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Communication Post-COVID: Overcoming Silos to Improve Workplace Collaboration and Well-Being
No full textWith COVID-19, public health measures were adopted to prevent transmission in the workplace. As a consequence, the work environment changed with video conferencing utilized not as a novelty, but a necessity. The use of video conferencing is now routine, with 300 million daily meeting participants and ‘zoom fatigue’ a reality. Workplace culture shifted to virtual communication; however, little is known regarding the psychological impact, limiting personal engagement and collaboration and altering work relationships due to its silo effect.The World Health Organization (WHO) provides a healthy workplace framework to protect and promote the well-being of workers by considering concerns of the psychosocial work environment, including workplace culture. Interpersonal interaction is transformed by video conferencing with additional cognitive effort needed to navigate technology and complexities of modified verbal and nonverbal behavior.A needs assessment was performed to evaluate the nursing staff development (NSD) employee’s position on continued use of video conferencing, with findings indicating the need to incorporate more in-person meetings and activities. Potential solutions to address the gap is to provide in person staff meetings, an NSD ‘Happy Hour’, a HWE share-point, and a consistent recognition system to celebrate employee contributions.The primary purpose of this project is to evaluate the effect of implementing in-person HWE initiatives on the NSD employee’s work-related quality of life. The initiatives focus on implementing face-to-face engagement opportunities to improve communication and collaboration and overall wellbeing in the workplace.To evaluate success, the employee’s experience at work and overall self-reported quality of working life will be measured with the Work-Related Quality of Life Scale-2 (WRQoL-2). The HWE Committee will administer the WRQoL-2 pre- and post-intervention. In addition, qualitative information will be collected post-intervention on attitudes toward initiatives to provide supporting context.Providing a healthy and inclusive workplace environment where employees feel valued and empowered is fundamental in supporting a sustainable workforce and a cultural environment of care. The goal of this project is to contribute meaningfully to practice by developing potential solutions to barriers related to video conferencing and virtual applications; how to overcome silos and improve employees’ work experience and wellbeing
Implementing Adjunct Surgical Count Technology
No full textAdjunct surgical count technology refers to advanced methods and systems designed to enhance the accuracy and efficiency of surgical counts, which are critical for preventing unintended retained surgical sponges. This technology often incorporates digital tools like barcode scanning, radiofrequency identification (RFID), and intelligent surgical sponges. Automating the counting process reduces human error, allowing for real-time tracking of sponges throughout the surgical procedure. This can involve using handheld devices or integrated systems that automatically log usage. The systems integrate with the electronic health record (EHR) and surgical management systems, providing comprehensive tracking reporting capabilities. This integration facilitates better communication among surgical teams and enhanced accountability
The Impact of Emergency Remote Learning During the COVID-19 Pandemic on Student Learning Outcomes
No full textBackground: Prelicensure nursing programs have traditionally taught students in person. In March 2020, as the novel coronavirus spread, many programs changed to emergency remote learning.Methods: This exploratory, retrospective study examined the impact of emergency remote learning on three learning outcomes (completing the program within the published time, scoring \u3e74.7% on the ATI Comprehensive Predictor Assessment, and passing the NCLEX-RN on the first attempt). The study received IRB approval and was exempt from review. This study had two aims: to determine the relationship between the time students spent in emergency remote learning and three outcomes, and to examine the relationship between the time students spent in emergency remote learning and three outcomes after controlling for demographic characteristics, pre-nursing preparation and training, and admission requirements.Results: Of the 546 students in this study, 473 (86.6%) were female, 297 (54.4%) were 18-25 years old at the time of application to the nursing program, and 358 (65.6%) were Hispanic. Most students (n = 525, 96.2%) indicated English was their primary language, 530 graduated from high school (97.1%), and 92 (16.8%) did not report their family received public assistance. Aim 1 results showed that students with any time in emergency remote learning had lower odds of meeting each outcome. Aim 2 findings showed lower odds of on-time completion for students who had any time in emergency remote learning or were 26 to 53 years old. Students with 1 to 7 or 13 to 16 months of emergency remote learning, 26 to 53 years old, or who identified as Hispanic had lower odds of scoring \u3e74.7% on the ATI Assessment. A student with an A or B in Anatomy and Physiology II had higher odds of scoring \u3e74.7% on the ATI Assessment. Students with 1 to 7 months or 8 to 12 months of emergency remote learning had lower odds of a first-attempt pass on the NCLEX-RN. Students who earned an A in Anatomy and Physiology II had higher odds of a first-attempt pass on the NCLEX-RN.Conclusions: This study concluded that time spent in emergency remote learning decreased the odds of students completing the program on time, scoring \u3e74.7% on the ATI Assessment, and passing the NCLEX-RN on the first attempt.Implications for Practice: All faculty might benefit from regular professional development about best practices for online teaching. Hispanic and younger students might benefit from coaching for computer-based tests
Bridging the Gap of BIPOC Patients, Clinicians, and Doulas
No full textThe project is a Doctor of Nursing practice quality improvement project addressing the barriers to collaboration between BIPOC prenatal patients, clinicians, and doulas. Maternal mortality and morbidity are a crisis in our nation with black women dying three times more than their white counterparts (Harris, n.d.). BIPOC prenatal patients are suffering from maternal mortality and morbidity. Stemming from such as historical racism, racial inequalities, implicit bias and structural determinants of health. The Doula can give cultural congruent care, impower BIPOC prenatal patients, while providing emotional and physical support. The utilization of a doula as continuous labor support is shown to decrease the rate of cesarean births, decrease low-birth weights, increase initiation of breastfeeding as well as shorter duration of labor, and decrease the usage of analgesia during birth (Ogunwole et al., 2022). However, many BIPOC patients have been unable to afford Doula services. The passing of California SB65 solved the financial burden by covering Doula services for Medi-Cal recipients. Yet, collaborative barriers still exist. The project aims to assess the barrier to clinician collaboration with community-based doulas (CBD), having clinicians communicate with BIPOC prenatal patients about CBD services, and subsequently determine the utilization of doula services in BIPOC patients. The purpose of this DNP project is to improve clinician apprehension of the evidence-based practice of CBD utilization and improvement in maternal mortality and morbidity in BIPOC populations: causing clinicians to increase patient literacy of CBD and utilization. This project is a two-part study to assess and improve clinician collaborative barriers with CBD and assess BIPOC patients’ utilization of doula services in a combined retrospective and prospective cohort. It asks the question in BIPOC (Black, Indigenous, and People of Color) patients receiving prenatal care, does the implementation of a doula toolkit for clinicians compared to current practice impact patient requests for doula services during childbirth
Mapping Expert-Endorsed Communication Skills With Surrogates to Uncertainty in Illness Theory
No full textMaking medical decisions for patients with impaired decision-making capacity due to serious illness is a stressful experience for surrogate decision makers (SDMs), which can result in emotional and psychological distress6,7 and delayed decision-making3. Uncertainty has been identified as a key contributor to the stress experienced by SDMs in decision-making1. High-quality communication addressing uncertainty improves the decision-making experience for SDMs2,3. Yet, there is a lack of targeted education to help healthcare providers effectively address uncertainty in communication with SDMs. Purpose statement: This study aims to identify techniques and strategies clinicians use to address various aspects of uncertainty experienced by the SDMs of hospitalized patients. Methods: The Uncertainty in Illness Theory (UIT) posits there are 8 key constructs involved in an individual’s perception of uncertainty related to an illness and its impact on psychological adjustment: stimuli frame, credible authority, social support, education, mobilizing strategies, affect control strategies, buffering strategies, and adjustment4,5. This study examined whether the essential communication skills endorsed by experts mapped to the key constructs discussed in UIT. Guided by UIT, we conducted a secondary analysis of qualitative data from a Delphi study involving 79 experts in serious illness communication worldwide who identified communication skills necessary for conversations with SDMs of hospitalized patients with serious illnesses, with and without concomitant dementia. Using deductive coding, we validated themes already discussed in the UIT framework under the key constructs, while inductive coding captured additional themes related to communication skills or strategies. Results: Results revealed that the majority of the Delphi-endorsed communication skills identified fell into the 8 distinct constructs of the UIT. 27 themes of techniques or strategies used by clinicians were identified across the 8 constructs, including assessing uncertainty sources, fostering trust, providing education, offering emotional or social support, and facilitating adjustment. Application: Our results support UIT as a practical framework for understanding communication behaviors that influence SDM uncertainty and coping. These findings can guide translational research and the development of communication training programs for clinicians working with SDMs of seriously ill patients
Engaging Nurses to Prevent Workplace Violence
No full textWorkplace violence in healthcare settings is a multifaceted problem and must be addressed using various strategies. Engaging nurses and providing opportunities for professional dialogue about workplace violence. The creation of innovative ways to reduce or eliminate workplace violence was the goal of this project.
InterventionsUsing grant funds awarded, the team embarked on a 2-year journey to identify and mitigate workplace violence against nurses. The team formed a workplace violence prevention committee which included nurses from various areas of the hospital, implemented educational activities, reviewed hospital policies, re-issued ID badges to not include last names, provided de-escalation training, completed an OSHA assessment of the organization, published hospital newsletter articles on workplace violence prevention committee activities, created a code of conduct for patients and families, completed 3 IRB approved surveys of hospital staff and their workplace violence experiences.
OutcomesNursing engagement was accomplished, and great input into current process, problems experienced and solutions to issues was accomplishedA total of 326 nurses attended de-escalation training,Seven educational activities were offered to nurses. The activities had a total of 283 nurse attendees.
217 Nurses participated in survey one, 228 nurses participated in survey two, and 136 nurses participated in survey number three.Reported disturbances/incidents did not decrease during the project, but rather increased.
Lessons LearnedWhile an overarching goal was to reduce the number of police calls and reported disturbances, the numbers increased. As nursing staff were interviewed, it was discovered that with the additional knowledge concerning the process to access the police officers along with their available resources, staff were more willing to report the incidence, thereby increasing the number of reports
De-escalation training was found to need to be individualized to meet the needs of the nurses and have a clearly outlined sustainability plan. Remind nurses tools are there to prevent escalation of a situation and calling for help does not need to only happen when violence occurs.
Hospital polices need to be easily accessible to nurses on the patient care units.Reports of workplace violence incidents should be reported and communication with the person who submits report need to be closed
Nurses’ Perspectives of Their Workplace Well-Being at a Tertiary Hospital in Saudi Arabia
No full textNursing is a demanding profession that requires substantial physical and emotional resilience, making nurses vulnerable to burnout and stress due to high job expectations and challenging work environments. In this context, many nurses are reluctant to seek help or divulge personal stressors, which can adversely affect their performance and coping skills. As a Magnet-recognized healthcare facility, the organization prioritizes outstanding patient outcomes and strives to enhance workplace conditions for nurses. A collaboration between the Magnet department and the Nurse Retention Office aims to understand the influence of the work environment on nursing wellbeing, with a focus on uncovering hidden psychological burdens that may hinder professional growth and personal wellbeing. The concept of wellbeing at work is crucial within the domains of occupational health and scientific research. This study aims to investigate nurses\u27 perceptions of wellbeing within a tertiary care hospital in Jeddah, Saudi Arabia—a locale where research on this topic is limited. The study involves a diverse sample of 1160 nurses and focuses on their understanding of wellbeing and factors affecting it. Qualitative research methodology is employed to provide in-depth insights into individual experiences and perceptions, laying a foundation for future quantitative studies and interventions aimed at improving workplace wellbeing. Data analysis, utilizing thematic analysis, occurred alongside data collection, which included interim analyses after the first two interviews.
The sample consisted of seven nurses with Bachelor of Science degrees, including positions such as Program Director and Nurse Manager, in addition to frontline clinical nurses. Interviews lasted between 30 to 55 minutes, capturing a range of perspectives.
In conclusion, with an increased emphasis on positive psychology, healthcare institutions are adopting initiatives to enhance employee wellbeing. Despite these efforts, workplace surveys often indicate reduced engagement and positive emotions among nurses. This study revealed that nurses recognize critical factors influencing their wellbeing, including salary considerations, social support, career development opportunities, work-life balance, and organizational backing. These findings provide a basis for future qualitative research aimed at creating a supportive work environment for nurses, ultimately benefiting both individual and organizational outcomes
Animal-Assisted Intervention to Increase Nursing Resilience in a Level-1 Trauma Center
No full textBackground: Trauma nursing is a complex balance of critical care theory and clinical expertise delivered in a stressful, unpredictable environment that challenges a nurse\u27s emotional well-being. Trauma nurses often encounter the end result of society\u27s unmet social determinants of health and systemic inequities precipitating trauma. At Temple University Hospital, trauma nurses care for patients from the most densely populated, poorest, and violent areas in Philadelphia. Temple University Hospital is a level-1 722-bed safety net facility with 36 trauma-related intensive care beds and experienced 2694 trauma alerts in 2023. Historically, nursing is associated with high work-related stress, emotional demands, and workplace violence that increases incidences of anxiety, depression, burnout, and lack of engagement (Lovell & Ranse, 2022; Maran et al., 2022). Nursing resilience is the development of coping strategies to prevent psychological harm by utilizing support recourses and adapting to the environment, which is essential in the delivery of patient care (Maran et al., 2022; Olaleye et al., 2022). Decreased nursing resiliency is associated with greater absenteeism, low productivity, professional dissatisfaction, and a high turnover rate (Machova et al., 2019; Gee et al., 2021). A literature review demonstrated that an animal-assisted intervention may positively affect a nurse\u27s well-being by decreasing stress and anxiety while improving a nurse\u27s ability to cope.
Purpose: To explore the perception of trauma nurses\u27 anxiety and stress after having an interaction with a therapy dog following a traumatic work-related event.
Method: An electronic questionnaire utilizing a five-point Likert scale was administered to trauma nurses following a traumatic work-related event to gain their perception of the effect that interacting with a therapy dog has on stress, feeling positive, anxiety, and delivering excellent patient care.
Results: The results were that majority of those surveyed or about 70% of participants agreed or strongly agreed that interacting with the therapy dogs decreased the work related stress experienced during the shift and they continued to work in a better emotional state after the stressful event than without the interaction of the therapy dogs
A Validation Experiment: Utilizing Ultraviolet Light to Disinfect High Use Nursing Equipment
No full textBackground: Healthcare staff continue to utilize equipment that can travel from patient room to patient room without disinfection or cleaning between use. Additionally, nursing and housekeeping staff may not always communicate clearly regarding responsibilities for cleaning some of these items. The purpose of this study was to identify if a portable UV-C tent utilized with a UV-C device (Xenex® LightStrike™ Robot) can effectively disinfect high use equipment used within inpatient nursing units across a large military medical treatment facility.
Method: Healthcare equipment consisting of commodes, toilet seat risers, wheelchairs, vital sign machines, workstations on wheels, and bassinets were pre swabbed to determine colony forming units (CFUs). These items were then placed into the portable UV-C tent and a cycle completed. The tent is very easy to use requiring items to be placed in the tent, the tent zipped up and the UV-C machine started. After a 15-minute cycle items can be removed and additional items inserted and the process repeated. Following UV-C disinfection, a post swab was completed on each item to determine CFUs. Standard microbiology techniques were utilized to sample, plate, and count CFUs from these sampled items. A variety paired t-test was conducted to identify if a significant change in the number of CFUs occurred.
Findings: Samples (n=66) of commodes, toilet seat risers, wheelchairs, vital sign machines, workstations on wheels, and bassinets had a significant reduction in contamination (17.08 CFUs vs 0.45 CFUs, P\u3c0.05) following UV-C treatment. This near elimination of CFUs highlights the effectiveness of UV-C to disinfect high touch surfaces. Nurses found the process easy to implement and felt it could be feasible for the night shift work personnel to perform when the equipment is available.
Implications for Nursing: It is important that nurses take steps to break the chain of infection while providing patient care. It is critical that high use items that travel across units are frequently cleaned and disinfected. Policies regarding infection control need to focus on these high touch items and include methods such as the UV-C tent utilized in this study to ensure these items are disinfected reducing the risk of healthcare associated infections
Boosting Trauma First Aid Proficiency with Constructivist Self-Learning and Video Production
No full textPurpose: Effective trauma first aid training is essential for preparing nursing students to handle emergencies. This study aimed to: (1) assess the impact of a 36-hour self-learning course, incorporating a trauma care video project based on constructivist principles, on students\u27 familiarity with trauma care processes; and (2) evaluate its effect on their confidence in applying trauma first aid.
Methods: Eight students completed a 36-hour trauma first aid course over three months, including Trauma First Aid Overview (5 hours), Emergency and ICU Experience with Case Studies (12 hours), and Video Production Guidance and Practical Exercises (15 hours). Students\u27 trauma knowledge and ability were assessed before and after the course through tests and surveys to measure changes in proficiency and confidence.
Results: The study found significant improvements in several areas. Knowledge of trauma first aid increased from 5.38 ± 2.33 to 8.00 ± 1.31 (t = -2.78, p = .027), ability to assess trauma first aid rose from 5.00 ± 2.00 to 7.88 ± 1.46 (t = -3.08, p = .018), and familiarity with trauma treatment procedures improved from 5.50 ± 2.33to 8.60 ± 1.51 (t = -3.57, p = .009). Problem-solving ability increased from 5.25± 1.98 to 8.00 ± 1. 07 (t = -3.19, p = .015), confidence in emergency work rose from 5.00 ± 1.85 to 8.00 ± 1.07 (t = -3.38, p = .012), and interest in emergency work increased from 6.75 ± 1.58 to 8.75 ± 1.17 (t = -3.74, p = .007). However, sense of achievement in learning improved from 6.63 ± 2.72 to 8.50 ± 1.31 (t = -1.72, p = .130) with no significant difference. Additionally, there was no significant difference in trauma first aid knowledge test scores.
Conclusion: The constructivist-based self-learning course significantly enhanced nursing students\u27 trauma care knowledge and confidence. The integration of theoretical instruction, practical experience, and interactive video production fostered deeper understanding and greater self-assurance in trauma first aid. These findings support the effectiveness of constructivist approaches in trauma education and suggest that similar methods could be beneficial in other training contexts