Extension for Community Healthcare Outcomes fetal alcohol spectrum disorder (ECHO FASD): Tele-mentoring program to increase healthcare capacity for FASD diagnosis.

BACKGROUND: Children with fetal alcohol spectrum disorder (FASD) often experience delayed, missed, or incorrect diagnosis due to low FASD awareness and diagnostic capacity. Current strategies to expand awareness and diagnostic capacity are insufficient or impractical. METHODS: This project examined the feasibility of Extension for Community Healthcare Outcomes (ECHO) tele-mentoring to train community clinicians about FASD. Participants attended ten 1-h weekly ECHO sessions that included presentations, vignettes, and discussions. Measurement utilized Bowen's feasibility domains. RESULTS: Robust webpage traffic yielded 19 participants (demand). Fidelity scores, hub team field notes, and participant ratings indicated feasibility based on acceptability, implementation, practicality, and adaptation. Clinicians' knowledge and confidence improved and case-based diagnostic accuracy was high (limited efficacy). CONCLUSIONS: ECHO FASD is a feasible training method that shows promise in increasing diagnostic capacity across many geographic regions.

Enhancing the sustainability of a Dedicated Education Unit: Overcoming obstacles and strengthening partnerships.

BACKGROUND: Dedicated Education Units are innovative teaching models that involve collaboration between nurse educators and clinical institutions to provide effective clinical learning. An essential requisite for Dedication Education Units is an effective academic-practice partnership. Following the initiation of a Dedicated Education Unit, partnerships can fade and lines of communication can deteriorate, resulting in dissatisfaction or termination of the partnership. PROBLEM: The ongoing sustainability of a Dedicated Education Unit was questioned due to personnel turnover, communication challenges, and infrequent provision of training for nurses. APPROACH: A redesign project was implemented with the goal to improve academic-practice collaboration, confirm mutual benefit, and envision long-term sustainability. Focus groups were conducted with key stakeholders to identify and evaluate program revisions following three semesters of student rotations on the redesigned Dedicated Education Unit. OUTCOMES: The redesigned Dedicated Education Unit elements received overwhelmingly positive feedback from nurses, students, and faculty. Participants reported increased collaboration between the academic and practice partners, improved communication between faculty and nurses, increased student satisfaction, and improved role preparation for nurses. CONCLUSION: This project demonstrated that Dedicated Education Units can provide mutual benefits to academic and practice partners; however, ongoing collaboration from all members of the partnership is essential for ongoing sustainability.

Impact of Training Frequency on Nurses' Pediatric Resuscitation Skills.

The ideal time frame for frequency of resuscitation skills training has yet to be determined. Results obtained from this performance improvement project using hands-on practice sessions suggest that 6 months may be an adequate time frame for retention of resuscitation skills. Professional development educators may want to consider 6-month retraining intervals for low-volume/high-risk skills such as cardiopulmonary resuscitation to optimize nurses' proficiency in these life-saving competencies.

Compassion Satisfaction and Compassion Fatigue Among Critical Care Nurses.

BACKGROUND: Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. OBJECTIVES: To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. METHODS: In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. RESULTS: Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. CONCLUSIONS: Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested.

Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department.

PROBLEM: Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. METHODS: To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. RESULTS: Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses. IMPLICATIONS FOR PRACTICE: This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques.

Increasing nurse certification rates using a multimodal approach.

The attainment of specialty nursing certification can be beneficial for nurses, patients, and the healthcare organization alike. Barriers may prevent nurses from seeking specialty certification, which may impede healthcare organizations from increasing certification rates among nursing staff. The purpose of this article is to share the process and outcomes of 1 medical center's multimodal plan designed to prepare and support nurses seeking specialty certification in pediatric nursing practice.

Pearls and pitfalls of community-based group interventions for adolescents: lessons learned from an adolescent asthma cAMP study.

This paper explores specific challenges in implementing community-based group interventions with adolescents and makes practical suggestions to researchers who contemplate the group approach. Group interventions have important implications for adolescent research and program development in the area of chronic illness. They have a capacity to address participants' psychosocial needs as well as to offer a cost and time-effective opportunity for disease-specific education. A group intervention encompasses an array of pragmatic challenges that need to be addressed through meticulous preparation. Based on the authors' firsthand experience with a group intervention for adolescents with asthma, this paper describes potential difficulties and logistics pertaining to recruitment, planning and implementation of a group intervention targeting adolescents and suggests general strategies that can be adopted.