Incivility in the Online and Hybrid Learning Environment During the COVID-19 Pandemic Era.

ABSTRACT: With the surge in online learning since the onset of the COVID-19 pandemic, fostering civil behavior in this environment is essential. This mixed-methods study examined online incivility among faculty and students at two schools of nursing using a quantitative survey instrument with several open-ended questions addressing the impact of the pandemic. Survey results suggested that faculty ( n = 23) and students ( n = 74) experienced a low frequency of online incivility that remained potentially disruptive. Qualitative analyses suggested that the pandemic placed considerable strain on nursing faculty and students while providing increased flexibility for working and learning.

Determining Postgraduation Readiness to Take the NCLEX-RN®.

BACKGROUND: This study examined the variables of gender, age, previous degree, first-generation college, type of nursing program, grade point average (GPA), amount of postgraduation recommended preparation completed, average score on recommended preparation examinations, the score on a postgraduation readiness examination, and the NCLEX-RN® outcome. METHOD: An exploratory field study approach was used to explore relationships among variables. The study was retrospective and longitudinal with quantitative data collected and analyzed and explored further by interviews. RESULTS: A postgraduation readiness examination was found to accurately predict the NCLEX-RN outcome. Correlations were found between the readiness examination score and gender, first-generation college, GPA, amount of recommended preparation completed, and average score on recommended preparation tests. Anxiety was the common theme for the outliers. CONCLUSION: This study provided rich data about postgraduation readiness to take the NCLEX-RN examination and lays the groundwork for further research on postgraduation variables associated with NCLEX-RN success. [J Nurs Educ. 2020;59(2):101-106.].

A whole-food plant-based experiential education program for health care providers results in personal and professional changes.

Diet-related diseases are the primary contributor to morbidity and mortality. The risk for these diseases can be reduced with a whole-food plant-based (WFPB) diet, but most people are never counseled on this dietary pattern. An experiential education program was designed and conducted in which sample of 30 nurse practitioners, registered nurses, and physicians learned about and followed a WFPB diet for 3 weeks. The objective was for the health care providers to increase their knowledge and acceptance of WFPB diets and increase their likelihood of counseling patients on this dietary pattern. Participants completed preintervention and postintervention questionnaires assessing dietary intake, knowledge, weight, mood, energy, benefits, barriers, self-efficacy, and likelihood of continuing to follow, or counsel patients about a WFPB diet. Participants decreased intake of animal-derived foods, increased intake of WFPB foods, had improvements in mood and energy, and lost weight. Perceived barriers to following and counseling about a WFPB diet declined and self-efficacy improved. Participants were likely to continue a WFPB diet and discuss the diet with their patients. The three-week intervention changed providers' knowledge, skills, and attitudes about WFPB diets. If nurse practitioners and other providers accept WFPB diets, more patients may be educated on this dietary pattern, helping to reduce the burden of diet-related chronic diseases.

Partnership integration for rural health resource access.

Increasing numbers of older adults are residing in rural areas of the USA. Many of these individuals experience greater rates of chronic diseases and lower income levels compared to their urban-residing counterparts. Aging in rural environments creates greater challenges in the provision of funding, staff and resources to meet the needs of these older adults, and contributes to immense health disparities and health inequities. Urban and rural older adult residents alike need healthcare, gerontological and public health resources to promote successful aging in place. Due to the nature of rural environments, many of these resources often exist great distances from these residents, which creates access challenges. There are also limitations in locally available facilities and trained practitioners, resulting in resource shortages for addressing chronic health conditions. The creation and use of interdisciplinary partnerships provides this much-needed support while addressing ever-increasing funding and staffing limitations. This article provides an innovative conceptual interdisciplinary partnership model that combines nursing, public health and gerontology to address the health and social challenges that rural-residing older adults face. Although well-trained practitioners who work within their discipline are an important contributor to assist with the needs of rural-residing older adults, this silo approach is expensive, inefficient, and clearly cannot support all of the needs for older adults in this type of environment. There is a need to blend the complementary skills provided by each of the presented disciplines so that the focus of the interdisciplinary partnership is on person-centered care addressing the health disparities and health inequities experienced by these older adults. To illustrate the integration of nursing, public health and gerontology disciplines, these disciplines are initially combined and presented as dyads, and are then incorporated into the full conceptual model. The dyads are public health and gerontology, public health and nursing, and gerontology and nursing. Steps are provided for the development of this (or any) interdisciplinary partnership. An example of the model's use through clinical and non-clinical disciplines and a community engagement framework is also described. Interdisciplinary approaches focused on person-centered care provide more well-rounded health and social support for rural older adults than any one discipline in isolation. Allocation of shared resources, roles, responsibilities and expenses allows practitioners engaged in interdisciplinary teams to provide superior economic and capacity efficiency. This efficiency is crucial at a time when many entities experience limitations in sustainable resources. Thus, practitioners and community agencies collaborating through interdisciplinary partnerships are better able to address the complex issues experienced by rural-residing community members.

Laboratory diagnosis of overt type 2 diabetes in the first trimester of pregnancy.

OBJECTIVE: The objective of this study was to compare the use of hemoglobin A1C to oral glucose tolerance testing to diagnose overt type 2 diabetes in the first trimester of pregnancy. The study used a nonexperimental descriptive design to compare the use of the hemoglobin A1C test results to oral glucose tolerance test results. METHODS: The study used a sample of 45 women at high risk for type 2 diabetes in the first trimester of pregnancy. Participants were consented to draw a hemoglobin A1C with their ordered oral glucose tolerance testing for comparison of the two tests' ability to diagnose overt type 2 diabetes. RESULTS: Hemoglobin A1C tests were highly positively correlated with oral glucose tolerance testing for diagnosis of type 2 diabetes in women in the first trimester of pregnancy. CONCLUSION: The research provides beginning evidence that the hemoglobin A1C should be considered as a first-tier diagnostic test for overt type 2 diabetes in the first trimester of pregnancy.

Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives.

Healthcare resources are stretched perilously thin and the demand for primary healthcare services has never been greater. Despite this demand for service, relatively little is known about the practice environment of primary healthcare providers, particularly certified nurse-midwives (CNMs), where workforce surveys frequently include these specialists within the broader nurse practitioner category. A distinct professional discipline, nurse-midwives are one type of primary care provider recommended to enhance access to services. The objective of this study was to understand the nature of the nurse-midwifery practice environment in the state of Colorado. Online survey of Colorado CNMs (N = 328) found little ethnic/racial diversity and an aging workforce, with most providing care in an urban, hospital/medical center environment. Several key legislative issues were identified though respondents felt ill prepared to engage in legislative change. Overall, CNMs were optimistic about the future of midwifery and were largely satisfied with their practice.

Designing and implementing the Army Nursing Leader Academy.

In 2008, the Chief of the Army Nurse Corps directed a thorough review of existing training programs available to and provided for Army Nursing personnel for the development of full-spectrum leaders for Army Nursing. The review provided the gap analysis necessary to restructure courses provided by the Department of Nursing Science at the Army Medical Department Center and School. This new grouping of courses is referred to as the Army Nursing Leader Academy. The Army Nursing Leader Academy is the first of its kind in that it addresses career-long learning of all Army Nursing by focusing on building skills, knowledge, and behaviors to produce sustainable, full-spectrum leaders. The Nursing Leader Academy consists of a series of sequential nurse leader development courses combined with a web based resource center. Grounded in the Patient CaringTouch System, guided by nurse competencies, and gauged by the Leader Capabilities Map, the Nursing Leader Academy provides learning that is relevant and timely designed to reinforce enterprise values and culture to ensure readiness for successive roles and positions. Full implementation of the Nursing Leader Academy will include the evidence-based elements of formal schooling, coaching, self-development, functional/technical (competency attainment), and professional experiences.

Modeling hospital response to mild and severe influenza pandemic scenarios under normal and expanded capacities.

William Beaumont Army Medical Center conducted quantitative modeling with FluSurge 2.0 (Centers for Disease Control and Prevention) to determine hospital capabilities in responding to patient arrival surges of the Fort Bliss population in mild 1968-type and severe 1918-type influenza pandemics. Model predictions showed that William Beaumont Army Medical Center could adequately care for all intensive care unit (ICU) and non-ICU patients during a mild pandemic, particularly if hospital capacity was expanded using the emergency management plan, excess surge plan, or activation of a contagious disease outbreak facility. For a severe influenza pandemic, model predictions showed that hospital beds, ventilators, and other resources would be exceeded within 2 or 3 weeks. Even at maximal hospital expansion, for a 12-week severe pandemic with a 35% attack rate there would be peak demand for 214% of available non-ICU beds, 785% of ICU beds, and 392% of ventilators. Health care planners and decision-makers should prepare for resource challenges when developing plans for the next influenza pandemic.