Interventions to Support Diversity in Nursing Education.

BACKGROUND: Despite increased awareness of the importance of cultural competence in the reduction of health care disparities, the nursing profession does not reflect the patient demographics of the United States. The purpose of this article is to report the results of a comprehensive review of the experiences of nontraditional nursing students in undergraduate nursing programs and the interventions used by nursing programs to increase their success. METHOD: Data from 13 studies were extracted, summarized, and synthesized. This review was organized using concepts from Jeffreys' nursing undergraduate retention and success model. RESULTS: Nontraditional nursing students faced unique challenges when pursuing undergraduate nursing education. CONCLUSION: This review highlighted the need for continued efforts to support nontraditional students that pursue nursing education. Future research is necessary to identify and prioritize interventions that enhance nontraditional students' experiences and improve student outcomes. [J Nurs Educ. 2019;58(11):641-646.].

Implementing Yoga Into the Management of Patients With Refractory Low Back Pain in an Outpatient Clinic Setting.

Purpose: To evaluate the effectiveness of implementing yoga into the treatment of patients with chronic low back pain. Design: Quantitative analysis with opportunity for qualitative feedback. Method: Effectiveness of this complementary treatment was assessed using a pretest/posttest design of patients who volunteered to participate in yoga classes as part of their back pain management. Measurements included low back pain rating, perception of back pain interference with daily activities, and self-efficacy in dealing with chronic low back pain. Findings: Although no statistically significant findings were found due to the small sample size, most participants demonstrated improved individual scores on all measurement surveys including qualitative comments. Conclusion: Based on the findings of this pilot study, further studies on implementing yoga into the treatment of chronic low back pain are encouraged.

Attention Health Care Leaders: Literature Review Deems Baccalaureate Nurses Improve Patient Outcomes.

AIM: This review of studies conducted since the 2011 publication of the Institute of Medicine (IOM) report "The Future of Nursing: Leading Change, Advancing Health" evaluates the current state of evidence showing an association between an increased ratio of BSN-prepared nursing staff and improved patient outcomes. BACKGROUND: The IOM established a nationwide goal to increase the number of BSN nurses to 80 percent by 2020 to meet the challenges seen in today's health care environment. METHOD: The literature search included a five-year (2011-2016) span following the initial release of the IOM report. RESULTS: Mortality, failure to rescue, and readmission rates all decrease as the proportion of BSN nurses is increased in a nursing staffing ratio. CONCLUSION: It is the recommendation of this project that nurse leaders and organizations support the findings of this literature review and the IOM BSN recommendation.

Workplace Incivility in Nursing: A Literature Review Through the Lens of Ethics and Spirituality.

A literature review was conducted to evaluate existing knowledge of incivility in the nursing workplace through the lens of nursing ethics and spirituality. Study articles presented a consistent theme of improved organizational commitment and job satisfaction when spirituality was injected into the workplace. It seems plausible to suggest a positive correlation between spirituality and more civil environments in nursing workplaces.

Transitions in a wicked environment.

AIM: The aim of this review is to synthesize the current body of knowledge concerning transitional care for patients 65 years of age and older moving from the acute care setting to home. BACKGROUND: Transitional care is a timely topic as hospital days of care decrease whereas patient needs grow more complex as a result of aging populations. EVALUATION: This review considers evidence-based research as well as reports, case studies and literature reviews related to transitional care. International articles are included. KEY ISSUES: The authors explore transitional care through the lens of wicked problems; problems that appear seemingly intractable and are characterized by inter-related dilemmas, contradictory agendas, and multi-layered societal, economic and political influences. Outcome measures of success, barriers to achieving successful transitional care and effectiveness of interventions are investigated. CONCLUSIONS: While the literature offers specific strategies that positively affect transitional care, there are few strategies that do not negatively affect an alternate agenda. Conscientious leaders should consider transitional care in the context of its wicked nature in order to achieve optimal patient care. IMPLICATIONS: Stakeholders include: hospital administrators, nurse leaders, direct-care nurses, acute care and primary care clinicians, patients, caregivers, community agencies, health sciences educators and insurers.

Do lean practices lead to more time at the bedside?

The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatient care was reviewed, excluding all research related to other service lines (i.e., surgical services, emergency services, laboratory, radiology, etc.). Increased value is also an important tenet of transforming care at the bedside (TCAB), an initiative launched by the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation (RWJF). Therefore, articles concerning TCAB were also included in this review. A systematic study of the literature revealed varied applications of Lean principles in practice, ranging from the implementation of a single tool, to full organizational restructuring. All articles reviewed reported positive results, although the majority lacked strong supporting evidence for claims of improvement. Even though there is some indication that the application of Lean principles to nursing processes is successful in improving specific outcomes, the authors cannot conclude that the implementation of Lean methodology or TCAB greatly influences direct patient care, or increases time spent at the bedside.