The experiences among bereaved family members after a left ventricular assist device (LVAD) deactivation.

BACKGROUND: The use of left ventricular assist devices (LVADs) is increasing with an estimated 2500 devices implanted each year. When burdens of the LVAD outweigh benefits, most individuals with LVADs will undergo deactivation in the hospital setting. While the decision to deactivate an LVAD is considered an ethical practice, little is known about the experience and needs of bereaved family members. OBJECTIVE: To investigate the experiences of bereaved family members of patients who died following LVAD deactivation. METHODS: In this qualitative study, 11 family members of patients who underwent LVAD deactivation were interviewed. The semi-structured interviews were conducted until data saturation was reached and relevant themes emerged. RESULTS: This qualitative study was conducted to understand the experience of family members before, during and after the patient underwent LVAD deactivation, including their perceptions of engagement with the healthcare team. Analysis revealed six overarching themes from the experience, including 1) hope for survival, 2) communication, 3) spirituality and faith, 4) absence of physical suffering, 5) positive relationships with staff, 6) post-death care needs. CONCLUSION: Bereaved family members of patients undergoing LVAD deactivation have unique lived experiences and concerns. This study highlights the importance of effective communication not only near end-of-life but throughout the LVAD experience. While the positive relationships with staff and the absence of physical suffering were strengths identified by bereaved caregivers, there is an opportunity for improvement, particularly during the decision-making and post-death periods.

Strategies to engage and retain African-American students in BSN programs based on oral history.

BACKGROUND: The nursing profession continues to struggle with attracting African-American applicants into our nursing programs, supporting their retention and their success to graduation. This problem must be rectified if we are to generate adequate numbers of African-American nurses to meet the increasingly diverse and complex needs of our changing demographics. METHOD: An oral history was conducted with the first four African-American nurses to graduate from a Predominantly White Institution between 1960 and 1969 to learn more about how they successfully navigated their educational environment and recommendations they could offer that could be used today to support our African-American students. RESULTS: Participants told us that we need to value and pay attention to students as unique individuals, provide mentoring and skill building support, create group gathering opportunities for African-American students to bond, create and deepen their connection with each other and faculty in order to build trust and community. In addition, the cultural role of religion and spirituality cannot be minimized in this population as it serves to reinforce connection, hope, grounding and a familiar source of support. CONCLUSION: To attract, retain and support academic success of Africa-American students in nursing programs, strategies must target the needs at the individual, group and faculty levels in addition to addressing organizational and structural practices that serve as additional impediments to the success of these nursing students.

Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care.

For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.

Patient perspectives of a heart failure action plan: A qualitative study.

Individuals with heart failure (HF) have difficulty evaluating their symptoms, understanding when to seek health care, and implementing self-care activities. The purpose of this qualitative study was to inform the development of a heart failure action plan (HFAP) for individuals living with HF. This study used a prospective, descriptive qualitative design with a content analysis approach. The HFAP included clinical indicators of self-reported symptoms, adherence to medication regimen, and physiologic changes. Patients with HF reviewed the HFAP and provided their perceptions to assist in developing the action plan. Participants had a mean age of 65 years, predominately male (78%) and African American (89%). Comorbidities included hypertension, atrial fibrillation, chronic kidney disease, ischemic heart disease, valvular heart disease, and diabetes mellitus. Five thematic categories emerged: (1) Understanding of symptoms and symptom severity, (2) management of symptoms, (3) educational opportunities, (4) changes, and (5) satisfaction. Participants suggested adding content about exercise, diet, additional symptom management, and a compact portable HFAP. Participants provided their perceptions of the HFAP. Their feedback was instrumental in modifying the action plan for use in a broader HF patient population to assist patients in self-management, including the understanding of when to seek health care.

Mentoring students engaging in scholarly projects and dissertations in doctoral nursing programs.

BACKGROUND: Doctor of Nursing Practice (DNP) programs in the US have grown exponentially, outnumbering Doctor of Philosophy (PhD) in Nursing programs. Faculty are mentoring increasing numbers of students on DNP projects or PhD dissertations. PURPOSE: This descriptive study explored faculty characteristics and examined support, engagement, and outcomes of American Association of Colleges of Nursing member nursing faculty mentoring student DNP projects or PhD dissertations. METHOD: A researcher-developed survey tool was emailed to 550 Deans and Program Directors of AACN doctoral programs for distribution to their doctoral faculty. Survey data were analyzed using descriptive statistics. FINDINGS: 177 DNP and 53 PhD (N=230) program surveys were completed. Faculty described challenges in the mentoring role including: time constraints, workload allocation, resources, faculty role preparation, student readiness, and variability in student outcomes. CONCLUSIONS: Additional dialogue and consensus is required to promote mentoring of students in nursing doctoral programs to ensure rigor of scholarly outcomes.

OC15 - Leading nursing educational progress in child mental health.

UNLABELLED: Theme: Nursing education, management and leadership. Given the increasingly complex mental health needs of children and young people and the critical shortage of proficient mental health specialists, a study of US nursing education programs was done. Does the current paediatric nursing workforce preparation best meet the distinct needs of young people with behavioral and mental health challenges is the key question? Experts in the field of child psychiatric nursing practice, education and research came together to find model nursing programs for educational and clinical preparation. This presentation will report an analysis of the content of curricula-preparing psychiatric mental health nurse practitioners, models for adaptation to paediatric nurses' training and recommendations for leadership strategies. OBJECTIVES: Describe existing US nursing education models for child and youth mental health care. Propose strategies for education leadership.

Addressing gaps in mental health needs of diverse, at-risk, underserved, and disenfranchised populations: a call for nursing action.

Psychiatric nurses have an essential role in meeting the mental health needs of diverse, at-risk, underserved, and disenfranchised populations across the lifespan. This paper summarizes the needs of individuals especially at-risk for mental health disorders, acknowledging that such vulnerability is contextual, age-specific, and influenced by biological, behavioral, socio-demographic and cultural factors. With its longstanding commitment to cultural sensitivity and social justice, its pivotal role in healthcare, and its broad educational base, psychiatric nursing is well-positioned for leadership in addressing the gaps in mental health prevention and treatment services for vulnerable and underserved populations. This paper describes these issues, presents psychiatric nursing exemplars that address the problems, and makes strong recommendations to psychiatric nurse leaders, policy makers and mental health advocates to help achieve change.