Interprofessional collaboration to improve care for patients with diabetes.

BACKGROUND: The COVID-19 pandemic resulted in decreased access to routine diabetes care in rural areas and adversely affected self-management of diabetes. METHODS: This article describes a descriptive pretest-posttest study conducted to assess efficacy in managing hemoglobin A1C (A1C) among patients with type 2 diabetes mellitus (T2DM) using a continuous glucose monitoring (CGM) system for 1 year. RESULTS: A total of 14 participants completed the Diabetes Mellitus Self-Efficacy Scale survey. Of those 14, 11 used CGM for 1 year; of the 11 who maintained CGM use, A1C levels improved in 9. CONCLUSIONS: Results indicate that CGM combined with medication management positively impacts self-efficacy in managing A1C levels among patients with T2DM. Interdisciplinary collaboration optimizes patient outcomes.

Factors that predict NCLEX-RN success at a Historically Black College and University: A four-year retrospective study.

INTRODUCTION: Ensuring NCLEX-RN success for graduates of Historically Black Colleges and Universities (HBCUs) is integral to increasing Blacks and other racial/ethnic minorities underrepresented as registered nurses (RNs). PURPOSE: To examine the association between program type (traditional (TBSN) and accelerated Bachelor of Science [ABSN]) and first-time NCLEX-RN exam outcome. METHODS: A retrospective descriptive design was used. TBSN and ABSN students (n = 465) who graduated between 2015-2018 at an HBCU were examined. RESULTS: First-time pass rates for the total sample was 91.58%. Differences were observed between program type in 10 nursing courses for both programs, with Child Health being the only course predicting NCLEX-RN in both programs. In a multivariate logistic regression model, male students were 69% less likely to pass NCLEX-RN exam on first attempt compared to females, AOR = 0.31, p = 0.005. CONCLUSION: HBCUs can successfully prepare a diverse population of BSN graduates who pass NCLEX-RN on first attempt. Increased understanding of factors that decrease NCLEX-RN success of males is a prerequisite to development of strategies to ensure that all students have positive outcomes. There is also a need to understand differential relationships between nursing course grades and NCLEX-RN success among students enrolled in TBSN versus ABSN paths.

Blinded Comparison of Clarity, Proficiency and Diagnostic Capability of Tele-Cystoscopy Compared to Traditional Cystoscopy: A Pilot Study.

PURPOSE: In order to expand the availability of cystoscopy to underserved areas we have proposed using advanced practice providers to perform cystoscopy with real-time interpretation by the urologist on a telemedicine platform, termed "tele-cystoscopy." The purpose of this study is to have blinded external reviewers retrospectively compare multisite, prospectively collected video data from tele-cystoscopy with the video of traditional cystoscopy in terms of video clarity, practitioner proficiency and diagnostic capability. MATERIALS AND METHODS: Each patient underwent tele-cystoscopy by a trained advanced practice provider and traditional cystoscopy with an onsite urologist. Prospectively collected tele-cystoscopy transmitted video, tele-cystoscopy onsite video and traditional cystoscopy video were de-identified and blinded to external reviewers. Each video was evaluated and rated twice by independent reviewers and diagnostic agreement was quantified. RESULTS: Six tele-cystoscopy encounters were reviewed for a total of 36 assessments. Video clarity, defined by speed of transmission and image resolution, was better for onsite compared to transmitted tele-cystoscopy. Practitioner proficiency for thoroughness of inspection was rated at 92% for tele-cystoscopy and 100% for traditional cystoscopy. Confidence in identification of an abnormality was equivalent. Four of 6 videos had 100% agreement between reviewers for next action taken, indicating high diagnostic agreement. Additionally, provider performing cystoscopy and location did not statistically influence the ability to make a diagnosis or action taken. CONCLUSIONS: This model has excellent completeness of examination, equivalent ability to identify abnormalities and external validation of action taken. This pilot study demonstrates that tele-cystoscopy may expand access to bladder cancer surveillance.

The Health Wagon Partners with the Virginia Department of Health to Provide COVID-19 Testing in Rural Southwest Virginia.

The Health Wagon has been providing care for the rural population of southwest Virginia for the past 40 years. The mission of the Health Wagon is to provide quality health care to the medically underserved people in the mountains of Appalachia. It has expanded to two stationary clinics, three mobile units, and a mobile dental unit, logging over 19,000 patients encounters in the past year.

Nursing at historically black colleges and universities.

Historically Black Colleges and Universities (HBCUs) have been committed to educating diverse and underserved populations since their inception. Their commitments for over 100 years have resulted in increased diversity in many careers, but specifically in the field of nursing. HBCU nursing schools have been producing diverse nurses since shortly after the Emancipation Proclamation freed the slaves in 1863, and today HBCUs continue to educate, motivate, and develop nurses at every level, including associate, baccalaureate, master, and doctorate. With universal consensus on the need for a diverse and highly functional nursing workforce, both the historic and potential future impact and contributions of HBCUs should not be ignored. HBCU schools of nursing continue to be committed to producing baccalaureate nurses prepared to advance and lead health care in a variety of settings, from a variety of backgrounds. Their commitments to first-generation college students and those from socially and economically disadvantaged backgrounds, continue to be a hallmark characteristic of HBCUs, therefore, clearly pointing to their paramount role in producing the future of healthcare.