Multisite Implementation of the Tiered Skills Acquisition Model for Orientation: Review and Analysis.

Nursing professional development (NPD) directors and practitioners are called to lead practice changes. Knowledge of implementation science and diffusion theory equips NPD professionals with the tools necessary for successfully influencing nursing practice. This article analyzes a multisite implementation of the tiered skills acquisition model for clinical orientation and provides NPD directors and practitioners with recommendations for effective implementation strategies that translate beyond clinical orientation to a variety of NPD programs and initiatives. [J Contin Educ Nurs. 2024;55(3):130-136.].

Nursing Challenges and Strategies During the COVID-19 Pandemic.

The COVID-19 pandemic has required healthcare organizations to creatively address patient care needs. The pandemic-induced disruption resulted in multiple examples of disruptive innovation. Several innovative strategies and learnings identified during the COVID-19 pandemic have resulted in approaches to nursing education and staffing, which will serve to optimize the future healthcare environment. The solutions identified by the nursing workforce during the COVID-19 pandemic can readily be replicated in similar or dissimilar healthcare environments.

Speaking to the Heart of Our Patients: An Empathic Communication Education Initiative.

Communicating with empathy is a critical skill within the nurse-patient relationship and a driver of a positive patient experience. Staff at a large midwestern medical organization identified an education-based communication improvement strategy to address a gap within its patient experience data. An evidence-based empathic communication education framework was developed and delivered to more than 8,400 nurses and allied health staff. Posteducation sustainment strategies were included within the framework to support ongoing concept mastery and practical application. A multilevel evaluation strategy was used to measure the education's impact from both a learner and patient perspective. Evaluations demonstrated the chain of impact from reaction, learning, behavior, and results, indicating the education improved staff members' ability to communicate empathically, contributing to an increase from baseline in communication-related patient experience data. [J Contin Educ Nurs. 2021;52(7):319-325.].

Peer review of a cancer weight of evidence assessment based on updated toxicokinetics, genotoxicity, and carcinogenicity data for 1,3-dichloropropene using a blinded, virtual panel of experts.

A cancer weight of evidence (WOE) analysis based on updated toxicokinetics, genotoxicity, and carcinogenicity data for 1,3-dichloropropene was peer reviewed by a panel of experts. Historically, 1,3-dichloropropene has been classified in the U.S. as "likely to be carcinogenic to humans" via oral and inhalation exposure routes based upon the results of rodent cancer bioassays conducted in the 1980s. Contemporary studies led the authors of the WOE analysis to conclude that the currently manufactured form of 1,3-dichloropropene is not mutagenic and not carcinogenic below certain doses, pointing to a threshold-based approach for cancer risk assessment. SciPinion conducted a peer review of the WOE analysis using methods for assembling and managing blinded expert panels that maximize expertise while minimizing potential selection/participation bias. The process was implemented through a web-based application that poses a series of questions soliciting the experts' scientific opinions and observations about specific topics. The goal of the peer review was to have experts provide conclusions about the WOE for carcinogenicity classification of 1,3-dichloropropene, identify potential data gaps, and evaluate the validity of a threshold-based risk assessment for 1,3-dichloropropene. Based on a robust peer review of the current scientific information, a cancer WOE classification of "not likely to be carcinogenic to humans" is best supported for 1,3-dichloropropene. This conclusion is reached with a high degree of consensus (consensus score = 0.92) across expert panel members.

How to Flip the Classroom to Improve Learner Engagement.

Providing effective nursing professional development that meets the needs of a variety of learners, promotes critical thinking skills, and results in application in clinical practice is challenging. The flipped classroom was successfully implemented at a large Midwestern teaching hospital to address these challenges. This article explores flipped classroom exemplars including descriptions of prework, active learning strategies, and recommendations for successful implementation of the flipped classroom.

Flipped Classroom Strategy: An Accessible, Application-Driven Approach to Genomics Education.

Gaps in nurses' knowledge and application related to genomics exist. This project aimed to develop an accessible genomic education program for oncology nurses. Consequently, the flipped classroom strategy was used. This involved the use of prework consisting of an online genetics and genomics module and optional journal articles. In-person class time built on the prework and focused on specific clinical applications. Outcomes demonstrated that learners were highly satisfied with the educational format and that course objectives were met. Improvement in knowledge of basic genomic concepts, clinical applications, and resources was achieved.

Introducing Essential Oils into Pediatric and Other Practices at an Academic Medical Center.

Aromatherapy is an integrative intervention that uses essential oils to address symptom management, potentially as a first-line intervention or as a complement to other medical treatments. Aromatherapy is gaining widespread acceptance and increased scientific evidence of efficacy. Integrative and holistic nursing care uses integrative therapies such as aromatherapy and the principle of moving from a less invasive intervention to a more invasive intervention according to patient needs, symptoms, and preferences. Aromatherapy is often provided as a minimally invasive, independent, and integrative nursing intervention. This article describes the process used to introduce essential oils into practices at a large Midwestern academic medical center.

Adolescent fatigue, POTS, and recovery: a guide for clinicians.

Many teenagers who struggle with chronic fatigue have symptoms suggestive of autonomic dysfunction that may include lightheadedness, headaches, palpitations, nausea, and abdominal pain. Inadequate sleep habits and psychological conditions can contribute to fatigue, as can concurrent medical conditions. One type of autonomic dysfunction, postural orthostatic tachycardia syndrome, is increasingly being identified in adolescents with its constellation of fatigue, orthostatic intolerance, and excessive postural tachycardia (more than 40 beats/min). A family-based approach to care with support from a multidisciplinary team can diagnose, treat, educate, and encourage patients. Full recovery is possible with multi-faceted treatment. The daily treatment plan should consist of increased fluid and salt intake, aerobic exercise, and regular sleep and meal schedules; some medications can be helpful. Psychological support is critical and often includes biobehavioral strategies and cognitive-behavioral therapy to help with symptom management. More intensive recovery plans can be implemented when necessary.

Orthostatic heart rate and blood pressure in adolescents: reference ranges.

This descriptive population study of 307 public high school students, ages 15 to 17 years, was performed to establish reference ranges for orthostatic changes in heart rate and blood pressure in adolescents, and to identify influential variables. Noninvasive measurements of blood pressure and heart rate were obtained. Reference ranges for orthostatic heart rate change in this population at 2 minutes were -2 to +41 beats per minute and at 5 minutes were -1 to +48 beats per minute. Orthostatic blood pressure changes were within the adult range for 98% of adolescents tested. One-third of participants experienced orthostatic symptoms during testing. In conclusion, this study shows that orthostatic symptoms and large orthostatic heart rate changes occur in adolescents. This suggests that the current orthostatic heart rate criterion aiding the diagnosis of adult orthostatic intolerance syndromes is likely not appropriate for adolescents and should be reevaluated.

Impact of the implementation of telemanagement on a disease management program in an elderly heart failure cohort.

The purpose of the present investigation is to examine the impact of a telemanagement component on an outpatient disease management program in patients with heart failure (HF). A total of 282 patients in whom HF was diagnosed and who were enrolled in an outpatient HF program were included in this analysis. One hundred fifty-eight patients additionally participated in a self-directed telemanagement component. The remaining 124 patients received care at an HF clinic but declined telemanagement. During the 7-month tracking period, 19 patients in the HF clinic plus telemanagement group and 53 patients in the HF clinic only group were hospitalized for cardiac reasons (log rank, 36.0; P<.001). The HF clinic only group had a significantly higher risk for hospitalization (hazard ratio, 4.0; 95% confidence interval, 2.4-6.7; P<.001). The results of the present study indicate that telemanagement is an important component of a disease management program in patients with HF.