Enhancing the Prelicensure Clinical Learning Experience: A Student-Centered Learning Approach.

BACKGROUND: Studies of the clinical learning environment document the importance of the student's clinical learning process. PURPOSE: The aim of this study was to gather information on students' perceptions of their learning in the clinical environment. METHODS: A mixed-method strategy was used to explore nursing students' (N = 194) perceptions of their clinical learning experiences. Data were collected using the Clinical Learning Environment Inventory (CLEI) survey and open-ended questions. RESULTS: The results showed that significant CLEI factors were affordances and engagement, student-centeredness, valuing nurses' work, and fostering workplace learning and that these factors were important to prelicensure nursing students' learning in the clinical environment. In addition, the thematic concepts that enhanced their learning were clinical faculty who exhibited strong communication, encouraged and challenged learners, and were readily available. CONCLUSIONS: Clinical faculty in the clinical environment must be competent and able to support the prelicensure nursing student learner.

Hepatitis E seroprevalence in the United States: Results for immunoglobulins IGG and IGM.

BACKGROUND: Previous research identified a decline in hepatitis E virus (HEV) seroprevalence in US in 1988-1994 and 2009-2010. We investigated most recent HEV epidemiology. METHOD: Using a nationally representative sample (7656 persons in the National Health and Nutrition Examination Survey [NHANES] 2013-2014 and 7124 persons in NHANES 2015-2016), we compared the weighted seroprevalence of HEV (immunoglobulin G [IgG]/immunoglobulin M [IgM]) among people from the US (aged ≧ 6 years) between these two time periods. Sampling-weighted multivariate logistic regression models were used to identify factors associated with HEV seropositivity. RESULTS: The median participant age was 37 years (interquartile range = 17-58 years); 51.17% of them were female. Among US-born individuals, HEV seropositivity (IgG/IgM) increased from 4.5% (95% confidence interval [CI] = 3.5%-5.5%) in 2013-2014 to 8.1% (95%CI = 6.5%-9.7%) in 2015-2016. Recent HEV infection (IgM) has nearly doubled in all US-born people. For participants born in and outside of the US, the overall weighted HEV (IgG/IgM) seropositivity increased from 5% (95%CI = 3.9%-6.1%) during 2013-2014 to 7.7% (95%CI = 7.2%-10.5%) during 2015-2016. In "non-Hispanic Asian" females, HEV seropositivity (IgG/IgM) rose from 8.4% (95%CI = 5.6%-11.1%) during 2013-2014 to 20.7% (95%CI = 15.8%-25.7%) during 2015-2016. In "non-Hispanic Asian" males, HEV seropositivity (IgG/IgM) increased from 9.3% (95%CI = 6.9%-11.8%) during 2013-2014 to 16.8% (95%CI = 12.5%-21.2%) during 2015-2016. HEV (IgG/IgM) seropositivity was significantly associated with "non-Hispanic Asian" ethnicity (odds ratio [OR] = 1.69; CI = 1.12-2.56), female (OR = 1.2, CI = 1.06-1.38), and age (OR = 1.058, CI = 1.05-1.06). No clear etiologic agent was found. CONCLUSION: The combined and strata-specific HEV weighted seroprevalence increased from 2013-2014 to 2015-2016. Although prior studies had found increasing age as the only significant factor associated with HEV, the attribute of "non-Hispanic Asian" had a stronger association with HEV seropositivity than the age factor alone.

School Nurse Evaluation.

Evaluation of one's school nurse practice is one standard in the school nurse's scope and standards of professional practice. The Virginia School Nurse Institute Partnership (SNIP) identified the need to develop a concise self-evaluation tool that school nurses and their nurse and non-nurse employers could use to appropriately document a school nurse's practice. The purpose of this article is to provide a self-evaluation tool that the school nurse and his or her employers can use to evaluate professional school nurse practice.

Managing the health care needs of adolescents with autism spectrum disorder: the parents' experience.

Parents of adolescents with autism spectrum disorder (ASD) experience the challenges of navigating the health care system, locating information about ASD, lacking an understanding of prescribed medications, and experiencing minimal social support from health care providers. The purpose of this phenomenological study was to describe the experiences of parents who manage the health needs of an adolescent with ASD. Qualitative interviews were conducted at a university setting with 12 parents of 10 adolescents with ASD residing in Central Virginia. Data were analyzed using Moustakas' method in which the phenomenologist asks the following questions: What are the individual's experiences and in what context did they experience them? This study maximized credibility using 3 strategies: prolonged engagement, peer debriefing, and member checking. "Parents needing assistance" emerged as the essence of the parents' experiences. Four themes representing the essential challenging elements of the parents' experiences included concern with medications, frustrations with health care services, recognizing secondary health issues, and the need for resources and services. Findings of the current study revealed key factors to be considered in the development and delivery of health care for adolescents with ASD. These include creating and planning interventions for parents, sharing information about resources and services, and collaborating with others in the health care field. Additional research, both qualitative and quantitative, is needed to understand how parents and adolescents with ASD experience this transitional period.

The aging Hispanic in America: challenges for nurses in a stressed health care environment.

The aging of America and the explosion of Hispanic immigrants into the United States are causing a tremendous burden to the health care system. The challenges already apparent in an overburdened health care system are examined, and useful strategies for health care providers are offered. The significant challenges facing the Hispanic population are presented, and the need for cultural sensitivity and its importance in providing culturally competent, patient-relevant care are highlighted.

Meningococcal meningitis: an emerging infectious disease.

Meningococcal meningitis is a potentially fatal disease which can affect many 15- to 24-year-olds and those that are affected could have been protected from the disease if they had received the vaccination. The number of reported cases has increased during the past decade and account for many preventable deaths. Adolescents and young adults account for nearly 30 percent of all cases of meningitis in the United States. According to the American College Health Association, approximately 100 to 125 cases of meningococcal disease occur on college campuses each year and at least 60% of these cases are potentially preventable by vaccination. Therefore, it is important to understand the disease process, surveillance and diagnosis of the disease, and the need for vaccination as a form of prevention.

School nurses' knowledge of autism spectrum disorders.

The purpose of this study was to determine school nurses' working knowledge of autism spectrum disorders (ASDs). The current knowledge of school nurses was investigated by means of a mixed-method exploratory descriptive pilot study. Instrumentation included a scale that measured the knowledge of school nurses in regard to ASD, including medication usage and side effects, communication skills, safety issues, collaboration skills, and community resources. Survey results indicated that the majority of school nurses are knowledgeable about ASD, including symptomology and related medications. Results also suggested that school nurses are not as knowledgeable concerning communication skills, behavioral therapies, and safety issues. This study confirms a need for school nurses to enhance their knowledge of ASD, to familiarize themselves with the policy and health care networks that they collaborate with, and to communicate effectively with students, parents, educators, and community members in dealing with ASD.

The effect of school-based health clinics on teenage pregnancy and parenting outcomes: an integrated literature review.

Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy and parenting has declined in the U.S., school-based health clinics can be used to provide support and guidance designed to avoid the negative outcomes associated with teenage pregnancy and parenting. By having school-based health clinics, nurse practitioners and school nurses can provide much needed services to pregnant and parenting teens. These services should include educational support, counseling, and community resources. This inquiry provides a metasynthesis of the literature and will review, examine, and summarize the literature relating to the effect of school-based clinics on teenage pregnancy and parenting outcomes.