Creating a Global Community of Learners in Nursing and Beyond: Caring Science, Mindful Practice MOOC.

AIM: The aim was to examine the usefulness of a massive open online course (MOOC) on caring and mindfulness to a broad international audience that included nurses, allied health professionals, and others. BACKGROUND: MOOCs in higher education have been evident since 2008. Very few MOOCs on nursing topics have appeared since that time. Exploration was needed regarding how MOOCs could be employed to share nursing knowledge with national and international communities. METHOD: Two "Caring Science, Mindful Practice" MOOC sessions were examined. Demographics, learner satisfaction, course flow, and perceived usefulness of content were analyzed. RESULTS: Learners from varied backgrounds participated. Higher than expected course activity levels and completion rates suggested effective learner engagement. Excellent course ratings demonstrated that content and delivery methods were effective. Active learners communicated specific plans to apply new knowledge in the future. CONCLUSION: MOOCs facilitate learning where participants learn about topics of interest in nursing and beyond.

What Student Cues Prompt Online Instructors to Offer Caring Interventions?

AIM: The aim was to describe how instructors respond to students' demonstrating a need for caring in online classrooms. BACKGOUND: Previous studies have documented student perceptions of caring in online classrooms. Knowledge development of instructor perceptions was needed. METHOD: Fifty-six online nurse educators from 10 states and 20 institutions completed an online survey requesting information about student cues that prompt caring interventions, what instructors do in response to those cues, and how students respond to the interventions. RESULTS: Identified student cues fell into six categories: Academic Struggle, Appeals for Help, Concerning Behaviors, Withdrawal, Personal Problems, and Positive Events. Instructor responses fell into three categories: Reaching Out, Concrete Academic Support, and Intentional Caring Comportment. Student responses to caring interventions fell into three categories: Gratitude, Finding Their Voice, and Academic Improvement. CONCLUSION Results clarify the dynamics of unstructured caring interactions between teachers and students in the online setting.

Provision and use of personal protective equipment among home care and hospice nurses in North Carolina.

BACKGROUND: We investigated the frequency with which home care/hospice nurses are provided with and use personal protective equipment (PPE) and factors associated with use. METHODS: We conducted a mail survey among home care/hospice nurses in North Carolina in 2006. RESULTS: The adjusted response rate was 69% (n = 833). Between 68% and 86% of nurses were always provided with the relevant types of PPE; these nurses were 2.5-3 times more likely to use the PPE in scenarios involving a potential for blood exposure compared with nurses who were not always provided with PPE. Nurses who always had sufficient time during home visits were 50% more likely to use PPE. Nurses who visited more homes with adverse working conditions were less likely to use PPE. CONCLUSION: The public health policy of providing PPE to health care workers and ensuring that they use that equipment to prevent occupational blood exposure is not being fully implemented for home care and hospice nurses. Greater provision of PPE could reduce blood exposure in this population. Conditions of the home care/hospice work environment may be impeding nurses' ability to use PPE.

Documentation of incidental factors affecting the home healthcare work environment.

Working conditions related to unrestrained pets, unruly children, clutter, and poor lighting during home healthcare visits are considered normal aspects of care providers' jobs. To date, there has been no documentation related to how often these factors are present in the home healthcare setting during home visits. In this study, 833 home healthcare nurses practicing in North Carolina answered a questionnaire that included items related to how often unrestrained pets, unruly children, poor lighting, and clutter existed in the homes they visited. Results showed that one-third to one-half of the respondents usually or always visited homes with unrestrained pets, clutter, or poor lighting and few nurses usually or always visited homes with uncontrolled children. Better understanding of the prevalence of these factors will facilitate further study related to their effects on safety, efficiency, and job satisfaction for home healthcare workers.

Blood exposure incidence rates from the North Carolina study of home care and hospice nurses.

BACKGROUND: Home care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. However, little is known about the incidence of blood exposure in this population. METHODS: A mail survey (n = 1,473) was conducted among home care/hospice nurses in North Carolina in 2006. RESULTS: The adjusted response rate was 69%. Nine percent of nurses had at least one exposure/year. Overall incidence was 27.4 (95% confidence interval: 20.2, 34.6)/100,000 visits. Nurses who had worked in home care < or =5 years had higher exposure rates than other nurses-seven times higher for needlesticks and 3.5 times higher for non-intact skin exposures. Nurses who worked part time/contract had higher exposure rates than nurses who worked full time-seven times higher for needlesticks and 1.5 times higher for non-intact skin exposures. The rates for part-time/contract nurses with < or =5 years experience were extremely high. Sensitivity analysis showed that it is unlikely that response bias had an important impact on these results. CONCLUSIONS: Approximately 150 North Carolina home care/hospice nurses are exposed to blood annually. If these results are representative of other states, then approximately 12,000 home care/hospice nurses are exposed each year nationwide. Improved prevention efforts are needed to reduce blood exposure in home care/hospice nurses. Am. J. Ind. Med. 52:99-104, 2009. (c) 2008 Wiley-Liss, Inc.

Diversity and the NCLEX-RN: a double-loop approach.

The United States is increasingly ethnically diverse. To provide culturally congruent care to this changing population, nursing programs must attract and support ethnically diverse students through to successful completion of the National Council Licensure Examination for Registered Nurses. Critically examining the literature on this topic revealed three themes: need for a diverse nursing workforce, lack of formal evidence, and narratives of concern. A double-loop theoretical approach that encompasses interventions in elementary and secondary schools, traditional student support services, faculty development initiatives focused on cultural competence, formative and summative evaluations, quantitative and qualitative research, and evidence-based interventions is proposed to address this multifaceted concern.

Twenty-first century doctoral education: online with a focus on nursing education.

The acute shortage of doctorally prepared nursing faculty has prompted the nursing profession to look to new and creative ways of delivering doctoral-level preparation to currently employed nurse educators. The development of an online PhD program, based on recommended benchmark guidelines for a "best practice" approach to Internet-based education, led to a program evaluation matrix for formative and summative student advising and program review. In addition, efforts to seek the student voice in formative as well as summative evaluation provided a well-rounded plan to monitor program outcomes based on recommended benchmark guidelines. The results of first-year student feedback and perceptions reflect that online PhD program delivery promotes high quality professional socialization, mentoring, and student-faculty interaction. The online education experience has served as a stimulus for the incorporation of new learning into the student workplace setting, provides opportunity for educational access not previously available, and builds strong personal and professional relationships among nurse educators.

An exploratory study of nurse bag use by home visiting nurses.

Although the bag of the home care nurse is functional and historical, there is limited information in the literature about its use and nurses' preferences. This study analyzes how the bag is used, and examines comfort issues and preferences nurses have for this valuable tool. Implications for design and features are gained from this research as well as specific features to seek when choosing this important ergonomic tool.