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BACKGROUND: Tobacco use remains the leading cause of preventable disease, disability, and death in the United States and is a significant cause of health disparities. PURPOSE: The purpose of this paper is to update the Tobacco Control policy paper published over a decade ago by the American Academy of Nursing's Health Behavior Expert Panel Tobacco Control subcommittee. METHODS: Members reviewed and synthesized published literature from 2012 to 2024 to identify the current state of the science related to nurse-led tobacco dependence treatment and implications for nursing practice, education, and research. FINDINGS: The results confirmed that nurse-led tobacco dependence treatment interventions are successful in enhancing cessation outcomes across settings. DISCUSSION: Recommendations for nursing leaders include: promote tobacco dependence treatment as standard care, accelerate research on implementation of evidence-based treatment guidelines, reduce health disparities by extending access to evidence-based treatment, increase nursing competency in providing tobacco treatment, and drive equity-focused tobacco control policies.
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OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.
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The Southeastern Conference (SEC) Nursing Dean's Coalition is a purposeful alliance organized to collaboratively address several challenges that arose during the COVID-19 pandemic. Over the last three years, this strategic team of academic leaders has evolved from a crisis response team to a multidimensional support team, leveraging both individual and collective strengths, to provide several benefits to the dean members, as well as other SEC nursing faculty members, students, and institutions. Participation has grown from the original 12 deans to engage a broader team of associate deans and nurse leaders in faculty development, research, service, and diversity, equity, and inclusion. This article describes the origin, evolution, and outcomes of this coalition to date, as well as visions for the future.
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Liderazgo , Pandemias , Humanos , Docentes de Enfermería , PredicciónRESUMEN
OBJECTIVE: The aims of this study were to explore the health of nurse leaders and assess intentions to integrate workplace mental health/wellness practices. BACKGROUND: National efforts address high rates of poor mental health and lifestyle behaviors among nurses. Few studies describe the extent to which nurse leaders in academic and clinical environments can influence a strategic mission for health/well-being among the nursing workforce. METHODS: Two hundred seventeen email invitations were distributed to nurse leaders from 5 Kentucky nursing organizations to complete a 1-time 46-item online survey assessing individual health behaviors and intentions to build a culture of workplace health/well-being. RESULTS: Most respondents reported positive physical health (86%), positive mental health/intentions for action to change behaviors (80%), improved self-care practices (86%), integration of self-care practices in the workplace (79%), and commitment to integrate suicide prevention training (55%). CONCLUSIONS: Overall, nurse leaders reported positive healthy behaviors. The finding that the highest intentions were reported to integrate, sustain, and/or advance lifestyle behaviors for self-care practices as well as to integrate practices for mental health and well-being in the work environment is encouraging. Enhanced strategies and efforts are needed to prioritize workplace cultures of wellness to benefit nurses and further promote well-being among nurse leaders.
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Salud Mental , Personal de Enfermería , Humanos , Intención , Lugar de Trabajo/psicología , Recursos HumanosRESUMEN
Introduction: Multiple recent critical societal/world events have impacted nurses' beliefs and emphasized the importance of the standards of behavior that frame nurses' professional values. Objectives: This study focused on the professional values of students in a Doctor of Nursing program (DNP), including the relationship between professional values, time in program, and intentions to participate in professionalism-focused activities. Methods: From fall 2019 through Spring 2021, 227 participants were invited to participate in this study through the completion of an online survey at several points in time. The survey contained various demographic variables, items from the Nurses Professional Values Scale-3 representing the dimensions of caring, activism, and professionalism, and Likert scale items that measured intentions to participate in professionalism-focused activities. Results: The overall mean NPVS-3 score was 118.30 (out of a possible range of 28-140). The highest mean score among the three dimensions was for caring (45.38), followed by activism (40.20) and then professionalism (32.71). Students indicated high intentions to participate in activities focused on professionalism (5.77 on a scale of 1 to 7). A moderate correlation between intentions and professionalism (r = .44, p < .0001) was noted. The association of intentions to caring and activism was weaker but significant (r = 0.26; p = .012) and (r = 0.37; p = .0003), respectively. Conclusion: DNP curricular efforts can strengthen nurses' professional values by focusing on the development of critically important professional attributes. Nurses, especially those who have a doctoral-level education, need to have strong professional values and understand the importance of their voice and impact as a leader in the profession.
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BACKGROUND: Make It POP (Pathway Optimizing Professionalism) Series (MIPS) leadership educational sessions were developed and taught by the Dean as a curricular focus on professionalism for Doctor of Nursing Practice (DNP) students. PURPOSE: Evaluating the association between Behavioral Beliefs, Normative Beliefs, Control Beliefs, and Intention to advance professional identity and values was a focus of this study. A secondary focus was to discern whether these Belief measures and attendance to the MIPS education series were predictive of Intention to increase professional identity and values. METHOD: Over a two-year period, 227 students were invited to attend the MIPS courses, which included four once per semester sessions. Students were invited to complete a survey structured around the tenants of the Theory of Planned Behavior prior to attending the MIPS and following each session; 91 students completed the survey at least once. RESULTS: A significant relationship was not noted between attendance to one or more MIPS sessions and Intention to advance professional identity and values. Behavioral Beliefs and Control Beliefs had the strongest associations with Intentions, but normative beliefs were not significantly associated with Intentions. CONCLUSION: Integrating curricular innovation with meaningful engagement and reflection in DNP education may advance DNP student's commitment for sustained professional growth.
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Intención , Estudiantes de Enfermería , Humanos , Liderazgo , Proyectos Piloto , ProfesionalismoRESUMEN
PURPOSE: The purpose of Cultivating Practices for Resilience (CPR) was to develop, implement, and evaluate college-wide strategic initiatives to promote wellness and resilience and improve mental health outcomes in baccalaureate nursing students. DESIGN AND METHODS: Six hundred and fifty-four students were invited to complete a 24-item survey over 3 weeks in 2021. Descriptive statistics/logistic regression were used for data analysis. FINDINGS: One hundred and thirty-one students completed the survey; 61% were sophomores. White students (p = 0.024) and males (p = 0.023) had higher intentions to refer colleagues to mental health services. Those perceiving CPR programming more helpful had higher intentions to refer (p < 0.001) and embrace the ANA's Healthy Nurse Healthy Nation™ campaign (p < 0.001). PRACTICE IMPLICATIONS: Stronger strategic efforts are needed to help shape an academic culture for cultivating practices for resilience among baccalaureate nursing students, especially females and underrepresented population groups.
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Bachillerato en Enfermería , Resiliencia Psicológica , Estudiantes de Enfermería , Masculino , Femenino , Humanos , Estudiantes de Enfermería/psicología , Proyectos Piloto , Encuestas y CuestionariosRESUMEN
PURPOSE/OBJECTIVES: The hCATS (health Colleges Advancing Team Skills) to CPR (Cultivating Practices for Resilience) Camp was an interprofessional pilot program to promote resilience, introduce strategies for coping with stress, cultivate compassion, and promote work-life balance to prevent burnout among health profession students, faculty, and healthcare professionals who team to provide patient care. PROGRAM DESCRIPTION: The University of Kentucky (UK) College of Nursing received funding to partner with the UK Center for Interprofessional Health Education for immersive weekend activities utilizing KORU and Mindfulness Based Stress Reduction models, conducted by certified UK faculty experts in self-stewardship techniques such as mindfulness practices. OUTCOMES: Thirty-nine participants from 7 UK colleges and UK HealthCare participated in 4 distinct CPR Camps, completed program assessments, and created team projects. Mean scores from each cohort significantly increased in a retrospective pre/post analysis of student perception of knowledge in all of the following categories: (1) habits and practices for resilient people, (2) strategies for building resilience and preventing/coping with stress/burnout in self and others, and (3) work-life balance (with the exception of cohort 4, for work-life balance). Students indicated on open-response items specific strategies they were willing to adopt going forward. These outcomes met our objectives for developing participants' understanding of resilience practices and adopting useful stress reduction practices. Planning and implementation of team projects successfully brought different professions together to advance learning in resilience. CONCLUSION: The CPR Camp initiative is an effective model for promoting and sustaining resilience-building strategies among health profession students. Similar programming conducted and/or attended by academic and/or health system leaders, such as clinical nurse specialists, can help cultivate practices for resilience among the members of the interprofessional workforce, enabling teams to better cope with stress, prevent burnout, and ultimately improve team-based care delivery for patients and their families.
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Relaciones Interprofesionales , Resiliencia Psicológica , Estudiantes del Área de la Salud/psicología , Adaptación Psicológica , Agotamiento Profesional/prevención & control , Femenino , Humanos , Masculino , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Estrés Psicológico/psicología , Estudiantes del Área de la Salud/estadística & datos numéricos , Equilibrio entre Vida Personal y LaboralRESUMEN
In a first of its kind authentic clinical interprofessional education (IPE) experience, University of Kentucky (UK) health profession students joined dental students to implement a pilot program to promote oral health and wellness with children living in underserved Appalachian communities. Known as hCATS (Health Colleges Advancing Team Skills) to Appalachia, a total of 113 students participated in interprofessional teams of 48 health profession students paired with 65 dentistry students to provide health services. Although the UK College of Dentistry has provided sealant services (tooth decay prevention) to elementary school children for several decades in eastern Kentucky counties, funding through the UK Women and Philanthropy Network allowed services to expand to include general health screening and age-appropriate education on oral health, nutrition, exercise, and prevention of substance abuse. The UK Center for Interprofessional Health Education (CIHE) coordinated the efforts for students from the colleges of Communication and Information Sciences, Health Sciences, Nursing, Pharmacy, Public Health, and Social Work. In addition to the clinical experience in the elementary schools, nursing and other health profession students explored the health resources of the communities visited and reflected on their experience in collaborative practice that the program was designed to encourage. The authors noted positive outcomes with interprofessional education competencies, although more structure for collaboration is required to ensure students who work with other professions in an authentic clinical setting can gain early relevant practice in, and experience the benefits of, collaborative patient care.
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Protección a la Infancia , Promoción de la Salud , Relaciones Interprofesionales , Salud Bucal , Estudiantes de Odontología , Estudiantes de Enfermería , Adulto , Región de los Apalaches , Niño , Curriculum , Educación en Odontología , Educación en Enfermería , Femenino , Humanos , Kentucky , Masculino , Proyectos Piloto , Población Rural , Estudiantes del Área de la Salud , Adulto JovenRESUMEN
BACKGROUND: In 2015, the majority of U.S. American Association of Colleges of Nursing (AACN)-accredited schools of nursing resided on campuses without smoke-free policies. PURPOSE: To determine the presence of smoke-free policies at AACN-accredited after resolutions from AACN and the American Academy of Nursing, and the creation of online resources. METHODS: Smoke-free policies (2015-2017) were determined through listings on the ANRF College Campus Policy Database© and survey responses from nursing deans. RESULTS: Smoke-free policies for 689 schools of nursing increased from 36% in 2015 to 91% in 2017. There were no significant differences by nursing program types or geographic area. Twenty percent of deans reported using the resources, with over 1700-page views. CONCLUSION: Smoke-free policies increased after support from two national nursing organizations. Learning in a smoke-free environment should be an expectation for nursing students to protect their own health, and to support their future critical role in tobacco control.
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Política de Salud/tendencias , Facultades de Enfermería/normas , Facultades de Enfermería/tendencias , Política para Fumadores/tendencias , Universidades/normas , Universidades/tendencias , Predicción , Humanos , Encuestas y Cuestionarios , Estados UnidosRESUMEN
OBJECTIVES: There is no safe or risk-free level of tobacco use or tobacco smoke exposure. In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention. METHODS: Ps/Cs and children were recruited from 14 elementary schools across rural and urban settings. Approximately one-fourth (24.3%; n = 110) of the total Ps/Cs enrolled in the randomized controlled trial (n = 453) were smokers, predominantly women (80.9%), with a mean age of 37.7 years. (SD 12.2); 62.7% were African American, 44% had less than a high school education, and 58% earned <$20 000 annually. P/C smokers were offered a tailored cessation intervention in years 1 and 2. Self-report smoking status and saliva cotinine were obtained at baseline, the end of treatment (EOT) and/or year 2, and in the year 4 follow-up. RESULTS: Ps/Cs in the intervention group showed a larger increase in self-reported smoking abstinence over time (EOT: 6.5% [SE = 5.7%]; year 4: 40.6% [SE = 5.7%]) than the control group (EOT: 0.0% [SE = 6.5%]; year 4: 13.2% [SE = 6.4%]; F = 4.82; P = .0306). For cotinine, the intervention group showed a decrease from baseline (239.9 [SE = 1.3]) to EOT 99.3 [SE = 1.4]) and then maintenance through year 4 (109.6 [SE = 1.4]), whereas the control group showed increases from baseline (221.1 [SE = 1.4]) to EOT (239.0 [SE = 1.4]) to year 4 (325.8 [SE = 14]; F = 5.72; P = .0039). CONCLUSIONS: This study provides evidence that tailored cessation offered to Ps/Cs in their children's schools during their children's enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.
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Contaminación del Aire Interior/prevención & control , Cuidadores/psicología , Exposición a Riesgos Ambientales/prevención & control , Padres/psicología , Cese del Hábito de Fumar , Contaminación por Humo de Tabaco/prevención & control , Adulto , Biomarcadores/análisis , Niño , Cotinina/análisis , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Saliva/química , Autoinforme , Factores Socioeconómicos , Fumar Tabaco/prevención & controlRESUMEN
Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.
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Centros Médicos Académicos , Práctica del Docente de Enfermería/organización & administración , Investigación en Enfermería/organización & administración , Facultades de Enfermería , Conducta Cooperativa , Humanos , Relaciones Interinstitucionales , Kentucky , Liderazgo , Modelos Organizacionales , Práctica del Docente de Enfermería/normas , Investigación en Enfermería/normas , Desarrollo de Personal/métodos , Desarrollo de Personal/organización & administración , Desarrollo de Personal/normasRESUMEN
BACKGROUND: Despite years of reducing tobacco use, few studies describe to what extent evidence-based tobacco-cessation interventions are a standard of acute and critical care nursing practice using the US Public Health Service 5 A's framework: ask, advise, assess, assist, and arrange. OBJECTIVES: To identify relationships between the 5 A's framework, attributes of individual and organizational excellence, and intention to integrate tobacco-cessation interventions as a standard of daily practice among nurses. METHODS: Nurses attending the American Association of Critical-Care Nurses National Teaching Institute were invited to complete a 21-item survey. Data were gathered in Boston, Orlando, and Chicago in a 3-year period. Descriptive statistics and logistic regression were used for data analysis. RESULTS: Among 1773 completed surveys, nurses from organizations with standing orders for tobacco dependence were 5 times more likely to have high confidence in their 5 A's skills (odds ratio, 5.037; 95% CI, 3.429-7.400; P < .001) and 3.4 times more likely to have high intentions to integrate tobacco cessation into their daily practice (odds ratio, 3.421; 95% CI, 1.765-6.628; P < .001). Nurses with certifications were more likely to want to learn how to integrate tobacco-cessation interventions (odds ratio, 1.676; 95% CI, 0.990-2.836; P = .05). CONCLUSIONS: Opportunities abound to create strategies leveraging attributes of nursing and organizational excellence to promote evidence-based approaches to improve health outcomes in acutely and critically ill tobacco-dependent populations.
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Cuidados Críticos/métodos , Personal de Enfermería en Hospital/organización & administración , Objetivos Organizacionales , Cese del Hábito de Fumar/métodos , Adulto , Anciano , Certificación/normas , Competencia Clínica , Femenino , Adhesión a Directriz , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/normas , Oportunidad Relativa , Guías de Práctica Clínica como AsuntoRESUMEN
INTRODUCTION: Tobacco remains the leading cause of preventable death in the United States. Recognizing that smoke-free policies can significantly reduce tobacco-related morbidity and mortality by preventing exposure to second-hand smoke and increasing quit rates, members of the Tobacco Control Subgroup of the American Academy of Nursing's (AAN) Health Behavior Expert Panel launched a health policy initiative entitled the Smoke-Free Campus Policy for Schools of Nursing Campaign. Designed as a two-phased initiative, the Campaign is a Call to Action to increase smoke-free policies on campuses with Schools of Nursing across the United States by 2020. METHODS: Phase I of the AAN Campaign included a cross-sectional study using secondary data analysis to describe the presence of smoke-free policies on campuses of Schools of Nursing across the United States. A list of colleges and universities with smoke-free policies maintained by the Americans for Nonsmokers Rights Foundation in January 2015 was accessed to conduct the analysis. Schools of Nursing granting baccalaureate and graduate nursing degrees were included. Descriptive statistics were obtained for Schools of Nursing by region of the country and by highest level of nursing degree program of study at each institution. RESULTS: Smoke-free policies of 689 Schools of Nursing were examined. Of these, 442 (64%) did not have 100% smoke-free policies on their campuses. A greater percentage of nursing schools without a smoke-free policy were located in the Northeast (114, 79%) and West (70, 73%). Nearly half (57, 46%) of the Schools of Nursing with a PhD/DNS program had a smoke-free policy in place compared with all other degree program levels (BS/BSN: 69, 35%; MS/MSN: 83, 35%; DNP: 38, 30%). CONCLUSIONS: With only 247 (36%) of Schools of Nursing on campuses with comprehensive smoke-free policies, more must be performed to promote healthy learning and working environments for nursing students, staff, and faculty. As public health advocates, nursing leaders in Schools of Nursing have a moral and ethical imperative to advance tobacco control on college campuses to meet the American College Health Association goals for smoke-free/tobacco-free environments.
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Promoción de la Salud/legislación & jurisprudencia , Facultades de Enfermería/legislación & jurisprudencia , Facultades de Enfermería/estadística & datos numéricos , Política para Fumadores , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Contaminación por Humo de Tabaco/prevención & control , Universidades/legislación & jurisprudencia , Estudios Transversales , Política de Salud , Promoción de la Salud/estadística & datos numéricos , Humanos , Estados Unidos , Universidades/estadística & datos numéricosRESUMEN
PURPOSE: Persistent smoking after a cancer diagnosis has adverse effects. Most smoking cessation interventions focus on individual behaviors; however, family members who smoke are major barriers to success. This article describes challenges and lessons learned related to recruitment and retention to a longitudinal, dyadic-centered smoking cessation intervention study for individuals confronting a new diagnosis of thoracic cancer and their family members who smoke. METHODS: A prospective, one-group repeated measures, mixed-method feasibility study measured recruitment, retention, adherence, and acceptability over a 6-month period in a thoracic surgery clinic at a university cancer center. A multidisciplinary, multi-component decision aid-"Tobacco Free Family"-was used to intervene with the dyads. Study recruitment occurred preoperatively with a thoracic surgery team member assessing smoking status. RESULTS: During the 6-month recruitment period, 50 patients who smoked were screened, and 18 eligible families were approached to participate. Sixteen participants (8 dyads) enrolled. Patients were all male, and participating family members were all female-either spouses or long-term girlfriends. Others types of family members declined participation. CONCLUSION: Recruitment was lower than anticipated (44%), retention was high (100%), and maximizing convenience was the most important retention strategy. Oncology nurses can assess the smoking status of patients and family members, facilitate understanding about the benefits of cessation, refer those willing to stop to expert resources, and help motivate those unwilling to quit. Research is needed to continue developing strategies to help patients with thoracic cancer and their families facing surgery as an impetus for stopping smoking. Novel intervention delivery and communication need further exploration.
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Familia/psicología , Promoción de la Salud/métodos , Motivación , Cese del Hábito de Fumar/psicología , Neoplasias Torácicas/prevención & control , Neoplasias Torácicas/psicología , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Neoplasias Torácicas/cirugía , Estados UnidosRESUMEN
BACKGROUND: The American Association of Critical-Care Nurses practice alert on verification of feeding tube placement makes evidence-based practice recommendations to guide nursing management of adult patients with blindly inserted feeding tubes. Many bedside verification methods do not allow detection of improper positioning of a feeding tube within the gastrointestinal tract, thereby increasing aspiration risk. OBJECTIVES: To determine how the expected practices from the American Association of Critical-Care Nurses practice alert were implemented by critical care nurses. METHODS: This study was part of a larger national, online survey that was completed by 370 critical care nurses. Descriptive statistics were used to analyze the data. RESULTS: Seventy-eight percent of nurses used a variety of methods to verify initial placement of feeding tubes, although 14% were unaware that tube position should be confirmed every 4 hours. Despite the inaccuracy of auscultation methods, only 12% of nurses avoided this practice all of the time. CONCLUSIONS: Implementation of expected clinical practices from this guideline varied. Nurses are encouraged to implement expected practices from this evidence-based, peer reviewed practice alert to minimize risk for patient harm.
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Enfermería de Cuidados Críticos/métodos , Nutrición Enteral/métodos , Humanos , Intubación Gastrointestinal/métodos , Encuestas y CuestionariosRESUMEN
PURPOSE/OBJECTIVES: To test the feasibility of a multidisciplinary, multicomponent, theory-based decision aid. DESIGN: Prospective, one-group repeated measures. SETTING: Thoracic surgery clinic in a university hospital cancer center in central Virginia. SAMPLE: 8 dyads, consisting of 16 total participants. METHODS: A multidisciplinary, multicomponent smoking cessation intervention incorporated a theory-based decision aid. Enrollment occurred preoperatively; four face-to-face visits and an exit interview were conducted during six months. MAIN RESEARCH VARIABLES: Feasibility was evaluated based on four criteria: recruitment, retention, adherence, and acceptability. FINDINGS: The recruitment rate was 44%, and the retention rate was 100%. Adherence to the intervention and the acceptability of the decision aid were greater for patients than family members. Patients had greater abstinence than family members before surgery and at six months. Exit interview themes included (a) preoperative timing was acceptable and (b) involving household members who smoke was important. CONCLUSIONS: Recruiting male patients and their female partners is feasible. Participants liked convenience, autonomy, and a family approach. Family members wanted more control over cessation timing and a more intensive approach to weight and mental health management. Successful dyads worked together to maintain abstinence. IMPLICATIONS FOR NURSING: Oncology nurses can assess patients' and family members' smoking status, facilitate understanding about specific benefits of smoking cessation and the obstacle posed by household smokers, and make referrals to expert resources. Encouraging smoke-free environments is an important step toward reducing secondhand smoke exposure and promoting cessation.
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Técnicas de Apoyo para la Decisión , Salud de la Familia , Neoplasias/terapia , Prevención del Hábito de Fumar , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
BACKGROUND: Clinical practice guidelines are intended to bridge the research-practice gap, yet little is known about how critical care nurses adopt guidelines. Feeding tube verification practices remain variable and have led to patient harm and death. OBJECTIVES: To examine factors influencing critical care nurses' adoption of the American Association of Critical-Care Nurses (AACN) practice alert on verification of feeding tube placement and its 4 recommended clinical practices. METHODS: Critical care nurses were invited to participate in a national, online questionnaire, guided by Rogers' diffusion of innovation framework. Descriptive statistics and logistic regression were used for data analysis. Alpha level was set at 0.05. RESULTS: Fifty-five percent of the 370 participating nurses were aware of the practice alert, and 45% had adopted it in practice. Only 29% of the adopters had also implemented all 4 clinical practices. Significant predictors of adoption included BSN or higher nursing education and guideline characteristics of observability and trialability. Predictors of implementation of the clinical practices included staff nurse/charge nurse role, academic medical center, research/web-based information sources, and perception of a policy. Policy was the only significant predictor of implementation of all 4 practices. Adoption of the practice alert was also a predictor for 2 of 4 clinical practices. CONCLUSIONS: Personal and organizational factors influenced implementation of practices associated with an AACN practice alert. Although a research-practice gap exists, the practice alert was a significant source of information for 2 of the clinical practices.
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Enfermería de Cuidados Críticos/normas , Nutrición Enteral/normas , Enfermería Basada en la Evidencia/normas , Adulto , Anciano , Enfermería de Cuidados Críticos/métodos , Enfermería de Cuidados Críticos/estadística & datos numéricos , Nutrición Enteral/métodos , Nutrición Enteral/estadística & datos numéricos , Femenino , Adhesión a Directriz/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Sociedades de Enfermería , Estados Unidos , Adulto JovenRESUMEN
Compelling evidence exists that continued smoking after a diagnosis of lung cancer adversely affects treatment effectiveness, survival, risk of recurrence, second malignancy, and health-related quality of life (HRQOL). The importance of HRQOL to patients with cancer and their families has been well documented. Because of increasing evidence of the benefits of smoking cessation, more research has focused on the impact of smoking on HRQOL. Smoking is a behavior that clusters in families; patients who smoke are likely to have family members who smoke, and together they experience impaired HRQOL. This article describes the evidence regarding HRQOL measurement in individuals diagnosed with lung cancer and their family members who smoke and explores the implications for nursing practice. Oncology nurses are in a critical position to advocate for the integration of HRQOL assessment into clinical settings, monitor patient and family member smoking status and environmental tobacco smoke exposure, and support development of smoking cessation interventions to enhance HRQOL.
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Familia , Neoplasias Pulmonares/etiología , Calidad de Vida , Fumar , Humanos , Neoplasias Pulmonares/enfermería , Neoplasias Pulmonares/fisiopatología , Relaciones Enfermero-Paciente , Cese del Hábito de FumarRESUMEN
PURPOSE: This study evaluated similarities and differences of enrollment rates using two different recruitment strategies for a tobacco control trial in rural and urban African-American (AA) elementary school families. DESIGN: A comparative study, nested within a larger randomized controlled trial, was used to test the effectiveness of two recruitment approaches on enrollment rates in rural and urban AA families. SETTING: The study was conducted in 14 Title 1 elementary schools in the southeastern United States: 7 rural and 7 urban. SUBJECTS: There were 736 eligible AA families, and 332 (45%) completed informed consent and were enrolled into the study. INTERVENTION: The Facilitate, Open and transparent communication, Shared benefits, Team and tailored, Educate bilaterally, and Relationships, realistic and rewards (FOSTER) approach guided the two recruitment strategies: (1) written informational packets provided to fourth graders to take home to parents; and (2) proactive, face-to-face family information sessions held at schools. MEASURES: Enrollment rates were based on responsiveness to the two recruitment strategies and completion of the informed consent process. ANALYSIS: Chi-square, Cochran-Mantel-Haenszel, and Breslow-Day tests were performed. RESULTS: Higher enrollment rates occurred during the family session for both rural and urban families (100% rural, 93.6% urban; p = .0475) than informational packets alone (28.7% rural, 22% urban; p < .0001). Rural family enrollment rates were overall higher than urban rates regardless of recruitment strategy (52.0% rural vs. 39.6% urban; p = .0008). CONCLUSION: The findings suggest the FOSTER approach, although effective in both rural and urban settings, was more successful in recruiting rural families.