An NCLEX-RN Improvement Project: A Study of Student Attributes Associated With Test Success.

BACKGROUND: A school of nursing developed a process to improve graduates' NCLEX-RN scores through a committee tasked with identifying approaches to assist students in passing the NCLEX-RN on the first attempt. METHOD: The process involved: (1) engaging the faculty to use current published evidence; and (2) conducting an anonymous survey of previous graduates to identify the factors associated with NCLEX-RN success in the school's student population. Logistic regression analysis was conducted on a sample of 165 graduates of the program. RESULTS: The analysis of the graduates' psychosocial, academic, and NCLEX-RN preparation attributes compared with NCLEX-RN outcome revealed grade point average was the strongest significant predictor of success. CONCLUSION: The NCLEX-RN success program served to engage the school of nursing faculty. In addition, a study of the program's graduates revealed a predictor of potential student success that can identify students who may need additional support early in the program. [J Nurs Educ. 2024;63(2):102-107.].

Attitudes of Emergency Nurses toward Clients with Mental Illness: A Descriptive Correlational Study in a Nationwide U.S. Sample.

Introduction: Individuals with mental illness often experience stigma from healthcare professionals, including emergency nurses. The purpose of this study was to identify personal and professional attributes of emergency nurses that may be related to their level of stigma toward people with mental illness in the U.S. Methods: Secondary analysis of a cross-sectional study to analyze emergency nurses' characteristics against their perceptions of stigma toward mental illness as measured by the Mental Illness: Clinicians' Attitudes Scale-4 (MICA v4). Data analyses consisted of descriptive statistics; stepwise linear regression; and analysis of the internal consistency of the MICA v4 in the current sample. Results: The mean MICA v4 scores for this sample were 53.4. The linear regression analysis revealed a significant model explaining 23.5% of the variance of MICA v4 scores (F[34] = 6.4, p < 0.001, R2 = 0.235). Many attributes were found to have a strong association with lower stigmatizing attitudes. Discussion: The results of this study indicated high levels of stigma toward individuals with mental illness. Findings from this study can inform nursing education and research, and ultimately improve the health outcomes of individuals with mental illness.

Hospice and Palliative Care for Undergraduate Nursing Education: Results from a Delphi Study.

There is an urgent need to strengthen the nursing workforce through hospice and palliative care education to support patients living with serious illness. The aim of this study was to identify skills/topics in hospice and palliative care for undergraduate nursing education. We conducted a two-round online Delphi Survey of hospice and palliative care leaders and clinicians in New York State between June and August 2022. Participants were asked to list and rate the importance of clinical skills and topics in hospice and palliative care for undergraduate nursing education. Twenty-eight participants completed Round One and 21 participants completed Round Two. Topics ranked as extremely important were goals of care, patient/family education, communication skills, advance directives, medication management, pain management, and symptom management. Our findings highlight the importance of including the perspective of healthcare systems leaders and clinicians in discussions about training of future nurses to meet the needs of patients with serious illness and their families.

Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations.

BACKGROUND: Stressful environments can have significant effects on an individual and lead to burnout. Psychological consequences of burnout include trauma reactions, depression, anxiety and substance use disorders. Resilience, a protective mechanism can mitigate the negative impact of burnout. METHOD: This study utilizes an exploratory correlational design to determine whether or not there is 1) a similar correlation between resilience and burnout between psychiatric nurses working in a high stress environment and students who are naive to the high stress academic environment and 2) a higher level of resilience in the psychiatric nurses compared to the healthcare students. RESULTS: A significant inverse relationship was observed with respect to resilience and burnout in both the professional nurse and student groups. However, the inpatient psychiatric nurse group was not found to have a higher level of resilience than the student group, when controlling for age. CONCLUSION: This suggests that resilience to burnout is not related to the work environment but life experience (age) was found to be a factor related resilience in this sample.

The relationship amongst ethical position, religiosity and self-identified culture in student nurses.

BACKGROUND/PURPOSE: Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students' ethical position; no studies have been conducted in the United States on students' ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States. PARTICIPANTS AND RESEARCH CONTEXT OBJECTIVES: The study's two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students' level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated. RESEARCH DESIGN: A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA. ETHICAL CONSIDERATIONS: The study was approved by the Institutional Review Board at Adelphi University. RESULTS: Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents' place of birth, and if participants were US born. Students' level of education or participation in past courses on ethics did not influence idealism. CONCLUSIONS: The study's findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students' culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education.

A Study of the Use of Psychopharmacologic Agents by Acutely Medically Ill Older Adults.

This retrospective study sought to investigate issues related to the safety of psychopharmacological agents used by acutely medically ill hospitalized older adults. It explored if there were any associations between commonly prescribed psychiatric medications that medically ill hospitalized older adults received and adverse events. It also sought to compare the safety of antidepressants, sedative/hypnotics, and antipsychotics, when used as a standing (on a preset schedule) and as needed pro re nata (PRN) basis. The study found that psychopharmacological agents are frequently prescribed for medically ill hospitalized older adults. No statistically significant difference was found as far as safety was concerned. The number of PRN medications that were used, and the total number of medications was associated with increased risk of transfer within the hospital to a higher level of care or transfer upon discharge to long-term-care/rehabilitation or hospice. Overall, the use of psychopharmacological agents did not appear to be related to serious adverse events.

Post-Traumatic Stress, Trauma-Informed Care, and Compassion Fatigue in Psychiatric Hospital Staff: A Correlational Study.

Assault of staff in psychiatric hospitals is a frequent occurrence, and studies indicate that hospital staff are at risk of developing post-traumatic stress disorder (PTSD). We performed a correlational study with a convenience sample of 172 staff in a psychiatric hospital and compared the rate of traumatic events (TEs), resilience, confidence, and compassion fatigue to PTSD symptoms (PTSS). Regression analyses identified two variables that were unique predictors of PTSS: (1) trauma-informed care (TIC) meeting attendance and (2) burnout symptoms. Severe TEs, age, and compassion satisfaction also contributed to the model. Attention to these factors may help reduce PTSS in psychiatric staff.

The effect of a calorie-restricted diet on weight gain in short-term psychiatric inpatients receiving atypical antipsychotic medications.

This study attempted to evaluate the effect of a calorie-restricted diet on weight change in short-term acute care psychiatric patients receiving atypical antipsychotic medication. A descriptive correlational design utilizing chart review and a convenience sample of 100 participants was used. Fifty charts of patients hospitalized prior to the implementation of the calorie-restricted diet for those receiving atypical antipsychotic agents were compared to 50 charts of patients who received the diet. Weight changes in the two groups were compared relative to age, gender, length of time taking the medication, and the type of medication. The Mann-Whitney U test, Spearman's rank-correlation coefficient, and the two-way analysis of variance were used to conduct the analyses. The calorie-restricted diet was not significantly associated with a reduction in weight gain in participants who received any of the atypical antipsychotic agents except for olanzapine; therefore, findings indicate that the calorie-restricted diet may only be effective for patients receiving olanzapine.

PTSD in psychiatric nurses and other mental health providers: a review of the literature.

Psychiatric nurses are subject to a high rate of assault by patients. The stress of exposure to assault and the potential for assault appear to impact nurses' emotional states in the form of post-traumatic stress and post-traumatic stress disorder (PTSD). Most studies report a prevalence rate of PTSD in this population of between 9-10%. Training in the management of aggressive patients, participating in Critical Incident Debriefing, and having routine structured debriefing meetings may play a role in facilitating the development of resilience in nurses with respect to the risk of PTSD. Knowledge about the state of the science regarding aggression and PTSD is necessary for clinicians and researchers to develop and test effective strategies. This article presents a review of the current literature on this topic.