An Innovative Nurse Practitioner Curricular Design Using an Adaptive Learning Platform, Adaptive Case Studies, and Telehealth Simulations: A Feasibility Study.

Introduction: This project explored the feasibility of implementing an innovative cross-curricular framework using an adaptive learning (AL) platform and telehealth simulations. Objective: To determine the feasibility of implementing an innovative cross-curricular framework using an AL platform and telehealth simulations. Methods: A mixed-method pilot study was conducted using novel AL modules, adaptive case studies, and telehealth simulation. Results: Quantitative data analysis demonstrated significant correlations within and across demographics using the Technology Acceptance Model (TAM) and Simulation Effectiveness Tool-Modified (SET-M). Specifically, significant correlations are evident between TAM ease of use items 1-6, 8, and 10 and TAM usefulness 1, 3, and 9, with SET-M items 3 and 5-15. Thematic analysis revealed that participants felt that the overall project was worthwhile and increased confidence in telehealth. Conclusion: Participants found the technology used in this study was easy and useful, and they indicated a positive experience with telehealth simulation. Overall, this study demonstrated that implementation of AL using our paradigm is feasible and supports further investigation into implementing a cross-curricular framework using an AL platform and telehealth simulations.

Medications for opioid use disorder: An interactive educational program developed for the nurse practitioner curriculum.

ABSTRACT: Opioid overdose deaths remain a major public health concern in the United States and led to the recent changes in regulations that allow nurse practitioners (NPs) to prescribe buprenorphine without the previously required Drug Addiction Treatment Act waiver. Previously, waiver requirements included 24 hours of opioid use disorder (OUD) and medications for OUD (MOUD) training. Although this training is no longer required, NPs need education related to providing nonstigmatizing care to individuals with OUD and safe MOUD prescribing practices. A combination of online didactic modules, in-person simulation activities, and experiential learning was provided to psychiatric mental health NP (PMHNP) and family NP (FNP) students enrolled in a Doctor of Nursing Practice (DNP) program. OUD was presented through a chronic care lens to normalize treatment and decrease stigma, and harm reduction principles were included to increase safe prescribing of MOUD. Fifty-six students completed the didactic training, 51 students participated in the simulation, and 11 students completed shadowing experiences with an experienced MOUD provider. Psychiatric mental health NP and FNP graduates of this DNP program have the knowledge and skills to provide MOUD to individuals struggling with OUD, thus potentially increasing access to care and decreasing overdose deaths.

Palliative Care Conversations for Heart Failure Nurses: A Pilot Education Intervention.

INTRODUCTION: Heart failure is a progressive condition affecting 6.2 million Americans. The use of palliative and supportive care for symptom management and improved quality of life is recommended for persons with heart failure. However, 91% of nurses believe they need further training to have palliative care conversations. The purpose of this pilot education intervention was to determine if providing nurses with education on the timing and content of palliative care conversations would improve their perceived skill and knowledge. METHODS: This was a pilot study of an online educational intervention. Data were electronically collected from 13 participants using validated questionnaires delivered via Qualtrics. Participants completed a demographic survey and End-of-Life Professional Caregiver Survey (EPCS) before and after completing an online, asynchronous education module. RESULTS: Mean scores were higher on all posttest measures. Independent samples t-tests revealed statistically significant differences on the Effective Care Delivery (ECD) scale (t[32] = -2, p = .05) and total EPCS scale scores (t[32] = -2.2, p = .03) from pre- to posttest. CONCLUSION: Scores increased on all dimensions pretest to posttest with statistically significant differences in ECD and total scores. Providing asynchronous online education on timing and content of palliative care conversations to nurses caring for people with heart failure is a feasible and effective way to improve perceived knowledge and skill of palliative care conversations.

Life-space constriction in aging adults.

BACKGROUND: Early indicators of declining function and frailty, such as life-space constriction (LSC), are important in identifying those at risk for frailty. PURPOSE: Examine factors associated with LSC and the influence on function and frailty. METHODS: A cross-sectional, descriptive study was conducted using a convenience sample of community dwelling persons 55 and older living in the South. RESULTS: Most participants (N = 72) were female (69%; n = 50) and half were White (53.5%; n = 38). Individual factors including challenges (age-related physiological changes, disease burden, mental health limitations) and buoy (assistive devices, and other compensatory strategies) explained 22% variance in self-reported frailty (F = 3.099 (6, 65); p = .01). LSC explained 34% variance in function (F = 3.805 (8, 59); p = .001) when environmental supports (family ties, and social network) and challenges (area deprivation, built environment, and social disorganization) and individual factors were controlled for. Number of assistive devices was the only significant predictor of frailty.

Narratives of Doctorally Prepared Nursing Faculty on Tenure Track: A Pilot Study.

BACKGROUND: The process of transitioning to academia as a new faculty on tenure-track is complex. During a global nursing shortage and the rising number of nursing faculty needed, careful attention must be given to the consideration of retaining nursing faculty. The purpose of this pilot study was to explore the experiences of DNP and PhD prepared faculty on tenure-track in academia through narrative stories. METHODS: A qualitative narrative design was used to explore doctorally prepared nursing faculty experiences with tenure-track. Viewed through the lens of postmodern feminism, 19 participants shared stories related to being a professional in academia striving for tenure status. RESULTS: Five themes of PhD and DNP faculty experiences on tenure-track were found: These themes existed under an umbrella storied pattern of needfulness. The interpreted themes included: (1) the ability to develop meaningful partnerships, (2) a necessity to balance responsibilities, (3) Destructive criticism is real, (4) I have value in academia, and (5) multifaceted coaching to produce achievement. CONCLUSION: The needs among faculty on tenure-track in nursing are similar, despite the achievement of a DNP or PhD. This emphasizes the necessity of uniformity related to appreciation and utilization of faculty, regardless of terminal degree.

Correction to: Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

The original version of this article unfortunately contained an error in author group. The second author Tamatha Arms was inadvertently missed to include in the author group.

Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

Individuals with severe and persistent mental illness (SPMI) encounter both poorer physical health and psychosocial well-being in comparison to the general population. Obesity, hypertension, heart disease, and diabetes can result from the symptoms of mental illness, the side effects from psychotropic medications, as well as disparities associated with being mentally ill. Mental health nurses are in a prime position to implement healthy lifestyle interventions (HLIs). This study tested a HLI (physical exercise and nutrition) and examined the effects on physical and psychosocial outcomes in clients obtaining mental health services at a community-based facility. Key findings included a decrease in anxiety and depressive symptoms at 3 months and consistent improvement in self-efficacy for exercise in the intervention group. Bridges and barriers to achieving optimal results in physical and psychosocial well-being were identified. Findings from this study offer insight into designing and executing more effective HLIs with individuals who have SPMI.

Implementing a Theoretical Debriefing Model in a Prelicensure BSN Program.

The National League for Nursing and International Nursing Association for Clinical Simulation and Learning stress that debriefing fosters critical reflection and is essential to all educational settings. The call to action for nurse educators is to incorporate theory-based debriefing throughout the curriculum. This article reports on how one school of nursing implemented the theory-based model, Debriefing for Meaningful Learning©, into the prelicensure baccalaureate curriculum.

Opioids: Literature Findings and Recommendations.

The opioid epidemic is a national public health concern. Nurses are the largest portion of the health care workforce and play a critical role in education, recognition, and referral to treatment. The purpose of the current article is to offer recommendations for nurses caring for individuals using opioid drugs. Searches for abuse, nursing, opioid, opiate, prescription, identify, and treatment were performed using Ovid Nursing, PubMed, and CINAHL databases. Articles were judged based on title, keywords, and abstract to determine inclusion. Thirty-three articles were chosen for review. Articles were chosen based on relevance to nurses' roles in care for individuals who were prescribed or misusing opioid drugs. Nurses are health care providers who can assess patients for opioid use and/or dependency. Recognizing substance use disorders early may prevent death due to opioid drug misuse. Through patient assessment, education, and treatment referrals, nurses can reduce fatal consequences that may result from opioid drug use. [Journal of Psychosocial Nursing and Mental Health Services, 56(9), 17-24.].

Red Flags and Off Ramps: Providing Community Education About Driving and Dementia.

Driving safety for older adults with dementia presents a continuing complex challenge in the community. More than 5 million people in the United States suffer from dementia, and their numbers are expected to grow. Evidence-based resources to identify and manage driving risks in older adults with dementia do exist, but the challenges of limited time in primary care and outpatient settings can make application difficult. This innovative project, funded by a Hartford Foundation Change Agents Action grant award, focused on interprofessional work to address the educational need for primary care professionals and family caregivers to manage driving safety for their loved ones with dementia. An interactive theater performance with development of an educational DVD was tested in a sample of professional and family caregivers. This project also forged new sustainable interprofessional community partnerships among educators/researchers and healthcare providers caring for this vulnerable community population.

Where the Rubber Hits the Road: What Home Healthcare Professionals Need to Know About Driving Safety for Persons With Dementia.

Driving cessation for people with dementia is a significant personal safety and public health issue. Home healthcare professionals frequently encounter situations where patients/clients should not continue to drive, and family members are unaware of how to approach the issue. This article will inform readers of the current state of the healthcare driving assessment process, measures and instruments used to assess, and effective strategies and resources when working with families facing the dilemma of how and when to proceed with a driving cessation plan.

The NPs Role of Assessing and Intervening with Older Adult Drivers.

As the silver tsunami continues, assessing and intervening with older adult drivers are becoming an essential aspect of the comprehensive geriatric exam. The current lack of time efficient clinical guidelines is a concern and barrier for NPs. The purpose of this study was to identify strategies currently used by NPs. The critical incident technique was used to obtain data from a convenience sample of NPs. A total of 89 incidents were collected. The perspective of the NP can provide important information for developing clinical guidelines to promote individual and community safety.

Psychosocial Effects of Health Disparities of Lesbian, Gay, Bisexual, and Transgender Older Adults.

The 1.5 million older adults who self-identify as lesbian, gay, bisexual, and transgender (LGBT) are expected to double in number by 2030. Research suggests that health disparities are closely linked with societal stigma, discrimination, and denial of civil and human rights. More LGBT older adults struggle with depression, substance abuse, social isolation, and acceptance compared to their heterosexual counterparts. Despite individual preferences, most health care providers recognize the right of any individual to have access to basic medical services. The U.S. Department of Health and Human Services requires that all hospitals receiving funds from Medicare and Medicaid respect visitation and medical decision-making rights to all individuals identifying as LGBT. The Joint Commission also requires a non-discrimination statement for accreditation. The current literature review examines LGBT health disparities and the consequential psychosocial impact on LGBT older adults as well as brings awareness to the needs of this underserved and underrepresented population.

Educational intervention to increase detection of metabolic syndrome in patients at community mental health centers.

The prevalence of metabolic syndrome and associated illness is approximately double in individuals with mental illness compared with the general public. An educational intervention on metabolic syndrome was provided to mental health counselors, who performed intake assessments of patients newly admitted to two outpatient mental health facilities. Researchers of the current study first measured mastery of metabolic syndrome content following the educational intervention; they then conducted a chart audit on new admissions to measure changes in clinician behavior. Prior to the intervention, neither facility screened for metabolic syndrome at intake or referred patients with a body mass index (BMI) >25 for medical evaluation. A paired t test showed no significant difference in the educational pre-posttest scores; however, following the intervention, 53 of 132 patients had a documented BMI >25, and 47 of 53 patients were referred to a primary care provider for evaluation. The current study's findings suggest that mental health counselors who screen for metabolic syndrome and associated illnesses will increase the rate of detection of these chronic conditions.