Parental reports of vaccine information statement usage in Utah.

BACKGROUND: Since the implementation in 1986, there is little research focused on vaccine information statements (VISs) use for vaccine education and parental perception. PURPOSE: To explore parental reports of dissemination and use of VISs. METHODS: Data for this pilot, cross-sectional, descriptive study were collected through an online survey in both English and Spanish. RESULTS: Responses from 130 parents in one school district were analyzed. Most participants (67.7%) reported getting vaccine information from a pediatric health care provider. A majority (71.5%) said that VISs were included in the vaccination process. Approximately one third of participants (37.7%) reported reading some or all the VIS before their child was vaccinated, and more than half (59.3%) read some or all the VIS after their child was vaccinated. CONCLUSIONS: While promising that many parents reported receiving a VIS, more than one quarter of parents reported they did not. Inadequate time to read and understand VIS information before an immunization may lead to limited parental understanding. Although some participants reported struggling to understand VISs, more than half said that VISs were helpful and would read another in the future. IMPLICATIONS: Without appropriate use of vaccine education material, providers miss the opportunity to educate parents on the risks and benefits of vaccinating their children. Providers must be aware of literacy levels and vaccine attitudes and create appropriate opportunities for parents to read and learn about vaccines. VISs are valuable educational tools for patients and parents. Improvements are needed to improve both VIS clarity and dissemination.

Effectiveness of a vaccination education module for college freshmen.

Objective: To evaluate the effectiveness of a vaccination education module to improve vaccine expectations and behaviors among college freshmen. Participants: The participants were 177 college freshmen at one private Utah university. Participants were eligible for this study if admitted as new freshmen during the 2019-2020 school year. Methods: The study was a cross-sectional pre- and post-education evaluation assessing vaccine expectations and behaviors using Likert-type and open-ended questions. Results: After completing the vaccination education module, participants' vaccine expectations and behavioral intentions improved. Participants reported they were more likely to be up-to-date on personal vaccines and more likely to expect other students to be up-to-date on their vaccinations. Participants were more likely to ask other students to vaccinate and were also more likely to ask their family members to be vaccinated. Conclusions: This online vaccination education module effectively improved participants' vaccine expectations and behavioral intentions.

Extending "Helping Babies Breathe" to an Academic Setting in Fiji: A Project Involving American Nursing Faculty and Graduate and Undergraduate Nursing Students.

ABSTRACT: Approximately 2.5 million neonates died worldwide in 2018. Over one quarter of neonatal deaths are caused by birth asphyxia. Helping Babies Breathe (HBB) was created to teach basic neonatal resuscitation steps in limited-resource settings. Fifteen Fijian faculty members attended a master teacher class. Nine undergraduate nursing students from the western United States assisted in teaching two HBB classes for Fijian nursing students. Fijian faculty and student knowledge increased significantly posteducation. Educational settings provide ideal locations for future nurses to learn and practice evidence-based neonatal resuscitation skills. Implementing HBB in an academic setting, though novel, may ensure educators are familiar with current guidelines.

Critical Care Nurses' Qualitative Reports of Experiences With Physician Behaviors, Nursing Issues, and Other Obstacles in End-of-Life Care.

BACKGROUND: Critical care nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Obstacles to EOL care in ICUs exist and have been previously published along with reports from CCNs. Further data exploring obstacles faced during ICU EOL care may increase awareness of common EOL obstacles. Research focusing on obstacles related to physician behaviors and nursing issues (and others) may provide improvement of care. OBJECTIVE: The aim of this study was to gather first-hand data from CCNs regarding obstacles related to EOL care. METHODS: A random, geographically dispersed sample of 2000 members of the American Association of Critical-Care Nurses was surveyed. Responses from an item asking CCNs to tell us of the obstacles they experience providing EOL care to dying patients were analyzed. RESULTS: There were 104 participants who provided 146 responses to this item reflecting EOL obstacles. These obstacles were divided into 11 themes; 6 physician-related obstacles and 5 nursing- and other related obstacles. Major EOL ICU barrier themes were inadequate physician communication, physicians giving false hope, poor nurse staffing, and inadequate EOL care education for nurses. DISCUSSION AND CONCLUSION: Poor physician communication was the main obstacle noted by CCNs during ICU EOL care, followed by physicians giving false hope. Heavy patient workloads with inadequate staffing were also a major barrier in CCNs providing EOL care.

Educating Patients About Opioid Disposal: A Key Role for Perianesthesia Nurses.

PURPOSE: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication. DESIGN: Mixed methods design with a chart review and structured phone interview. METHODS: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them. FINDINGS: Average number of excess pills ranged from 0 to 42 (mean = 14; SD = 11.7). Nearly half of patients (47%) perceived the prescribed quantity as "too many." Seventy-one percent of patients using opioids for 5 days or less and 88% did not recall any instruction about medication disposal. CONCLUSIONS: Patients often have excess prescribed opioids after laparoscopic cholecystectomy, and they do not understand proper disposal of unused medications. Education about proper disposal of unused opioids medications is a key role of perianesthesia.

Emergency Nurses' Department Design Recommendations for Improved End-of-Life Care.

INTRODUCTION: Although death is common in emergency departments, there is limited research regarding ED design as an obstacle to end-of-life care. This study identifies emergency nurses' recommendations regarding ways designs have negative or positive impact on care for dying patients and their families. METHODS: A 25-item questionnaire was sent to a national random sample of 500 emergency nurses. Inclusion criteria were nurses who could read English, worked in emergency departments, and had cared for at least 1 patient at the end of life (EOL). Responses were individually reviewed and coded. RESULTS: Major obstacles included (1) issues related to limited space, (2) poor department layout and design, and (3) lack of privacy. Despite emergency departments being a challenging place to provide EOL care, positive ED design characteristics had impact on EOL care. DISCUSSION: Emergency nurses understand the need for family presence during resuscitation, for secure body stowage areas, and for more resuscitation rooms so that families have time to grieve before being removed because of the immediate needs of a second trauma patient. Nurses can evaluate existing facilities to identify areas in which potential change and remodeling could improve care, increase patient privacy, or further utilize space. Understanding ED design's impact on EOL care is crucial. Modifications to ED layout and design may be challenging; however, improvements to space, layout, and privacy need to be considered when planning new emergency departments or remodeling existing departments. Further research is required to determine the impact of ED design on EOL care.

Rural Emergency Nurses' Suggestions for Improving End-of-Life Care.

Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments. METHODS: A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify the one aspect of EOL care they would change for dying patients in rural emergency departments. Each qualitative response was individually reviewed by a research team and then coded into a theme. RESULTS: Four major themes and three minor themes were identified. The major themes were providing greater privacy during EOL care for patients and family members, increasing availability of support services, additional staffing, and improved staff and community education. DISCUSSION: Providing adequate privacy for patients and family members was a major obstacle to providing EOL care in the emergency department, largely because of poor department design, especially in rural emergency departments where space is limited. Lack of support services and adequate staffing were also obstacles to providing quality EOL care in rural emergency departments. Consequently, rural nurses are commonly pulled away from EOL care to perform ancillary duties because additional support personnel are lacking. Providing EOL care in rural emergency departments is a challenging task given the limited staffing and resources, and thus it is imperative that nurses' suggestions for improvement of EOL care be acknowledged. Because of the current lack of research in rural EOL care, additional research is needed.

Immunization Status of NICU Graduates at a Tertiary Care Children's Hospital.

BACKGROUND: Approximately 500,000 infants are born prematurely each year in the United States. Immunization of infants in a neonatal intensive care unit (NICU) set a precedence for future immunizations. PURPOSES: The objectives of this study were to determine the current rates of immunization and identify variables associated with immunizations of NICU graduates who were aged 60 days or older at time of discharge. METHODS: This descriptive pilot study utilized retrospective paper medical record review in one tertiary children's hospital. The relationships between immunization status and study variables were examined using t tests and logistic regression. RESULTS: Of 43 infants discharged at least 60 days of age or older from the NICU, 74.4% were fully immunized in accordance with American Academy of Pediatrics (AAP) recommendations. Significant predictors were age at discharge for immunization and steroid use for nonimmunization. IMPLICATIONS FOR PRACTICE: Immunization needs to be a priority in order to give NICU infants every advantage regarding their future health status. Nurses need to implement hospital policies ensuring immunizations of NICU graduates. IMPLICATIONS FOR RESEARCH: Future studies should focus on samples from diverse hospitals and levels of NICUs. Qualitative studies exploring and describing parent and provider knowledge of current AAP guidelines will strengthen our understanding of potential barriers to immunization.