Preparing Nurse Educator Students for the New National Council of State Boards of Nursing NCLEX and AACN Essentials.

BACKGROUND: Graduate nursing education students are required to complete essential core content (such as education theory, accreditation, evidence-based teaching strategies, and evaluation methods) to prepare them to transition into independent practice. The 2021-2022 academic year required a monumental change in the existing curriculum to incorporate the 2021 American Association of Colleges of Nursing Essentials and the Next Gen National Council Licensure Examination (NCLEX) content. METHOD: An innovative, prioritized, learner-centered, backward design was used to update the existing curriculum to add the new core content to the nursing education student curriculum. RESULTS: The end of program comprehensive exams revealed that the students were able to successfully develop a test blueprint, utilizing case studies with Next Gen NCLEX question types designed to measure clinical judgment, and map to the 2021 AACN Essentials. CONCLUSION: The timely implementation of the curriculum revisions resulted in the achievement of desired student learning outcomes. [J Nurs Educ. 2024;63(3):192-196.].

A ladder that matters: Conceptual development of a clinical ladder program for nurse practitioners and physician assistants.

ABSTRACT: Clinical ladders are professional enhancement models that encourage and reward participants for continued professional engagement and leadership development. They have the potential to affect patient care through improved provider retention, advanced and refined clinical skills, and increased engagement. Recent literature has demonstrated development and implementation of clinical ladder models for nurse practitioners (NPs) in the acute care setting. A free standing pediatric academic hospital in Florida identified the need for such a program for nurse practitioners and given its increased utilization of physician assistants, these providers were also targeted for inclusion. This new clinical ladder included development strategies appropriate and attainable for both NP and PA scopes of practice. Consistent with Benner's theory of novice to expert (1982), each advancing rung in the ladder contains more stringent criteria and additional competencies demonstrating increased engagement, learning, and leadership. As this was a development project only, future directions for the new model include implementation and evaluation of various metrics including nurse practitioner and physician assistant retention and satisfaction. This model has laid the foundation for ladder development for additional health care professions within the institution.

Measuring the Validity and Reliability of the Vascular Access Complication Staging and Treatment Instrument in a Pediatric Population.

A multiphase study designed with Delphi and observational components was conducted to establish the preliminary validity and reliability of the 2018 Vascular Access Complication Staging and Treatment Instrument in pediatric and neonatal populations from a single, free-standing academic children's hospital. The instrument uses objective measurement criterion to determine the severity of swelling and tissue damage to inform treatment decisions. The results of the study provided preliminary empirical evidence to support a pediatric and neonatal intravenous complication staging instrument to assess degree of swelling and severity of tissue injury. The study also offered preliminary evidence that the instrument was perceived by the nurses who participated in the study to be efficient and easy to use.

Communication Under Pressure: A Quasi-Experimental Study to Assess the Impact of a Structured Curriculum on Skilled Communication to Promote a Healthy Work Environment.

Effective communication in health care is a mainstay of patient safety and staff perception of a healthy work environment. A quasi-experimental study was conducted to assess the impact of a course on staff perceptions of communication. A Wilcoxon signed-ranks test indicated a statistically significant difference between pre and post scores for the self-assessment component of the Heathy Work Environment Instrument (p = .0005); coworker assessments revealed borderline statistical significance (p = .056).

Targeted Education and Trends in Pediatric Nurses Perceptions of Barriers, Facilitators, Confidence, and Attitudes Toward Research and Evidence-Based Practice Over Time.

The purpose of this repeated cross-sectional study was to periodically assess perceptions of pediatric nurses' confidence, attitudes, barriers, and facilitators to research utilization and evidence-based practice as changes to the nursing research environment and a targeted curriculum were implemented. The study results were used by the nursing professional development specialist to further customize the nursing research curriculum to better meet the self-reported education and mentorship needs of the nurses.

Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses.

The purpose of this descriptive study was to identify the perceived barriers and facilitators to research utilization and evidence-based practice among nurses employed in a tertiary care children's hospital. Results revealed seven facilitator and six barrier themes that contribute to the understanding of the problem. The themes can be utilized by nursing professional development specialists to customize organizational infrastructure and educational programs.

Long-Term Outcomes of Infants with Neonatal Abstinence Syndrome.

Parents of infants with neonatal abstinence syndrome (NAS) in the NICU may have questions about the long-term consequences of prenatal exposure to methadone, both asked and unasked. Although the signs of withdrawal will abate relatively quickly, parents should be aware of potential vision, motor, and behavioral/cognitive problems, as well as sleeping disturbances and ear infections so their infants can be followed closely and monitored by their pediatrician with appropriate referrals made. Furthermore, this knowledge may inspire parents to enroll their infants in an early intervention program to help optimize their outcomes. There are still many unanswered questions about epigenetic consequences, risk for child abuse/neglect, and risk of future substance abuse in this population.

Ethical issues related to caring for low birth weight infants.

BACKGROUND: Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations. RESEARCH PURPOSE: The purpose of this study was to describe the ethical and moral issues that neonatal intensive care nurses experience when caring for low birth weight preterm infants and their families. RESEARCH DESIGN: A phenomenological method design was used to describe the lived experiences of nurses with ethical and moral issues encountered in the neonatal intensive care unit. One-on-one, semi-structured interviews using open-ended questions were used to gather data from the participants. RESEARCH PARTICIPANTS: The setting for this study was a 97-bed neonatal intensive care. A total of 16 female nurses were interviewed. ETHICAL CONSIDERATIONS: Approval to conduct the research study was obtained from the institutional review board of the hospital where the study was conducted. Formal signed consent was obtained from each participant. To ensure confidentiality, each participant was asked to choose a confederate name to be used in the interview and the transcriptions. FINDINGS: The thematic analysis identified five recurring themes: (a) at the edge of viability, (b) infant pain and discomfort, (c) crucial decisions, (d) communicating with parents, and (e) letting go. CONCLUSION: Neonatal intensive care unit nurses indicated that they often had challenges to their own sense of morality as they struggled to protect the infant from pain and unnecessary discomfort, provide care to an infant and their family whom they thought was faced with a lifetime of challenges and poor health, accepting decisions made by parents, and feeling as if parents were not adequately informed about outcomes.

Validation of the Finnegan neonatal abstinence syndrome tool-short form.

PURPOSE: The purpose of this study was to reduce the number of items in the Modified Finnegan Neonatal Abstinence Syndrome Tool (M-FNAST) to the minimum possible while retaining or improving its validity in a short version. SUBJECTS: All infants with a diagnosis of neonatal abstinence syndrome (171) who were admitted to a large neonatal intensive care unit in southwest Florida between September 2010 and October 2012 comprised the sample. DESIGN: This was a psychometric evaluation of 33 856 M-FNAST assessments that were downloaded from the electronic medical record. METHODS: Principal axis factoring extraction with varimax rotation was performed on the M-FNAST data. Principal components extraction was used before principal factors extraction to estimate the number of factors with the scree test and factorability of the correlation matrices with Bartlett's chi-square test, and Kaiser-Meyer-Olkin Measure of Sampling Adequacy. RESULTS: The M-FNAST scores ranged from 0 to 29, with a mean of 3.5 (SD = 2.5). Less than 1% (21) of infants had scores of 17 or more. Nearly all (97.7%) scores fell between 0 and 9. Most subjects were full-term gestation, but 11 were preterm between 28 and 37 weeks' gestational age. The 2-factor solution explained 23.74% of the total variance and consists of 2 factors, mild/early and moderate/advanced signs. The 2-factor solution was significantly correlated with the total score on the MFNAST (r = 0.917; P < .001). Among infants who scored 8 or greater, the total score on the 2-factor solution short form FNAST was significantly correlated with the total score on the M-FNAST (r = 0.629; P < .001).

NICU nurses' lived experience: caring for infants with neonatal abstinence syndrome.

PURPOSE: The primary aim of this qualitative methods study was to describe the lived experiences of neonatal intensive care unit (NICU) nurses with ethical and morally challenging issues. SUBJECTS: The target population for the study was registered nurses working in the NICU. Interviews were completed with 16 nurses from 1 hospital. DESIGN: A phenomenological method design was used to describe NICU nurses' lived experiences with ethical and moral issues encountered in the NICU. METHODS: After obtaining signed consent, the principal investigator interviewed all participants, using a semistructured interview guide consisting of open-ended questions. MAIN OUTCOMES: Ethical and moral distress related to neonatal abstinence syndrome was the predominant outcome. PRINCIPAL RESULTS: Caring for infants, coping with families, and discharging infants home were the major concerns voiced by nurses in this study. CONCLUSIONS: Nurses in this study struggled with issues of beneficence and nonmaleficence and were not aware of scientific evidence that guides methadone management of pregnant women.