Ensuring Advanced Practice Nursing Students Meet the 2023 Drug Enforcement Agency Requirements.

BACKGROUND: All advanced practice nursing students in the doctor of nursing practice program at Johns Hopkins School of Nursing are required to complete 3 core courses (pathophysiology, pharmacology, and physical assessment). As of June 2023, the Drug Enforcement Agency (DEA) required all prescribers of controlled medications to attest to at least 8 hours of substance use training. PURPOSE: To quantify the amount of time advanced practice nursing students learn substance use-related content and engage in teaching/learning activities across the 3 courses as a basis for meeting the DEA requirement. METHODS: Lead course faculty teaching identified content related to substance use disorders, including reading assignments and skill-building activities, and the minimum amount of time that students spend in those teaching/learning experiences. RESULTS: Advanced practice nursing students complete a total of 14 hours of substance use-related content in the 3 core courses. CONCLUSIONS: This article describes substance use-related content and strategies that can be integrated in advanced practice nursing programs for students to meet the new DEA requirement.

Professionalism in pre-licensure nursing education: Core values, didactic coursework and clinical training.

AIM: To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training. BACKGROUND: Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice. DESIGN: A discursive paper. DATA SOURCES: A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice. DISCUSSION: Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust. CONCLUSION: The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper.

Understanding healthcare engagement for people who inject drugs.

People who inject drugs (PWID) are at an increased risk of multimorbid mental health and chronic diseases, which are frequently underdiagnosed and under-treated due to systemic barriers and ongoing substance use. Healthcare engagement is essential to address these conditions and prevent excess morbidity and mortality. The goal of this study was to understand how PWID engage in care for their chronic health conditions and substance use treatment given the known historic and pervasive barriers. We conducted 24 semistructured qualitative interviews informed by the Behavioral Model for Vulnerable Populations between July-September 2019. Participants were sampled across a range of comorbidities, including co-occurring mental health disorders. Thematic analysis was conducted to explore experiences of healthcare engagement for multimorbid chronic diseases, mental health, and treatment for substance use disorder. Mean age for participants was 58 years; 63% reported male sex and 83% reported Black race. Interviews yielded themes regarding healthcare access and wraparound services, positive patient-provider relationships, service integration for substance use treatment and mental health, healthcare needs alignment, medication of opioid use disorder stigma, and acceptance of healthcare. Taken together, participants described how these themes enabled healthcare engagement. Engagement in care is crucial to support health and recovery. Clinical implications include the importance of strengthening patient-provider relationships, encouraging integration of medical and mental health services, and counseling on substance use treatment options in a non- stigmatizing manner. Additionally, policy to reimburse wrap-around support for substance use recovery can improve care engagement and outcomes related to chronic diseases, mental health, and substance use among PWID. No Patient or Public Contribution: While we acknowledge and thank ALIVE participants for their time for data collection and sharing their perspectives, no ALIVE participants, other people who use drugs, and service users were involved in data collection, analysis or interpretation of data, or in preparation of the manuscript.

Long COVID in the context of social determinants of health.

The COVID-19 pandemic has been a challenge for the public health system and has highlighted health disparities. COVID-19 vaccines have effectively protected against infection and severe disease, but some patients continue to suffer from symptoms after their condition is resolved. These post-acute sequelae, or long COVID, continues to disproportionately affect some patients based on their social determinants of health (SDOH). This paper uses the World Health Organization's (WHO) SDOH conceptual framework to explore how SDOH influences long COVID outcomes.

Addressing systemic racism and intergenerational transmission of anxiety using Bowenian family therapy with African American populations: A Discursive paper.

AIM: To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long-standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. DESIGN: Discursive Paper. METHOD: Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. DISCUSSION: Evidence-based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American  populations. CONCLUSION: Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. IMPACT TO NURSING PRACTICE: Nurses play an integral role in providing holistic quality patient-centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self-awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion.

Promoting the integration of peer support specialists into the healthcare team.

ABSTRACT: The 21st Century Cures Act to address the opioid crisis spurred the expansion of the peer support specialist (PSS) workforce. Nurses are in key positions to promote the successful integration of the PSS into the healthcare team. This article describes the role of the PSS, including key functions that overlap with those of nurses and ways they can help mitigate stigma, which remains a significant barrier to patients' access to treatment.

Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care.

For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.

Efficacy of Motivational Interviewing and Brief Interventions on tobacco use among healthy adults: A systematic review of randomized controlled trials / Eficacia de la entrevista motivacional y de las intervenciones breves sobre el consumo de tabaco en adultos sanos: Una revisión sistemática de ensayos controlados aleatorizados / Descriptores: entrevista motivacional; cese del uso de tabaco; uso de tabaco; adulto. Eficácia da entrevista motivacional e intervenções breves sobre o uso de tabaco em adultos saudáveis: uma revisão sistemática de ensaios clínicos randomizados

Objective.To assess the effectiveness of a brief intervention and motivational interviewing in reducing the use of different tobacco-related products in adults Methods. Forthis systematic review, PubMed, Web of Science, and PsychINFO databases were electronically searched for randomized controlled trials on the effect of a brief intervention and / or motivational interview on tobacco reduction among healthy adults published between January 1, 2011 to January 1, 2021. Data from eligible studies were extracted and analyzed. CONSORT guidelines were used to assess the quality of the studies by two reviewers for the included studies. The titles and abstracts of the search results were screened and reviewed by two independent reviewers for eligibility criteria per the inclusion and exclusion criteria. Cochrane review criteria were used to assess the risk of bias in included studies. Results. A total of 12 studies were included in the final data extraction of 1406 studies. The brief intervention and motivational interviewing showed varied effects on tobacco use reduction among adults at different follow-ups. Seven of the 12 studies (58.3%) reported a beneficial impact on reducing tobacco use. Pieces of evidence on biochemical estimation on tobacco reduction are limited compared to self-reports, and varied results on quitting and tobacco cessation with different follow-ups. Conclusion. The current evidence supports the effectiveness of a brief intervention and motivational interviewing to quit tobacco use. Still, it suggests using more biochemical markers as outcome measures to reach an intervention-specific decision. While more initiatives to train nurses in providing non-pharmacological nursing interventions, including brief interventions, are recommended to help people quit smoking.

Objetivo. Evaluar la eficacia de una intervención breve y de la entrevista motivacional para reducir el consumo de diferentes productos relacionados con el tabaco en adultos. Métodos. Para esta revisión sistemática, se buscaron en las bases de datos PubMed, Web of Science y PsychINFO ensayos controlados aleatorizados sobre el efecto de una intervención breve y/o una entrevista motivacional en la reducción del consumo de tabaco entre adultos sanos, que hubieran sido publicados entre el 1 de enero de 2011 y el 1 de enero de 2021. Los títulos y los resúmenes de los artículos incluidos fueron evaluados por dos revisores independientes para determinar los criterios de elegibilidad, se analizó la calidad de los estudios con la guía CONSORT y se utilizaron los criterios de Cochrane para evaluar el riesgo de sesgo.Resultados.Se incluyeron un total de 12 de los 1406 estudios que arrojó la búsqueda. La intervención breve y la entrevista motivacional mostraron efectos variados en la reducción del consumo de tabaco entre los adultos en diferentes seguimientos. Siete de los 12 estudios (58.3%) informaron de un impacto beneficioso en la reducción del consumo de tabaco. La utilización de indicadores bioquímicos de la reducción del consumo de tabaco fueron limitados en comparación con los autoinformes. Los resultados sobre el abandono y la cesación del tabaco fueron variados con diferentes seguimientos. Conclusión.La evidencia apoyó la efectividad de una intervención breve y de la entrevista motivacional para la cesación del consumo de tabaco. Sin embargo, se sugiere realizar más estudios con marcadores bioquímicos como medidas de resultado para llegar a una decisión específica de la intervención. Se recomienda formar a los enfermeros en la realización de intervenciones de enfermería no farmacológicas, incluidas las intervenciones breves, para ayudar a las personas a dejar de fumar.

Objetivo. Avaliar a eficácia de uma intervenção breve e entrevista motivacional na redução do uso de diferentes produtos relacionados ao tabaco em adultos. Métodos.Para esta revisão sistemática, se buscou nas bases de PubMed, Web of Science e PsychINFO ensaios controlados aleatórios sobre o efeito de uma breve intervenção e/ou entrevista motivacional na redução do uso de tabaco entre adultos saudáveis, publicados entre 1º de janeiro de 2011 e 1º de janeiro de 2021. Os títulos e resumos dos artigos incluídos foram avaliados por dois revisores independentes para critérios de elegibilidade, a qualidade do estudo foi avaliada usando a diretriz CONSORT e os critérios Cochrane foram usados para avaliar o risco de viés. Resultados. Um total de 12 dos 1.406 estudos retornados pela busca foram incluídos. Intervenção breve e entrevista motivacional mostraram efeitos mistos na redução do uso de tabaco entre adultos em diferentes acompanhamentos. Sete dos 12 estudos (58.3%) relataram um impacto benéfico na redução do uso de tabaco. O uso de indicadores bioquímicos de redução do uso de tabaco foi limitado em relação ao autorrelato. Os resultados sobre parar de fumar e parar de fumar foram variados com diferentes seguimentos. Conclusão. As evidências apoiaram a eficácia de uma intervenção breve e entrevista motivacional para a cessação do uso do tabaco. No entanto, mais estudos com marcadores bioquímicos como medidas de resultados são sugeridos para chegar a uma decisão de intervenção específica. Recomenda-se que os enfermeiros sejam treinados na execução de intervenções de enfermagem não farmacológicas, incluindo intervenções breves, para ajudar as pessoas a parar de fumar.

Symptom Profile Characterization Using the Beck Anxiety Inventory Among Undergraduates in the United States.

BACKGROUND: The Beck Anxiety Inventory (BAI) is widely used to measure the severity of anxiety. This tool may additionally allow for an in-depth analysis of symptom typology, as reported symptoms can be placed into four categories (subjective, neurophysiologic, autonomic, and panic-related). Although overall severity ratings in populations may be similar, the type of symptoms reported as severe may differ dependent on characteristics of the populations assessed. OBJECTIVES: This study examines the variety of anxiety symptoms manifested among U.S. university students and the impact of symptom typology on seeking treatment. DESIGN: This was an online survey completed by undergraduate students in the United States, responding to questions including the BAI. RESULTS: A multivariate logistic regression analysis model showed that the likelihood of students seeking treatment increased when they experienced more "subjective" anxiety symptoms, odds ratio (OR) = 2.443, 95% confidence interval (CI) = [1.462, 4.082], p = .001, as compared to symptoms in the other three categories. Students were also asked to report which symptoms were "most bothersome" to them. Many students reported difficulty sleeping and an inability to concentrate. These symptoms are not measured by the BAI. CONCLUSION: The results of this study show the potential for the BAI to be used as a symptom categorization tool to be considered independently in identifying target areas for treatment. An understanding of the existence of these gaps may allow providers to better identify students with anxiety who present with symptoms not included in the BAI.

Recommendations for Emergency Departments Caring for Persons with Opioid Use and Opioid Use Disorders: An Integrative Review.

INTRODUCTION: The emergency department is a primary portal to care for persons after an opioid overdose and those with an opioid use disorder. The aim of this integrative review was to provide best practice recommendations for nurses caring for this highly stigmatized and often undertreated population. METHODS: An integrative review was conducted using studies focusing on adults treated with opioid agonist-antagonist medications in the emergency department. The integrative review method by Whittemore and Knafl was used to guide this review and enhance its rigor. RESULTS: Twelve studies were included in the review. Opioid care begins with identifying opioid use risk, followed by implementing tailored strategies including opioid agonist-antagonist treatment if indicated, referral to treatment when warranted, and follow-up opioid use monitoring when feasible. Eleven recommendations provide guidance on integrating best practices into routine emergency care. DISCUSSION: The emergency department is an ideal setting for addressing the opioid crisis. Nurses can use the recommendations from this review to lead system change and more effectively manage the care of persons with opioid use and opioid withdrawal, and those at risk for opioid overdose.

Efficacy of Motivational Interviewing and Brief Interventions on tobacco use among healthy adults: A systematic review of randomized controlled trials.

OBJECTIVES: To assess the effectiveness of a brief intervention and motivational interviewing in reducing the use of different tobacco-related products in adults. METHODS: For this systematic review, PubMed, Web of Science, and PsychINFO databases were electronically searched for randomized controlled trialson the effect of a brief intervention and / or motivational interview on tobacco reduction among healthy adults published between January 1, 2011 to January 1, 2021. Data from eligible studies were extracted and analyzed. CONSORT guidelines were used to assess the quality of the studies by two reviewers for the included studies. The titles and abstracts of the search results were screened and reviewed by two independent reviewers for eligibility criteria per the inclusion and exclusion criteria. Cochrane review criteria were used to assess the risk of bias in included studies. RESULTS: A total of 12 studies were included in the final data extraction of 1406 studies. The brief intervention and motivational interviewing showed varied effects on tobacco use reduction among adults at different follow-ups. Seven of the 12 studies (58.3%) reported a beneficial impact on reducing tobacco use. Pieces of evidence on biochemical estimation on tobacco reduction are limited compared to self-reports, and varied results on quitting and tobacco cessation with different follow-ups. CONCLUSIONS: The current evidence supports the effectiveness of a brief intervention and motivational interviewing to quit tobacco use. Still, it suggests using more biochemical markers as outcome measures to reach an intervention-specific decision. While more initiatives to train nurses in providing non-pharmacological nursing interventions, including brief interventions, are recommended to help people quit smoking.

Posttraumatic stress disorder in nurses in the United States: Prevalence and effect on role.

AIMS: The purpose of this study is to determine the prevalence of posttraumatic stress disorder among U.S. nurses and to examine how severity of posttraumatic stress disorder symptoms are associated with their role. BACKGROUND: The lifetime prevalence of posttraumatic stress disorder is estimated at 6.8%. Loss of workdays, inability to perform at full capacity, and loss of fulfillment are a few of the issues associated with an individual diagnosed with posttraumatic stress disorder. Untreated consequences include early retirement, loss of job, disability, and suicide. METHOD: Participants completed an online survey that included the 20-item posttraumatic stress disorder checklist-5. RESULTS: Severity of posttraumatic stress disorder symptoms among nurses estimates that 28.4% have a probable diagnosis of posttraumatic stress disorder with 15.4% experiencing severe symptoms. The impact of stress was negative job performance impacting mental fatigue and workplace attrition. Coping skills included mindfulness and utilizing social networks. CONCLUSIONS: Nurses are exposed to traumatic experiences, which has an impact on their mental health and well-being and ability to successfully perform their jobs. The impact of these experiences is not differentiated by demographic correlates. IMPLICATIONS FOR NURSING MANAGEMENT: This highlights multiple modifiable factors that impact the severity of stressful experiences. Addressing environmental, organizational, and intrapersonal changes are key components in alleviating the negative impact experienced by nurses.

Telehealth and the Psychiatric Mental Health Nurse Practitioner: Beyond the COVID-19 Pandemic.

OBJECTIVE: Examine the advantages, disadvantages, and challenges of telehealth for the psychiatric mental health nurse practitioner (PMHNP) in practice and student education. Describe areas for future research and policy development regarding telehealth in PMHNP practice and training during and beyond the COVID-19 pandemic. METHODS: Review current evidence, standards of practice, and education for the PMHNP. RESULTS: Recent rapid pandemic-related shifts in utilization of telehealth for clinical practice and student education have highlighted the advantages, disadvantages, and areas in need of additional study. CONCLUSIONS: Postpandemic telehealth care delivery will likely persist or expand. PMHNPs must advocate for high practice and education standards.

Home/community-based interventions to improve function in persons with mild cognitive impairment/early dementia.

Persons with mild cognitive impairment/early dementia have a possible 20-year trajectory of disability and dependence with little information on the effectiveness of interventions to improve function. This review investigates the literature of home/community-based interventions for physical and executive function in persons with mild cognitive impairment/early dementia. A 2007-2020 systematic literature search was conducted through PubMed, CINAHL Plus with Full Text and PsycINFO. Of the 1749 articles retrieved, 18 eligible studies were identified and consisted of three types of interventions: cognitive training-only (n = 7), multicomponent (n = 9), and physical activity-only (n = 2). Results showed that the interventions impacting function in persons with cognitive impairment incorporated a visual/written element, technology-based training, caregiver support, and modified duration/increased frequency of interventions. In studies improving function, participants simulated Instrumental Activities of Daily Living. They addressed cognitive function using both objective and subjective cognitive measures. We found gaps in the literature in incorporating race/ethnicity and appropriate socioeconomic status measures.

Dignity Therapy for End-of-Life Care Patients: A Literature Review.

Dignity therapy as an intervention has been used for individuals receiving palliative care. The goal of this review is to explore the current state of empirical support to its use for end-of-life care patients. Data sources were articles extracted from search engines PubMed, Cochrane, Embase, CINAHL, Web of Science, and PsycINFO. The years searched were 2009 to 2019 (10-year period). The review process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results revealed the feasibility, acceptability, satisfaction, and effectiveness of dignity therapy for life-limiting cases/conditions of patients in different age groups. It also highlighted the importance of the therapy setting and the need to apply this in the cultural context. The meaning of dignity therapy to patients and their family care members also emerged. Findings showed most patients displayed the need to leave a legacy and from this their core values surfaced. In conclusion, this review highlighted the contribution of dignity therapy to the holistic care of patients who hope to leave a legacy. The therapy was also relevant to decrease the anxiety; depression, and burden of family members throughout the palliative care period of their loved ones.

Creating a community of researchers: Fostering global collaboration for doctoral prepared nurses and nursing students.

BACKGROUND: Few publications have explored the role that professional organizations play in facilitating global partnerships; particularly regarding research and educational collaboration between doctoral prepared nurses and students residing in low- and middle-income countries with those from high-income countries. OBJECTIVE: To describe a pilot Spotlight Project which was developed to foster communication and collaboration among global doctoral prepared nurses and nursing students within an international nursing organization. METHODS: Twenty-seven members were identified and sent requests to complete the spotlight form created for this project. This form gave potential participants the option to do a 250 to 350-word write-up or develop a video describing their current research/educational initiatives, achievements, short and long -term goals. RESULTS: Eight of the 27 spotlight requests were returned. Information was received from one recent graduate and 7 faculty members. It included descriptions of motivation to pursue doctoral education, future aspirations, and academic and career accomplishments. DISCUSSION: The Spotlight Project could serve as an avenue for nursing students, researchers, and nursing schools; especially those from low- and middle-income countries that typically have limited funding and access to conferences and other professional opportunities to disseminate information about current projects, and a means of celebrating achievements of organization's members. This is also a potential avenue for international research and education collaboration between students and institutions.