Interventions to improve nurse-family communication in the emergency department: A scoping review.

AIM: To determine and describe what interventions exist to improve nurse-family communication during the waiting period of an emergency department visit. BACKGROUND: Communication between nurses and families is an area needing improvement. Good communication can improve patient outcomes, satisfaction with care and decrease patient and family anxiety. DESIGN: Scoping Review. METHODS: A scoping review was conducted following the Joanna Briggs Institution methodology: (1) identify the research question, (2) define the inclusion criteria, (3) use a search strategy to identify relevant studies using a three-step approach, (4) select studies using a team approach, (5) data extraction, (6) data analysis, and (7) presentation of results. DATA SOURCES: Medline, CINAHL, EMBASE, PsychInfo and grey literature were searched on 3 August 2022. RESULTS: The search yielded 1771 articles from the databases, of which 20 were included. An additional seven articles were included from the grey literature. Paediatric and adult interventions were found targeting staff and family of which the general recommendations were summarised into communication models. CONCLUSION: Future research should focus on evaluating the effectiveness of interventions using a standardised scale, understanding the specific needs of families, and exploring the communication models developed in this review. IMPLICATIONS FOR CLINICAL PRACTICE: Communication models for triage nurses and all emergency department nurses were developed. These may guide nurses to improve their communication which will contribute to improving family satisfaction. REPORTING METHOD: PRISMA-ScR. TRIAL AND PROTOCOL REGISTRATION: Protocol has been registered with the Open Science Framework, registration number 10.17605/OSF.IO/ETSYB. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion.

BACKGROUND: Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs' effectiveness using a pre-post self-assessment pilot study. METHODS: A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. RESULTS: There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4-5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. CONCLUSIONS: Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.

Shaping Social Justice Values Through Inclusive Assessment and Debriefing of eLearning Modules.

BACKGROUND: Nurses need to recognize how intersectionality shapes the experiences of individuals and families navigating complex health systems. Guided reflection on complex social justice issues serves as an approach to move beyond simply understanding social determinants of health toward shaping core professional values of developing nurses to promote lasting change. METHOD: Third-year Canadian undergraduate prelicensure nursing students co-created assignment expectations, completed online modules, and submitted initial reflections before class in a mandatory social justice course. In-class debriefing was based on students' reflections and cofacilitated by subject matter experts. Students completed a final reflection that focused on advocating for social change. RESULTS: Student feedback, reflections, and grades as well as faculty observations support the success of this interactive student-centered approach. CONCLUSION: A flexible approach to debriefing modular content informed by universal design for learning and simulation theory enables nurse educators to promote in-depth, meaningful, and lasting student learning. [J Nurs Educ. 2024;63(1):48-52.].

Palliative Care for the Elderly With Heart Diseases in Tertiary Health care: A Concept Analysis.

BACKGROUND: The increasing incidence of heart failure (HF) in the elderly leads to increased mortality, hospitalization, length of hospital stay, and health care costs. Older adults often face multiple drug treatments, comorbidities, frailty, and cognitive problems, which require early palliative care. However, these patients do not receive adequate palliative care. OBJECTIVE: This concept analysis aimed to develop an in-depth understanding of palliative care for elderly patients with cardiac diseases in tertiary care. DESIGN: The analysis was guided by Walker and Avant's method, and databases were searched using keywords, such as palliative care, tertiary care, elderly, and heart. Covidence was used to review the results using the inclusion and exclusion criteria. RESULTS: The World Health Organisation's definition of palliative care is widely accepted. Palliative care for older adults with heart disease in tertiary care is preceded by chronic illness, polypharmacy, symptom burden, physical and cognitive decline, comorbidities, and psychosocial/spiritual issues. The main attributes of palliative care for this population include health care professionals and patient education, holistic patient/family-centered care, symptom management, shared decision-making, early integration, advanced care planning, and a multidisciplinary approach. Palliative care improves elderly cardiac patients' and their family satisfaction while reducing readmission, hospital stays, and unnecessary invasive procedures. CONCLUSION: Collaboration between hospitals, community organizations, transitional palliative care services, and research has the potential to improve early palliative care and the well-being of the elderly cardiac population. Advanced Practice Nurses (APNs) competencies play a crucial role in promoting palliative care in the elderly HF population.

The use of clinical simulation in wound care education for nurses: a scoping review protocol.

Many nurse educators consider simulation a valuable tool to supplement and augment learning due to current shortages of clinical placements. Wound care is integral to nursing practice yet many students and practicing nurses experience difficulties in securing sufficient learning opportunities or experience at the undergraduate level to feel competent in providing it. Emerging evidence supports simulation as a promising intervention to facilitate student learning in wound care, building nurses' confidence and competence in providing evidence-based wound care. OBJECTIVE: To understand how clinical simulation is being used to educate nurses about wound assessment and management, and to explore the impact of clinical simulation on learning outcomes, including knowledge, attitudes, confidence, and skills related to wound care. INCLUSION CRITERIA: Inclusion criteria include studies of nursing students and nurses, simulation educational interventions, and learning outcomes related to wound care evaluated by any measures. Any studies that do not fit these criteria will be excluded. METHODS: Databases to be searched include PubMed/MEDLINE, CINAHL, ERIC, SciELO up to February 2022. Studies in English with a date limit of 2012 to 2022 will be included. Search results will be imported into Covidence and screened by two independent reviewers, first based on the title and abstract and then full text. Data will be extracted with a novel extraction tool developed by the reviewers and then synthesised and presented in narrative, tabular, and/or graphical forms. DISSEMINATION: The finished scoping review will be published in a scientific journal once analysis is completed.

Mutuality in nurse-caregiver relationships in pediatric nursing: A concept analysis.

PROBLEM: Mutuality is often used in literature in the context of family-centered care and therapeutic relationship building. A therapeutic relationship is necessary to deliver family-centered care, strengthen family health and function, increase patient and family satisfaction, reduce anxiety, and empower decision-makers. Despite mutuality being such an important concept, it is not well defined in the literature. ELIGIBILITY CRITERIA: The Walker and Avant method for concept analysis was used. The databases Medline, PSYCHInfo, CINHAL and Nursing & Allied Health were searched for texts in English from 1997 to 2021 using specific search terms. SAMPLE: Of the 248 results, 191 articles were screened and 48 met inclusion criteria. RESULTS: Mutuality was found to be a process of dynamic reciprocity whereby the partners contribute uniquely to their shared goals, values, or purposes. CONCLUSION: Mutuality is an important aspect of family-centered care and is used throughout nursing and advanced nursing practice. IMPLICATIONS: The concept of mutuality should be incorporated into family-centered care policies, as without it, family-centered care cannot be established. Further research should be done to develop methods or educational techniques to establish and maintain mutuality in advanced nursing practice.

Developing simulation games to advance public health nursing competence in baccalaureate education.

We describe the development of an innovative baccalaureate nursing education strategy for public health nursing. Virtual simulation pedagogy is known to be effective for acute care nursing practice while less known for public health nursing. Three Canadian nursing schools, the Canadian Association of Schools of Nursing (CASN), and the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) partnered to develop three public health nursing virtual simulation games. Learners work through unfolding population health scenarios, simulating public health nursing practice focused on entry level public health nursing competencies. Each game fosters clinical reasoning and collaborative, community decision-making to respond to population health issues during community assessment, evidence-informed health promotion planning, and evaluation processes. A companion guide was developed to support best practices in implementing virtual simulation and promote optimum student learning using the public health nursing games.

'They all stay with me'-An interpretive phenomenological analysis on nurses' experiences resuscitating children in community hospital emergency departments.

AIM: To understand the lived experiences of nurses resuscitating children in community hospital emergency departments. BACKGROUND: Emergency department nurses exposed to paediatric resuscitations are at a high risk of developing post-traumatic stress. This may be especially true in community hospital emergency departments, where nurses have less exposure to, knowledge about, and resources for managing these events. Interventions to proactively prevent nurse trauma in these contexts remain largely uninvestigated. To inform such interventions, a detailed understanding of the largely unknown lived experiences of these nurses is necessary. DESIGN AND METHODS: In-depth, semi-structured interviews were conducted with four registered nurses that had experienced at least one paediatric resuscitation while working in a community hospital emergency department in Ontario, Canada. Data were analysed using interpretive phenomenological analysis. Reporting follows the COREQ checklist. RESULTS: Analysis revealed three superordinate themes (i.e. 'Conceptualising Paediatric Resuscitations', 'Seeing What I See', and 'Making Sense of What I Saw') and nine corresponding subthemes. CONCLUSION: This study provides insight into the infrequent, but profound experiences of nurses resuscitating children in community hospital emergency departments. Nurses, who conceptualise these events as unnatural, emotional, and chaotic, are comforted by those who understand their experiences and are distressed by those who cannot see what they see. To reconcile what they have seen, nurses may reflect and ruminate on the event, ultimately restructuring their experiences of themselves, others, and the world to make room for a new reality where the safety of childhood is not certain. RELEVANCE TO CLINICAL PRACTICE: Our findings contribute to pragmatic recommendations for interventions to proactively prevent nurse distress in these contexts, including psychoeducation, psychological support and in-situ simulation activities. Nursing leaders should consider staff that have resuscitated children as valuable sources for information on how to improve practice settings.

Wolfgang's Story: A Virtual Simulation Supporting Effective and Supportive Communication With an Older Gay Adult.

Lesbian, gay, bisexual, transgender, queer, intersex, and Two-Spirit (LGBTQI2S) older adults face barriers to quality health care, often because practitioners misunderstand the unique health needs of this population. Education is essential to support nurses in maintaining culturally safe practice. Wolfgang's Story, a virtual simulation developed as an educational resource to address this need, focuses on an interaction between an older gay adult and a nurse during a health-care encounter, exploring the use of appropriate terminology, personal assumptions, biases, and key concepts related to heterosexism and to grief. The aim of the article is to report on the development, implementation, and evaluation of this project.

Exploring the effect of neurofeedback on postcancer cognitive impairment and fatigue: A pilot feasibility study.

Purpose: Postcancer cognitive impairment (PCCI) and fatigue are adverse effects that often persist following cancer treatment, and impact quality of life. The study purpose was to evaluate feasibility and effect of neurofeedback on cognitive functioning and fatigue in cancer survivors. Specifically, we aimed to test feasibility of recruitment strategies and our study protocol including outcome measures. Design: This pilot feasibility study used a 10-week wait-list design. Participants served as their own controls and received neurofeedback training twice a week for 10 weeks. Participants: The sample consisted of breast cancer survivors from Kingston, Ontario (n = 16). Methods: Outcomes were assessed using validated, self-report scales and neuropsychological tests before, during, and after neurofeedback. Findings: The neurofeedback protocol was feasible and resulted in significant decreases in perceived cognitive deficits, fatigue, sleep, and psychological symptoms. Implications for psychosocial providers: Neurofeedback may be an effective, non-invasive complementary therapy for PCCI in breast cancer survivors.

Development of an online educational toolkit for sexual orientation and gender identity minority nursing care.

OBJECTIVE: to develop and implement an online education resources to address a gap in nursing education regarding the concept of cultural humility and its application to healthcare encounters with persons who identify as lesbian, gay, bisexual, transgender, queer, intersex (LGBTQI) or Two-Spirit. Improved understanding of LGBTQI and Two-Spirit community health issues is essential to reducing the healthcare access barriers they currently face. METHOD: an online educational toolkit was developed that included virtual simulation games and curated resources. The development process included community involvement, a team-building meeting, development of learning outcomes, decision-point maps and scriptwriting for filming. A website and learning management system was designed to present learning objectives, curated resources, and the virtual games. RESULTS: the Sexual Orientation and Gender Identity Nursing Toolkit was created to advance cultural humility in nursing practice. The learning toolkit focuses on encounters using cultural humility to meet the unique needs of LGBTQI and Two-Spirit communities. CONCLUSION: our innovative online educational toolkit can be used to provide professional development of nurses and other healthcare practitioners to care for LGBTQI and Two-Spirit individuals.

Rapid Development of a COVID-19 Assessment and PPE Virtual Simulation Game.

OBJECTIVE: A virtual simulation game (VSG) educational module focused on COVID-19 assessment and personal protective equipment (PPE) was designed to strengthen the capacity of graduating nursing students and practicing nurses to provide care during the COVID-19 health crisis. METHODS: In less than two weeks, a team of simulation and clinical experts from the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), the Canadian Association of Schools of Nursing (CASN) and the Canadian Nurses Association (CNA) collaborated to virtually developed a high-quality virtual simulation module. RESULTS: A bilingual VSG and related resources was created, focusing on the assessment and PPEs required when caring for a patient with or suspected of contracting COVID-19. CONCLUSIONS: This educational module has been accessed by over 600,000 users and implemented in nursing programs across Canada and globally.

How Stigma and Discrimination Influences Nursing Care of Persons Diagnosed with Mental Illness: A Systematic Review.

One in four people in the world will be affected by mental illness in their lifetime, placing mental disorders as the leading cause of disability worldwide. This qualitative systematic review was to explore perceived stigma and discrimination experienced by individuals seeking care for physical or mental health concerns. Specifically, it sought to uncover the level of perceived stigma and discrimination experienced by mentally ill patients seeking care for physical or mental health concerns. Seven databases were searched between January 1, 2007 to November 1, 2018. Selected studies met the following inclusion criteria: 1) English language and published within North America, Australia, or United Kingdom; 2) studies and articles that consider individuals with mental illness seeking help for either mental or physical conditions in the hospital setting except for within mental health wards; and 3) research in which the phenomenon of interest examined how stigma and discrimination influences the perception of nursing care received by the mentally ill patient and the perception of nurses who provide care to the mentally ill patient. Eight studies met the inclusion criteria. Studies reported that both patients and nurses perceive similar barriers to person-centered care resulting from stigma toward mental illness. This significantly compromised quality person-centered care, and negatively affected the nurse-client relationship. Results indicate the need for further research to determine how health care and educational institutions play a role in perpetuating stigma against mental illness through the prioritization of physical illness over mental illness.

Development of an online educational toolkit for sexual orientation and gender identity minority nursing care / Desenvolvimento de um kit de ferramentas educacionais online para os cuidados de enfermagem das minorias de orientação sexual e identidade de gênero / Desarrollo de un kit de herramientas educativas en línea para la atención de enfermería de las minorías de orientación sexual e identidad de género

Objective: to develop and implement an online education resources to address a gap in nursing education regarding the concept of cultural humility and its application to healthcare encounters with persons who identify as lesbian, gay, bisexual, transgender, queer, intersex (LGBTQI) or Two-Spirit. Improved understanding of LGBTQI and Two-Spirit community health issues is essential to reducing the healthcare access barriers they currently face. Method: an online educational toolkit was developed that included virtual simulation games and curated resources. The development process included community involvement, a team-building meeting, development of learning outcomes, decision-point maps and scriptwriting for filming. A website and learning management system was designed to present learning objectives, curated resources, and the virtual games. Results: the Sexual Orientation and Gender Identity Nursing Toolkit was created to advance cultural humility in nursing practice. The learning toolkit focuses on encounters using cultural humility to meet the unique needs of LGBTQI and Two-Spirit communities. Conclusion: our innovative online educational toolkit can be used to provide professional development of nurses and other healthcare practitioners to care for LGBTQI and Two-Spirit individuals.

Objetivo: desenvolver e implementar uma ferramenta educacional online para atender a uma demanda na educação de enfermagem a respeito do conceito de humildade cultural e sua aplicação às consultas e cuidados de saúde das pessoas que se identificam como lésbicas, gays, bissexuais transgêneros, queers, intersexuais (LGBTQI) ou Dois-Espíritos. Um melhor entendimento das questões de saúde da comunidade LGBTQI e Dois-Espíritos é essencial para reduzir as atuais barreiras que eles encontram no acesso aos cuidados de saúde. Método: foi desenvolvido um kit de ferramentas educacionais online que inclui jogos de simulação virtual e recursos selecionados. O processo de desenvolvimento abrangeu envolvimento comunitário, encontro para formação de equipe, desenvolvimento de desfechos de aprendizagem, mapas de pontos de decisão e escrita de roteiros para gravações. Um site-sistema de gerência da aprendizagem foi desenhado para apresentação dos objetivos de aprendizagem, recursos selecionados e os jogos virtuais. Resultados: o Kit de Ferramentas de Enfermagem para Orientação Sexual e Identidade de Gênero foi criado para a promoção da humildade cultural na prática de enfermagem. O kit de aprendizagem foca nos encontros que usam humildade cultural para atender às necessidades específicas das comunidades LGBTQI e Dois-Espíritos. Conclusão: nosso inovador kit de ferramentas educacionais online pode ser usado para promover o desenvolvimento profissional de enfermeiros e outros profissionais da saúde nos cuidados aos indivíduos LGBTQI e Dois-Espíritos.

Objetivo: desarrollar e implementar una herramienta educativa en línea para satisfacer una demanda en la educación de enfermería sobre el concepto de humildad cultural y su aplicación a las consultas y atención de la salud de las personas que se identifican como lesbianas, gais, bisexuales, transgénero, queer, intersexuales (LGBTQI) o Dos Espíritus. Una mejor comprensión de los problemas de salud de la comunidad LGBTQI y Dos Espíritus es esencial para reducir los obstáculos que enfrentan actualmente para acceder a la atención médica. Método: se desarrolló un kit de herramientas educativas en línea que incluye juegos de simulación virtual y recursos seleccionados. El proceso de desarrollo incluyó la participación de la comunidad, reuniones para la formación de equipos, desarrollo de resultados de aprendizaje, mapas de puntos de decisión y redacción de guiones para grabaciones. Se diseñó un sitio-sistema de gestión del aprendizaje para presentar los objetivos del aprendizaje, los recursos seleccionados y los juegos virtuales. Resultados: se creó el Kit de Herramientas de Enfermería para la Orientación Sexual y la Identidad de Género para promover la humildad cultural en la práctica de la enfermería. El kit de aprendizaje se centra en reuniones que utilizan la humildad cultural para satisfacer las necesidades específicas de las comunidades LGBTQI y Dos Espíritus. Conclusión: nuestro innovador kit de herramientas educativas en línea se puede utilizar para promover el desarrollo profesional de enfermeros y otros profesionales de la salud para el cuidado de personas LGBTQI y de Dos Espíritus.

Developing a Sexual Orientation and Gender Identity Nursing Education Toolkit.

BACKGROUND: Current education lacks lesbian, gay, bisexual, transgender, questioning, intersex, and two-spirit (LGBTQI2S) content for health care providers (HCPs). Providing HCPs with understanding of LGBTQI2S health issues would reduce barriers. The Innovative Thinking to Support LGBTQI2S Health and Wellness trainee award supported the development of a website with virtual simulation games (VSGs) about providing culturally humble care to LGBTQI2S individuals to address this need. METHOD: An online educational toolbox was developed that included VSGs and resources. Development processes included a visioning meeting, development of learning objectives, and using a decision-point map for script writing. Bilingual VSGs were filmed, and the website was developed. RESULTS: The Sexual Orientation and Gender Identity Nursing Toolkit was created to advance cultural humility in practice. Learning modules focus on encounters using cultural humility to meet the unique needs of the LGBTQI2S community. CONCLUSION: Our innovative educational toolkit can be used to provide professional development of nurses and other HCPs to care for LGBTQI2S individuals. [J Contin Educ Nurs. 2020;51(9):412-419.].

Exploring the Use of Neurofeedback by Cancer Survivors: Results of Interviews with Neurofeedback Providers and Clients.

OBJECTIVE: Cancer survivors may experience persistent physical and psychological symptoms following completion of cancer treatment. Neurofeedback is a noninvasive form of brain training reported to help with symptoms including pain, fatigue, depression, anxiety, insomnia, and cognitive decline; however, there is a lack of research exploring its use with cancer survivors. The objective of this study was to describe the experiences of neurofeedback and its impact on the lives of posttreatment cancer survivors as perceived by neurofeedback providers and cancer survivor clients. METHODS: This qualitative descriptive study employed semi-structured interviews and thematic analysis of interview transcripts. A convenience sample of twelve neurofeedback providers and five cancer survivor clients participated in this study. RESULTS: Thematic analysis revealed seven overarching themes as follows: (1) paying it forward; (2) transforming lives; (3) regaining control; (4) brain healing itself; (5) comforting experience, (6) accessibility, and (7) failure to respond. The first five themes related to benefits of neurofeedback, and the final two related to challenges of using neurofeedback with cancer survivors. CONCLUSIONS: Results support the use of neurofeedback to improve quality of life for cancer survivors; however, more research is needed to determine which neurofeedback systems and protocols are most effective for this population with persistent symptoms.

Effectiveness of neurofeedback therapy for anxiety and stress in adults living with a chronic illness: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to systematically examine the effectiveness of neurofeedback therapy for managing anxiety and stress in adults living with a chronic illness.The specific objectives are to identify which neurofeedback systems and/or protocols demonstrate effectiveness and determine the level of supporting evidence.The review question is as follows: What is the effectiveness of neurofeedback therapy for managing anxiety and stress in an adult population aged 18 years of age or older living with a chronic illness?

Pre-simulation preparation and briefing practices for healthcare professionals and students: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to systematically examine the use and effectiveness of pre-simulation preparation and briefing practices for healthcare professionals and students. More specifically, the objectives are to identify characteristics/activities of pre-simulation preparation and briefing and their effects on knowledge, attitudes, self-confidence, self-efficacy, anxiety and skill performance in healthcare professionals and students.The review question is: What are the characteristics/activities of effective pre-simulation preparation and briefing?

Introduction of unresponsive patient simulation scenarios into an undergraduate nursing health assessment course.

BACKGROUND: Despite certification in basic life support, nursing students may not be proficient in performing critical assessments and interventions for unresponsive patients. Thus, a new simulation module comprising four unresponsive patient scenarios was introduced into a second-year nursing health assessment course. METHOD: This cross-sectional study describes nursing student experience, knowledge, confidence, and performance of assessments and interventions for the unresponsive patient across 3 years of an undergraduate nursing program. RESULTS: Overall knowledge, confidence, and performance scores were similar between second-, third-, and fourth-year students (N = 239); however, performance times for many critical assessments and interventions were poor. Second-year nursing students' knowledge increased significantly following the new simulation module (p = 0.002). CONCLUSION: Findings suggest a need for more repetition of basic unresponsive patient scenarios to provide mastery. It is anticipated that addition of unresponsive patient scenarios into the second year will enhance performance by the final year of the program.