The Impact of DNP Scholarly Projects on Healthcare Organizations: A Road Map for Success.

Many DNP scholarly projects occur in healthcare organizations, often taking various forms based on specific academic requirements. Projects require site mentorship, project facilitation, and institutional review board resources. This article highlights the impact of DNP scholarly projects on healthcare organizations and provides a road map for success for healthcare leaders and site mentors.

Self-Compassion and Resilience in a National Sample of Nursing Students Amid the COVID-19 Pandemic.

ABSTRACT: Nationwide, nursing students experienced multiple interruptions in learning because of the pandemic. Little is known about the impact of COVID-19 on resilience and self-compassion. A descriptive cross-sectional design was used to examine pandemic-related factors, resilience, and self-compassion using the Brief Resilience and Self-Compassion scales. The majority of participants (n = 259, 73.4 percent) described declining mental health. There was a moderate relationship between resilience, self-compassion, and age (r = .30, n = 353, p = .00/r = .290, n = 353, p < .01). Resilience and self-compassion are integral to student success. Strategies to support students' mental and physical health are discussed.

Building research infrastructure and multisite studies in merged health care settings: A framework for nurse scientists and health care leaders.

BACKGROUND: Merged healthcare settings, particularly those with Magnet designated sites, present distinct opportunities for PhD nurse scientists developing nursing research infrastructure. PURPOSE: This article aims to assist nurse scientists and healthcare leaders in defining nurse scientist roles, and in developing research infrastructure for conducting multi-site research in merged settings. METHOD: Practical strategies and a framework are provided to assist in building and navigating nurse scientist roles and research infrastructure development. DISCUSSION: Emphasizing the necessity of organizational support, the article underscores the importance of clear role delineation and leadership support. CONCLUSION: To optimize the contributions of nurse scientists in merged healthcare settings, especially in Magnet organizations, clear role definitions, robust research infrastructure, and strong organizational support are imperative.

Professional values and nursing care quality: A descriptive study.

BACKGROUND: Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. RESEARCH QUESTION/AIM/OBJECTIVES: The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct patient care settings? RESEARCH DESIGN: This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. PARTICIPANTS AND RESEARCH CONTEXT: Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. ETHICAL CONSIDERATIONS: Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. FINDINGS: 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement (p = 0.38), professional values (p = 0.037), practice environment: participation in hospital affairs (p = 0.00), foundations for quality care (p = 0.016), and resources adequacy (p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably (p = 0.00), got help as soon as wanted (p = 0.00), and treated with courtesy and respect (p = 0.00). DISCUSSION/CONCLUSIONS: Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MESH TERMS: Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction.

Optimizing the productivity and placement of NPs and PAs in outpatient primary care sites.

OBJECTIVE: Organizational leaders must continually assess the productivity, turnover, and vacancies of physician assistants (PAs) and NPs. Optimizing the feasibility, effect, strategic placement, and monitoring increases patient access, improves wait times and affordability, and increases revenue. This quality improvement project sought to develop a systematic, data-driven approach to optimize productivity and placement of NPs and PAs in outpatient primary care sites. METHODS: Results from this project are reported using the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE) framework. Postformation of a quality improvement team, a gap analysis, and action plans were developed and implemented. RESULTS: Priority areas requiring action included the development of an integrated position justification algorithm and tracking form addressing NP and PA placement, establishing consistent patient contact hours, setting workload expectations, and consistently communicating these via an organization-specific situation, background, assessment, and recommendation communication tool. CONCLUSIONS: Healthcare leaders should leverage the talents of NPs and PAs meeting organizational benchmarks and goals as well as the needs of patients. NP and PA leaders should focus on benchmarking performance and analyzing barriers to optimization. These efforts are most beneficial when multidisciplinary in nature.

Huddling as an Academic Quality Improvement Initiative.

ABSTRACT: A huddle is described as a tight group gathered together to talk privately for the purpose of reviewing performance and engaging in future planning. Although huddles are described as an effective communication tool to enhance patient safety in hospital settings, little is known about their use in academe. This article describes a quality improvement initiative involving weekly huddles of faculty teaching medical/surgical nursing and provides preliminary findings after one year.

A qualitative examination of graduating nurses' response to the Covid-19 pandemic.

BACKGROUND: Currently, graduating nurses face pandemic-related uncertainty including gaps in risk perception, unexpected Covid-19 moral dilemmas, and distress surrounding personal health risk. RESEARCH QUESTION/AIM/OBJECTIVES/METHOD: The purpose of this basic qualitative descriptive study is to describe the willingness of graduating nurses to provide care during the Covid-19 pandemic. PARTICIPANTS AND RESEARCH CONTEXT: One week prior to graduation, students were required to submit a written assignment describing willingness to practice in light of the ongoing pandemic. ETHICAL CONSIDERATIONS: This study was approved by an Institutional Review Board. FINDINGS/RESULTS: Eighty-four (n = 84) assignments were used for analysis. Of these, 82% (n = 69) of the graduating nurses describe a willingness to voluntarily care for Covid-19 patients. After summarizing narrative responses, two themes emerged including self-assessment of personal and familial risk and conflicting obligations. DISCUSSION: The assessment of risk to self and family are key in determining whether graduating nurses will care for Covid-19 patients. Conflicting obligations may contribute to stress and uncertainty potentially leading to early burnout. CONCLUSION: Findings from this study can inform academicians of the need to adequality prepare graduating nurses for Covid-19-associated risks and ethical decision making. Organizations should alter residencies and orientation to support the needs of new nurses.

Intravenous Lidocaine for Chronic Neuropathic Pain A Systematic Review Addressing Nursing Care.

BACKGROUND: The intravenous administration of lidocaine for patients with chronic neuropathic pain is well documented in the literature. However, little is known about the role of the nurse caring for patients receiving the infusion. AIM: The purpose of this systematic review was to examine and describe common side effects associated with the intravenous administration of lidocaine to patients with chronic neuropathic pain and outline nursing care described in an effort to develop evidence-based protocols for care. METHOD: A comprehensive search of databases was completed and yielded eleven (n = 11) articles and one care protocol for analysis. RESULTS: Evidence was appraised and findings suggest intravenous lidocaine has a low risk of causing adverse events, however patients should be monitored closely. CONCLUSIONS: Nursing care focuses on pain assessment, close observation and intervention if neurological changes occur.

A Cost-Benefit Analysis of A Community Free Clinic.

Uninsured patients lacking access to primary and preventive care continues to be an issue. The purpose of this analysis is to describe operating costs surrounding a nurse-driven freestanding community clinic and to calculate quality of life benefits using clinically preventable burden scores. A retrospective records review of patients (n = 200) receiving care at a free clinic were used. Annual costs were $387,252. The benefit gained in quality-adjusted life years is estimated to be 57.47-203.94 yielding a return on investment ranging from $1,200,264-$8,948,184. Free clinics have sustained cost savings over time. Policies addressing this form of care are imperative.

Teaching Culturally Competent Veteran Nursing Care in Prelicensure Programs.

With the publication of Healthy People 2020, health disparities have been redefined to expand concepts beyond traditional racial and ethnic minorities and include a broader range of populations. Veterans, with their unique experiences and values, comprise a distinct culture with health risks and potential disparities. Although accrediting agencies require programs of nursing to teach culturally competent care, it is unknown whether nurse faculty recognize veterans as having a culture distinct from the rest of the population. Recognizing veterans as possessing a distinct culture is a first step in the provision of culturally competent care.

Attitudes of nurses towards care of the dying patient in India.

BACKGROUND: Worldwide, end-of-life care is coming under increasing scrutiny as nurses struggle to balance cultural norms and legal requirements with the desires of patients and families. The purpose of this descriptive pilot study was to examine and describe nurses' attitudes when caring for dying patients in India, and whether participation in an educational conference, which included two scenario-based, low-fidelity simulations increased knowledge of end-of-life care. METHOD: Participants' attitudes were measured with the 30-item Frommelt Attitudes Toward Care of the Dying (FATCOD-B) scale. Knowledge was measured with a researcher-developed 15-item content-focused test before and after the conference. RESULTS: The mean attitude scores of nurses (n=101) were M=101.45 (range 65-143, SD=15.99). Participation in the educational conference and end-of-life care simulations increased the knowledge of most nurses (P<0.05). CONCLUSION: Conferences and low-fidelity simulation are effective methods for improving nurses' knowledge of end-of-life care in India. Improved education surrounding end of life may positively affect attitudes.

Simulation STEPS Ahead: Preparing to Engage in Systematic Evaluations of Simulation Activities.

Nursing programs need to be prepared to engage in systematic evaluations of simulation activities specifically linked to course and program outcomes. This article describes how components of the Jeffries simulation framework and S.T.E.P. Educator Preparation Plan were used to guide construction, implementation, and evaluation of cost-effective, program-wide simulation experiences with the addition of "S" for systematic evaluation. Expanding the Jeffries plan to STEPS offers a strategic way to evaluate simulation systematically in nursing programs.

Improving the Recruitment and Retention of Unlicensed Assistive Personnel: A Quality Improvement Initiative.

With increasing demands for unlicensed assistive personnel, strategies for optimizing recruitment and retention are paramount. The purpose of this quality improvement project was to increase the recruitment and retention of unlicensed assistive personnel in a nonprofit healthcare organization. Initiatives included expanding academic affiliations enhancing pipeline, developing a tailored onboarding program, and introducing a clinical ladder. Results indicate increases in numbers of academic affiliations and hiring, with unlicensed assistive personnel turnover rates below national averages.

Nurse care coordination and technology effects on health status of frail older adults via enhanced self-management of medication: randomized clinical trial to test efficacy.

BACKGROUND: Self-management of complex medication regimens for chronic illness is challenging for many older adults. OBJECTIVES: The purpose of this study was to evaluate health status outcomes of frail older adults receiving a home-based support program that emphasized self-management of medications using both care coordination and technology. DESIGN: This study used a randomized controlled trial with three arms and longitudinal outcome measurement. SETTING: Older adults having difficulty in self-managing medications (n = 414) were recruited at discharge from three Medicare-certified home healthcare agencies in a Midwestern urban area. METHODS: All participants received baseline pharmacy screens. The control group received no further intervention. A team of advanced practice nurses and registered nurses coordinated care for 12 months to two intervention groups who also received either an MD.2 medication-dispensing machine or a medplanner. Health status outcomes (the Geriatric Depression Scale, Mini Mental Status Examination, Physical Performance Test, and SF-36 Physical Component Summary and Mental Component Summary) were measured at baseline and at 3, 6, 9, and 12 months. RESULTS: After covariate and baseline health status adjustment, time × group interactions for the MD.2 and medplanner groups on health status outcomes were not significant. Time × group interactions were significant for the medplanner and control group comparisons. DISCUSSION: Participants with care coordination had significantly better health status outcomes over time than those in the control group, but addition of the MD.2 machine to nurse care coordination did not result in better health status outcomes.

Perceived marginality in veteran and nonveteran nursing students in baccalaureate programs.

BACKGROUND: Veteran nursing students often have difficulty transitioning to campus life. Barriers include issues with admissions, financial support, as well as classroom environments. These barriers often push veterans and their unique needs to the periphery. METHOD: The purpose of this descriptive cross-sectional study was to examine mean differences in perceived marginality between veteran and nonveteran nursing students enrolled in baccalaureate programs using the Englund Marginality Index. RESULTS: Results indicate that veteran nursing students report higher perceived marginality (M = 40.18, SD = 10.68) than nonveteran nursing students (M = 38.82, SD = 9.51); t (1154) =2.09, p = 0.036. CONCLUSION: Veteran nursing students in this study demonstrate higher levels of perceived marginalization. Strategies aimed at decreasing attrition and marginalization should be implemented, thus improving the diversity of the nursing workforce.

Differences in Marginality Between Nursing Students With and Without Disabilities.

BACKGROUND: Barriers exist in nursing education for students with disabilities. Students with disabilities often experience associated stigma and a perceived lack of support by nursing faculty and academic leaders. METHOD: A nonexperimental descriptive design was used to examine differences in perceived marginality between nursing students with and without disabilities (n = 7,399) in the United States. RESULTS: Participants who identified as having a disability described more marginalization (M = 45.9, SD = 10.5) than participants who did not identify as having a disability (M = 38.3, SD = 9.2), t(927) = 19.4, p < .001. CONCLUSION: Findings suggest marginalization exists for students with disabilities. Academic leaders and faculty should address systems, structures, and polices that potentially pose barriers to self-reporting, matriculation, and progression of students with disabilities. [J Nurs Educ. 2022;61(8):429-438.].

Original Research: TikTok's 'Dancing Nurses' During the COVID-19 Pandemic: A Content Analysis.

BACKGROUND: Amid the challenges of the ongoing COVID-19 pandemic, health care workers are using social media to publish increasing numbers of posts, memes, and videos. On TikTok, a rapidly growing and widely used social networking platform, videos labeled "dancing nurses" have recently been trending. Whether nurses or the general public consider such videos to breach professional ethical standards is unknown. PURPOSE: The aim of this study was to analyze and describe the use of the social media platform TikTok by nurses whose videos featured dancing nurses during the ongoing pandemic. METHODS: Between March 1 and December 31, 2020, we conducted a search on TikTok using terms such as dancing nurse and hashtags such as "#dancingnurse." For each identified video, the numbers of followers, views, likes, concurrent COVID-19 morbidity and mortality rates, and other data were collected. For videos meeting the inclusion criteria, content analysis was performed to evaluate dancing nurse behaviors and apply the American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements, ANA social networking principles, and National Council of State Boards of Nursing social media guidelines. RESULTS: A total of 52 videos met all inclusion criteria and were included for analysis. These videos had a mean of 1.51 million views each. Among these videos, there were 356 violations of Code of Ethics provisions, social networking principles, and social media guidelines. Forty of the videos (77%) included a choreographed dance; 24 (46%) contained twerking and three (6%) featured dance moves such as pelvic thrusts and gyrations. CONCLUSION: The findings offer insight into how nurses are using TikTok, specifically with regard to posting videos that feature dancing nurses. Some of the analyzed videos included content that could be construed, in our view, as inappropriate and even sexually suggestive. The concern is that such videos could damage the professional image of nurses and downplay the seriousness of the current pandemic. It's essential that nurses who use social media consider the content and presentation of what they post. There is an urgent need for nurses to understand professional and workplace guidelines and policies regarding the use of social media, and how these may apply to content developed and posted on platforms such as TikTok.

Optimizing the productivity and placement of nurse practitioners and physician assistants in outpatient primary care sites.

BACKGROUND: It is increasingly imperative that organizational leaders continually assess nurse practitioners' (NPs) and physician assistants' (PAs) productivity, turnover, and vacancies. Optimizing the feasibility, impact, strategic placement, and monitoring increases patient access, improves wait times and affordability, and increases revenue. LOCAL PROBLEM: A healthcare system needed a systematic, data-driven approach aimed at optimizing productivity and placement of NPs and PAs in outpatient primary care sites. METHOD: Results from this project are reported using the Revised Standards for Quality Improvement Reporting Excellence framework. After formation of a QI team, a gap analysis, and action plans were developed and implemented. INTERVENTION/RESULTS: Priority areas requiring action included the development of an integrated position justification algorithm and tracking form addressing NPs' and PAs' placement, establishing consistent patient contact hours, setting workload expectations, and consistently communicating these via an organization-specific situation background, assessment, and recommendation communication tool. CONCLUSION: Health care leaders should leverage the talents of NPs and PAs meeting organizational benchmarks and goals as well as the needs of patients. Nurse practitioner and PA leaders should focus on benchmarking performance and analyzing barriers to optimization. These efforts are most beneficial when multidisciplinary in nature.

Differences in perceived marginalization in doctorally prepared nursing faculty.

BACKGROUND: Debate regarding the role of Doctor of Nursing Practice-prepared faculty in academic settings continues. Perceived barriers to successful integration include a lack of respect, inadequate infrastructure, and insufficient resources. PURPOSE: The purpose of this study was to compare differences in self-reported marginalization in doctorally prepared (Doctor of Philosophy/Doctor of Nursing Practice) nursing faculty working in academic settings. METHOD: A descriptive cross-sectional design was implemented to compare differences in self-reported marginalization between doctorally prepared faculty teaching in Commission on Collegiate Nursing Education accredited colleges. Marginality was measured using the Englund Marginality Index. FINDINGS: Results of an independent-samples t-test indicate that Doctor of Nursing Practice -prepared faculty self-reported higher levels of marginalization (M = 41.7, SD = 9.6) than Doctor of Philosophy -prepared faculty (M = 39.1, SD = 10.5); t(583) = 2.8, p = .006. DISCUSSION: Strategies to decrease marginalization include improving systemic issues surrounding shared governance and outdated tenure systems as well as enhancing infrastructures that improve collaboration among doctorally prepared faculty.

A quality improvement project: Defining and operationalizing a holistic admission selection policy.

Nationwide, faculty in colleges of nursing are struggling to define practices surrounding holistic admission. Faculty may support the idea of holistic admissions however, little is known about how policies and procedures are developed, operationalized and applied across pools of applicants. The objective of this article is to describe the quality improvement (QI) process surrounding the development of a holistic admission selection policy by faculty in a college of nursing. The Experience-Attributes- Metrics Model was altered and adopted for use in our prelicensure programs. Selection criteria were defined and operationalized. Findings indicate that the QI process took approximately two years. The new policy and tiering are currently being applied to our pools of admission candidates.