<p> Heart Failure readmissions (HFR) significantly contribute to all cause hospital readmissions rates. Current evidence on the effectiveness of interventions for reduction of HFR is inconclusive. Recent research suggests that nurses&rsquo; emotional intelligence (EI) may be associated with better patient outcomes. </p><p> The purpose of this study was to examine if nurses&rsquo; EI is significantly related to HFR and if that relationship is mediated through patient satisfaction with care. One hundred and thirty six Registered Nurses were recruited from 11 in-patient units at a large teaching hospital in the south eastern United States. Two surveys were mailed to eligible participants; the Bar-On Emotional Quotient Inventory 2.0 and a demographic survey. Patient satisfaction was measured with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The unit of observation for the analysis of the current study was the individual nursing unit with monthly measures for 14 months. Nurses EI was assessed at a single point in time and served as the basis for the data collected. </p><p> Results of one-way ANOVA showed a non-significant small trend of higher total EI being associated with lower rates of HFR. The generalized estimating equation model was used to account for correlated observations and revealed a greater non-significant likelihood for higher total EI to translate to no HFR. Results of Pearson&rsquo;s correlations found non-significant positive correlations between nurses total EI and the patient satisfaction items of rate hospital, nurses&rsquo; courtesy and respect, nurse listening, nurse explaining, and nurse communication. The linear mixed model to account for correlated observations showed small non-significant trends for total nurse EI and all patient satisfaction items. Results of one-way ANOVA showed no association between patient satisfaction and HFR. When accounting for correlated observations, increases in total nurse EI were not significantly associated with the predicted odds of no HFR. In conclusion, the examination of the aims in this study demonstrated results that were in the expected direction but not at the level expected. The findings of this study indicate that there is a need to further examine how nurses&rsquo; EI may influence patient outcomes. </p>

<p> HIV/AIDS epidemic is a significant public health issue in the United States (U.S.). A dearth of research focusing on the need to increase HIV screening across healthcare settings (Branson et al., 2006; Centers for Disease Control and Prevention [CDC], 2010) exists, yet few studies focus on the healthcare providers perspective. Utilizing the Theory of Planned Behavior (TPB), this study examined nurse practitioner (NP) attitudinal, normative, and control beliefs toward routine HIV screening and their associations and relationships with intentions and behaviors.</p><p> A cross sectional study was conducted using a random sample of 600 members from the American Academy of Nurse Practitioners. A total of 180 NPs completed a questionnaire. SPSS Version 22 was used for analysis. Although NPs care for a majority of patients aged 13 - 64, few (25.3%) report routine HIV screening while almost half (48.2%) report having intentions. NPs with higher HIV screening intentions were associated with higher HIV screening behaviors, positive attitude scores, higher normative expectation scores, higher normative priority scores, higher facilitator scores, and lower control barrier scores. Logistic regression revealed that social normative expectations and control facilitators predicted intentions toward routine HIV screening. Higher HIV screening behaviors were associated with positive attitude scores, higher normative expectation scores, and lower control barrier scores. Logistic regression revealed that social normative expectations and attitudes predicted behaviors toward routine HIV screening. Logistic regression revealed few beliefs or demographic variables predicted intentions and behaviors. Practicing for 10 -20 years predicted HIV screening intentions, while belief of obtaining consent from a parent/guardian in patients &lt;18 years of age, both rural and suburban communities, and having little to no specialty education in HIV screening were found to be most predictive of not routinely screening for HIV. Office staff support was found to be most predictive of HIV screening behaviors. The TPB is a valuable framework to examine healthcare provider behavior. The NP plays an important role in screening and case finding while focusing on health promotion and disease prevention. Greater coordinated efforts are needed to help NPs incorporate universal HIV screening into healthcare settings. </p>

<p> The Use of Coaching Sessions and a Mobile Reminder Application to Enhance Medication Adherence in Adults at an Outpatient Psychiatric Clinic by Jorge Luis Trujillo The primary aim of this Clinical Scholarly Project was to assess the effectiveness of coaching sessions and a mobile reminder application to enhance medication adherence in adults at an outpatient psychiatric clinic. Several studies have suggested that patients with chronic health conditions adhere to 50&ndash;60% of the prescribed medication regimen. However, up to 80% of patients with psychiatric disorders fail to comply with their medication regimens. This translates into annual costs of $100&ndash;$300 billion per year for individual patients and healthcare systems, which significantly burdens the current healthcare system. </p><p> A pre- and post-quasi-experimental time series design was implemented for four months. The group of 15 participants was monitored for the first two months, using traditional care (e.g., presenting at the outpatient psychiatric clinic for evaluation, diagnosing, and medications management). After two months, the same group received the interventions: coaching sessions and a mobile reminder application. To determine whether the aims of the project were met, an independent paired t-test was performed to compare pre- and post-intervention data.</p><p> Conclusion: A paired-samples t-test confirmed that the medication adherence rates differed between the two post-intervention months (Times 3 and 4), <i>t</i>(9) = 6.00, <i>p</i> &lt; .01.</p>

<p> In the United States, one out of every thirty-three infants is born with some sort of birth defect or congenital malformation. Certain risk factors such as age and substance use increase the likelihood of having a baby afflicted with a defect and public health nurses have worked tirelessly to educate the public about these factors. In addition, thanks to modern medicine, many defects are detected early in pregnancy, which allows for careful monitoring and planning for the delivery. In spite of these gains, birth defects continue to dominate the public health arena because they are a leading cause of death for infants and play a prominent role in long-term morbidity and disability.</p><p> Gastroschisis and omphalocele are abdominal wall defects that present with herniation of intestines and organs due to failure of abdominal wall closure during embryonic development. Of the two abdominal wall defects, gastroschisis has demonstrated a worldwide increase in prevalence over the last three to four decades. The common denominator in the literature is young maternal age. However, the relationship between maternal age and gastroschisis is unclear. This study utilized birth certificate data from New York State to examine the relationship between maternal characteristics and delivering an infant with gastroschisis.</p><p> In this study, the infants diagnosed with gastroschisis were mostly singleton births born at an earlier gestation (34-36 weeks) and a lower birth weight (1500-2499 gm) than infants without gastroschisis. From a demographic perspective, mothers of infants with gastroschisis were more likely to be younger (&le;24), Hispanic or less educated. The findings also revealed that mothers of infants with gastroschisis were more likely to have inadequate prenatal care, use tobacco, illicit drugs or have a sexually transmitted disease. Mothers of infants with gastroschisis were also more likely to live in a non-metropolitan county or fall into a lower socioeconomic status. Further research is needed to continue examining the relationship between maternal characteristics and a diagnosis of gastroschisis in the newborn infant.</p>

<p> The nursing faculty shortage has impacted the ability of nursing programs to enroll, educate, and graduate the number of students who are interested in careers in the profession of nursing. The educational institutions are expected to maintain a certain enrollment or even increase enrollment in order to meet the demands of the healthcare delivery system in the area of nursing. The ability to meet these demands will be difficult with the nursing faculty shortage. The purpose of this qualitative research study was to investigate the benefits or barriers that nurses encountered when transitioning into roles in academia from roles of clinical practice in the patient care setting. Three educational institutions participated in the research study, with 10 participants volunteering for the interview process. The semi-formal interviews were conducted to obtain information regarding influential factors when choosing a career in nursing, motivating factors when choosing a career in nursing education, benefits and barriers in the transition process, and similarities and differences noted between the nursing roles in clinical practice and academia. The transition processes from a role in clinical practice into the role in academia were described by the participants. The results of the interviews were categorized into three themes that focused on motivating/influential factors, benefits, and barriers. Findings of the study could be used in the development of a recruitment tool that focuses on the benefits of a nursing role in academia. </p>

<p> African Americans&rsquo; tendency to choose life-prolonging treatments (LPT) over comfort focused care (CFC) at end-of-life is well documented but poorly understood. There is minimal knowledge about African American (AA) perceptions of decisions to continue or discontinue LPT. The purpose of this study was to examine AA family members&rsquo; perceptions of factors that influenced end-of-life care decision-making for a relative who recently died from serious illness. A conceptual framework informed by the literature and the Ottawa Decision Support Framework was developed to guide this study. A retrospective, mixed methods design combined quantitative and qualitative descriptive approaches. Forty-nine bereaved AA family members of AA decedents with serious illness who died between 2 to 6 months prior to enrollment participated in a one-time telephone interview. Outcomes examined include end-of-life treatment decision, decision regret, and decisional conflict. Quantitative data were analyzed using descriptive statistics, independent-sample t-tests, Mann-Whitney U tests, chi-square tests, Spearman and Pearson correlations, and linear and logistic regressions. Qualitative data were analyzed using content analysis and qualitative descriptive methods. Family members&rsquo; decisional conflict scores were negatively correlated with their quality of general communication (rs = -.503, p = .000) and end-of-life communication scores (rs = -.414, p = .003). There was a significant difference in decisional regret scores between family members of decedents who received CFC versus those who received LPT (p = .030). Family members&rsquo; quality of general communication (p = .030) and end-of-life communication (p = .014) were significant predictors of family members&rsquo; decisional conflict scores. Qualitative themes related to AA family members&rsquo; experiences in end-of-life decision-making included understanding (e.g., feeling prepared or unprepared for death), relationships with healthcare providers (e.g., being shown care, distrust) and the quality of communication (e.g., being informed, openness, and inadequate information). Additional qualitative themes were related to perceptions of the decision to continue LPT (e.g., a lack of understanding, believe will benefit) or discontinue LPT (e.g., patient preferences, desire to prevent suffering). In conclusion, this study generated new knowledge of the factors that influenced AA bereaved family members&rsquo; end-of-life decision-making for decedents with serious illnesses. Directions for future research were identified.</p>

<p> The Hispanic population is the fastest growing minority in the United States and is also a minority in the cystic fibrosis (CF) community. Therefore, an increase in CF in the U.S. might be anticipated. This study explored stories of Hispanic mothers&rsquo; perspectives of parenting their child with CF, health beliefs, and health care experiences. The study interviewed 10 mothers of which half were English speaking. Narrative structural and thematic analyses were applied through a critical feminist lens. The major themes that emerged were mothering, growing and growth, mother talk, and connected; all informed by Ruddick&rsquo;s (1995) framework on maternal thinking. Additional major themes were life disrupted and being here. Findings were consistent with existing literature of the dominant Euro-American culture of being a mother of a child with CF. Health beliefs specific to CF care were aligned with prescribed medical treatments. Language emerged as a primary barrier for Spanish-speaking mothers. Mothers acknowledged an existing lack of awareness of CF in the Hispanic community and as underrepresented within the larger CF community. They expressed a desire to see a shift of stereotyped Caucasian images of CF to represent Hispanic people to promote greater awareness in the Hispanic communities and with health care providers.</p>

<p> Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson&rsquo;s theory of transpersonal caring. Program development was guided by a team of interdisciplinary stakeholders in the institution, including a nurse educator, institutional directors of both education and nursing departments, and senior staff nurses who agreed agreeing to function as project coordinators. The peer-reviewed literature and institutional contexts informed program conceptualization and planning for implementation and planning. A series of meetings were held in which the project team explored and discussed available evidence relative to institutional context and needs. The primary product of the project was a mentoring program, and secondary products include plans for implementation and evaluation of that program by the institution in the future as part of a broader institutional initiative. The developed program was shared with 5 nurse scholars with relevant expertise as a content validation process, with revisions made in accordance with feedback. The implementation and evaluation plans include all details necessary for operationalizing as well as evaluating merit and worth of the program over time.</p>

<p> The traditional new graduate nurse (NGN) orientation process places NGN with an experienced preceptor for 24 weeks and requires clinical skills checklists to be completed by the preceptor, a practice which is not an evidence-based practice for orienting NGNs. The purpose of this quality improvement project was to develop an evidence-based orientation to decrease time requirements and standardize the processes and evaluation of the NGN in the emergency department. The project was informed by Benner&rsquo;s novice to expert theory and focused on acquisition of clinical skills. The project team included 6 stakeholders: the Doctor of Nursing Practice student-leader, the unit manager, and several preceptors and novice nurses. The current evidence was identified utilizing various search terms via OVID, CINAHL, and MEDLINE. Five emergency department nurse residency programs and 7 rubric-based criterion articles were identified and evaluated. The team synthesized the available evidence to create the program. Resulting products included guidelines, evaluation rubrics, and projected pathways for ongoing development. Content validation was undertaken using peer review by 2 nurse scholars with area expertise, after which the project team revised all products based on feedback. Together, these products comprise an evidence-based solution to the problematic orientation of NGNs in the institution&rsquo;s emergency department. Adoption of methods that have proven valuable in undergraduate education, such as incorporation of syllabi and rubrics, may increase retention and improve clinical judgment in the NGN. These improved educational outcomes will, in turn, promote improved health outcomes for patients. Outcomes for the project will be monitored using retention rates and the results of the Casey-Fink Graduate Nurse Experience Survey.</p>

Background: Intensive care unit (ICU) nurses may experience cumulative loss as they are routinely exposed to traumatic situations, patient suffering, and death. They must also deal with personal grief and grief of patients' family in a time of uncertain crisis. Currently, there is minimal literature that acknowledges grieving and coping in the ICU. The grief and coping experiences of medical intensive care unit (MICU) nurses is little understood. Purpose: Explore grief and coping amongst registered nurses working in the MICU at a major metropolitan hospital in Hawaii. Method: A qualitative descriptive approach was used. Open-ended interviews and a brief demographic questionnaire were used to collect data from five registered nurses who work in the MICU. A pragmatic approach to qualitative data analysis was used. Results: The findings of this study are presented in two main categories: grief and coping. Subthemes of grief are further described in the following categories: 1) circumstance of death; 2) keeping professional boundaries; 3) being supported; and 4) learning from experience. Coping is addressed by describing the main methods used by the nurse participants. Coping includes: 1) talking and being heard; 2) finding a support system; 3) using humor; and 4) spirituality. Findings suggest that MICU nurses have unique grief experiences and their coping is individualized. The nurses are aware of the effects grief has on their personal and professional lives. Additionally, they all seem to have developed effective coping habits to manage grief. Conclusion: There is no single method to manage grief responses. However, there is a level of mutual understanding of experiencing death in the MICU, which yields support and camaraderie amongst MICU nurses. Further research is needed to explore differences in other ICUs.