Problematic internet use in adolescents and implementation of a social media hygiene protocol.

PURPOSE: This quality improvement project aimed to evaluate whether a social media hygiene education intervention designed for adolescents with problematic internet use (PIU) receiving treatment at a pediatric outpatient mental health clinic reduced PIU and/or improved mental health outcomes in adolescents. METHODS: Participants were 28 adolescents (71.4% females, mean age = 14.2 years) with PIU seeking outpatient mental health treatment. The most common associated diagnoses were anxiety (42.9%) and attention-deficit activity disorder (28.6%). A within-adolescent pre-post design was used to evaluate changes in PIU severity measured by the Generalized Problematic Internet Use Scale-2 (GPIUS-2), depression and anxiety severity was assessed by the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS), and screen time defined as the average hours/day during past 7-days recorded of the adolescent's smartphone. The practice change was an ad hoc social media hygiene education intervention conducted by their provider over five, once-a-week, one-hour telehealth sessions. RESULTS: A significant reduction in screen time (paired t = 10.14, df = 27, p < 0.001), severity of PIU (paired t = 12.07, df = 27, p < 0.001), and severity of depression and/or anxiety symptoms (paired t = 8.3, df = 27, p < 0.001) was demonstrated. Large effect sizes were observed (Cohen d = 1.6 to 2.3). Attendance for each session was 100% for Weeks 1, 2 and 5, 93% for Week 3 and 89% for Week 4. CONCLUSION: The findings suggest administration of a social-media hygiene protocol conducted via telehealth may reduce the severity of PIU and improve mental health outcomes in adolescents seeking outpatient mental health treatment.

Substance Use Education in Schools of Nursing: A Systematic Review of the Literature.

The authors systematically reviewed the nursing literature for articles describing substance use disorders (SUDs) education in schools of nursing. Five literature databases were searched, producing 3107 retrieved articles, of which 12 were included in this review. A Medical Education Research Study Quality Instrument score was calculated for each study. The included studies demonstrated that teaching nursing students about SUDs produced a positive impact on their attitudes, knowledge, and skills.

Evaluation of a Sickle Cell Disease Educational Website for Emergency Providers.

Sickle cell disease (SCD) is a complex multisystem debilitating disease. Despite its complexity, health care providers who are not SCD experts receive little formal education on SCD. An open-access, educational website, "Emergency Department Sickle Cell Disease: Crisis Management and Beyond," was created to provide education about SCD to emergency department (ED) providers who are not SCD experts but who provide care for patients with SCD. Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. The evaluation consisted of (1) individual module pre- and post-knowledge assessment, (2) content validity assessment of educational modules, (3) overall website content assessment, and (4) overall website assessment (Health on the Net core principles). A convenient sample of ED providers, accelerated bachelor of science in nursing students, SCD experts, and website experts completed the anonymous surveys. Descriptive statistics and paired t tests were used to compare mean difference in post- minus pre-knowledge test scores. Knowledge scores statistically improved for nursing students (p value less than 0.0001). Emergency department providers showed a mean improvement of 3.2 points on the eight-item knowledge assessment. Both SCD experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives. Participants agreed that the website was clear, easy to navigate, and visually appealing. Website experts stated that the website met much of the Health on the Net criteria. The website is a useful resource for providers and nursing students, especially those who serve or plan to serve in EDs.

Writing Across the Curriculum: Strategies to Improve the Writing Skills of Nursing Students.

BACKGROUND: Writing across the curriculum (WAC) is a strategy in which writing instruction occurs in classes outside of composition, literature, and other English courses. This literature review was conducted to identify and synthesize the peer-reviewed literature about WAC in nursing education. METHODS: The team performed searches of MEDLINE (PubMed), CINAHL Plus With Full Text, and ERIC for articles published between January 2003 and April 2014. A combination of Medical Subject Heading terms (or equivalent) and keywords were used to create the database search strategies. RESULTS: There were 48 articles that discussed WAC. Most of the papers described writing courses in nursing programs, strategies to teach writing to nursing students, and writing activities or assignments within nursing courses. High-level evidence examining the impact of writing strategies and exercises in courses and occurring across the curriculum was lacking. Only 18 (37.5%) of these papers were evaluative; most of the databased articles were either author observations or perceptions of changes in students' writing ability, or low-level research studies. CONCLUSIONS: Strategies, assignments, and courses intended to promote writing skills of nursing students were documented in this literature review; however, further evaluation is needed to determine which are most effective. Hawks Turner Derouin Hueckel Leonardelli Oermann.

Strategies to Address Individual Level Social Determinants of Health Designed to Cultivate the Next Generation of Minority Nurse Leaders Committed to Health Equity.

In response to the need for increased racial and ethnic diversity in the nursing profession, the Duke University School of Nursing (DUSON) established the Academy for Academic and Social Enrichment for Leadership Development in Health Equity (Health Equity Academy). The aim of the Health Equity Academy is to improve the diversity of the nursing workforce by expanding nursing education opportunities for underrepresented minority (URM) students who are economically disadvantaged to prepare for, enroll in, and graduate from the DUSON's Accelerated Bachelors of Science in Nursing program. The goal of this program is to cultivate URM nursing graduates with advanced knowledge and leadership skills who can address health disparities and positively influence health care issues currently plaguing underrepresented populations. The article discusses the Health Equity Academy framework, which consists of two unique components: the Pre-entry Immersion in Nursing and the Pathway to Success in Nursing (PSN). These two components are designed to address the nursing student individual level social determinants which could be potential barriers to success as well as provide support in their academic and professional development goals.

Use of Workshops to Develop Nurses' and Nursing Students' Writing Skills.

Workshops have been described in the literature as a strategy for preparing nurses to publish their work and develop their writing skills. Articles about the use of workshops for these purposes have not been integrated systematically. Seventeen articles were included in the current review. The workshop method has been found to be effective for preparing nurses to write for publication and for improving nurses' and nursing students' writing skills. However, workshops must be combined with one-to-one mentoring and feedback on writing to be successful.

Beginning with the end in mind: cultivating minority nurse leaders.

In response to the need for increased racial and ethnic diversity in the nursing profession, the Duke University School of Nursing (DUSON) established the Making a Difference in Nursing II (MADIN II) Program. The aim of the MADIN II Program is to improve the diversity of the nursing workforce by expanding nursing education opportunities for economically disadvantaged underrepresented minority (URM) students to prepare for, enroll in, and graduate from the DUSON's Accelerated Bachelors of Science in Nursing program. Adapted from the highly successful Meyerhoff Scholarship Program model, the program is to cultivate URM nursing graduates with advanced knowledge and leadership skills who can address health disparities and positively influence health care issues currently plaguing underrepresented populations. The article discusses the MADIN II framework consisting of four unique components: recruitment of students, the Summer Socialization Nursing Preentry Program, the Continued Connectivity Program, and the Succeed to Excellence Program, providing a framework for other academic programs interested in cultivating a pipeline of minority nurse leaders.

Systematic review of educational programs and strategies for developing students' and nurses' writing skills.

The purpose of this article is to describe the outcomes of a systematic review of educational programs and strategies for developing the writing skills of nursing students and nurses. Of 728 screened citations, 80 articles were included in the review. Writing assignments in nursing courses were the most common, followed by strategies for writing across the curriculum and specific courses to improve the writing skills of nursing students. To improve nurses' writing skills, workshops were used most frequently. Only 28 (35%) of the articles were data based, and most articles described the writing program, strategy, or assignment but did not evaluate its effectiveness.

Nurse practitioner management of type 2 diabetes.

CONTEXT: Multifactorial barriers prevent primary care clinicians from helping their adult patients with type 2 diabetes achieve good control of hemoglobin A1c (HbA1c) levels. Patients' depression and low self-efficacy can complicate diabetes management by impairing tasks needed for effective disease self-management. OBJECTIVES: To evaluate whether nurse practitioners in collaborative practices with primary care clinicians are effective in helping improve control of HbA1c, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) in adults with uncontrolled hyperglycemia, and to assess whether nurse practitioner-guided care affects depression and self-efficacy in these patients. DESIGN: De-identified preintervention and postintervention data were collected from prospective review of medical charts of patients in a managed care organization's primary care clinics. MAIN OUTCOME MEASURES: Preintervention and postintervention HbA1c values were evaluated as the primary outcome measure. Preintervention and postintervention values for BP, LDL-C, body weight, and depression and self-efficacy scores were secondary outcome measures. RESULTS: After intervention, 50% of 26 patients achieved HbA1c benchmarks, 95.6% achieved systolic and diastolic BP benchmarks, and 57.8% achieved LDL-C benchmarks. Wilcoxon paired samples tests showed significantly increased self-efficacy (z = -3.42, p < 0.001) from preintervention to postintervention. Depression scores decreased slightly from preintervention (mean = 0.44, standard deviation = 1.34, median < 0.001) to postintervention values (mean = 0.18, standard deviation = 0.73, median < 0.001), but this decrease was not significant. CONCLUSION: Integrating nurse practitioners into primary care teams to provide innovative methods of support to adults with uncontrolled hyperglycemia improves clinical outcomes and self-efficacy for patients with type 2 diabetes.

Effectiveness of an on-site health clinic at a self-insured university: a cost-benefit analysis.

This study assessed the impact and cost-effectiveness of an on-site health clinic at a self-insured university. Health care costs and number of claims filed to primary care providers were trended before and after the clinic was established to determine savings. A retrospective chart review of all full-time, insured employees treated for upper respiratory tract infections (URIs) during a 1-year study period was conducted. On-site clinic costs for the treatment of URIs were compared to costs at outside community providers for similar care. Community cost norms for the treatment of URIs were provided by Primary Physicians Care, the administrator of insurance claims for the University. A cost-benefit analysis compared the cost of services on-site versus similar services at an outside community provider. Based on the results of this study, the University's on-site health care services were determined to be more cost-effective than similar off-site health care services for the treatment of URIs. [Workplace Health Saf 2014;62(4):162-169.].