Evaluating and Addressing the Diversity, Equity, Inclusion, and Belonging Climate in a School of Nursing.

BACKGROUND: There is a critical need to prepare a diverse nursing workforce and address issues of structural racism and health inequities. PROBLEM: A shortage of underrepresented nurse faculty exacerbates the lack of diversity in nursing education. Microaggressions and discrimination experienced by underrepresented nursing students hinder their personal and professional growth. Evaluating diversity, equity, and inclusion (DEI) and belonging within a school of nursing is crucial for progress. APPROACH: An alumni survey and a faculty/staff survey were conducted to assess DEI perceptions, which informed the development of a strategic plan. Goals focused on monitoring the cultural climate, increasing diversity and inclusivity, and enhancing faculty competencies. Educational offerings and initiatives were implemented to support these goals. OUTCOMES: Ongoing evaluation is essential to sustain progress in this critical area. CONCLUSION: These efforts are necessary for sustainable progress and equitable care provision.

U.S. Primary Care Provider Needs: An Analysis of Workforce Projections and Policy Implications.

The primary care (PC) physician workforce has consistently been projected as requiring additional numbers to meet the needs of the U.S. The Health Resources and Service Administration (HRSA) has reported the PC nurse practitioner (NP) workforce to be 90,000 NPs more than required to meet the PC needs of the U.S. With both clinician types contributing to the PC workforce in the country, it is difficult to understand such an oversupply of NPs with continued deficit in PC physicians. The purpose of this study was to investigate results and methods used for HRSAs current PC workforce projections and compare those with the same used for Bureau of Labor Statistics (BLS) and American Association of Medical Colleges (AAMC) projections. Methods included a review of technical documents, dashboards, and published reports. Interviews with subject matter experts were also completed. Projections were found to differ significantly, as did data and assumptions. Two of the three projections modeled physicians as the sole provider of PC. An integrated model gives the most comprehensive and accurate picture of PC workforce needs. The utilization of NPs as PC providers has been demonstrated to be safe and effective, with the potential to alleviate predicted shortages, improve patient care outcomes, reduce cost, and address PC inequities. Implications include improving workforce data, creating projections that mirror clinical integration in PC, adjusting workforce preparation funding, incentivizing interprofessional collaboration in research, addressing barriers to practice among non-physician providers, and leveraging growth in the NP workforce.

Inclusion and Belonging at the Bedside and Beyond.

Inclusive work environments lead to a sense of belonging and improve retention.

Creating Collaborative Relationships With Historically Black Colleges and Universities: An Approach to Diversifying the Nursing Workforce.

BACKGROUND: The lack of a diverse nursing workforce and inclusive nursing student pipeline initiatives can impact existing health disparities in the United States. PROBLEM: Gaps in the representation of future Black nurses in schools of nursing provide missed opportunities for cultural congruence and awareness. APPROACH: Developing collaborative relationships with historically Black colleges and universities (HBCUs) for recruitment is a mutually beneficial strategy. Undergraduate interns from 3 HBCUs attended a 6-week summer nursing immersion program at a graduate school of nursing on the campus of a predominately White institution. The aim was to provide awareness of the nursing profession and mentorship for further exploration into the profession. CONCLUSIONS: The program managed by Black nurse faculty provides a recruitment strategy that serves as a framework to support the financial, emotional, and social needs of prospective Black nursing students.

A Summer Professional Immersion in Nursing Program for Underrepresented Minority Undergraduate Students.

BACKGROUND: By 2044, more than 50% of the U.S. population will consist of ethnic/racial minorities. To facilitate optimal health, the projected nursing workforce should mirror this statistic. This pilot study examined the effects of a Summer Professional Immersion in Nursing Program (SPIN) on confidence in career decision making of under-represented minority undergraduate students. The 4-week program exposed participants to various nursing experiences. METHOD: The Career Decision Self-Efficacy Scale was administered pre- and post-SPIN to measure level of confidence in career decision making. RESULTS: The sample included eight women, with an average age of 19.63 years (SD = 0.52). Comparative analysis was performed using a reliable change index. The pre- to post-SPIN change was 0.38, indicating a meaningful significant increase in confidence. CONCLUSION: SPIN is an example for nursing programs interested in attracting undergraduate underrepresented minority students. The program positively influenced self-efficacy toward career selection and may positively influence enrollment of underrepresented nurses in the future. [J Nurs Educ. 2020;59(11):631-636.].

Proctitis in Men Who Have Sex with Men.

Sexually transmitted infections (STIs) are diseases that are transmitted from one person to another person through acts of vaginal, anal, or oral intercourse. The increased presence of STIs among men who have sex with men (MSM) results in a higher rate of STI-related diagnoses, such as proctitis. Proctitis is a common, but often misdiagnosed condition experienced by MSM who present to primary care, urgent care, and emergency settings. It is important that health care providers be knowledgeable of the pathophysiology, risk factors, and clinical presentation of proctitis among MSM for accurate and timely management.

The Perceived Medical Condition Self-Management Scale can be applied to patients with chronic kidney disease.

Chronic Kidney Disease (CKD) is a major burden on patients and the health care system. Treatment of CKD requires dedicated involvement from both caretakers and patients. Self-efficacy, also known as perceived competence, contributes to successful maintenance of patient's CKD self-management behaviors such as medication adherence and dietary regulations. Despite a clear association between self-efficacy and improved CKD outcomes, there remains a lack of validated self-report measures of CKD self-efficacy. To address this gap, the Perceived Kidney/Dialysis Self-Management Scale (PKDSMS) was adapted from the previously validated Perceived Medical Condition Self-Management Scale. We then sought to validate this using data from two separate cohorts: a cross-sectional investigation of 146 patients with end-stage renal disease receiving maintenance hemodialysis and a longitudinal study of 237 patients with CKD not receiving dialysis. The PKDSMS was found to be positively and significantly correlated with self-management behaviors and medication adherence in both patient cohorts. The PKDSMS had acceptable reliability, was internally consistent, and exhibited predictive validity between baseline PKDSMS scores and self-management behaviors across multiple time points. Thus, the PKDSMS is a valid and reliable measure of CKD patient self-efficacy and supports the development of interventions enhancing perceived competence to improve CKD self-management.