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Transforming Nurse Leaders: The Power of Flexible Schedules in Healthcare
No full textPurpose: This pilot feasibility study investigated the impact of flexible work schedules on the mental, psychological, and physical health of healthcare workers within a large hospital system, aiming to identify innovative leadership strategies for workforce planning and development.
Background: Traditional work schedules often negatively impact productivity, well-being, and job satisfaction, contributing to challenges in recruiting and retaining nurses. This study explored the feasibility and benefits of flexible work schedules as a leadership initiative to improve workforce well-being and retention.
Methods: A quasi-experimental, mixed-methods, time-series design was implemented across a 12-hospital system with the partnership of 4-Day Global. Eligible leadership teams were encouraged to flex their work hours daily or at least weekly. Clinical leaders ensured coverage during flexible work periods. Participants were surveyed at baseline, midpoint, and post-trial to assess work time, job conditions, well-being, and environmental factors.
Results: A total of 173 exempt healthcare workers participated, representing the largest cohort studied globally on flexible work schedules in healthcare. While flexibility varied, all teams experienced significant improvements in well-being, work-life balance, and organizational outcomes. Notably, the team with complete schedule autonomy demonstrated the most significant improvements, suggesting the importance of agency and ownership in flexible work arrangements. All improvements were highly significant (p \u3c .001), except for a significant reduction in work absenteeism (p \u3c .01), exercise and pro-environmental behaviors (p\u3c.05).
Limitations: Study results may not be generalizable due to the short duration (six months) and the limited participation of only exempt healthcare workers.
Conclusions: This pilot demonstrates the feasibility of implementing flexible work schedules as an innovative leadership strategy to enhance workforce well-being, improve job conditions, and promote work-life balance without compromising patient care. This approach supports the development of future leaders by empowering nurses with greater autonomy and control over their work schedules
An Interdisciplinary Tabletop Simulation for Disaster Preparedness in Nursing Education
No full textThe purpose of this study was to explore the effectiveness of an interdisciplinary tabletop simulation on student learning outcomes and American Association of Colleges of Nursing core competences related to disaster preparedness.Nurses deliver a variety of services in the community and acute care settings and have historically been highly active in volunteerism. Disaster preparedness education can prepare future nurses to meet the needs of their communities during these emergency situations. There are opportunities to provide disaster preparedness education to nursing students using the AACN competencies and domains related to disaster response through simulation.This IRB reviewed mixed methods study documented whether students met AACN competencies related to disaster preparedness. This was a classroom tabletop simulation activity facilitated by public health and nursing experts. Data collection included a 13-question guided worksheet and 10 patient scenarios to triage. Students worked in small groups answering questions related to prioritization of patients and resources, coordination response, communication, safety, and support. Data from questionnaires were reviewed using a rubric and reviewed for themes.A rubric was developed by faculty to identify if each AACN competency was met with a scoring of Excellent (4), Proficient (3), Developing (2), and Remediation Required (1). Any student group scoring Remediation Required (1) did not meet the competency. There were nine groups of students between the two classes. Four groups met all six competencies. The remaining five groups failed to meet one or more of the AACN competencies. Themes from debriefing and reflections highlighted the importance of interdisciplinary teamwork, cultural awareness, prioritization, and ongoing disaster preparedness education.There are opportunities to provide disaster preparedness education to nursing students using the AACN competencies and domains related to disaster response through a tabletop stimulation. Tabletop simulations and unfolding case studies engage students through the cross-disciplinary applications of material learned in the classroom. Students continue to develop their critical thinking and problem-solving skills as they analyze situations, weigh options, and make difficult decisions. This in-class activity was conducted in a low-stress environment, alleviating the fear of failure while encouraging creativity and fostering risk-taking in problem-solving
Breaking the Silence: Addressing the Crisis of OSEC & the Knowledge Gap Among Health Professionals
No full textOSEC is a significant public health crisis globally. It involves the sexual abuse of minors through the internet, including creating, sharing, or possessing sexual material featuring children. OSEC is widespread yet often hidden due to its sensitive nature, making it challenging to address openly. The increasing use of digital technology and social media exacerbates this problem, providing predators with more tools to exploit children.
Children are especially vulnerable, facing serious threats to their physical and emotional well-being. Despite global efforts to combat OSEC, the ubiquity of the internet and advancements in technology have made prevention and intervention difficult. Early identification and support are critical, as the long-term effects of any form of child abuse can be devastating.
Effective strategies to address OSEC must include normalizing difficult conversations, educating children on safe internet practices, and equipping parents and guardians with tools to protect their children. Healthcare professionals are uniquely positioned to educate patients and families, providing essential preventive measures and resources.
To understand healthcare professionals\u27 perspectives on OSEC, a qualitative study was conducted. A small, convenience-sampled cohort participated in interviews to assess their knowledge of OSEC, their openness to screening questions, and their perceived roles in addressing this issue. Themes emerging from the analysis revealed significant gaps in knowledge. Participants were generally unaware of OSEC’s term, prevalence, and scope. The findings suggest that baseline education about OSEC is more urgent than implementing screening tools.
Healthcare professionals must be educated in three critical areas to combat OSEC effectively:
Understanding OSEC: Its definition, prevalence, perpetrator tactics, and impact on children’s mental and physical health.
Age-Appropriate Communication: Strategies to discuss OSEC with children during clinical interactions, fostering awareness and trust.
Parent Engagement: Tools for guiding parents and caregivers to recognize warning signs and implement preventive measures.
By bridging the awareness gap and enhancing healthcare professionals\u27 preparedness, this initiative aims to protect children from OSEC and empower healthcare providers to be proactive advocates in combating this global crisis
Incivility in Graduate Nursing Online Environment
No full textIncivility is rampant in nursing. The most frequent targets are student nurses, newly graduated nurses, or nurses moving into a new area. Authors suggest faculty should role model civil behaviors for nursing students. Unfortunately, incivility also occurs in nursing education. Much has been written about faculty targeting students. Recently, incivility from students has been identified. In our graduate nursing program, faculty identified an increase in uncivil student behavior. We sought to determine if faculty and student perceptions of incivility were the same and if differing generations were a factor in the perception of uncivil behavior.
Students enrolled in online graduate nursing courses (N=2,400) and faculty teaching these courses (N=135) at a midwestern regional university were recruited. Participants completed the Incivility in the Online Learning Environment tool electronically.
A total of 110 participants fully completed the data collection, 93 students and 24 faculty. Most participants were working full-time (67.24%) and were members of the Generation Y cohort (50.86%).
One student behavior, challenging faculty knowledge was always considered uncivil by faculty, but most students felt it was usually uncivil. Students identified failing to fulfill group responsibilities as always uncivil while faculty reported it as usually uncivil. Faculty identified failing to complete assignments in a timely manner, taking credit for others’ work, challenging faculty knowledge, and failing to fulfill group responsibilities occurring sometimes/often during the last twelve months. Faculty behaviors of unclear syllabi/expectations and lack of timely response were viewed as uncivil by students.
Faculty (66.67%) and students (63.0%) reported incivility as a mild or moderate problem. Students identified students as a little more likely and faculty felt students were much more likely to engage in uncivil behavior. Both groups rated the level of civility within the online program as 81% to 100%
An Interprofessional Approach to Advanced Birth Planning for Special Babies and Parents
No full textIntroduction: This community hospital in Southeast Texas strives to provide unparalleled care to even the most unique patients. According to the Centers for Disease Control and Prevention (CDC, 2023), Trisomy 13 affects one in every 6,967 births, and Trisomy 18 affects one in every 3,336 births. A more staggering statistic is that one in 33 births is impacted by some form of birth defect in the United States each year (CDC, 2023). There were minor differences in the historical pattern of caring for patients and babies with special circumstances. After delivery, mothers faced with birth defects and fetal demise were strategically roomed in a quiet area. However, there was no special care plan to meet the mental and emotional needs of a grieving mother. Looking back, we did not do enough to care for these patients!Methods: This hospital noted an increased volume of babies with birth defects and fetal demise in the past year. Following the literature, we formed an interprofessional team to better meet this unique population\u27s needs. The team included neonatologists, the obstetrician, childbirth center leadership, the neonatal program manager, palliative care (PC) team, and spiritual care team (Bucholtz et al., 2023). The purpose was to meet with expectant parents early in the pregnancy to provide information, discuss treatment options versus comfort measures, introduce hospice and funeral preparations, provide grief resources, answer questions, understand the parents’ wishes, and develop an advanced birth plan (Bertraud et al., 2023; Leuthner et al., 2020).Results: In spring 2024, the interprofessional team met with expectant parents and a grandmother at 28 weeks gestation to begin drafting a unique birth plan. The expectant parents voiced their wishes for PC and to spend as much time as possible with their baby after delivery. The PC social worker assisted with funeral preparations, support and counseling resources, and Trisomy information between the interprofessional meeting and delivery.Conclusion: At delivery and throughout the hospital stay, all members of the advanced birth plan, plus respiratory therapy, were on site and prepared to address the precious family\u27s unique needs. Parents and baby were discharged to home with neonatal hospice services (Weaver & Boss, 2022). Interprofessional advanced birth planning is now hardwired and a best practice at our hospital. It can be applied at any women’s services unit to improve care for all special babies
Enhancing Management of Hospitalized Patients with Opioid Withdrawal
Get PDFOpioid use disorder (OUD) impacts over 1.2 million people in the United States. This population suffers from multiple comorbidities which can result in the need for hospitalization. Managing opioid withdrawal in hospitalized patients is challenging. Assessment tools like the Clinical Opioid Withdrawal Scale (COWS) help healthcare providers determine appropriate interventions to alleviate withdrawal symptoms for these patients. This quality improvement project aimed to decrease the number of incidents of violent behaviors and/or patients leaving the hospital against medical advice (AMA) during opioid withdrawal and enhance nurses’ ability to perform the COWS assessment. Organizational data from a 402-bed acute care hospital demonstrated a need for an evidence-based intervention to screen patients for opioid withdrawal and treat its symptoms, which may contribute to violent behaviors and/or leaving AMA. Patients screening positive for OUD were offered treatment, including COWS assessment and interventions based on the COWS score. Frequencies and percentages are reported for numerical variables. A Fisher’s Exact test was conducted to determine any potential associations between COWS, AMA, and violent behavior. A two-tailed z test was performed to evaluate the significance of the COWS assessment in relation to AMA and violent behaviors. Descriptive statistics evaluated nurses’ ability to administer the COWS. There was no statistical significance between COWS, AMA, and violent behaviors which could be a result of low acceptance of treatment. Nurses performed and documented the COWS assessment correctly 82% of the time. Despite the lack of statistical significance, this project holds substantial clinical importance for highlighting the need to treat hospitalized patients for opioid withdrawal
Caring with Courage: A Bone Marrow and Hematopoetic Stem Cell Transplant Caregiver Instructional Class and Support Group
Get PDFInformal caregiver preparedness plays a crucial role in successful cellular therapy recovery. An interdisciplinary workshop was implemented between 1/2019 and 5/2024 to educate caregivers on symptom management, infection prevention, safe food handling, discharge planning, home safety, and internal and external supportive services. This quality improvement project aimed to increase confidence in caregiver-related tasks
Effects of Dyadic Motivational Interviewing (MI-Dyad) Program for Improving Activity Participation of Stroke Survivors and Family Caregivers: A Mixed-Methods Feasibility Study
Get PDFThis study aimed to assess the feasibility, acceptability and preliminary effects of a dyadic motivational interviewing (MI-Dyad) program for stroke survivors and family caregivers (i.e., stroke dyads) (Trial registry: Chinese Clinical Trial Registry ChiCTR2500100532)
Earthing Practice for Mental Health Among Adults in the United States: A Phenomenological Inquiry
Get PDFThis study aimed to explore the lived experience of adults in the United States who practice earthing for mental health
Decreasing the Incidence of Residual Neuromuscular Blockade
Get PDFThe presence of muscle weakness after the administration of a neuromuscular reversal agent is described as a residual neuromuscular blockade (RNMB) due to an incomplete antagonism of a neuromuscular blocker. To decrease the incidence of RNMB, the American Society of Anesthesiologists (ASA) strongly recommends quantitatively monitoring the degree of neuromuscular blockade perioperatively and extubating the patient when the train-of-four (TOF) ratio is greater than or equal to 0.9 at the adductor pollicis. There are acceleromyography (AMG) based and electromyography (EMG) based quantitative monitors; the limitations of AMG have been addressed by EMG