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Professional Identity in Nursing Scale Development, Testing, and Future Directions
No full textBackground: According to the International Society for the Professional Identity of Nursing (ISPIN), professional identity in nursing (PIN) is defined as a “sense of oneself, and in relationship with others, that is influenced by characteristics, norms, and values of the nursing discipline resulting in an individual thinking, acting, and feeling like a nurse.”1 In addition, four domains of professional identity were established: knowledge, leadership, values and ethics, and professional comportment.2 The Professional Identity in Nursing Scale (PINS) was designed, tested, and revised to effectively measure perceptions of PIN related to self and the work environment.Methods The PINS was created and revised using the DeVellis and Thorpe scale development model.3 There are eight steps in the model including 1) deciding which concept to measure, 2) creating an item pool utilizing subject matter experts4, 3) determining the format of the scale, 4) -8 having an item pool reviewed by experts, 5) administering a sample scale, 6-7) evaluating inclusion and exclusion of items based on psychometric evaluation, and 8) optimizing the scale’s length.Results Three versions of the PINS have been empirically tested. The PINS 1.0 was tested on nurse educators (n=1074) to measure perceptions of the level of importance for each of the 34 items of PINS 1.0.4 Based on the analysis of the findings and the endorsement of 95% of the participants, items on the PINS 1.0 were reduced from 34 to 30 scale items. Once the PINS 1.0 was revised, PINS 2.0 was tested with a sample of practicing RNs (n=633). Both the exploratory and confirmatory factor analysis demonstrated adequate psychometric properties for the PINS 2.0. Cronbach’s alpha coefficients for reliability were: PINS 2.0-self=0.97 and PINS 2.0-environment=0.98.5 After revision of the PINS 2.0, PINS 3.0 was tested with hospital-based RNs (n=334). Cronbach’s alpha coefficients for reliability were: PINS 3.0-self=0.91 and PINS 2.0-environment =0.95.6Conclusions Future studies include evaluation of PINS 3.0 to effectively quantify nurses’ professional identity and develop interventions. The PINS is currently being tested with nurse practitioners, nurse veterans, and over a dozen doctoral students. It is also being tested in China, Norway, and Iran and going through commercialization development. To further strengthen the psychometrics of the PINS, replication studies are necessary to support reliability and validity
Enhancing ECG Knowledge and Satisfaction with Kahoot! for Nursing Students
No full textThis study addressed the need for effective educational strategies in nursing, focusing on ECG learning essential for patient care. It evaluated the effectiveness of Kahoot! in enhancing ECG learning and identifies key factors influencing the process. A mixed-methods design was used, involving two classes from a Critical Care Nursing course in a Taiwanese university. The experimental group received three Kahoot! sessions, while the control group had traditional discussions. Pre- and post-tests were conducted using open-ended questionnaires. After the post-test, the control group also received one Kahoot! session. Ninety-eight participants completed a satisfaction survey, and ten volunteers were interviewed about their learning difficulties. No significant difference in learning outcomes was found between the groups, but the experimental group reported higher satisfaction. Pre-test scores differed significantly by RN license status and advanced cardiac life support training. Post-test scores showed significant differences by gender and RN license status. The experimental group had higher scores in simulated ECG monitoring. Main learning difficulties included lack of motivation, understanding ECGs, and needing more practice. The study was limited by randomized cluster sampling and different past learning experiences. Future studies should use randomized clinical trials, focus on ECG beginners, and extend the duration of Kahoot! intervention to enhance generalizability
Advanced Machine Learning Techniques for Cardiovascular Disease: Early Detection and Diagnosis
No full textThe identification and prognosis of the potential for developing CardiovascularDiseases (CVD) in healthy individuals is a vital aspect of disease management. Accessing the comprehensive health data on CVD currently available within hospital databases holds significant potential for the early detection and diagnosis of CVD, thereby positively impacting disease outcomes. Therefore, the incorporation of machine learning methods holds significant promise in the advancement of clinical practice for the management of Cardiovascular Diseases (CVDs). By providing a means to develop evidence-based clinical guidelines and management algorithms, these techniques can eliminate the need for costly and extensive clinical and laboratory investigations, reducing the associated financial burden on patients and the healthcare system. In order to optimize early prediction and intervention for CVDs, this study proposes the development of novel, robust, effective, and efficient machine learning algorithms, specifically designed for the automatic selection of key features and the detection of early-stage heart disease. The proposed Catboost model yields an F1-score of about 92.3% and an average accuracy of 90.94%. Therefore, compared to many other existing state-of-art approaches, it successfully achieved and maximized classification performance with higher percentages of accuracy and precision
AI-Driven Solutions for Climate-Related Mental Health Risks in Black Pediatric Populations
No full textIntroduction: Climate change significantly impacts mental health, especially in vulnerable populations such as Black pediatric communities who experience compounded climate stressors due to socioeconomic and environmental inequalities. Artificial Intelligence (AI) provides innovative methods for predicting, managing, and mitigating these mental health risks.
Purpose: This integrative review aims to explore AI\u27s potential in addressing the mental health challenges posed by climate change, specifically within Black pediatric populations.
Methods: A systematic approach was used to review studies examining climate change, mental health, and AI interventions targeting Black pediatric populations. Out of 183 screened studies, 20 met the criteria for inclusion based on their focus on AI-driven mental health interventions.
Results: AI demonstrates potential in identifying at-risk populations, tailoring mental health interventions, and facilitating early detection of mental health conditions linked to climate stressors. However, ethical considerations, including data privacy and equitable access, are essential to avoid perpetuating existing health disparities.
Nursing Implications: Nurses play a critical role in applying AI to assess risks, coordinate care, and advocate for fair access to mental health resources in underserved communities. Their involvement is also vital in policy development to ensure AI technologies benefit vulnerable populations.
Conclusions: AI offers promising solutions for addressing climate-related mental health impacts in Black pediatric populations through predictive analytics and personalized care. Future research should focus on refining AI algorithms to incorporate social determinants of health, ensuring equitable access, and evaluating long-term outcomes. Nurses and healthcare professionals are essential in implementing these tools ethically and effectively, enhancing support for those most affected by climate change
The Impact of Music Experience Sessions on Participants With Agitation Related to Dementia
No full textProblem Statement: As dementia progresses, a person can experience behavioral and psychological symptoms of dementia (BPSD). There are numerous ways BPSD can affect people with dementia (PWD), caregivers, and society, causing a negative impact on quality of life, stress, caregiver burnout, and economic stability for society (Lorusso & Bosch, 2018; Maseda et al., 2018).
Purpose: The purpose of this project was to determine if the intervention would decrease episodes of BPSD without using pharmacological interventions.
Methods: The intervention was performed for an eight-week time frame were facilitated with participants with a known history of dementia.
Analysis: The Cohen-Mansfield Agitation Inventory (CMAI) short form was completed by a dedicated certified nursing assistant (CNA) prior to the start of the intervention. Subsequent CMAIs were completed four weeks from initiation of the intervention, and after the last intervention session. In summary, the CMAI scores over three-time points during the implementation of the intervention showed a significant improvement in three of the four factors of the CMAI form.
Implications for Practice: The aging American population has soared in numbers over the past twenty years. As the size of the United States population age 65 and older continues to increase, the numbers of Americans with Alzheimer\u27s disease and other forms of dementia will grow. By 2050, the number of people in the United States with Alzheimer\u27s disease will reach 12.7 million (Alzheimer\u27s Association, 2021). This disease will also have a significant monetary impact on the nation. Pharmacological approaches are often the first line of treatment professionals seek when a patient experiences BPSD. There are no drugs specifically approved by the Food and Drug Administration (FDA) to treat behavioral and psychiatric symptoms that may develop in the moderate and severe stages of dementia (Alzheimer\u27s Association, 2021). Instead, many providers rely on antipsychotic medications to treat BPSD. Antipsychotic drugs are associated with an increased risk of serious injuries from falls, stroke, and death. Addressing BPSD effects the population and system levels. If there are fewer episodes of BPSD, staff can be free to care for more participants at a time. Implementing this intervention may prevent or reduce episodes of BPSD, improve quality of life, and promote a positive milieu
The Influence of Substance Use on Sleep Architecture in College Students: A Cross-Sectional Analysis
No full textBackground: Substance use and poor sleep quality are prevalent issues among college students, often impacting their physical, mental, and academic well-being. This study examines the relationship between substance use and sleep quality.
Methods: Utilizing variables from the American College Health Association National College Health Assessment III (Fall 2019-present) Spring 2022 reference group dataset (n = 69,131 students), we employed adjusted logistic regression models to assess associations between tobacco, alcohol, and cannabis use risks and multiple dimensions of sleep quality, including sleep onset latency, early awakening, daytime fatigue, and difficulty falling asleep. Substance use risk was calculated using the ASSIST tool.
Results: Increased substance use risk is significantly associated with various sleep disturbances in college students. Higher risk levels of tobacco, alcohol, and cannabis use correspond to greater odds of delayed sleep onset, early awakening, daytime fatigue, and difficulty falling asleep. High-risk users across all substances exhibit the highest odds for these sleep issues, highlighting a clear trend that sleep architecture is disrupted more as substance use risk increases.
Conclusion: The findings underscore a strong association between substance use and various aspects of sleep architecture, suggesting that substance use may significantly disrupt sleep quality. These results support the need for integrated health interventions that address both substance use and sleep health among college students.
Implications: Colleges should consider implementing targeted health education and intervention programs to address the interconnected nature of substance use and sleep issues, promote healthier lifestyles, and improve overall student well-being. There is a need for targeted, tailored programs addressing the specific challenges for students at higher risk, i.e., those with pre-existing mental health conditions or poor sleep habits
A Mixed Method Study on Nurses Pain Management for Hospitalized Persons Living with Dementia
No full textPurpose Statement: To assess factors influencing nurses’ beliefs and knowledge when assessing and managing pain in hospitalized older persons living with dementia (PLWD).
Background: Hospitalized PLWD often experience unrelieved pain. Pain is common in PLWD. Undermanaged pain accelerates changes in cognition, memory loss, and functional decline. Nurses’ personal feelings and professional experiences with pain may lead to inaccurate knowledge and beliefs based on negative stereotypes of aging and dementia.
Methods: A mixed method study was conducted using an explanatory sequential design. The quantitative cross-sectional survey study measured nurses’ self-perceived knowledge and beliefs about pain assessment and management in PLWD. The qualitative descriptive study methodology used individual semi-structured interviews to further explore nurse’s pain management practices. Findings from the quantitative study informed construction of the interview guide for qualitative data collection.
Results: Nurses working in two hospitals, one of which was designated as a Nurses Improving Care for Healthsystem Elders (NICHE) site voluntarily participated in the studies. General beliefs, knowledge about pain, dementia, and aging were measured using a validated survey tool. A bi-variate analysis of variance and a multivariate analysis of variance (MANOVA) was conducted on survey results. The findings of the MANOVA analysis were not statistically significant. However, bivariate analysis findings indicated that male nurses of all ages and years of experience held less favorable beliefs about pain in older people, than female nurses.
A content and thematic analysis of 12 individual nurse semi-structured interviews indicated that knowledge deficits negatively influenced pain management strategies based partly on nurses’ experiences, negative beliefs, and ageist stereotypes about older people and PLWD.
Conclusion: The mixed method study confirmed that nurses’ knowledge, beliefs, and experience influenced pain assessment and management practices. Unique to this study is the extensive experience nurse study participants had caring for hospitalized PLWD. Knowledge-practice gaps and negative stereotypical beliefs about older people and dementia were found. Strategies to address ageism and improve care of hospitalized PLWD require the attention of hospital leaders. A best practice person-centered dementia model is suggested
Thriving As A Recent Graduate with Learning Disability: A Mixed Methods Study
No full textThe nursing shortage is critical globally (Buchan & Catton, 2023). Several factors contribute to this, including disability. Promoting retention measures for nursing graduates, particularly those with learning disabilities (LD), helps address the nurse shortage in line with equity, diversity, inclusion, and accessibility. Federal laws mandate that academic institutions offer reasonable accommodation to students with LD to enhance their educational outcomes. However, the automatic accommodations offered to these students ‘fade away’ after graduation, although LD is a lifelong difference. Workplace stress and lack of transition support increase graduate nurse turnover, which LD exacerbates. Recent graduates with learning disabilities (RGwLD) are required to disclose their disability and seek reasonable accommodation to succeed in the workplace. However, these RGwLD do not disclose their LD for fear of marginalization associated with the disability label. Using the Critical Disability Theory and Duchscher’s Transition Theory, this study intends to enhance understanding of how RGWLD encounters marginalization in the workplace. It also intends to investigate how the disability identity affects their experiences of marginalization and the correlation between disability marginalization, disability identity, coping mechanisms, emotional regulation, and the intrinsic psychological needs for autonomy, clinical self-efficacy, and relatedness within the workplace.
Influenced by the transformative paradigm, sequential explanatory mixed-methods research will be utilized to examine the breadth and depth of the marginalization experienced by RGwLD. Snowball sampling will be used to recruit RGwLD from the University of Manitoba within the past year who have recent work experience, self-identify as having LD, and have a formal diagnosis of LD. The Brief-COPE scale, Emotion Regulation Questionnaire, and Clinical Self-Efficacy Scale will be used to collect quantitative data. Qualitative data will be collected using semi-structured interviews. Limited research examines ableism or LD in nursing, and no research addresses RGwLD and the challenges they experience as they transition into practice.This research is significant for developing a nuanced knowledge of the growing climate of disability within nursing
Integrating Telehealth Simulations to Prepare Advanced Practice Registered Nurse Students
No full textIntroduction: Telemedicine improves patient care access and has a positive economic impact. In 2018, the National Organization of Nurse Practitioner Faculty (NONPF) proposed integrating telehealth competencies into the advanced practice registered nurse (APRN) education curriculum. This project aims to implement telemedicine educational content addressing the telehealth competencies for the APRN student, including didactic and simulation components to enhance students’ competence and confidence with telemedicine care.Methods: This quality improvement project implements an evidence-based approach to educate APRN students on telemedicine. The NONPF telehealth competencies are introduced to 37 family, pediatric, psychiatric-mental-health nurse practitioner, and clinical nurse specialist students enrolled in Advanced Health Assessment. Participants engage in a one-week didactic learning module, including readings and micro lectures in preparation for a simulated learning experience. During the simulation, participants work in small groups where each individual has the opportunity to conduct a virtual visit with standardized patients while fellow students use the iSOAP checklist for peer feedback.Findings: Pre- and post-learning activity surveys collect anonymous data via REDCap measuring student competence and confidence related to the specified telehealth competencies. Results show a statistically significant improvement in the student-perceived competence and confidence. The TeleOSCE survey assesses students’ telehealth experiences and demonstrates an increased understanding of telemedicine. The NLN Simulation Design Scale, Student Satisfaction and Self-Confidence in Learning, and open-ended questions capture student insights into the simulation experience and suggest areas for improvement. Students report positive simulation experiences including a safe space to learn from mistakes.Conclusion: Telemedicine is essential to 21st-century healthcare, improving patient care through increased access to needed services. The outcomes of this competency-based educational activity for APRN students provide insight into best practices for integrating telehealth content in APRN curricula. Findings are useful for APRN faculty seeking innovative educational approaches to address telehealth competencies in their curricula. The modalities used present an easily replicable and sustainable model
Development of Patient-and Family-Centered Care Education Program for Nurses in Intensive Care Unit
No full textBackground: Patient- and family-centered care (PFCC) emphasizes consumer-centered nursing by respecting patients’ and families’ needs, values, and preferences. Implementing PFCC in intensive care units (ICUs) remains challenging, highlighting the need to enhance nurses’ competencies. Therefore, this study aimed to develop and conduct the pilot study of an educational program to improve PFCC competencies for ICU nurses.
Methods: The topics of the program were developed based on the PCN theory, and the program contents were established through literature review and focus group interview. Contents validation was conducted two times by seven clinical experts, followed by development education program. The pilot study involved twelve adult ICU nurses, and participants’ feedback on the program was gathered through group interviews.
Results: The contents of the program consisted of two domains: prerequisites (professional competencies, knowing self, clarity of beliefs and values, commitment to the job, and interpersonal skills) and care environment (physical environment and peer support). The program, consisting of six sessions of 70 minutes, demonstrated an improvement pattern in PFCC competencies among ICU nurses. Participants also reported increased motivation, confidence to perform PFCC and behavioral changes.
Conclusion: This educational program was designed to not only impart knowledge to ICU nurses but also to enhance their practical skills in clinical practice. This initiative is expected to significantly strengthen the PFCC competencies among ICU nurses. Future studies should evaluate the effectiveness of program utilizing a larger sample across various ICU settings