Spiritual Support Staff Influence Stress Among Hospital-Based Health Care Personnel: A Cross-Sectional Study.

BACKGROUND: Stress negatively affects well-being, relating to poor physical, emotional, and occupational outcomes for health care personnel. Health care professionals faced extreme stressors in the context of the COVID-19 pandemic, making occupational stress relief a top priority for hospital administrators. Many health systems employ specially trained spiritual support staff as one strategy to alleviate work-related stressors. It is unclear whether health care personnels' perceptions of the availability of spiritual care staff influence self-reported stress. OBJECTIVE: The purpose of this study was to explore relationships between perceived stress and perceptions of availability of spiritual support among acute care health care personnel. METHODS: This study analyzed cross-sectional, survey-based data collected between February and April 2022 from 1352 interdisciplinary health care staff working in a large, nonprofit Catholic health system in the Western United States. Bivariate tests and multivariate linear regression models were conducted to test for factors influencing perceived stress. RESULTS: Results support that high stress was prevalent in the sample. Perceived availability of spiritual support staff in the hospital and seeking coworker and professional support for work-related stress all independently influence stress in this population when controlling for confounders. CONCLUSIONS: Stress of health care personnel may be influenced by the perceived availability of specially trained spiritual support staff. Hospital administrators should advocate for spiritual support staff availability in all health care settings as one strategy to mitigate occupational stress that health care professionals may experience through providing high-stakes patient care. Further research is warranted to uncover targeted spirituality-related strategies to reduce stress and preserve well-being of health care personnel.

Relationships Between Perceived Importance of Chaplain Presence and Health Professionals' Emotional Well-Being in the United States.

Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff's emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap). Findings suggest that as perceived levels of chaplain importance increase, burnout may decrease and compassion satisfaction may improve. Chaplain presence in the hospital setting may support healthcare staff emotional and professional well-being following occupational stressors including COVID-19-related surges.

Caring for COVID-19 infected patients admitted to redesignated coronavirus ICUs: Impact on nurse stress and burnout.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic globally impacted healthcare due to surges in infected patients and respiratory failure. The pandemic escalated nursing burnout syndrome (NBS) across the workforce, especially in critical care environments, potentially leading to long-term negative impact on nurse retention and patient care. To compare self-reported burnout scores of frontline nurses caring for COVID-19 infected patients with burnout scores captured before the pandemic and in non-COVID-19 units from two prior studies. METHODS: The descriptive study was conducted using frontline nurses working in eight critical care units based on exposure to COVID-19 infected patients. Nurses were surveyed in 2019 and in 2020 using Maslach Burnout Inventory (MBI), Well Being Instrument, and Stress-Arousal Adjective Checklist (SACL) instruments. Researchers explored relationships between survey scores and working in COVID-19 units. RESULTS: Nurses working in COVID-19 units experienced more emotional exhaustion (EE) and depersonalization (DP) than nurses working in non-COVID units (p= .0001). Pre-COVID nurse burnout scores across six critical care units (EE mean = 15.41; p= .59) were lower than burnout scores in the COVID-19 intensive care units (EE mean = 10.29; p= .74). Clinical significance (p= .08) was noted by an EE subscale increase from low prepandemic to moderate during the pandemic. CONCLUSION: Pinpointing associations between COVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Further research is required to establish causal relationships between sociodemographic and work-related psychological predictors of NBS.

Detecting blood transfusion reactions: What are vital signs anyway?

There is a lack of consistency in the scientific literature regarding what is included in vital signs and considered derangement in findings. We used vital signs during blood product administration as an exemplar to explore this controversy. Vital sign components varied across all studies when reviewed by a cohort of frontline nurses attempting to align institutional policy with current evidence. Only low-level data linking conventional approaches to vital sign monitoring for transfusion reaction detection were found.

Self-Efficacy: Changing the Tide of Evidence-Based Practice.

AIMS: The specific aim for this study was to describe differences in evidence-based practice (EBP) and self-efficacy in frontline RNs. This project utilized a national study with a convenience selection of acute care agencies to examine the relationship between organizational and unit culture, EBP, and self-efficacy in frontline nurses. METHODS: This national study used descriptive correlational methodology to describe differences in EBP and self-efficacy among RNs. The sample included 245 frontline RNs employed in acute care settings. To measure the study variables, the Nursing Evidence-Based Practice Survey (Titler, Hill, Matthews, & Reed, 1999)  and the Evidence-Based Nursing Practice Self-Efficacy Scale were used (Tucker, Olson, & Frusti, 2009). Each instrument was delivered via the Qualtrics online platform. RESULTS: The correlation of bivariate interval level variables was analyzed using Pearson's r. The correlation between EBP and self-efficacy was strongly correlated: r(170) = .537, p = .01. Sections within the Nursing Evidence-Based Practice Survey were calculated and found to be significant (unit culture r = .241, p = .01; organizational culture r = .570, p = .01; knowledge, skills, attitude r = .538, p = .01). LINKING EVIDENCE TO ACTION: Several implications exist for education, staff development, and nursing management. Nursing school programs incorporate EBP into the curriculum so that nurses have a foundation for EBP. However, staff development professionals in clinical settings must continue to build on the nurses' knowledge and skill, thus increasing self-confidence for EBP. Nursing management can provide the resources for staffing models and policies to reinforce the value of EBP and positive patient outcomes. This combination provides frontline staff with EBP participation and increased self-efficacy in its usage.

Integrative Review of Dietary Choice Revealed by fMRI: Considerations for Obesity Prevention and Weight-Loss Education.

BACKGROUND: Emerging findings from neuroimaging studies investigating brain activity associated with dietary behavior are illuminating the interaction of biological and behavioral mechanisms that have implications for obesity prevention. Globally, A total of 1.9 billion adults are overweight, and 650 million are obese. Obesity and being overweight are major risk factors for chronic illness and death. Behaviorally based health interventions have had limited success in curbing the obesity epidemic. Greater understanding of brain responses to food cues will contribute to new knowledge and shape public health efforts in obesity prevention. However, an integration of this knowledge for obesity prevention education has not been published. AIMS: This study links evidence generated from brain activation studies generated in response to diet and food images and highlights educational recommendations for nurses engaged in obesity prevention and weight-loss education. METHODS: An integrative review of the literature was conducted using the MeSH keywords "magnetic resonance imaging," "diet," and "food images" in PubMed, MEDLINE Complete, CINAHL, and Cochrane databases from their first appearance in 2006 through March 2018. Studies published in English and using functional magnetic resonance imaging to measure brain response to diet, and food images were initially identified. Animal models, those whose primary focus was a specific disease, and intervention studies were excluded. RESULTS: Of 159 studies identified, 26 met inclusion criteria. Findings from neuroimaging studies may help explain the relationship between brain mechanisms and behavioral aspects of dietary choice and inform patient education in obesity prevention. Awareness of this evidence is applicable to nursing education efforts. This review contributes several recommendations that should be considered by nurses providing individualized weight-loss education. LINKING EVIDENCE TO ACTION: Nurses engaged in patient education for obesity prevention should consider personalized interventions that cultivate internal awareness for dietary adherence, self-care, exercise, hydration, and mood state; avoid using caloric deprivation approaches, such as skipping breakfast, for weight-loss interventions; and note the importance of individualized obesity prevention and weight-loss education.

Brain activation and affective judgements in response to personal dietary images: An fMRI preliminary study.

Emerging evidence from functional magnetic resonance imaging (fMRI) brain activation studies associated with dietary behavior reveals significant interaction of biological and behavioral mechanisms in response to visualized food stimuli. Because food intake is influenced by neurosensory stimulation and memory cues, personalized food images may be useful in prompting appropriate affective responses to food intake, which may subsequently lead to healthier eating behaviors. The current study used a cross-sectional mixed methods approach to explore neural responses and self-perceptions of eating behavior during review of personalized food images. A sample of college students (N = 16; 9 females; M age = 21.44) used cell-phone cameras and an online dietary tracking website to collect and report three days of diet. Within 2-3 weeks of completing dietary tracking activity, participants underwent an fMRI scan while reviewing recorded personal images and text descriptions of their diet. They also responded to three questions related to memory for the food items and future eating intentions. Post-scan interviews explored how participants felt after reviewing personal food images and the possible impact that such review might have on future food choices. Whole brain analyses suggested, compared to a written dietary record, that the visualization of personal images of diet evoked greater brain activation in memory regions (e.g., superior frontal gyrus) along with mediating emotion (e.g., thalamus, putamen, anterior cingulate cortex), imagery and executive functions (e.g., inferior orbitofrontal gyrus, fusiform, and parietal lobe). This study offers preliminary support for the use of personal food images to strengthen dietary monitoring.

Implementation of a MEWS-Sepsis screening tool: Transformational outcomes of a nurse-led evidence-based practice project.

BACKGROUND: One in three patients who die in the hospital has sepsis. Alerting clinicians to early detection of high-risk patients before deterioration is a top health care priority. Modified Early Warning Scoring (MEWS) tools have assisted organizations in identifying at-risk patients at the first sign of subtle deterioration. AIM AND SETTING: In conjunction with an academic-clinical partner, we evaluated, revised and implemented a modified MEWS-Sepsis screening tool in an acute care facility. PARTICIPANTS: One hundred and thirty-nine direct-care nurses participated in tool evaluation. METHODS: Using a plan-do-study-act cycle of quality improvement, critical care scenarios from septic patient data were created and tested in a simulated setting. RESULTS: Upon implementation of the MEWS-Sepsis tool, the monthly risk-adjusted sepsis mortality rate immediately declined by 24%. The decline in mortality has been sustained from implementation to the present, spanning a 5-year period. CONCLUSIONS: The implementation of a MEWS-Sepsis screening tool contributed to early identification and implementation of time-sensitive interventions aimed at preventing sepsis-associated deaths. MEWS-Sepsis tools hold potential for scale-up and spreading out of evidence-based practice nursing innovations to transform care, improve patient outcomes, and save lives.

Probiotics in Preventing Acute Upper Respiratory Tract Infections.

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.

Investigating Vulnerability for Developing Eating Disorders in a Multi-confessional Population.

The present study aimed to examine the vulnerability to eating disorders (ED) among 949 Lebanese female young adults as well as its association with stress, anxiety, depression, body image dissatisfaction (BID), dysfunctional eating, body mass index, religious affiliation (Christian, Muslim, Druze or Other), religiosity and activity level. Results showed that anxiety had the greatest effect on increasing the predisposition to ED, followed by stress level, BID, depression and restrained eating. Affiliating as Christian was found to significantly decrease the vulnerability to developing an ED. Furthermore, the interaction of anxiety with intrinsic religiosity was found to have a protective role on reducing ED. The current study emphasized a buffering role of intrinsic religiosity against anxiety and ED vulnerability.

Effectiveness of a Technology-Based Intervention to Teach Evidence-Based Practice: The EBR Tool.

BACKGROUND: As the world becomes increasingly digital, advances in technology have changed how students access evidence-based information. Research suggests that students overestimate their ability to locate quality online research and lack the skills needed to evaluate the scientific literature. Clinical nurses report relying on personal experience to answer clinical questions rather than searching evidence-based sources. To address the problem, a web-based, evidence-based research (EBR) tool that is usable from a computer, smartphone, or iPad was developed and tested. The purpose of the EBR tool is to guide students through the basic steps needed to locate and critically appraise the online scientific literature while linking users to quality electronic resources to support evidence-based practice (EBP). METHODS: Testing of the tool took place in a mixed-method, quasi-experimental, and two-population randomized controlled trial (RCT) design in a U.S. and Middle East university. RESULTS: A statistically significant improvement in overall research skills was supported in the quasi-experimental nursing student group and RCT nutrition student group using the EBR tool. A statistically significant proportional difference was supported in the RCT nutrition and PharmD intervention groups in participants' ability to distinguish the credibility of online source materials compared with controls. The majority of participants could correctly apply PICOTS to a case study when using the tool. CONCLUSIONS: The data from this preliminary study suggests that the EBR tool enhanced student overall research skills and selected EBP skills while generating data for assessment of learning outcomes. LINKING EVIDENCE TO ACTION: The EBR tool places evidence-based resources at the fingertips of users by addressing some of the most commonly cited barriers to research utilization while exposing users to information and online literacy standards of practice, meeting a growing need within nursing curricula.

Effects of Recording Food Intake Using Cell Phone Camera Pictures on Energy Intake and Food Choice.

BACKGROUND: The well-documented increases in obesity and unhealthy dietary practices substantiate the need for evidence-based tools that can help people improve their dietary habits. The current spread of mobile phone-embedded cameras offers new opportunities for recording food intake. Moreover, the act of taking pictures of food consumed may enhance visual consciousness of food choice and quantity. The present study aimed to assess the effect of using cell phone pictures to record food intake on energy intake and food choice in college students. The effectiveness and acceptability of cell phone picture-based diet recording also was assessed. METHODS: A repeated measures crossover design was used. One group of participants entered their food intake online during 3 days based on their memory, although a second group recorded their food intake using cell phone pictures as their reference. Participants then crossed over to complete 3 more days of diet recording using the alternate method. Focus groups were conducted to obtain feedback on the effectiveness and acceptability of cell phone picture-based diet recording. RESULTS: Intake of meat and vegetable servings were significantly higher in the memory period compared with the cell phone period, regardless of the order. Results from the focus group indicated a positive attitude toward the use of cell phone pictures in recording food intake and an increased awareness of food choice and portion size. LINKING EVIDENCE TO ACTION: Cell phone pictures may be an easy, relevant, and accessible method of diet self-monitoring when aiming at dietary changes. Future trials should combine this technique with healthy eating education.

Modified early warning scoring (MEWS): evaluating the evidence for tool inclusion of sepsis screening criteria and impact on mortality and failure to rescue.

AIMS AND OBJECTIVES: To evaluate current research evidence reporting outcomes from modified early warning scoring system tools utilisation to prevent failure to rescue in hospitalised adult medical-surgical/telemetry patients. BACKGROUND: Early sepsis detection exhibits clinical significance to practitioners and patients. Thorough and timely clinical observations, along with a willingness of nurses to call for help, are pivotal to survival of hospitalised patients. This project examined effects of modified early warning scoring system tool usage on patient mortality and failure to rescue events in hospitalised adult medical-surgical/telemetry patients as reported in the literature. DESIGN: A comprehensive review and evaluation of published peer-reviewed literature was conducted. METHODS: Electronic databases searched included PubMed, MEDLINE, CINAHL, Cochrane Library of systematic reviews and Agency for Healthcare Research and Quality through 2014. RESULTS: Eighteen articles were identified for review. Evidence ratings included 6% (1) Level I, 44% (8) Level IV, 6% (1) Level V, 33% (6) Level VI and 11% (2) Level VII. Six reported mortality predictive value and/or reduction, three measured impact on emergency calls, and four reported impact on mortality and rapid response team utilisation. CONCLUSION: While modified early warning scoring system tools have been widely adopted and are recommended for utility in detection of inpatients at-risk for clinical deterioration, limited high-level data and no clinical trials linking use of modified early warning scoring system tool usage to robust outcomes were found. Established criteria for validating modified early warning scoring system criteria, organisational-specific reliability testing and multi-site trials are recommended. RELEVANCE TO CLINICAL PRACTICE: Development of all-cause illness screening tools, including sepsis, is imperative. The clinical picture may be quantified with scoring tools to assist nurses' clinical decision-making, thus leading to improved outcomes and decreased incidence of failure to rescue. Clinical outcomes of interest should be measured and reported in peer-reviewed literature to disseminate the impact on clinical outcomes.

Effectiveness of cell phones and mypyramidtracker.gov to estimate fruit and vegetable intake.

AIM AND BACKGROUND: Inadequate fruit and vegetable intake is linked to leading causes of global mortality and rise in obesity. Measuring fruit and vegetable intake is problematic. Advances in cell phone technologies may improve the accuracy and ease of recording diet. This study tested the effectiveness of using cell phones with digital pictures to prompt memory and mypyramidtracker.gov to estimate self-reported fruit and vegetable intake in 69 college students. METHODS: A repeated measures design was used. Focus groups provided feedback on the acceptability, usability, and feasibility of cell phones for diet recording in this population. RESULTS: A statistically significant difference in fruit and vegetable scores, F(1, 58)=4.64, p=.04, was supported between cell phone use for short-term memory prompt and mypyramidtracker.gov alone. CONCLUSIONS: Cell phone pictures improved memory and accuracy of recall when using an online self-reported interactive diet record and was considered an easy, relevant, and accessible way to record diet.

Validating graduate student programmatic outcomes.

One area of paramount importance for a school of nursing's accreditation process is the evaluation of competencies and/or outcomes for the program. Each course within a program is expected to bring the students to the point of comprehending the selected programmatic outcomes while determining an improvement in the mastery of the designated competencies. Schools of nursing have used capstone courses to provide an avenue for the documentation of the synthesis and acquisition of material addressed by programmatic outcomes.This article provides a discussion of one such capstone endeavor used within a university setting, where the school of nursing elected to conduct a non-thesis-requiring program. The capstone experience employed for this program allows for synthesis of concepts, self-reflection, personal assessment, and striving for completeness.