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The Changing Trends in Post-Intensive Care Syndrome Among Survivors Transferred out of the ICU
No full textAim: Intensive care unit (ICU) survivors suffering from post-intensive care syndrome (PICS) have been recognized as post-intensive care comorbidities. However, there are rare literature exploring the changing trends of intensive care unit survivors. The purpose of this study was to explore the changing in PICS among survivors transferred out of the intensive care unit.
Methods: The study conducted a longitudinal design, participants were recruited from a medical center in Southern Kaohsiung, Taiwan. Following approval by the participant hospital’s institutional review board (EMRP-108-145). Inclusion criteria were patients who were diagnosed with critical illness and stay at ICU at least 7 days. Outcome measurement variables included the Post-Intensive Care Syndrome Scale (PICS), personal characteristics, and disease-related variables. The demographic and medical variables were collected from 104 ICU survivors at the day they were transferred to the ward. The baseline data were collected within one week (T1), one month (T1), and three months (T2) after they were transferred to the ward and after discharge.
Results: The PICS scores ranged from 0 to 54 (T1), 0 to 54 (T2), and 0 to 53 (T3) with a mean score of 22.17 (SD=14.56) at T1; 15.39(SD=15.40) at T2, and 8.56 (SD=11.87) at T3. The CESD mean scores showed that participants experienced PICS decreased at the one and three months after they were transferred to the ward and discharge. The generalized estimating equation analysis showed that time was significantly different, indicated that patients experienced PICS improvement after transferred out ICU. The results indicated the participants’ PICS scores decreased, and there was a significant trend from Time 1 to Time 3. These results showed that the 3-month PICS score was significantly lower than one-week by 27.03 points, and one-month PICS score was significantly lower than one-week by 12.58 points.
Conclusions: The study confirmed that the changing in PICS among survivors transferred out of the intensive care unit. This results recommend for the healthcare staff aware the PICS of ICU survivors, and embed the changing trends into discharge plan in care of ICU survivors
Three-Month Trajectories and Key Factors of Preventive Treatment Efficacy in Patients with Migraine
No full text1. Purpose: The primary aim of this study is to explore the trajectories of monthly headache days (MHDs) among patients with migraine over a three-month period following preventive treatment. The secondary aim is to identify key factors that influence these trajectories, providing insights for effective nursing interventions that emphasize health promotion and chronic disease prevention to alleviate the chronic burden of migraine.2. Methods: A prospective cohort study was conducted at a neurology outpatient clinic in Taiwan, involving 132 migraine patients, of whom 116 completed the 3-month follow-up. Nursing assessments included evaluations of personality traits, sleep quality, anxiety, depression, and stress levels. Migraine headache days (MHDs) were documented using a headache diary. Group-Based Trajectory Modeling (GBTM) was employed to identify patient groups, and multinomial logistic regression was utilized to determine the influencing factors.3. Results: Three trajectory groups were identified: well-controlled, gradually improving, and treatment-resistant. Factors associated with poorer outcomes included pre-treatment daily headaches (OR = 13.73, p = 0.001), being female (OR = 42.68, p = 0.009), and being aged 40-49 (OR = 64.01, p = 0.013). Conversely, protective factors included unemployment or retirement (OR = 0.08, p = 0.020) and caffeine consumption (OR = 0.12, p = 0.023). The model demonstrated a predictive power of 71.54%. Furthermore, significant differences were observed in sleep quality, psychological health status, and stress levels among the groups three months after the initiation of preventive medication treatment. Notably, the change in anxiety levels between the treatment-resistant group and the other two groups also exhibited significant differences (p \u3c 0.05).4. Conclusions: Understanding the trajectories of headaches and the factors that influence them in migraine patients is essential for developing tailored nursing interventions. By identifying distinct patient groups, this study emphasizes the necessity for targeted non-pharmacological approaches, such as sleep and anxiety management, to enhance care outcomes and support individualized care plans
Evaluating the Impact of Interactive Virtual Modules on Mental Health Content Mastery Assessment
No full textIntroduction: In today\u27s rapidly evolving technological landscape, education must adapt to effectively engage students and enhance learning outcomes. As technology becomes increasingly integrated into daily life, it is essential to reevaluate teaching strategies to align with students’ preferences and improve academic performance. Utilizing virtual active learning pre-lecture assignments have shown to increase student engagement for learning. This study aims to investigate the effectiveness of pre-lecture virtual assignments and their impact on student achievement, as measured by content mastery assessment levels, in an undergraduate mental health nursing course.
Methods: This study retrospectively analyzes content mastery assessment data from four cohorts of third-semester mental health nursing students at a local undergraduate nursing program: Fall 2022, Spring 2023, Fall 2023, and Spring 2024. The content mastery assessment levels at the end of the semesters were used to compare levels among the four cohorts. The content mastery levels provide students with probability of passing the Mental Health course content in National Council Licensure Examination (NCLEX).
Results: Cohorts without interactive learning modules as pre-lecture assignments scored 17.79% for below level 1, 33.05% for level 1, 46.19% for level 2, and 2.97% for level 3. In comparison, cohorts with interactive learning modules as pre-lecture assignments scored 4.35% for below level 1, 29.25% for level 1, 65.22% for level 2, and 1.19% for level 3. Indicating significant improvement in level 2, which indicates increased probability of students passing the NCLEX. The results also indicate significant decrease in below level 1, which indicates decrease in probability of students not passing the NCLEX.
Conclusion: Inclusion of pre-lecture interactive assignments significantly improved the number of students who scored level 2, indicating higher probability of passing the mental health content on the NCLEX. Although there were fewer students who scored level 3, overall probability of passing NCLEX was increased as majority of the students in Fall 2023 and Spring 2024 scored level 2 or level 3. Comparing below level 1 or level 1 between the two groups of cohorts also indicated improvement as fewer students scored below level 1 or level 1, indicating decrease in the number of students who may not be successful on the mental health content on NCLEX
Clinical Placements for Nursing Education and Student Perceptions in Correctional Healthcare
No full textBackground: Texas has the largest prison population in the United States, with approximately 134,000 individuals currently incarcerated. Ensuring quality healthcare for all patients, including incarcerated individuals, is essential to uphold ethical standards and legal requirements. However, correctional health facilities face unique challenges in recruiting and retaining skilled nursing staff due to the demanding nature of the work, safety concerns, lower pay, and the stigma of working in a prison environment (Chafin & Biddle, 2013). Introducing nursing students to correctional healthcare through positive clinical experiences may increase their interest in this field for future employment.
Purpose: The project investigated nursing students’ perceptions of their clinical rotations at a correctional healthcare facility and helped faculty evaluate clinical orientation to prepare students for a correctional health setting.
Methods: Student perceptions were evaluated using a modified version of the Attitude Towards Prisoners (ATP) scale. The evaluation occurred at two points to capture changes in student attitudes: before orientation and after the clinical rotation. Additionally, a survey administered immediately after the clinical site orientation evaluated the orientation’s value and preparedness.
Results: A convenience sample of 34 students completed all three surveys. The analysis revealed no significant difference between pre-clinical and post-clinical ATP scale surveys. However, 52% of the students expressed willingness to consider future employment in correctional health. Qualitative feedback identified themes such as pre-orientation concerns about safety and empathy, increased safety and knowledge post-orientation, and post-clinical improvements in clinical skills, unbiased care, and collaboration with nursing staff.
Conclusion: Exposing students to the unique environment of correctional healthcare encourages graduates to pursue careers in this field, potentially improving patient outcomes within the correctional health system by fostering motivated and well-prepared healthcare professionals. Insights gained from this study highlight the influence of educational and experiential components on students’ perceptions of incarcerated individuals and their attitudes toward providing healthcare in correctional settings
Sexual Dysfunction Among Patients Living With Interstitial Lung Diseases: A Scoping Review
No full textAlthough sexual function is an important facet of quality of life (1, 2), it is an aspect that is frequently overlooked by healthcare professionals in patients with interstitial lung diseases (ILDs) (3, 4). It is known that living with chronic lung diseases such as COPD, asthma, and cystic fibrosis makes maintaining sexual function strenuous (4, 5). Although patients with ILDs face similar difficulties, they have been underrepresented in academic research.
This scoping review aimed to explore the subtypes of sexual dysfunction (SD) encountered by patients with ILDs and to identify its associated factors.
This study was guided by Joanna Briggs Institute framework, and we conducted the database search across PubMed, CINAHL, Cochrane Library, Embase, and APA PsycINFO up until May 31, 2024. Formulating search terms were consulted by a professional librarian. Two independent reviewers performed literature screening and data extraction, resolving discrepancies through discussion with a third reviewer. Data were analyzed by descriptive approach and were presented in a tabular format.
Out of 1896 studies, 14 studies were included in the review. The studies were conducted in Europe (n=7), the United States (n=2), China (n=2), Egypt (n=2), and Australia (n=1). The predominant study designs were qualitative (n=4), followed by cross-sectional (n=3), mixed methods (n=3), observational (n=3), and quasi-experimental (n=1). Erectile dysfunction was the most commonly reported SD among male patients, along with decreased libido. Meanwhile, female patients reported SD across multiple domains, including desire, arousal, lubrication, orgasm, satisfaction, and dyspareunia. The associated factors of SD were categorized into physiological (e.g., age, dyspnea, hypoxemia, lung function, hormonal imbalances, disease duration), treatment-related (e.g., medication side effects, supplemental oxygen therapy), and psychosocial (e.g., altered body image, low self-esteem, communication difficulties, depression).
This review highlights the presence of SD among patients with ILDs and underscores the importance for healthcare professionals, especially nurses who interact frequently with these patients, to be aware of and actively intervene in their sexual health needs
Elevate and Educate: Rapid Response Nurse Led Learning Sessions
No full textPurpose: Traditional formal education and skill fairs are increasingly shifted to online learning creating a need for innovative educational methods to reach nurses. The purpose of this initiative is to provide education through informal presentations to creatively share key evidenced based practice to enhance patient care and foster nursing development.Synthesis of Evidence: Studies consistently indicate that concise and informal educational sessions can be highly effective in delivering specific knowledge or skills. For example, in healthcare settings, short sessions have been shown to improve retention of information compared to longer, more traditional formats (Lee et al., 2020). Informal education methods, such as impromptu sessions or brief tips, often lead to higher engagement among participants. (Daws et al, 2020; Mlambo et al., 2021).Implementation: This project initiated in June 2023 at a 711-bed level 1 trauma academic medical center. The rapid response team RN develops a “tip of the month” based on education needs derived from surveys and bidirectional dialogue from nursing staff. The entire team and an educator with expertise in the area vet the completed topic with clear objectives outlined.While rounding on units the rapid RNs present these topics to nursing staff for informal in the moment learning. These topics are also shared via the intranet and educator emails, maximizing accessibility and dissemination across staff. A survey is offered to staff receiving the education directly from the rapid nurses to garner feedback and improve future offerings.Evaluation: Over 12 months, 2309 surveys were submitted averaging 192 contacts monthly. Ranking on a Likert scale of 1 to 5 (far below average to far above average), staff ratings show an average 27% improvement in knowledge and 23% improvement in confidence on the topic. Feedback from participants include “I love the fast, short offerings” and “love the impromptu education” and multiple comments illustrating value in hearing the education from trusted sources. This initiative is crucial to adapt to modern educational demands and improve patient care by providing targeted, practical knowledge directly to bedside staff. This method leverages the team’s expertise to foster and encourage ongoing learning among nursing staff
Strengthening Global Health Curriculum Via International Partnerships
No full textNurses worldwide play an important role in improving global health due to their collective education and clinical practice experiences. They bring a patient centered focus to care delivery and their hands-on experience enables them to better observe how healthcare policies and programs affect people and their communities (Salvage & White, 2020). While nursing curriculum includes elements of global health, the need for an academic framework was identified that prepares nurses to improve global health outcomes for all clients (Bain & Adeagbo, 2022). Nursing practice has witnessed increased mobility, as more than 12% of nurses work in a country other than where they were born or educated (Baker, Cary & Bento, 2021). Nurses require a strong foundation in global health to meet demands. Yet, nursing education varies across the globe, and in recognition of nurse mobility and educational variance, the World Health Organization (WHO, 2024) set forth policies to ensure public health competencies are met, and nurse leaders are prepared to institute evidence-based practice in global healthcare.
The purpose of this scholarly project was to develop approaches to internationalize best practices in global nursing education by partnering with health science faculty at the University of Dundee. Focus was placed on integrating international health perspectives that serve to increase students’ global knowledge in undergraduate and graduate programs (Kunaviktikul & Turale, 2020). The aim was to develop a virtual global health seminar that prepares students to assess global health risks that include geopolitical, socioeconomic, and environmental factors that disrupt the delivery of quality healthcare. Three health topics were selected for discussion during the seminar. A public health worker was also recorded discussing scenarios related to those selected health topics. Questions were asked at the end of the videos that relate to each topic and focus on health care delivery. Students were paired with their international colleagues to discuss how the seminar content relates to their practice. Outcomes are measured by assessing increases in global health awareness via pre/post seminar surveys that were designed to explore this international experience. Forming an international partnership was critical to developing and delivering this experience and nursing faculty should consider this strategy when working to embed global health content into nursing curricula
Improving Student’s Attitudes, Perceptions, and Comfort Caring for Patients with Disabilities
No full textPurpose statement: The purpose of this project was to evaluate the impact of a two-week intensive curriculum on the perception, attitudes, and comfort of medical students towards people with disabilities (PWD).
Background: PWD represent the largest legally protected minority that experiences health disparities in the United States (US)(1). Healthcare providers (HCP) receive inadequate education to support this growing population(2). In 2021, only 40.7% of surveyed physicians (MDs) reported confidence in their ability to provide the same quality of care to PWD as to those without and only 56.5% strongly agreed that PWD were welcome to seek care in their practices(3). A 2022 study found MDs discharging patients with disabilities from their care due to perceived inadequate reimbursement(4). PWD face barriers in their ability to access care and in the quality of care they receive(5). A study of MDs in the US showed that 82.4% believed that PWD have a lower quality of life(2). The implicit and explicit bias held by HCP impacts the care and outcome of patients(2).
Methods: A two-week, 72-hour intensive curriculum was developed to address the gap in healthcare disability education. Faculty and students with lived experience of disability designed a theory- and skills-based curriculum focused on disability justice and caring for PWD. Content was delivered through online and in-person sessions, along with interactions with PWD. Pre- and post-course surveys utilizing the Interactions with People with Disability Scale (IPDS) assessed changes in students’ perceptions and attitudes towards PWD. Thematic analysis was completed on student and panelist feedback to further understand course impact.
Outcomes: Pre- and post-course evaluations utilizing the IPDS showed significant (p\u3c 0.001) improvement in student’s perceptions and attitudes towards PWD. Thematic analysis of medical student feedback demonstrated increased confidence in caring for PWD and plans for advocacy.
Implications: Outcomes from this mixed-method study demonstrate the positive impact of disability in healthcare education. This current curriculum will continue to be offered to MD students, with plans to translate the curriculum into nursing and physician assistant training programs
The ART of Nursing, a Retention and Recognition Program Evaluation
No full textPurpose: This presentation will describe an evaluation of a nurse retention and rewards program using a mixed methods research design.
Introduction: Recognition and reward programs may support retention and engagement while encouraging staff investment in hospital outcomes1, 2, 3. Hospital leaders developed an innovative strategy; The Achieving Professionally, Recognizing Contributions and Talent Sharing (ARTs) program to recognize clinical nurses for work beyond their defined job duties, while encouraging professional investment in the organization. Participants are matched with a coach to complete an annual portfolio and obtain a monetary reward.
Design: This study used a convergent mixed methods design supported by the Context, Input, Process, Product (CIPP) Evaluation Model4.
Methods: Multiple choice and open-ended question surveys and interviews were conducted between June and December of 2022 in a large academic medical center. Annual Likert scale (5-point) survey evaluation data was obtained for the first four program years.
Results: Study surveys (N=224) and annual evaluations (N=447) showed consistent program re-enrollment, with rising portfolio completion rates, demonstrating product (CIPP) impact, effectiveness and sustainability. Respondents agreed that the ARTs program promotes professional practice (M=4.1, SD=0.9, encouragement (M=4.0, SD=1.1), recognition (M=3.9, SD=1.1), and participation in shared governance (M=3.8, SD=1.1). Analysis from interviews (n=42) identified themes of benefits, challenges, support, disheartened, and structure. Participants reported ARTs projects have benefitted their unit, department, and hospital outcomes. Coaches reported feeling fulfilled by guiding others. Both noted time and structure were barriers requiring product adjustment (CIPP).
Implications: Nurses are often asked to support their professional development and organizational needs by completing projects, contributing to shared governance, or participating in the community. Implementing a program which rewards nurses for their commitment to go above and beyond shows a dedication to nurses, while benefitting the organization and the nurse. Coaches and participants stated overall ARTs program satisfaction, but there were opportunities for improvement noted. This innovative program aligns with strategic goals, contributes to RN staff development, and supports Magnet status
Investigation of the Influences of Planned Exercise on Food Choices in School-Age Children
No full textThis investigation explored the influence of a single bout of planned intense exercise on food choices (calories and macronutrients) in a controlled laboratory setting, in normal-weight school-age children. The National Heart, Lung, and Blood Institute (2022) reports that 1 in 5 children have obesity. Yet, research on the effect of exercise on children is limited. Studies often lack controls for environmental, social, or behavioral influences that may impact food choices. Also, studies often provide limited food options to identify macronutrient choices. (Donnelley et al., 2014) (Fearnbach, et al., 2016) (Kristina, et al., 2021) (Noll, et al., 2017).A quasi-experimental single-group repeated-measures design was used to compare food choices after intense exercise and after being sedentary in the laboratory setting. After prescreening/fitness testing, 30 normal weight junior high children participated in an exercise and a sedentary intervention in random order. After each intervention session subjects ate lunch from the same large buffet-type meal.The data showed that, fat consumption at the buffet meal increased in the exercising group (p=0.0373). However, once macronutrient intake was adjusted for the total changes in caloric intake no significant differences were found between groups. When looking at just their first intervention day, results showed a statistically significant increase in fat intake in the exercising subjects for calories (p= 0.001) and for percentages (p= 0.007) of fat intake. Sedentary subjects showed a significant increase in the percentage of carbohydrate intake at the first exposure to the buffet meal (p= 0.034). Exercising subjects ate significantly more calories (p= 0.046). Yet, when looking at the second intervention days, there were no significant differences in intake patterns between the two groups.Children who were exercised or sedentary, showed significant differences in caloric and macronutrient changes upon first exposure to the buffet meal. Previous exposure to the buffet may override natural physiologic drives toward food selections. Further studies with adolescents in controlled laboratory settings controlling for behavioral and environmental variables is warranted. With a clearer understanding of what macronutrients would naturally be ingested based on an individual’s activity level, we may enhance our understanding of the needs of children who exercise. This may also lead to improvement of obesity-prevention programs