Creative Learning Through the Use of Simulation to Teach Nursing Students Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use in a Culturally Competent Manner.

INTRODUCTION: Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients' cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. METHOD: Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. RESULTS: Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. DISCUSSION: Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.

Interprofessional collaborative practice incorporating training for alcohol and drug use screening for healthcare providers in rural areas.

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment-SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.

Enhancing Nurses' Pain Assessment to Improve Patient Satisfaction.

Patient satisfaction with pain management has increasing importance with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores tied to reimbursement. Previous studies indicate patient satisfaction is influenced by staff interactions. This single-group pre/post design study aimed to improve satisfaction with pain management in older adults undergoing total joint replacement. This was a single-group pre-/posttest design. Nurse (knowledge assessment) and patient (American Pain Society Patient Outcomes Questionnaire Revised [APS-POQ-R], HCAHPS) responses evaluated pre- and postimplementation of the online educational program. Nurse focus group followed intervention. Nurses' knowledge improved significantly (p < .006) postintervention. HCAHPS scores (3-month average) for items reflecting patient satisfaction improved from 70.2 ± 9.5 to 73.9 ± 6.0. APS-POQ-R scores did not change. Focus group comments indicated need for education regarding linkages between pain management and patient satisfaction. Education on linkages between patient satisfaction and pain management can improve outcomes; education on strategies to further improve practice may enhance ability to achieve benchmarks.

Increasing the Cultural Competence Levels of Undergraduate Nursing Students.

BACKGROUND: This study evaluated the effectiveness of the Culturally Competent Nursing Modules (CCNMs) developed by the U.S. Office of Minority Health on improving the cultural competence levels of undergraduate nursing students. METHOD: Students completed the CCNMs over a 2-week period, and their pre- and posttraining cultural competence was assessed using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised tool. RESULTS: The CCNMs were effective in increasing the cultural competence of the nursing students (pretest mean = 68.44 ± 6.58; posttest mean = 79.06 ± 7.99; t(17) = 7.44; d = 10.61; 95% confidence interval = 7.60, 13.62; p < .001). Before training, 89% of the students were culturally aware and 11% were culturally competent. After training, 22%, 67%, and 11% were culturally aware, culturally competent, and culturally proficient, respectively. CONCLUSION: The CCNMs training program is effective and should be incorporated into nursing curricula.

Implementation of an integrative coping and resiliency program for nurses.

PURPOSE: To improve resiliency and reduce burnout in nurses through implementation of the Healing Pathways program (University of Maryland School of Medicine, Baltimore). Aims of this study include assessment of feasibility and acceptability and to explore changes in stress, coping, burnout, and mindfulness. DESIGN: A single-group, pre-, posttest design of an 8-week program in which participants attended weekly sessions that included Reiki, yoga, and meditation. Sample included 8 nurses with 1 advanced practice nurse, all female, ages ranging from 22 to 49 years, experience levels ranging from <1 year to 26 years. METHODS: Participants completed the Perceived Stress Scale, Coping Self-Efficacy Scale, Maslach Burnout Inventory, and Mindful Attention Awareness Scale before intervention, at last session, and 1 month after last session. Data were analyzed using one-way analysis of variance and qualitative narrative inquiry. FINDINGS: Improvements were noted in perceived stress, coping, burnout exhaustion subscale, and mindfulness. CONCLUSION: Healing Pathways was effective at reducing stress and improving coping and mindfulness in nurses. IMPLICATIONS: Nurses who invest time in self-care techniques including Reiki, yoga, and meditation improve their overall wellbeing and may provide higher-quality patient care. Implementation of an 8-week program in integrative self-care is feasible and important for the health of nurses.

Propósito: Mejorar la resiliencia y reducir el desgaste en el personal de enfermería a través de la implementación del programa Healing Pathways (Caminos de cura), (University of Maryland School of Medicine, Baltimore). Los fines de este estudio incluyen la valoración de la viabilidad y aceptabilidad y la exploración de cambios en el estrés, el afrontamiento, el desgaste y la concienciación.Diseño: Diseño de un programa de prueba anterior y posterior de 8 semanas para un único grupo en el cual los participantes asistían a sesiones semanales que incluían Reiki, yoga y meditación. La muestra incluía 8 enfermeras con una enfermera de practica avanzada, todas mujeres, con edades comprendidas entre los 22 y los 49 años, con niveles de experiencia entre <1 año y 26 años.Métodos: Las participantes completaron la Escala de estrés percibido, la Escala de manejo de autoeficacia, el Inventario de desgaste de Maslach y la Escala de concienciación de atención consciente antes de la intervención, en la última sesión y un mes después de la última sesión. Se analizaron los datos usando un análisis de la varianza unidireccional y encuestas narrativas cualitativas.Hallazgos: Se notaron mejoras en el estrés percibido, el afrontamiento, la subescala de agotamiento por desgaste y la concienciación.Conclusión: Healing Pathways fue efectivo a la hora de reducir el estrés y mejorando el afrontamiento y la concienciación en las enfermeras.Consecuencias: Las enfermeras que invirtieron tiempo en técnicas de autocuidado incluyendo Reiki, yoga y meditación mejoraron su bienestar general y pudieron proporcionar una mejor calidad en la atención al paciente. Es viable la implementación de un programa de 8 semanas de autocuidado integrador y es importante para la salud de las enfermeras.

Identifying at risk individuals for drug and alcohol dependence: teaching the competency to students in classroom and clinical settings.

Alcohol use and other drug use affect patient healthcare outcomes. This article describes a classroom-to-clinical approach teaching nursing students to utilize motivational interviewing techniques to support patient behavior change. Through the lens of a universal prevention method, nursing students learned about reward circuit activation leading to risky substance use and the difference between addiction and at-risk use. Specific assessment tools and motivational interviewing techniques were presented in the classroom. Students then applied their knowledge in simulation laboratories and clinical rotations.

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.

Confirming the factor structure of the alcohol and alcohol problems questionnaire (AAPPQ) in a sample of baccalaureate nursing students.

The Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) is a multi-dimensional measure of clinicians' attitudes toward working with patients with alcohol problems. In the past 35 years, five- and six-subscale versions and a short version of the AAPPQ have been published. While the reliability of the AAPPQ subscales has remained acceptable, the factor structure has not been verified using confirmatory techniques. In the current study, we split a sample of 299 baccalaureate nursing students to use exploratory (EFA) and confirmatory factor analyses (CFA). When compared to the original six-factor solution and an imposed six-factor structure in CFA, the EFA seven-factor solution with three original items (19, 20, and 25) removed had the best model fit.

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.