The Doctor of Nursing Practice Project Data Collection Tool: A Teaching Strategy for Data Collection.

ABSTRACT: This article introduces the Doctor of Nursing Practice (DNP) Project Data Collection Tool developed to guide data collection and outcome analysis to promote student success in the DNP project. The DNP project combines student clinical expertise and an evidence-based intervention to address a complex practice or systems problem. Outcome data are needed to evaluate the project. The DNP Project Data Collection Tool is designed as a teaching strategy and project-specific tool that provides a model for faculty and students to use in DNP project development. Elements of the tool are discussed, and results of a student evaluation are presented.

HPV vaccine promotion: Snapshot of two health departments during the COVID-19 pandemic.

The COVID-19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID-19 pandemic.

A culture of caring: the essence of healthcare interprofessional collaboration.

Collaboration among healthcare professionals is essential in creating a synergy to provide efficient, safe, and high-quality patient care. Interprofessional collaborative practice (IPCP) has become a core measure in promoting healthcare practice. An understanding of the underlying mechanism for healthcare professionals to collaborate can provide strategies to foster IPCP. The purpose of the study was to investigate healthcare professionals' perspectives on ways to promote IPCP. This was a qualitative descriptive study. Thirty-six healthcare professionals from a university-affiliated hospital participated in the study. Data were collected via face-to-face in-depth interviews and analyzed using a thematic networks framework. The findings indicated that the underlying facilitator of IPCP was a culture of caring - human connections among interprofessional team members. The culture of caring could be fostered through five processes: building caring relationships, developing an ownership mentality, providing constructive feedback, applying the strengths-based practice, and acting as the first and last lines of defense. An Interprofessional Caring Model (ICM) was proposed in this study. Creating a caring culture is a dynamic process requiring all team members' efforts. The ICM can have significant clinical implications. It can be used as a framework to design and implement specific strategies to improve interprofessional collaboration.

Nurse leaders' strategies to foster nurse resilience.

AIM: To identify nurse leaders' strategies to cultivate nurse resilience. BACKGROUND: High nursing turnover rates and nursing shortages are prominent phenomena in health care. Finding ways to promote nurse resilience and reduce nurse burnout is imperative for nursing leaders. METHODS: This is a qualitative descriptive study that occurred from November 2017 to June 2018. This study explored strategies to foster nurse resilience from nurse leaders who in this study were defined as charge nurses, nurse managers and nurse executives of a tertiary hospital in the United States. A purposive sampling method was used to have recruited 20 nurse leaders. RESULTS: Seven strategies are identified to cultivate nurse resilience: facilitating social connections, promoting positivity, capitalizing on nurses' strengths, nurturing nurses' growth, encouraging nurses' self-care, fostering mindfulness practice and conveying altruism. CONCLUSIONS: Fostering nurse resilience is an ongoing effort. Nurse leaders are instrumental in building a resilient nursing workforce. The strategies identified to foster nurse resilience will not only impact the nursing staff but also improve patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: The strategies presented are simple and can be easily implemented in any settings. Nurse leaders have an obligation to model and enable evidence-based strategies to promote nurses' resilience.

Outcome of young children with high-grade glioma treated with irradiation-avoiding intensive chemotherapy regimens: Final report of the Head Start II and III trials.

PURPOSE: To report the final analysis of survival outcomes for children with newly diagnosed high-grade glioma (HGG) treated on the "Head Start" (HS) II and III protocols with chemotherapy and intent to avoid irradiation in children <6 years old. PATIENTS AND METHODS: Between 1997 and 2009, 32 eligible children were enrolled in HS II and III with anaplastic astrocytoma (AA, n = 19), glioblastoma multiforme (GBM, n = 11), or other HGG (n = 2). Central pathology review was completed on 78% of patients. Patients with predominantly brainstem tumors were excluded. Patients were to be treated with single induction chemotherapy regimen C, comprising four cycles of vincristine, carboplatin, and temozolomide. Following induction, patients underwent marrow-ablative chemotherapy and autologous hematopoietic cell rescue. Irradiation was used for patients with residual tumor after consolidation or >6 years old or at the time of tumor progression. RESULTS: The 5-year event-free survival (EFS) and overall survival (OS) for all HGG patients were 25 ± 8% and 36 ± 9%, respectively. The EFS at 5 years for patients with AA and GBM were 24 ± 11% and 30 ± 16%, respectively (P = 0.65). The OS at 5 years for patients with AA and GBM was 34 ± 12% and 35 ± 16%, respectively (P = 0.83). Children <36 months old experienced improved 5-year EFS and OS of 44 ± 17% and 63 ± 17%, compared with children 36-71 months old (31 ± 13% and 38 ± 14%) and children >72 months old (0% and 13 ± 12%). CONCLUSIONS: Irradiation-avoiding treatment strategies should be evaluated further in young children with HGG given similar survival rates to older children receiving standard irradiation-containing therapies.

New media simulation stories in nursing education: a quasi-experimental study exploring learning outcomes.

New media simulation stories are short multimedia presentations that combine simulation, digital technology, and story branching to depict a variety of healthcare-related scenarios. The purpose of this study was to explore whether learning outcomes were enhanced if students viewed the results of both correct and incorrect nursing actions demonstrated through new media simulation stories. A convenience sample of 109 undergraduate nursing students in a family-centered maternity course participated in the study. Study findings suggests that students who viewed both correct and incorrect depictions of maternity nursing actions scored better on tests than did those students who viewed only correct nursing actions.

Impacts of Nursing Student Burnout on Psychological Well-Being and Academic Achievement.

BACKGROUND: Burnout, depression, and suicide among health care professionals and learners have reached a rampant level. This systematic review aimed to synthesize literature findings of nursing student burnout and its impact on psychological well-being and academic performance. METHOD: This systematic review followed PRISMA guidelines and included data-based studies on nursing student burnout published in peer-reviewed journals between January 2015 and January 2020. RESULTS: This review included 17 articles. Four major themes were identified: 1) a negative relationship between burnout and student self-concept, 2) a negative association between burnout and student engagement, 3) risk factors contributing to student burnout, and 4) interventions to mitigate student burnout. Promoting positive self-concept, engagement, and resilience may alleviate student academic burnout. CONCLUSION: Student burnout has negative influences on health and academics, and interventions to mitigate burnout should be considered early in nursing programs. Nurse educators can create an engaging learning environment to build resilience and reduce burnout. [J Nurs Educ. 2021;60(7):369-376.].

Using simulation to teach patient safety behaviors in undergraduate nursing education.

The purpose of this article is to describe how our college of nursing began to integrate patient safety instruction into simulation experiences for undergraduate nursing students. A system for evaluating and grading students was developed. Data on student safety behaviors were collected before and after implementation of instruction designed to improve adherence to hand washing and patient identification procedures. In the first semester in which data were collected, students did not demonstrate satisfactory performance of either hand hygiene or patient identification 61% of the time. After instruction, students still did not perform these procedures consistently 38% of the time. Lessons learned and future plans for addressing these problems with basic patient safety behaviors are discussed.

Parents' and healthcare professionals' perceptions of the quality of care: A PITSTOP model of caring.

BACKGROUND: Quality of care is measured by various indicators. Besides objective quantifications, it is necessary to understand the meaning of quality of care from the perspectives of patients, families, and healthcare professionals. OBJECTIVES: This study aimed to understand parents' and healthcare professionals' perceptions of the quality of care. METHODS: This was a secondary data analysis of two qualitative studies examining parents' and healthcare professionals' perceptions of caring in 2014 and 2018, respectively. Both studies took place in a children's hospital in the United States. There were 40 participants, 13 parents of children undergoing heart surgery and 27 healthcare professionals. The current study focused on parents' and healthcare professionals' viewpoints about the quality of care. RESULTS: Seven themes emerged: patient-centered care, interprofessional collaboration, team communication, safety and security, trusting relationships, optimal outcomes, and positive patient experiences. The acronym PITSTOP was developed to enable healthcare professionals to recall the elements deemed as important to the quality of care by parents and professionals. CONCLUSIONS: This study brought up a novice opinion that healthcare should be like a "pitstop," not just a "repair shop." Healthcare encounters may be brief but invaluable in helping patients and families succeed in their health promotion.

Small Numbers, Big Challenges: Adolescent and Young Adult Cancer Incidence and Survival in New Zealand.

PURPOSE: This study was undertaken to determine cancer survival and describe the unique spectrum of cancers diagnosed among New Zealand's adolescents and young adult (AYA) population. METHODS: Registrations for 1606 15-24 year olds diagnosed with a new primary malignant tumor between 2000 and 2009 were obtained from the New Zealand Cancer Registry and classified according to AYA diagnostic group and subgroup, age, sex, and prioritized ethnicity. Age-standardized incidence rates (IRs) per million person years and 5-year relative survival ratios were calculated. RESULTS: Cancer incidence was 228.6 per million for adolescents aged 15-19 years and 325.7 per million for young adults aged 20-24 years. Overall IRs were consistent across all ethnic groups but there were unique ethnic differences by tumor group including a higher incidence of bone tumors, carcinoma of the gastrointestinal tract, and gonadal germ cell tumors among Maori, a higher incidence of leukemia among Pacific peoples, and a higher incidence of melanoma among non-Maori/non-Pacific peoples. Five-year relative survival for adolescents (75.1%) and AYA overall (80.6%) appeared poorer than had been achieved in other high-income countries. Maori (69.5%) and Pacific (71.3%) AYA had lower 5-year survival compared to non-Maori/non-Pacific peoples (84.2%). CONCLUSION: The survival disparities observed require further investigation to identify and address the causes of these inferior outcomes. The newly established AYA Cancer Network Aotearoa has been tasked with improving cancer survival and care and ensuring equality of access for New Zealand AYAs with cancer.

Nutrition knowledge and attitudes of allied health and fitness students.

Using survey methodology, this study assessed the nutrition-related knowledge and attitudes of nursing (n = 54), physical therapy (n = 48), and fitness (n = 62) students. The mean scores on the nutrition knowledge test were 21 points (SD 3.8 points, range 8 to 28 points) for nursing, 21 points (SD 3.0 points, range 15 to 27 points) for physical therapy, and 22 points (SD 3.9 points, range 15 to 31 points) for fitness students, out of a possible 32 points. Students with previous exposure to nutrition education earned significantly (p < .05) higher scores. The majority of students planned to comply with, and to encourage client compliance with recommendations to decrease fat intakes, maintain a healthy weight, and include fruits and vegetables in their daily diet, and generally regarded nutrition as important to their chosen profession. Findings suggest a need to enhance and reinforce key nutrition principles and to promote a greater appreciation for the role of the registered dietitian as a valuable member of the health care team. Interactive nutrition education activities throughout the health sciences curricula and presentations by registered dietitians describing their job responsibilities may help attain these outcomes. In conclusion, findings suggest a need to promote increased interdisciplinary collaboration among future allied health professionals to provide evidenced base care.

A review of the phenotypic variation due to the Denys-Drash syndrome-associated germline WT1 mutation R362X.

The gene WT1 is required for the normal development and function of the urogenital tract. Constitutional mutations are associated with familial Wilms tumor and syndromes such as Denys-Drash syndrome (DDS) characterized by nephropathy, genital anomalies and often a predisposition to Wilms tumor. We report a case of constitutional WT1 mutation in an XX female with multifocal Wilms tumor but no genital anomalies or renal dysfunction and, for the first time, review patients previously reported with this germline mutation. The mutation (1084C>T) changes the amino acid arginine at position 362 to the translation stop codon TGA (R362X) resulting in a predicted truncated protein lacking three of the four zinc finger domains necessary for correct functioning of the gene. This constitutional mutation has been reported to cause a variety of phenotypes in eleven different patients, including the classical Denys-Drash phenotype of diffuse mesangial sclerosis which leads to early renal failure, genital anomalies in XY individuals and Wilms tumors. The absence of mesangial sclerosis and renal failure in our patient excludes DDS. Our case differs from those previously described as the normal kidney tissue shows some small subcapsular glomeruli indicating that the WT1 mutation has impaired nephron development. This patient extends the range and variation of phenotypes that may arise from a specific germline mutation in WT1.

Pica in pregnancy: does it affect pregnancy outcomes?

PURPOSE: To discover the prevalence of pica, the documentation of pica on medical records, and any relationship of pica to pregnancy outcomes in rural socioeconomically disadvantaged pregnant women. STUDY DESIGN AND METHODS: Prospective, descriptive, correlational investigation with 128 women who sought prenatal care from two rural community health agencies. Demographic and sociocultural variables, pica practices, pica substances ingested, and pregnancy outcomes were collected. RESULTS: Thirty-eight percent of these pregnant women practiced pica. African-American women reported practicing pica more often than other ethnicities. Substances ingested included ice (>1 cup/day), freezer frost, laundry starch, cornstarch, clay dirt, and baked clay dirt. Polypica (ingestion of more than one substance) was practiced by 11 women. Women practicing pica were more likely to have been underweight prior to pregnancy, and smoked fewer cigarettes. Women reporting daily pica practice were significantly more likely to have lower prenatal hematocrits than women who did not practice pica, or who practiced pica less frequently than daily. No specific pregnancy complication was associated with the practice of pica. CLINICAL IMPLICATIONS: Pica exists, and might be more common than healthcare providers assume. Although this study did not show specific pregnancy complications associated with pica, other studies have shown anemia and lead poisoning among women who practice pica. It is not clear that patients volunteer information about pica, so it would be helpful if nurses queried patients at each prenatal visit regarding pica practice. Discussion of pica practices should be based on a nonjudgmental model, for pica may have strong cultural implications, and may be practiced for cultural reasons unknown to the nurse.

Introductory pharmacology for clinical practice.

The average woman will take many medications, both prescription and nonprescription, as well as herbs or other dietary supplements over the course of her lifetime. These chemicals can produce therapeutic benefits but can also cause toxic effects. Pharmacokinetics, pharmacodynamics, pharmacotherapy, adverse drug reactions, and research in pharmacology are discussed as applied to women's health. Clinicians must have a firm understanding of the basic principles of pharmacology so that they can appropriately administer medications, monitor for anticipated effects and adverse reactions, and communicate as needed with women, their families, and other health care team members.

Protracted postnatal natural histories in childhood leukemia.

Studies of monozygotic twins with concordant leukemia and scrutiny of archived neonatal blood by polymerase chain reaction (PCR) indicated that many pediatric leukemias are initiated prenatally by chromosomal translocation followed by a variable postnatal period before diagnosis of disease. The latter is thought to reflect a persistent preleukemic stage and a requirement for secondary genetic events. We sought to examine this further by examination of blood spots in rare cases of MLL fusion-positive or ETV6/RUNX1 (TEL-AML1) fusion gene-positive acute leukemia that were diagnosed at ages beyond the normal age range. We present evidence that the duration of the postnatal preleukemic state can occasionally be very protracted in these biological subtypes of pediatric leukemia, and we discuss its biological significance.