Addressing health equity through a telehealth maternal-newborn home visit for nurse practitioner students.

ABSTRACT: This educational innovation describes the implementation and evaluation of a telehealth maternal-newborn home visit clinical experience for nurse practitioner students at an urban, private research university in the Midwest. The visits were conducted using the Family Connects evidence-based universal support program for families with newborns to evaluate each family's unique risks and to align their needs with available community resources. Students were prepared for the clinical experience through advanced practice didactic modules and simulation and then participated in the visits over a 2-week period. After the clinical opportunity, both students and community health nurse collaborators completed a survey about their experiences. The students reported feeling prepared to participate in the visits, that they were able to meet clinical objectives using telehealth, and learned about the community resources available for families with newborns. The nurses reported feeling prepared to collaborate with nurse practitioner students and that they benefitted from having a student participate in the visits. The experience prepared the students to meet the needs of a diverse patient population during the early postpartum/newborn period by providing newborn care advice, addressing access to health, assessing social determinants of health, and considering community resource referrals to reduce disparities and improve health equity. This article describes how a telehealth clinical experience addresses the American Association of Colleges of Nursing Essentials for advanced-level nursing students and provides recommendations for incorporating and evaluating telehealth clinical experiences in pediatric advanced practice education.

Barriers to the Use of Pain Prevention Techniques During Immunization.

INTRODUCTION: The purpose of this project was to identify barriers to the use of pain prevention techniques during immunization. METHOD: A national, voluntary survey was distributed to members of the National Association of Pediatric Nurse Practitioners in June 2019. RESULTS: The survey gathered information about the type of practitioner (pediatric nurse practitioner, family nurse practitioner, nurse, etc.), practice location (inpatient, primary care, specialty care, etc.), and patient population served and also included information regarding geographic location, socioeconomic status, insurance coverage, and immunization status as well as current practice information. Respondents identified the following barriers: time (22.4%), availability (17.5%), lack of knowledge (17%), staff support (14.1%), cost (12.1%), lack of resources (7.4%), safety concerns (4.7%), environmental factor (3.4%), and other (1.4%). DISCUSSION: The lack of pain prevention techniques is primarily because of availability, lack of knowledge and staff support, and cost. Proposed means to address these barriers include the development of a toolkit.

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives.

PURPOSE: The purpose of this study was to assess nurses' knowledge, perceived self-efficacy, and intended behaviors relative to integrating the social determinants of health (SDoH) into clinical practice. DESIGN AND METHODS: A cross-sectional study was completed with 768 nurses working in three hospitals within a large regional healthcare system located in the Midwest. Data were collected using an adapted 71-item SDoH Survey, which measured nurses' confidence in and frequency of discussing the SDoH with patients, general knowledge of the SDoH, familiarity with patients' social and economic conditions, and awareness of their institution's health equity strategic plan to achieve health equity. The institution's health equity strategic plan reflects the organization's commitment to improving the health of individuals and neighborhoods by addressing the SDoH known to influence health status and life expectancy. Finally, participants were asked to describe barriers to incorporating the SDoH into practice along with completing five demographic items. Descriptive statistics were used to describe the findings. FINDINGS: Of the 768 respondents, 63% had a baccalaureate degree in nursing and 33.1% reported more than 20 years in nursing. Fifty percent of respondents reported feeling more knowledgeable or confident in their ability to discuss access to care issues with patients compared to the other SDoH. Identified barriers to discussing the SDoH included insufficient time to address identified needs and unfamiliarity with internal and external resources. Respondents stressed the need for interdisciplinary education and collaboration along with more information on the role of social workers. CONCLUSIONS: Nurses are more confident in discussing certain determinants of health and could benefit from more skill development in discussing SDoH issues and stronger collaborative partnerships to address identified needs. CLINICAL RELEVANCE: Findings from the study have implications for supporting the educational and resource needs of front-line nurses employed in hospitals and health systems seeking to address broader societal issues influencing the health status and outcomes of patients and communities.