Surviving the NCLEX Dip.

Schools of nursing are charged with preparing graduates to meet minimal practice standards upon workforce entry. To that end, students must pass the National Council of State Boards of Nursing Licensure Examination (NCLEX-RN®) upon graduation. Increased rigor and higher recent passing standards for the exam can contribute to declining scores, which negatively impact graduates and the nursing program. The purpose of this article is to describe a successful 10-step action plan implemented to remediate a brief dip in NCLEX-RN pass rates at one university. The plan contributed to a 10 percent increase in NCLEX scores within one year.

After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.

AIM: The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. BACKGROUND: Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. METHOD: Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. RESULTS: Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. CONCLUSION: Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.

Geriatric sexual experiences: The seniors tell all.

AIM: To gain insight into the aging sexual health experiences and concerns of older adults aged 60 years or older. BACKGROUND: Despite the prevalence of sexual activity among older adults and the documented health benefits, little is known about how sexual health changes as individuals age. METHODS: Participants for this study were recruited through a local senior center and qualitative interviews were conducted. RESULTS: Eight older adults (six female, two male) between the ages of 62 and 95 participated in this study. Some participants commented that expression of sexuality changed due to partner's health. Some identified less sexual frequency and spontaneity, while others stated that they were now more open with their sexual relationship. Participants stated that they wished their or their partner's physicians would discuss their sexual needs. CONCLUSIONS: Sexual changes reported by participants in this study were consistent with the research relating sexual health to overall health. The finding that half the sample did not discuss sexual problems with anyone highlights the opportunity for nursing research to further explore this phenomenon.

If They Were Real: Lessons Learned from Literary Characters With Dementia.

Dementia and its side effects often leave individuals unable to tell their stories or experiences. Consequently, nurses must rely strictly on clinical observations as a basis for understanding dementia--an understanding that is necessary to provide the best possible care. Relying on clinical observations leads to challenges in fully understanding the experience of living with dementia. Fictional literature gives authors license to write about individuals with dementia rather than the clinical aspects of the disease, which provides insight into the patient and family experience and illustrates their needs. The current article explores dementia through an analysis of eight literary works and insights that may help expand the quality of geriatric nursing care.

Transformational learning in graduate nurse education through podcasting.

AIM: To introduce faculty to podcasting, giving them opportunities for course integration in nursing. BACKGROUND: Faculty represented adult, gerontological, psychiatric, acute, and family health specialties interested in technology integration. METHOD: Faculty were invited to submit an abstract describing interest and experience with educational technology and intended use of podcasting. Each faculty received an iPod and sessions were held updating the required technical skills. Transformational learning was the conceptual framework, and faculty and students were encouraged and tutored in workshops to utilize podcast technology. Faculty launched podcasts on the university's platform, monitored students' responses, and conducted end-of-course evaluations. RESULTS: Faculty enthusiastically embraced podcasting's potential. Students' responses were mixed. Many viewed podcasts as extra work and preferred face-to-face class or written assignments. Podcasts were helpful to others, especially during commutes or for reviewing or reinforcing material. Auditory learners also preferred podcasts. CONCLUSION: Despite some technical difficulties, responses were positive. Using the theory of transformational learning and allowing students greater flexibility in obtaining knowledge, asynchronously, and at their own pace, proved beneficial.

Uncertainty and perception of danger among patients undergoing treatment for prostate cancer.

UNLABELLED: Study Type - Therapy (attitude prevalence) Level of Evidence 2a What's known on the subject? and What does the study add? Marked differences in uncertainty among patients have been found relating to race and social environment indicating that as uncertainty increases, social functioning declines. Correlations have been found between uncertainty and patients' coping, psychological adjustment and perceptions of their health and illness. Studies suggest the detrimental effect of uncertainty among patients with prostate cancer in the perception of their quality of life. These studies underline the potential benefit of targeted intervention. The study provides a unique insight into the impact of uncertainty and perception of danger on overall satisfaction with treatment outcomes in men with prostate cancer. Its results suggest that possible disparities related to patient racial background and education may exist in the perception of cancer-related uncertainty. Racial and educational disparities, coupled with a mild to moderate association of uncertainty or danger perception and overall outcome satisfaction, suggest an unmet need for healthcare and nursing services for men undergoing treatment for prostate cancer. OBJECTIVES: To investigate patient uncertainty and perception of danger regarding prospects for clinical prostate cancer control. To determine the impact of these factors on satisfaction with overall prostate cancer treatment outcome. PATIENTS AND METHODS: Men who had undergone primary treatment for early stage prostate cancer and who were participants in the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROSTQA) prospective cohort study of prostate cancer outcomes (the parent study) were offered the opportunity to participate in the present study. Centralized phone interviews were conducted to determine patient-reported uncertainty regarding cancer status (measured by the Mishel Uncertainty in Illness Scale-Community Form), perception of danger (measured by Folkman and Lazarus' Appraisal Scale) and satisfaction with treatment outcome (measured by the Service Satisfaction Scale for Cancer Care). The study used the same centralized telephone interview centre as was used in the parent study. Data were collected at 48, 60 or 72 months after the completion of prostate cancer treatment. Relationships among measures were characterized by Spearman rank correlation coefficients (r). RESULTS: A total of 338 agreed to participate, representing 76% of those who were invited. Younger patients experienced less uncertainty (r = 0.20, P < 0.001), yet reported greater perception of danger (r = -0.12; P = 0.03) concerning their previously treated prostate cancer. African-American patients showed greater uncertainty than other ethnic groups (P = 0.005) but did not have a greater perception of danger (P = 0.36). Education played a major role in uncertainty; patients with lower levels of education tended to report higher degrees of uncertainty (r = -0.25; P < 0.001). There was a mild to moderate general association between the three outcomes. A greater sense of uncertainty was associated with a greater perception of danger (r = 0.34, P < 0.001), and as danger and uncertainty increased, satisfaction with treatment outcome tended to decrease (r was between -0.30 and -0.34, P < 0.001). CONCLUSIONS: Results suggest that possible disparities related to patient racial background and education may exist in the perception of cancer-related uncertainty. Racial and educational disparities, coupled with a mild to moderate association of uncertainty or danger perception and overall outcome satisfaction, suggest an unmet need for healthcare and nursing services for men undergoing treatment for prostate cancer.

Validity and reliability of the geriatric sexuality inventory.

Effective health care for older adults requires that providers assess and manage sexual health needs with high priority. This assessment begins with an effective sexuality assessment tool. A two-step, research approach was undertaken to develop and test the Geriatric Sexuality Inventory (GSI). Literature and expert review resulted in a 34-item instrument that was initially completed by 34 older adults ages 60 to 91 (mean age = 75). The testing was repeated in 19 of the original participants. The sample was 75% women, and 88% Caucasian with 9% single, 27% married, 18% divorced, and 46% widowed participants. Internal consistency reliability was run on all 53 responses and revealed adequate reliability (alpha = 0.74). Test-retest analysis also revealed good initial instrument reliability (r = 0.78; p < 0.001). Responses to open-ended questions regarding sexual information and care needs supported evidence gathered from the literature. Initial testing of the GSI revealed content validity and good internal consistency and test-retest reliability.

The role of spiritual nursing interventions on improved outcomes in older adults with dementia.

Dementia is a devastating condition that takes a toll on all involved. This integrative literature review focuses on the role of spirituality/spiritual nursing interventions in the improved health outcomes of older adults with dementia. Dementia treatments are constantly being explored and current findings are promising. Older persons with dementia, respond best to holistic care that includes the spiritual aspects of their lives. Not only is attention to spirituality beneficial to the patient, but to caregivers and nurses/healthcare providers as well. Research indicates that the memory needed to explore one's spirituality may be spared the effects of dementia. This preservation of memory allows older adults with dementia to benefit from spiritual nursing interventions, especially music and rituals. However, further investigation examining the phenomenon of spiritual interventions as treatment is warranted.

Supporting the Foundation of Nurse Anesthesia Education: A Report of the Faculty Stabilization Taskforce.

Without highly qualified educators and educational program administrators, the ability to provide anesthesia and pain management services throughout the healthcare system will be threatened by the inadequate supply of Certified Registered Nurse Anesthetists (CRNAs). The average turnover rate between the years 2016-2020, for CRNA program administrators, was 15% with some programs changing leadership as often as every two to four years. In response, the American Association of Nurse Anesthesiology (AANA) and the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) created the Faculty Stabilization Taskforce (FSTF) to review reasons for the high turnover rate and to develop methods and tools to support program faculty and administrators in their role of educating the future CRNA workforce. The FSTF provided two recommendations: 1) to create a robust faculty development program for all faculty at all levels of CRNA education, and 2) to create a repository of information needed to administrate, and educate students, in a high-quality CRNA program. This article summarizes the report made to the AANA Board of Directors (BOD) which was unanimously accepted and is already being implemented by AANA and COA staff. The full text of the report can be found on the AANA's website at www.aana.com/FSTF.

Older adults and HIV and STI screening: the patient perspective.

To explore patient provider interactions regarding human immunodeficiency virus (HIV) and sexually transmitted infection (STI) screening of older adults in Connecticut through a focus group approach. Older adults were defined as individuals over 64 years old. Two focus groups convened. The data analysis revealed that the majority of participants had not been screened for HIV or STIs and had not talked with their health care providers about sexual health in recent years. The lack of conversation about sexual health and sexual health screening was the major barrier to sexual health screening. Instigation of the conversation of sexual health and a positive relationship with the health care provider were suggested to overcome these barriers. Health care providers have an important role in initiating conversation about and screening patients for STIs, including HIV. The media, specifically television, was identified as a potential avenue for successful health education.

Effect of a geriatric nurse education program on the knowledge, attitudes, and certification of hospital nurses.

Although nurses are the primary care providers for hospitalized and vulnerable older adults living in the community, they are generally not prepared in geriatric care. This study examined the effect of a 21-hour nursing education program on nurses' knowledge and attitudes regarding care of older adults and the geriatric nursing certification of the participants. The program was offered to 92 nurses in three cohorts over a 1-year period. Participants completed pre- and posttest measures of geriatric knowledge and attitudes. Significant differences were found between pretest and posttest knowledge and attitudes. Program evaluation and success in achieving certification in gerontological nursing also indicated a positive effect of the program.

Perceptions of Campus Climate on Program Satisfaction for Accelerated Nursing Students.

BACKGROUND: Nationwide, schools of nursing have recognized the significance of increasing their diversity but continue to be challenged with recruitment and retention of historically underrepresented students. In 2008, the New Careers in Nursing program was implemented to alleviate the shortage and increase nursing diversity. METHOD: Secondary analysis of a subsample of participants was used to investigate how campus climate affected program satisfaction of accelerated nursing students of color. Specific objectives included exploring social supports such as interpersonal interactions and experiences with faculty and peers. RESULTS: Those who self-identified with an under-represented group were more likely to feel uncomfortable with those whose race/ethnicity was different from their own, more likely to report hearing racists or stereotypical remarks in school, and less likely to have a supportive group of friends on campus. CONCLUSION: The results of this study revealed significant relationships between campus climate variables that included peer and faculty interactions. These results are relevant to all nursing programs seeking to create a more welcoming environment within their campus community. [J Nurs Educ. 2019;58(7):409-416.].

Examining changes to statewide NP practice in Connecticut.

In 2014, Connecticut legislators eliminated the need for advanced practice registered nurses with 2,000 practice hours to obtain collaborative practice agreements with physicians. This study examined resulting practice changes, barriers, and suggestions for improved implementation of independent practice. Thirteen NPs participated in focus groups to share their experiences and recommendations.

Prostate cancer overview.

OBJECTIVES: To review prostate anatomy, epidemiology and risk factors, presentation and diagnosis, staging and treatment, emerging therapies, and patient education. DATA SOURCES: Review of current and classic literature. CONCLUSION: Patients must be educated regarding screening recommendations and offered evidence-based guidance regarding the risks, benefits, and alternatives to treatment. Adverse effects of treatment may impact quality of life. IMPLICATIONS FOR NURSING PRACTICE: As the incidence of prostate cancer continues to rise, nurses will play an essential role in the treatment and counseling of men facing this malignancy. Nursing research will also be necessary to further investigate quality-of-life concerns and evidence-based practice regarding symptom management.