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Empowering Nurses: A Strategic Approach to Retention and Professional Growth
No full textPost-pandemic, nursing recruitment has been crucial for workforce staffing solutions. However, retaining qualified and experienced professionals is now more vital than ever to care for a growing, sick, and complex patient population. According to the Bureau of Health Workforce, the average years of experience for RNs is 2.8 years. Literature suggests that nurses leave their current organizations due to a lack of access to professional growth aligned with their career goals.
Identifying the need to retain experienced nurses and increase their organizational commitment. Leaders and Nursing Professional Development (NPD) partnered to identify sustainable strategies for growing internal nurses. The aim was to create a career coaching program to support nurses in exploring career paths and setting professional goals that align with their passions and purposes. Designed to provide nurses with opportunities for professional development, identify career goals, and empower them to become highly qualified and prepared candidates.
Sessions tailored to meet nurses where they are, with the NPD/Nurse Retention Strategist collaborating with each nurse to explore their passions & goals. Themes of questions included personal and professional goals, strengths, purpose, passions, reflections on professional experiences, well-being, and growth opportunities. Personalized development plans with goal timelines were created, and nurses received assistance with resume building, interview preparation, certification, & shared governance participation.
A survey revealed that 82% of participants felt confident in the job application process, 100% reported enhanced self-assurance in pursuing job opportunities, and 100% planned to apply the skills and insights gained in coaching sessions to their professional lives. After six months, additional outcomes included nurses advancing in the RN Fellowship program, Nursing Supervisor, clinical coach, and mentor roles, as well as achieving national certification.
The program strives to develop a holistic understanding of nurses’ perceived career success and satisfaction. Empowering participants to seek out and find professional growth opportunities that align with their purpose, passion, and intent to contribute to the profession. Studies from institutions that implemented career coaching have shown improvements in nursing retention and overall organizational finances, increasing successful internal growth and decreasing turnover rates and costs
Shortcuts in Obtaining Medication: Impact on Medication Errors in Nursing
No full textProblem Statement: Medication administration errors are a global healthcare issue that pose substantial risks, contributing significantly to patient safety events and mortality rates.1 This presentation reports on a student project conducted with oversight of a research mentor. The nursing student noted extreme deviations in witnessed clinical practice from learned practice.
Significance: The study purpose is to understand the correlation between the use of shortcuts during medication retrieval from electronic medication management systems (EMMS) and the incidence of medication errors. Specifically, it investigates how deviating from accepted nursing practice may contribute to errors such as medication confusion, omissions, misplacements, and/or dosage errors.2 Despite guidelines from The Joint Commission emphasizing patient safety and effective medication management, the practice of multitasking in medication management persists.3-5 This study aims to better understand normalized deviations from recommended practices and their implications for nursing care as well as nursing education.
Methods: An observational study will be conducted in the medication rooms on medical-surgical/telemetry units of two hospitals. Nurses will be observed as they retrieve medications from EMMS and will document any deviations from established best practices, specifically noting the type and frequency of each shortcut taken per trip to the EMMS. At the end of each observed shift, records will be reviewed to identify any medication errors that occurred during that period. Surveys will also be administered to nurses, seeking to understand their perspectives on shortcuts taken during medication administration and whether they have experienced errors as a result. Data collected from observations and surveys will be analyzed to explore patterns in medication administration practices and their potential link to medication errors, providing insights into opportunities for improved patient safety.
Results: An IRB application in process with study completion and data to be completed in time for this presentation. By identifying patterns and potential causes of medication errors, this study seeks to inform strategies for improving medication safety protocols and reinforcing adherence to established guidelines in nursing practice.
Discussion: Discussion will lean towards implications to improving medication administration, guidance for nurse educators, and integrity for practicing nurses
Association Between Care Recipient Factors, Caregiver Health Literacy, and Caregiver Burden
No full textBackground: Family caregivers play a crucial role in senior care in Taiwan, where caregiver burden is a significant issue. Health literacy is essential for effective caregiving and navigating healthcare systems. This study aims to investigate the relationship between caregiver health literacy, care recipient factors, and caregiver burden.
Methods: We conducted a cross-sectional study in a medical center and community settings in Southern Taiwan, targeting adults aged 65+ and their caregivers. The study examines caregiver demographics (age, gender, education, employment, living arrangement, spousal status), health status, health literacy (HLS-EU Q16), caregiver burden (ZBI score), and the Activities of Daily Living(ADL) of care recipients. Caregiver demographics were summarized descriptively, and multiple regression analyzed the links between health literacy, care recipient factors, and caregiver burden.
Result: The study included 333 caregivers with a mean age of 55.3±12.6 years, 53.15% (n=177) of whom were female. Most caregivers (60.06%, n=200) had low education levels, and 59.94% (n=199) were spouses or cohabitants. The mean ZBI score was 16.6±11.57, and the mean HLS-EU score was 56.52±6.85. Caregiver burden showed no differences by gender or education level. The overall regression model is statistically significant (p \u3c 0.0001). Caregiver health literacy, ADL of care recipients, and age (p\u3c0.001) are negatively associated with caregiver burden, indicating that better health literacy, more ADL independence, and older caregiver age correspond to lower burden levels.
Conclusion and implication: Enhancing health literacy and supporting younger caregivers are key to reducing burden. Future research should include family living arrangements and resource utilization for deeper insights
The Intersection of Tradition and Health: Insight to Herbal Medicine Use in Pregnancy
No full textBackground: The use of herbal medicines has increased significantly with around 80% of consumers worldwide particularly among women (Afriyie & Kumi-Kyereme, 2023). The prevalence of herbal medicine use during pregnancy varies by country, from 7% to 55%, influenced by social status, ethnicity, and culture (Illamola et al., 2020). In Australia and the UK, rates range from 52% to 58%, while Norway and Italy report 40% to 48%. In contrast, Canada and the US show lower rates of 6% to 9%, and in parts of Africa, such as Nigeria, rates range from 12.08% to 66.7% (Adamolekum etal 2023; Orief et al., 2014).
Purpose: The study assessed the predictors of herbal products usage among pregnant women in State Health Facilities in, Osun State, Nigeria.
Methods: This study employed a cross-sectional descriptive research design to investigate the knowledge, usage, medical conditions, and factors influencing herbal medicine among 347 pregnant women in four Primary Health Care facilities in Osun State, Nigeria. Data were gathered using a self-developed and pilot tested questionnaire. Both descriptive and inferential statistical analyses, including chi-square tests, were utilized to examine the relationships between various demographic factors and the use of herbal medicine. The analysis was conducted at a significance level of 0.05, facilitating an evaluation of how demographic characteristics may affect the adoption of herbal remedies among the participants.
Result: The study results indicate that approximately 70% of pregnant women utilize herbal products, particularly during the first trimester, to alleviate symptoms such as nausea, vomiting, malaria, heartburn, backaches, and abdominal pain or indigestion. The herbal medicines commonly used during pregnancy include lime, bitter kola, bitter leaf, ginger, garlic, neem leaves, as well as moringa seeds and leaves. Furthermore, there was a significant association observed between factors such as religion, education, monthly income, pre-pregnancy herbal use, and the usage of herbal remedies during pregnancy at p \u3c 0.05
Conclusion: The findings of the study reveal significant socio-demographic factors that predict the usage of herbal medicine among pregnant women. Notable influences include religion, educational attainment, and average monthly income, with prior usage patterns . These results emphasize the necessity of understanding cultural beliefs and socio-economic contexts in shaping health behaviors
Reducing Patients’ Relapse in Schizophrenia Using a Community Model: A Quality Improvement Project
No full textRelapse in schizophrenia poses significant challenges for mental health management, especially in community settings (Almond, et al., 2018; Almuqrin et al., 2023). This quality improvement (QI) project aimed to reduce relapse rates in patients with schizophrenia in Bermuda by leveraging community empowerment and implementing an Assertive Community Treatment (ACT) model. The project engaged a cohort of 59 high-risk patients and focused on interventions such as medication adherence, social support, vocational activities, and training community members and family in relapse prevention. Over a six-month period, from November 2023 to May 2024, the project sought to decrease relapse rates from 87% to 50%. Key findings indicated significant improvements: 92% of patients adhered to prescribed medication regimens, 98% participated in community job placements, and there was a progressive increase in trained community members (from 50% to 100%). The relapse rate was successfully reduced to 51% by May 2024. These outcomes reflect the efficacy of ACT in supporting schizophrenia patients through community-based, holistic care, and enhancing their recovery and integration (Docherty et al., 2020; Latalova et al., 2021) The project also highlighted the importance of family engagement, regular follow-up with healthcare professionals, and addressing comorbid conditions. Recommendations include sustained community support, improved nursing education, and the implementation of telepsychiatry for wider service accessibility. The findings suggest that adopting the ACT model can significantly improve relapse prevention and mental health outcomes in community settings
Before the Buzz, it was Competency Based!
No full textWith emergence of the buzz words “competency-based education” (CBE) nurse educators can determine how to evaluate student competency. Aimed at facilitating competency development, program curriculum can be examined through the lens of Miller’s Pyramid of Clinical Competence (Miller, 1990; Sam et al., 2020; Lavery, 2022; Hampton et al., 2024).Less than satisfactory certification exam success prompted a high-level meeting with university leadership. A novel question was posed as to how every program course promoted certification success. The graduate program leadership were charged with maximizing core course contributions to certification success. A curriculum review identified underutilization of university provided third-party resources in three core courses which identified an opportunity for program enhancement.An innovative curricular approach was devised for maximizing contributions of three core courses; advanced pathophysiology, pharmacology, and health assessment - previously referred to by AACN (2011) as the ‘Direct Care Core’ or the 3Ps. The innovative design leveraged university provided third-party resources to promote student competency development prior to entry into the first clinical experience. Restructuring course activities ensured alignment of paid resources with weekly teaching and learning strategies. Student success was supported with assignment of a success coach to facilitate competency development.With restructuring in place, a decision was made to utilize a national standardized exam as an innovative approach for assessing student 3Ps competencies. This is also known as the clinical proficiency exam which requires a student to achieve the benchmark score before being permitted to enter their first clinical course. Aligned with CBE principles, students who do not achieve the benchmark are provided a success coach and an individualized remediation plan prior to subsequent attempts on the exam.Implementation of a CBE approach, such as described, provides the opportunity to improve clinical judgment in new graduate and advanced practice nurses (Lewis et al., 2022).This innovative CBE approach increased certification exam pass rates from an 86% to a 92% at the end of the next year. Certification exam rates continue to increase with each testing cohort utilizing this CBE model. Following launch of this initiative, preceptor evaluations of clinical performance demonstrates positive feedback about the high-level of student competency
Knowledge About Intellectual Property Rights Among Faculty: A Cross-Sectional Survey
No full textBackground: Any original work of human mind, whether it be artistic, literary, technological, or scientific, is considered intellectual property (IP). The legal rights granted to an inventor or creator to safeguard his creation for a specific amount of time are known as intellectual property rights, or IPR. For a specific amount of time, these legal rights grant the inventor or his assignee the sole right to make full use of his creation. In the healthcare sector, where innovation is what propels better healthcare, intellectual property legislation is essential. This study aimed to assess the knowledge of Intellectual property rights among nursing faculties of selected colleges of nursing in Uttarakhand.
Methodology: A descriptive cross-sectional study was conducted on a convenient sample of 100 nursing faculties. Data was collected with a self-structured validated questionnaire consisting of 31 questions on knowledge about intellectual property rights.
Results: 49% of the participants had moderate knowledge and 48% of them had adequate knowledge while only 3% demonstrated inadequate knowledge about IPR. Binary logistic regression analysis has shown that knowledge of participants has a statistical significant association with the number of publications.
Conclusion: This study showed that a significant number of individuals possess a moderate level of understanding but may benefit from further learning or refinement of their knowledge. Thus, conducting more workshops and seminars based on IPR should be encouraged
Program Evaluation of Delirium Screening, Notification and Management
No full textBackground: Delirium is an acute confusion state associated with poor health outcomes, such as increased mortality and long-term cognitive impairments (Fong & Inouye, 2022; Mattison, 2022; Pereira et al., 2023; Rieck et al., 2019). Hospitalized older adults, ages 65 years and older, and patients with dementia are at increased risk of developing delirium (Mattison, 2022; Pereira et al., 2023). Delirium is prevalent and occurs in 2.6 million hospitalized older adults every year (Fong & Inouye, 2022). Despite the adverse impact of delirium on health outcomes, delirium diagnosis is often missed in routine hospital care. While delirium identification is integral to the management of delirium, effective communication is equally fundamental to patients receiving appropriate care as communication failures result in up to 30% of medical errors (Huang et al., 2023).In 2023, a medical unit at a Pacific Northwest tertiary hospital only identified three percent of patients with delirium. With the intent of improving delirium identification, the medical unit implemented a new brief delirium assessment tool and notification workflow.
Aims: The aim of this program evaluation is threefold and will determine if 1) bedside nurses routinely completed the new abbreviated delirium assessment, 2) nurses notified providers of a positive screening result, and 3) providers entered the delirium order set.Details of Evaluation: A program evaluation will be performed to determine the impact of implementing an abbreviated delirium screening tool. The program evaluation will consist of reviewing electronic health records for older adults admitted to a medical surgical unit in a community-based hospital. Data collected will include documentation of delirium screening, provider notification method (i.e. via pager, EMR secure chat, etc.), and subsequent ordering of delirium order set. Data will be collected for three months pre and post implementation of the new abbreviated delirium screening tool. Descriptive analysis will be performed for patient demographics. Inferential analysis will be performed for pre and post implementation data including delirium screening, provider notification and order set entry.Outcomes: Outcomes of this program evaluation may demonstrate that a brief delirium screening tool increases screening older patients for delirium. Strategies for the most effective communication method to increase delirium order set entry may be identified
Predicting Preceptorship: A Multi-State Survey Study
No full textPreceptorship, students working with expert clinicians, is a common model of clinical education for health professions. Preceptorship allows students to apply knowledge, refine skills, and adopt professional attitudes. However, an ongoing preceptor shortage hinders nursing education at all levels. The purpose of this study was to evaluate factors influencing nurse practitioners’ (NPs) decision to be preceptors. We deployed an online survey to NPs residing in the United States. We used quantitative and rapid qualitative analysis to evaluate the influence of 11 factors on preceptorship status and intent to be a future preceptor. We received 1,295 responses. Employer support, self-efficacy, NP program, clinical setting, incentives, and benefits of preceptorship, predicted status as a previous or never, compared to current preceptor. Attitude toward preceptorship predicted previous preceptors, while normative beliefs predicted never preceptors. Narrative responses highlighted clinical setting and lack of employer support as predictors of previous or never preceptors. These findings support previous studies of NP preceptorship. NP programs should develop strategies focused on employers, relationships with potential preceptors, and optimization of clinical placements. This study could be replicated with other nursing roles and professions to evaluate a common barrier to healthcare provider education
Qualities of an Effective Mentor in Clinical Practice: Insights From Nurses and Midwives in Rwanda
No full textIntroduction: Globally, many countries have adopted mentorship programs to support new and less experienced nurses in enhancing their skills (Hoover et al., 2020). In Rwanda, mentorship has been a part of the professional development of nurses and midwives (Musabwasoni et al., 2020; Nyiringango et al., 2021). Mentorship offers numerous benefits, serving as a tool for professional growth and fostering camaraderie among nursing and midwifery professionals. From 2016 to 2020, a clinical mentorship program named Training, support, and Access Modal (TSAM) was implemented to help nurses and midwives improve their competencies in providing maternal and neonatal care at selected health facilities in Rwanda (Ngabonzima et al., 2020). This study aimed to explore the lived experiences of nurses and midwives who participated in the TSAM mentorship program as mentees.
Methods: This study used interpretive phenomenology (van Manen, 2023). The author conducted 28 in-depth individual interviews to explore participants’ experiences. Audio-recorded Kinyarwanda interviews were transcribed and translated in English. The author organized and conducted initial coding with NVivo software and performed a thematic analysis based on Crist and Tanner\u27s (2003) framework. Western University (project ID: 111866) and the University of Rwanda (No 359/CMHS IRB/2019) institutional review boards approved this study.
Results: More results from this study were presented elsewhere. Participants identified key qualities of an effective mentor, which include: 1) facilitation skills, 2) advocacy skills, 3) role modeling skills, and 4) interpersonal skills.
Conclusion: In numerous low- and middle-income countries, clinical mentors play a crucial role in the ongoing professional development of nurses and midwives, which can help alleviate workforce shortages. Health institutions must foster a mentorship culture and allocate dedicated time for mentors and mentees to engage with one another. Additionally, funding is essential to facilitate mentorship activities in these countries