The crucial importance of accurate enumeration to bringing public health nurses out from behind the "Other" category.

Public health nursing is a unique field of nursing with specialized skills, roles, and functions designed to address disease prevention and health promotion of populations and to respond to emerging health crisis such the COVID-19 pandemic. Despite the unique role and professional responsibilities of public health nurses, they are not identified as a distinct nursing specially by the U.S. Bureau of Labor Statistics workforce data. This is problematic as accurate enumeration of public health nursing can supply the necessary data to identify gaps of these essential professionals. To effectively address this gap and have the capacity to identify public health nursing workforce needs, a method to define, describe, and enumerate the public health nursing workforce nationally with a unique split Standard Occupational Classification is necessary. Further, the Centers for Disease Control and Prevention's Public Health and Data Authority must have the ability to coordinate data reporting on the public health workforce, support standardization, and streamline annual enumeration.

Social Capital as a Framework to Address Organizational Climate Change Policy.

PURPOSE: To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels. METHOD: Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy. RESULTS: AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies. CONCLUSION: Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11-15.].

Nurses´ and nurse managers´ perceptions of sustainable development in perioperative work: A qualitative study.

AIMS AND OBJECTIVES: To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision-making in perioperative work. BACKGROUND: Sustainable development involves interpersonal social and cultural relations and long-term economic and ecological thinking in societal decision-making. These dimensions are well-suited for a foundation of decision-making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective. DESIGN: Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ). RESULTS: The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision-making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision-making process in perioperative work. CONCLUSIONS: Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision-making in perioperative work. RELEVANCE TO CLINICAL PRACTICE: Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision-making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely.

The role of nurses in surveillance to enhance global health security: A delphi study.

BACKGROUND: Internationally, nurses are gaining recognition for their contributions to public health and global health initiatives, however, their contributions to surveillance and the detection of new and emerging infectious disease, which is an important element of global health security, remain largely unknown. PURPOSE: The purpose of this study was to investigate the perceptions of nurse experts related to the current and optimal roles of nurses in surveillance of new and emerging infectious diseases. Additionally, this study aimed to identify the skills needed by nurses in all practice settings for optimal performance of surveillance and to identify barriers to achieving optimal performance of surveillance. METHODS: A three-round Delphi study was conducted. Nurse experts participated in Round 1 interviews followed by ranking current and optimal role, skill, and barrier statements in Rounds 2 and 3. FINDINGS: Findings revealed four current roles and 13 optimal roles for nurses in surveillance, 13 skills needed to perform surveillance activities, and seven barriers to optimal performance of surveillance activities by nurses. DISUCSSION: Results of this study are intended to inform nursing practice and education in the U.S., and to provide guidance on the role of nurses in surveillance of new and emerging infectious disease as part of the Global Health Security Agenda.

Addressing the Health Risks of Climate Change in Older Adults.

Our climate is changing. These changes have an impact on health, especially in vulnerable populations such as older adults. Many older adults lack the physical, cognitive, social, and economic resources to avoid and/or mitigate the effects of exposure to extreme weather events. The purpose of the current article is to help nurses understand climate change and how that relates to the need for specific interventions to support climate adaptation for the older adult population. A model of exposure, contact to stressors, and adaptive capacity are used to address the health needs of older adults in the face of climate change. Gaps in nursing knowledge, resources for nurses, and a proposed agenda for research and practice in climate change are offered. Gerontological nurses are in an important position to lessen the harm of climate change in older adults through practice, research, and policy. [Journal of Gerontological Nursing, 45(11), 21-29.].

Ethical Principles and Guidelines of Global Health Nursing Practice.

BACKGROUND: Nurses are among the many U.S. health professionals engaged in international learning or service experiences and often travel to low-resource countries lacking guidance for ethical practice, respect for host partners, or collaborative work in different health systems. PURPOSE: The aim of this study is to develop evidence-based principles or guidelines for ethical global health nursing practice. METHODS: A three-round Delphi study was conducted. Global health nurse experts participated in Round 1 focus group, followed by nurses with global health expertise ranking global health nursing statements in Rounds 2 and 3. DISCUSSION: Findings led to 10 Ethical Principles for Global Health Nursing Practice and 30 statements for Ethical Guidelines in Global Health Nursing. These Ten principles address beneficence, nonmaleficence, dignity, respect, autonomy, social justice, and professional practice. The 30 guidelines offer more specific actions nurses must consider when working in global settings.

Health Concerns of Northeastern Pennsylvania Residents Living in an Unconventional Oil and Gas Development County.

OBJECTIVES: This study was conducted to describe the health concerns of residents of an unconventional oil and natural gas development (UOGD) community and identify methods to best disseminate health information to the residents. DESIGN AND SAMPLE: A qualitative descriptive study of 27 residents of Wyoming County, Pennsylvania, was conducted. RESULTS: Residents described their health concerns in terms of their changing community as a result of UOGD, their feelings of stress and powerlessness related to these changes, and the limited response of their local policymakers and protective agencies. There were indications of misinformation related to routine environmental health and UOGD environmental risks. Web-based educational programs with downloadable printed materials to bridge the knowledge gaps of residents and health professionals are recommended. CONCLUSIONS: Recommendations include public health nurses providing education to communities and other health professionals regarding environmental health risks, working with communities to advocate for health-protective regulations, and adopting a community-based participatory approach to meet the needs of community members.

Effect of an Education Intervention on Nursing Students' Knowledge of and Attitudes Toward Caring for Transgender and Nonbinary People.

BACKGROUND: Transgender and nonbinary (TGNB) people experience inequities in health care access, quality, and outcomes. Health care professionals' lack of knowledge and biased attitudes toward gender minorities contribute to inequitable care. PURPOSE: This study examined the effect of TGNB health education on nursing students' knowledge and attitudes about caring for TGNB clients. METHODS: A quasi-experimental study using a one-group pretest/posttest design was conducted with 46 nursing students at 2 private baccalaureate nursing programs. RESULTS: A paired-samples t test found a significant increase in knowledge about caring for TGNB clients at posttest ( P = .02). Attitudes toward caring for TGNB clients showed a significant improvement in the Sex and Gender Beliefs subscale at posttest ( P = .014). CONCLUSIONS: The findings suggest that TGNB health education is effective for inclusion in nursing curricula to better prepare nurses to care for gender-diverse clients.

Climate change integration in nursing education: A scoping review.

BACKGROUND: The environmental impacts of climate change such as extreme weather, affects human physical and mental health; therefore, including climate change and health is important in nursing education. Despite the recognition of the link between climate change and health, this important knowledge has not yet been systematically integrated into nursing curricula, highlighting the need for immediate action to prepare nurses for these emerging human health challenges. OBJECTIVES: The objective of this review was to gain an overview of the existing literature exploring climate change in nursing curricula and answer following questions: DESIGN: Scoping review. METHODS: A protocol was created and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-SrC). Five data bases were searched: CINAHL, Academic Search Premier, PubMed, Scopus and Cochraine, in addition to databases, grey literature was searched from different sources (reference lists, Google). A total of 1055 articles were derived from the search and 47 articles were included in this review. After selection results from selected studies on educational interventions and climate change education, and opinion pieces were charted, followed by a team review and consensus on the findings. CONCLUSION: This review shows the importance of integrating the topic of climate change into nursing curricula. This integration of climate change-related content into nursing curricula is essential for preparing students, not just for their future roles in healthcare, but also their role in policy and climate justice. These results also reflect strong support from students for that integration. But while progress has been made, further research is essential to evaluate the impacts of these teaching strategies on nursing education.

Health promotores' perceptions of their communities' health needs, knowledge, and resource needs in rural Nicaragua.

OBJECTIVES: This study was conducted to determine rural Nicaraguan health promotores' perceptions of their community's health problems, their self-identified learning needs, and resource needs. Despite the valuable contributions of promotores, there is limited research regarding unpaid volunteer promotores' perceptions of their needs in providing care to remote communities. DESIGN AND SAMPLE: A qualitative descriptive study of 13 unpaid, volunteer promotores in Waslala, Nicaragua, was conducted. MEASURES: Data were collected during individual interviews with seven promotores and two focus groups with 13 promotores. Data were analyzed by reading verbatim transcripts repeatedly and establishing general themes. Promotores confirmed the findings. RESULTS: Waslalan promotores described a synergy of traditional folk health beliefs and natural practices along with use of modern medications while working to meet the health needs of their communities. Without much formal training, the promotores used public health strategies to influence health behaviors and address health disparities in the communities they serve. Serving their communities and God were their motivation in their work. CONCLUSIONS: Recommendations include supporting efforts to meet promotores' needs regarding community health education with messages from community leaders and nurses, finding methods to financially compensate promotores, and including promotores in health program planning and evaluation.

Female Arab-Muslim nursing students' reentry transitions.

As nursing students are increasingly studying abroad and returning to their home countries to practice, it is important to identify international nursing students' reentry transition to understand their reentry needs. Phenomenological inquiry was used to describe the reentry experience of seven Omani nurses after studying in the United States. The nurses' reentry experience was influenced by the personal and professional transformation from studying abroad and included themes of adaptation to cultural differences and service to themselves, their profession, and their nation. These nurses returned home to resume previous roles; they were changed and this required them to redefine and adapt to their roles within their families and workplace. Nurses returning from international study could benefit from a formal reentry program to assist their transition to family, community, and professional life and to enhance the nurses' contribution from their international education.

Lived Experiences of Young Adults With Lymphoma During Acute Survivorship.

BACKGROUND: Hodgkin lymphoma and non-Hodgkin lymphoma are hematologic malignancies of the lymphatic system with increased prevalence in young adults. Numerous studies have examined the health-related quality of life dimensions in young adults with lymphoma; yet, limited research has investigated the experiences of this population. OBJECTIVE: This study aimed to explore the lived experiences of young adults with Hodgkin lymphoma and non-Hodgkin lymphoma ( n = 8) receiving acute treatment from one National Cancer Institute-Designated Cancer Center in the Northeastern United States. METHODS: A qualitative interpretive phenomenological study design and method was applied to explore the lived experiences of young adults with lymphoma during acute survivorship. RESULTS: The participants lived experiences were shaped by the diagnostic challenges and impediments of cancer and lymphoma in young adults. Through postdiagnosis, they were determined to safeguard parents and close family members from the burden of cancer. The bonds between medical oncologists and nurses offered the participants a dynamic structure to endure acute survivorship. CONCLUSION: Cancer was challenging to diagnose in this sample of young adults with lymphoma. The presence of nurses was shown to be deeply impactful for young adults with lymphoma. More research is necessary to understand the experiences of young adults with lymphoma through extended or long-term survivorship. IMPLICATIONS FOR PRACTICE: Healthcare providers require additional education regarding the diagnostic guidelines in young adult patients with lymphoma. This study underscores the importance of well-defined and structured postdiagnosis survivorship care in young adults with lymphoma.

Protecting Children's Health: Asthma and Climate Change.

ABSTRACT: Children are particularly vulnerable to the impacts of climate change. Their lungs are developing, making children with asthma especially susceptible to temperature extremes, variations in precipitation, poor air quality, and changes in pollen and flora. Structural and social determinants of health, such as racism and poverty, that disproportionately affect children of color are linked to higher rates of asthma and negative effects of climate change. These factors lead to increased absences from school and social activities, loss of work for caregivers, and increased health care costs, thus negatively affecting children, their families, and the greater community. Nurses must support caregivers and children to link climate change to asthma care, be involved in health education; climate change mitigation and adaptation strategies and policies; and develop the evidence to address climate change and asthma strategies. We address the impacts of climate change on children with asthma and nursing adaptation responses.

Preserving health in the Marcellus region.

Community health nurses (CHNs) have an opportunity and responsibility to address potential environmental health issues related to shale drilling, even in the face of scientific uncertainty. Potential health impacts to air and water quality related to shale drilling are addressed within the context of the CHNs role of educator, case finder, advocate and researcher. Since 2005, an estimated 5,500 unconventional natural gas wells have been drilled in Pennsylvania's Marcellus Shale (Pennsylvania Department of Environmental Protection [PA DEP], n.d.), resulting in tremendous controversy throughout the state regarding impacts to human health and the environment. Although there are numerous anecdotal reports of illnesses in humans and animals living in drilling areas, there is a notable lack of peer-reviewed research on the impacts. Research efforts are underway to study these issues, including a proposed retrospective study of hospital and clinic data by Geisinger Health System's Weis Center for Research (Begos, 2012). However, CHNs have the opportunity and the responsibility to help address potential environmental health issues related to shale drilling, even in the face of scientific uncertainty. This responsibility is highlighted by the American Nurses Association's (ANA) (2003, p. 2) adoption of the Precautionary Principle, which states that "when an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically." CHN practice includes the promotion and preservation of health, and the prevention of disease, as well as assisting people in their response to illness (Maurer & Smith, 2009). In Pennsylvania's Marcellus Shale regions, CHNs must assume the critical nursing roles of educator, case finder, advocate and researcher when addressing the health needs in shale drilling communities. Unfortunately, CHNs practicing within these regions may feel unprepared to take on these roles related to unconventional gas extraction. The following discusses these CHN roles in the context of environmental health impacts of shale drilling on air and water quality.

Nursing Students' Self-Efficacy in Immigrant Health.

BACKGROUND: The United States has the largest, most diverse immigrant population. Nurses will care for immigrant clients in all areas of nursing practice. PURPOSE: The purpose of this study was to determine nursing students' self-efficacy in working with immigrant clients following a service-learning experience. METHODS: A pre-/posttest descriptive study was used to measure students' self-efficacy in cultural aspects of screening, providing health education, and assisting with health care access prior to and after a voluntary service-learning experience at a resettlement agency. RESULTS: Statistical significance was found in overall scale score and in all 19 individual items except 2 related to working with (P = .21) and communicating with (P = .49) the health care team. Overall, pretest and posttest results revealed that students' self-efficacy working with immigrant clients was improved. CONCLUSION: Collaborating with an immigrant resettlement program to provide a structured immigrant health learning experience for prelicensure nursing students can improve self-efficacy in working with immigrant clients.

Going alone: the lived experience of female Arab-Muslim nursing students living and studying in the United States.

Since 2004, international student enrollment in the United States has increased. Middle Eastern students studying in the United States have been part of the increase. In 2008-2009 there were 29 140 Middle Eastern students, representing an 18% increase from the previous academic year. Despite these increases, there is limited research examining the experience of Arab-Muslim international students or international nursing students studying in the United States. Phenomenological inquiry was used to describe the experience of 12 female Omani nurses living in the United States while studying for their baccalaureate degrees in nursing. The women described the experience of going alone and being away from the support and presence of their large, extended families; this influenced their international student experience. They also described their religious, cultural, and educational adaptation. The experience of living and studying nursing in the United States was transformational as they became self-reliant, learned their capabilities, and adapted to cultural and educational expectations.

Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review.

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl's framework for an integrative review. Ninety-eight articles were included in the review from three databases-PubMed, Web of Science, and Scopus-with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

Identifying the key personnel in a nurse-initiated hospital waste reduction program.

Hospitals in the United States generate more than 6600 tons of trash a day and approximately 85% of the waste is nonhazardous solid waste such as food, cardboard, and plastic. Treatment and management of hospital waste can lead to environmental problems for the communities that receive the waste. One health system's shared governance model provided the foundation to develop a nurse-led hospital waste reduction program that focused on point-of-care waste management. Waste reduction program development required working with a variety of departments within and external to the health system. The interdisciplinary approach informed the development of the waste reduction program. This article identifies the key departments that were necessary to include when developing a hospital waste reduction program.

Advancing Gerontological Nursing Science in Climate Change.

Older adults have unique health risks related to climate change. This commentary addresses the health impacts of climate change for older adults, identifies gaps in gerontological nursing research, and highlights areas for research to address the significant gap in nursing science. Climate risks of extreme weather events, such as heat, rain, flooding, and wildfires, as well as poor air quality, vector-borne diseases, interruptions of services, and treatment plans all place older adults at risk of experiencing greater morbidity and early mortality. Despite these risks, there is a gap in nursing research related to climate change and aging. Nurse scientists can address this gap with an interdisciplinary approach. There are climate resources and theoretical frameworks to support scientific inquiry. Funding sources must be made available to assure rigorous scholarship of climate-related health impacts for older adults. Gerontological nurse researchers must build capacity to address climate change and health. [Research in Gerontological Nursing, 13(1), 6-12.].

Identifying best practices in electronic health record documentation to support interprofessional communication for the prevention of central line-associated bloodstream infections.

BACKGROUND: There is a paucity of research on best practices for communication through the electronic health record (EHR) to support shared decision-making and to prevent adverse events. To explore this issue, this study focused on interprofessional communication around a specific clinical issue, the prevention of central line-associated bloodstream infections. METHODS: The Delphi technique was used to describe what information is needed to support decisions regarding central venous catheter (CVC) management, and best practices for communicating this information among the interprofessional team. RESULTS: The expert panel, 4 physicians and 6 nurses, identified 12 information types necessary for decisions regarding CVC management and the removal of unnecessary lines. For each of the 12 information types, the panel reached agreement regarding the best channel to communicate this information, including asynchronous EHR formats and synchronous oral channels. CONCLUSIONS: Findings address 2 important aspects of postinsertion CVC practices and a gap in the literature by moving beyond a description of current practices to a description of how the EHR ought to be used to support collaboration and interprofessional communication. Future research should examine how the communication practices identified in this study contribute to a reduction in central line-associated bloodstream infections.