Bloom's Taxonomy: Framing Virtual Simulations During the COVID-19 Pandemic.

The COVID-19 pandemic required a significant pivot in nursing education, whereby in-person simulations moved to an online format. Kaplan's i-Human Patients was a virtual simulation platform utilized at a large Midwestern university for student nurses. This online virtual simulation platform helped evaluate students' clinical knowledge and understanding using the Bloom's taxonomy framework to scaffold cases. In addition, the five phases of professional development was incorporated to aid faculty instruction.

Agreement of the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) With NICU Nurses' Assessments.

BACKGROUND: Objective assessment tools should standardize and reflect nurses' expert assessments. The Neonatal Pain, Agitation, and Sedation Scale (N-PASS) and the Neonatal Infant Pain Scale (NIPS) are valid measures of pain. The N-PASS also provides a sedation subscale. PURPOSE: The objective of this study was to determine N-PASS clinical validity and utility by evaluating agreement of N-PASS scores with bedside nurses' assessments of pain/agitation and sedation in a 64-bed tertiary neonatal intensive care unit. METHODS: Fifteen bedside nurses trained to use the N-PASS and the NIPS prospectively completed 202 pain/agitation and sedation assessments from a convenience sample of 88 infants, including chronically ventilated, medically fragile infants. N-PASS and NIPS scores were obtained simultaneously but independently of nurse investigators. Bedside nurses also made recommendations about infants' pain and sedation management. RESULTS: There was moderate agreement between N-PASS pain scores and nurses' recommendations (κ= 0.52), very strong agreement between N-PASS sedation scores and nurses' recommendations (κ= 0.99), and very strong associations between N-PASS pain and NIPS scores ( P < .001). Bedside nurse and independent investigator interrater reliability was good for N-PASS pain and NIPS scores (intraclass correlation coefficient [ICC] = 0.83, ICC = 0.85) and excellent for N-PASS sedation (ICC = 0.94). During 93% of assessments, bedside nurses reported that the N-PASS reflected the level of infant sedation well or very well. IMPLICATIONS FOR PRACTICE AND RESEARCH: The N-PASS provides an easy-to-use, valid, and reliable objective measure of pain and sedation that reflects nurses' assessments. Additional studies using the N-PASS are needed to verify results and the influence of the N-PASS on pain and sedation management for medically fragile infants with chronic medical conditions.

Examining Whiteness in Obstetric and Pediatric Simulations: A Content Analysis.

BACKGROUND: Whiteness is a systemic construct that functions to make itself invisible and prevent its racialization. Whiteness informs the nursing profession on all levels and impacts how nurses learn, relate to, and perpetuate whiteness through structural, curricular, interpersonal, and ideological means. The aim of this study was to use an antiracist framework to analyze manifestations of whiteness in select prelicensure obstetric and pediatric clinical simulation scenarios at a large midwestern college of nursing. METHODS: Nine prelicensure nursing simulations were analyzed for themes using qualitative content analysis. RESULTS: Two themes related to whiteness emerged from the data-normalizing whiteness in assessment and othering. CONCLUSION: Applying an antiracist framework in clinical nursing education can assist educators and students to see the embedded whiteness and racism in the curriculum and begin to address it. Additional analysis is needed to explore nurse educators and student perceptions of whiteness in simulations. [J Nurs Educ. 2021;60(12):690-696.].

Enhancing Cultural Sensitivity in a Community Health Care Setting for LGBTQ Patients.

Lesbian, gay, bisexual, transgender, or queer (LGBTQ)-identified individuals, particularly transgender individuals, experience significant health inequities such as increased risk for chronic health conditions and mental health concerns. Discrimination by health care professionals is a major deterrent for LGBTQ individuals to seek health care. The purpose of the article is to offer practice recommendations using targeted community actions to enhance LGBTQ cultural sensitivity in community health care settings. Strategic planning, assessment for readiness to change, environmental strengths, weaknesses, opportunities, and threats analysis, and use of community resources are recommended as part of a basic model for change in a community setting. Outcomes are measured using a cultural competency tool.