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Impact of Novel Rheumatic Heart Disease Education on Rwandan Nurses\u27 Knowledge and Skills
No full textUntreated group A streptococcus pharyngitis, along with the resulting post-infection sequelae of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) of young susceptible individuals occurs in lower income countries, including Rwanda. This is largely due to limited access health care and inadequate knowledge about the detection and treatment of the infection. Approximately 33 million people worldwide live with RHD. In Rwanda, the prevalence of RHD is estimated at 6.8 per 1000 school children. With only nine cardiologists serving a population of nearly fourteen million, there is a significant gap in accessible RHD care across the country. In Rwanda, nurses, estimated to number around ten thousand, are often the first healthcare professionals to encounter patients with RHD. However, these nurses are frequently found to lack the necessary knowledge and skills for effectively managing RHD patients. Patients with RHD require prompt disease recognition, early diagnosis, and an evidenced based management plan to be implemented for optimal patient outcomes. Nurses would benefit from an educational program to improve knowledge and skills in assessment, diagnosis, and management of Streptococcal pharyngitis, ARF and RHD. The focus of the educational program will include the recognition, diagnosis, and management of streptococcal pharyngitis, ARF, and RHD. The project design will be a train-the-presenter educational intervention with a pre-test and post-test to assess for the nurses’ Streptococcal pharyngitis, ARF, and RHD knowledge and skills following the program
Minority Stress in Nursing
No full textProblem. The physiological and psychological stress caused by adverse social conditions affecting minority groups impacts their ability to function in academia, the workplace, and other areas of life.
Purpose. This literature review examines the impact of minority stress on nurses\u27 and nursing students\u27 perceptions of their environment and overall satisfaction with the profession.
Search Strategy. Articles for this literature review were found using electronic databases CINAHL and PubMed.
Results. Twenty-two articles were selected for analysis. All articles were appraised using Joanna Briggs Institute tools to ensure validity.
Synthesis of Evidence. Nurses and nursing students belonging to a minority group report facing verbal and non-verbal prejudice from their patients and their peers. Recent evidence indicates that minority nurses who do not feel supported are at risk for decreased job satisfaction and are less likely to plan to continue their employment.
Implications to Practice. Building a culture of respect for minority nurses has been shown to increase retention, encourage the diversification of new nurses, and promote a nursing field that better reflects the diversity of the client population in the United States of America. Establishing support networks and affinity groups for minority nurses can offer a safe space for sharing experiences and strategies for coping with stress
Fostering Nursing Professional Identity Through a Comprehensive Teaching Strategy
No full textOBJECTIVES: Describe the significance of developing a strong professional identity in nursing. Explore methods for incorporating reflective practice as a teaching strategy to help nursing students internalize professional values. Integrate reflective practice to support the development of professional identity among students.
The development of a strong professional identity is crucial for nursing students as it shapes their values, behaviors, and attitudes towards patient care. This presentation will share a teaching strategy that was designed to incorporate the concept of professional identity in nursing. The strategy employed reflective practice to foster understanding of professional identity among nursing students.This presentation will describe how reflective practice was implemented with nursing students during orientation. Reflective practice encourages students to engage in self-assessment and critical thinking about their experiences and values. Through a guided reflection session, students explored their motivations for choosing nursing, their personal and professional goals, and the ethical principles that will guide their practice. This process helped students to internalize the values and standards of the nursing profession, promoting a sense of belonging and commitment. The activity encouraged students to reflect on their professional identity and expectations during nursing school. This initial reflective exercise helped students set the foundation for their professional identity journey, encouraging them to think deeply about their motivations and goals from the very beginning of their nursing education. By fostering reflective practice, this approach helped nursing students to build a strong, values-based professional identity that will guide their practice throughout their professional career. This strategy not only enhances the educational experience but also prepares students to become compassionate, competent, and ethical nursing professionals, exemplifying their professional identity
National Resources to Maximize Nursing’s Implementation Capacity and Influence
No full textThis presentation will describe the current availability of capacity building resources, pointing to ways of leveraging existing national resources and adding the nursing perspective. The panel’s consensus strategies will be outlined. Panelists will engage the broad base of nurse scholars in attendance to further delineate strategies. Recommendations will be solicited regarding implementation science theories, methods, and strategies that inform practice change and implementation science research through a nursing lens. The session will be summarized with a focus on the next bold steps to increase nursing capacity and influence on implementation science in research and practice
Medical Cannabis Conversation Between Adult Oncology Patients and Provider: The Impact of Provider Education
No full textBackground: It is estimated up to 40% of adult oncology patients use medical cannabis (MC) for a myriad of symptoms, including not limited to, nausea, pain, appetite, and anxiety. Conversely, less than one-third of oncology health care providers (HCPs) feel confident making cannabis recommendations. Furthermore, studies have shown low disclosure rate and poor communication between oncology patient and provider regarding integrative medicine, which includes cannabis. This study sought to examine the degree of correlation between the desire for information regarding cannabis in the adult oncology population, the level of communication regarding cannabis between patients and providers, and educational efforts to move toward an evidence-based discussion.
Methods: A two-page questionnaire was provided to adult oncology patients currently receiving treatment at the Eleanor N. Dana Cancer Center. They were asked if a member of the healthcare team discussed medical cannabis within the last 3 months. An educational session reviewing ASCO Cannabis guidelines was held for Oncology Physicians, Nurse Practitioners, and Registered Nurses. HCPs were provided questionnaires for pre- and post-education. The patient questionnaire was then repeated within 3 months of the educational intervention.
Results: Sixty percent of patients wanted medical cannabis information. Of those patients, 40% percent were waiting for HCPs to bring up the topic. Most conversations were with a physician or nurse practitioner. Pre-education 23% of HCPs knew the ASCO guidelines existed; however, 0% had used them. Conversely, post-education session, 85% plan to use ASCO guideline to aid in cannabis discussion.
Conclusions: Of the conversations that did take place among patients and HCPs, 100% of patients found it helpful. Post education session, 61% of HCPs were ‘very likely’ or ‘somewhat likely’ to discuss MC with patients
Understanding Medication Adherence Among American Indian/Alaska Native People with Type 2 Diabetes within a Commercial Health System
No full textAmerican Indian/Alaska Native (AI/AN) adults experience higher rates of type 2 diabetes and worse glycemic control than non-Hispanic White Americans. Despite the importance of medication adherence for T2DM management, there is only one study in the last 15 years examining the relationship between medication adherence and A1C among AI/ANs. Furthermore, T2DM research among AI/ANs has largely been conducted within Indian Health Service and Tribal healthcare systems, though most AI/ANs live outside of reservations, meaning many use commercial health systems. The purpose of this dissertation is twofold. We sought to first understand the experience of AI/AN people accessing T2DM in a commercial system, and second to identify and understand factors driving T2DM medication adherence, and the subsequent effect on glycemic control within the context of a commercial health system.
This dissertation consists of a systematic review of predictors of glycemic control among AI/AN people with T2DM, a qualitative study investigating the experience of AI/AN people within a commercial healthcare system receiving T2DM care, and a cross-sectional quantitative study of potential drivers of medication adherence and their relationship with glycemic control. Studies were conducted within a large, non-profit commercial health system in the Western United States. Participants of the studies were AI/AN adults, aged 18-65 with T2DM and an A1C measured in the previous year.
For our qualitative study, we conducted fifteen semi-structured in-depth interviews about experiences accessing the healthcare system for T2DM care. The following themes were identified: difficulty navigating health system bureaucracy, smart phones facilitating access to care, positive relationships with healthcare providers and a variable desire for cultural care accommodation.
The quantitative study gathered data from participant surveys and electronic health records. Potential predictors were defined using the World Health Organization Medication Adherence Model. Outcomes were medication adherence, measured as proportion of days covered (PDC), and glycemic control, measured as A1C. Among all predictors investigated, self-efficacy is the only significant driver of PDC. Furthermore, PDC was associated with superior glycemic control. It is important that clinicians evaluate medication adherence in routine clinical care, and leverage interventions that improve self-efficacy so patients can optimize both adherence and glycemic control
What’s In a Name?: Transgender People’s Affirming and Invalidating Experiences with Preferred Names
No full textTransgender and nonbinary (TNB) people’s gender identity differs from the sex they were assigned at birth. Approximately 1.6 million people identify as TNB in the US. Affirmation, the process of acknowledging a person’s gender identity, plays a significant role in the mental health and well-being of TNB people by reducing feelings of isolation, dysphoria, and anxiety. Invalidation, which occurs when a person’s gender identity is denied, can have significant adverse effects on the mental and emotional well-being of TNB people. This presentation explores TNB people\u27s affirmative and invalidating experiences related to using preferred names and pronouns. Twenty semi-structured interviews with TNB people occurred to gather data. To analyze the data, the researcher conducted a thematic analysis utilizing a six-step process. Two major themes emerged from the data: Feeling Invalidated and Receiving Affirmation. Feeling Invalidated describes the meaning and feelings TNB people experience when being misgendered whereas Receiving Affirmation explores the experiences of TNB when appropriately gendered. Implications for nursing education, research, and practice are discussed, highlighting the importance of using TNB people\u27s preferred pronouns and names when providing care
Mixed-Methods Evaluation of a Digital Resource for Interdisciplinary Delirium Education in Ireland
No full textBackground: Delirium is a common, underdiagnosed symptom of acute illness that can be prevented through early recognition and intervention. There is limited understanding of effective delirium education for pre-registration health students, and no evidence-based interdisciplinary digital resources exist. Using mixed methods, this study evaluates a co-designed digital tool for health students in Ireland to enhance their ability to prevent, identify, and manage delirium collaboratively [1-3].Methods: Phase 1 assessed health profession students’ knowledge and self-efficacy in managing delirium through validated pre- and post-intervention questionnaires, including the Delirium Knowledge Questionnaire and a self-efficacy measure. Usability was evaluated using the System Usability Scale and open-text feedback. In Phase 2, focus groups were conducted to explore students\u27 practice post-intervention. Data were analysed using descriptive statistics, paired t-tests, and thematic analysis to assess changes in knowledge, self-efficacy, and usability.Results: A total of 511 participants from two universities in Ireland took part in the study, including 316 nurses, 118 medics, and 77 allied health professionals (pharmacists, occupational therapists). Statistically significant improvements (p \u3c 0.01) were found in participants\u27 knowledge, self-efficacy, and confidence in managing delirium, with nurses and pharmacists demonstrating the largest gains. Six focus groups were also conducted 3 months post-intervention, involving 44 students from all disciplines. Thematic analysis revealed four key themes: ‘reframing delirium,’ where students felt empowered to support patients with delirium in practice; ‘delirium-friendly design,’ showing how students adapted clinical environments; ‘creative communication,’ reflecting improved verbal and non-verbal interactions; and ‘realities of delirium,’ highlighting suggestions for curriculum improvements.Discussion: This study demonstrates that digital resources can effectively improve delirium education for pre-registration health students. Significant gains in knowledge, self-efficacy, and confidence were found, especially among nurses and pharmacists. The focus groups highlighted how students applied their learning in practice, adapting care environments and communication for patients with delirium. These results suggest that digital tools can address gaps in delirium training and should be integrated into health education curricula
The Impact of Removing Concepts of Health Equity from US Nursing Education: A Scoping Review
No full textPurpose: Racial bias contributes to health disparities. Efforts to increase awareness of principles of diversity, equity, and inclusion (DEI) are needed to reduce health disparities. Increasing diversity of the U.S. population highlights an imperative that student nurses graduate with the skills necessary to care for all patients. Proliferation of anti-DEI laws has meant that in some states, faculty are not able to teach about diversity and the root causes of health disparities. Some faculty have reported they are removing content related to social determinants of health from their lectures and readings for fear of losing their jobs. The purpose of this project is to determine how anti-DEI laws have affected nursing faculty and their ability to teach health disparity.
Methods: To date, 10 states have implemented anti-DEI laws and 8 have language that impact higher education. We reviewed the laws of each state to determine the extent of restrictions and what content can be taught in the classroom. Concurrently, a scoping review of the literature was done to determine the extent of anti-DEI laws on nursing and other health profession faculty. This data will inform a mixed-methods study to determine the impact on nursing education. Findings from the study will be used to provide evidence to support reversing higher education restrictions.
Results: According to the U.S. Census Bureau Diversity Index, the diversity of the population is increasing; in 2010 diversity was 54.9%, in 2020 diversity was 61.1% and this trend is predicted to continue. Health disparities have not improved since the first Unequal Treatment report was released. The follow up report Unequal Treatment Revisited indicates that health disparities continue to persist among certain racial and ethnic groups. Four of the eight recommendations to address health disparities (increase minority health professionals, improve education on bias treatment, increase awareness of racial and ethnic disparities, address structural determinants of health) are forbidden by some states’ anti-DEI laws.
Conclusion: Censoring educational content that pertains to DEI is a disservice to nursing students and the public who will one day be treated by them. A solid understanding of health disparities, health equity, social determinants of health, and principles of social justice will help nurses deliver high quality care from a place of cultural humility. In the absence of these skills, unequal treatment will persis
Family Understanding of Intensive Care Unit Rounds: A Qualitative Research Study
No full textPURPOSE: The aim of this qualitative study was to explore whether families who attended rounds in the adult intensive care unit (ICU) understood the daily plan of care. National ICU societies support family attendance at ICU-rounds so families are fully informed.(Allum et al., 2022; Au et al., 2021; Calderone et al., 2022) Family satisfaction imay increase by attending rounds.(Blakeney et al., 2023; Debay et al., 2023) Yet little is known about how families use the information they hear.
PARTICIPANTS: Family surrogate decision makers were invited. The setting was a medical-surgical ICU in a university-affiliated hospital in the United States. Local ethics approval was obtained. Before rounds, all participants signed a consent form.
METHODS: Family members were interviewed in a private conference room using a semi-structured interview guide. Both ICU rounds and interviews were audio-recorded and transcribed verbatim. Transcripts were reviewed for accuracy and analyzed by two investigators to identify major themes.
RESULTS: Twenty–three family members (19 families) were interviewed. A comparison of recorded ICU-rounds transcripts, and interview transcripts demonstrated that families accurately understood the ICU plan of care. Two salient themes emerged.
Theme 1: Family Comprehension. Families\u27 understanding improved with repeated daily attendance at ICU rounds. Three distinct phases were identified (1) Shock (first attendance); (2) Deciphering Medical Jargon (attended several times); (3) Listening for changes (attended many times). Medical terminology was an initial barrier to comprehension. A simplified summary at the end of rounds helped families comprehend the plan.
Theme 2: Communication Responsibilities. Family members described a responsibility to communicate daily updates to a wider family and friend network. Summaries were composed and distributed by phone, email, or group-text immediately after rounds. Close family members received detailed texts, and the extended network received an overview. These communication tasks were not disclosed to nurses and physicians. This intra-family communication role has not previously been described in the literature.
IMPLICATIONS FOR PRACTICE: It is essential when family members attend rounds, that a brief, simple summary of the daily plan of care be provided at the end. This summary helps family members understand the ICU plan and ensures accurate dissemination to their extended family network