Early Immersion Clinical for an Accelerated BSN Nursing Program.

ABSTRACT: Ensuring clinical competency and judgment in nursing students is critical. Developing ways for students to obtain this goal in a second-degree bachelor of science in nursing (BSN) program is challenging. One method described here is the early immersion clinical (EIC). Occurring concurrently with health assessment and fundamentals courses, EIC allowed for quick application of skills in the context of clinical care. Weekly clinical objectives were aligned with objectives for both courses. This article describes how EIC was implemented in a 12-month second-degree accelerated BSN program.

The Impact of Transition Readiness and Stress on Patient-Centered Outcomes in Young Adults With Inflammatory Bowel Disease.

Young adults, 18-35 years of age, account for nearly half of all inflammatory bowel disease emergency department visits annually, costing millions of healthcare dollars and signifying undue pain and suffering. To mitigate this sequela, the study aimed to characterize the relationships between transition readiness (self-management ability), stress, and patient-centered outcomes. Outcomes were defined as disease activity and inflammatory bowel disease-related healthcare utilization (emergency department visits and inpatient hospitalization). This was a descriptive, correlational design via online survey of young adults with inflammatory bowel disease. Participants (n = 284) utilized an estimated 2.77 million healthcare dollars in 12 months. Transition readiness decreased the odds of having consistently active disease and healthcare utilization, with adjusted odds ratio ranging from 6.4 to 10.9 (p < .05). Higher stress levels increased the odds of having consistently active disease and healthcare utilization, with adjusted odds ratio ranging from 9.5 to 10.5 (p < .0001). Twenty-five percent (24.7%) of the variation in transition readiness was explained by changes in stress (p < .0001). Transition readiness and stress impacted all patient-centered outcomes. Stress negatively impacted transition readiness. These results are powerful reminders for healthcare providers to assess and treat stress and support transition readiness in young adults with inflammatory bowel disease. The potential to decrease pain, suffering, and healthcare cost is enormous.

Effectiveness of School-based Health Center Delivery of a Cognitive Skills Building Intervention in Young, Rural Adolescents: Potential Applications for Addiction and Mood.

PURPOSE: Uniquely positioned, school nurses address two of the most critical adolescent health issues - addiction and mood. Cognitive behavioral therapy, the mainstay in management of adolescent mood disorders, demonstrates promise in the treatment and prevention of addictive behaviors. Quality decision-making may protect adolescents from substance abuse. Executive function, a neurocognitive aspect of decision-making, involves impulse control, future thinking, and behavioral regulation. Further, the continuum of addition implicates executive function, which makes executive function a viable target for prevention and treatment of substance use. This pilot study examined the effectiveness of a nurse-led cognitive skills training intervention, Creating Opportunities for Personal Empowerment, on executive function and mood in a novel population and setting. DESIGN AND METHODS: The study sample included adolescents ranging in age from 12 to 15 years and enrolled in a rural school-based health center. Fifteen (n = 15) adolescents completed the seven-week cognitive skills building intervention led by a nurse practitioner. Researchers measured executive function, anxiety, and depression at: baseline, after the intervention series, and three-months later. RESULTS: One domain of executive function - behavioral regulation - improved, as did anxiety. Depression showed short-term improvement. Metacognition did not change over time. CONCLUSIONS: Preliminary results indicate that cognitive skills building delivered by school nurses may enhance aspects of executive function linked with addiction and coping, such as behavioral regulation. Further, this intervention may also improve mood in this population. PRACTICE IMPLICATIONS: Delivery of cognitive skills training by school nurses could be an accessible, effective piece in addressing addiction and mood in young, rural adolescents.