Online Graduate Student Retention: Integrative Review With a Theoretically Framed Case Exemplar.

BACKGROUND: Retention of online nursing students in graduate education is essential as the need for nurses exceeds the current supply. METHOD: The factors contributing to student attrition are reviewed, and a real-world case exemplar is presented to demonstrate the theoretical design and implementation of an orientation to support retention. RESULTS: Knowles' theory of adult learning and Cooper's PECS (purpose, expectations, connections, and support) model for an evidence-based orientation framework guided the design of the orientation. Knowles' theory was aligned with the PECS model to further describe how student and environmental factors can be addressed in an orientation framework and provide strategies for implementation. Additionally, these PECS definitions were applied to specific activities within a conceptual, theoretical, and empirical framework for development of orientations. CONCLUSION: This case exemplar demonstrated an orientation framework for a feasible application of theory and evidence-based strategies for graduate online nursing programs. [J Nurs Educ. 2022;61(6):314-321.].

An Interprofessional Course on Trauma-Informed Care.

BACKGROUND: Health care professionals need to recognize trauma exposure and provide trauma-informed care. There is a concomitant need to develop resilience when working in this context. PROBLEM: We recognized the need to educate future health care professionals to provide trauma-informed care, develop resilience skills, and collaborate with other disciplines to provide this care. APPROACH: We used a systematic instructional design process and an interprofessional approach to design and deliver the course. We utilized a range of resources and approached the course from micro, meso, and macro perspectives. OUTCOMES: Through purposeful design, we developed a course that was well-aligned with our objectives. Assessments provided documentation that students achieved the learning outcomes. CONCLUSIONS: The course educated future health care professionals on trauma-informed care. Students gained valuable experience that will help them contribute to interprofessional teams in the future. Students also practiced resilience techniques essential for health care professionals.

Resilience Education for Health-Care Professionals.

BACKGROUND: Burnout among health-care professionals is a growing problem having a sizeable impact on patient safety and health care as a whole. High levels of resilience in health-care professionals have been associated with safer care environments, improved health outcomes, higher quality care, and improved caregiver well-being and mental health. Resilience education can improve personal and professional resilience. OBJECTIVE: The goal of this project was to evaluate a resilience education program to improve measures of burnout and resilience in health-care professionals. DESIGN: A quantitative cross-sectional pretest/posttest design was used. SETTING: The resilience education program was implemented in a large, not-for-profit health-care system in the southeastern United States. METHODS: Participants completed the Copenhagen Burnout Inventory (CBI) and The Connor-Davidson Resilience Scale-25 (CD-RISC-25) immediately before the workshop and 2 weeks afterward. Participants also completed an evaluation survey one day after the education. RESULTS: Scores on the CD-RISC-25 showed statistically significant increases in resilience qualities after the education. Although not statistically significant, burnout as measure by CBI scores decreased following the workshop. CONCLUSION: A relatively short educational program can positively impact resilience and burnout levels in health-care professionals. Positive outcomes included successful learning outcomes and increased resilience qualities.

Building Nurses' Resilience to Trauma Through Contemplative Practices.

Nurses can benefit from strategies that build resilience to counterbalance trauma exposures. Adverse childhood experiences (ACEs) and adverse community environments are common; nurses frequently encounter trauma victims and hear trauma narratives in most care settings. Having skills to manage the triggers present in health-care environments is essential. Contemplative practices can help to meet these needs. Breathing exercises can be used as needed throughout the work day; gratitude practices are simple but powerful; and visual journaling can help nurses process experiences. These practices are easy to implement and can profoundly affect health outcomes for nurses.

Addressing adverse childhood experiences, trauma and resilience through interprofessional course development.

National and international organizations are increasingly focused on interprofessional education in health-related fields to address complex and emerging health issues. One public health concern is the impact of adverse childhood experiences (ACEs). At one public university in Appalachia, faculty of nursing, public health, and social work collaborated to develop an interprofessional course at the undergraduate and graduate levels that focus on ACEs, trauma, and resiliency literature as well as interprofessional collaboration and evidence-based prevention and treatment. In this paper, the faculty detail the approach undertaken to develop this interprofessional course, lessons learnt and key resources.

Self-Transcendence, Well-Being, and Vulnerability in Healthcare Mission Participants.

The purpose of the study was to investigate the presence and relationship of self-transcendence and spiritual well-being in persons who have participated in short-term, faith-based, foreign, healthcare missions. This was a descriptive correlational study with the addition of open-ended questions. The mean Self-Transcendence Scale score for this sample was higher than mean scores of comparison studies and scores for women were higher than mean scores for men. Qualitative data provided rich accounts of the central concepts of Reed's self-transcendence theory. Reed's theory of self-transcendence was extended to a new and different population.

Self-Transcendence Theory and Contemplative Practices.

Reed's theory of self-transcendence describes relationships between vulnerability, self-transcendence, and well-being. Contemplative practices can promote self-transcendence and well-being, consistent with this theory. The central concepts of Reed's theory of self-transcendence are presented. Ways contemplative practices can be utilized to promote 1 or more dimensions of self-transcendence and well-being are discussed.

Nurse Stressors and Satisfiers in the NICU.

BACKGROUND: Working in a neonatal intensive care unit (NICU) can be both rewarding and stressful. Stressors can outweigh satisfiers, leading to job dissatisfaction and turnover. Nurse retention remains a problem, particularly for nurses within the first year of employment. PURPOSE: The purpose of this study was to examine current nurse stressors, satisfiers, and coping processes in the NICU. METHODS: Seventy-two neonatal nurses from 3 Magnet facilities in North Carolina completed the ICU Stressors Survey, the Ways of Coping Scale, demographic data questions, and free-text questions in Qualtrics, a secure online survey system. Questionnaires were analyzed using protocols developed and validated by instrument developers, and quantitative data were analyzed using SPSS statistical software. Free-text responses were analyzed using iterative coding and thematic grouping. RESULTS: Most nurses thought that NICU nursing was stressful, but they coped well with work stress. Nurses felt confident in their knowledge and patient care abilities and were not stressed by the NICU environment. Inadequate staffing was the most common stressor. Coping strategies were aimed at task completion. Nurses wanted better teamwork on their units. Nurses felt more respected by their peers and families than by their immediate supervisors and physicians. IMPLICATIONS: Attention to staffing patterns is paramount. Team-building activities may help foster mutual respect and collegiality among the nursing staff and between disciplines. Research investigating creative staffing patterns would be helpful. Interprofessional research may also reduce stressors and enhance team performance.

Contemplative Activities in Undergraduate Nursing Courses.

BACKGROUND: Affective learning is valued in nursing, but it is often difficult to plan and evaluate learning activities in this domain. Contemplative activities can promote learning and are relatively easy to implement. These activities can promote deep, reflective thinking. METHOD: A variety of contemplative activities were used in undergraduate nursing courses. Students participated in and reflected on a vigil promoting domestic violence awareness. They attended two different art exhibits and related these exhibits to nursing. The students used journals and eportfolios to reflect on the entire nursing program. They participated in breathing exercises and guided imagery meditations. RESULTS: Students evaluated the activities positively, and their reflections were thoughtful. CONCLUSION: Contemplative activities can be useful to develop affective competencies. [J Nurs Educ. 2017;56(6):378-382.].

Contemplative Practices, Self-efficacy, and NCLEX-RN Success.

Despite program completion, not all graduates are successful on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Contemplative practices such as meditation and guided imagery were added to an NCLEX-RN preparatory course. The difference between self-efficacy scores at the beginning and end of the course was statistically significant. Students reported that the contemplative activities were beneficial, and they would use these activities again in the future.

Human milk banking.

Forms of human milk banking and donation have been present for more than a century worldwide, but, since 1985, the Human Milk Banking Association of North America (HM BANA) has established guidelines to make the use of donor's breast milk safe and the second best form of feeding to maternal breast milk for a neonatal intensive care unit (NICU) infant. The Indiana Mother's Human Milk Bank provides an extensive and meticulous process of selecting breast milk donors. The process begins with a phone interview with a potential donor and includes the review of the donor's medical records, blood laboratory screening, medication and dietary intake, as well as consent from the donor's pediatrician. The milk bank follows steps of collecting, storing, and receiving the breast milk in accordance with the guidelines of the HM BANA. Pasteurization is the method used to ensure the proper heating and cooling of breast milk. Despite the rigorous pasteurization method, the donor's breast milk will not lose most of the important beneficial components needed for sick or ill NICU infants. Every batch of pasteurized breast milk will be cultured for any possible contamination and shipped to NICUs after it has been cleared by laboratory testing.

Inflicted childhood neurotrauma.

In this article, we review literature related to inflicted childhood neurotrauma (ICN). We discuss the rationale for use of the term "ICN," rather than the more benign, commonly used "shaken baby syndrome." The change in language alters the discourse about a potentially lethal outcome or lifelong problem for survivors. A description of ICN is followed by a discussion of ethical parameters and obligations of those who care for infants and children and professionals who are sentinels to these events such as law enforcement officials, nurses, physicians, and social workers.

Effective strategies to prepare infants and families for home tracheostomy care.

In neonates tracheostomies are most often indicated to provide a stable airway for infants with congenital or acquired airway obstructions and to provide long-term mechanical ventilation. Learning to care for an infant with a tracheostomy can be challenging for both professionals and families. This article provides an overview of tracheostomy care and the essential elements of family teaching. The surgical procedure and basic anatomical changes are reviewed. Complications such as accidental decannulation, mucus plugging, infection, bleeding, and granulation tissue formation are discussed. Humidification is critical for the infant with a tracheostomy and humidification delivery methods are discussed. Further, an overview of the impact of the tracheostomy on normal development, such as swallowing and language development, is provided. Teaching parents to safely care for the infant with a tracheostomy at home requires careful planning and systematic education. The parents must acquire a unique set of technical skills demonstrating competence and comfort in providing stoma care, suctioning, and tube changes. Parents must be prepared to initiate cardiopulmonary resuscitation (CPR) and need to understand alterations in CPR techniques in infants with a tracheostomy. They also need to develop critical thinking skills to handle emergency situations. A safe transition to the home can be accomplished by using a multidisciplinary approach to coordinate all facets of care.