A syndemic effect: Interrelationships between systemic racism, health disparities, and COVID-19.

ABSTRACT: This article discusses the interconnection between the syndemic effect of racial inequities and disparities as well as the impact of the COVID-19 pandemic on Black Americans. It also highlights meaningful reforms and priorities to achieve health equity in Black communities.

A deep learning approach to student registered nurse anesthetist (SRNA) education.

OBJECTIVES: This manuscript describes the application of deep learning to physiology education of Student Registered Nurse Anesthetists (SRNA) and the benefits thereof. A strong foundation in physiology and the ability to apply this knowledge to challenging clinical situations is crucial to the successful SRNA. Deep learning, a well-studied pedagogical technique, facilitates development and long-term retention of a mental knowledge framework that can be applied to complex problems. Deep learning requires the educator to facilitate the development of critical thinking and students to actively learn and take responsibility for gaining knowledge and skills. METHODS: We applied the deep learning approach, including flipped classroom and problem-based learning, and surveyed SRNA students (n=127) about their learning experience. RESULTS: Survey responses showed that the majority of students favored the deep learning approach and thought it advanced their critical thinking skills. CONCLUSIONS: SRNAs reported that their physiology knowledge base and critical thinking benefited from the use of the deep learning strategy.

The aging veteran population: Promoting awareness to influence best practices.

The older adult population is the most rapidly growing population in the United States. It is projected that by 2035, the population of adults older than 65 years is expected to be greater than the population of children. The projected number of Veterans age 60 and older is about 11 million. Along with common age-related complex and high-risk chronic medical conditions, care of older adult Veteran requires a holistic approach that focuses on the culture, and subcultures, and unique health care needs resultant of military service. Veterans' health care is often multifocal and complex, requiring an integrated, collaborative, and comprehensive model of care that better facilitates meeting health goals to the degree most realistic and attainable for each older adult Veteran. This highlights the need to promote awareness and provide educational opportunities for engaging in best practices that meet the unique needs of the aging Veteran population.

Implementing an Integrated Team-Based Model of Care.

Team-based methods of delivering primary care were launched nationally within the US Department of Veterans Affairs (VA) through the Patient Aligned Care Teams (PACT) initiative in 2010. The most essential component of PACT is the establishment of partnerships between veterans and their health care teams. The purpose of PACT is to improve and transform the way in which veterans receive health care. This partnership is aimed at promoting efficiency and improving the quality of care and clinical outcomes by providing holistic care that embodies the whole person.

Strategies for Developing a Nurturing Environment for the next Generation of Nurses.

With the introduction of more complex health conditions and the changing landscape of the healthcare infrastructure, burnout is increasingly becoming a crisis for the nursing profession and for the public. Recruitment in nursing must consider the concept of a nurturing environment as a key driver of sustainability within the profession. Human beings cannot flourish in hostile and unwelcoming environments. Failure to thrive in nursing is a real phenomenon that is driven by multiple factors, including incivility, workplace bullying, and lack of support. Mitigation requires intentional, strategic interventions toward building nurturing environments in education and practice for the next generation of nurses.

Implementation of Cultural Awareness and Cognitive Bias Training Within Graduate Nursing Programs.

BACKGROUND: Cognitive bias negatively affects patient outcomes, resulting in medical errors, sentinel events, and legal claims. The brunt of bias-induced inequities and disparities has fallen on Black and Brown people, women, and the LGBTQ+ communities. Faculty training programs have rapidly increased in number, whereas student training has lagged. METHOD: A three-part curricular series was developed for students seeking nurse practitioner (NP) training. The series addressed racial bias, microaggression, and gender bias using vignettes and guided pre- and debriefing. RESULTS: The series was initially implemented to 70 students from four different specialty areas of study. Students resoundingly reported the content as valuable and challenging and the environment as a safe space to learn, be vulnerable, and be empathetic to the experiences of others. CONCLUSION: This three-part series has been implemented across eight NP majors and has become a required component of the NP on-campus intensive experience. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Structural Racism Hurts All Nurses.

Why health care must be reenvisioned through a DEI lens.

The impact of systemic racism on health outcomes among Black women: Recommendations for change.

ABSTRACT: Black women suffer disproportionately from healthcare inequities in comparison to their White counterparts. Using the Public Health Critical Race framework, this article explores the lasting effects of systemic racism on the health outcomes of Black women across the lifespan. A case study and specific strategies are presented to examine how clinicians, educators, and policymakers can work with Black women to mitigate and eliminate health inequities.

Applying Cultural Intelligence to Improve Vaccine Hesitancy Among Black, Indigenous, and People of Color.

Despite the overwhelming evidence to support the benefits of vaccines for preventable diseases and improving health outcomes throughout the world, vaccine hesitancy and resistance continues to be a concern during the COVID-19 pandemic. Although Black, Indigenous, and People of Color (BIPOC) experience the highest rates of morbidity and mortality from COVID-19, mistrust and historical unethical research and medical practices continue to preclude this population from getting the vaccine. This article urges clinicians to subscribe to development and application of cultural intelligence to understand the impact of structural racism and cultural considerations of BIPOC to partner in strategy development.

Diversity in Nursing Is Not Enough.

An introspective look.

Uprooting Racism: The Role of Nurses in Cultivating Improved Maternal Outcomes for Black and African American Women.

After controlling for education, socioeconomic status, and genetic factors, Black and African American patients in the United States are three to four times more likely to die in childbirth than are White patients. The literature is replete with strategies to improve maternal outcomes for Black and African American patients. Existing strategies focus on addressing poverty and individual risk factors to reduce maternal mortality, yet maternal outcomes are not improving for these patients in the United States. Recent literature suggests that a nuanced approach that considers the effects of individual and structural racism could improve maternal outcomes, especially for Black and African American patients. As nurses comprise the largest component of the health-care system, their collective power and influence can provide a powerful tool for dismantling structural racism. Some important concepts to consider regarding the care of the Black and African American population are cultural intelligence (CQ), allostatic load, and humanitarian ethos. By developing CQ and consistently including the four CQ capabilities (drive/motivation, knowledge/cognition, strategy/metacognition, and behavior/action) in all aspects of practice, nurses can help to uproot racism and cultivate experience to improve maternal health outcomes for Black and African American patients.

Reliability and validity of the Personal Wellness Profile (PWP) Questionnaire in African American college women.

BACKGROUND AND PURPOSE: The Personal Wellness Profile (PWP) is a 75-item questionnaire used to assess an individual's level of wellness in clinical and non-clinical settings. Currently, there are no published scientific data regarding the validity and reliability of the PWP. Therefore, this study was designed to assess convergence validity of the PWP using established instruments in which validity has been previously supported and to determine the reliability of the PWP using the test-retest method. METHODS: A correlational design was used with a non-probability convenience sample of 100 African American women, ages 18 to 40 years, enrolled in a university in southern Louisiana. Convergence validity of the PWP was assessed by using the Michigan Alcoholism Screening Test (MAST), Drug Abuse Screening Test (DAST), Geiselman Food Preference Questionnaire II (GFPQ II), Weekly Stress Inventory (WSI), Fagerstrom Test for Nicotine Dependence (FTND), and the 7-Day Physical Activity Recall Questionnaire (PAR) as criteria. RESULTS: The PWP had statistically significant correlations with two of the six subscales of the GFPQ II, and with the WSI, MAST, and FNTD. Findings also suggest that the PWP has moderate to moderately high internal consistency as a whole (r = .77), and that the subscale scores were also reliable over time (r = .52 to .90). CONCLUSIONS: The PWP will be valuable as a valid, standardized, highly portable tool that can be taken into the community and administered to African-Americans and other populations who do not readily have access to treatment, research and health care centers.

Male and Female Hypogonadism.

Hypogonadism is a clinical syndrome that results in hormone deficiency in men and women. Primary hypogonadism is caused by gonadal (testicular or ovarian) failure. Secondary hypogonadism is the result of a dysfunction within the hypothalamus and/or pituitary. Diagnosis of hypogonadism requires a comprehensive health history, evaluation of the signs and symptoms, complete physical examination, as well as laboratory and diagnostic testing for both sexes. Hormone replacement is the hallmark of hypogonadism treatment. Restoring and/or maintaining quality of life is a major consideration in the management of patients with hypogonadism.

Immunosuppressive/Autoimmune Disorders.

Autoimmune disorders are a category of diseases in which the immune system attacks healthy cells as a result of a dysfunction of the acquired immune system. Clinical presentation and diagnosis are disease specific and often correspond with the degree of inflammation, as well as the systems involved. Treatment varies based on the specific disease, its stage of presentation, and patient symptoms. The primary goal of treatment is to decrease inflammation, minimize symptoms, and lessen the potential for relapse. Graves disease, Hashimoto thyroiditis, rheumatoid arthritis, Crohn disease, ulcerative colitis, systemic lupus erythematosus, and multiple sclerosis are discussed in this article.

Predicting student success in nurse practitioner programs.

BACKGROUND AND PURPOSE: Criteria for admission to nurse practitioner (NP) and other professional programs provide a snapshot of students' potential for success in those programs. Critical examination of admission criteria is a vital component of ensuring timely matriculation and completion of NP programs. The purpose of the current study was to examine the relationship between admission criteria and student progression and completion of NP programs. METHODS: A retrospective review of 150 randomly selected student records from a total of 232 available records was conducted. A predictive correlational design was used to examine factors that influence success in NP programs. CONCLUSIONS: Statistically significant relationships existed among type of admission status, change in program concentration, age, Graduate Record Examination (GRE) verbal score, GRE quantitative score, total GRE scores, and program progression and completion. IMPLICATIONS FOR PRACTICE: Data collection from this and related research is paramount in developing information infrastructures that support consistent evaluation and revision of admission criteria and program curricula. Leaders in academia can use these data to achieve instructional excellence, improve education systems, and ensure timely matriculation through NP programs. This facilitates workforce planning and supports efforts to meet the expanding need for primary care providers.