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Collaborative Post-Doctoral Program for Sigma DNP and PhD Members: A Proposal for Action
No full textOver the past decade, there has been a global focus on increasing the number of doctorally prepared nurses to advance nursing education, expand the body of knowledge, and promote the status of nursing as a research and evidence-based profession. Upon completing doctoral studies (PhD or DNP), nurses are expected to continue developing by engaging in coursework and professional activities to produce scholarly work for further development. Globally, accessibility to postdoctoral studies varies significantly, and there is a lack of leadership and career development frameworks in both clinical and academic pathways. A significant challenge is combining postdoctoral studies with a work position and household work. Moreover, the costs of the post-doc program and the financial burden create a significant obstacle for nurses who live far from centers of academic excellence.
As part of Sigma\u27s GLMC program and discussions in our mentoring dyads, we discovered challenges in providing continued development and integration of doctorally prepared nurses in both the academic and clinical settings in Israel and the United States. We shared this conversation with the entire cohort, and it was clear that this was a global issue with significant ramifications for leadership, mentoring, collaboration, and partnership. Suppose the profession is to realize the benefits of doctorally prepared nurses and the knowledge created by the quality improvement, evidence-based practice, and research they will produce. In that case, we, as a global community of nurse leaders, will need to examine this more closely and design strategies to support the entire professional development pipeline. We reviewed the literature and will outline interventions and strategies that inform hybrid-type models of professional development strategies that address the global issue and provide access to a global impact. After several attempts to find postdoctoral programs accessible to female academic faculty from Israel, an idea arose to examine the possibility of establishing a collaborative framework for online or hybrid postdoctoral studies within the Sigma organization. Sigma\u27s academies, the New Academic Leadership Academy and Experienced Academic Leadership Academy, can serve as a basis for establishing the infrastructure to promote the idea through global cooperation using the platforms under Sigma\u27s umbrella. In this lecture, we will examine this proposal
Innovative Leadership for Success Among BIPOC and First-Generation Students
No full textBackground: The literature review reveals that Black, Indigenous, and People of Color (BIPOC) and first-generation college (FGC) students need more support during their college transition. Barriers to success include feeling uncomfortable seeking help while under stress, which can stem from racist attitudes on campus, feeling isolated, and the rigor of the nursing curricula that are often immediately pushed on BIPOC and FGC students.
Purpose: The Connecting Future Caregivers Program (CFCP) was developed to facilitate community-building and enhance academic success strategies, without positioning faculty and staff as benevolent authorities providing knowledge to BIPOC and FGC nursing students,
Methods: This descriptive cross-sectional pilot study examined students’ satisfaction, and program outcomes after events in the CFCP. Sixteen nursing students participated in the CFCP that consisted of 5 in-person events including an early move-in event and 2 additional events each semester during the first year of college. These 1–2-hour events were scheduled around academic schedules with snacks, refreshments, and activities. Data were collected using post-event anonymous evaluation surveys that included Likert-type and open-ended questions.
Results: Students rated the events as helpful in a variety of ways. The Healthcare Theatre© event increased students\u27 understanding of how to ask patients clarifying questions when communicating (5.00; SD-0.58) and body language use (5.29; SD-0.76). Just a few weeks into the semester, the study skills event revealed that some students reported having trouble studying (4.14, SD-1.57, range 2-6) and feeling overwhelmed with the amount of coursework (4.29, SD-1.11, range 3-6). However, most planned on using the discussed studying tips (5.57, SD-0.49, range 5-6).
Conclusion: Programs like the CFCP demonstrated that a more deliberate and proactive approach cultivates a supportive community for BIPOC and FGC nursing students. The CFCP offered students who represent underserved and underrepresented populations the ability to build life-long connections with their classmates, student mentors, and faculty members, and form relationships to help support them throughout their entire nursing career
Creating Impact Through Training: A Train-the-Trainer Model for Nurse Preceptor Education
No full textThe Academy for Clinical Instructor and Preceptor Excellence in the Southeast (CAPES), funded by a $3.9 million HRSA grant, addresses critical gaps in nursing education by training clinical nursing faculty and preceptors to support nurse education among nurses in underserved areas. CAPES is an innovative approach to workforce development, targeting health professional shortage areas in HHS Region IV. This presentation will showcase the creation of a train-the-trainer (TTT) program designed to offer an evidence-based curriculum that trained nurse preceptors can use to educate others within their organizations.
A Train the Trainer (TTT) program is an educational approach where experienced instructors train individuals to become trainers at their respective institutions or organizations. TTT programs enable organizations to scale training efforts by creating a multiplier effect. A small group of master trainers can educate many future trainers, reaching even more learners. Training local nurse trainers can deliver educational programs in multiple locations simultaneously, even in resource-limited or remote areas. This cost-effective model enhances training quality, fosters professional growth, and supports a sustainable nursing workforce.
During the development of a preceptor training program, qualitative feedback offered insight into the needs of the nursing workforce. It revealed that trained preceptors needed access to a program that would enable them to return to their organizations and train others, a TTT program. This program, grounded in evidence-based research, focuses on sharing the principles and best practices of nurse preceptor training. The curriculum design began after defining objectives that aligned with the competencies required for effective preceptorship. Curriculum design focused on essential topics such as: Teaching Techniques Interactive Training Methods Clinical Competency Development Communication Skills Technology Integration Well-being Inclusive Teaching Excellence
The CAPES Academy is dedicated to creating valuable resources and ensuring their distribution to nurses who need training materials for nurse preceptors. The development of the TTT program offers a cost-effective solution that promotes consistency in training quality, fosters empowerment and professional growth, enhances engagement and learning retention, supports a sustainable workforce, and increases the capacity for mentorship and guidance
Facilitators and Barriers in Using Technology in Caregiver Support for Hospital Discharge
No full textDespite advances in virtual technology, many hospital nurses still widely use bedside, face-to-face teaching to prepare family caregivers for hospital discharge of their loved ones (Gatto & Newcomb, 2022; Hayajneh et al., 2020). In this pilot study, we investigated facilitators and barriers in using Communication, Learning, Advocacy, Resources and Expertise (CLARE), a digital application to support caregivers for hospital discharge. CLARE contained materials on hospital discharge preparation such as information on patient care and caregiver self-care. Twenty caregivers participated in individual interviews to explore their experiences in using CLARE. We used the Unified Theory of Acceptance and Use of Technology (Venkatesh et al., 2003) as a guiding framework in developing interview questions and analyzing caregiver responses. For many caregivers, the idea of using a caregiver-specific app was unfamiliar and represented a new experience, and a novel concept. Several caregivers expressed excitement at the prospect of using an app designed to support their caregiving role, seeing it as a promising new tool. Facilitators in using CLARE included available assistance in downloading the app. Caregivers also liked the daily reminders that CLARE provided to improve patient care at home. Many found the app to be easier than initially expected and easy to navigate, with tasks described as very simple and straightforward. Caregivers appreciated that the app helped them stay in tune with things, providing tips and reminders for patient care, as well as valuable information on self-care. The barriers ranged from technological challenges to personal and logistical constraints. Some caregivers found that using an app, in addition to their daily tasks, added complexity to their already busy schedules. Many caregivers noted that they would like the app to offer more feedback, such as direct responses to their inputs and questions to provide a more interactive experience. As the world’s aging population exponentially grows (World Health Organization, 2024), the number of caregivers will continue to rise as well (Kong, n.d.). Hospitals need to discover ways to integrate technology to support caregivers for home discharge for enhanced efficiency and access
Integrating Social Determinants of Health Into Clinical Practice
No full textBackground: Health is a concept with multiple definitions, and it is influenced by a range of determinants. Social determinants of health (SDOH) are societal systems and resources that cause health consequences, by influencing the distribution of health-supporting factors and risks across populations (Hahn, 2021). SDOH are widely associated with health outcomes (Enard et al., 2023; Glauser et al., 2022; Vince et al., 2023), and they are recognised in various national (Flaubert et al., 2021; Kuehnert et al., 2022) and international health strategies (United Nations, 2015; World Health Organization, 2019). SDOH affect on individual’s health regardless the effectiveness of the care, making them essential to be integrated into clinical practice. This umbrella review aims to analyze current integration of SDOH into clinical practice.Method: Systematic literature search was conducted on January 2024 in Pubmed, Cinahl and Cochrane -databases. Inclusion criteria were as follow: SDOH mentioned in title or abstract, investigation of SDOH intervention or screening, clinical healthcare context, adult patients and literature review as a study type. Data were analysed with inductive content analysis.Results: Out of 560 identified studies, 31 reviews (which included a total of 1166 papers, ranging from 5 to 214 papers) published between 2016-2023 met the inclusion criteria. SDOH are integrated into the clinical practice through 1) screening: SDOH are usually screened in clinical practice with standard screening tools or other assessment methods, 2) multisectoral efforts: collaborations are established between hospitals and communities to improve care, as well as medical-legal partnerships to help patients resolve legal issues affecting their health, 3) social prescribing and community linkages: patients are directed to resources for needs identified in clinical practice, but which cannot be addressed within it, and 4) interventions targeting specific SDOH in clinical practice: typically through patient education or material support.Conclusion: Integrating SDOH into clinical practise is increasingly recognized as essential for providing comprehensive, patient-centred healthcare. Screening tools and assessments serve as foundational steps for identifying and addressing SDOH. With multisectoral efforts, interventions and connecting patients to community resources, healthcare systems can better address the broader SDOH affecting on health outcomes
Strategies to Recognize and Prevent Workplace Violence
No full textSince the beginning of the COVID-19 pandemic, United States healthcare facilities have experienced a rise in workplace violence, placing significant stress on health systems and their employees. Incidents such as bullying, intimidation, verbal abuse, and assaults also put our patient safety, experience, and quality outcomes at risk. Nurses face a significant risk of experiencing workplace-related violence. Studies have demonstrated that almost half of all nurses experience some lateral or horizontal violence during the first year of their nursing career.There is a prevailing attitude that workplace violence is a culturally accepted and expected part of one’s occupation. According to the Occupational Safety and Health Administration, the rate of workplace violence events for healthcare workers was more than four times greater than that of private industry, and the number of violent events in healthcare workplaces equaled the number for all other industries combined. The Healthy Work Environment Survey conducted by the American Association of Critical-Care Nurses (AACN) in 2018 found that acute and critical-care nurses (n=8080) experienced verbal abuse, physical abuse, sexual harassment, and discrimination frequently. From the total sample, 80% reported experiencing verbal abuse at least once, 47% reported experiencing physical abuse at least once, and 40% reported sexual harassment.Professional organizations and government agencies have published position statements that speak against violence and incivility. This session will empower nurses as leaders and change agents by providing training on workplace violence prevention policies and guidelines. Examples will be shared from an academic center that has developed programs and tools to implement best practices across the organization. Information will be shared on resources for disruptive behaviors, patient/visitor escalation decision tree, de-escalation verbiage and situational awareness, setting limits, and a template letter to the disruptive patient. The resources mentioned can be utilized with patients and/or visitors during challenging behavioral situations. Every individual plays an integral role in recognizing and preventing workplace violence to promote safe work environments for all
Symptoms of Pain and Fatigue Among Adults with Gaucher Disease Type 1
No full textPeople with rare disease have lower health-related quality of life (HRQoL) than the general population (Megari, 2013). Gaucher disease type 1 (GD1) is a rare, autosomal recessive, lysosomal storage disorder, caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, that affects multiple bodily systems and is classified by the absence of neurodegenerative disease (Mistry et al., 2015; Stirnemann et al., 2017). An estimated 125,000 people have GD1 worldwide with about 6,000 people in the U.S. Pain and fatigue are the most commonly reported symptoms (Hayes et al., 1998), but both have been understudied (Drelichman et al., 2016; Zion et al., 2016). This study explored associations between pain and fatigue with HRQoL among 97 adults with GD1 who were taking enzyme replacement (67.4%) or substrate reduction therapy (32.6%). Participants were recruited through Facebook pages of U.S., Canadian, and international Gaucher organizations. The sample was 73% female, 92% non-Hispanic white, 8% Hispanic or Latino, mostly adults age 45 years or over (62.9%), with 53.7% having been on any type of treatment for 20 years or longer. On average, they reported pain and fatigue scores of (M = 51.89, SD = 9.51) and (M = 53.65, SD = 11.22), respectively, on a scale of 0 - 100; physical HRQoL scores of (M = 63.48, SD = 24.63), and mental HRQoL scores of (M = 67.00, SD = 22.40) on a scale of 0 - 100. There were strong, negative correlations between both pain and fatigue for both physical (r = -.83, r = -.68, respectively) and mental (r = -.69, r = -.75, respectively) HRQoL (all p \u3c .001). Pain and fatigue were significant predictors in the regression analyses for physical and mental HRQoL, even when controlling for individual differences, treatment type, and treatment satisfaction. People with GD1 who report higher levels of pain or fatigue also report lower HRQoL. Even though treatment has been available for many years, people with GD1 still have lower than U.S. population norms for health-related quality of life, with pain and fatigue as significant contributors. Nurses have the opportunity to impact people with GD1 globally through the use of standardized, valid pain and fatigue measures in their assessments to better understand the symptom experiences of people with GD1. The implementation of pharmacological and non-pharmacological interventions by nurses can address and improve pain and fatigue which can further improve HRQoL among people with GD1
Experience of Managing Financial Impact of Cancer and Cancer Treatment
No full textBackground: Not all of cancer treatment will be covered by health insurance, even in the country providing public coverage, such as in Taiwan. Treatment costs, medical necessity, and care processes may impose a significant financial and emotional burden on patients and their families, especially facing with diverse coverage of national or commercial health insurance for new cancer drugs or systemic treatments. Financial burdens may involve absences from work, and hidden costs related to the alteration of family roles. That\u27s how to manage the burden remains to be uncovered for further development of supportive care.
Purpose: This study aimed to describe the experience of managing financial burden in cancer patients and family. Lung or breast cancer survivors and family who are susceptible to confront for managing finance or dealing with social function were invited, such as those with advanced or recurred cancer, being recommended for self-paid systemic treatment in Taiwan.
Methods: The qualitative inquiry applied audio-recorded, open-ended interviews on a purposive sample of 19 survivors or families with advanced stage, recurred lung or breast cancer, or who received systemic cancer treatment. Data were transcribed and analyzed by constant comparison.
Findings: Experience of managing financial impact from cancer treatment characterizes being distressed by medical and related costs, constrained work and daily activities, disruptions in family dynamics, and uncertainty of treatment outcome. Participants also encountered difficulties in managing the constraints of insurance coverage and making challenging financial decisions for treatment. Managing strategies included exploiting medical and social support services, increasing information for informed decision-making, financial planning, modifying daily routines, depending on familial support, and seeking emotional and spiritual support.
Discussion and Implications: This study addressing psychosocial and economic aspects emphasizes the diverse effects of cancer and cancer treatment on patients and families, and emphasizing the necessity of integrated support networks for coping with these challenges
Burnout among Racial Minority Registered Nurses Working in Nursing Homes
No full textPurpose Statement: There is an ongoing increase rate of growth in the older adult population, ages 65 and above in the United States. In 2020, 1.4 million (2.5%) older adults, including racial minorities, lived in nursing homes (Caplan & Rabe, 2023). This growth necessitates increased nursing care that could be provided by registered nurses (RNs) who are already understaffed, overworked, and burned out in diverse care settings (Dall’Ora et al., 2020), especially nursing homes.Burnout affects 62% of nurses and has adverse consequences on patient safety, outcomes, satisfaction, and nurses’ health (ANA, n.d.; Jun et al., 2021). Nurse burnout have been widely studied, however, studies that focused on racial minority RNs who work in nursing homes are rare. This study examines the prevalence of burnout and contributing organizational factors among these RNs.Methods: A cross-sectional design and descriptive statistics will be employed to implement this study. Data will be collected from interested registered nurses working in nursing homes nationwide using demographic, burnout, and practice environment instruments via an online survey. Analyses will be conducted using the IBM Statistical Package for the Social Sciences.Implications: Older adults deserve quality care and maintenance of their physical, mental, and psychosocial well-being. Healthy nurses provide care that positively affects patient outcomes while inadequate RNs staffing have a deleterious health effect on vulnerable older adults (Cho et al., 2023). This study is significant for improving care of older adults; alleviate staffing shortage; help with retention; reduce costs; increase care access and reduce health disparities among racial minority older adults who would benefit from a diverse workforce
Telemedicine for Improving Healthcare Access in Communities
No full textPurpose/Background: Telemedicine reduces barriers to access which can decrease inappropriate emergency room use. This quality improvement project aimed to connect a community-based organization (CBO) to a telemedicine urgent care in the Midwest.Framework: The PRECEDE-PROCEED framework guided the population assessment and the Theory of Planned Behavior guided the project development/implementation.Methods: A mixed method design was used (interviews and pretest/posttest) for the development and implementation of a 12-week project at a large academic medical center. This project included (a) interviewing CBO staff and utilizing pre-test survey to determine awareness/utilization of telemedicine, (b) development of CBO staff education and training protocol for CBO and telemedicine staff, (c) development of flyers with QR codes, and (d) festival marketing. Evaluation measures included (a) post-intervention survey for CBO staff, (b) QR code scanning for tracking telemedicine program engagement, and (c) a post-visit survey for telemedicine program patients.Results: At 12-week follow-up, 100% of CBO staff (n=11) indicated a high level of confidence on a 5-point Likert scale in assisting patients with telemedicine and 33.3% reported referring at least one patient. Per post-visit survey, 62.7% (n=83) of patients reported the telemedicine visit kept them out of the ER and 23.5% reported they would not have otherwise received healthcare. Program engagement tracking showed 53 QR code scans with 50 new users.Conclusions: The project demonstrated a promising potential in preventing ER visits. This project was adopted by the telemedicine program as a model for future community outreach to benefit CBOs serving diverse medically underserved communities