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A Train the Trainer Approach to Fostering Critical Thinking in Emergency Nursing
No full textPurpose/Background: Emergency departments (EDs) globally present a challenging environment for new graduate nurses (residents), often impacting proficiency and retention. This pilot study evaluates the effectiveness of an ED Train the Trainer (T3) program in improving resident proficiency, confidence, and retention, as well as preceptor confidence. The program focused on critical thinking and task management skills using the Identify, Intervene, Assess, and Reassess (IIAR) model, addressing the gap between academic preparation and clinical practice.
Methods: A time-series design was employed. The T3 program incorporated various learning modalities, including face-to-face sessions, instructional videos, and hands-on skills practice. Preceptors learned to utilize a checklist to observe and evaluate residents, linking performance to specific modules. Monthly meetings were held for ongoing support. The primary outcome was resident proficiency, defined as completing tasks within a 4-room patient assignment in 30-60 minutes. Confidence levels of both residents and preceptors were assessed pre, mid, and post-course.
Results: The T3 program improved resident proficiency, confidence, and preparedness. Residents reported improved critical thinking, faster patient assessment, and increased confidence in decision-making. Pre-survey data showed initial low confidence (40%) in handling a 4-room assignment, but post-training demonstrated marked improvement. While 83% of residents were somewhat familiar with IIAR, only 67% used it consistently. The program enhanced consistent IIAR application, improving critical thinking and task management.
Limitations: Small sample size and short duration limit generalizability.
Conclusion: Results suggest the ED T3 program may be effective in fostering a shift from task-oriented thinking to expedited critical thinking in resident nurses. By providing a centralized platform for visual, media, and video resources, the program streamlines learning and empowers residents to develop essential skills for effective decision-making in the fast-paced ED environment. This model has potential for broader dissemination and adaptation globally, contributing to a skilled, confident nursing workforce. Further research with a larger sample and longer follow-up is warranted to confirm these findings and explore long-term impacts on proficiency, confidence, and retention
Integrating Traditional and Modern Postpartum Care by Tai-Yuan Caregivers: A Phenomenological Study
No full textThai hospitals increasingly integrate local wisdom into postpartum care.1 Tai-Yuan, an ethnic Tai group from the ancient Lanna Kingdom, is distinguished by their unique dialect and cultural practices that continue to thrive in various regions of Thailand.2 Nakhon Ratchasima Province Thailand’s Tai-Yuan community maintain cultural practices that combine Buddhist beliefs with ancestral wisdom. While traditional practices show beneficial properties,3-4 understanding of caregivers\u27 experiences is limited. This research explored the experiences of caregivers providing postpartum care for Tai-Yuan women.
We employed Heidegger’s interpretative phenomenology to collect data from seven primary caregivers via semi-structured interviews. Analysis followed Interpretative Phenomenological Analysis guidelines,5 with trustworthiness established using Lincoln and Guba’s criteria.6
Findings revealed four themes 1) Dynamic Knowledge Transmission - adapting traditional wisdom to contemporary contexts; 2) Judicious Integration of Knowledge - combining traditional and modern practices; 3) Preservation of Cultural Identity - maintaining core beliefs while adapting to modern healthcare, and 4) Holistic Healthcare Approach - addressing physical, mental, and spiritual dimensions.
The findings support developing integrated care combining traditional and modern practices while respecting cultural values. Thai traditional wisdom, particularly in postpartum care, demonstrates remarkable adaptability by integrating ancient practices with modern approaches while maintaining its core therapeutic benefits.3,7 Healthcare providers should understand clients\u27 cultural beliefs and promote family and community participation in postpartum care
The Competency Assessment Companion: An Electronic Resource for Perinatal Nurses
No full textBackground: A lack of unanimity in the assessment of registered nurse (RN) competence can lead to the provision of inconsistent care, increasing the risk of medical errors and compromising patient safety. On the labor and delivery (L&D) unit of a 641-bed academic medical center in Chicago, there is currently no standardized practice for conducting RN competency assessments, leaving room for preceptor subjectivity and bias.Purpose: To develop and pilot an evidence-based electronic repository, the Competency Assessment Companion (CAC), aimed at standardizing RN competency assessments targeting five clinical domains outlined within the L&D unit’s existing New-Hire Competency Assessment Package (NHCAP): Patient Admission, Fetal Monitoring, Induction & Augmentation of Labor, Promotion of Physiological Labor, and Pain Management.Methods: Project implementation occurred over 11 weeks, beginning with distribution of an anonymous six-question pre-implementation assessment to 28 L&D RN preceptors and unit leaders. This was followed by five stages of CAC development: Blueprint Generation, Institutional Policy/Procedure Integration, Practice Guideline/Nursing Standard Alignment, Competency Curriculum Development, and Supplemental Resource Inclusion.Results: Development of the CAC was successful; however, limitations including (1) low pre-implementation assessment response rate (11%), (2) oversight of the extensive scope of work, and (3) time constraints prevented a formal pilot from being implemented on the unit. As such, a comprehensive evaluation was not conducted.Conclusions: To successfully pilot the resource on the hospital’s L&D unit, authors recommend full CAC standardization across all 43 NHCAP clinical domains
Empowering Black/African American and Latina/Hispanic American Women through Lupus Awareness
No full textBackground: Approximately 1.5 million Americans and at least 5 million people worldwide are affected by some form of lupus (Lupus Foundation of America, 2023), and recently approved lupus therapies remain inaccessible to many patients due to the lack of coverage by healthcare systems, disproportionately affecting individuals from lower socioeconomic backgrounds (Mosca et al., 2024).
Purpose: Guided by the Lupus Foundation of America’s (LFA) campaign theme, Be Fierce. Take Control. , the initiative emphasizes health empowerment and self-advocacy.
Methods: This study used a simple random sample of 36 undergraduate students at Bowie State University. Informed consent was obtained before participation. After Institutional Review Board (IRB) approval, data was collected via a self-assessment survey on Google Docs over four weeks. Participation was voluntary and confidential, and only eligible individuals could participate. The survey incorporated both quantitative and qualitative methods. Quantitative questions gathered demographic data (age, gender, race, student status, and education). Open-ended questions explored lupus-related challenges and strategies for raising awareness within the community. Descriptive analysis classified students, while thematic analysis examined qualitative responses on lupus knowledge and challenges.
Results: Of 36 participants, 22 (61.1%) were somewhat familiar with lupus, 4 (11.1%) were very familiar, 5 (13.9%) had heard of it but were unsure what it was, and 3 (8.3%) had never heard of it. Only 2 (5.6%) reported either having lupus or knowing someone with the disease. Findings highlight a significant knowledge gap and the need for greater lupus awareness and education. Participants expressed strong interest in learning more and provided feedback on improving outreach.
Conclusion: While most participants were somewhat familiar with lupus, knowledge gaps remain, particularly regarding symptoms and health impact. These results underscore the need for increased awareness and education, especially in communities facing health equity challenges. Future initiatives should prioritize targeted outreach, community engagement, and educational programs to bridge knowledge gaps and improve early diagnosis and treatment outcomes
Nursing Students\u27 LGBTQ+ Healthcare Knowledge and Attitudes: A Roadmap for Interventions
No full textPurpose: While awareness of LGBTQ+ health needs is rising, these topics remain underrepresented in nursing curricula, often due to limited faculty preparation and absence of standardized guidelines (Dalbey, 2023; Moore et al., 2023). This educational gap affects nursing students’ readiness to care for LGBTQ+ patients, particularly in non-Western settings, where cross-cultural research is limited (Ozcan et al,, 2021; Wang et al., 2022. This study examined nursing students\u27 knowledge and attitudes toward LGBTQ+ healthcare across five countries—the United States (U.S.), South Africa, the Philippines, Greece, and Indonesia.Methods: A quantitative descriptive study was conducted with 150 third-year undergraduate nursing students who completed the Nursing Students\u27 Knowledge of and Attitudes Toward LGBTQ+ Healthcare survey. The researchers made minimal modifications to the original instrument and administered the survey online or in person. The knowledge section consisted of 37 items and the attitude section consisted of 25 items. Higher mean knowledge scores and lower mean attitude scores indicated better knowledge and attitudes toward LGBTQ+ healthcare.Results: Majority of the students were female (62%), 18 to 21 years of age (46%), Christian (63%, and heterosexual (64%). Findings showed notable differences across countries, with Filipino students scoring highest in knowledge and exhibiting the most favorable attitudes. ANOVA analyses revealed significant differences with knowledge and attitudes based on country and demographic factors such as age, gender identity, sexual orientation, and religion. Students aged 26 and older, male, bisexual, Roman Catholic, and those who had not taken an LGBTQ+ healthcare course reported feeling more comfortable and responsible in providing care to LGBTQ+ individuals. Students who identified as bisexual or homosexual and had personal connections to LGBTQ+ individuals expressed greater willingness to provide care.Conclusion: Nursing students benefit significantly from LGBTQ+ cultural competency training, which enhances knowledge, skills, and attitudes essential for providing affirming care (Yu et al., 2023). Developing curricula with tailored content on LGBTQ+ healthcare needs can foster more inclusive and culturally competent practices among future nurses. Nurse educators can use these findings to develop a roadmap for tailored interventions that improve the quality of healthcare for LGBTQ+ individuals
The Global Crisis of Opiate Exposure in Youth
No full textBackground: The global opioid crisis is increasingly affecting youth, defined by the United Nations as ages 15–24 and young adults up to age 29 (United Nations, 2023). In the United States, 1 in 5 opioid overdose deaths occur in individuals under 30 (Centers for Disease Control and Prevention [CDC], 2024). Across Europe, overdose mortality is highest among males aged 25–39 in northern and western regions (European Monitoring Centre for Drugs and Drug Addiction [EMCDDA], 2024). Emerging synthetic opioids such as nitazenes have been identified in West African street drugs like “kush,” triggering public health emergencies disproportionately impacting youth (United Nations Office on Drugs and Crime [UNODC], 2024). Globally, opioids account for 80% of the 600,000 drug-related deaths, including 125,000 overdose deaths annually (World Health Organization [WHO], 2023).
Purpose: This study aligns the opioid crisis in youth with the Sustainable Development Goals (SDGs): SDG 3 (Health), SDG 4 (Education), and SDG 17 (Sustainable Partnerships). It proposes a youth-centered, technology-enabled prevention and advocacy framework.
Methods/Interventions: Evidence-based strategies include digital education (TikTok, chatbots, gamified school modules), social listening tools (WHO EARS), and game-based SEL curricula (UNESCO MGIEP). Community interventions include naloxone distribution, lay responder training (WHO, 2023), and peer navigators. Global platforms such as UNESCO Youth Forum and UN ECOSOC Youth Forum provide opportunities for youth-led policy recommendations. UNODC DAPC grants support youth prevention projects.
Collaborations: Key partners include WHO, UNODC, UNESCO, Global Shapers, Sigma, NAMI, and community leaders such as Mobile Moms. Voices from global and community perspectives highlight lack of access, stigma, and the need for culturally responsive prevention. Outcomes & Evaluation: Success will be measured through school surveys, digital campaign reach, naloxone utilization, and youth advocate retention. The goal is to build a measurable, scalable youth-led prevention movement that reframes opioid misuse as both a health and youth rights issue.
Conclusion: Opioid mortality among youth is rising globally (Xiong et al., 2024). Addressing this crisis requires integrating health, education, and partnerships to empower youth as leaders in prevention, advocacy, and policy change
Nursing the Future: Advocating for Equitable and Ethical Use of Robots in Nursing Practice
No full textBackground: Health systems face rising pressures from ageing populations, complex care needs, workforce burnout, and persistent nursing shortages. Robotics and artificial intelligence (AI) are emerging as potential supports; however, without clear policies, preparation, and nurse involvement, deployment risks being unsafe, inequitable, and poorly aligned with real-world care.
Aim: To advocate for the responsible, equitable, and ethical integration of robots in nursing practice by aligning action across policy, education, and research, and by situating this agenda within the UN Sustainable Development Goals (SDGs 3, 4, 8, 9, and 10).
Approach/Actions: Our approach is to align policy, education, research, and partnerships to drive responsible, person-centred use of robots in nursing. This means establishing clear standards and funding pathways; embedding digital health and robotics in curricula and CPD; generating practice-relevant evidence on readiness, safety, and ethics; and partnering with patients, industry, and international networks (e.g., Sigma) to ensure nurses’ insights shape design and deployment. Together, these strands enable safe, equitable, evidence-based adoption.
Expected Impact: Safer, evidence-based adoption; improved nurse confidence and capability; reduced fear and resistance; and policies that balance innovation with ethics—contributing to resilient, tech-enabled health systems and better patient outcomes.
Conclusion: Nurses must be central to technology decision-making. Robotics should augment, not replace, professional nursing, advancing person-centred, high-quality care through coordinated policy, education, research, and partnership
Nurse Leaders’ Perceptions of the Benefits of, and Barriers to, Embedding Nurse Well-Being at Work
No full textPURPOSE: The Future of Nursing 2020-2030 consensus report recommends that: Nurses attend to their own self-care and help to ensure that nurse well-being is addressed in educational and employment settings through the implementation of evidence-based strategies .1(p357) We interviewed nurse leaders in our health system to assess knowledge and beliefs about factors influencing nurse well-being, the impact of well-being on practice environments, how leaders influence well-being, awareness and utilization of existing well-being resources, resource gaps, barriers to nurses embedding well-being at work, and their interest in well-being-focused leadership competency development.
METHODS: The first author conducted 53 semi-structured interviews with all CNO\u27s and Magnet coordinators, and leaders CNO\u27s identified as being: key partners in work to support a positive practice environment and nurse well-being . Snowball sampling identified additional influencers. Respondents comprised 42 nurse leaders and 11 inter-professional partners. Interviews were recorded and transcribed. Both authors contributed to the thematic analysis.
RESULTS: All leaders described well-being as physical and emotional. Some added spiritual well-being, or meaningful work. Most said well-being included having balance and control in their personal and professional lives. Consequences of compromised organizational well-being included exhaustion, turnover, absenteeism, compromised team cohesion, decreased willingness to help others, impatience, fixed or uncompromising thinking, decreased capacity to flex, adapt or problem-solve, and a sense of hopelessness. Before a probe for: downstream consequences of compromised well-being few leaders mentioned impacts on care quality, safety, or patient experience. Once probed, several provided examples of these impacts. Respondents believed enhanced nurse well-being would improve retention, role satisfaction, engagement, productivity, team cohesion, collaboration, clinical reasoning, flexibility, willingness to try new things, and patient experience and outcomes. When asked how leaders influence well-being, almost all framed their answer inter-personally. Most mentioned presence, and more than half mentioned role-modeling; only 18 provided specific behavioral examples. The described attributes of leaders who support well-being included relational, trust-building and inspirational behaviors consistent with transformational and authentic leadership styles, and current well-being leadership evidence (2-3). Few mentioned organizational-level influence such as workflow review, break policies, flexible scheduling, strategic prioritization, or organizational investment. Awareness of well-being resources varied; most cited mental and emotional health support services. All leaders considered embedding well-being practices at work important, but cited several barriers to feasibility and frontline nurse acceptance. The main concerns across all hospitals were time and staffing constraints, and nurses\u27 beliefs about the incompatibility of integrating well-being into clinical practice. Two-thirds of nurse leaders and half the inter-professional leaders described the nursing culture of selfless service to patients as a key barrier to adoption. All expressed interest in enhancing well-being knowledge and skills personally, and within their organization.
CONCLUSION: While leaders recognized the impact of nurse well-being on the practice environment, and expressed interest in influencing it, their knowledge of evidence-based well-being strategies appeared limited. All expressed interest in enhancing well-being-focused leadership competency. They suggested that challenging the belief that integrating well-being practices at work is incompatible with safe patient care is essential for successful implementation of unit-level well-being strategies
Relational Coordination: Exploring Teamwork Across Hospital Units Among Healthcare Professionals in an Army Hospital
No full textIntroduction: High-quality communication and relationships among healthcare professionals are associated with better work environments and quality of care.1-2 Workflow differences across hospital units can impede communication and relationships among healthcare professionals.3 Researchers have used relational coordination (RC), a process of communication supported by shared goals, shared knowledge, and mutual respect, to understand healthcare professionals\u27 communication and relationships with each other in civilian hospitals.4-6 However, RC has not been explored in military hospitals. The aim of our study was to determine if RC among military and civilian nurses and physicians differs between hospital units in an Army hospital.
Methods: We conducted a secondary analysis from a cross-sectional, exploratory study using a convenience sample of military and civilian licensed practical nurses (LPNs), registered nurses (RNs), physician residents, and physicians (n = 289). Data was collected from January 2020 to March 2020 and participants completed a 47-item survey regarding their experiences of RC on various hospital units. We used t-tests and one-way ANOVAs to explore bivariate relationships between RC and other study variables, and multiple regression to explore whether RC varied by unit type.
Results: The overall response rate was 43% (678 participants were invited to complete the survey, and 289 completed the survey). The highest response rate was for LPNs, while the lowest was for physician residents (93%, 26%, respectively). Seventy percent of participants were civilian (n = 203), 75% registered nurses (n = 217), and 78% female (n = 216). The mean age of respondents was 40 years old (SD = 11.65) and the mean experience level was 11.9 years (SD = 9.49). RC was not associated with unit type. Total RC and between role RC were associated with professional role. Physicians reported higher RC (β = .45, P = .01), and LPNs reported lower RC (β = -.06, P = .01). Education and experience were associated with RC. Participants with less experience reported higher RC (β = - .01, P = .00), and participants with graduate degrees reported lower RC (β = -.62, P = .00).
Conclusion: To strategically transform healthcare, interprofessional clinical teams need to form cohesive relationships and seamlessly collaborate to effectively coordinate their work. Given our results, we suggest interventions to strengthen RC and communication, including joint interdisciplinary meetings, huddles, and structured communication tools.
Relevance to Clinical Practice: The results of this study are crucial to understanding how healthcare professionals, and specifically, nurses communicate, form relationships, and share interdependent tasks on healthcare teams. Armed with this knowledge, researchers can develop interventions to reduce the negative aspects of the social structure of interprofessional teams that constrict communication, degrade relationships, and promote poor outcomes, including authority gradients, hierarchies, and uneven levels of status and influence among team members. Nurse leaders and investigators can use the results of this study to improve RC, interprofessional relationships, communication, and mutual respect
Pediatric Critical Care Nurses’ Recommendations to Mitigate Moral Distress
No full textIn this presentation the presenter describes a qualitative description study that aimed to identify intervention attributes that pediatric critical care unit nurses with moral distress histories deem important to develop a future moral distress intervention. Identifying intervention attributes is necessary to develop effective strategies to minimize moral distress.
Detailed abstract attached