Burnout among academic nursing faculty.

BACKGROUND: Nurse faculty burnout is a growing concern in the United States. There are limited studies exploring the level of burnout in nursing faculty. PURPOSE: To assess the prevalence of burnout among nurse faculty in undergraduate and graduate programs and its relationship with specific demographic and organizational variables. METHODS: A descriptive cross-sectional research design was employed to examine the level of burnout of nursing faculty. An internet-based survey was administered to nursing faculty in over 1000 schools of nursing in the United States. Burnout was measured using the Oldenburg Burnout Inventory. RESULTS: A total of 3556 surveys were returned. Among all participants, most of the sample exhibited moderate levels of burnout, exhaustion, and disengagement. Based on the findings from the OBI, a moderate/high exhaustion level was reported in 85.5 % of participants, while disengagement was moderate/high in 84.9 %, and overall burnout was at moderate/high levels in 85.2 % of the nursing faculty. CONCLUSIONS: The nation's nurse faculty population is experiencing a moderate to high level of burnout, exhaustion, and disengagement. Academic nursing leaders are encouraged to identify ways and take action to reduce faculty burnout and promote faculty wellness and resilience.

Project to Publication-A Writing Mentorship Program.

PURPOSE/AIMS: Evidence is required to inform effective interventions promoting publication among clinical nurses. This study examined the effect of a mentored writing program on clinical nurse perceptions of writerly self-efficacy and publication. DESIGN: A mixed-methods, pretest-posttest study design with an education intervention was implemented. The Revised for Nursing Practice - Postsecondary Writerly Self-efficacy Scale (RNP-PSWSES) measured perception of writerly self-efficacy before and after intervention. Manuscripts submitted for publication were counted. METHODS: The purposive, convenience sample included registered nurses with completed research, evidence-based practice, or quality improvement projects. Subjects participated in a 3-month structured mentored writing program and completed the RNP-PSWSES survey before and after program completion. A Wilcoxon signed rank test was performed to determine the significance of difference between the pretest and posttest, and the number of published manuscripts was reported. RESULTS: The RNP-PSWSES items identified pretest-posttest Cronbach's α (.728, .818). Posttest RNP-PSWSES scores were statistically significantly higher than pretest scores (z = -1.96, P = .050) with a large effect size of r = 0.69. Two manuscripts were accepted for publication, and 1 manuscript was withdrawn after the third request for revisions. CONCLUSIONS: In this study, mentored writing workshops improve nurses' perceptions of writing ability and increase publications. Generalization of findings is limited by small sample size. Clinical nurse specialists are critical to champion writing and publication.

Current state and future recommendations for faculty in PhD in nursing programs.

In 2020 the American Association of Colleges of Nursing (AACN) Board of Directors appointed a 9-member task force to revise AACN's 2010 position statement, The Research-Focused Doctoral Program in Nursing: Pathways to Excellence, with the goal of developing a vision for research-focused doctoral programs and graduates. This resulted in 70 recommendations in a new AACN position statement, The Research-Focused Doctoral Program in Nursing: Pathways to Excellence (2022). The new document is based on a review of the literature from 2010 to 2021 and 2 inaugural surveys sent to deans and PhD students in nursing. The new The Research-Focused Doctoral Program in Nursing Pathways to Excellence document focuses on the critical need for nurse scientists who can develop the science, steward the profession, and educate new nurse educators. Several manuscripts have been developed describing various components of the PhD Pathways document focusing on the role of faculty, students and curriculum, resources and post-doctoral education. This article focuses on the recommendations related to explicating the faculty role in PhD education and includes data from the AACN (2020) deans' survey, the current state of the professoriate involved in PhD education and the developmental needs of PhD faculty for the future.

Research focused doctoral nursing education in the 21st century: Curriculum, evaluation, and postdoctoral considerations.

The AACN position statement on The Research-Focused Doctoral Program in Nursing: Pathways to Excellence was revised in 2022 by an AACN Task Force charged with creating a new vision for the PhD and similar programs in nursing. This document, which was informed by hundreds of academic nursing stakeholders, yields expectations and recommendations for PhD program curriculum, program evaluation, post-doctoral competencies, and resources. Results of an AACN 2021 survey indicated increased enrollment in PhD programs 2017-2000. Fifteen percent of students were enrolled in BSN-PhD, programs, 70 % of schools reported external review, and overall average time to degree completion was 5 years. Considerations for the education for the research doctorate include development of curriculum that fosters the scholarship of discovery and scientific inquiry and implements systematic evaluation of program outcomes while advancing postdoctoral competencies and resources, including the post-doctoral fellowship. Comprehensive assessment of the PhD program promotes ongoing program analysis and quality. Postdoctoral fellowships advance the science of nursing via the creation of a culture and workforce for nursing research. Successful postdoctoral programs have mentors, resources, and infrastructure to adequately enable the fellow to progress in their line of inquiry and develop as an investigator.

Impact of the COVID-19 Pandemic on the Future of Nursing Education.

Nursing is the largest health profession, with nearly 4 million providers practicing across acute, primary, and public health care settings. In response to the pandemic, nursing schools halted on-site course delivery and redesigned programs to attenuate risks to students and faculty. Key challenges faced by schools included financial cutbacks, rapid increases in online learning technology, maintaining student academic progression, disruption to clinical learning opportunities, and meeting accreditation standards, while addressing the stress and loss experienced by faculty, staff, and students. Despite challenges, nursing organizations provided guidance for decision making, new learning resources, and faculty development opportunities. Schools of nursing leveraged their resources to redesign nursing curricula, strengthen partnerships for student clinical experiences, and address needs of the community. Nursing education will look different from its prepandemic profile in the future. Lessons learned during the pandemic point to gaps in nursing education, particularly related to disaster and public health preparedness, health equity, and technology. The American Association of Colleges of Nursing's new Essentials-standards for professional nursing education-were finalized during the pandemic and reflect these lessons. The need for nurse scientists to conduct emergency response research was made evident. The importance of strong academic-practice partnerships was highlighted for rapid communication, flexibility, and responses to dynamic environments. For the future, nursing education and practice must collaborate to ensure that students and practicing nurses are prepared to address emergencies and pandemics, as well as the needs of vulnerable populations.

Using Data from a 360° Leadership Assessment to Enhance Nurse Manager Transformational Leadership Skills.

OBJECTIVE: The aim of this study was to compare self-perception of leadership practices among nurse managers (NMs), day shift nurses, and night shift nurses (NSNs). BACKGROUND: Nurse managers have complex roles in healthcare, with clinical, administrative, and 24-hour accountability for unit activities. Transformational leadership inspires performance beyond expectations, while transcending self-interest for the good of the organization. METHODS: A comparative, secondary data analysis study of the Leadership Practices Inventory (LPI) 2018. RESULTS: Day shift nurses' and NSNs' mean scores had lower perceptions of leadership practices than NMs' self-assessment. Day shift nurses, NSNs, and NMs identified the highest mean scores in "enable others to act" (8.57, 8.62, and 8.82, respectively). CONCLUSIONS: The LPI assessment, the defined observer groups, and unique data visualization informed development of a comprehensive follow-up plan supporting individual and group leadership development. Research examining differences in perceptions of LPI practices across observer groups, particularly direct report staff nurses, is warranted.

Preventing Falls Among Behavioral Health Patients.

BACKGROUND: Inpatient falls are among the most common hospital incidents reported. Fall-related injuries have significant implications for patients, staff, and organizations. Adult behavioral health inpatients are responsible for higher rates of injurious falls and challenge traditional fall prevention methods. An inpatient behavioral health unit in an acute care hospital identified an increased rate of injury from falls per 1,000 patient-days in three months; three falls resulted in major injury. PURPOSE: The purpose of this quality improvement (QI) report is to describe the redesign of a fall prevention program for adult behavioral health inpatients using evidence-based practice (EBP) and QI methods. METHODS: Root cause analyses (RCAs) were conducted on all three fall-related major injuries. Concurrently, a literature review identified EBP recommendations for fall prevention on behavioral health units. A fall prevention action program was developed consisting of four elements: RN education to improve Morse Fall Scale scoring, individualized fall prevention patient plans, revised staff workflow, and improved fall prevention communication. RESULTS: There were no fall-related injuries for six months and no fall-related major injuries for 12 months following implementation of the fall prevention program. Overall, this reduction in fall-related major injuries was sustained over a 21-month period. CONCLUSION: An interprofessional team approach using EBP and RCA is effective in redesigning and implementing a fall prevention program for the adult inpatient behavioral health population.

Routine Disinfection of Mobile Communication Devices in the Postanesthesia Care Unit.

PURPOSE: Explore the effect of routine disinfection of mobile communication devices (MCDs) in postanesthesia care unit (PACU). DESIGN: Experimental, repeated measures design. METHODS: At a 247-bed, 20-bed PACU hospital, Mid-Atlantic region, United States, mean baseline bacterial adenosine triphosphate (ATP) counts of six MCDs were established with 3M Clean-Trace Luminometer. MCDs were routinely disinfected with CaviWipes for 10 days, every 12 hours. Mean bacterial ATP counts on six MCDs were repeated at day 11 and month 36. FINDINGS: For six MCDs, baseline ATP counts identified Failure for cleanliness. Postroutine disinfection bacterial ATP counts identified Caution and Passing; 36-month bacterial ATP counts identified sustained Passing for cleanliness. CONCLUSIONS: Routine disinfection of MCDs in the PACU defined by time and method, obtains, and sustains Passing level of cleanliness. Staff nurses identified trigger, researched practice, changed practice, and implemented quality improvement follow-up.

Apoptotic Activities of Sanguinaria canadensis: Primary Human Keratinocytes, C-33A, and Human Papillomavirus HeLa Cervical Cancer Lines.

BACKGROUND: Sanguinarine is a benzophenanthridine alkaloid derived from the root of Sanguinaria canadensis. Multiple published, preclinical studies have demonstrated that sanguinarine causes apoptosis in human cancer cells. An expert panel of naturopathic doctors identified sanguinarine as a component for consideration in cervical atypia management protocols. Clinical studies have identified positive outcomes when Sanguinaria is a constituent of escharotic treatment in cervical atypia management protocols. Therefore, further investigation and development of sanguinarine as a potential cancer treatment is recommended. Thus, the aim of this study is to further elucidate the signaling pathways of sanguinarine-induced cell death. METHODS: Cell cultures of cervical cancer line C-33A (human papillomavirus [HPV] negative), HeLa (HPV positive), and normal primary human keratinocytes were established. Microscopic plate inspection, cell viability, initiator and effector caspase assays were completed in triplicate on C-33A (HPV negative), HeLa (HPV positive), and normal primary human keratinocytes cells exposed to incremental doses of sanguinarine. RESULTS: Sanguinarine induced dose-dependent cell death in cervical cancer lines as well as in normal human keratinocytes. Microscopic plate inspection confirmed morphologic changes of cell death in normal keratinocytes, C-33A, and HeLa including cell shrinkage, round up, and detachment from plate surface. Caspase assays demonstrated that sanguinarine treatment of C-33A cells resulted in an induction of caspase-3/7 when compared with vehicle-treated controls. CONCLUSIONS: Sanguinarine demonstrates potential as an agent with therapeutic impact because of the capacity to eliminate cancerous cells through apoptosis, the process of programed cell death. Further elucidation of signaling pathways of sanguinarine-induced cell death is necessary when considering sanguinarine as a treatment for cervical cancer.

Visiting again? Subjective well-being of children in elementary school and repeated visits to school health nurses.

BACKGROUND: Children with vague complaints are without chronic illness, and who repeatedly visit the school nurse may be at risk for limited academic success. This study compares student reports of subjective well-being between children who do and do not repeatedly visit the school nurse with vague complaints. METHODS: Children in grades 4 through 6 completed the School Well-Being Profile-American English (SWBP-AE), a questionnaire with 4 well-being subscales: health status, school environment, social relationships, and school as a means of self-fulfillment. School nurses extracted data on clinic visits from clinic records. Logistic regression explored associations between well-being subscales and repeated visits to the school nurse. RESULTS: Of the 320 students participating in the study, 33 (12.04%) students made repeated visits to the school nurse. Perception of health status (OR = 2.072; 95% CI = 1.037, 4.163) was the only significant (p < .05) predictor of repeated visits to the nurse. CONCLUSION: Children with poor perception of their health status are more likely to repeatedly visit the school nurse. Children's perceptions of their school environment, social relationships, or school as a means of self-fulfillment are not statistically significant predictors of repeated visits to the school nurse.

Naturopathic management of females with cervical atypia: a delphi process to explore current practice.

BACKGROUND: Human papillomavirus is the most significant factor contributing to cervical cancer. Naturopathic doctors (NDs) implement an integrative approach to treat cervical atypia. This study explored practice consensus and variance among NDs. METHODS: A purposefully selected panel of six NDs participated in a modified Delphi study to validate practice. Three electronic web-based surveys were completed over nine months. RESULTS: Local and systemic treatments were included in all ND protocols. Six protocols included cervical cancer screening guidelines, green tea suppositories, and oral folic acid. Five protocols included oral green tea, diindoylemethane (DIM), and cartenoids. Four protocols incorporated Vitamin C. Two NDs considered escharotics when managing cervical atypia. All NDs included health behavior management in their protocols. CONCLUSION: Naturopathic management of cervical atypia varies across practitioners. However, in general, elements of management include (1) cervical cancer screening guidelines, (2) local and systemic treatments, (3) health behavior/lifestyle recommendations, and (4) immune system support.