An Innovative Academic Practice Model for Clinical Nursing Education During the COVID-19 Pandemic.

In March of 2020, Columbia University School of Nursing (CUSON) Masters Direct Entry (MDE) program and New York Presbyterian Hospital (NYPH) created an innovative academic partnership to address the clinical needs of students and to help alleviate the burden of surging COVID-19 cases on nurses and the health care system. Through this partnership, students were hired as nurse technicians to assist with patient care during the first wave of the COVID-19 pandemic. As a result of this enhanced relationship, a pipeline of well-qualified graduate nurses with unique skills to adapt to a rapidly changing practice environment was created. Student participants in this opportunity developed an understanding of the organizational and leadership structures of the health care institution. The understanding of organizational and leadership structures will help transform the delivery of care.

Neonatal Nurses' Perceptions of Palliative Care in the Neonatal Intensive Care Unit.

PURPOSE: Neonatal palliative care is widely endorsed as an essential aspect of neonatal intensive care unit (NICU) practice, yet inconsistencies in its use continue to exist. We examined neonatal nurses' perceptions of barriers and facilitators to palliative care in their NICU setting. STUDY DESIGN AND METHODS: A cross-sectional design using the Neonatal Palliative Care Attitude Scale (NiPCAS™©) was administered using an online survey distributed to neonatal nurses through the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) and National Association of Neonatal Nurses (NANN). Parametric statistical analyses were conducted to explore relationships between unit policy and neonatal palliative care (NPC) education, and the nurses' perceptions. RESULTS: Ninety-nine of 1,800 AWHONN members who identified as NICU nurses completed the survey, representing a response rate of 5.5% and 101 of 4,000 NANN members who subscribe to the MYNANN message boards completed the survey, reflecting a 2.5% response rate. N = 200 surveys were completed with minimal data missing, resulting in a final sample of 200. Exploratory factor analysis yielded these subconstructs: Unit Culture, Resources, and Perceived Inappropriate Care. Barriers identified were Perceived Inappropriate Care and Societal Understanding of NPC. A positive correlation was noted for NiPCAS™© scores and unit culture support (r(185) = .66, n = 187, p < .01), unit NPC policy (r(184) = .446, n = 186, p < .01), and NPC education (r(185) = .373, n = 187, p < .01). CLINICAL IMPLICATIONS: Nurses who work in a NICU with an NPC policy and who have received palliative care education demonstrated more favorable attitudes toward NPC. Policy and educational programs are important strategies to promote high-quality care for high-risk infants and their families.

Enhancing the undergraduate nursing education experience with clinical elective courses.

The nursing faculty, in concert with the University's vision of personalized learning for undergraduate students, sought creative opportunities for nursing students to explore distinctive career specialty paths. The development, implementation, and evaluation of three undergraduate clinical electives developed by a School of Nursing (SON) is described here, in collaboration with three clinical practice partners. These nursing elective courses were designed to meet student requests for additional content in specialty nursing practice areas, enhance new nurse career readiness, and meet practice partner staffing needs for nurses with additional knowledge and skills in specific identified specialties. These nursing specialties included perioperative nursing, neonatal intensive care nursing, and oncology nursing. The SON faculty and each practice partner co-developed unique specialty-nursing elective courses that provide foundational specialty knowledge and skills in each practice arena. Project outcomes include enhanced relationships between the SON and practice partners, high levels of satisfaction of students and employers, and subsequent recruitment and employment of these students as new graduate nurses by our practice partners.

Conceptually Redefining Neonatal Palliative Care.

BACKGROUND: First defined in 2002 by Catlin and Carter, neonatal palliative care (NPC) is a relatively new model of care in neonatal pediatrics, first appearing in the medical literature in the early 1980s. PURPOSE: The purpose of this article is to suggest a conceptual definition of NPC that encompasses all the essential concepts as a way of moving NPC forward by having a consistent approach. METHODS: Following a review of the NPC literature, a thematic analysis as a method for identifying, analyzing, and interpreting patterns of meaning in the definitions ("themes") within the literature was undertaken. FINDINGS: The major themes identified included philosophies of care, support, culture and spirituality, the team, and clinical management. IMPLICATIONS FOR RESEARCH: At the heart of NPC is the primacy of maintaining quality of life, while providing ethical and humane care that supports a "good death." The extensive elements presented in this article are considered essential to a comprehensive and conceptual definition of NPC proposed here.

Randomized controlled trial evaluating the effects of cobedding on weight gain and physiologic regulation in preterm twins in the NICU.

OBJECTIVE: To compare the differences in growth and physiologic regulation in cobedded preterm twins versus individually bedded preterm twins while in the neonatal intensive care unit (NICU). SUBJECTS: Infants born between 28 to 34 weeks gestation in a Level III NICU were eligible for enrollment into the study. Forty-nine sets of twins were enrolled in the study and 41 sets were ultimately analyzed. There were 21 twin sets (42 infants) in the experimental group and 20 sets (40 infants) in the control group. DESIGN: A prospective randomized design was used. METHODS: Parents of twins in a level III NICU were approached for consent to participate in the study. Twins were randomized using sealed envelopes that designated placement in either the control or experimental group. Twin sets who were randomized to the control group received routine care in separate beds. Twin sets in the experimental group received routine care in the same bed. Guidelines for positioning of cobedded twins were utilized. Treatment and data collection started when infants met the inclusion criteria for the study. MAIN OUTCOME MEASURES: Measurements of weekly weight gain and episodes of apnea/bradycardia/desaturation (A/B/D) were collected for each group. PRINCIPAL RESULTS: After adjusting for baseline weight in an analysis of covariance model, the cobedded group demonstrated a significantly higher mean weight compared to the control group at week 1 (1,644 vs. 1,572 grams, respectively, F = 11.6, P = 0.001) and at week 2 (1,755 vs. 1,693 grams, respectively, F = 5.7, P = 0.02). There was no difference in the median number of total combined A/B/D episodes between the 2 groups. CONCLUSIONS: A greater increase in mean weight gain was noted in the cobedded group compared to the control group.

Using web-based animations to teach histology.

We have been experimenting with the use of animations to teach histology as part of an interactive multimedia program we are developing to replace the traditional lecture/laboratory-based histology course in our medical and dental curricula. This program, called HistoQuest, uses animations to illustrate basic histologic principles, explain dynamic processes, integrate histologic structure with physiological function, and assist students in forming mental models with which to organize and integrate new information into their learning. With this article, we first briefly discuss the theory of mental modeling, principles of visual presentation, and how mental modeling and visual presentation can be integrated to create effective animations. We then discuss the major Web-based animation technologies that are currently available and their suitability for different visual styles and navigational structures. Finally, we describe the process we use to produce animations for our program. The approach described in this study can be used by other developers to create animations for delivery over the Internet for the teaching of histology.