to three times higher than other high-income countries.2 Prenatal use of licit and illicit substances contribute to maternal mortality though a range of mechanisms, including overdose, cardiovascular complications, and suicide.4 This study characterized substance use and SUD among a nationally representative sample of pregnant women.Methods: Pooled data from the 2021 and 2022 National Survey on Drug Use and Health were analyzed using weighted frequencies and Rao-Scott chi-square in SAS 9.4. Pregnant and non-pregnant women ages 18-49 answered questions about demographics, past 30-day substance use, and DSM-5 criteria for SUD.Results: Pregnant women (n = 1,367) met criteria for SUD related to cannabis (8.7%) and opioids (1.9%) at rates similar to non-pregnant women of childbearing age (n = 39,197, 8.3% and 1.9%, respectively, p \u3e.05). Alcohol-related SUD was more common in non-pregnant women (12.8%) compared to pregnant women (9.4%, p .04). Past 30-day use was lower among pregnant women than non-pregnant women for tobacco, cannabis, cannabidiol (CBD), and alcohol (p \u3c .01, but similar for opioids (p = .87). First-trimester use was high for all substances: tobacco (8.4%), alcohol (24.3%), cannabis (9.3%), CBD (7.5%), and opioids (3.0%). Rates for all substances except opioids (p = .93) decreased significantly across trimesters (p \u3c .01).
Discussion: Pregnant women and women of childbearing age face high rates of SUD and past 30-day substance use. Falling rates across trimesters indicate that interventions to decrease use in pregnancy may be working to some degree, yet opioid use rates were nearly 3-fold higher than those reported in 2020.5 Attention to maternal mental health is needed to achieve goals to reduce preventable maternal mortality
Reflection and Appreciation: A Journey to Improving Care for Older Adults After Critical Illness
No full textWith 25 years of research, my work has focused on improving outcomes for critically ill older adults by addressing delirium, frailty, malnutrition, and functional decline. I’ve advocated for care bundles to prevent complications and support recovery. In this International Nurse Researcher Hall of Fame session, I’ll share my journey to advancing care for older adults after critical illness. This award is humbling and reflects the collective efforts of my colleagues, mentors, and students
An Innovative and Equitable Approach for Global Learning: Internationalization at Home
No full textIn an era of increasing global connectivity and cultural diversity, fostering cultural competence among students is paramount. It is a prevailing notion that cultural competence is primarily achieved through international mobility. However, the reality is that most students are unable to travel abroad due to economic limitations, family obligations and work commitments. With these limitations of international mobility, innovative strategies to enhance cultural competence “at home” were developed by Lovisenberg Diaconal University College (LDUC) in Norway and Ohio State University College of Nursing in Ohio. Grounded in Campinha-Bacote’s model of cultural competence, these strategies include a) systematic integration of domestic and international students, b) peer-learning between Norwegian and American students where students collaborate and learn from each other, c) collaborative online international learning (COIL) that creates equitable and team-taught environments where international faculty develop a shared syllabus, emphasizing experiential and collaborative learning, d) international exhibit day with structured on-campus activities disseminating cultural competence acquired by students who have studied abroad.Contrary to conventional belief that cultural competence is mainly attained through international exposure, evaluating student feedback has shown that \u27internationalization at home\u27 serves as an effective substitute to foster cultural competence in nursing education. By implementing supplementary strategies, educational institutions can ensure that nursing students acquire the essential skills and awareness to deliver inclusive and equitable healthcare to a diverse range of cultural backgrounds
Influence of Leadership Styles Upon Staff Well-Being: Strategies to Create a Healthy Work Environment
No full textBackground: Nurses comprise the largest segment of healthcare and are essential to the mission of creating a healthy work environment (Haddah, Annamaraju, & Toney-Butler, 2022). Global shortages have endangered nursing care delivery effectiveness and exacerbated nurses\u27 stress, burnout and intent to leave their jobs (Tamata, Mohammadnezhad, & Tamani, 2021). Contributing factors include: 1) staff shortages; 2) workload; 3) no advancement opportunities; 4) physical and psychological job-associated risks; and 5) lack of leadership support (Tamata, Mohammadnezhad, & Tamani, 2021). Exploitive leadership styles often result in psychological detachment among direct reports (Majeed & Fatima, 2020). Researchers have inferred that management styles have a profound impact on work-related well-being (Niinihyhta & Haggman-Laitila, 2022). Leader support to work efficiently and produce good patient outcomes affects the well-being of nurses working in patient-facing positions (Long, 2020).
Purpose: Our safety net hospital has experienced nurse attrition during the pandemic. The impetus for transfer to other specialty services, voluntary separation to pursue other opportunities, or leaving the nursing profession have been related to nurse leaders\u27 management styles. A nurse-led team launched an evidence-based practice (EBP) project to explore the extant literature to determine what tactics afford leaders the knowledge, confidence, and opportunities to adapt leadership styles that consider multi-ethnic and multi-generational attributes.
Implementation: The following PICO question was created: Among registered nurses and ancillary personnel working within acute care services (P), is the incorporation of innovative tactics (e.g., technology-based communication) or more traditional strategies (e.g., in-person exchanges) (I) more effective in creating an environment that promotes creativity, sense of well-being, perceptions of appreciation, team cohesion, improving patient experiences, and diminishing voluntary nurse turnover (O)? Literature (N=356) was retrieved from CINAHL. After careful screening, 25 articles met the specific inclusion criteria and were independently appraised by team members using the Johns Hopkins Nursing EBP criteria. Nurse and ancillary personnel volunteers (N=341) were polled to determine preferred leadership styles. Survey questions queried broad age ranges (to determine generational designation), ideal leadership style, communication preferences, and desired work conditions. Because of the nature of the inquiries and safeguards to protect privacy, anonymity, and confidentiality, Institutional Review Board approval was not required.
Results: Researchers noted that transactional leaders can be effective in emergency situations; however, it is vital to maintain open communication and allow team members to feel valued when voicing concerns. Transformational leaders are inherently visionary, engage team members, effect organizational change, and improve patient care delivery. Collaborative leadership and in-person communication was preferred, and feedback from managers was rated the most important attribute among Baby Boomers, Gen X and Gen Z. Millennials listed flexible work schedule as their top priority and 41% selected transformational leadership as the preferred style.
Implications for Practice: Considering the ongoing nurse shortage, it is imperative that leaders delineate more effective strategies to maximize employee well-being and retention (Niinihuhta &; Haggman-Laitila, 2022). Regardless of management style, nurse leaders should be perceived as having integrity, ability to think critically and communicate, and be professional. These qualities support creating and sustaining a healthy work environment
Nurses’ Professional Values as Indicators of Organisational Commitment
No full textThe healthcare system has been subjected to many changes that necessitate rapid and innovative solutions to achieve a positive outcome. Present-day healthcare practice is governed by numerous rules, policies, and procedures. However, that is not necessarily enough to ensure excellent practice. Therefore, professional values are considered the foundation motivating nurses to provide better patient care and show greater dedication to raising up nursing as a profession. The importance of values centers on the fact that values explain the range of manifestations of nursing practice and variations in quality. The power of professional values in the nursing profession extends to affecting nurses\u27 organizational commitment. Nurses who have high levels of organizational commitment can make a difference in care and in achieving an organization\u27s mission and vision. Both professional values and organizational commitment are intricate concepts that include psychological and non-psychological elements. Though intangible, values and commitment govern daily nursing practice and organizational productivity. Their effects and outcomes are seen in negative patient experiences and high turnover rates. Thus, the aim of this study is to examine nurses\u27 professional values as predictors of organizational commitment in the Saudi Ministry of Health.
A quantitative, cross-sectional, descriptive correlational, comparative design was selected. The study participants were recruited through convenience sampling and included 412 staff nurses from two major hospitals in Jeddah City. The results showed that nurses\u27 professional values differ according to demographic factors such as experience, department, career choice, and having taken an ethics course, whereas there are no differences based on basic education or gender. Nurses\u27 levels of commitment differ according to their experience, their religion, and whether they have taken an ethics course. Furthermore, nurses generally have strong professional values and high levels of organizational commitment. Almost all the professional values domains correlate with the organizational commitment domains.
This study asserts that professional values are a predictor of organizational commitment. This study\u27s findings contribute to the body of knowledge, particularly in the disciplines of education and management, by providing deep insight into the relationship between these concepts. Nursing care behavior and organizational outcomes are affected by professional values and organizational commitment. Consequently, an understanding of the relationship between these two concepts can improve nursing practices
A Stress Reduction Toolkit Practice Improvement Project to Promote Wellness in Intensive Care Unit Nurses
No full textParticipants will learn evidence-based stress reduction interventions bundled in a toolkit to promote wellness and improve self-care practices. Designated wellness champions provide toolkit promotion and support to help mitigate the stressful ICU environment in an effort to reduce stress and burnout.
Detailed abstract attached
Developing a Diverse Mindfulness Course for the Elderly in the Community- A Modified Delphi Study
No full textBackground: As Taiwan is about to enter a super-aged society, the research team has found in previous studies that improving the psychological aspects of older people will contribute to promoting healthy aging. There is existing evidence indicating that interventional mindfulness courses are effective in enhancing self-awareness and well-being among older adults. However, there are still no relevant theory-based mindfulness courses for older people in Taiwan. Therefore, this study aims to use the modified Delphi method to develop mindfulness courses for older adults in the community.
Methods: We developed the mindfulness curriculum through literature review, combine a course outline by integrating Dr. Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR) curriculum, Dr. McBee’s Mindfulness-Based Elder Care (MBEC), and Mindful Sustainable Aging (MSA) proposed by Nilsson et al. A total of 16 professional mindfulness instructors, experts in geriatric psychology, psychologist and clinical care specialists were invited to assess the applicability of the course content in three stages and offer recommendations for modifications in writing. In the first stage of discussion, the focus was on reviewing the course outline and providing feedback for the development of course content, while the second and third stages concentrated on assessing the applicability of the content and its alignment with the main structure of the course. The experts were invited to evaluate the suitability of each concept using a 4-point Likert scale. In addition, the panel of experts established a consensus threshold of \u3e0.78, with selected items rated as quite suitable or highly suitable. The content validity index (CVI) was evaluated.
Results: The research showed that the CVI in the second stage was 0.985, while that in the third stage was 0.988 for suitability and clarity. Eight curriculums were conducted, with consensus reached on 103 items covering pre-course preparation, course content, after-class exercises, etc.Conclusion: This study provides relevant course guidelines for mindfulness programs targeting older adults in Taiwan’s communities. It will also serve as a reference for promoting community-based psychological care to achieve healthy aging for older adults
The Experience of a Medicalized Hotel Due to COVID-19
No full textThe emerging pandemic(1) caused by the rapid spread of the new coronavirus Covid-19 required urgent reorganization to respond to care demands of patients with this new disease(2-4). In Spain, nurses were key contributors to providing out of hospital care. Transforming a hotel into a medical setting was an innovative idea that was able to provide integrated nursing and quality health care for patients recovering from Covid-19(5,8,9).
Purpose: To examine the experiences and perceived care of patients admitted to a Medicalized Hotel (MH) for Covid-19, from March 25 and May 15, 2020, by asking them directly(10) using a validated and translated survey, the 15-item Picker Patient Experience Questionnaire (PPE-15)(11,12). Additional information from professional focus groups was used to validate responses and increase understanding of factors that supported quality care or created problematic experiences for patients.
Design: A cross-sectional descriptive design used the PPE-15 questionnaire and 4 open questions as a single survey, 1 month after discharge, supplemented with data from professional focus groups.
Methods: Following consent, the survey was emailed or asked by phone to all patients (n=517) admitted tin MH from March 25 and May 15, 2020. Descriptive statistics categorized patients\u27 perceptions of factors supporting quality care as well as problem areas in the MH. The MAXQDA© program analyzed the qualitative data.
Results: Total participants 427. The 83% response rate (258 phone/169 online) revealed positive patient perceptions: “being treated with respect and dignity” (95%), “being informed about the medicines to take at home (86%) and “getting understanding answers” by doctors (79%) and nurses (86%). Problems were: “involvement in decisions about care and treatment” (57%); “finding anyone to talk to about worries and fears” (46%); and “being informed about side effects of medication” (46%). Personal treatment was positive (64%) and organizational aspects (catering and cleaning) were problems. Professional focus groups (N=18) identified problems including Isolation, patient concerns or fears, and communication.
Conclusions: These findings identify opportunities for clinical nurse specialists to address patient and professional perceived needs in future alternative out-of-hospital care. They may help institutions and organizations to consider adopting this Medicalized Hotel model in future similar situations as alternatives to conventional hospitalization
Effects of Working from Home Job Satisfaction, Productivity, Employee Retention: A Systematic Review
No full textPICO Question: Does working from home, as opposed to traditional office-based work, affect employees’ job satisfaction, productivity, and retention globally?
Purpose Statement: The purpose of this review is to align SDG 3 (Good Health and Wellbeing)/SDG 8 (Decent Work and Economic Growth) to examine the impact of working from home on job satisfaction, productivity, and employee retention.
Background: Telecommuting across industries has become a prevalent practice, driven by changing dynamics of the workplace and technological advancement of the office. While telecommuteing offers work-life balance and flexibility, its effects on job satisfaction, productivity, and employee retention remain unexplored, especially in relation to social determinants of health and health outcomes. Telecommuting may impact key elements that enhance wellness, such as improved mental health, increased economic stability, and reduced stress, potentially impacting both organizational and individual outcomes while aligning with the SDGs.
Method: We conducted a thorough systematic review using studies from various databases, including CINHAL, PubMed, Medline, PsychINFO, Cochrane, and Scopus. We incorporated studies published between 2010 and 2023, focusing on the effects of telework on employees\u27 job satisfaction, productivity, and retention. This review was registered in the PROSPERO database (Registration Number: CRD42024495468), following the PRISMA guideline for transparency. The studies were screened and selections were dependent on inclusion criteria significant to telecommuting plus its impact on productivity, retention and job satisfaction.Quality appraisal of the studies selected is in progress, applying the Critical Appraisal Skills Programme tool and the Joanna Briggs Institute to help minimize bias and ensure vigorous assessment of the study quality.
Expected Results: Although, this work is in progress, but the Initial findings propose that working from home may have a positive impact on employee job satisfaction, productivity, and retention by promoting work-life balance and decreasing commute-related anxiety.
Conclusion: Working from home suggests offering an encouraging approach to enhancing job satisfaction, productivity, and retention while cultivating a more equitable, healthier workplace
Effect of a Culturally Focused Parenting Program on Korean Parents and Children: A Pilot Study
No full textTraditional Korean parenting practices, heavily grounded in Confucianism which emphasizes educational success, family obligations, and repressed emotionality1, may be related to children’s mental health issues2. The Ottuki Korean Parenting Program (OKPP)3, integrated Korean culture and values, was recently developed for Korean American parents to improve the parent-child relationship. The purpose of this study was to investigate the effect of the OKPP on Korean American parenting practices, parental confidence, and child mental health.
Method: Participants were assigned to either the Intervention group or the Control group. The intervention group received a 3-hour parenting class weekly for 8 weeks. The intervention consisted of teaching effective parenting skills to raise children emotionally and psychosocially healthy. During each session, participants watched the prerecorded video for one hour followed by a 2-hour practice session where parents were led in different role-playing scenarios. Surveys addressing parenting practices, confidence in parenting, child behaviors and emotions, and parental cultural beliefs and behaviors were collected at three-time points: pre-intervention, post-intervention, and three months after the completion of the intervention. Data were analyzed using repeated measures ANOVA to examine the effects of Time and Group (Control vs. Intervention) on each outcome measure. Pairwise comparisons were conducted to further investigate significant effects when needed.
Results: The final sample consisted of 28 participants, with 14 assigned to the Control group and 14 to the Intervention group. Mothers\u27 ages ranged between 28 and 47 years, with a mean age of 34.54 years (SD = 4.75). The length of stay in the US ranged between 1 and 27 years, with a mean of 10 years (SD = 6.90). The Intervention group showed improvement in emotional coaching, expression of love, and parenting confidence, indicating the potential benefits of the intervention. There was no significant improvement in the child’s mental health, positive parenting practices, and parents’ mental health.
Conclusion: The Ottuki Korean Parenting Program was effective in improving parenting skills, including emotional coaching, expression of love, and parenting confidence. This culturally tailored parenting program can support immigrant parents with young children in learning positive parenting practices while enhancing parental confidence