The Adolescent Parenting Program: Improving Outcomes Through Mentorship

Adolescent parents and their infants are a population at risk. Infant mortality, low-birthweight, and child maltreatment are inordinately higher within this population than within slightly older cohorts. The purpose of this one group pretest-posttest intervention study was to analyze the efficacy of a program designed to improve infant outcomes through the enhancement of health practices and parenting skills in a sample of 137 low-income, pregnant and parenting adolescents who reside in an urban area and who screened positive for risk of child maltreatment. Based on theories of mentorship and social support, the program provided intensive home visitation by nursing paraprofessionals, indigenous to the community, for the 2 year study period. Program outcomes were compared to local and national data. Findings revealed only 4.6% of program infants were low-birthweight compared to local and national percentages of 13.5% and 9.42%. The mean length of gestation was 39.27 weeks (SD = 1.55). The incidence of infant mortality was zero, comparing favorably with national data as well as the local infant mortality rate (almost twice the state average). There were only four cases of child neglect, representing only 2.91% of the sample. This finding also compares favorably with national data.     

A Nursing Care Monitoring and Evaluation System: Making it Work in Differentiated Practice

This article describes the evolution of a chart audit tool that became an integral part of a nursing care monitoring and evaluation system at two healthcare agencies in South Dakota. These agencies, an acute care hospital and a federal healthcare agency, continue to use the audit tool for multiple purposes within their institutions. The initial design of the tool had two objectives: to measure objectively the quality and effectiveness of patient care provided by the nursing staff and to educate nurses about expectations of their roles as case managers or case associates. The tool has been revised and continues to be modified to fit needs within hospital, ambulatory care, and community based care settings, to meet program standards for accreditation, and other purposes within each agency.     

Collaborative Practice Through Nursing Case Management

A 528-bed community teaching hospital redesigned its patient care delivery system, implementing a collaborative practice model on the 30-bed inpatient rehabilitation unit in April 1990. This model is a patient-centered delivery model that encourages the healthcare team to facilitate the achievement of patient outcomes within effective time frames and with an appropriate use of resources. The collaborative practice model includes a nurse case manager's role for the staff nurse, which had as its framework the concept of nursing case management. Tested project management techniques were used to ensure a successful implementation process. Various strategies, such as using project teams and providing educational programs, were used to respond to the issues of role conflict and overlap, especially between social workers and nurse case managers. The implementation of this model provided a number of benefits, including improved interdisciplinary relationships and decreased length of stay.     

A Contemporary Model for Improving RN Job Outcomes

The pandemic has highlighted 3 critical nursing workforce issues: turnover, wellbeing, and equity. A comprehensive framework is needed to understand the interactions between these concepts. This paper proposes a model that allows for more inclusive understanding of professional outcomes for RNs, with attention not just to job outcomes, but also to equity for underrepresented groups in the workforce and individual wellbeing. The model highlights the importance of systems and societal elements, contextual elements, and individual responses to the dynamic conditions of work and life, and can be used to advance research and practice to create effective retention and support strategies.     

A Model for Professional Rehabilitation Nursing Practice

As partners in health care, clinical and administrative nurses must share in the work, risks, and rewards inherent in nursing practice while promoting high-quality results in a cost-conscious and cost-effective environment. One way to achieve these results is by developing a nontraditional rehabilitation structure and nursing practice model. This article discusses practical strategies for constructing and implementing such a model; it also identifies tangible outcomes of using the model. The healthcare environment in the 1990s demands a high level of involvement on the part of staff; the rehabilitation nursing model presented in this article meets this challenge.     

Addressing Sexual Violence Through Preventive Nursing Practice

Approximately 1 in 20 women will experience sexual violence at some point in her life. The negative health consequences to women can be serious and lifelong, prompting the Centers for Disease Control and Prevention and the World Health Organization to declare sexual violence a public health problem. Nurses, in their provision of care to individuals and communities, can contribute to improved outcomes related to the problem of sexual violence through the application of preventive care practices.     

Improving Therapeutic Communication in Nursing Through Simulation Exercise

Becoming proficient in therapeutic communication requires adequate educational preparation, as well as ongoing practice and personal reflection about one’s ability to communicate. This article discusses a study that examines the effects of a nursing lab simulation used to increase the self- efficacy of 32 nursing students with their ability to utilize effective communication skills. We concluded that the lab simulation was helpful in improving student self-efficacy regarding their therapeutic communication skills.     

Population-Based Public Health Nursing Interventions: A Model from Practice

Abstract In a changing and complex health care system, public health nurses face challenges to explain their work and contributions to health outcomes. In response to this need, the Minnesota Department of Health, Section of Public Health Nursing, initiated a process to describe public health nursing interventions. The Public Health Nursing Interventions (PHI) Model was developed through a collaborative process by public health nurses at the state and local levels. The purpose of the model was to define more clearly the practice of public health nursing and to describe better the work of public health nurses at the community and systems levels. The PHI model identifies 17 interventions and provides practice examples at the systems, community and individual/family levels. The model defines a broader view of the mission and scope of public health nursing. Practice examples are given for agency staff, administrators, educators, and policy makers.     

Community as Client: A Challenge for Nursing Education

Abstract The mandate of public health departments has been, and continues to be, to provide and deliver a variety of health programs and services pertinent to local circumstances and needs. Public health nurses are the largest group of health care professionals who deliver these services. The objectives of this paper are to identify what policy makers expect of public health nurses related to community development for health, and to describe the educational components necessary for baccalaureate nursing curricula if these expectations are to be met.     

Nursing Practice Conceptualized: An Interaction Model

This paper presents a broadly based conceptualized model of nursing practice. Nursing is defined as the therapeutic use of self for the benefit of others after first having acquired the knowledge and skill necessary to identify need. Essential to nursing is the interaction of nurse with client(s). Interactions can be diagnostic, therapeutic, educative, or supportive, and can address four categories of client needs: health, developmental, emotional, and interpersonal.     

Improving Healthy Work Environments Through Specialty Nursing Professional Development

A healthy work environment (HWE) is an interrelated system of people, structures, and practices enabling nurses to engage in work processes and relationships identified by clinical nurses as standards of quality care to patients in hospitals. In HWEs, nurses can make a maximum positive contribution to their patients and the organization. According to AACN, the six standards of an HWE include skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership. HWEs have been correlated with employee engagement and organizational commitment. Much of HWE literature findings are based on designs that assess the presence or absence of HWE and the outcomes of HWE. Few studies evaluate the impact of professional development interventions on HWE. The authors aimed to investigate the effect of an acute care professional development intervention for three nursing units on staff nurse perception of HWE.Study aimThis study aimed to administer a pre- and post-intervention assessment of the work environment among staff nurses working on acute care units in a Magnet® hospital in southeastern Louisiana.MethodsThis study used a pre-test and post-test single group study quantitative design where subjects completed online assessments before and after an educational intervention. The intervention included an educational presentation tailored for each hospital unit’s nursing specialty and patient population. Education topics reinforced the HWE standards and TeamSTEPPS® communication techniques to enhance teamwork. The online assessments included demographic questions and a valid and reliable AACN HWE survey. The HWE survey consists of 18 questions, 3 for each standard. The sample included staff nurses working in three acute care units. Demographic questions included gender, age, education, certification, participation in shared governance, career ladder participation, years in the current unit, hours worked per week, and years in nursing. Following the baseline assessment collection, an educational intervention was developed and delivered to the staff nurses. The intervention ranged from 4 to 8 hrs. It included specialty-focused education topics based on each unit’s patient populations (e.g., cardiac, pulmonary/sepsis, and stroke/renal care). The participants received information on certification, TeamSTEPPS® techniques for feedback, and conflict management. Following the intervention, electronic HWE surveys were sent to participants via e-mail for reassessment. Both the pre- and post-test participation was voluntary. No identifying information was collected, and the study was Institutional Review Board approved.ResultsA total of 53 staff nurses (50 females; 3 males) working among three acute care inpatient units completed the pre/post-test and intervention. The results were analyzed using SPSS. There was a significant increase in the means for 9 of 18 HWE survey questions from the pre- to post-test (P < .05). These results demonstrated a positive impact of the professional development intervention on staff nurse perception of HWE.ConclusionsImproving nurse work environments results in improved nurse empowerment, nurse satisfaction, and increased patient safety [DiChiara, J. (2015); https://revcycleintelligence.com/news/how-the-nursing-work-environment-affects-patient-outcomes]. This study demonstrated the benefit of a professional development that supported HWE standards on staff nurse perception of HWE in acute care work environments. This intervention study could serve as a strategy for units aiming to improve nurse perception of HWEs.