Successfully Increasing the Diversity of the Nursing Workforce in Rural South Carolina.

This innovative project was funded by the Health Resources and Services Administration (HRSA) Nursing Workforce Diversity (NWD) grant (2017), with a resultant increase in the diversity of the nursing workforce in the rural Pee Dee Region of South Carolina. The project provided resources to at-risk students (n = 100) and compared participants with a control group (n = 92). The project provided participants mentors, financial assistance, experiential learning, advising, and professional development. The project descriptively compared program outcome benchmarks between groups. The project's multifaceted approach was key to success, providing implications for other programs to increase diversity of the nursing workforce.

Providing Veterans With Innovative Nursing Educational Opportunities.

This funded project assisted veteran students to obtain a baccalaureate in nursing by aligning the skills learned through military training with concepts and skills valued by professional nursing and taught to nursing students. Nine concepts or skills were identified by nursing faculty that validated for course credit. The identified concepts and skills were incorporated into four simulation scenarios. Veteran students' skills were validated through simulation experiences in place of taking a three-credit nursing course. Anecdotal data from the debriefing process were rich with students' experiences and gratitude for being recognized for their military knowledge and service.

Using Simulation to Prepare Nursing Students for Professional Roles.

The current job market for nurses is variable and although there remains a projected shortage of nurses for the future, availability of entry-level positions has changed. This mixed-methods pilot study describes the successful use of simulated role-play to prepare senior nursing students (N = 66) for competitive job markets. The simulation laboratory was set up as a human resource department. The students and interviewers were evaluated by surveys. The majority of students rated the experience high for understanding interviews and assisting them with readiness for interviews. Qualitative results revealed themes of nervousness, confidence, and readiness. Interviewers also discussed student nervousness and the benefits of simulated interviews. These results affirmed that the overall learning outcome of the experience was positive and can assist in promoting professional role transition. The project will continue to be implemented, and it will be extended to graduate students in the future.

Feeding tolerance in preterm infants on noninvasive respiratory support.

To evaluate differences in feeding tolerance between infants maintained on continuous positive airway pressure (CPAP) and those receiving high-flow (nasal) cannula (HFC) with or without CPAP. This is a retrospective, cross-sectional study. Two groups of very low-birth-weight infants (750-1500 g) were compared on the basis of respiratory support: (1) infants born between the January 2002 and December 2004 treated with CPAP; and (2) infants born between January 2005 and December 2006 treated with HFC with or without CPAP. The groups were compared to determine which of the two attained full feedings sooner. Successful achievement of full feedings was measured in days from birth and defined by discontinuation of hyperalimentation-supplementation and attainment of 120 mL/kg/d of enteral feedings. A total of 185 infants met inclusion criteria (103 who received CPAP exclusively and 82 who received HFC with or without CPAP). There was no statistical difference in time to full enteral feedings between the 2 groups. There was also no difference in time of initiation of oral feeding or days to full oral feedings between 2 groups. The use of HFC was not associated with changes in feeding tolerance in premature infants. Further studies are needed to investigate efficacy and potential advantages and disadvantages to the use of HFC in the very low-birth-weight infant population.

An 8-week externship program designed for recruitment and retention.

This collaborative project focused on improving self-efficacy and emancipated decision-making skills for nursing learners during an 8-week externship program. The learners attended educational sessions about topics identified as stressful and were paired with a preceptor. The long-term purposes of this pilot program involve nurse recruitment and retention. Job placement and retention will be followed for 2 years. This article will discuss the short-term program outcomes: self-efficacy and emancipated decision making.

The relationship between personal knowledge and decision self-efficacy in choosing trial of labor after cesarean.

INTRODUCTION: The number of women in the United States giving birth via cesarean remains high as the number of vaginal births after cesarean (VBAC) declines. The purpose of this study was to explore how personal knowledge and decision self-efficacy of women who had a prior cesarean birth affected their decision about mode of birth in a subsequent pregnancy. METHODS: A sample of 45 pregnant women with a history of a prior cesarean birth between 10 and 22 weeks' gestation were surveyed to assess their knowledge of the risks and benefits of trial of labor after cesarean (TOLAC) and elective repeat cesarean delivery (ERCD), and their degree of decision self-efficacy related to their choice of mode of birth for the present pregnancy. RESULTS: Decision self-efficacy was not a significant predictor of choice for mode of birth (P = 0.58). Knowledge scores of women who chose ERCD ranged from 0 to 10 (mean [SD], 4.64 [2.94]). Of women who chose TOLAC, knowledge scores ranged from 0 to 13 (mean [SD], 5.90 [3.64]) out of a total possible score of 14. Knowledge was found to be a significant factor in the decision-making process for mode of birth (P = 0.03). Among women who were deemed to have high knowledge, 55% chose TOLAC, whereas 24% of women with high knowledge chose ERCD. The likelihood of a woman with high knowledge scores choosing a TOLAC was 3.9 (95% confidence interval [CI], 1.09-13.81) times the odds of a woman with low knowledge scores choosing ERCD. DISCUSSION: In this study, more knowledge about the risks and benefits of TOLAC and ERCD was found to be positively associated with the decision for TOLAC. This finding is important for health care providers when counseling women who have had a prior cesarean about their choices regarding mode of birth during a subsequent pregnancy. Supplying women with complete and accurate information about the risks and benefits of both choices may help increase the number of women who opt for TOLAC.

Development and revision of the Wittmann-Price Emancipated Decision-Making Scale.

BACKGROUND AND PURPOSE: The original Emancipated Decision-Making (EDM) scale was revised to test 3 subconcepts (flexible environment, personal knowledge, and awareness of social norms) of an emancipated decision-making process. METHODS: The original EDM scale was significantly related to the Satisfaction with Decision (SWD) scale in two separate studies (r = 0.79, r = 0.59). Two of the original 5 subconcepts showed a lack of contribution. The third study (N = 50) had good total scale reliability (r = 0.89). RESULTS: The revised EDM (EDM-r) scale was then leveled to the SWD scores and quantified into 2 categories and the subscales for the 3 subconcepts were reanalyzed for reliability and scale-if-item contribution. CONCLUSION: The final EDM-r is a generically worded, 20-item, 3-subscale instrument with good total and individual subscale reliability.

Successful implementation of evidence-based nursing practice: the indispensable role of staff development.

The professional development department members are instrumental in leading nursing research and quality improvement projects. Rarely do academic nurse researchers know the staff, culture, and capabilities of an organization like the members of the staff development department. Developing a collaborative program using the talents of the professional development department members and the nurse researcher is a win-win situation and, in this article, describes how it successfully assisted the healthcare organization to be awarded the Magnet Recognition.

Women's decision-making regarding medication use in pregnancy for anxiety and/or depression.

AIM: To increase understanding of women's decision-making process concerning the medication use for anxiety and/or depression while pregnant. BACKGROUND: Anxiety and depression affects many pregnant women, yet the decision to take psychotropic medication is complex and possibly subject to social oppression. DESIGN: Cross-sectional descriptive survey design. METHODS: A web-based survey was used to collect data from a convenience sample of 143 pregnant women over 3 months beginning in early 2011. An independent t-test was conducted to determine differences in satisfaction between women with high and low levels of emancipated decision-making (EDM). A multiple regression analysis was conducted to determine which subscales of the emancipation scale best predict level of satisfaction with the decision. FINDINGS: The majority of respondents were White, between 25-34 years of age. The group with lower levels of emancipation reported lower mean satisfaction scores compared with those with higher levels of emancipation. Regression analysis showed that the three subscale emancipation model was a statistically significant predictor of satisfaction with the decision and accounted for 54% of the variance in satisfaction. The subconcept of personal knowledge was most predictive of satisfaction with decision. CONCLUSIONS: Women may be able to overcome oppressive forces by using an EDM process. EDM allows them to make a decision that feels right for them and to feel satisfied with the decision.

Use of personal phones by senior nursing students to access health care information during clinical education: staff nurses' and students' perceptions.

Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smartphones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource.

The olfactory sense: a developmental and lifespan perspective.

AIM AND OBJECTIVE: The objective of this literature review is to discuss human olfactory development, function and assessment through the lifespan. This article will highlight the importance of accurate olfactory function assessment. BACKGROUND: Olfactory function in humans is an understudied sense and may contribute significantly to patient safety and quality of life. Studies related to olfactory function are presented for different life stages. Olfactory development is reviewed as is terminology used to describe functionality. This article highlights the need for nursing assessment of olfactory function to develop holistic nursing interventions since there are implications for patient safety, quality of life issues related to respiratory function, bonding and nutrition. DESIGN: Literature review. METHOD: Articles were searched in CINAHL, PsychInfo and PubMed limited to those published in English to 2010 with the key terms 'olfactory and nursing'. The search yielded 47 articles that were clinically based on patient care. Those articles that dealt specifically with traumatic brain syndrome were excluded. However, peer reviewed and research article were both specified. RESULTS: There is evidence that olfactory assessment should be completed by nurses on high risk populations to ensure patent safety and enhance quality of life. CONCLUSIONS: More studies are needed to improve clinical knowledge about the role of olfactory function. RELEVANCE TO CLINICAL PRACTICE: Nurses are in a prime position to assess olfactory function for patients at high risk for deficits to provide holistic nursing care.

Elective Cesarean births: are women making emancipated decisions?

This mixed method study investigated the extent to which women used emancipated decision making when selecting a birth method, whether they perceived they had a choice, and if they were satisfied with their decision. Findings suggest that vaginal birth is still the preferred method of delivery for these study participants.

Physical assessment: a continuing need for clarification.

PROBLEM: Physical assessment skills are a mainstay of the nursing process and are taught to pre-licensure learners. Little research has been conducted on the skills that are actually used in practice compared to those that are taught in pre-licensure education. METHOD: This article provides an integrated literature review regarding physical assessment skills and their practical application. FINDINGS: Physical assessment skills are consistently referred to as part of the first step of the nursing process, but further clarification about which skills are included in the definition is needed. CONCLUSIONS: Further research is needed to clarify if what is taught is actually used and to what extent in clinical practice.

Exploring perceptions of "do not resuscitate" and "allowing natural death" among physicians and nurses.

Many patients spend their last days in expensive, painful intensive care units instead of receiving comfortable, palliative care. This study surveyed perceptions of physicians and nurses about using the more holistic "allow natural death" (AND) terminology in end-of-life care as opposed to the current "do not resusciate" (DNR) order.

Objectives and outcomes: the fundamental difference.

This discussion focuses on the difference between educational objectives and outcomes. Both terms are used in nursing education, many times for the same purpose, yet they are expressions of different educational paradigms. A historical view of the development of objectives and outcomes is provided as well as a description of each. The discussion concludes with a demonstration of formats for developing educational outcomes.

Creating opportunities for successful international student service-learning experiences.

Healthcare and educational expeditions to developing countries are a life-altering experience for both faculty and students. The benefits gained personally and professionally from foreign travel are invaluable. Providing healthcare to people in developing countries gives a new dimension to holistic care. Proper trip preparation with consideration of safety, legal liabilities, and educational goals is a necessity to ensure positive outcomes for patients, students, faculty, and the university or college. This article extracts lessons learned from an actual trip and dissects them from a safety, legal, and educational standpoint. The information presented is a "must read" for any faculty member considering embarking on a healthcare expedition with students to a developing country.