Development of Competency-based Online Genomic Medicine Training (COGENT).

The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training modules that are broadly available for busy clinicians.

The Impact of Proper Opioid Disposal Education.

BACKGROUND: Every day, more than 190 people in the United States die from opioid overdose. Unused opioid medications pose a risk to the patient and the community as they increase the potential for abuse or misuse. A contributing factor is lack of education on the proper disposal methods of unused opioid medications. PURPOSE: The purpose of this quasi-experimental nursing study was to examine whether providing education on proper disposal of opioid medications would increase the proportion of patients who properly dispose of unused opioids. METHODS: The study site's mandatory orthopaedic preoperative class was used for consenting patients. The control group did not receive targeted education on opioid disposal, whereas the intervention group did receive targeted education. A total of 86 patients were consented during Months 1 and 2 of the study. Forty-one patients were in the control group and 45 were in the intervention group. Demographic variables such as age, gender, and marital status were collected to determine whether certain demographic factors had an influence over whether or not opioids would be disposed of properly. FINDINGS: Those in the intervention group who attended the class were slightly younger than those in the control group (68.2 ± 9.9 years vs. 70.3 ± 10.6 years, p = .5098), primarily male (57.5% vs. 35.0%, p = .0436), and more likely to live with a significant other (94.7% vs. 74.4%, p = .0249). Of those who had medication left over, 62.5% disposed of their unused opioid prescription in the intervention group compared with 40.7% in the control group (p = .1208). In the intervention group, 86.7% of the individuals with leftover medication disposed of it correctly compared with 63.5% in the control group (p = .3478). CONCLUSION: Those who received education on appropriate opioid disposal were more likely to dispose of it in general as well as dispose of it correctly. Although not statistically significant, the findings from this study are clinically significant in that they provide direction on the importance of standardized and focused patient education on proper opioid disposal.

Empowering Nurses to Engage With Transplant Quality Data and Outcomes.

BACKGROUND: Understanding patient outcome data and quality improvement metrics can help the health-care team target interventions to improve patient care and guide practice. Challenges to understanding and use of data include finding time during clinical work, determining meaning, and understanding a connection to practice. PROBLEM STATEMENT: Acute care nurses who routinely care for organ transplant patients could not speak to transplant quality data or outcomes. This was evidenced by 81% accuracy in interpreting transplant quality data. METHODS: The setting was an inpatient/acute care organ transplant and progressive care unit. A survey was employed to staff; the lowest scoring areas were training to accurately interpret and having time to understand transplant quality data and outcomes. A multimodal intervention that included an education session at a mandatory staff education event followed by routine posting quality data on the unit was devised. Goals were to improve the accuracy of transplant quality data interpretation to an average of 90% and the average key confidence indicators to 6.0 (out of 7.0). PROCESSES ADDRESSED: Education was created to cover background and initial results, data interpretation, and clinical significance. A display board in the staff lounge was dedicated to transplant quality data. OUTCOMES: All goals were met. Accurate interpretation improved to 90% and average key confidence indicators increased to 6.54. IMPLICATIONS FOR PRACTICE: An interdisciplinary team process that involved stakeholders was essential to success. A similar method could be employed with nurses and other frontline staff.

Education Resource Nurse: Engaging Clinical Nurses to Enhance the Patient Experience.

It is challenging to implement a hospital discharge process that effectively prepares patients for success at home, especially when self-care needs are immense. This article describes a disruptive model that leverages nurse autonomy on an acute care medical-surgical hospital unit. The integration of an education resource nurse within existing resources is showing positive gains in 30-day readmission rates and specific patient experience metrics. The continued success of this newly created role is dependent on an adaptive capacity to leverage principles of complexity leadership and to grow the role within the ever-changing health care environment.

Unifying Nursing Education Across the Care Continuum: Creating Consistency in Organ Transplant.

Patients with complex healthcare needs, such as those undergoing organ transplantation, must receive consistent care and patient education across the care continuum for successful self-management. A coordinated effort to unify nursing education across acute care and ambulatory practices was successful; benefits included reduction in redundancy of effort on the part of nursing professional development specialists and assured compliance with regulatory requirements. The nursing professional development standards of practice were essential in guiding this program to success.

Learning Style Preferences of Practicing Nurses.

Nursing professional development practitioners are encouraged to consider incorporating preferred learning styles into professional development programs. However, conclusive evidence about preferred learning styles does not exist. This study describes the preferred learning styles of nursing staff. Results showed that learning style preferences existed and were correlated with satisfaction, years of experience, and gender. The results can be used to plan and deliver professional development opportunities that are engaging and promote retention of learning.

Peer-Review Competency Assessment Engages Staff and Influences Patient Outcomes.

BACKGROUND: Nurse educators must guide competency assessment in a way that influences safe patient care. The goal of this innovative competency assessment was for RNs to demonstrate performance of sound practice related to anticoagulation medication, pressure injuries, and pain management using a peer-review format. METHOD: The process was initiated through the unit-based team. The clinical RN was required to bring forth the information that he or she had met the competency requirements. Rubrics provided consistency in evaluation. RESULTS: The process was perceived to have evaluated actual performance and allowed demonstration of performance. For patient outcomes, anticoagulation safety measures were sustained, pressure injury measures were improved, and pain outcome measures were not improved during and after the competency period. CONCLUSION: A peer-review process for clinical RN competency assessment enhanced professionalism through professional practice evaluation, was perceived as favorable, and was associated with positive patient outcomes. J Contin Educ Nurs. 2018;49(3):119-126.

Registered nurse intent to promote physical activity for hospitalised liver transplant recipients.

AIM: To describe how registered nurse work motivation, attitudes, subjective norm and perceived behavioural control influence intention to promote physical activity in hospitalised adult liver transplant recipients. DESIGN: Descriptive study of clinical registered nurses caring for recipients of liver transplant at a tertiary medical centre. METHODS: Intent to Mobilise Liver Transplant Recipient Scale, Work Extrinsic and Intrinsic Motivation Scale, and demographics were used to explore registered nurses' work motivation, attitudes, subjective norms, perceived behavioural control and intention to promote physical activity of hospitalised adult liver transplant recipients during the acute postoperative phase. Data analysis included demographics, comparison between scale items and analysis of factors predicting intent to mobilise. RESULTS: Factors predictive of intention to promote physical activity after liver transplant included appropriate knowledge to mobilise patients (R2  = .40) and identification of physical activity as nursing staff priority (R2  = .15) and responsibility (R2  = .03). DISCUSSION/IMPLICATIONS FOR NURSING MANAGEMENT: When implementing an early mobilisation protocol after the liver transplant, education on effects of physical activity in the immediate postoperative period are essential to promote implementation in practice. Nursing care environment and leadership must be supportive to ensure mobility is a registered nurse priority and responsibility. Nursing managers can leverage results to implement a mobility protocol.

Making Sense of Nursing-Sensitive Quality Indicators.

Developing the capability to interpret nursing-sensitive quality indicators and other outcome data can be a challenge for registered nurses. An interactive, facilitator-led learning activity effectively addressed this issue in one organization. Registered nurses identified solutions to quality measures in an environment that engaged all levels of Benner's novice-to-expert continuum. The activity had positive outcomes, and learning was shown after the activity.

Principles of successful partnerships.

Health care providers must understand and value the unique contributions of all interdisciplinary professionals, with the goal of optimizing the wellness or illness needs of each patient. Work cannot be done in silos, and the ability to develop and sustain effective professional partnerships is essential. Health care teams must work within a complex environment that depends on the shared efforts of multiple professionals to successfully provide care in a fragmented, highly stressed system. Implementing partnerships that foster relationships through shared interests, vision, and values can aid in the coordination of resources to provide a more positive patient experience and outcome. The development of partnerships requires time and acceptance of shared risks and responsibilities. In return, involved parties will be able to build trust, share rewards, and expand the possibilities of what can be accomplished. The purpose of this review is to describe results-oriented partnerships, which include the attributes of collaboration, coordination, and communication. Essential concepts and practical tools for success are reviewed to offer new and existing partnerships a lens through which to view interdisciplinary interactions that can contribute to organizational success and longevity. Potential pitfalls that may impact patient services and organizational health are also discussed.

Educating a new generation: teaching baby boomer faculty about millennial students.

This review examines the impact of generational influences on the faculty-student relationship. Specifically, the baby boomer faculty-millennial learner dyad is explored, as these two generations are most representative of the faculty-student demographic. Teaching and learning preferences are emphasized, and implications and recommendations for nursing faculty are presented.

Perceptions and characteristics of registered nurses' involvement in decision making.

PURPOSE: This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). SUBJECTS AND METHODS: A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. RESULTS AND CONCLUSIONS: A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.