Understanding the student's experience of community health nursing simulations.

OBJECTIVES: The purpose of this study was to explore nursing students' experiences after completing community health nursing simulation encounters. METHODS: The study used a descriptive qualitative design. Through conventional content analysis, the research team analyzed the experiences of 73 nursing students after participating in community health nursing simulation encounters. The data come from nursing students' responses to three post-simulation qualitative questions. RESULTS: Nursing students identified both positive aspects (simulation as a great learning method, useful in understanding community health nurses' roles, faculty's role in facilitating an effective learning environment) and opportunities for improvement (needing for clear objectives, expectations, and roles). CONCLUSIONS: Community health nursing simulation encounters can be a powerful educational method to help students experience and understand the roles of community health nurses. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Augmentation of the pre-brief component will further improve students' simulation experiences.

Cultural Humility Toolkit.

BACKGROUND: Diversity, equity, and inclusion (DEI) are increasingly recognized as core values for nursing education and practice. PURPOSE: The purpose of this article is to offer teaching tools and strategies to integrate cultural humility within the nursing curriculum and create a more inclusive learning environment. APPROACH: Various teaching tools, methods, and strategies are presented. OUTCOMES: Use of ground rules, an environmental assessment, examination of the curriculum landscape and teaching materials, bias awareness activity, modified privilege walk, Modified Monopoly, simulation, low-income community experiences, study abroad, debriefing, and evaluation with valid and reliable tools are suggested. CONCLUSIONS: By threading cultural humility concepts throughout the curriculum, nurse educators have the potential to shape learner perspectives to better appreciate and value diversity.

Asthma academy: A student nurse-led telehealth education program for low-income family caregivers of children with asthma.

AIMS: The aims of the Asthma Academy study were to (1) evaluate the telehealth performance of DNP students, (2) evaluate the perceived learning experience of DNP students and (3) investigate whether an association exists related to student performance and family caregiver outcomes. DESIGN: A descriptive study was conducted with doctor of nursing practice students. METHODS: Students conducted telehealth visits to help family caregivers of children with asthma and were rated on their performance by two faculty members using a rubric. Student perception data were gathered via survey. RESULTS: Out of a total possible score of 15 points, the mean telehealth performance score of students was 13.38 points. Students indicated the telehealth experience was valuable and that they were satisfied with their learning. This model of leveraging telehealth to bridge nursing students to the community may be adapted to help family caregivers of children with various disease foci.

Assessing Undergraduate Student Nurses' Performance in Various Public Health Roles Using Simulation.

Purpose: To expose students to various public health roles and complement clinical experience using simulated encounters.Design: This exploratory study assessed students' performance of basic nursing tasks for three public health nurse roles.Methods: 15-guided questions were used to evaluate a convenience sample of 137 students' expected performance compared to their actual performance of basic nursing skills.Findings: Students' performed well in all nurse roles with some significant differences in completing a few critical tasks in the case manager and school nurse roles.Conclusion: Simulation can address gaps in nursing programs and expose student nurses to various public health roles using real-life scenarios.Clinical Evidence: Lack of clinical sites in public health limits students' experience to a myriad of nurse functions within communities.

Medical Mistrust Among Black Women in America.

This qualitative research study highlights medical mistrust as a significant barrier to quality health care for Black women. Unraveling mistrust is essential for reducing health disparities and improving well-being for women and their families. Three research sites were included: Florida, Ohio, and the U.S. Virgin Islands. Three 90-minute focus groups were convened with 10 women in each of them. The discussions were recorded. Five themes will be discussed through the voices of women from each of the sites. Mistrust of healthcare professionals was associated with fears about being rejected, embarrassed, and misunderstood during the clinical encounter. Others reported that providers who were reluctant to make physical contact with them during the clinical visits provoked feelings that the color of their skin might seem "dirty." Finally, this research will help to inform discussions about COVID-19 vaccine hesitancy, which remains a critical health concern among Black women and healthcare providers.

Improving knowledge and decreasing depressive symptoms in caregivers of children with asthma through the asthma academy: A randomized controlled trial.

Background: Caregivers of children with asthma demonstrate higher levels of anxious and depressive symptoms when compared to caregivers of healthy children. Objectives: The objectives of this study were to: 1) Evaluate feasibility and acceptability of two nurse-led, remotely offered interventions for caregivers of children with asthma; 2) Compare effectiveness of two interventions (a virtual education session and a virtual education session supplemented with a telehealth visit) in relation to caregiver outcomes, and 3) Assess the preliminary effect of the interventions on caregivers' knowledge of asthma, sleep, anxiety and depressive symptoms. Methods: A mixed methods approach was used inclusive of a qualitative, descriptive design and randomized controlled trial design. Caregivers were provided virtual education and telehealth visits and evaluated from pre-posttest. Results: The intervention was found to be feasible and acceptable. Both the virtual education session and telehealth visit were effective. The intervention had a significant effect on caregiver's asthma knowledge and depressive symptoms (p<.05), but did not affect caregiver's sleep or anxiety. Qualitative analysis of the virtual educational session revealed themes of 1) valuable learning experience, 2) more medication education needed, and 3) appreciated remote format. Qualitative analysis of the telehealth visits revealed themes of 1) educational, helpful, and worthwhile and 2) virtual offering was easy and convenient. Conclusions: Remotely conducted, nurse-led interventions such as virtual education sessions and telehealth visits are a feasible, acceptable, and effective way to improve caregiver outcomes.

Barriers and Facilitators of Asthma Management as Experienced by African American Caregivers of Children with Asthma: An Integrative Review.

INTRODUCTION: African American children with asthma demonstrate significant health disparities and poor health outcomes. Understanding the burdens faced by parents and caregivers of children with asthma may be helpful to develop future interventions to address this disparity. PURPOSE: The purpose of this integrative review was to reveal the barriers and facilitators of child asthma management experienced by African American caregivers. METHOD: Whittemore and Knafl's (2005) method of integrative review was used to review 40 articles. The integrative review involved appraising the quality of the literature, conducting a thematic analysis, and evaluating the barriers and facilitators of pediatric asthma management experienced by African American caregivers. RESULTS: Barriers and facilitators were identified as themes. Barriers included caregiver burdens, and lack of home and neighborhood safety. Facilitators were family and community support, education and empowerment, and culturally competent healthcare providers. DISCUSSION: To improve the care of African American children with asthma, nurses should work to engage, communicate, and foster trust with families. Nurses should assess and address the family caregivers' burdens while emphasizing support systems.

Psychological and Socioeconomic Burdens Faced by Family Caregivers of Children With Asthma: An Integrative Review.

INTRODUCTION: Asthma affects nearly 1 in every 12 children in the United States. Caring for a child with asthma poses significant challenges for the parent or caregiver. The purpose of this integrative review was to identify the psychological and socioeconomic burdens faced by family caregivers of children with asthma. METHOD: An integrative review was conducted to review and appraise 80 studies. RESULTS: Psychosocial burdens included decreased mental health, quality of life, sleep, family stress, educational deficits, cultural and health disparities, and health care communication challenges. Socioeconomic burdens included poor access to care, as well as work and financial challenges. Studies demonstrated a link between family caregiver health and child health outcomes. Facilitators included education and empowerment, social support, and use of technology. DISCUSSION: As the family caregiver's health directly affects the asthmatic child's health, addressing the burdens of family caregivers should be a key consideration in pediatric asthma care.

Medication Adherence of Latino Children and Caregivers: An Integrative Review.

INTRODUCTION: There are significant disparities in medication adherence among underserved minority groups such as Latinos. Adherence to medication is a primary determinant of treatment success. Little is known about medication adherence among Latino children. This integrated review aims to describe what is known about medication adherence among Latino children and explore barriers and facilitators to medication adherence. METHOD: This review was guided by Whittemore and Knafl's method of integrative review and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. RESULTS: Of the 20 articles reviewed about medication adherence among Latino children, the analysis of these articles revealed four major themes: (1) low adherence, (2) low adherence associations, (3) child outcomes, and (4) effective interventions. CONCLUSION: Health practitioners should consider medication adherence associations and interventions when collaborating with the family caregiver to improve child outcomes.

Underrepresentation of Racial Diversity in Simulation: An International Study.

AIM: The purpose of this study was to: 1) examine the presence of racial diversity in simulation centers globally and 2) determine the opinion of the simulation community related to incorporation of a diversity component into international simulation standards. BACKGROUND: Leading organizations in nursing education recommend improved efforts toward diversity and inclusion. Research suggests a lack of diversity in simulation-based education. METHOD: This study employed a mixed-methods design. RESULTS: Quantitative results demonstrated an underrepresentation of racial diversity in manikins, body parts/task trainers, standardized patients, and simulation facilitators. Two thirds of respondents indicated that international simulation standards should recommend a diversity component. Qualitative findings indicated categories of: 1) challenges of purchasing, realism, and availability; 2) importance of diversity in simulation; 3) representation of the regional population; 4) more diversity considerations needed; and 5) presence of diversity. CONCLUSION: There is a continued need for diversity advocacy efforts in nursing education.

Nursing Management of the Patient Undergoing Focused Ultrasound: A New Treatment Option for Essential Tremor.

Essential tremor (ET) is among the most common neurological movement disorders that causes postural or action tremors, with an estimated prevalence nationwide of less than 3% of the population. The incidence of ET increases with age but often affects younger adults and has a familial trait association. Depending on disease progression, ET can cause significant limitations for individuals, in many cases, significantly limiting their ability to perform activities of daily living and occupational responsibilities. Until recently, treatment of ET heavily relied on medication management and invasive surgery, such as deep brain stimulation. With advances in the use of focused ultrasound (FUS) for treatment of various medical conditions, recent clinical trials have revealed positive outcomes with the use of FUS as a less invasive approach to treat patients with medication-refractory ET. In a large academic medical center in the mid-Atlantic region, the Department of Neurosurgery conducted a continued access study, recently approved by the Food and Drug Administration, to evaluate the effectiveness of transcranial FUS thalamotomy for the treatment of medication-refractory ET. One patient's experience will be introduced, including discussion of evidence-based treatment options for ET and information on the nursing management of the patient undergoing FUS thalamotomy.

Caring for the patient undergoing transsphenoidal surgery in the acute care setting: an alternative to critical care.

Patients undergoing transsphenoidal surgery have complex needs that require expert care and the coordination of a multidisciplinary team of healthcare professionals. In general, patients requiring this surgery are cared for in intensive care units. An innovative program at the University of Virginia, developed 11 years ago, enables these patients to be cared for on an acute care unit for the entirety of their hospitalization. The success of this program is evident in positive clinical and financial outcomes.