<p> Aim &amp; Objective: The aim of this project is to review the background literature and discuss the PICOt question as follows: In adult nursing students, age 30+, who are experiencing anxiety in the clinical setting, does peer dyad mentoring support in the clinical setting enable these students to decrease their anxiety level and pass their clinical effectively over a 90 day period of time?</p><p> Background: Clinical experience is an integral part of nursing education and prepares students nurses to integrate knowing with doing. Anxiety can cause a disruption in the learning and professional functioning of the student, and subsequently of the graduate nurse. Further to this, many non-traditional mature nursing students are adults entering the college or university setting with life experience unrelated to their new nursing career. They are attempting to balance work, home and school responsibilities. This anxiety has a variety of causes and also appears to have a variety of solutions.</p><p> Design: This project is a mixed method analysis, which contains both quantitative and qualitative aspects. Participants in the project were a convenience sample of Nursing students age 30+, in the BSN program at California State University Sacramento, willing to partake in this intervention, to assist in reducing their anxiety level during clinical. The project engages the use of true peer dyads (students at the same level of education) for the purpose of collaborative learning in the clinical setting. All subjects were given pre- and post-tests consisting of the State form of the State-Trait Anxiety Inventory (STAI). The State-Trait Anxiety Inventory for Adults&trade; (STAI-AD) is the definitive instrument for measuring anxiety in adults. The participants also completed a written qualitative interview guide at the end of the semester. </p><p> Results: The mean score of the STAI Anxiety Scale shows a definite decrease in anxiety after the peer dyad intervention in clinical. Of interest is the fact that the trait anxiety level also decreased in the final measurement. All sixteen mature students completed the peer dyad experience. The overall quantitative response to the peer dyad experience in clinical was a positive one according to the mature students involved.</p><p> Conclusions: Nursing students, are stressed and anxious in both the clinical setting (State anxiety) and appear to be more anxious in general (Trait anxiety). Formalized peer learning can decrease anxiety, help students learn effectively and is an important addition to the repertoire of learning activities that can enhance the quality of nursing education. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction, such as collaborative learning using student peer dyads.</p>

No description available.

<p> The purpose of this descriptive study is to collect the experiences of cervical cancer survivors related to the information they received from their health care providers about how their diagnosis and treatment may impact their sexuality and sexual health. The perspectives of the cervical cancer survivors will be used to modify public domain educational materials used in oncology practices and cancer support organizations to reflect a more patient centered approach to sexual health information. Study outcomes will contribute to existing knowledge through submission to appropriate journals and conferences to improve cancer patient-provider sexual health communication.</p><p>

Recently there has been a call for the enhancement of environmental health content in undergraduate curricula to help nurses become more familiar with environmental hazards which place their clients at risk. This survey was conducted among the 478 National League for Nursing (NLN) accredited undergraduate programs in the United States. This non-experimental, descriptive, and exploratory research was conducted to determine the following with respect to environmental health: (1) current and ideal emphasis, (2) faculty preparation, (3) competencies expected of graduates, (4) didactic and clinical contact hours allocated, (5) barriers and incentives to greater emphasis, and (6) differences among type of institution with respect to education in this topic. A mailed self-administered questionnaire was sent to the Deans of these programs. The response rate was 81.4%. Data analysis indicated that ideally 94% of respondents believed environmental health should be given moderate to substantial emphasis while only 73.4% actually provided this emphasis. As actual and ideal emphasis increased, the respondents' perception of faculty willingness to modify the curriculum to include environmental health content, faculty preparation to teach or provide clinical supervision in environmental health, and expected program graduates competencies also increased (p = 0.001). Most significant barriers to increased emphasis were an already overburdened curriculum, lack of qualified faculty to teach this topic, and lack of emphasis on the NCLEX. Factors likely to increase the emphasis were nursing faculty with expertise in environmental health, greater emphasis on environmental health on the NCLEX, and "other", most often the need for faculty development in this area. No evidence of any relationship between research questions and institutional type or size was found (p =.05). Findings contribute to nursing education by providing an assessment of the status of environmental health content in nursing education and clarify some of the complex reasons for the present neglect of environmental health in the education of professional nurses.

The delivery system of health care to Americans is in crisis. As costs continue to escalate, and as access to services deteriorates, an increasing number of individuals in need of physical and mental health care are experiencing difficulty accessing the necessary services. Changes in economic resources have resulted in quantitative shifts in mental health service delivery. A greater number of individuals seek mental health services as a result of the stress and anxiety created from a threatened or actual loss of financial stability. This increase in demand for service comes at a time when mental health programs are experiencing a decrease in resources which has resulted in reduced access to services. The emergency mental health service utilization patterns and client characteristics have changed during the same period of time that the overall mental health care delivery system has undergone transformation. However, the changes in mental health care have not necessarily evolved out of careful rational planning, but rather as a response to chaotic shifts in the mental health system at large. The purpose of this study was to gather data about access to these mental health outpatient services as they related to client diagnostic characteristics, system ability to provide the service needed, and ability of the service to meet the client's perceived need. The implications of the findings are clear. Access to services during a crisis was dependent upon system response, degree of psychopathology and a supportive environment. Any reform effort must include adequate crisis intervention and social services to meet the need of the changing population. Education for the general population and the professional would enhance understanding of the needs of the mentally ill and service availability.

<p> Individuals diagnosed with dementia make up the majority of the population in skilled nursing facilities (SNFs). Certified Nursing Assistants (CNAs) are the primary caretakers of older adults living in SNFs. The purpose of this grant project was to write a proposal for funding to provide Person-Centered Care (PCC) training to help CNAs enhance their skills to better enhance the quality of life of older adults living with dementia in SNFs. </p><p> The goal of PCC training is to help CNAs better understand the signs and symptoms of Alzheimer&rsquo;s and dementia, improve communication skills, and provide strategies to manage the behavioral and psychological symptoms of dementia. Previous research on PCC has found it to be effective in improving the quality of care of older adults who are affected by dementia and who are living in nursing homes. </p><p> Actual submission or funding of the grant was not required for the successful completion of this project.</p>

<p> Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided the theoretical framework to guide this quality improvement project. A 45-minute in-service and accompanying reference manual was given to 4 participating PCPs, along with a demographic questionnaire asking about their age, race, gender, marital status, and years in practice. Following the in-service, a 10-question self-completed questionnaire consisting of a combination of open-ended and nominal scale yes/no questions, was administered. A thematic analysis revealed 2 primary barriers for diagnosis without the FDST: lengthy screening time and trouble differentiating FMS from a patient&rsquo;s other conditions. In response to one of the yes/no questions, the participants all replied that the in-service on FDST was helpful in diagnosing FMS. Implications for social change include improved diagnosis with a diagnostic screening instrument, improved quality of health care, and cost effectiveness at the system level for chronic disease prevention and management. This project demonstrates in a localized primary care setting that the FDST may offers PCPs a reliable method to diagnose FMS.</p>

<p> The purpose of this study was to increase the knowledge level and change self-reported behavioral intent among a sample of healthcare providers regarding safe sleep messaging. From 1995 through 2015 in New York City, an average of one infant died every week from unsafe sleeping conditions. One agency in New York City experienced four unsafe sleep infant deaths within two months in 2010. In 2011, the city provided case managers with training on infant safety. Before this training, up to six sleep-related infant deaths were reported annually. The following year, one sleep-related infant death occurred. None occurred during the second year subsequent to the training. Current literature demonstrates healthcare providers have considerable influence on safe sleep messaging. This current study utilized a similar educational training designed for healthcare providers working in an urban health facility.</p><p> A single group pre/post-test quasi-experimental design was delivered to 23 participants. The design incorporated an online educational intervention in order to increase healthcare provider&rsquo;s knowledge level and change their self-reported behavioral intent to educate parents and caregivers on the importance of safe sleep practices. Data were gathered at pre-test and post-test to assess changes.</p><p> Final analysis, using a repeated measures general linear model, was carried out on data from the twenty-three participants who returned completed pre- and post-class surveys. There was a statistically significant change in the overall 13-item composite score reflecting knowledge level and change the self-reported behavioral intent from pretest (M=6.13, SD=2.78) to post-test (M=8.78, SD=3.79) at the p &lt;.001 level. These findings support current literature recommendations for healthcare providers to incorporate the safe sleep message into their practice. Nonetheless, supplementary research is needed to conclude whether these results coincide with communities elsewhere and to examine the issues regarding knowledge and behavioral intent regarding safe sleep messaging.</p>

<p> Heart failure readmissions place a significant financial burden on the healthcare system. Stakeholders of this system have utilized many approaches to reduce the number and costs of heart failure readmissions, without significant improvement. The purpose of this practice improvement project was to determine whether education on the financial impact associated with readmissions improved a patient&rsquo;s measured quality of life, encouraged adherence to a therapeutic regimen, and thereby reduced readmission rates in Medicare and Medicaid patients diagnosed with heart failure. Theoretical support is derived from the theory of self-care of chronic illness, which recognizes the complex self-care processes a patient with chronic illness negotiates. The project used a quantitative methodology with a pre-test/post-test design. A convenience sample was enrolled of 10 Medicare and Medicaid patients who had recurrent heart failure readmissions. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to collect pre/ post-intervention data which was then analyzed by two-tailed paired t-test. There was no statistically significant difference from the intervention to determine any impact on the participant&rsquo;s measured quality of life (<i>p</i> = .953; &alpha; = .05). However, none of the participants were readmitted during the 30 day period of this project. The findings indicate heart failure patients acknowledge their financial constraints but quality of life is not as impacted by finances as anticipated. Polypharmacy and uncertainty with managing daily regimens during symptom exacerbation were the greatest concerns. It is recommended that heart failure patient education should be persistent and individualized to address the patient&rsquo;s unique needs. </p><p>

<p> Participation in youth sports is increasingly popular with estimates of 35&ndash;40 million U.S. children playing an organized sport each year. Current concussion education has not been shown to be consistently effective. The risk of concussion exposure is present in a number of youth sports. Much of the research surrounding concussion reporting has targeted older adolescents. A better understanding of the reporting process among younger athletes is needed. </p><p> <b>Purpose of the Study:</b> The purpose of this study was to generate a grounded theory that explained concussion reporting in youth sports from the perspective of the young athletes. </p><p> <b>Design and Methods:</b> A grounded theory approach was used to gather and analyze data from semi-structured interviews with soccer players ages 5 to 12. The sample consisted of eleven athletes (8 male, 3 female) from non-elite soccer leagues in two counties; Maricopa, Arizona and Santa Barbara, California. </p><p> <b>Results:</b> Data analysis induced four conceptual categories; trusted environment, self-monitoring, being a player and incentive structure. The resultant theoretical model explains injury reporting from the perspective of young athletes. This study suggests that there is an incentive structure related to injury reporting, that young athletes have a good understanding of the incentives in relation to their perception of self as a player. Athletes demonstrate self-agency in terms of self-monitoring, however important adult others provide a trusted environment that makes children feel safe with their decisions. </p><p> <i>Implications:</i> This study suggests that a better understanding of the incentive structure embedded in the reporting process is needed to design effective prevention and education strategies. Important other adults such as parents and coaches may play a pivotal role in injury reporting among younger athletes when compared to adolescents.</p><p>