Social Capital as a Framework to Address Organizational Climate Change Policy.

PURPOSE: To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels. METHOD: Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy. RESULTS: AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies. CONCLUSION: Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11-15.].

Climate change integration in nursing education: A scoping review.

BACKGROUND: The environmental impacts of climate change such as extreme weather, affects human physical and mental health; therefore, including climate change and health is important in nursing education. Despite the recognition of the link between climate change and health, this important knowledge has not yet been systematically integrated into nursing curricula, highlighting the need for immediate action to prepare nurses for these emerging human health challenges. OBJECTIVES: The objective of this review was to gain an overview of the existing literature exploring climate change in nursing curricula and answer following questions: DESIGN: Scoping review. METHODS: A protocol was created and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-SrC). Five data bases were searched: CINAHL, Academic Search Premier, PubMed, Scopus and Cochraine, in addition to databases, grey literature was searched from different sources (reference lists, Google). A total of 1055 articles were derived from the search and 47 articles were included in this review. After selection results from selected studies on educational interventions and climate change education, and opinion pieces were charted, followed by a team review and consensus on the findings. CONCLUSION: This review shows the importance of integrating the topic of climate change into nursing curricula. This integration of climate change-related content into nursing curricula is essential for preparing students, not just for their future roles in healthcare, but also their role in policy and climate justice. These results also reflect strong support from students for that integration. But while progress has been made, further research is essential to evaluate the impacts of these teaching strategies on nursing education.

Effect of an Education Intervention on Nursing Students' Knowledge of and Attitudes Toward Caring for Transgender and Nonbinary People.

BACKGROUND: Transgender and nonbinary (TGNB) people experience inequities in health care access, quality, and outcomes. Health care professionals' lack of knowledge and biased attitudes toward gender minorities contribute to inequitable care. PURPOSE: This study examined the effect of TGNB health education on nursing students' knowledge and attitudes about caring for TGNB clients. METHODS: A quasi-experimental study using a one-group pretest/posttest design was conducted with 46 nursing students at 2 private baccalaureate nursing programs. RESULTS: A paired-samples t test found a significant increase in knowledge about caring for TGNB clients at posttest (P = .02). Attitudes toward caring for TGNB clients showed a significant improvement in the Sex and Gender Beliefs subscale at posttest (P = .014). CONCLUSIONS: The findings suggest that TGNB health education is effective for inclusion in nursing curricula to better prepare nurses to care for gender-diverse clients.

Protecting Children's Health: Asthma and Climate Change.

ABSTRACT: Children are particularly vulnerable to the impacts of climate change. Their lungs are developing, making children with asthma especially susceptible to temperature extremes, variations in precipitation, poor air quality, and changes in pollen and flora. Structural and social determinants of health, such as racism and poverty, that disproportionately affect children of color are linked to higher rates of asthma and negative effects of climate change. These factors lead to increased absences from school and social activities, loss of work for caregivers, and increased health care costs, thus negatively affecting children, their families, and the greater community. Nurses must support caregivers and children to link climate change to asthma care, be involved in health education; climate change mitigation and adaptation strategies and policies; and develop the evidence to address climate change and asthma strategies. We address the impacts of climate change on children with asthma and nursing adaptation responses.

Lived Experiences of Young Adults With Lymphoma During Acute Survivorship.

BACKGROUND: Hodgkin lymphoma and non-Hodgkin lymphoma are hematologic malignancies of the lymphatic system with increased prevalence in young adults. Numerous studies have examined the health-related quality of life dimensions in young adults with lymphoma; yet, limited research has investigated the experiences of this population. OBJECTIVE: This study aimed to explore the lived experiences of young adults with Hodgkin lymphoma and non-Hodgkin lymphoma ( n = 8) receiving acute treatment from one National Cancer Institute-Designated Cancer Center in the Northeastern United States. METHODS: A qualitative interpretive phenomenological study design and method was applied to explore the lived experiences of young adults with lymphoma during acute survivorship. RESULTS: The participants lived experiences were shaped by the diagnostic challenges and impediments of cancer and lymphoma in young adults. Through postdiagnosis, they were determined to safeguard parents and close family members from the burden of cancer. The bonds between medical oncologists and nurses offered the participants a dynamic structure to endure acute survivorship. CONCLUSION: Cancer was challenging to diagnose in this sample of young adults with lymphoma. The presence of nurses was shown to be deeply impactful for young adults with lymphoma. More research is necessary to understand the experiences of young adults with lymphoma through extended or long-term survivorship. IMPLICATIONS FOR PRACTICE: Healthcare providers require additional education regarding the diagnostic guidelines in young adult patients with lymphoma. This study underscores the importance of well-defined and structured postdiagnosis survivorship care in young adults with lymphoma.

Nursing Students' Self-Efficacy in Immigrant Health.

BACKGROUND: The United States has the largest, most diverse immigrant population. Nurses will care for immigrant clients in all areas of nursing practice. PURPOSE: The purpose of this study was to determine nursing students' self-efficacy in working with immigrant clients following a service-learning experience. METHODS: A pre-/posttest descriptive study was used to measure students' self-efficacy in cultural aspects of screening, providing health education, and assisting with health care access prior to and after a voluntary service-learning experience at a resettlement agency. RESULTS: Statistical significance was found in overall scale score and in all 19 individual items except 2 related to working with (P = .21) and communicating with (P = .49) the health care team. Overall, pretest and posttest results revealed that students' self-efficacy working with immigrant clients was improved. CONCLUSION: Collaborating with an immigrant resettlement program to provide a structured immigrant health learning experience for prelicensure nursing students can improve self-efficacy in working with immigrant clients.

Nurses´ and nurse managers´ perceptions of sustainable development in perioperative work: A qualitative study.

AIMS AND OBJECTIVES: To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision-making in perioperative work. BACKGROUND: Sustainable development involves interpersonal social and cultural relations and long-term economic and ecological thinking in societal decision-making. These dimensions are well-suited for a foundation of decision-making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective. DESIGN: Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ). RESULTS: The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision-making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision-making process in perioperative work. CONCLUSIONS: Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision-making in perioperative work. RELEVANCE TO CLINICAL PRACTICE: Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision-making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely.

Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review.

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl's framework for an integrative review. Ninety-eight articles were included in the review from three databases-PubMed, Web of Science, and Scopus-with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

The role of nurses in surveillance to enhance global health security: A delphi study.

BACKGROUND: Internationally, nurses are gaining recognition for their contributions to public health and global health initiatives, however, their contributions to surveillance and the detection of new and emerging infectious disease, which is an important element of global health security, remain largely unknown. PURPOSE: The purpose of this study was to investigate the perceptions of nurse experts related to the current and optimal roles of nurses in surveillance of new and emerging infectious diseases. Additionally, this study aimed to identify the skills needed by nurses in all practice settings for optimal performance of surveillance and to identify barriers to achieving optimal performance of surveillance. METHODS: A three-round Delphi study was conducted. Nurse experts participated in Round 1 interviews followed by ranking current and optimal role, skill, and barrier statements in Rounds 2 and 3. FINDINGS: Findings revealed four current roles and 13 optimal roles for nurses in surveillance, 13 skills needed to perform surveillance activities, and seven barriers to optimal performance of surveillance activities by nurses. DISUCSSION: Results of this study are intended to inform nursing practice and education in the U.S., and to provide guidance on the role of nurses in surveillance of new and emerging infectious disease as part of the Global Health Security Agenda.

Advancing Gerontological Nursing Science in Climate Change.

Older adults have unique health risks related to climate change. This commentary addresses the health impacts of climate change for older adults, identifies gaps in gerontological nursing research, and highlights areas for research to address the significant gap in nursing science. Climate risks of extreme weather events, such as heat, rain, flooding, and wildfires, as well as poor air quality, vector-borne diseases, interruptions of services, and treatment plans all place older adults at risk of experiencing greater morbidity and early mortality. Despite these risks, there is a gap in nursing research related to climate change and aging. Nurse scientists can address this gap with an interdisciplinary approach. There are climate resources and theoretical frameworks to support scientific inquiry. Funding sources must be made available to assure rigorous scholarship of climate-related health impacts for older adults. Gerontological nurse researchers must build capacity to address climate change and health. [Research in Gerontological Nursing, 13(1), 6-12.].

Identifying best practices in electronic health record documentation to support interprofessional communication for the prevention of central line-associated bloodstream infections.

BACKGROUND: There is a paucity of research on best practices for communication through the electronic health record (EHR) to support shared decision-making and to prevent adverse events. To explore this issue, this study focused on interprofessional communication around a specific clinical issue, the prevention of central line-associated bloodstream infections. METHODS: The Delphi technique was used to describe what information is needed to support decisions regarding central venous catheter (CVC) management, and best practices for communicating this information among the interprofessional team. RESULTS: The expert panel, 4 physicians and 6 nurses, identified 12 information types necessary for decisions regarding CVC management and the removal of unnecessary lines. For each of the 12 information types, the panel reached agreement regarding the best channel to communicate this information, including asynchronous EHR formats and synchronous oral channels. CONCLUSIONS: Findings address 2 important aspects of postinsertion CVC practices and a gap in the literature by moving beyond a description of current practices to a description of how the EHR ought to be used to support collaboration and interprofessional communication. Future research should examine how the communication practices identified in this study contribute to a reduction in central line-associated bloodstream infections.

Addressing the Health Risks of Climate Change in Older Adults.

Our climate is changing. These changes have an impact on health, especially in vulnerable populations such as older adults. Many older adults lack the physical, cognitive, social, and economic resources to avoid and/or mitigate the effects of exposure to extreme weather events. The purpose of the current article is to help nurses understand climate change and how that relates to the need for specific interventions to support climate adaptation for the older adult population. A model of exposure, contact to stressors, and adaptive capacity are used to address the health needs of older adults in the face of climate change. Gaps in nursing knowledge, resources for nurses, and a proposed agenda for research and practice in climate change are offered. Gerontological nurses are in an important position to lessen the harm of climate change in older adults through practice, research, and policy. [Journal of Gerontological Nursing, 45(11), 21-29.].

Integrating Climate Change Into Nursing Curricula.

Climate change is a significant threat to human health across the life cycle. Nurses play an important role in mitigation, adaptation, and resilience to climate change. The use of health care resources, air quality and extreme heat, mental health, and natural disasters are major content areas across undergraduate nursing curricula that influence or are influenced by climate change. Teaching strategies and resources are offered to prepare nursing students to address climate change and human health.

Ethical Principles and Guidelines of Global Health Nursing Practice.

BACKGROUND: Nurses are among the many U.S. health professionals engaged in international learning or service experiences and often travel to low-resource countries lacking guidance for ethical practice, respect for host partners, or collaborative work in different health systems. PURPOSE: The aim of this study is to develop evidence-based principles or guidelines for ethical global health nursing practice. METHODS: A three-round Delphi study was conducted. Global health nurse experts participated in Round 1 focus group, followed by nurses with global health expertise ranking global health nursing statements in Rounds 2 and 3. DISCUSSION: Findings led to 10 Ethical Principles for Global Health Nursing Practice and 30 statements for Ethical Guidelines in Global Health Nursing. These Ten principles address beneficence, nonmaleficence, dignity, respect, autonomy, social justice, and professional practice. The 30 guidelines offer more specific actions nurses must consider when working in global settings.

Health Concerns of Northeastern Pennsylvania Residents Living in an Unconventional Oil and Gas Development County.

OBJECTIVES: This study was conducted to describe the health concerns of residents of an unconventional oil and natural gas development (UOGD) community and identify methods to best disseminate health information to the residents. DESIGN AND SAMPLE: A qualitative descriptive study of 27 residents of Wyoming County, Pennsylvania, was conducted. RESULTS: Residents described their health concerns in terms of their changing community as a result of UOGD, their feelings of stress and powerlessness related to these changes, and the limited response of their local policymakers and protective agencies. There were indications of misinformation related to routine environmental health and UOGD environmental risks. Web-based educational programs with downloadable printed materials to bridge the knowledge gaps of residents and health professionals are recommended. CONCLUSIONS: Recommendations include public health nurses providing education to communities and other health professionals regarding environmental health risks, working with communities to advocate for health-protective regulations, and adopting a community-based participatory approach to meet the needs of community members.

Developing curriculum recommendations for environmental health in nursing.

In 2010, the American Nurses Association (ANA) added an environmental health standard to the ANA Scope and Standards of Practice requiring that nurses implement environmental health strategies in nursing practice. To prepare nurse educators to integrate environmental health at all educational levels, nursing faculty members from the Alliance of Nurses for Healthy Environments developed environmental health competencies and curricular recommendations that address this need. Internet URLs are included for environmental health curricula for each level of nursing education.

Promoting cultural understanding through pediatric clinical dyads: an education research project.

This project explored the experiences of six undergraduate nursing students, three American nursing students and three nursing students from the Sultan of Oman, who participated in a faculty initiated education research project as part of their pediatric clinical practicum. Students were placed in dyads, with one American-born student and one Omani student in each dyad. Omani students also were paired with American nurse preceptors. A transcript-based content analysis was used to analyze data generated from qualitative focus group student interviews and student journals. The analysis generated three themes that described how myths were dispelled, cultural barriers were broken down and knowledge gained from another cultural perspective. The nurse preceptors were surveyed at the conclusion of the program. The survey findings suggest that preceptors gained a different cultural perspective of nursing care and they were better informed of the Omani students' learning needs. There was, however, an additional investment of preceptor time in meeting the learning needs of international students. Additional faculty time was also required for preparation and time during clinical conferencing to address differences in nursing practice between U.S. and Oman while meeting course learning objectives. Overall, the educational program provided evidence of enhancing American and Omani student cultural competence and Omani student adaptation to the United States. Coupling a domestic student with an international student to form dyads from the beginning of international students' experience could be a significant enhancement to both groups of students' learning experience.

Nursing education's response to the 1995 Institute of Medicine Report: Nursing, Health, and the Environment.

PROBLEM: Although environmental health has been central to nursing practice since the work of Florence Nightingale, the inclusion of environmental health concepts into nursing education has, for the most part, been confined to public health and occupational health nursing. The 1995 Institute of Medicine report, Nursing, Health, and the Environment, clearly stated that environmental health was an important aspect of nursing practice, but nurses were not adequately educated to address such in their practice. METHODS: This article highlights the initiatives by nurse educators, faculty development programs, federal agencies, nonprofit organizations, and private foundations to educate and engage nurses in environmental health since 1995, with a focus on the Alliance of Nurses for Healthy Environments. The historical summary was developed using professional literature, documents, personal interviews, and survey data. FINDINGS: Nurses responded to the mandates of the 1995 Institute of Medicine report, Nursing, Health, and the Environment, in formal educational programs, through continuing education for nurses, workshops, symposia, and regional faculty development trainings. Since the formation of the Alliance of Nurses for Healthy Environments, collaborative efforts led to the development of competencies, nursing outreach to organizations such as the American Nursing Association, the National Council of State Boards of Nursing, and the American Association of Colleges of Nursing to advance practice standards, academic curriculum, and the development of an electronic textbook. CONCLUSION: The environmental health nursing agenda moved forward since the publication of the 1995 IOM report; however, the development of the Alliance of Nurses for Healthy Environments accelerated the educational accomplishments through organizational collaboration.