Academic program enhancement supporting the success of undergraduate nursing students and graduates.

Nursing program administrators, faculty, academic success coaches, and remediation specialists have implemented many interventions in support of baccalaureate nursing students' retention and graduates' NCLEX-RN® first-time pass rates. A private university's undergraduate nursing program's team incorporated additional evidence-based interventions aimed improving students' achievement of benchmarks following a 3-year decline in NCLEX-RN pass rates. Interventions expanded the prelicensure academic program's activities using a continuous quality improvement approach. A simulation center was constructed and a director was hired. A consultant also facilitated faculty engagement in curricular revisions. A new position, coordinator tutor/remediation specialist, was filled and the academic success coach launched interventions that complemented an initial and subsequent strategies for success initiative. New interventions were trialed and evaluated and became integral to students' and graduates' success. The academic success coach's commitment to students' achievements promoted their engagement in interventions. Pass rates increased and were sustained. Examples of interventions, supported by evidence, are presented in tables for review. A logic model depicts components of the program plan and its interventions as augmented by prospective strategies and remediation interventions. Continuous quality improvement processes will continue. Students and graduates have commented positively on the benefits of the assorted, success-promoting interventions.

Perceptions of Academic Grief in Baccalaureate Nursing Programs: An Instrument Development Study.

Background and Purpose: Nursing students and graduates experience grief when not achieving curricular benchmarks or passing the NCLEX-RN. This study developed the perceptions of academic grief (PAG) instrument for baccalaureate nursing program completers experiencing academic failure. Methods: Content analysis methods generated items and achieved face validity. Focus group interview and experts' judgment of item relevance established content validity. A purposeful sample of registered nurses (RNs) and nursing students (N = 70) completed the pilot test on the 40-item instrument. Results: The highest ranked items included being disappointed, trying again to prove they could become a nurse, life investment in nursing school, and fear of failing again. The Cronbach's alpha coefficient was .94. Conclusions: The instrument was developed to measure nursing students' and RNs' academic grief. The PAG showed beginning reliability and validity and needs additional testing.

Expert-Type Content Validity Applications to Doctor of Nursing Practice Projects.

Background: Developing rigorous doctor of nursing practice (DNP) projects continues to challenge faculty and doctoral students. To address project rigor, expert content validity methods have been applied to clinical projects. Students implement expert content validity processes to literature-based project components. Objectives: The objectives of this study are to describe some of the developmental phases of DNP projects during the courses of one DNP program and to explore one strategy for increasing the rigor of DNP projects, review details on expert-type content validity methods, and examine literature for projects implementing an alternate application of expert-type content validity and scoring approaches to components of DNP projects. Methods: Expert content validity methods are described for DNP projects, such as guidelines, teaching plans, support groups, and algorithms. They are used to judge components generated from initial content analysis strategies. Types of expert panelists and descriptions of scoring ranks on project components are presented to represent different expert content validity strategies. Results The steps are presented to support expert content validity processes. Conclusions: DNP projects challenge faculty and students to create systematically constructed quality improvement projects on important and interesting clinical problems. The expert context validity process is one approach of enhancing project rigor. Implications for Nursing: An outline offers steps to establish expert content validity for translational DNP projects.

Components of Professional Practice Models.

OBJECTIVE: This study describes common components of nursing professional practice models (NPPMs) of Magnet ® -designated nursing service organizations. BACKGROUND: Components of professional practice models have not been consistently analyzed, suggesting a need to identify their concepts. Evidence-based guidelines may be unavailable to assist in the creation and revision of models. METHODS: A checklist was used to analyze 56 Web-based NPPMs of Magnet-designated nursing departments. RESULTS: Checklist items showed a match with parent organizations, an emphasis on patient- or family-centered care, a commitment to quality nursing services, and nursing's professional distinctiveness. Responses indicated engagement in shared governance and support of nursing staff's professional development. The concepts of health, care of sick and well people, and scope of nursing services were inconsistently addressed and call for further research. CONCLUSION: Nurse leaders should examine concepts in NPPMs and the extent they distinguish nursing's professional identity both within and externally to the organization.

The American Academy of Nursing 50th Anniversary of the Nursing Theory Guided Practice Expert Panel (NTGPEP): Exploring the Past-Re-envisioning the Future.

The Nursing Theory-Guided Practice Expert Panel (NTGP-EP), one of the 14 Expert Panels, is officially designated to advance the mission and strategic goals of the American Academy of Nursing. The NTGP-EP has created a forum for dialogue among nurse scholars interested in advancing nursing theory to promote health and wellbecoming. The purpose of this paper is to share the important work of the NTGP-EP and its history, contributions, and accomplishments, and to propose a member-driven agenda to re-envision our preferred future and the impact of the use of nursing theory to guide nursing education, research, practice, and policy.

A fish-like soft-robotic model generates a diversity of swimming patterns.

Fish display a versatile array of swimming patterns, and frequently demonstrate the ability to switch between these patterns altering kinematics as necessary. Many hard and soft robotic systems have sought to understand a variety of aspects pertaining to undulatory swimming, but most have been built to focus solely on a subset of those swimming patterns. We have expanded upon a previous soft robotic model, the pneufish, so that it can now simulate a variety of swimming patterns, much like a real fish. We explore the performance space available for this longer soft robotic model, which we call the quad-pneufish, with particular attention to the effects on lateral forces and z-torques produced during locomotion. We show that the quad-pneufish is capable of achieving a variety of midline patterns - including more realistic, fish-like patterns - and introducing a slight amount of co-activation between the left and right sides maintains forward thrust while decreasing lateral forces, indicating an increase in swimming efficiency. Robotic systems that are capable of producing an array of swimming movement patterns hold promise as experimental platforms for studying the diversity of fish locomotor patterns.

Bodywork and nursing practice: Development of a bodywork in nursing practice instrument.

Nursing's continued focus on caring for physical aspects of patients' bodies underscores the importance of bodywork and shows nursing's privileged, professional access to patients. This instrument development study presents the first phases of a new instrument. It established a conceptual definition of nursing's bodywork and initial psychometric properties of the Nursing Bodywork Instrument. Literature sources generated codes and clusters for item development. Literature-based and expert content validity were demonstrated. A pilot study tested nurses' (N = 53) agreement with draft items. The highest-ranked items confirmed nurses' bodywork and reliance on technological devices when giving direct patient care. Known groups validity testing by groups' years as a nurse did not differ statistically. Internal consistency reliability was 0.98 on the 128-item instrument, pointing to the need for future reduction. Inter-item correlations suggested that factor analysis with a large sample size might generate domains descriptive of nursing's bodywork. A total of 125 items resulted from item analysis and subsequent item revision. All items were matched with clusters; for example, technologic device management, physical comfort facilitation, skin/wound management, self-care facilitation, and respiratory management include some item clusters.

Developing an Effective Professional Panel.

Plenary panel planning and implementation, carried out by temporary teams, are described for nursing organizations and professional development across settings. The conference or meeting theme and objectives frame panel member selection and moderator focus. Panelist conversations highlight different career trajectories and connect with attendees. [J Contin Educ Nurs. 2020;51(3):100-102.].

Best Practices to Decrease Infusion-Associated Medication Errors.

Infusion-associated medication errors have the potential to cause the greatest patient harm. A 21-year review of errors and near-miss reports from a national medication error-reporting program found that infusion-associated medication errors resulted in the identification of numerous best practices that support patient safety. A content analysis revealed that most errors involved improper dosage, mistaken drug choice, knowledge-based mistakes, skill-based slips, and memory lapses. The multifaceted nature of administering medications via infusions was highlighted. Opportunities for improvements include best practices such as developing learning cultures and reinforcing the independent double-check process on medications. Staff will likely benefit from education on specific medications, prescription details, and smart pump technology.

Relationship Between Perceived Nurse Caring and Patient Satisfaction in Patients in a Psychiatric Acute Care Setting.

Patients admitted to psychiatric acute care settings benefit from interactions and caring relationships with hospital staff. The current study describes the association between patients' perceptions of nurse caring and their satisfaction with care at an inpatient psychiatric-mental health unit. The relationship between patients' perceptions of nurse caring and two measures of satisfaction with care were explored. A convenience sample of patients (N = 169) completed the Caring Behaviors Inventory-16 and Client Satisfaction Survey. Data were collected at the time of discharge from the hospital. The associations between perceived nurse caring and satisfaction with care and overall satisfaction with care resulted in strong, positive, statistically significant correlations. Treating patient information confidentially and giving treatments and medications on time were highly ranked, along with feeling safe during the hospitalization and satisfaction with nursing care. Additional research on patients' perception of nurse caring and satisfaction with care is needed. [Journal of Psychosocial Nursing and Mental Health Services, 57(7), 29-38.].

Strategies to Reduce Patient Harm From Infusion-Associated Medication Errors: A Scoping Review.

A scoping review of the literature examined strategies to prevent infusion-associated medication errors. Twenty articles were appraised and revealed studies using different research designs and types of literature reviews. Most were rated low quality. Observations in clinical agencies and laboratory settings were sites of some investigations. The work environment-including staffing, health care providers' education and supervision, standardizing equipment, protocols that supported medication decision-making and administration processes, medication lists, computerized devices, and cognitive aids-were addressed as strategies. The array of studies points to aspects of the complexity of the administration process for infusion-associated medications.

Nursing center-Health Intervention Program in Philadelphia: Program evaluation and outcomes.

BACKGROUND: The La Salle Neighborhood Nursing Center provided the Health Intervention Program (HIP) for vulnerable children with special needs, and families in Philadelphia challenged by chronic physical, developmental, behavioral, and emotional conditions and low incomes. AIMS: We evaluated the effectiveness of HIP for a 5-year period and the consistency of quarterly and annual reports as a quality improvement initiative. METHODS: Using program evaluation, secondary analysis design, the effect of a city-wide, family support home visiting program was assessed. Consistency of documentation of program outcomes on annual reports was described. Data were obtained from reports, framed by program objectives submitted via the ETO® database to the Department of Public Health. Components of the HIP consisted of case management, supportive services, information, and referrals provided by a multidisciplinary healthcare team. RESULTS: Family services, program outcomes, referrals, community meetings, and themes demonstrated program complexity and effectiveness. Reports showed inconsistent documentation on 19 outcomes for program objectives. CONCLUSIONS: Children with special needs and their families shared challenges and barriers to their health. The institution staff should create a table to report outcomes on program objectives to evaluate trends across funding years and establish interrater reliability on quarterly and annual reports.

Medication Errors Involving the Intravenous Administration Route: Characteristics of Voluntarily Reported Medication Errors.

Characteristics of medication errors involving the intravenous (IV) route of administration were analyzed in reports from 1995 to 2013. This was accomplished through a voluntary medication error reporting program. A retrospective case study design analyzed reports by practitioners or consumers on IV-associated medication errors (N = 975) affecting patients. Patterns in error accounts reflected cultural changes in health care organizations. Equipment, labeling, incorrect route of administration, types of errors, patient outcomes, and causal agents represented major codes. Results point to health care provider and consumer knowledge, the need for ongoing education of nursing staff, and interdisciplinary strategies for preventing IV-associated medication errors.

Bathing Disability and Bathing Persons with Dementia.

Bathing disability, evidence of functional decline, predicts admission to long-term care facilities following acute care hospitalizations. Nurses are challenged to assess bathing disability in hospitalized older persons and those with dementia to support their maximal functional performance and implement diverse bathing strategies.

Effectiveness of standard of care protocol on patient satisfaction and perceived staff caring.

BACKGROUND: Nurse caring has been linked to many clinical outcomes, including patient satisfaction, well-being, and healing. In addition, it is valued by nursing staff and viewed as being essential to clinical practice. OBJECTIVES: The purpose of this program evaluation study was to determine the difference in patient satisfaction with overall nursing care and perceived nurse caring when a nursing staff standard of care protocol, which included caring activities, was implemented within a nursing department at a National Cancer Institute-designated comprehensive cancer center. METHODS: A pre-experimental pre-/post-test design with comparison group and a post-test-only design were used to test the effect of the caring protocol on patient satisfaction with nursing care and perceived nurse caring. The study was conducted on seven inpatient units. FINDINGS: Patient satisfaction with nursing care increased for some items, and perceived nurse caring was ranked highly immediately before discharge. Additional program evaluation studies involving a modified caring protocol may improve satisfaction with nursing care in other settings.

Community-based abstinence education project: program outcomes.

PROBLEM: Middle school and adolescent populations demonstrate high rates of unintended pregnancies and sexually transmitted infections, with young people in inner cities in the United States especially vulnerable. Teen births remain high, and youth are affected physically, mentally, socially, and economically. METHODS: The Sex After Marriage primary prevention program, a federally funded, community-based abstinence education (CBAE) initiative, was implemented for 3 years in Philadelphia neighborhoods with vulnerable youth 12 to 18 years of age, supporting adults, healthcare professionals, and the general public. The three-tiered program offered a middle school curriculum, Sex Can Wait, at 16 different sites. The CBAE program delivered by the university's nursing center attempted to support vulnerable youths' decisions to postpone sexual activity by matching the interests of young people through an established curriculum, by holding workshops for supporting adults, and by creating a multimedia approach to supplement abstinence education initiatives including public service announcements and a website. Youth and college ambassadors and community colleagues were trained in the curriculum with a focus on healthy lifestyles. Youth and parents in experimental and control groups completed self-report surveys before and after program implementation. FINDINGS: The project achieved most of its objectives on program evaluation. Youth (n = 1,428) 12 to 18 years of age received services, with most completing ≥75% of the program. Parents (n = 338) and other participating adults (n = 486) also received education or services. CONCLUSIONS: The need for risk reduction programs persists for youth in light of pregnancy, birth, and sexually transmitted disease statistics. Bailey Wolf.

Nursing practice breakdowns: good and bad nursing.

Nurses' responsibility to provide good patient care is explored. Nursing practice breakdowns are examined, differentiating unintentional errors from intentional acts. Good and bad nursing care is portrayed through an emerging classification of intentional practice breakdowns.