A Team Approach to Enhance Scholarship Among Honors Students in Nursing.

Honors programs within schools of nursing have the potential to enhance young nurses' interest in developing programs of research early in their careers and can thus contribute to the successful development of nursing knowledge. Such programs also provide opportunities to enhance knowledge and skill in leadership and teamwork at a critical time during the development of their professional nurse identity. This article presents the successful approach one organization took when revising its honors program to meet the current needs of students, society, and the profession.

Developing a standardized tool to improve nurse communication during shift report.

Standardization of communication has been suggested as an effective approach to improve communication during patient handoffs such as shift report. Using the clinical microsystem framework, unit leaders and nursing staff developed and pilot tested the medical intensive care unit communication tool. Findings from the pilot study indicated that perceived communication among nurses in general and communication specific to shift report improved significantly following implementation of the tool.

Readability and usefulness of the clinical microsystem assessment tool.

Using an instrument such as the Clinical Microsystem Assessment Tool (CMAT) to examine microsystem performance can provide valuable guidance for the development of quality and safety initiatives within the microsystem. However, instruments developed for this purpose must take into account diverse literacy levels. Perceptions of health care professionals of the usefulness and readability of the CMAT were examined. Readability was determined with the Flesch Reading Ease scale, in which the CMAT was rated as "very difficult" to read, and a Simple Measure of Gobbledygook analysis revealed that 14.71 years of education would be needed to understand the content. Although the majority of the participating health care professionals identified the tool as useful, the high level of reading ability required to understand the content may create limitations for use, given the educational diversity of the health care workforce.

Rural perceptions of continuing professional education.

BACKGROUND: This study describes rural health care professionals' perceptions about professional isolation and the availability, accessibility, and relevance of continuing education. METHODS: Registered nurses (n = 165) and physicians (n = 59) providing health care services in 26 rural hospitals in two Midwestern states participated in the study. RESULTS: Rural health care providers experience barriers to accessing relevant continuing education. Although physicians reported higher levels of professional isolation than their nurse counterparts, professional isolation was identified as a concern by both provider groups. CONCLUSIONS: To ensure an adequate supply of knowledgeable and skillful rural health care professionals, continuing education specific to the delivery of care in rural settings is necessary. Once developed, the continuing education must be delivered in a manner that is acceptable and accessible to isolated rural providers.

Self-assessed knowledge of treatment and fertility preservation in young women with breast cancer.

Young women with breast cancer do not identify themselves as knowledgeable about the effect of cancer treatment on fertility or fertility preservation treatments and resources. These women need access to high-quality health information to support their participation in medical decision making about fertility preservation.

Provider readiness for neonatal resuscitation in rural hospitals.

OBJECTIVE: To describe nurse and physician readiness for neonatal resuscitation in rural hospitals. DESIGN: Descriptive, correlational, and comparative. SETTING: Twenty-six rural hospitals in two Midwestern states. PARTICIPANTS: Rural providers of care to newborns (165 nurses and 59 physicians). INSTRUMENTS: Neonatal Resuscitation Index (knowledge about neonatal resuscitation) and Neonatal Resuscitation Experience Index (comfort and recent skill performance). RESULTS: The average Neonatal Resuscitation Index (knowledge) score of 69% was low. Many skills needed for full resuscitation had not been performed by rural providers during the previous year. Nurses reported lower levels of comfort with skills needed for full resuscitation (t=-4.68; p<.01). Correlation between frequency of skill performance and comfort was higher for nurses than physicians (r=.50 vs. .34). Nurses who were current Neonatal Resuscitation Program providers had significantly higher average levels of comfort (3.67 vs. 3.11; p<.01), knowledge (72.18 vs. 60.71; p<.01), and recent experience (0.94 vs. 0.51; p<.01) with resuscitation skills than nurses who were not current Neonatal Resuscitation Program providers. CONCLUSIONS: Maintaining high levels of readiness for neonatal resuscitation in rural hospitals is challenging. Nurses and physicians should make special effort to obtain continuing neonatal resuscitation education to ensure optimal outcomes when newborn emergencies arise in rural hospitals. Teamwork training for neonatal resuscitation readiness is an important topic for future rural health research.

Challenges faced in providing safe care in rural perinatal settings.

PURPOSE: To examine and describe neonatal resuscitation preparedness, presence of connections to wider systems of care, continuing education activities, presence of trained staff, and other indicators of high performance in rural perinatal microsystems. STUDY DESIGN AND METHODS: A nonexperimental, retrospective, descriptive, cross-sectional design was utilized. Rural hospitals (n = 124) providing perinatal services in five southern states were invited to participate. Nurse managers completed the Hospital Neonatal Resuscitation Survey, describing policies, healthcare team members, educational activities, organizational culture, system connections, and process improvement. Descriptive data were also collected. RESULTS: A total of 44 (35.1%) hospitals participated. Annual birth volume ranged from 22 to 1,614 (M = 515.53; SD = 336.27). Low birth volume hospitals (<125 births per year) had significantly lower levels of preparedness than high volume hospitals (>125 births per year). Preparedness was not influenced by rurality. One-third (34.1%) did not identify relationships with Level III NICUs. Support of continuing education was universal. Efforts to increase interdisciplinary teamwork were common. Medical provider shortages were prevalent (n = 25: 56.8%), and the presence of midwifery services was infrequent (n = 12; 27.2%). Hospital nursing shortages (n = 35; 81.8%) were widespread. CLINICAL IMPLICATIONS: Challenges faced by rural hospitals and healthcare professionals in the delivery of perinatal care emphasize the importance of creating and maintaining high performance microsystems that are responsive to the changing needs of providers and the populations they serve. Lower levels of preparedness and the lack of established relationships with level III NICUs is concerning.

Readiness for neonatal resuscitation: measuring knowledge, experience, and comfort level.

Neonatal resuscitation is a complex procedure that requires the use of specialized knowledge and skills in an emotionally charged and stressful situation. Knowledge about neonatal resuscitation, frequent performance of skills, and comfort level with skill performance are dimensions of quality implementation of neonatal resuscitation. The Neonatal Resuscitation Index and Neonatal Resuscitation Experience Index are self-report instruments designed to measure these important variables. Information about nurses' responses to the Neonatal Resuscitation Index and Neonatal Resuscitation Experience Index, psychometric properties, and implications for research and practice are discussed in this article.