Suicide by firearm: One family's lived experience.

In this paper, my nephews and I will share our individual perspectives of their father's completed suicide 30 years ago. Our intention is that the importance of recovery, hope, and support will be illuminated by telling our unique stories to describe the lived experience of a tragedy by gun violence and its longstanding effects.

American Academy of Nursing expert panel consensus statement on inequities in the juvenile justice system rooted in systemic and structural racism.

The overrepresentation of youth of color has long been acknowledged and accepted in juvenile justice and legal systems. Many risk factors contribute to the detention and incarceration of youth; however, there is little evidence to explain how structural inequities and systemic racism add to that vulnerability. Historically, laws were passed to benefit the White society and resulted in outcomes that caused grave aftereffects for people of color and in some cases, ethnic minorities. Within the context of juvenile justice and the lens of critical race theory, the authors of this paper seek to illuminate selected historical educational, environmental, legal, and health care policies, practices, and decisions that led to their detrimental consequences. Recommendations for mitigating both intended (through law, funding, policies) and the unintended barriers as experienced by youth of color are presented.

Implementation of Sexual Assault Services in a Clinic Setting.

ABSTRACT: Sexual assault services cost Americans more than $420,000,000 annually for medical and mental health services. Personal costs include lost wages, lost quality of life, and victim assistance. Public costs include police work, legal adjudication, and sanctioning (penalties). In 2014, an estimated 284,350 adult women were sexually assaulted in the United States. Sexual assault is significantly underreported by those who are assaulted. Upon determination that sexual assault services in a clinic setting were nonexistent, services for sexual assault were developed and implemented in a clinic setting in a Midwestern state. The purpose of clinic services was to provide support, assessment, and forensic examinations for adult women and to evaluate the number of women receiving services. A quality improvement approach was used to determine how and when sexually assault victims received sexual assault services. Persons who have been sexually assaulted vary in gender and age; however, for the purpose of the pilot project, implementation initially included services to women over 18 years of age. Although the number of female patients receiving care was low in the inaugural clinic during the implementation and evaluation period, the services provision remains a viable option for women who experienced sexual assault in a community that previously had no access to clinic services.

Caring for the Mental Health of Youth and Families: What is the Role of the Psychiatric Mental Health Advanced Practice Nurse?

PURPOSE/OBJECTIVES: Children in our nation are experiencing the social, emotional, and physical impacts of an unprecedented time in history. Advanced practice nurses prepared as psychiatric clinical nurse specialists and nurse practitioners bring therapeutic interventions, psychopharmacologic management, and systems thinking to clinical environments of care. Insight into the mental health of youth and families and how clinical nurse specialists may provide solutions for forthcoming challenges is discussed. DESCRIPTION OF THE PROJECT/PROGRAM: Barriers to mental healthcare such as the invisibility of nurses at state and federal levels must be eradicated to mitigate the mental health challenges that youth, families, and communities endure. Contemporary issues such as effects of social media, stigma, and suicide present burdens that can be moderated through nursing interventions. OUTCOME: The psychiatric clinical nurse specialist provides evidence and community-based nursing interventions that, through early identification and advocacy, contribute to positive mental health outcomes for youth and families. CONCLUSION: The need for well-educated advanced practice nurses has never been greater for our vulnerable populations of children, adolescents, and families with mental health challenges. Nurse-delivered programs demonstrate that interventions are necessary for communication, psychoeducation, and prevention of consequences from unacknowledged social media, stigma, and suicide problems.

Developmental Issues and Mental Health.

The trajectory of human development follows a predictable course of milestones. As genomic research has brought us more understanding of the brain, the etiology of mental illness is progressing from psychodynamic origins postulated by Freud in 1960 to organic pathways and epigenetic derivations. Humans develop on normal pathways that can be derailed by poverty, illness, and trauma. When infants begin life from a healthy perspective, conditions that may follow such as a mental disorder may be moderated by healthy starts. In this paper, selected developmental theories and mental disorders are presented; then their interface is discussed. Implications for nursing are outlined.

Preparing Dedicated Education Unit Staff Nurses for the Role of Clinical Teacher.

Dedicated Education Units optimize the expertise of staff nurses to provide clinical instruction to nursing students, thereby creating a need to prepare staff nurses for the teaching role and educate them about clinical teaching strategies. A curriculum to educate Dedicated Education Unit staff nurses in the art of clinical instruction was created to fill this gap in staff development. This article describes the development of an innovative, interactive, evidence-based curriculum to prepare Dedication Education Unit staff nurses and strengthen an academic-practice partnership.

The clinical practice project: planning to publish.

PURPOSE: An increasing number of journals focused on clinical practice publish high-quality projects. However, research reports typically follow a distinct design, which is not always appropriate for reporting clinical practice projects. The purpose of this article is to provide a succinct guide for planning and reporting clinical projects, specifically, the Doctor of Nursing Practice applied clinical project. DATA SOURCES: Literature concerning clinical practice project planning and preparation for publication was reviewed for this article. CONCLUSIONS: This article provides a section-by-section summary of elements frequently included when preparing a manuscript for publication. The elements addressed in this article are suggestions and their inclusion and sequencing may vary depending on specific journal requirements. IMPLICATIONS FOR PRACTICE: If information from clinical research projects is to contribute to nursing knowledge in the form of lessons learned and information about translation of research into clinical practice, the design and conduct of the project must be rigorous and information about implementation and findings must be accurate and clearly communicated.

A comparison of still point induction to massage therapy in reducing pain and increasing comfort in chronic pain.

A quantitative study was completed to determine whether complementary techniques provide pain relief and comfort in patients with chronic pain. Subjects participated in sessions including aromatherapy and music therapy. Massage or cranial still point induction was randomly assigned. Statistically significant improvement in pain and comfort was noted in both groups.

War on the spore: Clostridium difficile disease among patients in a long-term acute care hospital.

The transmission of Clostridium difficile infection (CDI) is evident in healthcare facilities across the country and poses a risk for patients and communities. A comprehensive infection control program along with an active surveillance process was developed and implemented in a 50-bed long-term acute care hospital (LTACH) in the southeastern United States. Patients are admitted from surrounding hospitals, have an expected stay of at least 25 days, and are acutely ill. The majority of the patient population is ventilator dependent, immunocompromised, and treated with antimicrobials. The program, implemented in December 2009, utilized a tiered approach that included environmental cleaning and disinfection, diagnostics and surveillance, and infection control measures including antibiotic stewardship. The goal of this study was to decrease the incidence rate of CDI 15% by June 2010. Based upon year-end results, the facility achieved a 27.61% decrease in the CDI rate. During the following 12 months, the program continued to demonstrate sustainability resulting in a 23.0% decrease in the CDI rate. This program was successful in decreasing the incidence of CDI in the LTACH creating a safe and cost-effective environment for patients, families, and the community.

A qualitative study using a systemic perspective exploring the remediation of abusive interactions in intimate heterosexual couples.

Very little attention has been paid to both partners beliefs about why violence in their previously abusive relationship has stopped or significantly reduced despite well-documented details in the research literature outlining the characteristics of both victims and perpetrators. This study aimed to provide some understanding of how each partner believed that the violence has ended. However their answers often were not definitive; instead, they uncovered the complexities in their relationship and their struggle to overcome the uncertainty they have to achieve and maintain successful remediation. The article is based on a qualitative Interpretative Phenomenological Analysis (IPA) study that explored the nature of the relationship between six heterosexual couples before and after a therapeutic intervention for the men perpetrators, which followed the Duluth Model. The study included how they both understood the violence and how they maintained nonviolence in their relationship. The men were notably still in the process of reprocessing their understanding of why they were violent and they needed to further understand their reactions to maintain their nonviolence. The IPA themes provided some understanding of how the participants thought they had a better understanding of the factors that had maintained their relationship since the termination of the intervention. The themes, generated from the interviews provided by the perpetrators and their victims, are explored and some explanations for the successful continuation of their relationship following treatment are suggested. Implications for widening the treatment options for men perpetrators are suggested in addition to providing treatment options for couples who wish to remain within their relationships and need help to identify unhelpful and dangerous patterns of interaction.

Appreciative inquiry in youthful offender psychiatric nursing research.

PROBLEM: Combined with demonstrated impulsive behaviors and culturally bound expectations, youth who are detained in the juvenile justice system are challenged to find opportunities to articulate their stories and life experiences that contribute to a future life. METHODS: Appreciative inquiry (AI) as a research method is used to analyze interviews of youth residing in a juvenile detention center. FINDINGS: The narrative, or life pattern, that youth in detention express is explicated through the four processes of the 4-D Cycle in AI. The processes are discovery, dreaming, designing, and delivery. CONCLUSIONS: AI as a research method is useful to conduct interviews with detained youth, to provide a data analysis method for qualitative interviews, and generate nursing interventions. Through articulation of their own stories, youth discover voice and envision empowerment.

Psychometric testing of the children's resourcefulness scale.

PROBLEM: Resourcefulness is known to reduce depression in adults, but its effects on children are less well known, possibly for lack of a psychometrically sound measure. METHODS: This study examined the reliability and validity of the 32-item Children's Self-Control Scale (C-SCS), which measures resourcefulness, in 122 school-aged children. FINDINGS: Standard scale refinement methods produced a 10-item scale with alpha= .72 and correlations with the C-SCS (r = .86), positive thoughts (r = .38), and depressive symptoms (r =-.32). Factor analysis revealed two factors: problem-solving and delay of gratification. CONCLUSIONS: The 10-item scale may be useful for identifying children who are not resourceful and are at risk for depression.