Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19: US Survey Results.

The sudden, expanded need for telehealth during the COVID-19 pandemic added to the challenges advanced practice RNs face in the United States. The purposes of this article are to summarize advanced practice RNs' responses about the use of telehealth before and during the pandemic and to analyze free-text comments about how the use of telehealth changed during the pandemic. A 20-item survey was distributed using convenience sampling to advanced practice RNs from June 1 to September 23, 2020. Analyses of descriptive and open text responses related to telehealth were conducted. Most of the respondents did not use telehealth prior to the pandemic (n = 5441 [73%]), but during the pandemic, half used telehealth at least daily (n = 3682 [49%]). The most common barriers related to telehealth were about the difficulty some populations had in accessing the necessary technology. The most common favorable comments cited by respondents were related to some patients' improved access to care. Telehealth use is unlikely to return to prepandemic levels. As a result, considerations of telehealth-related recommendations provided for advanced practice RN education, policy, and practice are encouraged for the purpose of increasing healthcare access.

Results of a National Survey: Ongoing Barriers to APRN Practice in the United States.

Limited information is available on the barriers to practice for advanced practice registered nurses (APRNs) among states with full, restricted, and reduced practice. The purpose of this study is to identify practice barriers in relationship to United States (U.S.) state practice authority, APRN type, area of practice (rural, suburban, urban), and nature of practice (outpatient, inpatient, and both). An electronic survey of a convenience sample of APRNs was conducted to assess barriers to practice. Identified barriers were examined based on state practice environment, APRN role, practice setting, and location. Data were analyzed using thematic analysis for qualitative data and descriptive analysis for quantitative data. Over 7,000 APRNs representing all 50 states participated. Themes that were identified and reported by respondents, included licensure and administrative barriers, therapy restrictions, physician signature requirements, a lack of collegiality, prescribing barriers, uneven reimbursement, physician only procedures, and telehealth issues. Barriers were identified in all states, regardless of the type of practice authority. All four APRN role types identified practice barriers, some of which were more frequent for some roles than others. Restrictions for home health approval and the requirement for a physician signature for durable medical supply orders were identified by over 40% of respondents practicing in rural areas. Barriers to APRN practice continue to restrict aspects of patient care and patient access to care, even in states with full practice authority. Continued efforts to reduce barriers to APRN practice are needed to ensure patient access to care, especially in rural areas.

The Role of Social Determinates of Health in Discharge Practices.

Major risks associated with inadequate discharge preparation and execution include medication errors, adverse drug events, and hospital readmissions. Nurses must develop pertinent skills to assess how the social environment impacts patients' likelihood of a safe and healthy transition back into the community as they prepare patients for discharge. Recognition and consideration of social determinants of health are critical to minimizing health disparities, enhancing health equity and supporting positive patient outcomes. Examples of strategies for enhanced discharge practices include implicit bias assessment and training, screening for food insecurity, and assessment for quality referral sources.

Creating Collaborative Relationships With Historically Black Colleges and Universities: An Approach to Diversifying the Nursing Workforce.

BACKGROUND: The lack of a diverse nursing workforce and inclusive nursing student pipeline initiatives can impact existing health disparities in the United States. PROBLEM: Gaps in the representation of future Black nurses in schools of nursing provide missed opportunities for cultural congruence and awareness. APPROACH: Developing collaborative relationships with historically Black colleges and universities (HBCUs) for recruitment is a mutually beneficial strategy. Undergraduate interns from 3 HBCUs attended a 6-week summer nursing immersion program at a graduate school of nursing on the campus of a predominately White institution. The aim was to provide awareness of the nursing profession and mentorship for further exploration into the profession. CONCLUSIONS: The program managed by Black nurse faculty provides a recruitment strategy that serves as a framework to support the financial, emotional, and social needs of prospective Black nursing students.

Sexually Transmitted Infections Prevalence in the United States and the Relationship to Social Determinants of Health.

Rates of sexually transmitted infections (STI) are on the rise in the United States. Some STIs are at an all-time high. Research has shown that there is a higher prevalence of STIs among some racial and ethnic groups as compared with whites. Factors contributing to this endemic have been explored. Although some individual-level risk factors have previously been identified, data overwhelmingly suggest that social determinants of health are key factors in the overall increase in STIs. Additionally, these social factors have contributed to disparities in STI acquisition. Population-specific interventions targeting social factors are necessary in reducing the rates of STIs.

Writing a Diversity and Inclusivity Statement: Guidelines for Nursing Programs and Faculty.

BACKGROUND: For decades, nursing programs have worked to address the need for a culturally diverse workforce and student body to better reflect the populations they serve. The development of a diversity and inclusivity statement is a first step in ameliorating this issue. PROBLEM: A clearly communicated diversity and inclusivity statement should demonstrate a nursing organization's commitment to the value of people from all backgrounds. It should include language that emphasizes the value of diverse cultures, experiences, thoughts, and contributions. APPROACH: Nursing faculty can benefit from an organized and literature-supported model for writing meaningful diversity and inclusivity statements. CONCLUSIONS: Such an approach will communicate a nursing program's commitment to diversity and inclusion in the organization's mission, policies, practices, relationships, and curricula. This article provides nursing faculty with evidence-supported guidelines for writing meaningful diversity, inclusion, and equity statements for their nursing programs.