Impact of the 2019/2020 Australian Megafires on Air Quality and Health.

The Australian 2019/2020 bushfires were unprecedented in their extent and intensity, causing a catastrophic loss of habitat, human and animal life across eastern-Australia. We use a regional air quality model to assess the impact of the bushfires on particulate matter with a diameter less than 2.5 µm (PM2.5) concentrations and the associated health impact from short-term population exposure to bushfire PM2.5. The mean population Air Quality Index (AQI) exposure between September and February in the fires and no fires simulations indicates an additional ∼437,000 people were exposed to "Poor" or worse AQI levels due to the fires. The AQ impact was concentrated in the cities of Sydney, Newcastle-Maitland, Canberra-Queanbeyan and Melbourne. Between October and February 171 (95% CI: 66-291) deaths were brought forward due to short-term exposure to bushfire PM2.5. The health burden was largest in New South Wales (NSW) (109 (95% CI: 41-176) deaths brought forward), Queensland (15 (95% CI: 5-24)), and Victoria (35 (95% CI: 13-56)). This represents 38%, 13% and 30% of the total deaths brought forward by short-term exposure to all PM2.5. At a city-level 65 (95% CI: 24-105), 23 (95% CI: 9-38) and 9 (95% CI: 4-14) deaths were brought forward from short-term exposure to bushfire PM2.5, accounting for 36%, 20%, and 64% of the total deaths brought forward from all PM2.5. Thus, the bushfires caused substantial AQ and health impacts across eastern-Australia. Climate change is projected to increase bushfire risk, therefore future fire management policies should consider this.

The Nurse Residency Education Navigator: Educator, Facilitator, and Clinician.

Our health care system hired 105 newly graduated nurses during a 12-month period. The challenge of how to integrate and subsequently retain this large volume of nurses within a relatively short time frame was apparent. Therefore, the position of education navigator was created. The education navigator mirrors the traditional nurse navigator by expediting the transition of newly graduated nurses from novice to competent nurses via the roles of educator, facilitator, and clinician. When nurses have mentors and leaders they can trust and rely on for support and guidance, an organizational culture is created where performance is optimized, and staff are retained. The supportive culture influences the work environment, clinical practice, and education. As educators, it is imperative we act as mentors to our new nurses not only to retain them but to help them grow professionally. The education navigator role provides newly graduated nurses with a support system that leads to increased retention and professional development. [J Contin Educ Nurs. 2021;52(2):79-84.].

Using Research Findings to Design an Evidence-Based Practice Curriculum.

Evidence from a system-wide research study highlighted strengths and weaknesses in evidence-based practice (EBP) implementation, beliefs, and organizational readiness. To address this evidence, a curriculum was developed within the context of the shared governance and EBP models for nursing practice. The curriculum, Evidence-Based Practice: Clinical Applications in Professional Nursing Practice, consists of five modules that provide the knowledge, skills, and abilities relative to each step of EBP. The learning approach incorporates classroom- and unit-based education, facilitated by EBP curriculum mentors. Each module is rolled out quarterly for a 15-month curriculum cycle. Outcome data include pre- and post-learning assessments, in addition to EBP projects. This seamless approach to nursing education, based on research findings and established shared governance and EBP models, can be undertaken by community hospital systems. J Contin Nurs Educ. 2017;48(4):184-189.

Competition is key when it comes to fast-food outlets.

When University Hospital Southampton NHS Foundation Trust announced that it was ending its contract with Burger King and not renewing the fast-food outlet's concession at the city's general hospital, patients launched a campaign against the closure (News January 7).

Screening, brief intervention, and referral to treatment: overview of and student satisfaction with an undergraduate addiction training program for nurses.

Preparing nursing students to apply an evidence-based screening and brief intervention approach with patients has the potential to reduce patients' risky alcohol and drug use. Responding to Mollica, Hyman, and Mann's article published in 2011, the current article describes implementation results of an Addiction Training for Nurses program of Screening, Brief Intervention, and Referral to Treatment (SBIRT) embedded within an undergraduate nursing curriculum. Results reveal that students in other schools of nursing would benefit from similar, significant training on substance use disorders and SBIRT. Training satisfaction surveys (N = 488) indicate students were satisfied with the quality of the training experience. More than 90% of students strongly agreed or agreed that the training was relevant to their nursing careers and would help their patients. Additional clinical practice and skill development may increase students' reported effectiveness in working with the topic area of substance use and SBIRT.

Overcoming barriers in online workshop development: an ELITE experience.

The Emerging Learning and Integrated Technologies Education (ELITE) Faculty Development Program created eight online workshops to assist nurse educators in using technology within their organization's nurse education program. Continuing education units were provided for completion of the individual online workshops. The ELITE program worked through several barriers to transform content that was previously presented during face-to-face workshops into standalone online offerings. Barriers and implementation strategies for the on-site to online transition included restructuring workshop objectives, keeping current with rapid technology changes, altering a course management system to meet the needs of the program and the learner, and crafting independent practice opportunities for the online learner. The online workshop development experience of the ELITE program may assist other continuing education and staff development professionals who are updating their program offerings or pursuing online education for the first time.

Technology and the nurse educator: are you ELITE?

Faced with an increasingly varied technology environment, nurse faculty and students often see the value of technology but struggle with its effective use. To address this issue, our school of nursing created an innovative program that provided faculty with tools and training needed to effectively implement educational technology. The authors discuss program content, implementation strategies, and results.

Effects of Screening, Brief Intervention, and Referral to Treatment (SBIRT) education and training on nursing students' attitudes toward working with patients who use alcohol and drugs.

BACKGROUND: Screening, Brief Intervention, and Referral to Treatment (SBIRT) can reduce alcohol use and negative health outcomes in patients with risky substance use. However, negative attitudes that some health care professionals have toward patients who use substances are a barrier to implementing SBIRT. METHODS: The University of Pittsburgh School of Nursing, in partnership with the Institute for Research, Education, and Training in Addictions (IRETA), developed a curriculum to train baccalaureate student nurses to deliver SBIRT. RESULTS: Following SBIRT education and training, students' perceived attitudes toward patients who use alcohol became more positive. Less robust changes were found for attitudes related to patients who use drugs. CONCLUSIONS: Nurses composing the largest group of healthcare workers are in key positions to screen, intervene, and provide education about substance use.

Using high-fidelity simulation as a teaching strategy with Baby Boomers returning to the RN workforce.

As a result of a changing economy, many Baby Boomer nurses are returning to the workforce. Common teaching strategies used in schools of nursing, such as high-fidelity simulation, are unfamiliar to this group of learners. Educators must learn not only the characteristics of Baby Boomer returning nurses but also how to adapt simulation to their learning styles.

A relational leadership perspective on unit-level safety climate.

OBJECTIVE: This study compared nursing staff perceptions of safety climate in clinical units characterized by high and low ratings of leader-member exchange (LMX) and explored characteristics that might account for differences. BACKGROUND: Frontline nursing leaders' actions are critical to ensure patient safety. Specific leadership behaviors to achieve this goal are underexamined. The LMX perspective has shown promise in nonhealthcare settings as a means to explain safety climate perceptions. METHODS: Cross-sectional survey of staff (n = 711) and unit directors from 34 inpatient units in an academic medical center was conducted. RESULTS: Significant differences were found between high and low LMX scoring units on supervisor safety expectations, organizational learning-continuous improvement, total communication, feedback and communication about errors, and nonpunitive response to errors. CONCLUSION: The LMX perspective can be used to identify differences in perceptions of safety climate among nursing staff. Future studies are needed to identify strategies to improve staff safety attitudes and behaviors.

Leveraging differences for collaborative advantage: enhancing student learning through an international educational collaboration.

This case study in collaboration development describes the relationship from initiation through maintenance over three years between a high profile research-focused school of nursing in the U.S. and a school in the UK known for learning and teaching innovation. The ultimate goal of the collaboration is to enhance nursing student learning opportunities to best prepare students to function in the complex and ever-changing world of nursing practice. This goal has been, and continues to be, achieved through implementation of innovative teaching and learning strategies including the use of high fidelity simulation. The authors describe the intellectual collaborative advantage that the relationship between the schools has made possible as well as key principles to be considered when any organization is contemplating a collaboration.

Supporting preceptors: a three-pronged approach for success.

This article describes the development and implementation of the Nursing Preceptor Program (NPP), an innovative program that provides training and support to preceptors working with undergraduate nursing students. The main objective of the NPP is to support the learning outcomes of students by preparing and supporting preceptors for their roles. The University of Pittsburgh School of Nursing created a three-pronged program: a self-paced, modular, online preceptor course; a dedicated web page for both preceptors and students; and a relational database that can be queried for information on clinical sites and preceptors, catalogued by semester and year. A task force, consisting of local academic and clinical experts, was created to help with program development. To date, 25 preceptors have participated in the online course. Evaluations have been positive. Preceptors believe the included information is applicable and the modules, as a whole, are well planned and written.

Building an evidence-based practice infrastructure and culture: a model for rural and community hospitals.

The need to address the disparity between healthcare research findings and the implementation of findings into clinical practice is an essential factor in healthcare reform. Exponential growth over the past decade in health-related knowledge and technology has made access to research findings increasingly available. The authors describe a process initiated at a rural community hospital to support the integration of evidence-based practice into daily nursing practice.

The fast track back to registered nurses employment.

The registered nurse (RN) workforce continues to decline. One method to attract experienced RNs into the workforce is through RN refresher courses. To determine if our RN refresher program is successful in returning RNs to the workforce, we sought to measure the: characteristics of RNs who participate in our program; relationship among participants' employment and demographics; effect of high fidelity human simulation (HFHS) on participants' learning, and; program's ability to meet participants' preparation for employment. Seventy-three participants were surveyed to measure their demographics and employment; they ranked the HFHS experience and program experience on their learning and employment. Thirty-four (47%) surveys were returned. Thirty-three participants (97%) were female (mean age=50.44 years, SD=6.2). Their mean years of RN licensure was 24.93 years (SD=8.8), and their mean time out of nursing practice was 13.30 years (SD=8.0). Twenty-six (76.5%) were employed, with 20 (60.6%) employed as RNs at acute care facilities. Employed participants were licensed for less years than non-employed participants (p=0.047). Employed participants ranked their HFHS experience highly (p=0.04) and the program highly (p=0.04) on benefiting their current employment. Our refresher program appears to be successful in helping RNs re-enter the nursing workforce.

Returning nurses to the workforce: developing a fast track back program.

TOPIC: Fast Track Back: Re-entry into Nursing Practice program. PURPOSE AND SOURCES OF INFORMATION: Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. CONCLUSIONS: The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Building a foundation for an evidence-based approach to practice: teaching basic concepts to undergraduate freshman students.

The University of Pittsburgh School of Nursing introduced evidence-based practice (EBP) into the freshman-level curriculum this year. This article describes the reasons behind this decision, the development of the curriculum, the specific EBP content, and the student assignments. The introduction of EBP into the first-level nursing curriculum has proven to be successful; consideration is even being given to expanding the EBP content.