Nurses' self-care strategies: A mapping review.

OBJECTIVES: Nurses have long received recommendations to employ self-care behaviors to ensure their ability to remain in the profession; however, nurses are rarely asked what self-care behaviors are beneficial. This literature review aimed to map studies on nurses' self-care strategies to provide an understanding of how these strategies are addressed in the literature and to identify gaps in need of additional exploration. METHOD: Searches were conducted in accordance with published mapping review methodologies across MEDLINE, Embase, CINAHL, Scopus, PsycINFO, Web of Science, and identified influential nursing journals. Included studies were from the United States, peer-reviewed, and described self-care strategies related to nurses or the nursing profession. RESULTS: Thirty-five articles were identified for inclusion and were evaluated based on agreed-upon criteria to define how the concept of self-care was studied and applied to nurses. Three main categories were identified in this review: self-care and stress; self-care and burnout; and self-care and leadership, workplace factors, and physical activity. LINKING EVIDENCE TO ACTION: This mapping review revealed an abundance of literature related to self-care recommendations for nurses; however, there remains a dearth of studies investigating how nurses utilize self-care behaviors independently to improve their own professional well-being. Recommendations for next steps in research in this area are included.

Effectiveness of the Weighted Blanket With Psychiatric Patients in the Emergency Department: A Pilot Study.

BACKGROUND: Restraint and seclusion continue to be used with patients demonstrating aggressive and violent behaviors while in the emergency department and as inpatients in behavioral health (BH) units. The use of sensory interventions such as the weighted blanket (WB) is garnering interest as alternatives to aid in managing anxiety, anger, and aggressive behaviors. Reports of the effectiveness of the WB have primarily been anecdotal, and results of research with children have been mixed. Only one study has been conducted with the WB with adults on an inpatient psychiatric unit. AIMS: The aim of this pilot study was to assess the effectiveness of the WB by determining whether it decreases anxiety and/or anger in adult emergency department patients with preexisting psychiatric diagnoses. METHODS: The study used a quasi-experimental, nonequivalent control group design with pre- and posttests for anxiety and anger. The intervention was a 15-pound WB. Participants (N = 15) were in one of three groups, which included no weighted blanket (NWB), WB for 15 minutes, or WB for 30 minutes. RESULTS: All three groups showed a decrease in anxiety and anger scores. However, participants in the WB groups had a greater decrease in anxiety and anger posttest scores. CONCLUSIONS: The small sample size in this study did not allow for the determination of any differences between groups on anxiety or anger scores that could be viewed as a significant finding.

Who's Driving? The role and training of the human patient simulation operator.

Within the airline industry, where much of simulation-based education originated, cockpit simulators are operated by current or former pilots whose expertise ensures the authenticity of the training experience. As yet, identifying the most appropriate person to run a patient simulator has not been translated into healthcare. Furthermore, few training resources exist for those who must learn the intricacies of the relationship between patient simulators, simulation scenarios, and educational objectives. This article reviews literature related to the role, educational preparation, and training of the patient simulator operator and explores solutions to the uncertainty about the difference between simulator operators and technicians. Because simulators are operationally intensive and because scarce faculty may be best used to facilitate student learning within the laboratory, the tendency has been to use a variety of personnel to manage patient simulators. Recommendations for standardizing the role of the operator that are consistent with the pedagogical purposes of simulation are offered. Potential questions are posed, and methods for future work are discussed.

Rapid Handheld Continuous Electroencephalogram (EEG) Has the Potential to Detect Delirium in Older Adults.

BACKGROUND: Delirium-related biochemical derangements lead to electrical changes that can be detected in electroencephalographic (EEG) patterns followed by behavioral signs and symptoms. Studies using limited lead EEG show a large difference between patients with and without delirium while discriminating delirium from other causes. Handheld rapid EEG devices may be capable of detecting delirium before symptom onset, thus providing an objective physiological method to detect delirium when it is most amenable to interventions. OBJECTIVE: The aim of this study was to explore the potential for rapid EEG to detect waveform pattern changes consistent with delirium status. METHODS: This prospective exploratory pilot study used a correlational design and mixed models to explore the relationships between handheld portable EEG data and delirium status. RESULTS: While being under powered minimized opportunities to detect statistical differences in EEG-derived ratios using spectral density analysis, sleep-to-wake ratios tended to be higher in patients with delirium. CONCLUSIONS: Limited lead EEG may be useful in predicting adverse outcomes and risk for delirium in older critically ill patients. Although this population is at the highest risk for mortality, delirium is not easily identified by current clinical assessments. Therefore, further investigation of limited lead EEG for delirium detection is warranted.

Using the Clark Simulation Evaluation Rubric with associate degree and baccalaureate nursing students.

As simulation becomes a common teaching strategy in nursing education, faculty struggle with methods for measuring student performance in summative, or evaluative, scenarios. While skills checklists have been shown to be a valid way to quantify performance on many of the technical components of a patient care scenario, nurse educators have also begun to utilize simulation grading rubrics to capture more contextual and critical thinking components. The article describes a pilot study using the Clark Simulation Evaluation Rubric with undergraduate nursing students of different levels from two types of programs. Sixty-nine associate degree and 109 baccalaureate degree students were evaluated and scored in simulation performance using the rubric. The rubric was found to be a practical tool that could potentially be used with or without skills checklists. Future work will involve refining use of the rubric and establishing interrater reliability among faculty who routinely evaluate students using this rubric.

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.

Strategic planning for skills and simulation labs in colleges of nursing.

While simulation laboratories for clinical nursing education are predicted to grow, budget cuts may threaten these programs. One of the ways to develop a new lab, as well as to keep an existing one on track, is to develop and regularly update a strategic plan. The process of planning not only helps keep the lab faculty and staff apprised of the challenges to be faced, but it also helps to keep senior level management engaged by reason of the need for their input and approval of the plan. The strategic planning documents drafted by those who supervised the development of the new building and Concepts Integration Labs (CILs) helped guide and orient faculty and other personnel hired to implement the plan and fulfill the vision. As the CILs strategic plan was formalized, the draft plans, including the SWOT analysis, were reviewed to provide historical perspective, stimulate discussion, and to make sure old or potential mistakes were not repeated.

Teaching workflow analysis and lean thinking via simulation: a formative evaluation.

This article presents the rationale for the design and development of a video simulation used to teach lean thinking and workflow analysis to health services and health information management students enrolled in a course on the management of health information. The discussion includes a description of the design process, a brief history of the use of simulation in healthcare, and an explanation of how video simulation can be used to generate experiential learning environments. Based on the results of a survey given to 75 students as part of a formative evaluation, the video simulation was judged effective because it allowed students to visualize a real-world process (concrete experience), contemplate the scenes depicted in the video along with the concepts presented in class in a risk-free environment (reflection), develop hypotheses about why problems occurred in the workflow process (abstract conceptualization), and develop solutions to redesign a selected process (active experimentation).

As normal a life as possible: mothers and their daughters with congenital heart disease.

In this study, I used a qualitative descriptive methodology to examine the effect of chronic illness on the mother-daughter relationship. Many studies have examined the effects of the child's illness on the mother-child relationship when the child is very young, but few have looked at the ongoing problems that chronic illness may cause. Eleven mothers and 11 daughters were interviewed. Normalizing in the face of chronic illness was the overriding theme of the study. Two subthemes related to normalizing arose from the data. "It's no big deal" was found to best describe how most mothers and their daughters with heart disease viewed their lives and relationships. One other subtheme, "Sometimes it's a very big deal," was described by those mothers and daughters who could not, due to ongoing health problems, normalize their lives. Relationships with family as well as age, severity of illness, and developmental stage, were seen as mediators of normalizing in the lives of the participants.