Nursing Faculty Job Satisfaction During COVID-19: A Mixed-Methods Study.

AIM: The aim of this study was to understand stress, resilience, and compassion satisfaction of nursing faculty during the COVID-19 pandemic and identify factors related to their job satisfaction. BACKGROUND: The impacts of COVID-19 on faculty stress, resilience, compassion satisfaction, and job satisfaction were unknown. METHOD: A mixed-methods survey was distributed electronically to nursing faculty in the United States. RESULTS: Compassion satisfaction and resilience were positively correlated with job satisfaction; stress and job satisfaction were negatively correlated. Feeling safe to teach, feeling supported by administration, and spending more hours teaching online were positively associated with job satisfaction. Three themes were identified: challenges in the workplace, struggles with personal stressors, and building capacity in the face of the unknown. CONCLUSION: Faculty reported a strong professional commitment to nursing education during the COVID-19 pandemic. Leadership that supported faculty through concern for their safety contributed to participants' ability to respond to the challenges experienced.

Exploring the experiences of nursing faculty during the coronavirus (COVID-19) pandemic-A qualitative descriptive study.

Aim: To gain an understanding of the experiences of nurse educators during the COVID-19 crisis. Background: The pandemic forced the closure of colleges and universities nationwide. Nurse educators were challenged to offer didactic and experiential learning in online formats. Design: Qualitative description. Method: A purposive sample of 27 nurse educators employed in Maryland participated in semi-structured interviews from February to April 2021. Content analysis was performed by two researchers independently and results compared for thematic analysis. Results: Three themes were identified: (1) uncertainty within pandemic ambiguity, (2) prioritizing pedagogy, and (3) professional commitment. Conclusion: Faculty need increased pedagogical support for online teaching. Online pedagogies must include ways to support student emotional well-being and development of clinical judgment. A profession-wide reflection of how nursing education can meet the evolving needs of the health care system, especially when access to clinical sites is limited, is warranted.

Preadmission predictors for first semester course success in a baccalaureate nursing program.

BACKGROUND: Identifying students' who are able to complete a rigorous course of study, graduate on time, and pass the NCLEX-RN© is a principle role of nursing program admissions teams. PURPOSE: To examine which preadmission factors predict students' success in the first semester of a baccalaureate nursing program. METHODS: Undergraduate students' data from the academic years 2013 to 2017 were analyzed (N = 927). Bivariate and multiple regression analyses were used to examine potential predictors of first semester course success, and scores on standardized NCLEX preparation exams. RESULTS: Preadmission cumulative GPA (OR = 3.82, 95% CI = 1.43-10.16) and prerequisite science GPA (OR = 2.57, 95% CI = 1.14-5.78) predicted success in the pathopharmacology course. Preadmission cumulative GPA (OR = 6.53, 95% CI = 1.59-26.85) and TEAS composite score (OR = 1.15, 95% CI = 1.09-1.22) predicted success in the health assessment course. Preadmission cumulative GPA (OR = 3.42, 95% CI = 1.18-9.92) and TEAS composite score (OR = 1.05, 95% CI = 1.01-1.10) predicted success in the foundations course. Higher preadmission cumulative GPA (B = 14.19, p < 0.01), prerequisite science GPA (B = 12.62, p < 0.01), and TEAS composite score (B = 0.48, p < 0.01) predicted a higher pathopharmacology-KAPLAN, Inc. test scores. Higher preadmission cumulative GPA (B = 62.52, p < 0.01), prerequisite science GPA (B = 61.18, p < 0.01), and TEAS composite score (B = 4.76, p < 0.01) predicted a higher fundamentals-HESI test scores. CONCLUSIONS: Preadmission cumulative GPA, prerequisite science GPA, and TEAS composite score were significant predictors of success in first semester courses and performance on standardized tests.

Entry-Level Master's Programs in Nursing: Review of Programmatic Features.

BACKGROUND: This review describes the programmatic features of entry-level master's programs in nursing in the United States that result in a generalist degree for individuals with a baccalaureate degree in another field. The number of entry-level Master of Science in Nursing programs has grown over the past decade, increasing the importance of understanding the features, similarities, and differences among these programs. METHOD: Using a custom report of accredited schools of nursing with entry-level master's programs from the American Association of Colleges of Nursing and the Accreditation Commission for Education in Nursing's website, we conducted a program review to describe the programs' features. RESULTS: There is substantial variation in nomenclature, length, credits, and clinical hours among entry-level master's programs. CONCLUSION: The difference in these programs may create confusion among potential students of the programs and employees of the graduates. Investigations are needed on the relationship between programmatic features and outcomes. [J Nurs Educ. 2019;58(9):525-529.].

Evaluation of an Intervention to Improve Clinical Nurse Educators' Knowledge, Perceived Skills, and Confidence Related to Diversity.

This article describes the evaluation of a diversity-related video and its impact on clinical nurse educators. Our evaluation suggests that educators' knowledge, perceived skills, and confidence in creating a diversity-friendly learning environment were positively affected. Their awareness of their own biases did not improve significantly, thus suggesting the need for continued emphasis on self-assessment. The video was considered relevant and was supported by most educators, suggesting that similar videos may be an acceptable strategy for engaging them in diversity-related issues.

A Randomized Trial of Human Papillomavirus Self-Sampling as an Intervention to Promote Cervical Cancer Screening Among Women With HIV.

OBJECTIVE: Women living with HIV experience higher risk of cervical cancer, but screening rates in the United States are lower than recommended. The purpose of this study was to examine whether an intervention using self-sampling of cervicovaginal cells for human papillomavirus (HPV) with results counseling would increase cervical cytology ("Pap") testing among women with HIV. MATERIALS AND METHODS: This was a randomized controlled trial to test the effectiveness of an intervention of self-sampling for HPV and results counseling. Participants were 94 women older than 18 years, with HIV infection, attending an HIV clinic for a primary care visit, whose last cervical cancer screening was 18 months or more before baseline. Women were assigned to the intervention or information-only group. The primary outcome was completion of cervical cytology testing within 6 months of baseline. The secondary outcome was the women's perceived threat of developing cervical cancer. RESULTS: A total of 94 women were enrolled and analyzed in the study. The cytology completion rate overall was 35% by 6 months from baseline. There were no differences in comparing HPV-positive with HPV-negative women nor comparing them with the information-only group. In the intervention group, a positive HPV test increased perceived threat of cervical cancer. CONCLUSIONS: The intervention did not improve cytology test attendance, although education about HPV and cervical cancer risk as part of study procedures was associated with testing for 35% of this group of women whose previous cytology occurred an average of 3.6 years before the baseline appointment. Self-sampling for HPV testing was feasible.

CE: Sexually Transmitted Infections in the United States: Overview and Update.

OVERVIEW: Sexually transmitted infections (STIs) are the most common infectious diseases in the United States. They have enormous human consequences, including severe reproductive complications, neonatal injury, and death; and because STIs are associated with social stigma, they also have substantial psychological impact. The economic consequences are also enormous: it's estimated that STIs cost the nation about $16 billion in annual health care costs. All communities are affected, although significant racial, ethnic, and other disparities persist. Nurses play a critical role in educating patients on STIs, screening for disease, and providing treatment. Nurses can also help minimize the impact of social stigma by providing informed, confidential, and sensitive care, and by promoting sexual health. This article provides an overview of the symptoms, screening methods, and treatment recommendations for the most common STIs in the United States and describes the most recent relevant findings in order to inform nursing practice.

Sexually transmitted infection clinics as safety net providers: exploring the role of categorical sexually transmitted infection clinics in an era of health care reform.

BACKGROUND: For many individuals, the implementation of the US Affordable Care Act will involve a transition from public to private health care venues for sexually transmitted infection (STI) care and prevention. To anticipate challenges primary care providers may face and to inform the future role of publicly funded STI clinics, it is useful to consider their current functions. METHODS: Data collected by 40 STI clinics that are a part of the Sexually Transmitted Disease Surveillance Network were used to describe patient demographic and behavioral characteristics, STI diagnoses, and laboratory testing data in 2010 and 2011. RESULTS: A total of 608,536 clinic visits were made by 363,607 unique patients. Most patients (61.9%) were male; 21.9% of men reported sex with men (MSM). Roughly half of patients were 20 to 29 years old (47.1%) and non-Hispanic black (56.2%). There were 212,765 STI diagnoses (mostly nonreportable) that required clinical examinations. A high volume of chlamydia, gonorrhea, and HIV testing was performed (>350,000 tests); the prevalence was 11.5% for chlamydia, 5.8% for gonorrhea, 0.9% for HIV, and varied greatly by sex and MSM status. Among MSM with chlamydia or gonorrhea, 40.1% (1811/4448) of chlamydial and 46.2% (3370/7300) of gonococcal infections were detected at extragenital sites. CONCLUSIONS: Sexually Transmitted Disease Surveillance Network clinics served populations with high STI rates. Given experience with diagnoses of both nonreportable and reportable STIs and extragenital chlamydia and gonorrhea testing, STI clinics comprise a critical specialty network in STI diagnosis, treatment, and prevention.

HIV and STI testing in older adults: an integrative review.

AIMS AND OBJECTIVES: To examine the frequency of human immunodeficiency virus testing and sexually transmitted infection testing among older adults (50 years and older), present factors related to human immunodeficiency virus and sexually transmitted infection testing among older adults, and summarise the perspectives and practices of older adults and health care providers related to sexual health communication. BACKGROUND: Reported cases of sexually transmitted infections and human immunodeficiency virus among older adults have increased, therefore refuting the stereotype of the sexually inactive older adult. DESIGN: Integrative review. METHODS: Database searches in PubMed, EMBASE, CINAHL, and Web of Science; manual reference list searches; and database searches for articles that cited previously identified articles. RESULTS: There is limited research on this topic and considerable diversity in the populations studied and outcomes measured. The search process yielded 20 articles meeting the eligibility criteria. Human immunodeficiency virus and sexually transmitted infection testing of older adults are infrequent. Human immunodeficiency virus testing among older adults is associated with perceived risk of contracting human immunodeficiency virus and influenced by encouragement from health care providers. Sexually transmitted infection testing due to genital symptoms is more likely than asymptomatic screening. Few providers collect routine sexual histories from older adult patients, although older adults are receptive to sexual history taking. CONCLUSIONS: There are missed opportunities to identify sexually transmitted infections and human immunodeficiency virus in older adults. Stereotypes and assumptions have hindered providers from identifying and testing older adults at risk for human immunodeficiency virus and sexually transmitted infections. RELEVANCE TO CLINICAL PRACTICE: Sexual health assessment is essential to comprehensive health care. A sexual history provides information that may indicate human immunodeficiency virus and sexually transmitted infection testing. Detection and treatment of human immunodeficiency virus and sexually transmitted infections will break the chain of infection and improve quality of life.

Validity of behavioral measures as proxies for HIV-related outcomes.

Over the last 30 years, expectations for the quality, validity, and objectivity of the outcome measures used to assess the impact of behavior change interventions related to HIV have steadily increased. At this point (mid-2014 at this writing), biologic evidence or biomarkers of the incidence of HIV and other sexually transmitted infections in a target population is clearly preferable to self-reports of behavior. This kind of evidence is, however, much more expensive to collect than participants' reports of behavior change (eg, increased condom use, reduced substance use or abstinence from substance use, and high levels of medication adherence). In addition, although potentially less subject to reporting bias, biomarkers and biologic outcomes have their own flaws. In this article, we review the literature on the validity of self-reports of outcomes most relevant to HIV behavior change interventions, sexual behavior (ever having had sex and condom use), substance use, and medication adherence. We note the extent to which they may be adequate outcome measures without biologic data, and the conditions under which they may be most likely to be sufficient. We also argue, like many others, that where possible, both self-report and biologic measures should be collected.

Knowledge, attitudes, and practices of OB/GYN nurses and auxiliary staff in the care of pregnant women living with HIV.

The purpose of this study was to explore the knowledge, attitudes, and practices (KAP) of health care workers caring for HIV-infected pregnant women. A KAP survey was formulated in order to achieve this goal. Obstetric and gynecological (OB/GYN) health care workers (n = 121) in both inpatient and outpatient settings in an academic and an affiliated community-based hospital in a large urban academic medical center in the northeastern United States were surveyed. Findings suggest that KAP requires further improvement among OB/GYN staff, particularly in the areas of prevention of HIV and psychosocial care of patients with HIV. Further research is needed to determine the best strategies to improve clinical practice for pregnant women living with HIV.

Cervical cancer screening in the era of human papillomavirus testing and vaccination.

Cervical cancer screening algorithms have changed with the introduction of testing for human papillomavirus (HPV) and better understanding of the natural history of HPV. This review was undertaken to present recent developments related to cervical cancer screening, with HPV testing as a focus. Specifically, guidelines now recommend initiating cervical cancer screening at age 21, stopping at age 65 to 70 if previous tests are normal, and screening no more than every 2 to 3 years. Human papillomavirus testing is now incorporated into guidelines for cervical cancer screening in the United States, with the major impact being the lengthening of recommended screening intervals. Primary screening with HPV testing, although not yet approved in the United States, may serve to increase access to care for the millions of underserved women worldwide who bear most of the burden of cervical cancer. Despite clear guidelines from authoritative sources, many clinicians (including midwives) overscreen women. In cervical cancer screening, as in many areas of women's health care, performing tests that are unlikely to result in useful information may lead to harm.

What's new in sexually transmitted infection management: changes in the 2010 guidelines from the Centers for Disease Control and Prevention.

Screening, treatment, and follow-up of sexually transmitted infections (STIs) are an important part of the role of women's health care providers. Keeping abreast of new and changing treatment guidelines is crucial to providing competent care. The Sexually transmitted diseases treatment guidelines, produced every 4 years by the Centers for Disease Control and Prevention, summarize current evidence on prevention, diagnosis, and treatment of STIs. The purpose of this article is to review the changes in the 2010 guidelines from the previous 2006 guidelines. These changes include new diagnostic tests for bacterial vaginosis, Neisseria gonorrhoeae, and human papillomavirus; new treatment recommendations for bacterial vaginosis, gonorrhea, and genital warts; the increasing prevalence of antimicrobial-resistant N gonorrhoeae; new criteria for spinal fluid examination to evaluate for neurosyphilis; and the emergence of azithromycin-resistant Treponema pallidum.

Psychosocial impact of a positive HSV-2 diagnosis on adults with unrecognized HSV-2 infection.

OBJECTIVE: To evaluate the current research on the psychosocial impact of a positive herpes simplex virus type 2 (HSV-2) diagnosis on asymptomatic adults. DESIGN AND SAMPLE: A structured review of PubMed, CINAHL, and MEDLINE resulted in 8 articles published between 2000 and 2008. MEASURES: Articles were included if they investigated psychosocial reactions to HSV serological testing, including asymptomatic individuals, and used measurement instruments with adequate psychometric properties. RESULTS: The studies included participants of various backgrounds, including individuals with a new HSV-2 diagnosis concurrently receiving human immunodeficiency virus treatment, students within a university setting, and an HMO population. Current research indicates that a diagnosis of HSV-2 does not result in persistent psychosocial morbidity. However, studies that assessed for more nuanced reactions noted an impact on quality of life related to herpes. CONCLUSIONS: Further research is needed to confirm these findings among varied populations, to explore quality of life following HSV screening, and to identify the characteristics that may make particular individuals more susceptible to adverse psychological consequences.

Genital herpes testing among persons living with HIV.

This cross-sectional survey explored the frequency of genital herpes testing among 110 people living with HIV (PLWH) and reported barriers and facilitators related to testing. Forty-four percent of the respondents had not been tested for genital herpes since receiving an HIV diagnosis, 34% had been tested, and 22% preferred not to say. Respondents' most frequently cited factors affecting a decision to not be tested were: (a) testing not being recommended by a provider, (b) not having herpes symptoms, and (c) not thinking they had herpes. Data from this study indicated that PLWH were not frequently tested for genital herpes; there was a limited understanding of the frequently subclinical nature of infection; and provider recommendations for testing, or lack thereof, affected testing decisions.

Availability of serologic and virologic testing for herpes simplex virus in the largest sexually transmitted disease clinics in the United States.

BACKGROUND: The prevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in the United States is estimated to be 57.7% for HSV 1 and 17.0% for HSV 2. The Centers for Disease Control and Prevention recommends that both virologic and serologic tests be available at clinics that examined clients at risk for sexually transmitted diseases. METHODS: A telephone survey was conducted. Providers at the 230 largest sexually transmitted disease clinics in the United States were surveyed regarding the availability of HSV virologic and serologic testing at their clinics. RESULTS: Of the 230 clinics, 37% (87) had neither serological nor virologic testing available, 36% (87) had only virologic, 23% (50) had both serologic and virologic, and 4% (8) had only serologic testing. States in the western and northern regions were significantly more likely to offer any type of HSV testing than the southern and Midwestern states (P < 0.05). The ability and techniques used to diagnose HSV varied widely by site and ranged from diagnosing by clinical examinations only to offer serological testing for all patients. CONCLUSIONS: Almost three-quarters of the clinics did not comply with Centers for Disease Control and Prevention recommendations. Further efforts are needed to implement national guidelines for HSV testing.

What has changed about vaginal douching among African American mothers and daughters?

OBJECTIVES: To explore African American mothers' and daughters' practices and influences related to vaginal douching. DESIGN AND SAMPLE: Our overall study used a sequential mixed-method design with 3 phases. Phase 1, the focus of this report, used grounded theory methods and in-depth, semistructured individual interviews. Two generations of African American girls and women: 24 girls ("daughters") aged 14-18 and 17 women ("mothers" or "mother figures") aged 22-43, recruited from 1 adolescent health clinic in Baltimore, MD. MEASURES: In-depth interviews were taped and transcribed and data analysis used the constant comparison method. RESULTS: Daughters were much less likely to douche or to have been exposed to douching information than mothers. Many mothers and daughters were influenced by health care providers and/or family members to not initiate, to decrease, or to stop douching. Women who currently douche often do so because of the perception of improved smell and cleanliness around menstruation and sexual intercourse. CONCLUSIONS: These data indicate that although some women continue to believe that vaginal douching has therapeutic value, others have been influenced to stop or not start douching by family and health care providers. Health care providers should continue efforts to educate patients on the risks of vaginal douching.

Providers' knowledge, practices, and barriers related to genital herpes testing for patients with HIV.

This cross-sectional study explored the knowledge, practice, and reported barriers related to genital herpes testing among 102 health care providers who treat people living with HIV in the United States. Twelve percent reported always testing HIV-infected patients for genital herpes, 65% sometimes or usually tested, and 23% rarely or never tested for genital herpes. Seventy-five percent said testing was not standard of care. Providers were more likely to recommend a herpes test if the patient had symptoms (94%) or had a partner with herpes (83%) and were less likely to recommend testing if patients had no partners (60%) or would rather not know (49%). Our work adds to the growing body of literature on herpes simplex virus-HIV coinfection by documenting that (a) providers often do not screen for genital herpes, (b) knowledge of appropriate diagnostic evaluation is limited, and (c) many clinicians report the lack of clear guidelines is a barrier to testing.