Successfully Increasing the Diversity of the Nursing Workforce in Rural South Carolina.

This innovative project was funded by the Health Resources and Services Administration (HRSA) Nursing Workforce Diversity (NWD) grant (2017), with a resultant increase in the diversity of the nursing workforce in the rural Pee Dee Region of South Carolina. The project provided resources to at-risk students (n = 100) and compared participants with a control group (n = 92). The project provided participants mentors, financial assistance, experiential learning, advising, and professional development. The project descriptively compared program outcome benchmarks between groups. The project's multifaceted approach was key to success, providing implications for other programs to increase diversity of the nursing workforce.

Using Simulation to Prepare Nursing Students for Professional Roles.

The current job market for nurses is variable and although there remains a projected shortage of nurses for the future, availability of entry-level positions has changed. This mixed-methods pilot study describes the successful use of simulated role-play to prepare senior nursing students (N = 66) for competitive job markets. The simulation laboratory was set up as a human resource department. The students and interviewers were evaluated by surveys. The majority of students rated the experience high for understanding interviews and assisting them with readiness for interviews. Qualitative results revealed themes of nervousness, confidence, and readiness. Interviewers also discussed student nervousness and the benefits of simulated interviews. These results affirmed that the overall learning outcome of the experience was positive and can assist in promoting professional role transition. The project will continue to be implemented, and it will be extended to graduate students in the future.

Feeding tolerance in preterm infants on noninvasive respiratory support.

To evaluate differences in feeding tolerance between infants maintained on continuous positive airway pressure (CPAP) and those receiving high-flow (nasal) cannula (HFC) with or without CPAP. This is a retrospective, cross-sectional study. Two groups of very low-birth-weight infants (750-1500 g) were compared on the basis of respiratory support: (1) infants born between the January 2002 and December 2004 treated with CPAP; and (2) infants born between January 2005 and December 2006 treated with HFC with or without CPAP. The groups were compared to determine which of the two attained full feedings sooner. Successful achievement of full feedings was measured in days from birth and defined by discontinuation of hyperalimentation-supplementation and attainment of 120 mL/kg/d of enteral feedings. A total of 185 infants met inclusion criteria (103 who received CPAP exclusively and 82 who received HFC with or without CPAP). There was no statistical difference in time to full enteral feedings between the 2 groups. There was also no difference in time of initiation of oral feeding or days to full oral feedings between 2 groups. The use of HFC was not associated with changes in feeding tolerance in premature infants. Further studies are needed to investigate efficacy and potential advantages and disadvantages to the use of HFC in the very low-birth-weight infant population.

An 8-week externship program designed for recruitment and retention.

This collaborative project focused on improving self-efficacy and emancipated decision-making skills for nursing learners during an 8-week externship program. The learners attended educational sessions about topics identified as stressful and were paired with a preceptor. The long-term purposes of this pilot program involve nurse recruitment and retention. Job placement and retention will be followed for 2 years. This article will discuss the short-term program outcomes: self-efficacy and emancipated decision making.

Development and revision of the Wittmann-Price Emancipated Decision-Making Scale.

BACKGROUND AND PURPOSE: The original Emancipated Decision-Making (EDM) scale was revised to test 3 subconcepts (flexible environment, personal knowledge, and awareness of social norms) of an emancipated decision-making process. METHODS: The original EDM scale was significantly related to the Satisfaction with Decision (SWD) scale in two separate studies (r = 0.79, r = 0.59). Two of the original 5 subconcepts showed a lack of contribution. The third study (N = 50) had good total scale reliability (r = 0.89). RESULTS: The revised EDM (EDM-r) scale was then leveled to the SWD scores and quantified into 2 categories and the subscales for the 3 subconcepts were reanalyzed for reliability and scale-if-item contribution. CONCLUSION: The final EDM-r is a generically worded, 20-item, 3-subscale instrument with good total and individual subscale reliability.

Use of personal phones by senior nursing students to access health care information during clinical education: staff nurses' and students' perceptions.

Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smartphones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource.

The olfactory sense: a developmental and lifespan perspective.

AIM AND OBJECTIVE: The objective of this literature review is to discuss human olfactory development, function and assessment through the lifespan. This article will highlight the importance of accurate olfactory function assessment. BACKGROUND: Olfactory function in humans is an understudied sense and may contribute significantly to patient safety and quality of life. Studies related to olfactory function are presented for different life stages. Olfactory development is reviewed as is terminology used to describe functionality. This article highlights the need for nursing assessment of olfactory function to develop holistic nursing interventions since there are implications for patient safety, quality of life issues related to respiratory function, bonding and nutrition. DESIGN: Literature review. METHOD: Articles were searched in CINAHL, PsychInfo and PubMed limited to those published in English to 2010 with the key terms 'olfactory and nursing'. The search yielded 47 articles that were clinically based on patient care. Those articles that dealt specifically with traumatic brain syndrome were excluded. However, peer reviewed and research article were both specified. RESULTS: There is evidence that olfactory assessment should be completed by nurses on high risk populations to ensure patent safety and enhance quality of life. CONCLUSIONS: More studies are needed to improve clinical knowledge about the role of olfactory function. RELEVANCE TO CLINICAL PRACTICE: Nurses are in a prime position to assess olfactory function for patients at high risk for deficits to provide holistic nursing care.

Elective Cesarean births: are women making emancipated decisions?

This mixed method study investigated the extent to which women used emancipated decision making when selecting a birth method, whether they perceived they had a choice, and if they were satisfied with their decision. Findings suggest that vaginal birth is still the preferred method of delivery for these study participants.

Physical assessment: a continuing need for clarification.

PROBLEM: Physical assessment skills are a mainstay of the nursing process and are taught to pre-licensure learners. Little research has been conducted on the skills that are actually used in practice compared to those that are taught in pre-licensure education. METHOD: This article provides an integrated literature review regarding physical assessment skills and their practical application. FINDINGS: Physical assessment skills are consistently referred to as part of the first step of the nursing process, but further clarification about which skills are included in the definition is needed. CONCLUSIONS: Further research is needed to clarify if what is taught is actually used and to what extent in clinical practice.

Objectives and outcomes: the fundamental difference.

This discussion focuses on the difference between educational objectives and outcomes. Both terms are used in nursing education, many times for the same purpose, yet they are expressions of different educational paradigms. A historical view of the development of objectives and outcomes is provided as well as a description of each. The discussion concludes with a demonstration of formats for developing educational outcomes.

Creating opportunities for successful international student service-learning experiences.

Healthcare and educational expeditions to developing countries are a life-altering experience for both faculty and students. The benefits gained personally and professionally from foreign travel are invaluable. Providing healthcare to people in developing countries gives a new dimension to holistic care. Proper trip preparation with consideration of safety, legal liabilities, and educational goals is a necessity to ensure positive outcomes for patients, students, faculty, and the university or college. This article extracts lessons learned from an actual trip and dissects them from a safety, legal, and educational standpoint. The information presented is a "must read" for any faculty member considering embarking on a healthcare expedition with students to a developing country.

Strategies to promote deep learning in clinical nursing courses.

To help promote students' long-term memory retention of nursing concepts, the authors implemented deep-learning strategies. They discuss their strategies and the learning outcomes.

Reexploring the subconcepts of the Wittmann-Price Theory Of Emancipated Decision Making in women's healthcare.

This study explored the 5 subconcepts (empowerment, flexible environment, personal knowledge, reflection, and social norms) of the Wittmann-Price Theory of Emancipated Decision Making (EDM) in women's healthcare, a theoretical model. Pain management for labor was the clinical exemplar. The correlation of EDM and satisfaction with the decision (SWD) was measured, and flexible environment was the subscale with the highest mean score. There was a significant relationship between EDM and SWD (r = 0.70, P < .001). Personal knowledge and flexible environment were the best predictors of satisfaction. This study advances the theory of EDM for the nursing care of women.

Emergency Nurse Documentation Improvement Tool.

Nursing documentation for trauma resuscitation has improved significantly at our level I trauma center because of the introduction of our Emergency Nurse Documentation Improvement Tool (END-IT). The END-IT system was implemented as a performance improvement model and utilizes existing computer software. It provides quick computerized feedback to professional nurses when documentation of trauma cases needs further attention. The feedback is provided in written form and uses peer mentoring to improve accountability in documentation. The program has been successful and has decreased documentation omissions and mistakes by 21%.

And two become one: unit integration.

Time and space must take on a new dimension for nursing care as health systems evolve into expanded networks.

Exploring the subconcepts of the Wittmann-Price theory of emancipated decision-making in women's health care.

PURPOSE: To explore the subconcepts of the Wittmann-Price Theory of Emancipated Decision-Making (EDM); which is proposed as a new theoretical model for the nursing care of women to increase women's satisfaction with decision-making about healthcare issues. Infant feeding method was used as the clinical exemplar. DESIGN AND METHOD: A descriptive correlational design was used to test the five identified subconcepts of EDM (empowerment, flexible environment, personal knowledge, reflection, and social norms) in women's healthcare. The relationship of emancipated decision-making and satisfaction were explored with the Subject Demographic Questionnaire (SDQ), the Wittmann-Price Theory of Emancipated Decision-making Scale (EDMS), and the Satisfaction with Decision (SWD) scale. The research design was retrospective, without random sampling of subjects. Four research questions were posed for this investigation. Women who had uncomplicated deliveries and met the selected criteria were enrolled (N=97). FINDINGS: All five subconcepts of EDM were scored on subscales on the EDMS; flexible environment and personal knowledge had the highest mean scores. Pearson correlations showed that all five subscales were significantly related to each other except reflection with personal knowledge and reflection with social norms. A significant relationship was found between the EDM and satisfaction with the decision. Personal knowledge and flexible environment were the best predictors of satisfaction with the decision. CONCLUSIONS: The Wittmann-Price Theory of EDM is a theoretical model with implications for nursing care of women who are involved in a healthcare decision, such as choice of infant feeding. Further studies are needed to determine the importance of each of the subconcepts in relation to emancipated decision-making.

Get creative with performance improvement plans.

Initiate a performance improvement plan to facilitate nursing education and recruitment.