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Blending Virtual Learning and Travel Abroad as Teaching Strategies to Develop Global Perspectives
No full textIn 2022, there were 2.8 million undergraduate students in the U.S. About 6% studied abroad, leaving 94% of students without exposure to global perspectives. To enable global learning for nursing students, Ohio State University College of Nursing in Ohio and Lovisenberg Diaconal University College in Norway developed a common course on urban health whereby two separate teaching strategies were used: travel abroad to Norway/U.S. and “at home” collaborative online international learning (COIL). The purpose of these strategies is to connect COIL students with travel abroad students in both countries to enhance global learning.In spring of 2024 prior to starting the common course, 32 students were divided into four groups: 2 travel abroad and 2 “at home” COIL groups. All students participated in virtual “ice breaker” activities to build relationships and prepare for the course. Once the course started and the travel abroad and COIL students met, all groups focused on common health concerns impacting urban health in Norway and the US. All students participated in case studies, virtual reality simulations, and visited health care facilities in urban settings. Parallel synchronous and asynchronous discussions were used to compare support across different health care systems for marginalized populations. At the end, all groups completed virtual presentations that met course requirements for both countries.Blending “at home” COIL and travel abroad students in a global exchange is an effective teaching strategy that develops global awareness, broadens perspectives, and enhances cultural competence for nursing students. Feedback from students showed that these blended learning strategies fostered global learning and understanding
Health and Care Workers’ Roles in Infectious Disease Prevention in Long-Term Care: A Scoping Review
No full textAim: To describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities.
Design: A scoping review.
Methods: A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings.
Results: A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: ‘The roles of health and care workers evolve with the times’, ‘The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities’ and ‘The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels’. Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management model were found to have significantly improved infection prevention and control outcomes.
Conclusions: The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers
Haitian Nurses’ Perception about Disaster Preparedness and Disaster Nursing
No full textPurpose: Disasters happen worldwide. They devastate infrastructure, livelihoods, and often result in mass casualties. The increased occurrence of disasters means that disaster preparedness training is essential. Studies have shown that nurses make up the largest number of healthcare providers and are often the first point of contact for disaster survivors. The International Council of Nursing calls for nurses to be involved in all aspects of disaster preparedness, from risk assessment to multidisciplinary management. Nurses and nursing associations are urged to take leadership roles in preparing their countries for disasters. In a country such as Haiti that is prone to natural disasters, nurses require knowledge and skills to effectively respond to these events. There is a gap in the research on disaster preparedness and disaster nursing in Haiti. The purpose of this study is to explore Haitian nurses’ perception about disaster preparedness and disaster nursing.Methods: Fourteen participants met the inclusion criteria, which included: Haitian nurses who graduated from a three year or more nursing program in Haiti; currently working as a nurse; able to read and speak English; and age greater than 18. Data were collected using a demographic questionnaire and a semi-structured interview guide.Results: Four major themes were generated from the data: (1) Approaches to Care, (2) Education and Training, (3) Inadequate Resources, and (4) Recommend Being Prepared.Implications: Findings from this research study may: (1) add to the body of evidence and inform nurses about disaster preparedness and disaster nursing; (2) inform policy makers regarding funding and resources for disasters, and (3) provide a basis for disaster nursing education.Conclusion: Findings of this study revealed the roles of nurses before, during, and after a disaster and the varying challenges they encountered providing care in this population. In the process of describing their experiences, nurses, brought to light the fears they faced addressing disasters with lack of materials and medications, lack of infrastructure, lack of healthcare resources and funding, and lack of medical equipment. They described their efforts to educate the population, collaborate with communities, keep patients and themselves safe under these conditions. Participants overwhelmingly recommended to prepare before disasters and requested more education and training in nursing school and in practice to save lives
Identifying ICU-Acquired Weakness Risk Through Handgrip and Maximum Inspiratory Pressure
No full textPurpose: Intensive Care Unit Acquired Weakness (ICUAW) is a condition marked by neuromuscular dysfunction that leads to acute generalized weakness, commonly observed among critically ill patients. During their stay in the ICU, they often experience a reduction in peripheral muscle strength; notably, respiratory muscle weakness occurs at twice the rate of limb muscle weakness in this population. With more patients surviving ICU admissions but facing long-term impairments that can lead to unemployment and disability, further investigation into these outcomes is essential. Focusing on handgrip strength (HGS) and respiratory muscle force at ICU discharge, the study aims to determine if HGS and respiratory muscle force are independent markers for ICUAW development.
Methods: A prospective cohort study with a consecutive sampling of 407 adult patients free of systemic weakness from six National Taiwan University Hospital ICUs before their index hospitalization. The Medical Research Council sum score (MRC) was used to screen ICUAW. The handgrip strength (HGS) and maximum inspiratory pressure (MIP) were evaluated on the ICU discharge day.
Results: Of the 406 patients, predominantly male (65.1%), the mean age was 69.02±13.4 years old. Acute respiratory failure was the majority indication of admission to ICU. Upon ICU discharge, all ICU survivors were liberated from mechanical ventilation. Among patients who completed the MRC test (n=275), ICUAW was identified in 22.5% of survivors. A significant association exists between reduced HGS and MIP with ICUAW development. For every one kilogram decrease in HGS, the risk of developing ICU-AW increases by 1.14 times (adjusted odds ratio [aOR], 1.14; 95% confidence interval [CI]: 1.02-1.27, p = .17). Similarly, a one cmH2O reduction in MIP was associated with a 1.06-fold higher risk of developing ICUAW (aOR, 1.06; 95% CI: 1.01-1.11, p = .17).
Conclusions: The incidence of ICUAW was 22.5% in our study, slightly lower than in the previous report. Those affected experience a significant decrease in handgrip strength and respiratory muscle force, associated with higher ICUAW risks. The findings suggest that both HGS and MIP could serve as markers to ICUAW, providing potential for early and more accessible (relative to MRC manual testing) screens and serving as targets for improvement
Spatial Habits Advance Personal Excellence: Examining School Environments and Student Well-Being
No full textSchools are increasingly becoming the primary access point for health services for students, as families turn to schools to identify and address growing whole health needs. Before the COVID-19 pandemic, over 70% of children received mental health services solely through their schools (Kaskoun & McCabe, 2022). The built environment is a social and structural determinant (World Health Organization, 2010) influencing educational outcomes (Ikegbusi et al., 2022) including the readiness to learn (Colvin, 2024). Still, many schools lack the design necessary to support mental and physical health. There is limited nurse-driven research on how physical attributes impact students during critical transition periods at school. Spatial Habits Advance Personal Excellence (SHAPE) is an interdisciplinary study evaluating the impact of school buildings on student well-being.SHAPE is a mixed methods feasibility study across diverse school settings. We conducted a comprehensive evaluation of each school’s built environment via cartography. A participatory approach was used to examine perceptions of physical spaces via photovoice, focusing on transition areas. Physiological indicators of heart rate and blood pressure were collected in relation to these spaces. Principles on examining built environments from the international Collaborative ReDesign School Group were utilized alongside the Whole School, Whole Community, Whole Child (WSCC) model (Centers for Disease Control and Prevention, 2023), a student-centered comprehensive model to improve education and health outcomes. Primary study outcomes included adherence to study protocols, acceptability of data collection methods, and data analysis, including descriptive statistics and content analysis.Findings included a synergistic relationship between built environment attributes and student perception, the critical importance of student and staff perceptions of their built environment, and preliminary data on physiological responses to transition spaces. Overall, the SHAPE study was feasible to implement across diverse school settings and was positively accepted by each school community.Nurses are critical to an interdisciplinary approach in designing supportive school environments. By incorporating participatory approaches and exploring physiological measurements, the SHAPE study may inform evidence-based policies for school design that prioritize student well-being and advance health promotion curricula and services
Linking Ethical Leadership to Nurses’ Internal Whistleblowing Through Psychological Safety
No full textBackground: Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored.
Aim: This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety.
Research design: A multicenter cross-sectional research design was used for this study.
Participants and research context: This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses.
Ethical consideration: Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study.
Results: Ethical leadership was positively linked to nurses’ psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses’ internal whistleblowing intentions.
Conclusion: Our study suggests that nurse leaders can foster nurses’ intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses.
Implications:The study enriches the current body of nursing literature in several ways. First, to date, research on whistleblowing among nurses is highly limited.10 The present findings extend the literature on the determinants of nurses’ whistleblowing intentions. Second, the study highlights novel outcomes of ethical leadership in the nursing literature
Why All The Noise? How to Reduce Alarm Fatigue in the Intensive Care Unit
No full textBackground: Intensive care units have copious amounts of alarms and sounds that can lead to patient distress and alarm fatigue for staff, resulting in delayed responses to an alarm in a patient’s room. With so many alerts in the intensive care unit (ICU), staff can become desensitized to the noises, and patient care is affected, increasing the likelihood of adverse events (Gorisek et al., 2021; Leigher et al., 2020). The project examines the effects of changes in patient care to reduce the number of alarm alerts to impact the potential of alarm fatigue in nurses working in a busy ICU. With the large number of alarm alerts in the ICU, staff tend to become fatigued to the alarms and do not respond as quickly to alerts, creating potential for patient harm (Bosma & Christopher, 2023; Suba et al., 2019). Response time to alarms can decrease with the implementation of strategies that can prove to have positive impacts on patient care.
Method: The quality improvement project was a quantitative study in a forty-four-bed unit in upstate New York. The research to make the changes was based on reviewing evidence-based research and policies at the facilities (Asadi et al., 2022; Leigher et al., 2020). Changes in procedure were made, such as daily electrode changes, alarm limit assessment with hourly checks, and setting alarm parameters upon admission. The criteria evaluated were staff response times, alarm types, and the frequency of the alarms. The alerts were evaluated for approximately fifty hours per week for eight weeks, and the hours varied throughout a twenty-four-hour period in the intensive care unit.
Results: The alarm alerts were assessed over eight weeks, fifty hours each week, throughout the 44-bed units. Data was tracked and analyzed on an Excel spreadsheet. The alarm alerts did not decrease throughout the project and buy-in was not created by the staff.
Conclusions: Unfortunately, the changes did not reflect the expected decrease in alarm alerts. However, lessons were learned about creating buy-in and the stress the facility was experiencing at the time. Procedure changes can be successful with a longer period of change and creating buy-in
An Observational Study of Personalized mHealth to Promote Wellness in Healthcare Workers
No full textBackground: Healthcare workforce resilience weakened during and after the pandemic. Nutrition, physical activity, and sleep deficits further diminish health status. Providing just-in-time resources may promote healthier behaviors in direct-care hospital staff. We had two study aims: 1) coach healthcare workers (HCWs) to make lifestyle changes that enhance wellness, and 2) compare high and low engagement with mHealth resources to achieve recommendations for cardiometabolic health.
Methods: In this 1-year prospective observational study, HCWs had 24/7 access to a dashboard built for personalized health messages and wore an activity and sleep tracker continuously. On-demand UVB phototherapy was available to boost vitamin D status. High engagement meant wearing the tracker 70% of the time, achieving 7000 steps/day, and sleeping 7 hours/day. Work performance, diet, and sleep questionnaires occurred at 4 timepoints. Body composition, biomarkers, and gene expression were measured at 3 timepoints. Genes linking host response to nutrients were isolated for correlational analyses with lifestyle behaviors.Results: 104 HCWs (72% female, mean age 42) enrolled between July – October 2021. At 12 months, 60% of participants were highly engaged for device-wear and daily steps. Feedback via telehealth messages on the dashboard was continually updated and reviewed at appointments yet satisfaction ratings for messaging and dashboard were 1.7 and 1.8 out of 4.0, respectively. At 12 months, mean (sd) daily distance declined by 1.2 (2.0) miles, p\u3c .001 as did steps by 1970 (SD 2745), p\u3c .001; sleep was unchanged at 7.7 hours/day. Insomnia Severity Index suggested persistent subclinical insomnia with a mean baseline score of 9.12 (5.9) and 8.1 (6.1) at 12 months, p=NS. Thirteen genes had a significant moderate correlation with steps (.29-.37), sleep (.27-.37), distance (.28), and ISI (.30-.38), p\u3c .05 for all. Cardiometabolic health data were unfavorable for 30% of cohort at final follow-up. Phototherapy use (n=19) raised serum vitamin D at 12 months related to duration of treatment (p=.02).Implications for Global Health: mHealth can offer just-in-time access to evidence-based, personalized tools but requires collaborative effort with end-users for optimal engagement. The long-term health of HCWs remains threatened unless leaders invest in strategies that support healthful nutrition, regular activity, sufficient sleep, and resources that are necessary to optimize wellness and job performance
Development of a Novel KT Tool for Parents of Children With IDD Seeking Emergency Care
No full textBackground: Children with intellectual developmental disorders (IDD) are generally defined as those under 18 years old who have conditions that can adversely impact their physical, intellectual, and/or emotional development. Taking a child to an emergency department (ED) is often unexpected and stressful for the parents and child. Children with IDDs are among the highest users of emergency health care services in their age group (3), with complex and challenging ED experiences. Digital knowledge translation (KT) tools can effectively share experiences and health information while addressing the learning needs of parents.
The aim of this study is to report on the development of a novel KT tool (i.e., interactive infographic) for parents of children with IDD that supports positive experiences in the ED and meets parent information needs.
Methods: A mixed-methods systematic review (SR) was conducted to synthesize previous research about parent information needs and experiences related to bringing a child with IDD to an ED (10). Semi-structure interviews were conducted with parents of a child with IDD to gather self-reported experiences and information needs. Merging these results, a KT tool was co-developed with key partners. Following iterative feedback cycles, a finalized KT tool will undergo usability testing before being widely disseminated.
Findings: The SR (n=7 studies) highlighted parents’ disappointment and frustration when seeking care in the ED. Parents worried about lengthy wait times and the limited management of their child’s behaviors of concern. Parents wanted better communication with healthcare providers and a greater understanding by staff around their child’s needs. Little data was available relating to parents’ information needs. Parents expressed uncertainty about when to go to the ED and described preparing mentally and physically for a long visit. Parents identified communication as a significant challenge and noted the need to request extra support for their child. Frustration was common and parents felt the need to advocate for their child throughout the ED visit. A KT tool was codeveloped with parents based on these findings.
Conclusions: Our findings support the importance of understanding drivers of parents’ expectations and care decisions in the ED. This research highlights the critical need for ongoing collaboration between ED healthcare providers and families to enhance patient-centered care and supports for children with IDD
Healthy Aging and Pet Caretaking: Findings from the Health and Retirement Study
No full textThe global population of 1 billion people ≥ age 60 is expected to double by 2050, likely increasing the prevalence of age-related cognitive decline (Alzheimer’s Association, 2019). Examining biological, psychological, and social (biopsychosocial) factors and possible moderation by other critical factors, including neighborhood physical disorder (i.e., graffiti, litter, vandalism, safety) and cohesion (i.e., mutual trust/solidarity between neighbors), may inform development of targeted interventions to improve biopsychosocial and cognitive health. Human-animal interaction (HAI) has been found to improve health outcomes and may be a viable option to enhance biopsychosocial factors and delay cognitive decline in older adults (Gee et al., 2017). The purpose of this study was to utilize data from the 2010-2020 Health and Retirement Study (HRS) Core and the 2009-2019 HRS Consumption and Activities Mail Survey (CAMS) to examine the relationship between pet caretakers and non-pet caretakers’ biopsychosocial and cognitive health and the possible moderation by neighborhood disorder and social cohesion. Descriptive statistics summarized respondent characteristics (n= 1,499; Mage = 66.308; SD = 7.597; 86.5% White; 9.3% Black; 7% Hispanic). Longitudinal mixed model analyses were used to compare biopsychosocial (walking, self-rated health, depression, social relationships) and cognition (self-rated memory, vocabulary, numeracy, number series tasks) factors and to examine possible moderation by neighborhood factors (physical disorder and social cohesion) in pet caretakers and non-pet caretakers, while controlling for marital status, gender, race, educational level, smoking, drinking, BMI, diabetes mellitus, and hypertension. There was no significant relationship between the time spent walking, communicating with others, showing affection to others, helping others, being active with others, and cognition among these groups. However, pet caretakers were significantly more likely (p = .012) than non-pet caretakers to continue visiting others in person over time. Neighborhood factors did not moderate this effect. The study findings demonstrate the importance of pet caretaking in promoting in-person social connection among older adults. Nurses may leverage these findings to support meaningful practice and policy changes that support older adult pet caretakers who may benefit from this relationship