Reenvisioning Advising Models: Meeting the Needs of Prelicensure Nursing Students.

ABSTRACT: Effective academic advising is a dynamic process that is linked to student success. In 2015, a private institution in northern New England began the process of reenvisioning academic advisement as a quality improvement goal for program evaluation. A three-tiered model was used that encompassed targeted academic advising during the early foundational period (core coursework), academic advising during intensive theory and clinical coursework, and postgraduation advising targeting NCLEX-RN® support and mentoring. The goal of this advising model is to develop a relationship with students in forming a plan that leads to a self-fulfilling academic journey and life.

Strategies to Promote the Success of Academically At-risk Accelerated Bachelor of Science in Nursing Students.

BACKGROUND: Accelerated second-degree baccalaureate nursing (ABSN) programs are continuing to increase rapidly as a strategy to address a critical nursing shortage. The ABSN student profile differs from traditional entry-level nursing students, with some studies reporting higher attrition rates for ABSN students. Costs to students and nursing programs associated with program disruption can be high. PURPOSE: The purpose was to identify academic risk factors and develop strategies to promote academic success for timely progression to graduation and licensure. METHODS: Two consecutive descriptive correlational studies were conducted on sequential ABSN cohorts in a nursing program in northern New England. RESULTS: Data revealed modifiable factors that put students at risk of program nonprogression or dismissal. Evidence-based, targeted, individualized academic support interventions were developed and implemented. CONCLUSION: Strategies to promote academic success for ABSN students identified as at-risk have been shown to be effective.

Developing a Screening, Brief Intervention, and Referral to Treatment (SBIRT) program with multiple health professions programs.

Substance use is a major public health concern in the United States; only a fraction of people needing treatment for substance use receive care. Screening, Brief Intervention, and Referral to Treatment (SBIRT) training is one strategy to increase the identification and treatment of substance use. Integrated approaches to SBIRT delivery assure that every patient will be screened regardless of when and how they enter the healthcare system. The Collaborative SBIRT Training program at the University of New England includes 10 different health disciplines in its educational model (dental hygiene, dental medicine, nursing, occupation therapy, osteopathic medicine, pharmacy, physician assistants, social work, physical therapy, and health, wellness, and occupational studies). This article describes the development and implementation of this program, including steps taken to integrate SBIRT into diverse curricula, challenges and opportunities noted, and preliminary findings observed.

Rural Postpartum Women With Substance Use Disorders.

The incidence of perinatal opioid use and neonatal withdrawal continues to rise rapidly in the face of the growing opioid addiction epidemic in the United States, with rural areas more severely affected. Despite decades of research and development of practice guidelines, maternal and neonatal outcomes have not improved substantially. This focused ethnography sought to understand the experience of accessing care necessary for substance use disorder recovery, pregnancy, and parenting. Personal accounts of 13 rural women, supplemented by participant observation and media artifacts, uncovered three domains with underlying themes: challenges of getting treatment and care (service availability, distance/geographic location, transportation, provider collaboration/coordination, physical and emotional safety), opportunities to bond (proximity, information), and importance of relationships (respect, empathy, familiarity, inclusion, interactions with care providers). Findings highlight the need for providers and policy makers to reduce barriers to treatment and care related to logistics, stigma, judgment, and lack of understanding of perinatal addiction.

Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations.

In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice.

Strategies for Acute and Critical Care Nurses Implementing Complementary Therapies Requested by Patients and Their Families.

As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses. This article provides key information on the legal, ethical, safety, quality, and financial challenges that acute and critical care nurses should consider when implementing patient and family requests for complementary therapies.

Development of a Pediatric Fall Risk And Injury Reduction Program.

Fall prevention programs that include reliable, valid, and clinically tested screening tools have demonstrated more positive effects for adult and geriatric populations than those not including such assessment. In contrast, because falling is a natural part of growth and development for pediatric patients, progression toward effective prevention programs for this population has proven to be a challenge; a significant impediment is the lack of definition regarding what constitutes a reportable fall. This project explored pediatric health care providers' perceptions of patient falls in order to define a reportable pediatric fall and inform development of a prevention program. A concept analysis of defining attributes, antecedents, and consequences of pediatric falls from literature formed the basis for a set of questions; a convenience sample of 28 pediatric health care providers in an acute care hospital in New England participated in six moderated focus groups. Constant comparison method was used to code the qualitative data and develop themes. Participants unanimously agreed on several points; as expected, their years of experience in pediatric practice provided valuable insight. Three major themes emerged: patient characteristics, caregiver characteristics, and environmental characteristics. Based on factors identified by staff, a screening tool was adopted and integrated into the electronic medical record. Staff were actively engaged in developing definitions, selecting tools, and identifying next steps toward a comprehensive fall reduction program for their patients. As a result, they have embraced changes and advocated successfully for endorsement by the organization.

Relational Care for Perinatal Substance Use: A Systematic Review.

OBJECTIVE: The purpose of this systematic review of the literature is to highlight published studies of perinatal substance use disorder that address relational aspects of various care delivery models to identify opportunities for future studies in this area. METHOD: Quantitative, qualitative, and mixed-methods studies that included relational variables, such as healthcare provider engagement with pregnant women and facilitation of maternal-infant bonding, were identified using PubMed, Scopus, and EBSCO databases. Key words included neonatal abstinence syndrome, drug, opioid, substance, dependence, and pregnancy. RESULTS: Six studies included in this review identified statistically and/or clinically significant positive maternal and neonatal outcomes thought to be linked to engagement in antenatal care and development of caring relationships with healthcare providers. IMPLICATIONS/CONCLUSION: Comprehensive, integrated multidisciplinary services for pregnant women with substance use disorder aimed at harm reduction are showing positive results. Evidence exists that pregnant women's engagement with comprehensive services facilitated by caring relationships with healthcare providers may improve perinatal outcomes. Gaps in the literature remain; studies have yet to identify the relative contribution of multiple risk factors to adverse outcomes as well as program components most likely to improve outcomes.

Introduction to complementary, alternative, and traditional therapies.

The use of complementary, alternative, and traditional therapies is increasing in the United States, and patients and their families are bringing these practices into the acute care setting. Acute and critical care nurses are in a unique and trusted position to advocate for their patients and to promote safe incorporation of complementary, alternative, and traditional therapies into the plan of care.

Application of the Symphonological approach to faculty-to-faculty incivility in nursing education.

The nature of ethical interactions among nurse educators is crucial in modeling ethically based relationships for nursing students. This article focuses on the issue of uncivil faculty-to-faculty relationships in nursing education and is supported by a literature review of incivility in academic settings and the experiential reflections of seasoned nurse educators. The bioethical practice-based theory of symphonology provides a new perspective for framing these reviews and reflections. This theory can facilitate decision making in difficult interactions and sustain a focus on the central agreements that are foundational to nursing education. Incivility exemplars are explored within the context of autonomy, freedom, objectivity, beneficence, and fidelity, and the integration of academia and ethics is discussed as essential to nursing education and human caring.

Phase I: The development and content analysis of the Pediatric Sedation Agitation Scale.

No "gold standard" currently exists for the objective assessment of sedation depth in critically ill pediatric patients requiring mechanical ventilation. The risks for these patients due to both over-sedation and under-sedation include poorer outcomes, reduced patient and family satisfaction, and increased costs to the institutions. Available tools were unsatisfactory for the authors' patient population and practice model. The purpose of this study was to assess the content validity of the Pediatric Sedation-Agitation Scale (P-SAS), which was adapted from the Riker Sedation-Agitation Scale (SAS). Analysis by a panel of 30 health care professionals with expertise in pediatric acute care supported the content validity of the P-SAS.

An introduction to the multisystem model of knowledge integration and translation.

Many nurse researchers have designed strategies to assist health care practitioners to move evidence into practice. While many have been identified as "models," most do not have a conceptual framework. They are unidirectional, complex, and difficult for novice research users to understand. These models have focused on empirical knowledge and ignored the importance of practitioners' tacit knowledge. The Communities of Practice conceptual framework allows for the integration of tacit and explicit knowledge into practice. This article describes the development of a new translation model, the Multisystem Model of Knowledge Integration and Translation, supported by the Communities of Practice conceptual framework.

Exploring and evaluating five paediatric falls assessment instruments and injury risk indicators: an ambispective study in a tertiary care setting.

AIM: To evaluate currently available paediatric falls assessments instruments and to build a predictive fall model while also evaluating injury risk as a predictor of fall likelihood within the paediatric inpatient population. BACKGROUND: There is lack of paediatric-specific fall assessment instruments and little information on the exploration of injury risk as related to falls in hospitalized children. METHOD: An ambispective, matched case-control design conducted in a sample of 100 inpatient paediatric patients. Results Two out of five instruments performed well to classify children at risk of falls. Longer length of stay, bleeding cautions/blood disorders and temperament/behaviour issues were significant predictors of fall likelihood. Cognitive impairment or neurological disease was not related to an increased likelihood of fall or injury risk for this sample. CONCLUSIONS: More research is required to institute and standardize paediatric fall and injury risk assessments for everyday use. The explicit approach of using predictive modelling is critical in creating a universal, baseline reference for the most reliable and valid measure of assessment in children. IMPLICATIONS FOR NURSING MANAGEMENT: Findings of the present study increase awareness of nursing managers and leaders as to the necessity for fall and injury risk assessment as a safety and quality measure for inpatient paediatric populations.