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School nurses repeatedly have been stretched to the limits over the past few years with the COVID-19 pandemic—managing not only routine daily care of students but also juggling those unique needs of children and youth with special health care needs, especially for those who also lost a parent/caregiver from COVID-19. This article provides background demographic information on how the COVID-19 pandemic affected these children, along with a specific case report of a middle school student with attention deficit hyperactivity disorder who also experienced the loss of a parent from COVID-19. Specific practical suggestions are discussed on how school nurses proactively and collaboratively can assist these students whose lives were permanently changed by the life-changing event of losing a parent/caregiver from COVID-19. © 2022 National Association of Pediatric Nurse Practitioners
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This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students. A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic. Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings. Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic. The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.
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Aims: To develop and validate an instrument that integrates functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach towards nursing assessments in hospitalization units. Design: Cross-sectional validation multicentre study. Methods: Socio-demographic variables and assessments of Barthel Index, Braden Index and Downton Scale are included via electronic health records. Instrument's development process will include: (i) conceptual assessments;(ii) content validity;(iii) construct validity;(iv) internal consistency and (v) interobserver reliability. The analysis will consider possible differences in medical and surgical hospitalization units, hospitalization type or being a COVID-19 patient. This study was accepted for funding in November 2020 and approved by the Ethics and Research Committee in January 2021. Results: An integrated instrument that lowers the administrative load of nursing assessments and allows at-risk patients to be detected with at least the same validity and reliability as the original instruments is expected to be obtained. © 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.
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School nurses and unlicensed assistive personnel (UAPs) are essential to the health and wellness of school children. However, most US schools do not have a full-time licensed nurse. During the COVID-19 pandemic, school nurses and UAPs have been integral in ensuring that the health needs of students were met. They have seen a marked increase in their responsibilities included implementing COVID-19 mitigation strategies, screening for symptoms, testing students and staff, conducting contact tracing and data collection, and ensuring the implementation of rapidly changing COVID-19 guidelines and protocols for schools. The objective of this study was to explore COVID-19 occupational changes and their contributions to stress among school nurses and UAPs through a content analysis of local and national media articles. A Google search of articles published between February 2020 and September 2021 was conducted using the following search terms: 'school nurse', 'COVID-19', 'health aide', 'stress', and 'experiences'. A search was also conducted in Nexis Uni. Articles were included if the topic discussed school nurses or UAPs and COVID-19. All articles that examined nurses in other settings were excluded from the review. We examined topics and themes temporally (from February 2020 to September 2021) and spatially (i.e. the frequency by US state). Overall, 496 media articles discussing school nurses and COVID-19 were included in our review. The highest volume of articles was from September 2021 (22%, 111/496). Other months with relatively high volume of articles included August 2020 (9%, 43/496), January 2021 (10%, 47/496), February 2021 (9%, 44/496), and August 2021 (8%, 39/496). These larger article volumes coincided with notable COVID-19 events, including returning to school in the fall (August 2020 and August 2021), school nurses assisting with vaccine rollouts among adults in the USA (January/February 2021), concerns regarding the delta variant (August/September 2021), and vaccine rollouts for children ages 12–15 (September 2021). The representation of articles spatially (national, state, regional, or local) was 66 (13%) articles at national level, 217 (44%) state level, 25 (5%) regional level, and 188 (38%) local news at the city and/or village level. Pennsylvania had the highest frequency of articles, but when standardized to the state population, Alaska had the highest rate of media per 100 000 people. Three major themes were identified in our analysis: (i) safety;(ii) pandemic-related fatigue/stress;and (iii) nursing shortage/budget. The most represented theme for articles before September 2021 was that of safety. Over time, the themes of pandemic-related fatigue/stress and nursing shortage/budget increased with the most notable increase being in September 2021. The COVID-19 pandemic has resulted in new occupational risks, burdens, and stressors experienced by school nurses and UAPs. School nurses play a critical role in disease surveillance, disaster preparedness, wellness and chronic disease prevention interventions, immunizations, mental health screening, and chronic disease education. Furthermore, they provide a safety net for our most vulnerable children. Given that school nurses were already over-burdened and under-resourced prior to the pandemic, characterization of these new burdens and stressors will inform emergency preparedness resources for school health personnel during future pandemics or outbreaks.
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There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10);1–4 μm 50% (5/10);<1 μm 20% (2/10)] (Fischer exact test P = 0.076). The highest proportion of RNA-positive air samples on room level was found with a filtration-based sampler 80% (8/10) and the cyclone-based sampler 70% (7/10), and impingement-based sampler 50% (5/10). SARS-CoV-2 RNA was detected in 10 out of 12 (83%) passive air samples in patient rooms. Both high-touch and low-touch surfaces contained SARS-CoV-2 genome in rooms of residents with positive OPS [high 38% (21/55);low 50% (22/44)]. In one active air sample, infectious virus in vitro was detected. In conclusion, SARS-CoV-2 is frequently detected in air and on surfaces in the immediate surroundings of room-isolated COVID-19 patients, providing evidence of environmental contamination. The environmental contamination of SARS-CoV-2 and infectious aerosols confirm the potential for transmission via air up to several meters.
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To describe experiences of student nurses and faculty who participated in COVID‐19 vaccine delivery through a multischool collaboration. Cross‐sectional survey. Student nurses and faculty members from five university schools and colleges of nursing who participated in one or more COVID‐19 vaccination or education events in 2021. Surveys were designed for students and faculty to document process and outcome experiences associated with project participation. Surveys were administered through an online survey platform. Overall, 648 students and 68 faculty members participated in the project. The evaluation survey was completed by 115 students (18%) and 58 faculty members (85%). Students valued increasing their clinical skills and reported the experience influenced their perspectives on nursing, fueling their passion and informing future career choices. Students reported that it was personally important to contribute to the vaccination effort. Few students reported challenges in participating in the project. Faculty reported positive experiences including gaining knowledge about public health and their communities, fueling their passion for nursing education, feeling a deeper connection with students, and experiencing personal satisfaction from contributing to the pandemic response. This project resulted in meaningful student learning opportunities, enhanced capacity for the public health emergency response, and strengthened partnerships among nursing programs and between academia and public health community partners.
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BACKGROUND: Five telemedicine simulations were created during the coronavirus disease 2019 (COVID-19) pandemic to elucidate implicit biases and enhance awareness of social determinants of health among nursing students. Social determinants affect overall health, functioning, and quality-of-life outcomes and risks. Implicit biases are related to patient-provider interactions, treatment decisions and adherence, and ultimately patient health outcomes. PURPOSE: This article explains the simulation development and content, describes the student learning outcomes, and presents faculty insights that highlight the necessity of simulation experiences in nursing education. METHOD: Five telemedicine simulations that presented different social determinants of health and implicit biases were created for undergraduate nursing students. RESULTS: Nursing students increased knowledge related to social determinants and their own implicit biases. CONCLUSION: Telemedicine simulations were effective in assisting nursing students recognize their own implicit biases and the economic challenges of individuals living in poverty, as well as the potential influence of social determinants of health. [J Nurs Educ. 2023;62(1):58-61.].
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In 2020, the COVID-19 pandemic had an impact on treatment teams, including the palliative care mobile team (PCMT). During the first epidemic wave, some institutions decided to deploy professionals working in these PCMT to care services to strengthen the workforce. The health executive and the head of department of the PCMT 37, in agreement with the management of the university hospital of Tours, decided to maintain the whole PCMT in their usual duty, enabling them to continue their mission, within and outside the hospital. Whilst, looking back at the period, we thought about the specific roles played by the nurses of PCMT during the COVID crisis, from February to December 2020. We managed to bring out three major axes that structured our actions: (a) an efficient compagnionship, which helped the reshuffled teams regain their professional identity and the notion of teamwork. (b) practical training around symptoms related to COVID-19 and end of life with an adjustment on representations on palliative care, with the aim of avoiding that COVID patients are all considered terminally ill (c) through mediation, a support for people working on site to get to grips with the various recommendations. Relying on our reflexive practice, on our capacity to adapt and on our experience of coping with uncertainty, we were able to be proactive and hence, play a relevant role in this sanitary crisis. © 2022 Elsevier Masson SAS;En 2020, la pandémie COVID-19 a impacté l'organisation des équipes de soin y compris celle des équipes mobiles de soins palliatifs (EMSP). Lors de la première vague épidémique, certaines institutions ont fait le choix de déployer les professionnels de ces équipes dans les services de soins pour renforcer les effectifs. Le cadre de santé et le chef de service de l'EMSP37 en accord avec la direction du Centre Hospitalier Universitaire de Tours, ont décidé de maintenir dans leurs fonctions l'ensemble des professionnels de leur équipe, permettant la poursuite des missions intra et extra hospitalières. A posteriori, nous avons réfléchi aux fonctions spécifiques exercées par les infirmières d'EMSP dans la crise COVID de février à décembre 2020. Nous avons pu ainsi dégager trois grands axes ayant structuré nos actions: (a) un compagnonnage solidaire et étayant afin d'aider les équipes remaniées à retrouver leur identité professionnelle et la notion de collectif;(b) des formations pratiques autour des symptômes liés à la COVID-19 et à la fin de vie avec un ajustement sur les représentations sur les soins palliatifs, dans l'objectif d'éviter que les patients COVID soient tous considérés en phase terminale (c) une aide à l'appropriation des multiples recommandations par un travail de médiation. C'est en nous appuyant sur notre pratique réflexive, notre capacité d'adaptation et notre habitude à composer avec l'incertitude, que nous avons pu être force de propositions et ainsi tenir une place pertinente dans cette crise sanitaire. © 2022 Elsevier Masson SAS
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The current comparative study sought to identify psychosocial stressors of corona-virus disease 2019 (COVID-19)–dedicated (n = 110) and non-COVID-19–dedicated (n = 118) nurses (herein referred to as COVID nurses and non-COVID nurses, respectively). Data were collected online from October 20, 2020, to April 1, 2021. Significant predictors of mental health for COVID nurses were purpose/meaning (β = −0.32, p < 0.001), perceived stigma (β = 0.25, p = 0.001), perceived work environment improvement (β = −0.22, p = 0.004), and absolute work intensity (β = 0.26, p = 0.004). For non-COVID nurses, predictors were purpose/meaning (β = −0.34, p < 0.001) and absolute work intensity (β = 0.26, p = 0.003). It is necessary to develop programs and policies that support the mental health of nursing staff. Administrative efforts should be made to create a work environment that allows nurses to focus on their work during health crises, such as the COVID-19 pandemic. Nursing staff should be supported so that appropriate working hours are maintained and breaks are guaranteed. [Journal of Psychosocial Nursing and Mental Health Services, 61(1), 39–46.]
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Aim: Temporary lodging facilities which were non‐medical facilities were established to secure beds for severely and moderately ill patients with COVID‐19, as well as for isolation, non‐contact observation, and care of mildly ill and asymptomatic patients in Japan. This study aims to understand nursing management practices adopted in these facilities by examining cases of their establishment and operation. Methods: A multiple‐case study design was used. Interviews for qualitative data collection were conducted from August to October 2020. After analyzing the nursing management practices in four temporary lodging facilities, common points were collated and integrated. Results: For the establishment and operation of temporary lodging facilities, a three‐layer structure based on disaster management methods was adopted: headquarters at the helm as overseers, field supervisors in the middle, and frontline nursing staff at the base. The structure had clear roles, facilitated information exchange, and provided efficient and effective nursing care. Field supervisors mainly provided psychological and clinical support for staff and served as information and interprofessional hubs. Conclusion: It is recommended that temporary lodging facilities should be organized based on principles of the division of labor. The workforce should comprise nursing staff, and experienced nursing professionals should be recruited to the higher echelons.
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To our knowledge, no studies have explored leadership practices in relation to structural and psychological empowerment among nurses during COVID-19. Therefore, the purpose of this study was to examine those relationships in Jordanian nurses working in emergency departments during the COVID-19 pandemic. A descriptive, correlational cross-sectional design was used in this study. The participants were emergency nurses working at 3 large hospitals in Jordan. The participants were surveyed via an online questionnaire between September 2021 and January 2022. A total of 3 valid scales were included in the questionnaire to assess the nurses' clinical leadership practices in relation to perceived structural and psychological empowerment. A total of 193 emergency nurses were surveyed, of which 116 participants (60.1%) were male, and their average age was 29.64 (SD 4.74) years. Nurses had a moderate level of clinical leadership practices 12.50 (SD 1.65), moderate level of perceived structural empowerment 3.67 (SD 0.44), and a high-moderate level of perceived psychological empowerment 5.96 (SD 0.65). Clinical leadership practices were shown to have a significant positive relationship with structural (r = 0.65;P <.01) and psychological (r = 0.74;P <.01) empowerment. Predictors of clinical leadership practices of the Jordanian emergency nurses during COVID-19 were ranked in order of significance;structural and psychological empowerments were the highest significant predictors. However, patient to nurse ratio (>6 patients/nurse) was the lowest significant predictor. Although structural and psychological empowerments play a pivotal role in predicting the leadership practices of the emergency nurses in Jordan, the nurses should enhance their leadership style for better management and effective communication during critical situations such as pandemics.
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Background: The need for rehabilitation and skilled nursing services for coronavirus disease 2019 (COVID-19) survivors has been speculated from the beginning of the pandemic. However, real-world data describing utilization of these services post COVID-19 hospitalization and the factors associated with the same is limited. This retrospective cohort study on COVID-19 patients aims to identify the patients discharged to inpatient rehabilitation or nursing facilities post-hospitalization and the factors associated with the same. Methods: A retrospective cohort study on COVID-19 patients during second wave of the pandemic in the state of Michigan. Primary outcome was discharge disposition. Binary logistic regression was conducted to identify the factors associated with discharge to a facility. Results: A total of 559 COVID-19 patients [median age 64 years, interquartile range (IQR) 53–73 years, 48.5% males (n=271), 67.6% Blacks (n=378)] were included in the study. During hospitalization, 17.4% of the patients (n=97) died. Around 65% (n=365) patients were discharged home whereas 12.5% (n=70) were discharged to a facility for inpatient rehabilitation/nursing services. Older patients, males, those with longer hospital stay, and patients who needed new percutaneous endoscopic gastrostomy (PEG) tube, tracheostomy, initiation of hemodialysis or continuous renal replacement therapy (CRRT), or had an acute stroke during admission were more likely to be discharged to a facility post-hospitalization. Conclusions: About 12.5% of hospitalized COVID-19 patients needed discharge to a facility for inpatient rehabilitation/nursing services. Knowledge of the factors associated with discharge to a facility can optimize discharge planning, efficient resource allocation, and improve long-term COVID-19 care. © Annals of Palliative Medicine. All rights reserved.
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An excerpt from the article "Nursing Shortages and the Tragedy of the Commons: The Demand for a Morally Just Global Response" by M-J. Johnston, that was published in the "Australian Journal of Advanced Nursing," is presented.
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The article details how Queensland University of Technology (QUT) adapted its traditional approach to simulation within the Bachelor of Nursing course during the COVID-19 pandemic. Topics discussed include key composition of simulation classes, opportunity to practice and consolidate skills learned during simulation, and student engagement in the traditional versus simulation approach.