Improving Nurses' Attitudes Toward Substance Use Disorder: Screening, Brief Intervention, and Referral to Treatment.

ABSTRACT: Patients with substance use disorder (SUD) encounter many barriers to healthcare, including negative attitudes of healthcare personnel. Compared with other healthcare professions, nurses have been reported as having less tolerant attitudes toward patients with SUD. Knowledge acquisition combined with role support has been shown to improve therapeutic attitudes of nurses toward patients with SUD. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based educational intervention aimed to improve the outcomes of patients at risk and with SUD. SBIRT education has been shown as an effective educational tool with licensed nurses. Therefore, the aim of this study was to evaluate whether a 2-hour educational session on SBIRT (Mitchell et al., 2013) improved the therapeutic attitudes of nurses toward patients with SUD. Peplau's theory of interpersonal relations guided this study with an emphasis on the nurse-patient relationship. A quasi-experimental pretest/posttest design was used to evaluate nurses' attitudes pre and post a 2-hour educational session. Participants included 65 registered nurses employed in a 247-bed teaching hospital in New England. Attitudes were measured before and after the educational session using the 20-item, five-subscale Drug and Drug Problems Perceptions Questionnaire. A paired t test was performed, showing statistically significant improvements in attitudes postintervention. Prior education on SUD significantly correlated with baseline attitudes. A standard regression model, with practice setting, family history of SUD, and prior education as dependent variables, was not predictive of baseline attitudes. The results suggest conducting SBIRT should be considered a mandatory nursing competency, both in undergraduate curriculum and among licensed nurses.

Outcomes of In-hospital Cardiac Arrest: A Review of the Evidence.

Cardiac arrest is a significant cause of morbidity and mortality in the United States. Cardiac arrest can occur in the community or among hospitalized patients. There are many commonalities between in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest; however, significant differences exist. Optimizing outcomes for patients with IHCA depends on high-quality care supported by the best available evidence. It is essential that critical care nurses are familiar with the evidence related to IHCA. This article focuses on a review of the evidence on IHCA, focusing on practical implications for critical care nursing practice.

Interprofessional Evidence-Based Strategies to Enhance Provider and Patient Interactions During Electronic Health Record Use.

The purpose of this study was to develop and disseminate evidence-based interprofessional strategies to enhance provider-patient interactions, including ethical issues, that arise during electronic documentation. An interprofessional simulation scenario was implemented with students, and strategies developed were then used to train hospital staff. Nurses reported being significantly more likely to use the interprofessional strategies after completing the program. Interprofessional simulation and training is an effective method to address challenges that arise during electronic health record use.

Family Perceptions of Family Nursing in a Magnet Institution During Acute Hospitalizations of Older Adult Patients.

Family involvement during hospitalizations of older adults with chronic illnesses may benefit both patients and family. However, there is a limited amount of research focused on families of older adults managing chronic illness. This study describes family member perceptions of the relationship between family and nurses when an older adult with diabetes is hospitalized in a Magnet institution. The Calgary Family Intervention Model guided the study. A family member of 60 older adult patients completed the Family Function, Family Health, and Social Support Instrument. The results revealed positive perceptions from family members regarding their perceptions of family nursing practice. Family health, however, was found to decrease slightly as loved ones are hospitalized more frequently, and is an area where nurses may provide improved social support. Future research might target the implementation of a targeted family-level intervention designed to improve family outcomes as well as family nursing practice.

Nurses' Perception of the Impact of Electronic Documentation on the Nurse-Patient Relationship.

BACKGROUND: While there are many benefits of electronic medical record documentation, the presence of a computer may adversely affect provider-patient interaction. PURPOSE: The purpose of this project was to examine staff nurses' perception of the impact of electronic documentation in the presence of the patient on the nurse-patient relationship. METHODS: A survey was administered to 276 staff nurses, and open-ended interviews were conducted with 11 novice and 20 expert nurses. RESULTS: Nurses identified benefits and challenges to electronic medical record documentation as well as strategies used to maintain therapeutic relationships and communication. Numerous nurses commented that documenting with their back to the patient had a negative impact on the nurse-patient relationship and communication. CONCLUSIONS: Both novice and expert nurses identified strategies that they used to ensure they were "maintaining the connection" to patients during electronic medical record documentation.

Nurse perceptions of family nursing during acute hospitalizations of older adult patients.

AIMS: The purpose of this study was to describe nurses' critical appraisal of their family nursing practice and experience of interaction and reciprocity in the nurse-family relationship. BACKGROUND: Nursing practice that is inclusive of family during hospitalizations of older adults with chronic illnesses benefits patients and families, as well as nurses. There is, however, a limited amount of research that has focused on nurses' perceptions of caring for older adult patients and their families who are managing chronic illness. DESIGN: The Calgary Family Intervention Model guided this descriptive mixed-methods study. METHODS: Registered nurses working on four medical-surgical units completed the Family Nursing Practice Scale (n = 60), which includes a quantitative scale and three open-ended questions. RESULTS: The results showed positive perceptions from nurse participants overall with significant variation across study units in nurses' perceptions of interactions in the nurse-family relationship. Additionally qualitative results revealed several themes concerning the advantages and disadvantages of working with families, in addition to how nurses are currently including families in their practice. CONCLUSIONS: This study provides details concerning the advantages and disadvantages of working with families and how nurses currently strive to include families in their nursing practice. Although nurses in this study did espouse the importance of family nursing practice, they did point out a number of disadvantages. It is essential to understand the problems that can arise when working with families so that nurses are better able to manage these issues.

An introductory interprofessional exercise for healthcare students.

OBJECTIVE: To evaluate healthcare students' perceptions of an introductory interprofessional exercise and their team dynamics. DESIGN: A workshop was developed, combining second-year medical students, fourth-year nursing students, and third-year pharmacy students to work as an interdisciplinary team. The teams alternated between working together on patient cases focusing on chronic obstructive pulmonary disease and asthma, and on the evaluation of standardized pneumonia patients. Teams were given the patients' health information and no other instructions. A faculty member and the standardized patient evaluated the students using a teamwork global rating scale. ASSESSMENT: Student survey results showed a positive response to interprofessional teamwork. The faculty members and standardized patients reported that the students worked as a cohesive unit and demonstrated good team communication. CONCLUSIONS: This introductory interprofessional experience had a positive impact on the students' understanding of collaboration and teamwork. This type of experience will help students foster future collaborations as healthcare providers.