Opioid-involved overdose trainings delivered using remote learning modalities.

AIM: This education-focused study examined changes in nursing students' knowledge and attitudes towards responding to opioid-involved overdoses following participation in trainings delivered using remote learning modalities. DESIGN: This pre-post study examined learning outcomes among 17 nursing students. METHODS: Participants completed the Opioid Overdose Attitude Scale and Opioid Overdose Knowledge Scale to assess attitudes and knowledge, respectively. Trainings were delivered to two separate groups, one via virtual reality immersive video and another over video conferencing. RESULTS: Attitude scores increased by an average of 12.2 points and knowledge scores increased by 1.65 points. Within the virtual reality group, attitude scores increased by an average of 10 points, while no significant changes were observed in knowledge scores. The video conferencing group improved in both attitude and knowledge scores, by an average of 16.2 points and 2.1 points, respectively. CONCLUSIONS: These hypothesis generating results illustrate the utility of remote learning approaches to deliver trainings, while maintaining social distance during the ongoing COVID-19 pandemic.

An Evaluation of Traditional Versus Virtual Nurse Residency Programs on New Graduate Nurses' Perceptions of Preparedness to Provide Safe Patient Care.

The impact of the COVID-19 pandemic on nurse residents' perceptions of preparedness while learning in a virtual environment remains unknown. This cohort study compared nurse residents' perceptions of preparedness in traditional in-person versus virtual learning environments. Results found no statistically significant differences between these two groups over 1 year. This demonstrates that a virtual learning format can achieve comparable outcomes to a traditional in-person learning format in successfully transitioning newly licensed nurses into the profession.

Heart failure readmission reductions during the COVID-19 pandemic.

Behaviors, treatments, and self-management strategies used by patients and caregivers at home.

Policy Facilitators Versus Structural Barriers: Integrative Therapy Telehealth Changes in the United States During the COVID-19 Pandemic.

Introduction: Complementary and integrative therapies such as physical therapy (PT) and occupational therapy (OT) have been shown to improve functional outcomes and reduce opioid use. Due to the COVID-19 (or SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2]) pandemic, these therapies are switching to telehealth and telemedicine practices, but access and utilization may be limited due to state policies and social vulnerability. Objective: The objective of this cross-sectional analysis was to evaluate the policy changes to telehealth provisions during the pandemic and the degree to which structural barriers could stymie the intended impact of these policies (e.g., PT/OT accessibility). Materials and Methods: Our analysis examined each states' telehealth policies in relation to PT/OT, ranked their telehealth readiness, identified relationships between existing policies and opioid prescription rates, and discussed how social determinants of health may be associated with telehealth availability and accessibility. Results: Approximately two of five states have both telehealth and telemedicine policies, whereas the majority of states had either a PT- or OT-specific policy in place. In addition, almost all states and the District of Columbia (90%) had general telehealth/medicine policy changes as a result of the pandemic. Discussion: Although such policy changes could reduce COVID-19-related barriers, the degree to which these policies can have a large and long-lasting impact may be contingent on structural barriers. Many states that lack broadband access and have high social vulnerability need more improvements to ensure the utilization of telehealth care, including PT and OT. Conclusion: Despite the policies expanding PT/OT telehealth capabilities, structural barriers may further exacerbate inequities in care accessibility.

Pressure Injury Outcomes of a Prone-Positioning Protocol in Patients With COVID and ARDS.

BACKGROUND: During the COVID-19 outbreak, standard methods for treating acute respiratory distress syndrome (ARDS) were used for patients presenting with ARDS. One such treatment method involves placing patients prone to improve oxygenation and reduce mortality risk. Challenges in preventing pressure injuries in patients placed prone have been reported, and no studies have explored the effects of including a certified wound and skin care nurse as part of the care team on the incidence of pressure injuries in SARS-CoV-2-infected patients with ARDS. OBJECTIVES: To evaluate the association between including a certified wound and skin care nurse on a multiprofessional pronation team and prevention of pressure injuries in SARS-CoV-2-infected patients with ARDS. METHODS: This multicenter observational cohort study used retrospective data from the electronic health record. The intervention group consisted of SARS-CoV-2-infected patients diagnosed with ARDS who were treated by a multidisciplinary prone-positioning team that included a certified wound and skin care nurse specialist. The comparison group of SARS-CoV-2-infected patients with ARDS was treated by a multidisciplinary prone-positioning team that did not include a certified wound and skin care nurse specialist. RESULTS: As shown by multivariable logistic regression mixed-effect modeling, patients in the intervention group had a 97% lower adjusted odds ratio of a pressure injury developing than did patients in the comparison group (0.03 [95% CI, 0.01-0.14]; P < .001). CONCLUSION: The inclusion of a certified wound and skin care nurse on a multiprofessional prone-positioning team significantly reduced the odds of pressure injuries developing in patients infected with SARS-CoV-2.

Comparing medication adherence using a smartphone application and electronic monitoring among patients with acute coronary syndrome.

AIM: The purpose of this study was to determine the extent of agreement between adherence measures obtained using two technological interventions, electronic monitoring (EM) and a smartphone application (App). BACKGROUND: Clinicians, patients, and researchers depend on valid measurements of medication adherence to inform the delivery of preemptive care when needed. Technology is routinely used for monitoring medication adherence in both clinical practice and research, yet there is a dearth of research comparing novel App based approaches to traditional approaches used for assessing medication adherence. METHODS: Adherence rates were captured on both the EM and the App for 3697 daily observations from 44 participants with acute coronary syndrome over 90 days immediately following discharge from acute care. For EM, adherence was measured using EM equipped pill bottles. For the App, adherence was measured by having participants upload daily photos to the App prior to taking their daily aspirin. Agreement was assessed using a Bland-Altman analysis. RESULTS: The mean adherence rate was higher on the App, 92%, than the EM, 78% (p < 0.001). The mean difference in adherence rates between these methods was 14% (95% Confidence Interval: -23%, -5%). CONCLUSIONS: These findings illustrate a lack of agreement between technological interventions used for measuring adherence in cardiovascular patient populations, with higher adherence rates observed with the App compared to EM. These findings are salient given the increased reliance on telehealth due to the ongoing COVID-19 pandemic.