Using the Structural Influence Model to Explore U.S. Latina/O/X/E Undocumented Immigrants' COVID-19 Information Acquisition, Perceptions, and Prevention Behaviors.

In the first year of the COVID-19 pandemic, U.S. undocumented immigrants were at heightened risk of contracting COVID-19, with many of them being "frontline essential workers" and residing in crowded living spaces. Given undocumented immigrants' elevated susceptibility to contracting COVID-19 at the peak of uncertainty surrounding the virus, we used the structural influence model of communication to explore: (1) how undocumented immigrants acquired information about COVID-19; (2) how they assessed information trustworthiness and accuracy; (3) their perceptions of COVID-19; and (4) how they prevented or managed COVID-19. Drawing from semi-structured interviews with 46 Latina/o/x/e undocumented immigrants residing in California, we found four key themes: (1) (dis)trust in traditional media as participants relied heavily on social media for COVID-19 information; (2) weak and strong ties played a crucial role in co-constructing health outcomes with different levels of organization; (3) learning about COVID-19 through (in)direct experiences; and (4) coping through health literacy and cultural beliefs. The study's findings can inform future efforts to reach highly-vulnerable immigrant communities during a crisis (or different outbreaks in COVID-19 variants), and hopefully, help reduce health inequities.

Conducting multisite research studies in nursing education: brief practice of CPR skills as an exemplar.

Few large, multisite studies have been conducted in nursing education, and literature pertaining to conducting those studies is lacking. We recently completed a randomized trial to examine the effects of brief practice on nursing students' retention of CPR psychomotor skills. The purpose of this article is to describe strategies for implementing a multisite study in nursing education, using our research as an exemplar. Strategies are presented for structuring a multisite study; selecting, preparing, and communicating with team members across sites; selecting sites; recruiting and retaining participants; managing the technical aspects of an intervention; and collecting and managing data. Ethical considerations also are explored.

Deliberate practice of motor skills in nursing education: CPR as exemplar.

Our study explored the effects of deliberate practice on the retention ofcardiopulmonary resuscitation (CPR) psychomotor skills among nursing students. The practice sessions were short, six minutes a session one time a month. Differences in performance between students who had deliberate practice and a control group, with no practice beyond the initial training, were compared every three months for one year. The intervention group performed better than the control over the 12 months. There is a need in nursing education for deliberate practice of relevant and high-use skills for students to improve their performance and gradually develop their expertise.

HeartCode BLS with voice assisted manikin for teaching nursing students: preliminary results.

The purpose of this study was to evaluate the effectiveness of HeartCode BLS, a self-directed, computer-based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopulmonary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor-led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReporting System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who had the standard, IL course with regular manikins.

Advantages and barriers to use of HeartCode BLS with voice advisory manikins for teaching nursing students.

Nursing students are expected to have competency in cardiopulmonary resuscitation (CPR): they may care for patients at risk for cardiac arrest and may encounter other emergency situations in their clinical practice. In the United States, students may take a basic life support (BLS) course prior to entering a nursing program or beginning their clinical experience. Extensive research has shown, however, that CPR knowledge and skills decline rapidly, within weeks of completing a course. The purpose of this paper is to describe advantages and barriers to the use of HeartCode BLS with voice advisory manikins for learning and practicing CPR psychomotor skills in a nursing education program.

Using a wiki in nursing education and research.

With a wiki, learners can share information, resources, and experiences, and work together as a group. A wiki is equally valuable to a nursing research team: it can be used to communicate information to team members; foster collaboration among the team; disseminate resources, forms, and other documents for conducting the research; and share experiences with study implementation. Potential uses of a wiki in nursing education and research are discussed in this paper. One team's use of a wiki in a large multisite nursing education study is reported.

Planning and managing a complex multisite study in the age of technology.

A 2-year long, multisite research study that evaluated cardiopulmonary resuscitation skill decay among nursing students was conducted at 10 schools of nursing across the United States. The study was conducted in two phases and required carefully timed sessions for skill performance. Multisite studies in nursing education need to be carefully planned. Time delays should be anticipated with processes and Institutional Review Board protocols across sites. All team members were trained and consistently supported during the entire study. While challenges and obstacles were identified, innovative solutions were implemented that assisted the research team to successfully complete the study. The use of new and existing technology allowed the team to surmount many of the challenges encountered in this study. The purpose of this article is to describe the logistics, processes, challenges, and lessons learned related to conducting a complex multisite study.

Successful blood pressure control in the African American Study of Kidney Disease and Hypertension.

BACKGROUND: The African American Study of Kidney Disease and Hypertension (AASK) is an ongoing trial to evaluate the effect of blood pressure and choice of antihypertensive drug on the rate of decline of renal function. OBJECTIVE: To present the success of the AASK in achieving the trial's rigorous blood pressure goals in an extremely challenging patient population. METHODS: The AASK participants included African American patients with hypertension (n = 1094), aged 18 to 70 years, with glomerular filtration rates between 20 and 65 mL/min per 1.73 m(2) and no other identified causes of renal insufficiency. Participants were randomized to a goal mean arterial blood pressure (MAP) of either 102 to 107 mm Hg (usual MAP goal) or 92 mm Hg or less (low MAP goal). Participants in each of these groups were also randomized (double-blind) to a regimen containing metoprolol succinate, ramipril, or amlodipine besylate. Additional agents were added, if required, in the following recommended order: furosemide, doxazosin mesylate, clonidine hydrochloride, or hydralazine hydrochloride (or minoxidil, if needed). RESULTS: In participants randomized to the low MAP goal, the percentage of participants who achieved a blood pressure of less than 140/90 mm Hg increased from a baseline of 20.0% to 78.9% by 14 months after randomization. For usual MAP goal participants, the corresponding percentages increased from 21.5% to 41.8%. The difference in median levels of MAP between the 2 MAP goal groups increased and remained at approximately 12 mm Hg. Blood pressure reduction was similar regardless of age, sex, body mass index, education, insurance or employment status, income, or marital status. CONCLUSION: The blood pressure goals set and achieved in AASK participants clearly demonstrate that adequate blood pressure control can be achieved even in hypertensive populations whose blood pressure is the most difficult to control.

Diagnosis and management of laryngotracheal trauma.

Laryngotracheal trauma is life-threatening. We identified 23 patients between 1992 and 1998 with laryngeal (12), tracheal (8), and combined injuries (3). Nineteen patients had penetrating trauma (gunshot wound, 12; stab wound, 7), and four patients had blunt injury. Flexible laryngoscopy identified the injury in 8 of 12 patients (75%), and computer tomography scan was positive in 9 of 9 patients (100%). Twelve of the 19 patients with penetrating wounds were managed by primary repair, 4 had endotracheal intubation without surgical repair, and 3 were observed. No patient with a blunt tracheal injury required repair. Two had endotracheal intubation, and two were observed. A high index of suspicion is essential to identifying laryngotracheal injury. Computer tomography scan is a sensitive diagnostic test for laryngotracheal injury, and may be indicated despite normal flexible laryngoscopy. The decision to repair injuries or observe injuries is primarily based on respiratory distress and associated injuries.