Nurses' confidence in starting a new venture, startup or project in the context of nurse-led hackathons: Results of prehackathon survey.

BACKGROUND: A hackathon framework has been successfully applied to solving health care challenges, including COVID-19, without much documented evidence of nurses' baseline or acquired confidence. PURPOSE: To understand differences in baseline confidence levels in starting a new venture, startup or project in the context of nurse-led hackathons. METHOD: A retrospective secondary analysis of a presurvey of hackathon participants from two NurseHack4Health (NH4H) events held in 2021. DISCUSSION: Male nurses and international nurses were more confident than the U.S.-based nurses. When comparing the 75% of participants who had not attended a hackathon previously to the 25% of participants who had, there was an increased confidence level among non-nurses and among participants with the previous hackathon, datathon, and ideation experience. CONCLUSION: If hackathons can help nurses identify strengths, add new expertise and boost confidence, it may empower nurses to pursue their ideas more effectively, aid professional growth, and provide affirmation of innovator self-identity.

Communication challenges in social isolation, subjective cognitive decline, and mental health status in older adults: A scoping review (2019-2021).

PURPOSE: Through an evolutionary concept analysis, social isolation (SI) was defined as lack of social belonging and engagement with others, minimal number of social contacts, and insufficient quality relationships. This definition represents broader understanding of most contributing factors to SI and supports the concepts of reduced communication and socialization experienced during the COVID-19 pandemic. The COVID-19 pandemic served to heighten this problem, including communication challenges, and brought negative outcomes of SI to light. The overall research question examined the impact of communication challenges and SI on OAs with Alzheimer's disease, related dementias, and subjective cognitive changes (2020-2021). This scoping literature review was developed to compare the psychosocial and mental health of older adults between prepandemic and pandemic lockdown of 2020-2021. DESIGN AND METHODS: This review followed the procedures for scoping review reporting as stated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR). In collaboration with an expert scientific information specialist assigned to the college of nursing, the literature was queried through MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations and Daily 1946 to September 02, 2021; APA PsycInfo 1806 to August Week 5 2021; and Embase Classic+Embase 1947 to 2021 September 02. Search terms included social isolation; nursing home; home for the aged; long-term care; old age homes or convalescent home or nursing home; long-term care, or long-term care; aged or elders or seniors, dementia, Alzheimer's or dementia; osteoporosis; and fragility fracture. FINDINGS: Quantitative data informed outcomes through increased depression and anxiety, higher rates of depression during the pandemic than prepandemic, and increased symptomology in neuropsychiatric profiles. Further, COVID19-related restrictions, including impaired communication streams, seemed to be the origin of stress-related cognitive changes and symptomology. Communication challenges in residents with dementia may lead to feelings of social isolation. Qualitative evidence supports that dementia has a social, psychological, material, and socio-demographic impact. Further, the lockdown disrupted the existing flow of communication between all stakeholders and residents, resulting in heightened perceptions of SI and a profound sense of loss. PRACTICE IMPLICATIONS: The results include a diverse and complex characterization of negative outcomes. Further, strong evidence indicates that communication and human contact can ameliorate negative outcomes.

Human Trafficking in Rehabilitation: What Nurses Need to Know.

ABSTRACT: Violence and human trafficking are frequently paired and violate human rights. Human trafficking is a complex, global health issue. Trafficking survivors report seeking medical care for women's services, physical abuse, mental health, and gastrointestinal issues while being held in captivity. However, the majority of healthcare providers are unaware or unprepared to intervene, thus missing the chance to identify victims during these encounters. Rehabilitation nurses are no exception. Trafficking victims may come in contact with rehabilitation nurses because of injuries or chronic diseases caused by trafficking abuse. This article shares human trafficking red flags, victims' access to services, barriers to identification, and nursing interventions and implications.

Teaching nursing quantitative analysis with the integration of Andersen's framework.

Educators are challenged to engage in dramatic reformation and innovation including learning, teaching, and curriculum design. A PhD level quantitative nursing research course was redesigned using the Andersen Behavioral Model of Health Services (ABMHS) to guide data assignments. Students navigated through levels of theoretical abstraction from constructs to concepts to variables. Subsequent assignments offered students the opportunity to operationalize, code, and manage the variables in their models. Outcomes were positive and resulted in student confidence as they progressed to the dissertation phase. This article adds novel information to the literature about attention to theory, models, or frameworks, and specifically the ABMHS, in a doctoral quantitative course.

The Use of Communication Technology to Affect Patient Outcomes in the Intensive Care Unit.

Effective two-way patient-provider communication is challenging and is even more difficult when patients are communication vulnerable. The results of being unheard and unacknowledged can contribute to negative feelings and may manifest as symptoms of anxiety and depression. Researchers explored symptoms of anxiety and depression when using a team-developed, patient-centered, and nurse-led intervention called Speak for Myself-Voice (formerly published as Speak for Myself) in five intensive care units at a Magnet status, university-affiliated medical center in East Tennessee. This was an equivalent control group design. The data were analyzed with a mixed-effect analysis of variance (between and within groups) with repeated measures to see if the treatment group changed differently than the control group across time (48 hours). This study report adds information about anxiety and depression in patients who are communication vulnerable and using communication technology.

Improving Shared Decision-making and Treatment Planning Through Predictive Modeling: Clinical Insights on Ventral Hernia Repair.

Abdominal wall hernia repair, including ventral hernia repair, is one of the most common general surgical procedures. Nationally, at least 350 000 ventral hernia repairs are performed annually, and of those, 150 000 cases were identified as incisional hernias. Outcomes are reported to be poor, resulting in additional surgical repair rates of 12.3% at 5 years and as high as 23% at 10 years. Healthcare costs associated with ventral hernia repair are estimated to exceed $3 billion each year. Additionally, ventral hernia repair is often complex and unpredictable when there is a current infection or a history of infection and significant comorbidities. Accordingly, a predictive model was developed using a retrospectively collected dataset to associate the pre- and intra-operative characteristics of patients to their outcomes, with the primary goal of identifying patients at risk of developing complications a priori in the future. The benefits and implications of such a predictive model, however, extend beyond this primary goal. This predictive model can serve as an important tool for clinicians who may use it to support their clinical intuition and clarify patient need for lifestyle modification prior to abdominal wall reconstruction. This predictive model can also support shared decision-making so that a personalized plan of care may be developed. The outcomes associated with use of the predictive model may include surgical repair but may suggest lifestyle modification coupled with less invasive interventions.

Difficulty envisioning a positive future: Secondary analyses in patients in intensive care who are communication vulnerable.

The purpose of this study was to report a secondary analysis of data collected through a primary study. The primary study was a, randomized, control trial that used a team-designed (nursing, speech language hearing, engineering, communication sciences, and biostatistics), nurse-led, electronic communication intervention (Speak for Myself Voice) and measured patient outcomes of symptoms of anxiety and depression in five intensive care units at a regional, magnet-status, academic medical center. A secondary analysis of data using the Hospital Anxiety and Depression scale is reported here. The extant literature supports patient expressions of frustration, anger, anxiety, and depression when unable to communicate. This secondary analysis study report adds information about Hospital Anxiety and Depression subscales in the communication-vulnerable population. Implications include emerging awareness of potential feelings of depression and anxiety in patients who are receiving mechanical ventilation or who are unable to verbally communicate for any reason (e.g. obstruction, trauma, head and neck cancer) in the intensive care unit.

An Exploration of Sensation Seeking in Persons With Disabilities in Rehabilitation.

PURPOSE: This study reports the findings of a study about sensation-seeking or high-risk/challenging sports in persons who have disabilities. DESIGN: Exploratory, cross-sectional, and descriptive. METHODS: Two hundred and twenty-three recruitment e-mails were sent to potential participants. Data were collected through Qualtrics. FINDINGS: Mean score for Contextual Sensation Seeking Questionnaire for Skiing and Snowboarding (M = 30.21, SD = 8.18) was significantly lower than a sample of able-bodied skiers and snowboarders, t(239) = 2.75, p = .006. Mean for impulsive sensation seeking was lower than the same sample of able-bodied athletes cited in a previous study, t(240) = 4.56, p = .001. Means for the Zuckerman Kuhlman Personality Questionnaire subscales were impulsivity (M = 1.98, SD = 4.05) and sensation seeking (M = 6.75, SD = 2.68). CONCLUSIONS: This group scored lower in sensation seeking compared to able-bodied high-risk/challenging sports activities participants. Sensation seeking is not a motivating factor in this sample. CLINICAL RELEVANCE: Nurses could encourage rehabilitation patients to engage in challenging activities for personal and group mastery.

Prediction of Sepsis and In-Hospital Mortality Using Electronic Health Records.

OBJECTIVES: Our goal was to develop predictive models for sepsis and in-hospital mortality using electronic health records (EHRs). We showcased the efficiency of these algorithms in patients diagnosed with pneumonia, a group that is highly susceptible to sepsis. METHODS: We retrospectively analyzed the Health Facts® (HF) dataset to develop models to predict mortality and sepsis using the data from the first few hours after admission. In addition, we developed models to predict sepsis using the data collected in the last few hours leading to sepsis onset. We used the random forest classifier to develop the models. RESULTS: The data collected in the EHR system is generally sporadic, making feature extraction and selection difficult, affecting the accuracies of the models. Despite this fact, the developed models can predict sepsis and in-hospital mortality with accuracies of up to 65.26±0.33% and 68.64±0.48%, and sensitivities of up to 67.24±0.36% and 74.00±1.22%, respectively, using only the data from the first 12 hours after admission. The accuracies generally remain consistent for similar models developed using the data from the first 24 and 48 hours after admission. Lastly, the developed models can accurately predict sepsis patients (with up to 98.63±0.17% accuracy and 99.74%±0.13% sensitivity) using the data collected within the last 12 hours before sepsis onset. The results suggest that if such algorithms continuously monitor patients, they can identify sepsis patients in a manner comparable to current screening tools, such as the rulebased Systemic Inflammatory Response Syndrome (SIRS) criteria, while often allowing for early detection of sepsis shortly after admission. CONCLUSIONS: The developed models showed promise in early prediction of sepsis, providing an opportunity for directing early intervention efforts to prevent/treat sepsis.

Evaluation of a Novel Communication Application From Nurses' Perspectives.

The purpose of this article is to report usability of a computer application, Speak for Myself, from nurses' perspectives. This was a one-group exploratory survey. Nurses included patients in the study who were older than 18 years, could write and speak English, were unable to verbalize needs for any reason, and had a specified sedation-agitation scale (-1 to +1). Patients were excluded if they were younger than 18, could not write and/or speak English, or had a Richmond Agitation-Sedation Scale score exceeding -1 to +1. Twelve RNs from various ICUs in two hospitals in South Florida participated in the study. A person who was a supervisor or clinical specialist was chosen in each participating unit and at each hospital for recruitment of patient participants. Five nurses (41.6%) stated their patients were able to communicate better with the use of Speak for Myself, and all 12 nurses (100%) indicated they would use Speak for Myself again. Suggestions for further development of Speak for Myself were offered from the nurses. Limitations include a small sample in South Florida. The results of this and previous studies about Speak for Myself will be used in further development and testing of the computer application.

Communication Needs of Critical Care Patients Who Are Voiceless.

Voice is crucial for communication in all healthcare settings. Evidence-based care highlights the need for clear communication. Clear communication methods must be applied when caring for special populations in order to assess pain effectively. Communication efforts also should be offered to patients who are in end-of-life care and would like to make independent decisions. A computer communication application was offered to patients in intensive care/critical care units in three hospitals in South Florida. Inclusion criteria included the age of 18 years or older, Richmond Agitation Sedation Scale between -1 and +1, ability to read and write English, and willingness to use the computer application. Exclusion criteria included inability to read and write English, agitation as defined by the Richmond Agitation Sedation Scale, and any patient on infection isolation protocol. Four qualitative themes were revealed, which directly relate to two published evidence-based guidelines. These are the End of Life Care and Decision Making Evidence-Based Care Guidelines and the Pain Assessment in Special Populations Guidelines. This knowledge is important for developing effective patient-healthcare provider communication.

Evaluation of Speak for Myself with Patients Who Are Voiceless.

PURPOSE: To describe the creation and initial feasibility study of a new computer application to improve communication with people who cannot communicate by customary means during their hospitalization. DESIGN: This was a mixed-methods, quasi-experimental design. METHODS: This exploratory feasibility study obtained data about the experiences of 20 intensive care patients in three South Florida hospitals who were unable to speak due to mechanical obstruction. FINDINGS: Study participants (20), who ranged in age from 45 to 91 years (M=67.4, SD=12.88) and between -1 to +1 (SD=-0.15) on the Richmond Agitation Sedation Scale, used Speak for Myself from 4 to 16 hours with a mean of 8.86 (SD=2.12). Ninety-five percent of the participants stated that Speak for Myself was helpful for communication. CONCLUSIONS: Speak for Myself was helpful to patients who used it. This was a small study (n=20). It warrants further investigation. CLINICAL RELEVANCE: Patients who are unable to communicate their needs through conventional methods still want to make their preferences and needs known. Speak for Myself is a new application that facilitates ensuring the patient's voice is heard.

Embodying identity in chemotherapy-induced alopecia.

PURPOSE: To report concept analyses of Embodying Identity in chemotherapy-induced alopecia. DESIGN AND METHODS: A case study approach was used to explore experiences of alopecia. A transcribed interview was analyzed using phenomenological methods. FINDINGS AND PRACTICE IMPLICATIONS: Embodying Identity was supported by themes from the interview and defined as the way in which persons change how they view self (mind, body, spirit) in an effort to reconcile physical or body alterations. Individuals pass through this process experiencing feelings of "it's not me" to recognition of self with changes ("but, it's me") and finally, acceptance and incorporation into self ("it's me").