Our New Normal: Pediatric Nurse Residents' Experiences with Transition to Practice during the COVID-19 Pandemic.

This phenomenological qualitative study examined the lived experience of pediatric nurse residents' transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I'm Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents' narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic.

Don't Ask, Won't Tell: Suicide Screening in the Pediatric Perioperative Setting.

Suicide is the second leading cause of death for children and adolescents ages 10-19 in the United States. Globally, suicide is the fourth leading cause of death among adolescents and young adults ages 15-29. The World Health Organization identifies suicide prevention and promotion as a public health priority. In the United States, one of the key prevention strategies has been the recognition of the need for screening, particularly for children and adolescents. The American Academy of Pediatrics (AAP), National Institute of Mental Health (NIMH), and the Joint Commission recommend suicide risk screening for those ages 10 and older. Research has shown that children and adolescents won't disclose suicidal thoughts unless directly asked. Perioperative units in pediatric hospitals are uniquely positioned to integrate suicide screening as part of the nurses' pre-operative assessment of surgical patients. Utilizing pre-operative units for screening can identify at-risk patients who otherwise may not be screened. The purpose of this evidence-based practice (EBP) project was to determine if a one-time, educational intervention highlighting the importance of universal suicide screening in pediatric patients 10 years old or older would affect the beliefs and comfort level of pediatric perioperative nurses. The survey assessed perioperative nurses' beliefs and comforts around suicide screenings for patients ages 10 and older in the perioperative unit. Twenty-minute educational unit-based in-services were provided over a 2-week period to all current staff. The survey was then repeated to assess for changes in nurses' beliefs and comfort. Pre-educational intervention, 43.5% of participants did not believe it is important to ask patients about suicidal thoughts. Only 60.9% of participants agreed that all patients 10 years and older should be assessed for suicidal risk, regardless of behavioral health history. After the educational intervention, all perioperative nurse participants (n = 22) agreed it was important to ask patients about suicidal thoughts and to screen all patients 10 years and older for suicidal risk, not just behavioral health patients. Post-education, all participants (100%) agreed it was important to ask patients about suicidal thoughts and believed patients 10 years and older should be assessed for suicidal risk. Early detection through screening is crucial to combating this growing health crisis for children and adolescents. Educational in-services strengthened this group of perioperative nurses' understanding of the importance and feasibility of universal suicide screening in their unit. Responses from this EBI can potentially help guide the educational component of pediatric hospitals' initiatives to implement suicide screening.

Impact of an Evidence-Based Pediatric Palliative Care Program on Nurses' Self-Efficacy.

Background The purpose of this study was to determine the effect of a 1-day evidence-based pediatric palliative care continuing professional development program on nurses' and advanced practice registered nurses' perceived self-efficacy regarding palliative care. Method The revised Pediatric Palliative Care Questionnaire was administered to participants before and after a 7½-hour program. A multimodal approach was used to teach topics specific to pediatric palliative care. Results Thirty-one participants completed questionnaires. Notably, most of the participants had provided palliative or end-of-life care, but few had previous education specific to pediatrics. The self-efficacy scores of the participants significantly increased after program attendance (Z = 3.53, p < .001). Conclusion Continuing professional development in pediatric palliative care improves nurses' and advanced practice registered nurses' confidence in their skills to provide this care. Findings of this study support the need for pediatric-specific education in nursing training programs and continuing professional development offerings. Continuing education may be the key to improving access to high-quality care for children living with serious illness and their families. [J Contin Educ Nurs. 2022;53(6):264-272.].

A Nursing Research and Evidence-Based Practice Fellowship Program in a Magnet®-designated pediatric medical center.

AIM: To describe the structure and outcomes related to a nursing research and evidence-based practice fellowship program in a Magnet®-designated pediatric medical center and explore perceptions of knowledge, skills, and barriers to evidence-based practice and research. BACKGROUND: The Magnet® Recognition Program is a model for nursing excellence that promotes nursing research and evidence-based practice. Studies show that nurses need assistance in overcoming common barriers to scholarly inquiry, including knowledge and skills, confidence, scarce time, and financial support. The fellowship program was developed to reinforce institutional goals related to nursing scholarship and Magnet® designation. METHODS: A pre-test post-test repeated measures study assessed fellowship program outcomes immediately before, after, and at one year post program completion. Data collected included descriptive data related to the fellowship program participants and projects. The 49-item Developing Evidence-Based Practice Questionnaire survey evaluated evidenced-based practice knowledge and skills. RESULTS: Over a 5-year period, 22 (+2 pilot) participants graduated from the fellowship program with a total of 9 completed projects (+1 pilot) and 1 ongoing study. The fellowship program helped to overcome some common obstacles related to skill and confidence in using research evidence and completing scholarly projects. Many improvements were sustained over time. The greatest barrier to nursing inquiry, time, needs continued attention, as this was reported as an enduring limitation to nursing scholarship. CONCLUSION: The fellowship program reinforced and enhanced the organizational commitment to building and sustaining a passion for clinical inquiry through research and evidence-based practice, supporting the requirements of a Magnet®-designated hospital. Continued support is needed to garner nursing success.