ABSTRACT
The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs. Newly graduated nurses entering practice in November 2019 described their transition through nurse experience surveys and focus group discussions. Results from the quantitative data reported on compassion satisfaction, burnout, and exposure to secondary traumatic stress. The qualitative data mirrored these findings with the discovery of the following five themes: transitioning through an NRP, impact to nursing care, value of coworkers, coping, and professional growth. These findings illustrate the need to better support future practice transitions in times of disruption and change.
Subject(s)
COVID-19 , Nurses , Humans , Pandemics , Adaptation, Psychological , Focus GroupsABSTRACT
The National Diabetes Prevention Program (National DPP) is a nationwide delivery system for a lifestyle change program (LCP) proven to prevent or delay onset of type 2 diabetes. As a result of the COVID-public health emergency (PHE) declared in March 2020, in April 2021, the National DPP distributed a brief survey to approximately 2,000 CDC-recognized organizations to assess how they adjusted program delivery, including actions and strategies taken to navigate delivery during the PHE. 412 responses were received between April and June 2021. 148 paused delivery and 62 remained paused at the time of response. Of those that paused, 1 (74%) reported applying strategies such as phone calls, emails, and texts to keep in contact with participants. Of these, 64% reported they had resumed or restarted their cohorts at the time of response. When asked what influenced the decision to pause cohorts, 63% of organizations that normally deliver in-person, paused due to participant hesitancy toward use of or lack of access to technology. Of the 360 organizations that normally use in-person delivery, 260 reported switching to virtual delivery during the PHE. Of these, more than half reported difficulties in making that transition, mainly due to participant hesitancy to use or lack of access to technology. When asked if any support was provided to participants outside the scope of the LCP, 61% responded no. Of the 39% that did provide support, 84% of responding organizations indicated providing COVID-related support to participants;these were mainly organizations classified as Hospitals/Healthcare Systems/Medical Groups/Physician Practices. Many CDC-recognized organizations may have paused delivery at some point during the PHE, but based on these survey results, plans for future delivery remains strong. With the help of technology and strategies employed, 225 of the 412 organizations that responded indicated they would be starting new cohorts during the PHE.
ABSTRACT
The National Diabetes Prevention Program (National DPP) is a public-private partnership to build a nationwide delivery system for an evidence-based lifestyle change program (LCP) proven to prevent or delay the onset of type 2 diabetes in adults with prediabetes. Using data collected through the Diabetes Prevention Recognition Program (DPRP) , which certifies programs as official National DPP sites since 2012, this study shows how programmatic milestones have impacted enrollment trends over the past years. At the end of 2012, only 13 states had enrolled participants, with the highest number reported by MT (269) . By 2013, the number of states with programs increased to 41, with the highest number of enrollees reported by OH (931) and FL (840) . In 2015, online delivery modes were introduced, this allowed participants to enroll in programs located outside of their current states of residence and led, to an increase in enrollment across 50 states and DC. Notable increases were then seen in IL (13 to 670) , KS (9 to 786) , and LA (59 to 1362) . In January 2018, the Medicare Diabetes Prevention Program (MDPP) was launched, which allowed eligible Medicare beneficiaries to enroll in the LCP as a covered service. By the end of 2018, in-person (IP) enrollment sharply increased in organizations approved as MDPP suppliers, and large increases in IP enrollment from 2017 to 2018 were seen in AL, MO, NJ, and NV. The ongoing COVID-pandemic significantly impacted National DPP enrollment trends. Most states' online enrollment increased by at least 20% from March 2020 to March 2021, with NC, CO, and NY showing large increases of 176%, 243%, and 590%, respectively. In contrast, CA, DE, and MS had decreases in online enrollment of 7%, 8%, and 26%, respectively. Enrollment trends have proven to be important reflections of milestones in the evolution of the National DPP. Expanding the number of organizations offering the MDPP, as well as those offering virtual delivery, allows the Program to continue to scale.
ABSTRACT
Retention is closely linked to clinical outcomes in the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) . We examined retention, defined as the number of sessions attended, using data collected by the CDC Diabetes Prevention Recognition Program, the quality assurance component of the National DPP. We evaluated participants who enrolled in in-person lifestyle change programs from March 2018 to November 2020 and had the opportunity to complete at least 9 months of the 12-month program. To control for programmatic changes due to COVID-19, we divided enrollment into 3 cohorts: 1) 3/1/2018 - 5/31/2019 (before) , 2) 6/1/2019-2/29/2020 (mixed) , and 3) 3/1/2020-11/30/2020 (during COVID-19 pandemic) . Mean sessions attended was lower in cohort 3 (10.8, p<0.05) than in cohorts 1 (12.9) and 2 (12.6) . As shown in Table 1, across the 3 cohorts the following factors were associated with lower mean number of sessions attended: younger age, Hispanic ethnicity and non-White race, lower educational attainment, and Medicaid as a payer source. Our findings highlight that new strategies could be useful to improve retention among some demographic and socioeconomic groups (e.g., younger adults, Hispanic individuals, individuals with lower educational attainment, and Medicaid recipients) in the National DPP.
ABSTRACT
BACKGROUND: Proning intubated intensive care unit patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the intensive care unit. LOCAL PROBLEM: Nursing units previously designated for medical/surgical populations had to adjust quickly to provide evidence-based care for COVID-19 patients attempting self-proning. METHODS: Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale. INTERVENTIONS: A new self-proning nursing protocol was implemented outside the intensive care unit. RESULTS: Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol. CONCLUSIONS: Implementation of a new nursing protocol is possible with strong unit-based support, even during a pandemic.