Preparing Compassionate Nurses: Infusing School Mission and Values in Undergraduate Education.

ABSTRACT: In preparation for a curriculum revision, a cross-sectional, descriptive mixed-method research study sought to describe senior-level students' perspectives of Mercy and Jesuit faith-based tradition values integration in a pre-licensure BSN program. Integration of values was examined in both clinical settings and didactic classes. Students strongly articulated the importance of the school's values and mission to their future role as professional nurses. However, although value integration is occurring, greater attention to mission and values is needed in the clinical area.

Progressive Supranuclear Palsy: Challenges and Considerations for Care Transitions.

Progressive supranuclear palsy (PSP) is a fatal neurodegenerative disorder. Care requires a patient-centered approach encompassing compassion, communication, and empathy. Despite concerted actions to streamline PSP patient transitions, the care is multifaceted and cause of concern. Patients with PSP undergoing transitional care are at an increased risk of undesirable outcomes, frequently endure poor communication, and encounter inconsistent care. Therefore, patients with PSP and families worry about the uncertainty in care, including who is accountable for the care and available resources. Through the three spheres of impact, Clinical Nurse Specialists can educate and assist intensive care unit nurses caring for patients with PSP /families, aiding in the successful care transition.

Virtual Nursing Education with Ignatian Pedagogy and Jesuit Charisms During a Pandemic.

ABSTRACT: Amid the COVID-19 pandemic, higher education faculty at a Jesuit university were compelled to adapt pedagogies that were immersive and learner-centered within a virtual learning environment. The Ignatian pedagogical paradigm presented in this article is based on a practical teaching context that values Ignatian principles and world views while promoting Jesuit education. This educational interventional study measured the transformation of nursing student online learners into active, caring, and compassionate participants as they developed their nursing knowledge in a maternal-child health course. With an Ignatian pedagogy as a structure for the online courses, students were challenged to embrace diverse ways of thinking, knowing, and learning.

Respiratory Assessment.

Respiratory illnesses often require acute care admissions and are a leading cause of death globally, thus creating a financial burden for healthcare systems. Home healthcare clinicians can significantly reduce morbidity and hospital readmissions by becoming proficient at respiratory assessment. This article aims to assist homecare clinicians in performing a respiratory assessment in a logical and structured approach, including inspection, palpation, percussion, and auscultation. This article reviews the anatomy and physiology of the respiratory system and describes subjective and objective respiratory assessment. It is anticipated that becoming adept at these skills will enable home healthcare clinician to assess and identify those patients at risk for deterioration and readmission.

Assessment and Management of COPD.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction, worsening exercise performance and deteriorating health. It is associated with significant morbidity, mortality, and costs to healthcare systems. Although no cure exists for COPD, there are treatments, medications, and lifestyle changes patients can adopt to feel better and prevent further damage to their lungs. This article discusses the assessment and treatment strategies, medication administration, oxygen management, and education for patients with COPD. Home care strategies may alleviate readmissions or the need for emergent care, thus reducing the impact of COPD on patients.

Cardiovascular Assessment.

Cardiovascular (CV) disease affects 6.2 million people in the United States, placing many of these individuals at risk for heart failure. The number of patients with heart failure who utilize home healthcare services after hospital discharge is high. There is also a high rate of readmission following hospitalization for heart failure, contributing to morbidity and mortality, as well as creating a financial burden for healthcare systems. Home care clinicians can make a significant contribution to reducing CV morbidity and readmissions by becoming proficient at CV assessment and using this information to develop an action plan to prevent exacerbations and rehospitalizations. This article reviews the anatomy and physiology of the CV system and describes subjective and objective CV assessment.

Breastfeeding and Human Lactation Curriculum Survey of Midwifery Programs in the United States.

INTRODUCTION: The health attributes and advantages of breastfeeding are well documented in the literature. Current research identifies the importance of comprehensive lactation knowledge among health care professionals to improve breastfeeding outcomes. Educational curricula to incorporate lactation content is necessary for student preparedness to provide competent care. Midwives are in a unique position to support, promote, and manage breastfeeding. The purpose of this study was to survey Accreditation Commission for Midwifery Education (ACME)-accredited midwifery education programs in the United States for their breastfeeding curricular content including opportunities for clinical experiences in managing and counseling breastfeeding parents. METHODS: A descriptive survey was deployed online to midwifery programs listed by the American College of Nurse-Midwives, with a response completion rate of 44.7%. Data collection included program descriptors, hours of lactation content, educational topics, faculty preparation, use of simulation, and clinical breastfeeding experiences. RESULTS: Descriptive analyses revealed differences among the midwifery education programs surveyed regarding the amount of lactation content and clinical opportunities. Two programs offer a course specific to breastfeeding, with the remaining programs providing lactation content threaded throughout their curricula; 29.4% of programs offer 3 to 4 hours of lactation content, 35.3% report 5 to 8 hours of content, and 11.8% provide at least 10 hours of content. One program reports 18+ hours of content provided in both didactic and clinical settings. All programs report providing breastfeeding clinical opportunities for students; 18% of programs offer simulation experiences. No programs report using standardized lactation clinical competencies. DISCUSSION: Midwives play a pivotal role in breastfeeding promotion, counseling, and clinical support. Standardization of didactic lactation education will assist programs in future curriculum mapping. Given the variability of clinical settings and patient access, creating clinical competencies and providing lactation simulation experiences may offer midwifery students a broader opportunity to gain critical skills in lactation management to best support breastfeeding families.

As nurses, are we meeting the unique needs of the intact client?

PURPOSE: Current routine circumcision rates declined indicating a procedure reduction and because of this, nurses will encounter more intact male patients. Best practices are needed to provide appropriate, safe nursing care. The research aim was to understand what American nurses presently know about intact care and if any knowledge deficits exist. DESIGN AND METHODS: The research was conducted using a cross-sectional survey design. American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention. METHODS: American nurses currently in practice were invited to participate in a survey distributed via social media groups for nursing professionals. No incentive was offered for participation. An author-developed instrument was used to assess knowledge levels regarding intact care. Analysis was performed using descriptive statistics as there was no intervention. RESULTS: A convenient sample of 345 nursing professionals participated indicating an intact care knowledge deficit across the lifespan. Fourteen percent of respondents did not indicate that replacing the foreskin back over the glans was necessary with adult genital hygiene for intact patients. In pediatrics, 41.7% answered yes to the item statement "Do you retract the foreskin of an infant male child for catheter placement." PRACTICE IMPLICATIONS: The results indicate a knowledge deficit among American nurses regarding genital hygiene, particularly for pediatric patients. Practicing without knowledge of intact care that scientifically based can endanger the caring relationship between nurse and patient, resulting in physical harm and may open themselves and their health systems to legal liability.

Using Simulation to Teach Breastfeeding Management Skills and Improve Breastfeeding Self-Efficacy.

Breastfeeding rates in the United States continue to be variable and are not meeting benchmarks established by Healthy People 2020. The literature indicates that although breastfeeding knowledge of providers is paramount in the success of breastfeeding mothers, most receive minimal education regarding breastfeeding management. Recognizing a lack of opportunities for nursing students to practice breastfeeding management during clinical rotations, a breastfeeding simulation program was implemented for students prior to beginning Maternal Child Health clinicals. Students reported increased confidence in caring for breastfeeding dyads and enhanced comfort when providing care to a breastfeeding mother (breastfeeding self-efficacy). This hands-on educational approach can be utilized for any provider working with breastfeeding dyads.

Self-care promotion of the intact (non-circumcised) patient: A review of available recommendations.

PURPOSE: With routine infant circumcision rates declining in the United States, nurses are likely to encounter more intact (non-circumcised) male patients requiring genital hygiene, nursing interventions, and education accessing the health system. To date, a little emphasis has been placed on the care of the intact male patient in the nursing literature, resulting in ambiguity in care recommendations. The vagueness is problematic, as improper intact care, particularly in the pediatric patient, can result in forced retraction injuries, bleeding, scarring, and unnecessary intervention. In addition, with nurses conducting many of the tasks of hygiene and education for self-care, there is potential for impaired patient self-care and harm if nurses are not knowledgeable in intact care. Utilizing Orem's self-care theory as a framework, the aim of this effort is to perform a review of current recommendations on intact care to inform nursing practice with this population. As no evidence was found in the scientific literature, readily available consumer website resources were reviewed. CONCLUSION: Themes of hygiene and age of retraction emerged. While recommendations for hygiene practices were variable, all review sources (n = 12) were clear in advising against the premature retraction of the intact foreskin and identified this as a route for injury. PRACTICE IMPLICATIONS: With no current literature available to summarize current nursing clinical or educational practices, dissemination of these recommendations is necessary to prevent patient injury and promote appropriate patient self-care.