Diversity, Equity, and Inclusion Competencies for a Graduate Nursing Program.

BACKGROUND: The integration of diversity, equity, and inclusion (DEI) concepts throughout the curriculum is imperative to the preparation of advanced-practice nurses to deliver person-centered care. This article describes the design and evaluation of one institution's faculty-developed DEI competencies for graduate nursing students. METHOD: A task force of faculty and content experts utilized a modified Delphi approach in the development of DEI-focused competencies related to advanced-level nursing education. A literature review, a faculty survey, and content experts were employed in the modified Delphi approach. RESULTS: Creation of interdisciplinary faculty-lead graduate nursing DEI curricular competencies included an overview, identification of three domains, eight competencies with associated key elements, and a glossary clarifying nine essential DEI terms. CONCLUSION: The development of DEI competencies for graduate nursing programs is feasible and an important strategy for preparing students with the values and skills to address the ongoing embedded structural inequalities in health care. [J Nurs Educ. 2024;63(X):XXX-XXX.].

The Role of Simulation in Graduate Nursing Education: Preparing Learners for Practice.

The effectiveness of simulation to reduce the theory-practice gap in graduate nursing education is supported by an extensive body of research, and numerous studies have demonstrated improved learner outcomes in such areas as clinical competence, confidence, and preparedness for practice. This paper explores the types of simulation-based education available for graduate nursing programs and provides examples of graduate nursing simulations that educators can use in their own programs to prepare clinicians for practice.

Application of an Antiracism Framework to Improve Pediatric APRN Education.

Poor health outcomes for children are directly tied to poor social determinants of health and systemic, embedded health care inequities. To prepare the next generation of pediatric advanced practice registered nurses (APRNs), nursing schools must educate students to address inequities through innovative curricular models and teaching modalities. The purpose of this manuscript is to describe the application of an antiracism framework to a graduate APRN program. This article describes the application of this framework, which led to significant administrative, curricular, and course changes to prepare pediatric-focused APRN students to address the health inequities and poor social determinants of health facing children today. By describing our journey to embed an antiracism framework, other nursing schools can make substantive changes necessary to prepare their students to address these health inequities.

An Educational Quality Improvement Project to Enhance Culturally Appropriate Care by Pediatric Nurse Practitioner Students Using a Multimodal Approach.

INTRODUCTION: Cultural identity has a profound impact on the health of children. The delivery of culturally appropriate care is key to patient-centered care. To combat health inequities children face, nursing faculty must prepare students to provide culturally appropriate care. METHOD: We conducted a quality improvement educational intervention to enhance pediatric nurse practitioner students' educational preparation in providing culturally appropriate care. The setting for this project was a large academic institution. This study aimed to evaluate a multimodal approach to educating nurse practitioner students on culturally appropriate care. A three-phase intervention was used to explore the impact of the multimodal approach. RESULTS: Surveys were used to explore the impact of each modality on the student's knowledge and confidence in delivering culturally appropriate care. Results suggest that a multimodal approach is an effective modality. DISCUSSION: Experiential learning opportunities are imperative to enhance the delivery of culturally appropriate care.

Incubating Collaboration for a Neonatal Scholars Writing Group.

One method to improve writing and scholarship is through the formation of writing teams. While not new, we will present our innovative strategy for creating an effective neonatal writing team for faculty and students. Tuckman's Model of Team Development was used to guide our group through the five stages of effective teams including forming, storming, norming, performing, and adjourning to develop an effective writing group. The application of this model facilitated a strong foundation for our writing group, the Neonatal Scholars Interest Group, through the intentional movements through developmental stages and the ability to sustain our writing group. Furthermore, the impact of our writing group, as a model, resulted in several other specialized writing groups within our school. Our writing group improved the knowledge and skills of nurse faculty and students in sustained writing efforts through successful scholarship dissemination, mentoring students, and advancing nursing education and practice.

Association between Day-to-Day Pulsatility Index Change and Neurocognitive Outcomes in Pediatric Traumatic Brain Injury.

Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality in children despite advances in prevention and mitigation strategies. Transcranial Doppler (TCD) ultrasound measures cerebral arterial circulation and allows for the calculation of pulsatility indices (PIs), which provides an assessment of cerebral blood flow changes. Yet, the use of PIs in children with TBI is not well understood. In this study, we defined the day-to-day (DTD) PI change of the anterior cerebral circulation and describe its relationship with injury characteristics and neurocognitive outcomes in children with TBI. A prospective observational parent study of 42 children, 2 months to 15 years of age, with mild or moderate-severe TBI who had serial TCDs provided data for this analysis. Both the mean and variation of DTD PI change were evaluated in the context of injury severity, injury sidedness, and neurocognitive outcome. In those with a unilateral injury, a larger mean DTD PI change in both the injured and uninjured side was found in those with a worse Glasgow Outcome Scale-Extended Pediatrics score at discharge. A larger variation in PI was associated with a worse neurocognitive outcome, irrespective of injury severity. Therefore, the mean and variation of DTD PI change may serve as a potential cerebral vascular biomarker of ongoing secondary injury. The use of PI measurements in the monitoring of children with TBI may provide clinicians with new diagnostic and prognostic insights to inform therapeutic interventions and recovery strategies. However, a larger prospective study is needed to confirm these findings and elucidate potential mechanistic links between DTD PI and clinical outcome measures. To our knowledge, this study is the first of its kind to evaluate the use of PI changes in cerebral vasculature in pediatric TBI patients admitted to the hospital.

Mystery in the Crib: An Interactive Case Study Experience.

Nurses and nurse practitioners are often required to process vast amounts of information while caring for neonates. The ability to process available information, analyze relevance, and collaborate with others requires specialized knowledge and skills. Mystery in the Crib is an innovative, critical thinking activity where neonatal nurse practitioner students are presented clues in the form of historical, diagnostic, and clinical data. Students are required to critical appraisal available information, collaborate with others to develop a plan of care, and present findings and a plan of care. Students demonstrated an enhanced ability to synthesis relevant clinical information, effectively collaborate, and develop comprehensive plans of care. While designed for graduate students, this activity was adapted for undergraduate and clinical practice application. Critical thinking and collaboration activities such as Mystery in the Crib are versatile and can be utilized by other specialties, various disease processes, and by all levels of learners.

Simulating Telehealth Experiences in the Neonatal Care Environment: Improving Access to Care.

Telehealth in the neonatal environment can improve remote medical care and access to specialized care and training eliminating barriers for effective health care delivery. Clinicians are utilizing telehealth in their practice to provide specialized care and training in areas that have little access. Educating health care clinicians on the basics of telehealth is an essential component of clinical training programs. Use of simulation-based telehealth experiences as part of that training can provide hands-on learning in a safe, realistic environment. Simulation can prepare health care teams in using telehealth technology in managing patient care, postdischarge care, and specialized care programs.

The evolution of a clinical scholars program through a pediatric nursing academic-practice partnership.

Academic-practice partnerships have the potential to improve clinical outcomes through joint initiatives focusing on nursing. Nurses at the bedside are able to greatly impact care, but often they lack the resources (time, knowledge, and expertise) to enact and facilitate quality improvement initiatives. Through an academic-practice partnership, academic and practice partners can work collaboratively to develop innovative evidence-based practice, quality improvement, and research projects. The benefits of these partnerships are far reaching as they involve faculty, students, and clinicians within the practice. In this article, we describe the development and evolution of a pediatric clinical scholars program that increases nursing engagement for leadership in evidence-based practice, quality improvement, and research projects to improve health outcomes.

Adolescent Girls and Alcohol Use: Increasing Concern During the COVID-19 Pandemic.

ABSTRACT: Adolescence is a time known for risky behaviors and often the initiation of alcohol use. Readily available, alcohol is often one of the drugs of choice for adolescents. Whereas in the past 30 years, the overall consumption of alcohol is down, the data in the past 10 years have shown more girls are binge drinking and meeting criteria for alcohol use disorder (AUD). The alarm of early alcohol use is the association with problems with the substances later in life. Historically, men and male adolescents consumed more alcohol than females. Recent studies indicate girls' alcohol use surpasses boys, whereas women now are developing AUD at the same rate as men. The consequences of early use can result in women's increased risk for multiple cancers, having a more severe form of AUD with less alcohol consumption as well as premature death. To further exacerbate this growing concern, the novel coronavirus (COVID-19) pandemic has created a perfect storm for increased use of alcohol to cope with the stress of living in an uncertain world. Normal daily activities have been halted with the uncertainty of school closures, zoom classroom sessions, and living in mandated social isolation. All nurses need to be screening for how families under their care have been managing stress. The time is opportune to educate and support parents in engaging their children in conversations around substance use. Parents can be supported to increase awareness of their own coping mechanisms and strengthen positive coping. Adolescents need support to strengthen interpersonal skills as well as make informed decisions concerning when and how they engage in alcohol consumption. This article will illuminate the growing need for all healthcare providers to assess and guide adolescents' coping skills during COVID with a focus on mental health, high-risk behavior, and alcohol use.

A Distance Accessible Education Model: Teaching Skills to Nurse Practitioners.

INTRODUCTION: Health care providers in rural areas are often unable to attend continuing education trainings due to limited staffing coverage. The coronavirus pandemic has created a unique situation, requiring many health care providers to obtain continuing education through virtual offerings. METHODS: This study used a descriptive design with a team-developed presurvey for demographics, 2 posttraining instruments, and a team-developed competency validation checklist. RESULTS: The study sample included nurse practitioner (NP) students and practicing NPs. All participants met competency in the skills validation. DISCUSSION: The results indicate that continuing education and competency validation of procedures is feasible in a virtual format.

Simulation to Enhance Communication Skills in Neonatal Nursing Practice.

Effective communication is essential to the delivery of safe, quality health care. Handoff reporting, situational reporting, interprofessional collaboration, caregiver communication, and team huddles are forms of status reporting and communication common in a neonatal nursing practice. Adequate training for health care professionals on effective communication techniques is often lacking. Simulation provides a method to develop and refine necessary communication skills for neonatal health care professionals and affords the opportunity for the learner to immerse into realistic clinical scenarios. The purpose of this article is to review communication techniques in the neonatal setting and describe methods of utilizing simulation to enhance communication skills for neonatal nursing practice.

Highlighting Simulation Practices in the Neonatal Environment.

Simulation is an effective teaching methodology to enhance clinical thinking and reasoning skills among nursing students and practicing nurses. The opportunity to practice in a safe environment maintains a structure that promotes learning at all levels. There are various levels of fidelity as well as cost to facilitate simulation in the neonatal setting. This at times hinders the ability to incorporate simulation into educational practices. The purpose of this article is to provide a discussion on simulation practices in the neonatal setting, an overview of low-cost neonatal simulation exemplars, and implications for practice.

Anxiety of Active and Passive Role Groups in Clinical Simulation: A Pilot Study.

Clinical simulation within nursing programs is a hallmark teaching strategy. With faculty challenged to design effective simulations for large groups of students, students are often divided into an active or passive role group. This study examined the anxiety levels experienced by students in the two roles. Results indicated that trait anxiety was similar in both groups before and after the simulation; however, there was a significant decrease in state anxiety ratings in the active role group following the simulation. The finding that students in the active role group experienced reduced state anxiety can theoretically facilitate learning.