Examination of the Relationship Between Clinical Hours and NCLEX Success.

BACKGROUND: Clinical education provides important learning opportunities for students. Finding clinical sites and faculty can be a challenge. Exploring the relationship between the number of clinical practice hours and NCLEX-RN success may be helpful for curriculum development and revision. PURPOSE: The purpose of this study was to provide descriptive information about clinical education in RN programs and determine if a relationship existed between the number of clinical hours and NCLEX-RN pass rate. METHOD: A descriptive research design using a survey was sent to over 1000 accredited nursing programs in the United States. RESULTS: One hundred and fourteen surveys were completed. When comparing 2021 NCLEX-RN pass rates with clinical hours, there was a statistically significant difference at the 500 clinical hour interval. CONCLUSION: Nursing programs can ensure fiduciary responsibility while supporting clinical judgment development and licensure success by reviewing their curriculum and reconsidering the number of clinical hours in their programs.

Heat Metrics and Maternal-Child Health Diagnoses in Emergency Departments in the United States: A Scoping Review.

OBJECTIVE: To summarize current research on associations between heat metrics and emergency department discharge diagnoses for US pregnant women and children from birth to age 18 via a scoping review. BACKGROUND: Climate change directly contributes to extreme weather conditions and environmental changes and indirectly affects health and the health care system. Pregnant women and children are believed to be more susceptible to extreme heat, but few empirical studies have been conducted evaluating effects of heat metrics on these populations. METHODS: Ovid MEDLINE, CIHAHL, SCOPUS, Web of Science, JSTOR, and PsycINFO databases were searched using a combination of key words. RESULTS: Twelve studies were selected for this review. In pregnant women, positive associations were found between mean daily temperature and multiple subtypes of pregnancy complications, including threatened or spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension. In children, positive associations were found with all-cause diagnoses; asthma; dehydration; electrolyte disorders; heat-related illness; infection; endocrine, nutritional, and metabolic diseases; injury; and otitis media and external emergency department discharge diagnoses and temperature or heatwave versus non-heatwave. CONCLUSION: By tracking associations between maternal-child emergency department discharge diagnoses and various heat metrics, researchers can contribute to better clinical practices that promote environmental justice and climate resilience.

The Role of the School Nurse in Addressing Climate-Associated Illnesses: Heat.

Extremely hot or humid days are anticipated to continue, occur more often, and intensify over time. School-age children are especially vulnerable to extreme heat. The primary acute health effects of heat on children can range from heat exhaustion to heatstroke. The purpose of this article is to raise awareness of the impact some acute heat-related illnesses have on school-age children's health and to provide school nurses with information on the signs and symptoms of heat-related illnesses as well as prevention tips to share with parents and school administrators. This is the fifth article in a series meant to inform school nurses about illnesses linked to the climate and provide them with the tools they need to safeguard children' health.

Deaths From Drug Overdoses What School Nurses Need to Know.

Drug overdose deaths in pre-teen and adolescent students have risen over the past several years, causing increasing concerns in our society, along with concerns over the rise in availability of more counterfeit pills and illegally manufactured fentanyl. School nurses interface regularly with pre-teen and adolescent students and therefore are in a position to recognize students at risk for illicit drug use and provide important education to students, staff, parents, and the community. The purpose of this article is to briefly discuss risk factors for opioid misuse and to provide recommendations for interventions school nurses can use, including collaboration with other school and community leaders, to help prevent opioid overdose and death in pre-teen and adolescence.

"Make-up" Examinations: Comparison of on-Time and Late Examination Student Scores.

BACKGROUND: Nursing faculty may have concerns about unfair advantages and inflated examination grades when students take an examination late. PURPOSE: The purpose of the study was to compare make-up examination scores with on-time examination scores to determine whether scores were higher in students who took an examination late. METHODS: A descriptive, comparative study using retrospective examination scores from a large nursing program was analyzed. Late examination scores were compared with the student's individual on-time examination average and the class's average of on-time examination scores. RESULTS: A total of 156 examinations were taken late. There were no statistically significant differences between students' late examination scores when compared with the student's on-time examinations or the class average of the examination. CONCLUSION: Students do not appear to gain an advantage when taking an examination late. Findings may assist faculty in developing policies for taking make-up examinations.

Common Skin Infections in High School Athletes and the Role of the School Nurse.

Skin infections in high school athletes pose a risk of transmission to other student athletes. Therefore, it is important to promptly identify possible skin infections and refer them to the healthcare provider for treatment so athletes can return to play quickly and with little interruption to the team. Common skin infections include bacterial infections such as Streptococcus and Staphylococcus, viral infections such as herpes simplex and molluscum contagiosum, and fungal infections such as tinea corporis and capitis. The National Federation of State High School Associations provides guidance for the prevention of skin infections as well as return to play guidelines. The school nurse and high school athletic trainer are both healthcare professionals who play a role in preventing, identifying, monitoring, and caring for student athletes who contract skin infections.

Anxiety and Answer-Changing Behavior in Nursing Students.

BACKGROUND: Anxiety in college students, including nursing students, has increased significantly and has been implicated as a cause of lower academic achievement and answer-changing behavior. This study investigated the relationship between student anxiety and answer-changing behaviors. METHOD: One hundred thirty-one nursing students from a large midwestern baccalaureate nursing program were enrolled in a quasiexperimental prospective research study. Data included demographics, analysis of student movement through the examination to identify changed answers, and completion of the PROMIS Short Form version 1.0-Emotional Distress-Anxiety 8a tool. RESULTS: PROMIS anxiety scores did not covary significantly with the rate of answer-changing behaviors including rate of negative changes. CONCLUSION: This study did not identify a relationship between students' answer-changing behavior and anxiety. Future studies should evaluate other characteristics, such as confidence and level of examination preparation, as possible reasons for changing answers. [J Nurs Educ. 2023;62(6):351-354.].

Evaluation of Dog Presence as a Therapeutic Classroom Intervention.

BACKGROUND: The American Association of Colleges of Nursing has called on nurse educators to increase mental health support for nursing students. Animal visit programs reduce stress, anxiety, and negative mental health feelings; however, most are intermittent and occasional. This pilot study explored the feasibility, acceptability, and outcomes of integrating a therapy dog into the classroom. METHOD: This pretest-posttest, two-group design study included 67 baccalaureate nursing students. Two sections of a course were taught: one section included a therapy dog and one section did not. RESULTS: At the end of the course, participants in the intervention group showed improvement in stress, anxiety, and happiness, whereas participants in the control group did not demonstrate any improvement. Students reported positive feelings and benefits from the presence of the therapy dog. CONCLUSION: Integrating a trained therapy dog into the classroom is both feasible and acceptable, with students identifying positively with the experience. [J Nurs Educ. 2023;62(6):355-358.].

Celiac Disease and Disorders of Gut-Brain Interaction: What School Nurses Need to Know.

Abdominal pain and discomfort are common reasons students visit the school health office. Abdominal pain, in children, may be related to gastrointestinal conditions such as celiac disease (CD) or disorders of gut-brain interaction (DGBIs). Both CD and DGBIs, formerly known as functional abdominal pain disorders, are both prevalent in the pediatric population. Manifestations, presentation, and management of these disorders overlap and will be reviewed in this article. Due to their chronic nature, school nurses should be aware of both the management and complications associated with CD and DGBIs. Dietary recommendations, including the gluten-free and low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPS) diet, will be presented as part of the management of the disorders.

Minor Skin Injuries at School: The Role of the School Nurse.

School nurses routinely provide simple wound care for minor injuries in the school health office. Simple wound care is centered on the principles of moist wound care and only requires a few supplies to be on hand. This article outlines the steps for simple wound care for minor abrasions, cuts, blisters, and burns. Recommendations for referral of more complicated wounds are also provided. Student encounters for minor wound care can also be used by school nurses to provide education on first aid and to teach students, parents, and caregivers about infection prevention and control of the wound.

Increasing Faculty Resources and Student Capacity Through Shared Faculty Expertise.

BACKGROUND: The ongoing nurse faculty shortage has resulted in a need for schools of nursing to become both innovative and creative in their approach to nursing education. A literature review revealed some schools of nursing across the United States are sharing faculty for undergraduate and pre-licensure nursing programs. PURPOSE: The purpose of this pilot project was to explore the effectiveness of a shared faculty content expert in a live-streamed lecture modality to improve nursing schools' access to high quality specialty content. The feasibility and satisfaction of sharing a course and faculty between two independent schools of nursing were evaluated. METHODS: An online synchronous format was utilized to share a mental health nursing course between two independent schools of nursing. RESULTS: Results indicated that theoretical classroom content and experiences can be shared and delivered synchronously among schools of nursing; however, challenges existed related to scheduling conflicts. Additionally, technology issues were found to negatively impact the student experience at times. CONCLUSION: Given the challenges identified in the project, an asynchronous content delivery modality may be a more advantageous option. Future research is needed to identify ways to mitigate the challenges experienced.

A Longitudinal View of Perceptions of Entering Nursing Practice During the COVID-19 Pandemic.

Background The COVID-19 pandemic significantly changed the landscape of health care and transition to practice for new graduates. The purpose of this pilot study was to explore the effects of the pandemic on the first-year experience of new nurses. Method A longitudinal, observational, descriptive study design was used. One hundred eighteen survey links were sent to new bachelor of science in nursing graduates from June 2020 to May 2021, with 56 responses to the first survey. Results Participants indicated the COVID-19 pandemic negatively affected the new graduate experience, resulted in concern for personal health and safety, and negatively altered preparation for the first year in practice. However, desire to be a nurse and view of nursing remained positive. Conclusion The first year in practice is stressful and challenging. The pandemic posed additional challenges to employers and new graduates. Future research should explore the long-term impact of the pandemic on an already strained nursing workforce. [J Contin Educ Nurs. 2022;53(6):256-263.].

Staying Ahead of Head Lice: Pediculosis Treatment Updates.

Pediculosis (head lice) infections are one of the more sensitive issues that may involve the school nurse. In the 3- to 11-year-old age group in the United States, head lice infections are common and can elicit anxiety in students, parents, and school personnel. Head lice do not transmit any communicable diseases and therefore exclusion from school and "no nit" policies are not warranted. Treatment and management for head lice include a range of over-the-counter products and prescription topical and oral medications. Nonpharmacologic and alternative treatments do exist; however, many do not have established efficacy studies, and some can be costly. The school nurse plays an integral role in providing education related to treatment and environmental recommendations for families affected by head lice. Through this education, the nurse can also reduce the stigma and anxiety many feel around the subject of head lice infections.

Laboratory Testing in the School Setting: Are You CLIA Compliant?

Nurses are qualified to design, manage, supervise, and deliver health care in a public health setting such as the school. Considering this, school nurses should understand regulations necessary to aid in the care of children, especially related to point-of-care laboratory testing for the assessment and treatment of health conditions. The pandemic and resulting mitigation strategy of COVID-19 testing adopted by some schools, has raised questions about the need for school nurses to comply with the Clinical Laboratory Improvement Amendments (CLIA). CLIA was established to improve the quality of laboratory test results and school nurses who perform blood glucose monitoring and urine dipstick testing fall under the CLIA waiver category. Therefore, school nurses should be knowledgeable about CLIA certification. By developing policies and procedures for testing, completing the CLIA certificate of waiver, and following best laboratory practices, school nurses will be delivering high-quality nursing care in their health room.

Preparedness to Write Items for Nursing Education Examinations: A National Survey of Nurse Educators.

BACKGROUND: Nursing programs in the United States primarily use multiple-choice questions to prepare students for the NCLEX. BACKGROUND: Nursing programs in the United States primarily use multiple-choice questions to prepare students for the NCLEX. Currently, the optional next-generation NCLEX is testing the validity and reliability of situational case studies. PURPOSE: The purpose of this study was to investigate the preparedness and confidence of nurse educators in writing NCLEX-style questions. METHODS: A descriptive survey design with snowball sampling was used to collect the data and was sent to 1550 deans/directors/coordinators of publicly available email addresses of accredited schools of nursing. RESULTS: A total of 300 participants completed the survey from 44 states. When asked about confidence in writing NCLEX-style items, those who received formal education or training reported being somewhat confident (51%), whereas those who did not reported ambivalent or not confident (49%). CONCLUSION: Surveyed nurse educators lack confidence in writing questions and feel unprepared for the new question types instituted by the NCSBN in 2023. Nurse educators need continued education to develop and review NCLEX-style items and examinations.

Evaluation of a Brief Mindfulness Intervention on Examination Anxiety and Stress.

BACKGROUND: Nursing students report increasing levels of stress and anxiety related to academic performance. Mindfulness programs have been found to reduce stress, yet such programs have been identified as a time-burden for students. This study evaluated the integration of a brief preexamination mindfulness reflective intervention for nursing students. Perceived stress, anxiety, resilience, and acceptability were evaluated. METHOD: A mixed-methods experimental design with random assignment was used. Forty-nine nursing students were randomized to either an intervention group (N = 25) who participated in the brief preexamination mindfulness intervention or a control group (N = 24) who took their examinations without any intervention. Self-report tools measured stress, resilience, and mindfulness. Qualitative responses were collected. RESULTS: Outcomes revealed decreased feelings of helplessness and anxiety in the intervention group. Although students had positive views of mindfulness, barriers were indicated. CONCLUSION: Brief preexamination mindfulness interventions provide students with anxiety-reducing options. [J Nurs Educ. 2021;60(11):625-628.].

Multisystem Inflammatory Syndrome in Children and COVID-19 Infections.

The arrival of SARS-Co-V-2 (severe acute respiratory syndrome coronavirus 2) has brought not only the COVID-19 (coronavirus disease 2019) pandemic but also the development of a cluster of symptoms known as multisystem inflammatory syndrome in children (MIS-C). Information regarding the long-term implications of COVID-19 infections in children, as well as MIS-C, is scarce and is emerging on an almost daily basis. The purpose of this article is to provide an overview of the recent literature regarding COVID-19 and MIS-C, a Kawasaki-like inflammatory syndrome that developed in children around the same time the COVID-19 pandemic began. Because the school nurse monitors children across a variety of developmental domains, they are in a unique position to identify changes and notice long-term trends related to the health and development of children who contract both COVID-19 and MIS-C.

Assessment of Answer-Changing Behavior of Nursing Students and Faculty Recommendations.

BACKGROUND: Existing literature identifies a general positive benefit to students' examination scores when students change their answer on examinations. Current shifts toward computerized examinations and in test anxiety warrant a literature update on test-taking behaviors. PURPOSE: This study assessed answer changing on multiple-choice examinations and investigated faculty recommendations related to answer changing. METHOD: This study used a mixed-methods design using retrospective student data from ExamSoft reports and faculty responses from a national survey of nurse educators. RESULTS: Findings indicated 55% of students improved their examination score, with an average improvement of 3%, and 24% of students lowered their examination score. However, faculty continue to incorrectly recommend that students should not change answers on examinations. CONCLUSION: The results of this study support prior literature that answer changing benefits students. However, data are lacking on the characteristics of students who improve or lower their examination scores by changing answers.[J Nurs Educ. 2021;60(6):324-328.].

What Is "Hot" and What Is Not: Thermometers and Fever Control.

The purpose of this article is to review and help identify the advantages and disadvantages of different types of thermometers available for use and to provide guidance on fever education for the otherwise healthy child in the community and school health population. The measurement of body temperature is an essential part of standard medical care that monitors patient status, response to treatment, and helps gauge the severity and progression of disease. There are multiple types of thermometers on the market and each has advantages and disadvantages related to infection control measures, cost, and ease of use. Digital thermometers provide quick accurate results and are cost-effective. However, noncontact forehead, tympanic, or temporal scanner may be a better option for some populations of students. The noncontact forehead scanner may be a better choice when large numbers of students need to be screened. After fever has been identified, parent education should be provided, including when to seek further care and comfort measures such as safe, effective antipyretic usage.