Pandemic Footprints of Nursing Professionals: Processing Early Experiences.

Purpose: This study interpreted journaled experiences of registered nurses (RNs) who were working at the bedside early in the pandemic as they were simultaneously enrolled in a baccalaureate (RN-BSN) completion program. Design: This qualitative interpretive descriptive study used purposive sampling. Methods: Eighteen students participated in the journal assignment. Fifteen students consented to participate in journal analyses. Journals were de-identified and a code book was used to document the entirety of journal reflections to identify meaningful text, and, ultimately, assert thematic codes. Thorne's interpretive description guided analysis. Researchers coded four journals together to obtain trustworthiness and rigor. Each doctorally prepared researcher independently coded a subset of the remaining journals. Emerging significant statements and subthemes were discussed and verified as a team. Results: Researchers identified the essence of pandemic footprints as the following themes emerged: Physical Threats to Safety, Emotional Threats to Safety, Workplace Culture, Healing Energies, and Professional Identity. Conclusions: Compared to previously published research conducted at later points of the pandemic this study is unique. Study data captured nurses' expressed voices through journaling at the brink (March 2020) of what became a global reality. Results illuminated dichotomies that existed then, particularly in response to their own and others' safety and security, leaving profound imprints on their identities extending beyond care environments.

Embracing evidence-based nursing and informational literacy through an innovative undergraduate collaborative project.

Background Nurse educators are challenged to design courses that maintain rigor, promote student learning, maximize resource utilization, and ultimately prepare graduates for clinical practice. Purpose An innovative teaching strategy was used to educate BSN level students in nursing inquiry with a collaborative project. Methods Course faculty incorporated information literacy (IL) and evidence-based practice (EBP) competencies into an undergraduate research course by taking the traditional practicum research project and redesigning it as a longitudinal scoping review (ScR) collaborative project. Results At course conclusion, students verbalized having a deeper appreciation for nursing research, confidence in performing a literature search, and conducting a research critique. Conclusions The students' contributions towards the ScR through their collaborative project work fostered personal growth in IL and EBP competencies through a meaningful project that can extend beyond the classroom to possibly influence patient care.

Patient perspectives about bariatric surgery unveil experiences, education, satisfaction, and recommendations for improvement.

BACKGROUND: Following bariatric surgery, up to 35% of patients struggle with strict regimens and experience weight recidivism within 2 years [1-5]. Accredited weight management centers (WMC) must provide educational programs and support patients in lifestyle changes before and after surgery. Educational programs, however, may not be evidence-based or patient-centered and may vary in curriculum, approach, and educator type [6]. OBJECTIVE: To obtain patient descriptions about the weight loss surgery (WLS) experience, including education, satisfaction, and recommendations for improvement. SETTING: Participants were recruited from a university hospital-based WMC in Pennsylvania. METHODS: This qualitative descriptive study used purposive sampling and inductive content analysis. RESULTS: A NEW ME-VERSION 2.0, encompassed themes from semistructured interviews with 11 participants (36% male). Theme 1: Programming and Tools, explained how individuals undergoing WLS found support through educational programming. Theme 2: Updates and Upgrades, identified issues surrounding quality of life and challenges before and after surgery. Theme 3: Lessons Learned and Future Considerations, identified satisfaction levels and recommendations for improving the WLS experience. Participants reported positive experiences, acknowledging educational programs and extensive WMC resources, yet also offered recommendations for improving educational programming. CONCLUSION: Patient narratives provided evidence about the WLS experience. Achievement of weight goals, adherence to rules, and improved health status contributed to perceptions of WLS success. Participants encouraged educators to identify expected outcomes of educational programming, monitor holistic transformations, foster peer support, and use technology in WMC programming. Results also validated the need for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program's education requirement (standard 5.1). Future educational research could help develop best practices in WLS patient education and assess associations between education and clinical outcomes.

Systematic review of patient education practices in weight loss surgery.

BACKGROUND: Education plays a key role in adherence to lifestyle modifications after weight loss surgery (WLS). Education given before and after surgery may decrease weight recidivism rates and improve outcomes. OBJECTIVE: The purpose of this systematic review was to analyze educational practices in bariatric centers. METHODS: The Cumulative Index to Nursing and Allied Health and PubMed databases were searched in May 2016 for English-language, peer-reviewed studies about WLS patient education practices from 1999 to 2016. Publications were: (1) rated with the Advancing Research and Clinical Practice through Close Collaboration levels of evidence hierarchy (see Melnyk's pryamid [http://guides.lib.umich.edu/c.php?g=282802&p=1888246]) and (2) analyzed according to surgical phase, curriculum, program delivery, and educator. RESULTS: Twenty-four publications met the study criteria. Evidence ratings for preoperative (n = 16) and postoperative studies (n = 8) were levels I to III (n = 5) and IV to VII (n = 17). Two publications were not ratable. Preoperative and postoperative education programs varied in curriculum, teaching methods, and educator. Topics varied in depth. Commonalities were surgical procedure, nutrition, activity, and psychosocial behaviors. Preoperative education was mostly provided in small groups, whereas individual sessions were used postoperatively. Lecture and discussion provided by myriad of healthcare experts from multiple disciplines were typical in both phases. Written or web-based aides supported learning needs in both phases. CONCLUSION: WLS patient education varied by curriculum and dose and commonly used passive learning methods (e.g., traditional lecture style instruction with minimal engagement from learners). Results shared can inform future bariatric education programs and accreditation standard development (e.g., Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program patient education standards). Additional study is needed, but existing evidence can guide improvements in high-quality, cost-effective, and patient-centered educational programs.

Testing the effectiveness of the Amputee Mobility Protocol: a pilot study.

We studied prolonged length of stay (LOS) in the acute care setting on a medical-surgical vascular unit, related to loss of functional mobility status after lower extremity amputation, and implementation of the Amputee Mobility Protocol (AMP) as a standard of care for all patients pre- and post-lower extremity amputation who were admitted to the medical-surgical vascular unit. A comparative pre-post observational study evaluated the effect of AMP on level of functional mobility and LOS after lower extremity amputation in the patient population on the medical-surgical vascular unit. Data was collected retrospectively from patient chart reviews from November of 2004 to March of 2005 for the pre-AMP group and through concurrent patient chart reviews from November of 2005 to March of 2006 for the post-AMP group. Dependent variables included functional mobility and LOS, which were evaluated by a modified Functional Independence Measure (FIM) score and the hospital LOS. Forty-four eligible patients were enrolled in the AMP pilot study during a 5-month period. The sample population consisted of 30 patients pre-AMP and 14 patients post-AMP. LOS for transmetatarsal amputations decreased by 0.7 days, whereas functional mobility increased by a minimum of one level in the modified FIM score. Functional mobility increased for transtibial amputations by one level and transfemoral amputations by 2 levels using the modified FIM score. LOS increased for patients undergoing transtibial (7.1 days) and transfemoral (2.7 days) amputations. This quality improvement project heightened staff awareness regarding ambulation and its impact on functional mobility and early discharge. Vascular nurses were able to affect patients' functional mobility and LOS by implementing a standardized AMP. Data showed that using the standardized AMP increased patients' functional mobility but did not significantly decrease acute care setting LOS. The AMP continues to be used for this patient population because of its impact on functional mobility and independence. This pilot study relates to 3 of the top 20 vascular research priorities: 1) an interdisciplinary strategy to improve the patient's level of functional independence and thereby decrease LOS and cost; 2) the nursing intervention of early, predetermined ambulation schedules will increase the nursing knowledge of strategies that facilitate recovery after vascular surgery in this population; and 3) factors that affect patient outcomes after these three major vascular procedures will be addressed in pilot outcomes. Limitations of the AMP pilot study included the small sample size, staff turnover, and lack of a concurrent control group. The next phase of this project will create and implement a similar activity protocol for patients after abdominal aortic aneurysm repair and various types of lower extremity bypass procedures.