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Research From Around The World: Substance Use Disorder In The Us, Peggy Compton

SigmaCast [Podcast]

This episode we will be discussing the body of nursing research from Peggy Compton, PhD, RN, FAAN, a Sigma International Nurse Researcher Hall of Fame inductee in July of 2020 and an Associate Professor and van Ameringen Endowed Chair at the University of Pennsylvania School of Nursing.

Host: Matt Howard, DNP, RN, CEN, TCRN, CPEN, CPN: Director of Scholarship Resources, Sigma

Social Factors That Exacerbate Features Of Borderline Personality Disorder In Young Adult Women, Erika Marie Carrasquillo

International Nursing Research Congress (INRC)

Although there are studies conducted with Hispanics and Puerto Ricans living in the United States, there are no studies with female Puerto Rican BPD patients residing in the Commonwealth of Puerto Rico available. Since most of the individuals affected by this condition are female, the present research was focused on uncovering factors that increased the likelihood of BPD features in women between the ages of 25-35 years. The purpose of this study was to examine the social factors that exacerbate borderline personality disorder in the female population between 25 and 35 years of age living in the metropolitan area of …

Research From Around The World: Hiv/Aids In Africa And The Us, Jason E. Farley

SigmaCast [Podcast]

This episode we will be discussing the body of nursing research from Jason E. Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRN, a Sigma International Nurse Researcher Hall of Fame inductee in July of 2020 and a professor at Johns Hopkins University School of Nursing

Host: Matt Howard, DNP, RN, CEN, TCRN, CPEN, CPN: Director of Scholarship Resources, Sigma Theta Tau International, Indianapolis, Indiana, USA

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha H. Mims

Dissertations

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

Exploring The Relationships Between And Among Registered Nurses' Spiritual Well-Being, Spiritual Care Perspectives, And Their Provision Of Spiritual Care In Acute Care Settings, Barbara J. Kitchener

Dissertations

Despite acknowledgment that spiritual care is an essential aspect of holistic nursing care, nurses often feel ill-prepared for, uncomfortable with, and uncertain about providing spiritual care. Studies have indicated that nurses who have a strong sense of their own spiritual well-being and/or a positive perspective [attitude, value, belief] about spiritual care are more inclined to provide spiritual care to their patients. However there is a scarcity of such studies among acute care nurses. This descriptive correlational study aimed to explore relationships between and among acute care nurses' spiritual well-being (SWB), spiritual care perspectives (SCP), and their provision of spiritual care …

The Experience Of Living With Hypertension: Lessons From A Cohort Of Older Men, Junjira Seesawang

Dissertations

Poor adherence to treatment and poorly controlled hypertension are common in older men, especially in rural areas. Knowledge about the experience of living with hypertension among older men is important for developing nursing practices to enhance treatment adherence. However, little is known about the personal experiences of older men with hypertension. This dissertation includes three papers that address the following: (1) the experiences of men with hypertension, based on a review of literature, (2) factors influencing the ability to self-manage hypertension among older adults in Asian countries, based on a review of qualitative studies, and (3) grounded theory study exploring …

Advocacy: Strategies For Staff Under Stress, Karen L. Tomajan

Covid-19 Webinars

These are some unprecedented times, requiring new skills and ways of thinking. Some of the challenges we are experiencing included:

• Societal and demographic changes
• Political and social divisiveness and unrest
• Health care system challenges
• Most pervasive pandemic of our lifetime: Untold loss of life and health | Upended lives of our citizens | Unimagined stress and sacrifice for health care providers (HCP) | Economic uncertainty impacting individuals, businesses, and industries

Those who listen to this webinar will be able to:

• Define advocacy and advocate
• Discuss the skills of an advocate
• List the steps in the advocacy process
• Apply advocacy skills …

Set Up For Success: How The Pathway To Excellence® Framework Supports Ambulatory Care Nurses, Patience Harris, C. Preston Lewis, Rebecca Graystone

Group: American Nurses Credentialing Center (ANCC)

Healthcare is undergoing dramatic and unprecedented change. In particular, care delivered by nurses in ambulatory care settings, chiefly telehealth, has seen explosive growth in 2020 fueled by COVID-19. Now more than ever, ambulatory care nurses are called upon to coordinate and provide care in an array of hospital-based and nonhospital settings. Although the COVID-19 pandemic has exacerbated the existing demand for new nonacute care delivery models and settings, several factors have contributed to this tipping point.

Improving Screening For Child Physical Abuse In The Emergency Department, Sheri Carson

General Submissions: Presentations (Oral and Poster)

Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death secondary to escalating abuse. The purpose of this evidence-based, quality improvement project was to implement a comprehensive program to increase ED HCP screening for and recognition of child physical abuse.

Innovative Suicide Screening: Implementation Of An Electronic Tool, Tara Peloza, Kristin Kuharske, Ashley Servi, Michelle Pickett, Frances Kaczor, Amy Ciriacks

General Submissions: Presentations (Oral and Poster)

Adolescent suicide is the third leading cause of death and is an escalating public health concern in adolescents. The Ask Suicide-Screening Questions (ASQ) is a 4-question validated suicide screening questionnaire that identifies youth at risk for suicide. A 5th populates with a positive response to any of the questions. The emergency department (ED) is an ideal setting to perform suicide screening. However, a discrete and convenient way to disclose sensitive information in this fast-paced setting was needed. To address these issues, our team developed an electronic version of the ASQ. The purpose of this project was to determine if this …

Reattendance Of Pediatric Fever Cases In A Local Accident And Emergency Department: A Retrospective Cohort Study, Sun Fei Li, Janet Yuen Ha Wong, Daniel Yee Tak Fong

General Submissions: Presentations (Oral and Poster)

Fever in children is one of the most common reasons for pediatric reattendance in Accident and Emergency department (AED). These children who reattend to AED contribute to overcrowding, which may reflect the generalized deterioration of service quality in the public emergency healthcare system. As a result, the designed study is to determine the characteristics of febrile children who were admitted the local AED and reattended with a similar complaint within 72 hours by comparing the reattend and non-reattend group.

Randomized Controlled Study In The Use Of Aromatherapy For Pain Reduction And To Reduce Opioid Use In The Emergency Department, Adam N. Brown, Cindy Reed, Denise C. Rhew, Crystal Adkins, Merle Tai

General Submissions: Presentations (Oral and Poster)

The purpose of this study is to evaluate the effectiveness of a combination of lavender, sweet marjoram, and pink grapefruit oils on a patient's perception of pain, and the ability to reduce the use of opioids in an emergency department setting. In the midst of the current opioid epidemic, there is much discussion on the multi-modal approach to the treatment of pain. One potential source of analgesics that can be utilized in this approach to pain control is aromatherapy with essential oils.

Goal Zero: Eliminating Mislabeled Specimens In The Emergency Department, Michele Samsa, Tracie Henderson

General Submissions: Presentations (Oral and Poster)

This emergency department (ED) noticed an increase in misidentified laboratory specimens noted to be the highest in our hospital region. Misidentified specimens can result in misdiagnosis, medication errors and repeat laboratory (Lab) specimen collection with a direct impact on patient comfort, nurse workload and increased cost can result. This project was developed as a quality improvement project aimed at reducing misidentified laboratory specimens and promote patient safety.

Team Selection For Critical Care Transport, Cheryl Riwitis, Cynthia J. Bowers

General Submissions: Presentations (Oral and Poster)

Critically ill or injured patients often require specialized care. Regionalization of specialty services necessitates transport of patients from the scene of an accident to a trauma center or from one hospital to another (inter-facility) to receive specialized services, for example, trauma, cardiology or neurology. Debate exists regarding the selection of the transport team. No clear guidelines exist for critical care transport team selection (Swickard, Swickard, Reimer, Lindell, & Winkelman, 2014).

Emergency Department Pediatric Self Efficacy Scale (Pedi-Ed-Se): A Psychometric Study, Elizabeth Molle, Stephanie German

General Submissions: Presentations (Oral and Poster)

Extant literature supports that ED health care providers lack self-efficacy for recognizing and managing pediatric emergencies, particularly in community-based hospital settings. Further, empirical evidence supports that in-situ simulation provides an effective educational venue for improving self-efficacy. However, a gap exists in measuring self-efficacy with a validated and reliable instrument. Therefore, an instrument development research study was done to construct and test the new instrument.

Translating Field Practice Of An Emt To Acute Care Practice: A 9-Day Training Program To Increase Competency And Decrease Turnover, Lori Schaaf

General Submissions: Presentations (Oral and Poster)

Employee turnover can be directly related to the onboarding process which can cost upwards of $50,000 per employee. In 2017, turnover rates for EMTs at this network system were at 50% and there was a lack of role clarity and expectations. In the state of Ohio, there are also four different pre-hospital competency levels for EMTs, these include the emergency medical responder (EMR), basic EMT (BEMT), advanced EMT (AEMT), and Paramedic. Furthermore, the organization expanded quickly over the last 5 years, growing from 2 emergency departments to 12. This compounded the need to review the onboarding process. The objective was …

Implementation Of Emergency Department Nurse Triage Sepsis Screening Protocol, Lynne E. Ward, Jennifer M. Heusinkvelt, Lacey J. Huber, Breann N. Miller, Azusa Ronhovde, Susan A. Barnason, Katie A. Kranau

General Submissions: Presentations (Oral and Poster)

Sepsis is a life-threatening condition associated with high morbidity and mortality rates resulting in the death of 270,000 Americans annually (CDC, 2018). Most patients diagnosed with sepsis are admitted through the ED. Unlike many other emergency conditions, the signs and symptoms of sepsis along with variances in patient presentations are often vague and subtle, making early identification and treatment a challenge. The purpose of this study was to evaluate the implementation of an ED nurse-led triage sepsis protocol.

Epinephrine In Anaphylaxis: Assessing Knowledge Gaps In Administration And Strategies To Mitigate Error, Joyce Foresman-Capuzzi, Megan Buckley, Lisa Eckenrode, John Capuzzi

General Submissions: Presentations (Oral and Poster)

Given the low volume, high-risk situation which necessitates Epinephrine treatment in anaphylaxis, gaps in knowledge and practice were observed, resulting in error. A hypothesis was developed that nurses educated prior to 2000 would have a gap in administration knowledge, leading to error potential. This project was designed to identify those gaps and develop education to address them, leading to best practice and enhanced patient safety during a low volume, high risk emergency. Epinephrine is a high-risk drug,in that concentration differs according to diagnosis and has previously been expressed in ratio format, leading to confusion and error. Since the early 2000's, …

Ed Volunteer Safety Patrol: A Falls Reduction Strategy, Tina Johnson

General Submissions: Presentations (Oral and Poster)

Patient falls with injuries (FWIs) in the hospital are a serious risk. The Joint Commission reports that 63% of the 465 FWIs reported since 2009 led to death. In our emergency department (ED), we aimed to reduce falls with increased bundle compliance by expanding the role of volunteers.

Utilizing Cognitive Behavioral Therapy, Token Economy Technique To Positively Impact Boarding Of Pediatric Psychiatric Patients, Crystal Crider, Luna Sanchez Rivera, Beth Beaver, Sarah O'Rourke, Genalynne C. Mooneyham, Ann White

General Submissions: Presentations (Oral and Poster)

Recent US data estimates 5% to 7% of pediatric ED visits are related to mental health. The most common mental disorders diagnosed in childhood are Tourette syndrome, attention-deficit/hyperactivity (ADHD), behavior, mood, anxiety, autism spectrum (AS), and substance use disorders (SUD). Between 2011 and 2015, psychiatric ED visits per 1000 youth increased by 28%. Disposition is the major issue; the wait for outpatient psychiatry is long and inpatient psychiatric beds are a limited resource. This negatively impacts patient behavior, overall ED throughput and patient/family/staff satisfaction. This ED sought to develop an evidence based, proactive, consistent approach to improving pediatric patient behavior …

Effects Of Prehospital Communication Times In Stemi Patients, Melissa Connor, Kate Hurley, Ning Yao, Theresa Nicholson, Morgan Harris, Tyler Rodriguez, Nicholas Jackson, Pamela Miller

General Submissions: Presentations (Oral and Poster)

Expedient transfer of a ST-elevation myocardial infarction (STEMI) patient presenting to the Emergency Department (ED) to a cath lab for percutaneous coronary intervention (PCI) is well understood to make a difference in the patient outcome. The American Heart Association has given a goal of 30-30-30 from first medical contact (FMC) to device time, meaning that patients should spend no more than 30 minutes at each step when transported to a hospital, evaluated in an ED and re-perfused in a cath lab. In Los Angeles County, Mobile Intensive Care Unit (MICN) nurses are certified to provide specialty pre-hospital guidance from the …

Integrating Volunteer Peers Into The Emergency Care Of Substance Use Disorder, Brittany Punches, Colleen E. Laurence, Kiran A. Faryar, Rachel M. Ancona, Robert S. Braun, Natalie M. Qualkenbush-Frye, Daniel P. Ritchie, Michael S. Lyons

General Submissions: Presentations (Oral and Poster)

Peer influence increases the likelihood that individuals receiving substance use disorder (SUD) treatment will achieve sustained recovery. Analogous models in the emergency department (ED) for initial linkage to SUD treatment are less defined and typically require delayed peer contact after the initial encounter. EDs have ready access to populations in need of linkage to SUD treatment but face substantial operational and resource barriers. We describe a novel program using an existing hospital volunteer service framework to introduce real-time peer involvement with ED linkage to care efforts.

Interventions To Support Staff Caring For Pediatric Behavioral Health Patients In The Emergency Department, Jennifer L. Mattei, Denise Bach, Rebecca Neichter

General Submissions: Presentations (Oral and Poster)

Emergency departments (ED) across the country continue to see increasing volumes of behavioral health (BH) patients. With this increased volume, an increased number of aggressive patients has also been noted. The staff in our pediatric ED frequently expressed their uneasiness when caring for BH patients, and voiced concern over the number of resources being allocated to BH patients. The purpose of this evidence based practice (EBP) project was to discover what additional resources would be perceived by staff to be the most beneficial to increase their safety, comfort level and job satisfaction when caring for BH patients.

Pediatric Severe Sepsis Checklist Improves Timeliness Of Treatment, Sarah Maciolek, Kelly Perez, Megan Hughes, Emily C. Dawson

General Submissions: Presentations (Oral and Poster)

The 2017 American College of Critical Care Medicine recommends a first-hour resuscitation and stabilization bundle for the treatment of pediatric severe sepsis or septic shock. Priorities of care include rapid establishment of vascular access, initiation of fluid resuscitation within 30 minutes, and initiation of empiric antimicrobial therapy within 60 minutes of severe sepsis recognition. The utilization of a protocolized treatment in the Pediatric Emergency Department (ED) is associated with improved timeliness of care and reduced morbidity related to organ dysfunction. The purpose of this evidence-based practice (EBP) project is to improve timeliness of antibiotic administration and intravenous fluid bolus administration …

How To Be A First Responder For Colleagues After Adverse Events: Instituting A Peer Support Program In The Emergency Department, Kerry A. Gold, Melissa Connor, Ashley Trueblood

General Submissions: Presentations (Oral and Poster)

Healthcare workers exposed to adverse events can suffer emotional and physical consequences, often referred to as "second-victim" or "identified individual" After an adverse event occurs, there may be immediate, midterm, and delayed harm to the caregivers involved, including: increased depression, anxiety about future errors, loss of confidence, sleeping difficulties, reduced job satisfaction, and harm to their reputation. In our health system, the Emergency Department (ED) is subject to the highest number of staff assaults, workplace violence and critical events. With this knowledge, an interdisciplinary team was created to address the issues. The objective was to implement a peer support team …

Identification Of Human Trafficking Victims In The Emergency Department, Susan G. Blume

General Submissions: Presentations (Oral and Poster)

Healthcare professionals have not been successful in identifying human trafficking victims. Lack of recognition is related to inadequate training and screening tools. No patients had been identified as potential human trafficking victims in our Emergency Department prior to the initiation of this project. This was a staff development evidenced based practice project. We wanted to educate the staff on how to identify human trafficking victims in the clinical setting. Once patients were identified the staff had to be educated on how to respond appropriately to this patient population.

Nursing And Midwifery Links [December 2020 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

As a historic year comes to a close, this edition of the Links Magazine will serve as a reflection of the incredible innovation and fortitude shown by our colleagues worldwide. For perhaps the first time in many, many years, 2020 was the year that humanity shared the experience of a common event of global proportions. Healthcare was placed front and center as the world watched from where they were sheltered in place. From varying cultures and perspectives, the nurses and midwives of the world were presented with a deadly challenge that came on quickly, and continues to plague many countries. …

When Nurses Lead Change: Improving Door To Alteplase Times For Stroke Alert Patients, Andrea Perry

General Submissions: Presentations (Oral and Poster)

The American Heart Association Target: Stroke Phase II states that goals for alteplase administration should be set at 75% of cases within 60 minutes, and 50% within 45 minutes. The Stroke Champion Program was created to engage bedside nurses in identifying barriers and redesigning the stroke alert workflow. This process improvement project was designed to be led by bedside RNs. High performing ED RNs were identified by ED leadership and invited to participate. The ED CNL and Stroke Coordinators used LEAN processes to facilitate RN identification of barriers and develop future state workflows.

Human Trafficking Online Educational Training To Increase Emergency Nurses' Knowledge, Self-Efficacy, Skills In Identification, And Referral Of Human Trafficking Survivors, Patricia A. Normandin

General Submissions: Presentations (Oral and Poster)

Human trafficking inclusive of forced labor is a hidden global public health epidemic that crosses all cultures, countries, ages, genders, economic incomes and families. Worldwide human trafficking is known as modern day slavery globally exploiting an estimated 40.3 million victims of human trafficking. Of these 40.3 million victims of human trafficking 81% are trapped in forced labor, 75% include women as well as girls, and 25% are children. Human trafficking and forced labor are a $150 billion industry worldwide. The National ENA has a position statement on human trafficking which identifies that emergency nurses, as well as other healthcare professionals, …

Catch & Release: Impact Of A Standard Emergency Department (Ed) Discharge Process, Gentry Ridgeway, Tracy Thompson, Patricia Woltz

General Submissions: Presentations (Oral and Poster)

Inconsistent nursing practice for discharging patients was noted as shown by varying Professional Research Consultant (PRC) scores gathered by third party consultant group for discharge instructions. Research studies have shown misinterpretation or lack of understanding of discharge instructions by patients can have an adverse effect on patient's healthcare compliance. This presented an opportunity to initiate a nursing practice change in accord with the best evidence. The goal was to develop and implement a standard discharge process to improve patient discharge satisfaction.