Academic-Practice Partnership Pivot During COVID-19 Pandemic Surge.

Health care systems continue to experience the sequential aftermath of the COVID-19 pandemic, with major care access, quality, safety, financial sustainability, and workforce considerations. Yet, academic-clinical partnership opportunities exist for transformational change, even when efforts to respond to a pandemic seem insurmountable. A nursing partnership between an academic health center nursing school and university health system provided short- and long-term support for the nursing workforce shortage during a COVID-19 surge. An academic-clinical integration framework guided planning, clinical support activities, outcomes achieved, technology innovations, and shared lessons associated with these efforts. The COVID-19 surge response steps included a call to action, preparation for surge support by the academic and clinical partners, and a team approach for clinical service delivery by faculty, students, and staff. Through the 6-week COVID-19 surge response, more than 10 000 hours of hospital nurse staffing were provided by nursing school faculty and students; over 770 worked shifts that provided approximately 30% of the full surge hospital supplemental staffing and approximately 46 000 vaccine encounters. Well-established academic-clinical nursing partnerships allow for quick pivots in the rapidly changing COVID-19 environment that can enhance nursing clinical proficiency and competency, augment clinically immersive learning, and reinforce analytics to measure health outcomes, lower costs, improve access, quality, safety, and workforce conditions.

Race, regionality and pre-diabetes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

OBJECTIVE: To determine the association between race, region and pre-diabetes. METHOD: The study used 2003-2007 United States baseline data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study for this cross-sectional analysis. Participants in this study were 45years or older at recruitment. Logistic regression was used to assess whether race and region are associated with pre-diabetes independent of demographics, socioeconomic factors and risk factors. RESULTS: Twenty-four percent of the study participants (n=19,889) had pre-diabetes. The odds ratio (95% confidence interval) for having pre-diabetes was 1.28 (1.19-1.36) for blacks relative to whites and 1.18 (1.10-1.26) for people living in the Stroke Belt region relative to the other parts of the United States. The odds of having pre-diabetes for Stroke Belt participants changed minimally after additional adjustment for race (OR=1.20; 1.13-1.28), age and sex (OR=1.24; 1.16-1.32), socioeconomic status (OR=1.22; 1.15-1.31) and risk factors (OR=1.26; 1.17-1.35). In the adjusted model, being black was independently associated with pre-diabetes (OR=1.19; 1.10-1.28). CONCLUSION: The prevalence of pre-diabetes was higher for both blacks and whites living in the Stroke Belt relative to living outside the Stroke Belt, and the prevalence of pre-diabetes was higher for blacks independent of region.

Innovative Model to Recognize Previous Military Training of BSN Students.

BACKGROUND: Many of our military transitioning to civilian life are expertly trained medics, corpsmen, and health care specialists. PROBLEM: The medical training of these veterans does not follow traditional degree granting academic protocols. These individuals seeking formal academic credentials to work in the nonmilitary sector are often forced to start their health education over from the beginning. APPROACH: An innovative model was developed for waiving the requirements for specific nursing courses for veteran-students. Using a skills self-assessment tool and a validation process, veteran-students are able to demonstrate their knowledge, training, and experience. OUTCOMES: As part of the program, 32 veteran-students have validated out of 65 courses for 115 credit hours. All students have successfully progressed through the BSN program. CONCLUSION: This skills validation model represents a model that can be implemented for students entering a nursing program with a variety of health care backgrounds.

Strengthening universal health: development of a nursing and midwifery education quality improvement toolkit.

OBJECTIVE: to present the development of a toolkit for education quality improvement in universal health and primary health care, targeting schools of nursing and midwifery in Latin American and Caribbean countries. METHODS: an expert work group conducted a systematic literature review, selected key content and completed toolkit drafting, using an iterative consensus approach. International partners reviewed the toolkit. Cognitive debriefing data were analyzed, revisions and new tools were integrated, and the final version was approved. RESULTS: twenty-two articles were identified and mapped as resources. The Model for Improvement, a data-driven approach to performance analysis, was selected for its widespread use and simplicity in carrying out the following steps: 1) organize a team, 2) assess improvement need regarding universal health and primary health care education, 3) set an aim/goal and identify priorities using a matrix, 4) establish metrics, 5) identify change, 6) carry out a series of Plan-Do-Study-Act learning cycles, and 7) sustain change. CONCLUSIONS: the Education Quality Improvement Toolkit, developed through stakeholder consensus, provides a systematic, and potentially culturally adaptable approach to improve student, faculty, and program areas associated with universal health coverage and access.

Parent-adolescent communication and diabetes: an integrative review.

AIM: This paper presents a synthesis of findings from empirical studies about communication and interaction between parents and their adolescents with diabetes. BACKGROUND: Communication between parent and adolescent is essential in transitioning the adolescent to increased responsibility for diabetes self-management. Nurses are in a pivotal position to enhance the type of parent-adolescent communication that facilitates this transition. DATA SOURCES: A search of published studies from 1985 to 2006 featuring communication or interaction between parents and adolescents with type 1 diabetes was implemented through a computerized search. REVIEW METHODS: Papers were organized by type of evidence and were analysed sequentially. Sources were described based on data elements which were extracted. Findings in the areas of productive and problematic parent-adolescent communications were included. Data elements were compared and critiqued, noting consistencies, and findings were summarized and evaluated. RESULTS: Studies across several countries indicate that maternal support, conflict, control, involvement and emotional expression are important communication concepts that are linked to diabetes outcomes in adolescents. The influences of different family structures and cultural and socioeconomic circumstances, as well as developmental status and gender of adolescents on these types of communication, have not been systematically studied. CONCLUSION: Nurses caring for adolescents with type 1 diabetes need to consider family relationships and communication patterns in achieving health outcomes. Studies of communication, including perspectives of mothers and fathers, and the influence of family structure, economics and culture are needed to build a framework of parent-adolescent interaction and health outcomes for adolescents with type 1 diabetes.

Student Success Survey: Supporting Academic Success for At-Risk Nursing Students Through Early Intervention.

Diversity in the nursing workforce has a positive impact on the quality of care provided to minority patients. Although the number of students from diverse backgrounds entering nursing programs has increased, the attrition rate of these students remains high. This study assessed the construct validity of a self-assessment tool that can be used by faculty advisors to determine individual academic needs of students.

Family stress, family adaptation, and psychological well-being of elderly coronary artery bypass grafting patients.

As our population ages, more elderly patients will undergo coronary artery bypass grafting. The psychological well-being of a patient is influenced by many factors, including family support. This descriptive, correlational pilot study was conducted to examine the relationship between family characteristics and psychological well-being in elderly coronary artery bypass grafting patients. The results of this study, which consists of 42 participants, are presented, as well as implications for critical care nursing.