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Social Support in Hypertension Treatment Adherence: A Qualitative Study in Ghana
Full text linkBackground: Hypertension is a leading global public health concern, contributing to 55.6% of annual mortality and affecting nearly one billion individuals worldwide.
Objective: The aim of the study is to explore the experiences of social support in treatment adherence of persons living with hypertension.
Method: This study utilized a qualitative research design ensuring methodological rigor and credibility. Semi-structured interviews with open-ended questions were conducted, audio recorded transcribed verbatim and analyzed using thematic content analysis.
Results: Participants primarily relied on companionship and emotional social support to maintain treatment adherence. While immediate blood pressure optimization was not achieved, improvements in overall health and well-being were observed.
Conclusion: This study highlights social support as crucial factor in hypertension treatment adherence. Participants demonstrated how various social support types-informational, companionship, emotional, and tangible positively influenced their adherence behaviors, reinforcing the need for integrated support strategies in hypertension management
Improving Exclusive Breastfeeding Rates Using Role-Play in a Suburban Hospital
Full text linkThe purpose of this project is to improve exclusive breastfeeding rates of newborns by developing and implementing a breastfeeding education program for staff nurses in a suburban hospital
Association of Coparenting Relationship with postpartum Depression and Anxiety in Immigrants Postnatal Women
No full textBackground: Postpartum depression (PPD) and anxiety are growing public and global health concerns, particularly among immigrant populations. In Canada, first-time parents from minority immigrant backgrounds face unique stressors that may heighten their vulnerability to perinatal mental health challenges. While existing research has primarily focused on mothers, limited attention has been given to immigrant fathers and the experiences of both parents as a unit. This study explores the prevalence of depressive and anxiety symptoms among South Asian and Middle Eastern immigrant couples in Canada during the postpartum period.
Methods: A cross-sectional pilot study was conducted with immigrant couples who had moved to Canada within the past 10 years and had an infant under one year of age. Participants were recruited online, and telephone interviews were conducted by a research assistant. The Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder 7-item (GAD-7) scale were used to assess depressive and anxiety symptoms.
Results: As of this submission, 43 couples have participated in the study. The average age of mothers was 32, and fathers was 36. Most participants were originally from Pakistan (n=15) and Afghanistan (n=15), and a significant number of both mothers (34.6%) and fathers (37.2%) had graduate-level education. Preliminary findings show depressive symptoms in 25.6% of mothers and 9.3% of fathers, while 11.6% of both parents reported moderate to severe anxiety.
Conclusion: This study highlights a concerning prevalence of postpartum depressive symptoms among both immigrant mothers and fathers. The findings emphasize the need for inclusive screening practices and culturally responsive perinatal mental health interventions that engage both parents in immigrant families. Addressing these disparities is essential for promoting equitable healthcare and supporting the well-being of immigrant communities in Canada
Uniting Care in the Maternal Neonatal Dyad: A Call to Action for Collaboration
Full text linkPurpose: Clinical nurses at a Women’s and Children’s hospital advocated for a new campus-wide nursing practice council upon identifying the need to promote collaboration and ensuring a safe place for a healthy work environment between the maternal and neonatal nursing specialties via shared governance.
Relevance: Collaboration is associated with multiple positive outcomes including but not limited to nursing and clinical excellence, optimal patient outcomes, and an overall healthy work environment as set forth by the AACN framework (American Association of Critical-Care Nurses, 2016). The goal of this council is to improve collaboration, communication, and effective decision making across maternal/neonatal specialties related to nursing quality, practice, and workflow. The framework for council operation is based on the nationally accredited certification for obstetric and neonatal quality and safety.
Strategy: Council development was advocated for by clinical nurses and supported by executive leadership. It was then promoted within the organization’s current shared governance structure for nursing excellence. This affords the council monthly protected time for frontline nursing members across all perinatal and neonatal ICU units to engage in shared decision-making related to maternal and neonatal nursing practice.
Results: The council empowers nurses to participate in the promotion of clinical excellence and optimal patient outcomes while in a safe setting inclusive of authentic leadership, appropriate representation of staff, and collaboration of ad hoc members. This triad facilitates effective communication, decision making, and recognition of peers. Over three years the council has realigned four intra-specialty workflows, assisted in the creation of a regional safety operating procedure, a peer NICU support group, and a nurse driven lab rejection process improvement sustained through three PDSA cycles.
Conclusion: The success within the first year of establishing the council was largely attributed to the engagement of the frontline nurse members. Both returning and new shared governance applicants have continued to request this council most frequently as their top choice for membership over the last three years. In addition, various council members have been recognized with several accolades including several daisy award nominations/wins, a divisional Stand up for Safety Award, and the winning nominee for Exemplary Practice Nurse of the Year in 2023
Guiding Inclusive Learning: Using IDEAs to Transform Workplace Diversity and Well-Being
Full text linkBias, prejudice, or discrimination can be found in all areas of life through action and inaction, creating a call to action for systemic change in nursing (Wakefield et al., 2021). Given the need for a reflective nursing workforce to reduce health disparities (Stanford, 2020) and the predicted nursing shortage, identifying strategies to recruit and retain a diverse nursing workforce in healthy work environments (HWE) is key (Rosseter, 2023). This work aims to provide strategies for educators to develop inclusive learning environments to promote workplace diversity and wellbeing.Intentional application of inclusion, diversity, equity, and accessibility (IDEA) principles can foster belonging and diversity. Educators have a unique opportunity to change the culture of professional growth through inclusive learning environments. Applying IDEA principles to the educational design process supports psychologically safe and inclusive environments that respect, relate to, and reflect learners, particularly those in marginalized groups (Agic et al., 2021; Mabona et al., 2022; Martin, 2022; Shin & Lee, 2024).The 4th edition of the Nursing Professional Development Scope and Standards of Practice (Harper & Maloney, 2022) serves as a catalyst for educators to demonstrate the competencies found in Standard 9: Respectful and Equitable Practice. The AACN’s Healthy Work Environment standard for authentic leadership further supports IDEA principles in designing and sustaining HWEs (AACN, 2016). A needs assessment revealed a gap in knowledge and skill to effectively apply IDEA principles in learning environments (Cameron et al., 2022). Therefore, resources that support inclusivity were developed to guide those involved in planning, implementing, and evaluating educational activities.The resources focus on five categories – audience, environment, tools, relatability, and breaks – including considerations and recommendations to proactively apply the IDEA principles throughout the educational design process. Through awareness and integration of IDEA principles to support a HWE, guided by this tool, educators can increase psychological safety and promote effective learning while encouraging an organizational culture of belonging (Dewsbury & Brame, 2019; Imperial College, 2021). The implications are an empathetic, representative workforce better prepared to care for diverse patient populations and an enhanced commitment to the nursing profession
Enhancing Nurses’ Delirium Assessment Competence Through SVVR Approach a Randomized Controlled Trial
No full textBackground: With the rapid advancement of information technology, Virtual Reality (VR) has become increasingly prominent in nursing education. VR-based education offers immersive, interactive, and realistic clinical experiences, holding great promise for enhancing nurses\u27 clinical competencies, particularly in complex tasks such as delirium assessment.
Purpose: This study aims to assess the effects of Spherical Video-based Virtual Reality (SVVR) technology on improving nurses’ clinical knowledge, assessment abilities, and attitudes toward managing delirium in clinical settings. By integrating SVVR, this study seeks to provide an innovative, immersive educational approach that allows learners to practice real-world scenarios, thereby enhancing their practical skills.
Methods: The educational intervention involves scenario-based videos filmed in a real intensive care unit (ICU) setting, focused on the recognition and management of delirium. The SVVR technology will provide a highly realistic and interactive learning environment that simulates actual clinical conditions. Approximately 108 nursing staff from a medical center in northern Taiwan will be randomly assigned to either the experimental group, which will engage with a 20-min SVVR-based approach, or the control group, which will watch standard educational videos without interactive components. The effects of this educational intervention will be assessed using the Nurses’ Knowledge, Attitude and Practice of Delirium Subtype Assessment scale, the Attitudes Toward Science Learning Questionnaire, and the Technology Acceptance Questionnaire. Data will be collected before and after the intervention to evaluate changes in delirium assessment competence, attitudes toward scientific learning, and technology acceptance among participants.
Results: The production of the instructional SVVR-based content has been completed, and the trial is scheduled for implementation from January to March 2025. Participant feedback will be gathered to assess the effectiveness and usability of the SVVR educational model, and to explore potential improvements in the training approach
Physical Activity Level Associates With Long COVID Symptoms and Quality of Life
No full textBackground: Long COVID has emerged as a significant global health concern, leading to functional impairments, sleep disturbances, and a reduced quality of life (QoL). Moderate-to-high levels of physical activity (PA) have been shown to reduce the risk of health complications, improve cardiovascular health, and enhance patient-reported outcomes in chronic diseases. However, limited evidence exists regarding its impact on long COVID symptoms, sleep quality, and QoL in individuals with long COVID.
Objective: To investigate whether a moderate-to-high level of PA level associates with long COVID symptoms, sleep quality, and QoL in individuals with long COVID.
Methods: A cross-sectional study was conducted at an integrated outpatient clinic for post-COVID-19 in a medical center in northern Taiwan. A convenience sample of patients diagnosed with long COVID was recruited. The main outcome measures, including PA levels, sleep quality, and QoL, were assessed using the International Physical Activity Questionnaire, the Pittsburgh Sleep Quality Index, and the World Health Organization Quality of Life Questionnaire (Short Form), respectively, and compared between the low and moderate-to-high PA level groups. In addition, cardiorespiratory fitness (peak oxygen consumption, VO2 peak) and heart rate recovery were also evaluated through graded exercise testing.
Results: The participants with a mean age of 48.7 years had a mean duration of post-COVID-19 symptoms of 12.3 weeks. Individuals with moderate-to-high PA levels had a significantly lower prevalence of shortness of breath, higher VO2peak, improved 2-minute heart rate recovery, better sleep quality, and higher QoL compared to those with low PA levels. The multivariate regression model showed that PA level was not associated with QoL; however, after adjusting for potential covariates, cardiorespiratory fitness and sleep quality emerged as significant predictors of QoL in individuals with long COVID.
Conclusions: The findings offer valuable insights into rehabilitation practices for long COVID patients, emphasizing the importance of maintaining moderate-to-high levels of PA in alleviating the long-term negative effects of COVID-19. Improving cardiorespiratory fitness and sleep quality should be prioritized in the clinical management of long COVID patients to enhance their QoL
Enhancing Clinical Judgment Using Simulation with Multiple Patients
No full textBackground: Clinical judgment is crucial for nursing, enabling informed decisions (AACN, 2024). New graduates often lack this skill, emphasizing the need for better training (Monagle et al., 2024). Multi-patient simulations have proven more effective than single-patient scenarios in improving clinical judgment (Namgung et al., 2023).
Methods: Fifty fourth-semester nursing students in a critical care course engaged in a simulated emergency department scenario, requiring patient prioritization with one bed available. Students acted as charge or staff nurses, using QR codes for assessments. Cases included sepsis, myocardial infarction, and cerebrovascular accident, integrating prior coursework. Pre-simulation activities reviewed critical skills like the Glasgow Coma Scale and rhythm identification (McDermott et al., 2021).
Simulation and Debriefing: Students assessed, documented, and advocated for patient prioritization. Debriefing followed the PEARLS Tool for reflection (Bajaj et al., 2018), with collaborative review in the LMS.
Results: Qualitative feedback indicated enhanced critical thinking, collaboration, and assessment. Surveys showed 87% felt more confident in assessment and prioritization, 97% reported improved decision-making, and 90% believed the simulation enhanced readiness for patient care. Ninety-eight percent found the learning environment engaging.
Conclusions: Multi-patient simulations improve nursing students’ clinical judgment, providing realistic critical care training. This approach fosters independent decision-making, boosting confidence and clinical readiness
Development of a Nurse-Led Interprofessional Community Health Nursing Education Program
No full textThis presentation will describe an interprofessional community health nursing education project in a 5-county region. The preliminary phase of the project was to create a nurse-led interprofessional advisory group to direct a comprehensive health needs assessment with county health departments, area clinics and school officials, to determine community-based priorities. This phase was followed by an investigation of evidence-based interventions to address the acknowledged community health needs of substance use prevention and mental health promotion. Program costs and funding were identified and obtained through alumni donor gifts and internal university grants. A trained facilitator was selected to educate community health nursing, education, psychology, public health, and social work students in the evidence-based intervention. The nurse-led advisory group then collaborated with area rural school systems to implement the health education program with the interprofessional university students. On-going evaluation of the community health education project resulted in continual adjustments and modifications. This enhanced the effectiveness of the evidence-based intervention with the school-age children as well as with the university student implementers. The project’s impact on school-age students, teachers and university students will be explored. This project illustrates how community-university partnerships can benefit both the school-age and university students
Reducing CAUTI in the Neurocritical Care Unit Through Rapid Implementation of the Evidence
No full textCatheter-associated urinary tract infections (CAUTIs) from indwelling urinary catheter (IUC) account for 25% of all hospital-acquired infections. Neuro-critically ill patients are at 2–5 times greater risk of developing CAUTI because of increased use of indwelling urinary catheters due to neurogenic urinary retention. The CAUTI rate for the Neurocritical Care Unit was 7.814 per 1000 patient days with an average quarterly utilization rate of 84%. A robust quality improvement project that included rapid impleentation of evidence, removal or replacement of the IUC by day 5, weekly patient centered rounds, urine culturing best practices, order set changes, and supporting evidence to improve straight catheterization best-practices was implemented. Data was collected over an 11-month period. In 19,000 patient days, patient device utilization rate decreased 63%, SIR and SUR decreased below the mean for majority of the previous 8 quarters. The CAUTI rate decreased to 1.57. A paired samples t-test was performed to assess strength of intervention. Statistically significant improvement in device utilization reduction and infection count were seen. The SIR intervention group was significantly lower than the pre-intervention group, (t(6)= 1162.699, p= \u3c0.001). Additionally, the SUR intervention group (M=73.86, SD=8.630) was lower than the preintervention group (M=84.33, SD=7.356), (t(6)=-22.385, p= \u3c0.001). The project found the upper limit of 5 days of an indwelling urinary catheter for desired outcomes of improved CAUTI rates. This quality improvement project utilized best evidence of removing or replacing IUC by day 5