Addressing the Mental Health of Nursing Students During the Pandemic: The Evaluation of a Needs Assessment by a College of Nursing Mental Health Task Force.

BACKGROUND: A Mental Health Task Force (MHTF) was developed in a large public college of nursing in the Southeastern United States to address the urgent mental health needs expressed by growing numbers of nursing students related to the coronavirus disease 2019 (COVID-19). AIMS: The purpose of this study was to report on a needs assessment conducted by the MHTF. METHODS: The needs assessment study design was a 16-item cross-sectional online survey and four "Town Hall" focus groups with nursing students, faculty, and staff (n = 1-8 participants per group). Survey data were analyzed using descriptive statistics and free-text questions from the survey and focus groups were analyzed using a qualitative descriptive approach. RESULTS: Undergraduate and graduate students (n = 115) ranging in age from 17 to 50 years completed the survey; 95% female, 94% full-time, 56% employed, 77% White, and 81% in the Bachelor of Science in Nursing program. Eleven students participated in the focus groups. The analysis of the free-text survey questions identified the students' perceived needs. Mental health care was the most frequently requested, followed by faculty check-ins, stress management, and peer support. CONCLUSIONS: The administration of the survey provided an opportunity for students to communicate concerns and make requests. To address the ongoing effects of the COVID-19 pandemic on nursing students, multi-modal needs assessments should be conducted periodically to identify priority mental health needs.

Recommendations for evolving a doctor of nursing practice program.

As Doctor of Nursing Practice (DNP) programs have evolved within the nursing profession and nursing academia over the last 20 years, pedagogy and curriculum in DNP education have also continued to evolve. Educational innovation requires continuous assessment to ensure quality and efficacy are maintained. Using the Knowledge to Action (KTA) framework, we adapted the knowledge regarding best practices in a DNP program to fit our College of Nursing needs, our community of learners, and sustain this process improvement by implementing programmatic changes that enhanced the quality and rigor of the DNP program. A newly formed task force identified barriers and opportunities including lack of DNP-prepared faculty, changes needed to the scholarly project paper, revision of the DNP curricula, and a need for a mentor group model to replace the traditional committee structure. Recommendations to strengthen DNP programs include choosing a process model or framework to serve as a guideline for program evaluation and improvement, create a faculty-led task force that continuously monitors program elements, and conduct annual mini retreats to facilitate faculty discussion and review of program elements.

Curriculum and teaching methodologies that effectively refine DNP students' project proposals.

BACKGROUND: Despite early and continuing development of guidelines and frameworks by scholars and others, including AACN, to streamline the DNP project process, incorporation of DNP project resources into educational practice remains impeded. PURPOSE: To share a curricular innovation and specific teaching methodologies aimed at refining DNP students' project proposals. METHODS: Faculty developed a new DNP project proposal course utilizing low stakes writing assignments with feedback to elevate student learning and performance. RESULTS: Midterm evaluation allowed students to provide feedback and faculty to make course or assignments changes. End-of-course evaluation score showed the new course was above the overall college mean. The new course was associated with an increased number of successful DNP project defenses over previous methods. CONCLUSION: Implementing a structured DNP project proposal course is a successful and sustainable strategy and results in a streamlined approach and a more manageable pathway to complete DNP projects.

Tipping Point: Integrating Social Determinants of Health Concepts in a College of Nursing.

BACKGROUND: State health rankings, national nursing education reform, and increasing awareness of social injustices propelled a college of nursing to transform its strategic plan, infrastructure, and curriculum. The prevalence of social determinants of health (SDOH) in South Carolina indicates a need for the state's health workforce to understand the impact of SDOH and recognize strategies to address and ameliorate SDOH. With the paradigmatic integration of diversity, equity, and inclusion in nursing education, there is a need for programmatic and curricular integration of SDOH to increase awareness, foster understanding, and transform perspectives among nursing faculty, staff, and students. METHOD: Institutional changes were made to improve inclusive excellence, and the evolutionary process is described. RESULTS: SDOH-rich resources and experiential learning have been integrated across a college of nursing. CONCLUSION: This journey is ongoing and essential for preparing nurses to advance patient advocacy, health equity, and social justice for diverse populations. [J Nurs Educ. 2021;60(12):703-706.].

The Cultural Perceptions of Healthy Eating in Mexican American Children: A Focused Ethnography.

Introduction: Obesity in Mexican American children is reaching epidemic proportions. Improved understanding of children's healthy eating perceptions in culturally diverse populations is needed. The purpose was to describe the meanings and experiences associated with healthy eating from the perspective of Mexican American children. Methodology: The design was a focused ethnography. Midwestern children, aged 11 to 13 years, were interviewed in home and school settings. Leininger's four phases of qualitative data analysis was used to analyze data. Parental consent/child assent was obtained. Results: Twenty-one children were interviewed. Two themes emerged: (a) Mexican American children connect healthy eating with familiar foods in the context of their ethnic culture; and (b) foods that provide feelings of happiness and well-being are associated with healthy eating. Discussion: This study provides a clear understanding of the meaning and perceptions of healthy eating from the perspective of Mexican American children and offers data to promote culturally congruent care.

Discovering metformin-induced vitamin B12 deficiency in patients with type 2 diabetes in primary care.

BACKGROUND: Although metformin is the preferred initial pharmacological choice in type 2 diabetes, there is evidence that reveals a link between metformin use and vitamin B12 deficiency. The American Diabetes Association (ADA) has recently recommended periodic measurement of B12 levels for all patients on metformin. LOCAL PROBLEM: Medical record data collected for the preintervention period showed that only 5% (n = 23) of patients diagnosed with diabetes and on metformin had B12 levels checked at an internal medicine primary care practice. METHODS: This was a quasi-experimental project of preintervention and postintervention design using a checklist containing important measures of diabetes control. The project sample population consisted of data of adults with type 2 diabetes aged 18 years and older who were prescribed metformin in the previous year at the primary care practice. INTERVENTIONS: The intervention focused on revising an existing diabetes measures checklist to include a prompt for an annual measurement of B12 levels. RESULTS: There was significant improvement in monitoring vitamin B12 levels and discovery of low vitamin B12 levels. These data show that the number of B12 levels checked increased from 23 during the preintervention to 155 during the intervention (p ≤ 0.0000). CONCLUSIONS: This project supports a conclusion that including a prompt to check B12 levels to an existing checklist increases B12 monitoring in this patient population. Results may encourage other providers to follow the ADA guidelines for monitoring vitamin B12 levels for patients taking metformin.

The impact of podcasting on the learning and satisfaction of undergraduate nursing students.

Nursing education has evolved from traditional pedagogical models to current methods using technology for knowledge acquisition. Podcasting is one example of teaching methodology used in higher education. Studies demonstrate positive student satisfaction with podcasting, but there is limited data related to knowledge acquisition. The purpose of this study was to examine the impact of podcasting on nursing student learning and satisfaction. Two classes of junior baccalaureate nursing students had scores on selected exam questions compared. The 2007 class (n=63) had select content presented in traditional lecture format where the 2008 class (n=57) had the same content presented via podcast. Both methods used the same faculty and exam questions. The 2008 class completed a satisfaction survey. Results indicated no significant difference in correct responses on exam questions. Exam scores were better with the first podcast, equal for the second, and worse with the third podcast. Students were overall satisfied with the podcasting experience and commented positively on its portability and flexibility. This study contributes to the knowledge base of podcasting effectiveness and raises the question of evaluation of new teaching methodologies. Must an increase in learning occur for new methods to be considered effective, or is positive student satisfaction adequate to encourage the adoption of new technology methods?