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Valid and Reliable? Psychometric Evaluation of a Preceptorship Survey
No full textHealth professions use a preceptorship model for clinical education. Numerous studies have evaluated barriers and facilitators to nurse practitioner (NP) preceptorship. However, few used theory-guided, psychometrically-sound, survey instruments. My purpose was to develop and test validity and reliability of a preceptorship survey, using the Integrated Behavioral Model (IBM) as a framework. I developed a pool of 82 survey items that reflected 11 constructs in the IBM from published literature and unpublished research findings. Eight faculty and 12 NP preceptors evaluated content-validity and clarity of the items, and one item was removed. The survey was deployed to a sample of 125 NPs and scale reduction techniques were used to condense the instrument to 60 items, with Cronbach’s alpha (α) for subscales ranging from 0.725 to 0.944. The online survey was deployed to a national sample of NPs, with 1295 valid responses. A subset of 154 participants repeated the survey after 2 – 4 weeks to evaluate temporal stability of responses (test-retest reliability) using intraclass correlation coefficient (ICC). Upon completion of data collection, I used exploratory factor analysis to isolate 11 factors that mirrored the constructs in the IBM. I used confirmatory factor analysis to evaluate average variance extracted (AVE), average shared variance (ASV), and maximum shared variance (MSV) of the subscales and further refine the survey instrument. The final survey instrument consists of 41 items and 11 subscales. Subscales have acceptable internal consistency (α = 0.707-0.937), discriminant validity (ASV \u3c AVE and MSV \u3c AVE), and test-retest reliability (α of ICC = 0.739 – 0.908). All but one subscale has acceptable convergent validity (AVE \u3e .5). The resulting survey instrument is psychometrically-sound and could be adapted for other nursing roles and professions
Integrating Social Determinants of Health Into Advanced Health Assessment: A Sustainable Model
Get PDFSocial Determinants of Health (SDOH), including economic stability, access to quality healthcare and education, neighborhood characteristics, and social context, are critical factors influencing the health and well-being of individuals and communities.1 These factors are recognized as core objectives by Healthy People 20302 emphasizing the need for healthcare providers to address SDOH in clinical settings. The purpose of this initiative was to integrate content on SDOH into an Advanced Health Assessment for Advanced Practice Nurses (APNs) course, a foundational course for all APN students. Building content in this course sets the stage for further integrating this essential content and scaffolding throughout the APN programs to prepare our students to address significant health disparities and promote health equity.3This initiative was structured in multiple phases, beginning with the assessment of best practices for content on SDOH for health sciences, evaluation of current course content, identification of gaps, and development of new SDOH curricular components. Phase one included a literature review to inform curriculum changes. Subsequent phases involved detailed planning, curricular design, and integration of SDOH content in the Advanced Health Assessment course through interactive learning activities, case studies, and simulations, followed by content deployment and course evaluation. The initiative aimed to ensure that APN students across all specialties, including family, adult-gerontology, pediatric, acute care nurse practitioner, and nurse-midwifery, receive foundational advanced practice content on SDOH, to prepare them to consider SDOH and address these effectively in clinical practice.4The implications for the nursing profession are profound, as this initiative enhanced the competency of future nurse practitioners and midwives in recognizing and mitigating the impacts of SDOH on patient health. Additionally, this initiative has global implications by providing a model for SDOH integration into nursing education, potentially influencing curricula worldwide
Building Nursing Leadership Science With Impact: A Personal Journey and Program of Research
No full textThis presentation describes a program of research focusing on leadership science and health services outcomes covering a two decade journey to the Sigma International Nurse Researcher Hall of Fame. The presenter shares key transitions, learnings, outputs, dissemination, and policy impact associated with her work
Integrating Genomics into Nursing Education
No full textPrecision health aims to tailor care for each person by incorporating genomic data and other biological information with relevant environmental, behavioural, and social determinants of health. Nurses, the largest healthcare profession globally and experts in the provision of personalized, holistic care, have a vital role in safe, quality, evidence-based precision healthcare (Dewell et al., 2024). To fully participate, nurses require an understanding of genomics relevant to their practice (Campion et al., 2019). However, integration of genomics into nursing curricula is highly variable (Calzone et al., 2018). This is in part due to lower levels of genomic knowledge among nursing faculty who need support and strategies to deliver genomics education and assess all domains of student learning (McLaughlin et al., 2024; Thomas et al., 2023). By taking advantage of existing approaches and technology, nurse educators can be supported to seamlessly integrate genomics into existing curricula. In this presentation, we will use a train-the-trainer model using examples to highlight where and how to integrate genomics from foundational science to specialized practice in both undergraduate and graduate-level programs. We will describe key resources to help with course and program revision. Nursing education must adapt to the changing approach to healthcare and be nimble enough to incorporate new information, technologies, and changes to practice as genomic science advances. Using and building on initiatives that have been developed and evaluated is vital to transforming curricula that prepare nurses for up-to-date, evidence-based practice in an evolving healthcare landscape
Dilemmas and Prospects of Infectious Disease Prevention in Long-Term Care: A Qualitative Study
No full textAim: To explore the experiences of long-term care workers in preventing emerging infectious diseases, the challenges they faced during the pandemic, and how they were addressed.
Design: This study used an exploratory qualitative research design.
Methods: The study involved various long-term care institutions across Taiwan. Twelve interviewees, including four nurses, four nursing assistants, and four managers, were recruited via purposive sampling. All interviewees worked in the sector during the COVID-19 pandemic, were actively involved in clinical care or institutional management, and were proficient in Mandarin. In-depth interviews were conducted face-to-face between July and August 2024, and data interpretation was guided by thematic analysis.
Results: Four themes emerged. Two themes depicting dilemmas, “Islands Amid the Storm” and “Cracks in the Armor – Frontline Fragility”, illustrate the challenges of inadequate preparation, including technical, cultural, and communication barriers, noncompliance of family members, and resource shortages, and the physical and emotional strain endured by the frontline workers balancing duty with feelings of guilt and anxiety, respectively. The two forward-looking themes representing prospects of long-term care, “Enhancing Stability Through Preparedness and Participation” and “Building a Shield in Uncertain Times”, highlight the importance of continuous education, simulation-based training, and fostering participation, alongside the need for adaptive surveillance and tailored crisis response plans.
Conclusion: This study highlights the pivotal role played by long-term care institutions during outbreaks of emerging infectious diseases and the significant challenges they faced during the COVID-19 pandemic. The findings offer actionable recommendations based on the firsthand experiences of workers and serve to inform routine practices, enhance emergency response strategies, and support the development of more effective pandemic prevention policies within these institutions
Sexual Attitude Towards Adolescents Use of Online Sexual Content
No full textThe general objective of the study was to determine the relationship between the use of sexual content online and sexual attitudes in adolescents. The study design was descriptive-correlational. The sample consisted of 260 adolescents between the ages of 15 and 19 from a public high school in Monterrey, Nuevo León. A 95% confidence level and a power level of 90% were estimated. A sociodemographic data sheet and the instrument for the use of sexual content on the Internet and the scale of sexual attitudes were applied. Descriptive and inferential statistics were used, as well as the Spearman correlation coefficient and the Mann-Whitney U test. The mean age of the adolescents was 16 years (SD=1.22), 78% of the participants were male. It was identified that 33% of the participants use the Internet for sexual content online and 90% of these prefer to do so alone and at home. A significant relationship was found between sexual attitudes and the use of sexual content online by adolescents (rs=.189, p\u3c .01), no significant difference was found in the time and frequency that adolescents spend using sexual content according to the adolescent\u27s gender (p= .587). No significant relationship was found between sexual attitudes and the use of sexual content online in male adolescents (p= .242). It was identified that 100% of the students had access to the Internet through a computer, cell phone or tablet. Therefore, it can be observed that the Internet is increasingly accessible to adolescents, so it is necessary to propose online intervention strategies to minimize the risk they face when using information and communication technologies
Driving Excellence and Retention Through Professional Development Opportunities
No full textBackground: Clinical recognition advancement programs are invaluable for sustaining the development of clinical nurses and have been associated with improvement in nursing satisfaction and retention (Mijares & Radovich, 2020). At a large academic teaching institution in New Jersey, a voluntary clinical ladder program recognizes professional advancement through structured opportunities that align with institutional goals.
To participate in the program, criteria for each level are defined in domains of practice that reflect the ANA standards of professional practice and organizational values (Kanaskie & Reynolds, 2020). Submission of an electronic portfolio is required and reviewed by two committee members to ensure standards.In 2023, increased portfolio resubmissions regarding the program were notable. These incidental findings demonstrated the need for additional mentorship to encourage first-time submission and limit the need for resubmission.
Method: Targeted initiatives have enhanced program visibility, streamlined the application process, and offered mentorship for future participants. Creation of introductory and informational courses offered nurses an opportunity to clarify details about the program.
Discussion: The in-person and virtual live sessions provided ease of access to information. The courses awarded contact hours to participants, which promoted the importance of career advancement. The course reviewed professional development opportunities highlighting areas of leadership, volunteerism, research and innovation, preceptorship workshops and other initiatives related to the organization’s goals.
Successful completion of the program involves hospital-wide recognition award ceremony, ceremonial pin, lunch, and games (Bremer, 2020).
Conclusions/Implications for Practice: For future program initiatives, one goal is to focus on new graduate nurses and foster their organizational involvement and lifetime learning. The findings suggest that expanding access to professional development resources is vital to empowering nurses, allowing for professional advancement, and driving continuous improvement in patient outcomes
Improving Safe Practices for Firearm Storage in a Pediatric Primary Care Setting
No full textBackground: Firearm injury contributed to 15,706 pediatric deaths in 2019 (Xu et al., 2021). The number of children injured in these accidents exceeded motor vehicle collisions for the first time in 2019 (Andrews et al., 2022). While such events are preventable, gun violence is the leading cause of death in children under 19 years of age (Andrews et al., 2022). Thus, there is an urgent need to stop this source of pediatric morbidity and mortality.
Objectives: The aim of this DNP project was to evaluate whether providing a trigger lock safety device with firearm storage training using the Health Promotion Model effectively educating parents to use secure gun storage habits in the home to prevent pediatric injury.
Methods: A quasi-experimental design for a prospective study utilized a pretest and posttest strategy employed in a rural, pediatric primary care setting.Results: The study assessed the storage practices of firearms in the home and did not find a change in practices between families provided a trigger locking device with storage education compared with families provided education alone (χ2 (2, N = 152) = 4.423, p = .219).
Conclusion: The research questions pertaining to the storage practices of firearms in the home were fully answered. The provision of a trigger-locking device did not significantly change practices in this group. Implications for future nursing research and advancements in clinical practice should focus on more family education outcomes measurement
Multidisciplinary Mass Casualty Simulation Toolkit
No full textBackground/Introduction: The United States continues to experience mass casualty events at a staggering rate [1]. The preparation of healthcare students in both undergraduate and graduate programs can be supported with enhanced preparedness through a disaster simulation event. [3, 5] Specialized training with SMART Triage, Stop the Bleed, enhanced nursing, athletic training, police and cadets response to a mass casualty event. The application of a formalized toolkit allows for seamless construction of a disaster simulation supported by INACSL simulation best practice.Purpose: An extensive search for an all-inclusive disaster simulation toolkit revealed a gap in available resources. The presentation will share a formal toolkit for disaster simulation design, preparation, implementation, and assessment.Methods: The toolkit includes specific directions for wound design with moulage training, moulage station supply list, disaster scene victim map, victim clothing with information tags, first responder supply bags, pre- post survey, and debriefing guide. Procedures to run simulation: Extensive moulage training, SMART Triage and Stop the Bleed didactic instruction; sophomore nursing and athletic training students standardized victim preparation.Results: The use of self-designed pre- post- questionnaire measured students\u27 understanding of role, ability to apply the SMART algorithm, level of anxiety, and empathy with patients. The results indicated a decrease in anxiety and increase in an understanding of role, empathy, and abilities in applying the SMART triage algorithm. Students reported in debriefing the challenges with triaging in such a realistic disaster event. Faculty from the interdisciplinary team assessed the effectiveness of the simulation and feedback provided toolkit improvements for future simulations.Conclusion/Implications for Practice: The Interdisciplinary Mass Casualty Simulation Toolkit provided an organized, evidenced based approach to the design, implementation, debriefing and assessment of a disaster simulation. The foundation of simulation allows participants the opportunity for active learning in a safe environment and created a transferable learning environment to support students as they move from practice into the profession [2, 5]
Rewriting the Narrative: Empowering Healthcare Workers Through Storytelling and Posttraumatic Growth
No full textBackground: Recognizing the impact of trauma on healthcare professionals, the Echoes of Nursing storytelling initiative fosters a culture of healing and resilience within the workplace. By providing a safe space for self-expression and narrative medicine techniques, this program empowers individuals to process challenging experiences and rediscover purpose in their work.
Methods: This mixed-methods pilot study, implemented across a 12-hospital system, utilized journaling workshops, story drafting, and coaching to facilitate self-expression and exploration. Coaches employed narrative medicine techniques like externalizing the problem, mapping, and re-authoring to empower individuals. Outcomes were measured using the Posttraumatic Growth Inventory (PTGI). Over two years, three coaches partnered with 80 storytellers, culminating in events with over 1000 attendees, including family, peers, and administrators. Post-event interviews informed thematic analysis.
Results: Storytelling fostered significant posttraumatic growth, with themes including rediscovery of purpose, connection, recognition of positive impact, gratitude for healing relationships, and adaptation. It provided a pathway for regaining control, uncovering deeper meaning, and fostering hope. The PTGI revealed significant growth in relationships and personal strength (50%) and newfound possibilities and appreciation (33%). Anecdotal evidence suggests Echoes may reduce burnout and improve nurse retention, contributing to a more positive and sustainable workplace culture.
Limitations: Limitations include a relatively small sample size and reliance on self-reported data. Further research is needed to explore the long-term impact of Echoes and its potential for wider implementation.
Conclusion: Echoes of Nursing demonstrates the power of storytelling in fostering a culture of healing and resilience within healthcare. This initiative empowers individuals to process trauma, find meaning, and rediscover purpose, contributing to a healthier and more supportive work environment. By promoting individual well-being and interprofessional understanding, Echoes strengthens workplace culture and enhances the overall healthcare experience