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Meaningful Recognition to Nurses: A Contemporary Perspective to Support a Healthy Work Environment
No full textMeaningful Recognition is one of 6 components of a healthy work environment and one of the easiest to leverage for nursing leaders (AACN,2022). With the impacts of the pandemic over the past two years and especially the exacerbation of nursing shortages it is important to identify and understand what is truly meaningful to nurses when they are recognized. Using the American Association of Critical-Care Nurses (AACN) Healthy Work Environment (HWE) as the theoretical framework, the researchers wanted to understand what meaningful recognition means to nurses in differing settings given the effects of the pandemic on an already stressed workforce. Members of seven Sigma Theta Tau chapters in the state of Maryland were asked to respond to an online survey consisting of demographic data and questions exploring meaningful recognition and the healthy work environment using tools with established reliability and validity. One hundred sixty five nurses from a variety of practice settings, roles, and demographics responded to provide insight into what meaningful recognition is to them as well as provided responses to how well they perceive being meaningfully recognized in their places of work. A descriptive correlational design was used. Thematic analysis demonstrated themes in the type of recognition valued by nurses as meaningful. Earlier studies of meaningful recognition have identified differences between generations and between nursing leaders and their nursing staff (Johansen, Cordova, Weaver, 2021; Leger, Lajoie, Wood, 2021; Salvant, Wycech, Alexander, 2020). It is important to have congruency between the giver and the receiver of meaningful recognition to have the greatest impact (Lefton, 2012). By identifying meaningful recognition types, and employing them, leaders can better leverage this HWE tool. This study found three distinct themes of recognition that is considered meaningful by this sample, financial, personal recognition, and professional development. In addition the study uncovered opportunities for further discovery of new knowledge around gender, cultural and ethnic preferences
Voices of Emergency Department Nurses and their Experiences of Workplace Violence
No full textBackground: Nurses in many healthcare facilities frequently feel unsafe and threatened due to workplace violence (WPV) which is a serious and persistent problem across the United States, (American Nurses Association, 2015; Center for Disease Control and Prevention, 2019). While all nurses are at risk for experiencing WPV, the emergency department (ED) is considered an especially high risk unit due to factors such as the acuity of illness, traumatic events, victims of violence, and the 24/7/365 days open door policy, (Emergency Nurses Association, 2020; Morrison & Joy, 2016). Patients with substance use disorders (SUDs) generate unique challenges for ED nurses since these patients often present with aggression. There is evidence that substance abuse plays a significant role in the escalation of violent behavior from patients with SUDs towards nurses in the ED, creating an unhealthy and potentially dangerous workplace environment.
Purpose: To examine the experiences and perceptions of ED nurses who have encountered WPV specifically from patients with SUDs.
Methods: This descriptive qualitative study utilized Braun and Clarke (2013) thematic analysis with a sample of Registered Nurses (n=53; 45 females and 8 males) working in a Level I trauma center ED. Nurses participated in 24 focus groups between October 2019 — February 2020. All of the group discussions were transcribed verbatim and the Atlas.ti8TM software was used in the analysis.
Results: ED nurses discussed their interactions and experiences of WPV within the context of treating patients with active SUDs. Most described their perceptions of violent patient interactions and their emotions surrounding these incidents, along with nurse responses and measures of self protection. Four themes emerged from the data: 1) feeling verbally and physically abused, 2) feelings of frustration, 3) actions taken to feel safe, and 4) setting healthy boundaries. These themes come from WPV directed at nurses while the patient is directly under the influence of a substance, or not getting something they desire such as certain pain medication, or after Narcan (naloxone) is administered. Strategies nurses used to mitigate the violence include communication with the patient, wearing protective items, planning ahead for a dangerous situation, utilizing restraints, and calling security.
Conclusions: Acts of WPV in the ED undermine the health and safety of the nurses, providers, and staff. These experiences often lead to physical, psychological, and social repercussions with outcomes causing nurses to lose enjoyment and satisfaction in their job. Nurses who leave the ED and the profession altogether often cite WPV as a factor, (Cho et al., 2020). Healthcare organizations and nursing leaders have an obligation to address WPV in order to create a culture of safety. ED nurses should be supported by implementing effective strategies and providing active reporting programs to keep their staff safe. Fostering a healthy work environment in which the staff is confident, supported, and prepared for high-risk situations will reduce instances of violence in the ED by patients with SUDs, (The Joint Commission, 2018). Recognizing the experiences of ED nurses in the workplace is essential to developing solutions to prevent violence in the future
Zen Den to Improve Nurse Well-Being and Decrease Work-Related Stress
No full textWorkplace stress and burnout have been the ugly underbelly of healthcare since its inception. This project looked at contributors to stress and job satisfaction. Simple and effective EBP techniques were implemented, ultimately decreasing workplace burnout and improving overall job satisfaction.
Detailed abstract attached
The Implementation, Experience, and Efficacy of Changing Minds, Changing Lives: a Resilience Program for Nurses
No full textA nurse-created, nurse-led resilience program was implemented with a cohort of nurses to build resilience and create a healthy work environment. The program utilized an evidence-based curriculum to empower and connect nurses through facilitated learning, writing and reflection. We will review lessons learned from implementing this 10-week course for nurses.
Detailed abstract attached
Exploration of Experiences and Measurement of Burnout Among Clinical Research Nurses During the COVID-19 Pandemic
No full textExperiences among clinical research nurses during the COVID-19 pandemic were explored in a nationwide cross-sectional sample. Components of clinical research nurse burnout were evaluated using the Maslach Burnout Inventory.
Detailed abstract attached
Pill Passport: Optimizing Patient Education Tools Through Usability Testing
No full textIntroduction: Medication nonadherence among older adults who experience comorbidities and a high pill burden is a significant healthcare issue in the United States.1 Older adults are at risk for adverse drug effects, significant harm, and hospital readmissions if medications are not taken as prescribed.2-3
Purpose: This study aimed to develop a prototype design, Pill Passport, a tool intended for patients to participate in their own care by improving medication knowledge and reducing medication nonadherence.4
Methods: Electronic health records were reviewed to identify a convenience sample of participants from two medical centers. Inclusion criteria were patients or their caregivers aged 18 to 89 years, a 30-day readmission risk score of 4 or higher, and a pill burden defined as three or more medications taken daily. A feedback-driven iterative design identified the most user-friendly version of the prototype. Stage 1 was a needs analysis through a qualitative survey. Stage 2 obtained patient and caregiver feedback through interviews comparing two prototype designs. The final stage tested the prototype through an interview and activity assessment using the prototype, simulated medications, and pill organizers.
Results: Data collection was completed. Data analysis is in process.
Nursing Implications and Impact: Older adults are often underrepresented in the design and development of interventions and tools to improve medication adherence.5 Pill Passport serves as an ongoing medication education tool for patients and caregivers to use during healthcare interactions and for at-home medication management
Addressing Stigma Among Healthcare Professionals Caring for Patients With Opioid Use Disorder
No full textBackground: Opioid use disorder in primary care affects millions in the United States. Healthcare professionals and clinic staff are often unaware that they are stigmatizing individuals with opioid addiction. Increased awareness of the detrimental impact of perpetuated stigmas on opioid use disorder patient population outcomes needs to be addressed to minimize barriers to care and enhance quality care outcomes, care coordination, and treatment for patients with opioid use disorder.
Purpose: This quality improvement project investigates stigma reduction training programs to (a) improve healthcare professional perceptions and (b) decrease the stigma of the OUD patient population through a quality improvement project.
Methods: A quasi-experimental design was used to measure healthcare providers\u27 and staffs’ attitudes and beliefs about opioid addiction following the implementation of a web-based stigma training module. Demographic data was collected to assess trends or commonalities of healthcare professionals and clinic staff barriers to managing stigma through The Opening Minds Provider’s Attitudes Towards Opioid Use. Pre- and post-data will be collected from patients with opioid use disorder, assessing its impact on reducing patient perceptions of experienced stigma through the use of the Brief Opioid Stigma Scale. Quantitative data analysis, including t-tests and chi-squared tests, will determine changes in patient experiences related to perceptions of stigma.
Outcomes: The project is in progress, and definitive findings and conclusions are unavailable. Results and conclusions will be determined and articulated upon the project\u27s completion. The expected data collection and analysis completion timeline will be no later than January 31, 2025.
Implications: Stigma training for healthcare professionals and clinic staff enhances the ability to provide compassionate care tailored to patients with opioid use disorder. It promotes positive health outcomes by addressing biases and fostering open communication. Stigma training also addresses health equity by addressing structural barriers to care and promoting inclusive healthcare policies. Addressing stigma in healthcare has the potential for broader application across diseases associated with stigmas, mainly led by advanced practice nurses, in transforming healthcare responses and treatments
Impact of a Responsive Bassinet on Neonatal Abstinence Syndrome in the NICU
No full textDuring the COVID-19 pandemic, operational modifications resulted in an increased average length of stay (ALOS) for Neonatal Intensive Care Unit (NICU) infants with Neonatal Abstinence Syndrome (NAS), from 10 days to 30 days, and additional workload for nursing staff. In response an innovative responsive bassinet (SNOO) was introduced into existing Eat, Sleep, Console (ESC) care model with goal to improve sleep while maintaining American Academy of Pediatrics (AAP) Safe Sleep positioning.A retrospective chart review was conducted on neonates admitted to NICU who received scheduled methadone dosing for NAS from December 2020 to September 2022. Study inclusion criteria was primary diagnosis of NAS, birth gestational age ≥35 weeks, and no co-diagnosis which would contribute to length of stay. SNOO was introduced in November 2021. Neonates were grouped in pre-SNOO (baseline) and post-SNOO (intervention) periods. Outcome measures included ALOS and the number of sleep-related “yes” scores on our ESC Care Tool (indicating poor sleep related to NAS). All statistical analyses were conducted on IBM SPSS Statistics 28. Mann-Whitney analysis completed based on sample size. Satisfaction surveys evaluated nurse satisfaction and time savings at 1-month and 6-months post-SNOO.A total of 109 infant charts were reviewed. 13 infants (n=11%) fulfilled all inclusion criteria (baseline N=6, intervention N=7). ALOS declined by 17.38% (31.30 baseline; 25.86 intervention, p=0.57), and yes-scores for poor sleep decreased by 41.72% (28.67 baseline; 16.71 intervention, p=0.52). No significant differences based on gender, post-natal age, birth gestational age, length of stay, poor sleep scores, pharmacotherapy days, or “just in time” dosing were found. No other modalities of our preexisting ESC model of care were altered between groups. Satisfaction survey data demonstrated 84% of nurses surveyed at 6-months post-SNOO identified a timesaving’s of 1 to 2 hours per shift or more.Conclusions: While observed reductions in ALOS and yes-scores were not powered for statistical significance, the addition of SNOO as a non-pharmacologic intervention within ESC care models may lead to improved outcomes. Further, impact of SNOO on nursing workload has the potential to improve care, efficiency, and satisfaction. Future studies should explore SNOO’s impact on NICU NAS admissions when utilized in the Newborn Nursery setting or implications of modeling safe sleep practices for this at-risk population
Nurses Removing Arterial Sheaths: Disseminating Evidence-Based Practices to Improve Patient Care
No full textIntroduction: Arterial sheaths are vital to many minimally invasive cardiac procedures. Nurses have performed arterial sheath removal after cardiac procedures in critical care settings for over a decade (Sania et al., 2022). Nurses removing arterial sheaths is associated with improved patient safety outcomes, including decreases in hematoma formation and awareness of risk factors (Al-Lenjawi et al., 2022; Henedy & El-Sayad, 2019). Removal of arterial sheaths is an advanced skill that requires nurses to meet specific criteria and receive clinically appropriate education (Capasso et al., 2006). Preparing experienced nurses to remove arterial sheaths earlier can increase patient safety and decrease complications. This project aimed to decrease hematoma rates by preparing nurses to perform arterial sheath removals through the dissemination of education and return demonstration of skill (Ghods et al., 2022; Jakobsen et al., 2022; Jalili et al., 2015; Sania et al., 2022).
Methods: A group of expert nurses in the CCU and CVICU with a minimum of one year of experience participated in a live education session. Pre- and post-Qualtrics surveys measured knowledge change. Aggregate data on patient hematomas was evaluated for two weeks pre-implementation and 12 weeks post-implementation of the educational session.
Results: Hematoma rates decreased from 20% (1 of 5 open hearts) to 0% (0 of 8 open hearts) post the implementation of the education session. On a pre-test, the nurse participants scored 6-12 out of a maximum score of 20, with a mean score of 10.4 (95% CI [7.93, 12.92], SD 2.70). After the education, participants scored between 12-20 with a mean post-test score of 16.9 (95% CI [14.27, 19.44], SD 2.79). This represented an increase of 32.14% from the pre- to post-knowledge tests. The education session had a 93% overall average positive evaluation score.
Conclusion: The results of this project indicate that providing an educational session for nurses on arterial sheath removal can increase knowledge of the nurse at the bedside and patient safety. These findings indicate that the sessions could be replicated to include additional qualified nurses in this facility or other centers of critical cardiac care. Further research is needed to monitor the long-term clinical impact of this educational intervention
The Focus of Emotional Intelligence for Educators and Staff Within Professional Development
No full textEmotional intelligence (EI) has been defined as having the ability to perceive, express, understand, and manage emotions (Bru-Luna et al., 2021). Research suggests that by incorporating EI into professional development for nurse educators, nurses, and staff, will influence the health and wellness advances in both patient care and nurse wellness. An increase in EI increases the ability to cope, prevent burnout, maintain nurse retention, increase job satisfaction, and deliver quality care with improved patient outcomes (Chikobvu & Harunavamwe, 2022; Maillet & Read, 2024). Burnout has been a common, longtime problem in nursing. From new graduate nurses entering the field to highly trained seasoned nurses, burnout affects resiliency, grit, and compassion (Soto-Rubio et al., 2020; Ruiz Fernández et al., 2021). Emotional intelligence improves nurses’ ability to think critically and reason, communicate, collaborate in interdisciplinarity, and manage their emotional health (Christodoulakis et al., 2023). Nurses with high emotional intelligence manage stress better, resolve conflicts more easily, have better work-life balance, regulate their emotions, communicate effectively, take on natural leadership, and show higher morale in their employment (Apore & Asamoah, 2019). These traits make them more effective, better patient advocates, and better employees, ultimately leading to improved patient outcomes and overall healthcare system. Emotional intelligence is the answer to how redesigning in nursing occurs and how these changes help address new frontiers that are faced every day in the field