Interventions in maternal syphilis care globally: A scoping review.

Infectious and Congenital Syphilis rates continue to rise globally. Current recommendations for syphilis screening and treatment may be insufficient, and there is a pressing need for improved programs and services to address the increase in cases. A scoping review was conducted to examine approaches to maternal syphilis screening and treatment. Theoretical underpinnings and the key characteristics of these interventions were studied to identify gaps in the existing literature to guide future research. Developing a modified version of the socio-ecological model to guide data analysis, we included 33 academic studies spanning 31 years, covering a range of interventions, programs, and policies globally. We highlight key facets of interventions aligning with the five levels of the modified model that include: individual, interpersonal, institutional, community and policy. In this review, we provide valuable insights into the characteristics and principles of maternal syphilis screening and treatment interventions.

Even with advances in care, there remain many similarities in interventions for the improved treatment and screening of maternal syphilis over the past 30 years.There is a need for meaningful research that engages community members in study and intervention development and considers the social determinants of health in the context of maternal syphilis care.Examining interventions in relation to the socio-ecological model may help guide policymakers, researchers, and clinicians in intervention development.

Promoting Resident Autonomy to Maintain Quality of Life.

In response to the COVID-19 pandemic, Canadian governments and healthcare organizations implemented restrictions on continuing care residents. From an ethical lens, governments and healthcare organizations were focused on preventing harm through promoting beneficence and non-maleficence; however, this was at the expense of resident autonomy. The rights of continuing care residents were stripped away when they were not given the opportunity to make informed decisions regarding their care and day-to-day life. Governments and healthcare organizations denied them the dignity to experience the positive outcomes that result from risk-taking based on their personal values and preferences. In an attempt to prevent resident harm from COVID-19 cases and deaths, governments and continuing care facilities forced residents into isolation. This negatively affected residents' quality of life in the form of physical, mental, and cognitive health deterioration. Moving forward, governments and healthcare organizations need to take the time to engage residents in decision-making and policy development that affects their care, treatment, and support system. Governments and healthcare organizations must promote and safeguard resident autonomy to maintain quality of life.

A call for nurse practitioner-led cancer survivorship clinics: The need for development and adoption within Ontario, Canada.

The growing prevalence of cancer survivors requiring comprehensive follow-up care after the completion of treatment is placing a significant strain on the Canadian healthcare system (Moura et al., 2022). Given the current landscape and the higher workload demands that are further exacerbated by shortages in healthcare staffing, the oncology specialist-led care, as the standard model for survivorship care is unsustainable and suboptimal in addressing a broad range of physical, psychosocial, supportive, informational, and rehabilitative needs of cancer survivors (Brennan et al., 2010; Canadian Partnership Against Cancer & Canadian Association of Provincial Cancer Agencies, 2010). Nurse-led models of survivorship care provided by oncology nurse practitioners (NPs) have been shown to be safe, effective, feasible, and appropriate for follow-up care (Chan et al., 2018). In the province of Ontario, survivorship care is provided mostly by physicians. Specialized NP-led survivorship clinics or programs are currently lacking based on a recent environmental scan. This paper outlines current barriers and opportunities in NP-led survivorship care. This is a call to action and for advocacy regarding the examination of oncology services and outlines the need for the development and implementation of NP-led survivorship clinics in Ontario, Canada.

Lessons learned from clinical course design in the pandemic: Pedagogical implications from a qualitative analysis.

AIMS: The purpose of this study was to examine clinical pedagogy based on experiences of changes and adaptations to clinical courses that occurred in nursing education during the pandemic. Beyond learning how to manage nursing education during a pandemic or other crisis, we uncover the lessons to be learned for overall improvement of nursing education. DESIGN: Qualitative descriptive analysis using semi-structured interview data with baccalaureate nursing students. METHODS: Data were collected in the spring of 2021 using semi-structured interview with 15 participants. Transcribed text was analysed using thematic content analysis. The COREQ checklist was used to guide our reporting. RESULTS: Three themes were identified related to course design in clinical courses for nursing students: the role and limitations of simulation, competency evaluations and career implications. Students expressed some concern over not 'finishing hours', loss of in-person clinical experiences and their reduced exposure to different clinical settings. CONCLUSION: To prepare work-ready nurses, educators need to keep in mind the trends, issues and demands of future healthcare systems. Simulation may have been a temporary measure to achieve clinical competence during the pandemic but needs to be of high-quality and cannot meet all the expected learning outcomes of clinical courses. Exposure to different patients, families and communities will ensure that the future nursing workforce has experience, socialization, competence, and desire to work in various clinical settings. Competency evaluation similarly needs to be robust and objective and consider the role and perception of hours completed. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. Participants were nursing students.

Clinical learning during the pandemic: Experiences of LPN-BN undergraduate nursing students.

BACKGROUND: When the COVID-19 pandemic was declared in March 2020, nursing programs made rapid decisions regarding clinical placement experiences for students. In many nursing programs, this meant ending clinical placements early, delaying clinical courses, and moving clinical courses to simulation. PURPOSE: The purpose of this study was to explore LPN-BN students' experiences in clinical courses during the COVID-19 pandemic. METHOD: A qualitative descriptive approach was employed in this study. Fifteen semi-structured conversational interviews with nursing students and recent graduates were conducted. Inductive content analysis was used to analyse the data. RESULTS: Four main concepts were identified: (1) logistics of learning; (2) shifts in clinical learning; (3) mental health matters; (4) readiness to practice. CONCLUSION: It is important to understand the experience of nursing students as this is an inordinately stressful and impressionable time for them. Insight into the student experience, will inform educators in the areas of curriculum and competency-based evaluation as well as supports for student mental health and well-being.

Effect of online versus in-person clinical experiences on nursing student's competency development: A cross-sectional, quasi-experimental design.

BACKGROUND: Clinical experience is an important component of nursing education, yet placements in agencies are hard to secure, and evaluation of outcomes challenging. The shift to virtual, online clinical courses during the pandemic created the conditions of a natural experiment. OBJECTIVES: To compare differences in outcomes between an in-person and online design for a family and community health clinical course. DESIGN: Quasi-experimental, 2-group, cross-sectional study. METHODS: Competency evaluations were reviewed from a baccalaureate nursing program in Canada from 19 students who completed an in-person clinical, and 32 students who completed an online clinical. Quantitative analysis compared competencies achieved, interest in community health nursing, and linguistic analysis of unstructured narratives using natural language processing. RESULTS: There are differences in competency evaluations for in-person versus online community clinical courses, and potential implications for future interest in community health. Natural language processing detected differences in content and psychological processes between the two groups. CONCLUSIONS: Nursing programs could apply this methodology to track impact of changes to clinical course design on achievement of competencies. There are important differences in outcomes between online and in-person clinical courses.

Waiting as Performative and Relational: A Narrative Inquiry Study Into the Experiences of Women Who Use Substances.

BACKGROUND AND PURPOSE: The act of waiting in health care is becoming increasingly prevalent worldwide. Waiting in health care is not a neutral activity; it is filled with expectations marked by cultural and social norms. In this article, we consider the performative nature of waiting by reflecting on the experiences of two participants in a narrative inquiry study. METHODS: Drawing on a narrative inquiry study focused on the experiences of three women who disclosed illegal substance use during their pregnancy or early postnatal period, we inquired into two participants' experiences of waiting. The study which took place in a large urban center in Western Canada, where the researcher connected with participants who faced numerous challenges due to poverty, stigma, and discrimination. RESULTS: Sharing the narratives of Georgia Dewart, and participants Renate, and Marilynn, we explore the performative act of waiting in their interactions with health care. We consider the political and social implications of the act in order to explore the subtleties and overlooked consequences of waiting. This work encourages the nursing profession to address overlooked aspects of care, such as the act of waiting. IMPLICATIONS FOR PRACTICE: Our findings draw attention to the normative expectations within participants' experiences of waiting. This work offers methodological considerations for those engaging with Butler's concept of performativity when considering everyday acts. We also challenge care providers to reflect on their experiences working with clients, families, and communities to consider both the relational and performative nature of these interactions.

Teaching HIV-specific content for pre-licensure nursing and health professions students: a review and synthesis.

Persistent Human Immunodeficiency Virus (HIV) prevalence rates remain a challenge, particularly because health care providers (HCP) are not fully prepared to engage in HIV care. This hesitancy to engage creates access to care barriers for people living with HIV (PLWH). We conducted a systematic review to identify educational interventions focused on developing HIV competencies in higher education across health science disciplines. We searched databases for primary studies focused on interventions. Using PRISMA guidelines, we identified 20 articles from 19 distinct studies. While there was an overwhelming body of literature that assessed knowledge, skills, and attitudes in health sciences students on HIV and AIDS, the low number of intervention studies was notable. With the exception of two studies, PLWH were not included in the interventions. This finding stands in sharp contrast to the well-established Greater Involvement of People Living with HIV and/or AIDS (GIPA) and Meaningful Engagement of People Living with HIV and/or AIDS (MEPA) principles. The primary means of the educational intervention was focused on delivering lectures to address HIV and AIDS knowledge for HCP. There was a significant lack of focus on historical, cultural, policy and legal contexts of HIV and AIDS care; theoretical justifications for the interventions were absent. No study focused on the impact of an intervention on the care provided to PLWH by HCP after graduation. There is an urgent need to develop long-term sustainable and scalable interventions that address the consistently identified lack of knowledge and skills, and stigmatizing attitudes of HCP and students.