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Nursing Inquiry Apr 2024Racism in nursing is multifaceted, ranging from internalized racism and interpersonal racism to institutional and systemic (or structural) elements that perpetuate...
Racism in nursing is multifaceted, ranging from internalized racism and interpersonal racism to institutional and systemic (or structural) elements that perpetuate inequities in the nursing profession. Employing the socio-ecological model, this study dissects the underlying challenges across various levels and proposes targeted mitigation strategies to foster an inclusive and equitable environment for nursing education. It advances clear, context-specific mitigation strategies to cultivate inclusivity and equity within nursing education. Effectively addressing racism within this context necessitates a tailored, multistakeholder approach, impacting nursing students, faculty, administration, professional organizations, and licensing and accrediting bodies. This all-encompassing strategy recognizes that the interplay of interpersonal dynamics, community culture, institutional policies, and broader societal structures intricately shapes individual experiences. Nurses, nurse leaders, educators, organizations, and policymakers can work together to create a more equitable and inclusive nursing profession by targeting each of these levels. This transformational process can yield positive outcomes across various environments where nurses learn, work, and serve people and enable the demographic composition of nurses to better match the populations served.
PubMed: 38567694
DOI: 10.1111/nin.12639 -
Child and Adolescent Mental Health Sep 2023School-based mental health literacy interventions aim to prevent mental disorders and promote mental wellbeing through improving the knowledge and understanding of... (Review)
Review
BACKGROUND
School-based mental health literacy interventions aim to prevent mental disorders and promote mental wellbeing through improving the knowledge and understanding of mental health, mental disorders, and reducing stigma. Evidence suggests that good mental health literacy helps young people recognise mental health difficulties in themselves and in others, and seek help for mental health problems. Improved help-seeking can allow for early intervention, which prevents the progression of mental disorders and ultimately reduces the burden of mental disorders. The aim of this review is to identify and synthesise evidence on the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes.
METHODS
We searched MEDLINE, Embase, PsycINFO, ERIC, Child Development and Adolescent Studies, British Education Index and ASSIA (June 2020). Additional searches were conducted a year later to identify any new publications (June 2021). We included randomised controlled trials (RCTs) assessing the effectiveness or cost-effectiveness of school-based interventions to improve help-seeking outcomes for children and young people aged 4-18 years. Included studies were critically appraised.
RESULTS
We identified 11 studies investigating help-seeking outcomes of school-based mental health literacy interventions including a total of 7066 participants from 66 secondary schools. Overall, there is no strong evidence for the effectiveness of school-based mental health literacy interventions in improving help-seeking outcomes, including general attitudes towards help-seeking, personal intentions to seek help, knowledge of when and how to seek help for mental disorders, confidence to seek help, and actual help-seeking behaviours. None of the studies investigated the cost-effectiveness of the interventions.
CONCLUSION
The lack of standardised measures with established reliability and validity for help-seeking outcomes, and the incomprehensive consideration of the multi-faceted concepts of MH literacy and MH stigma have contributed to the scarcity of evidence for the effectiveness. Future research should focus on developing standardised measurement tools and including economic evaluations to understand pragmatic and financial aspects of school-based mental health literacy interventions.
Topics: Child; Adolescent; Humans; Mental Health; Health Literacy; Mental Disorders; School Nursing; Schools
PubMed: 36377083
DOI: 10.1111/camh.12609 -
Journal of Professional Nursing :... 2023A diverse nursing workforce is key to addressing health disparities and moving the United States towards health equity. Building and sustaining a diverse nursing work...
A diverse nursing workforce is key to addressing health disparities and moving the United States towards health equity. Building and sustaining a diverse nursing work force requires close attention to admissions, including interviews. Bias in nursing school interviews has been documented, particularly impacting applicants from historically excluded groups (especially racial and ethnic minorities). With the pivot to remote interviews due to Covid 19, faculty and schools now need to consider bias in remote interviews. This article describes the implementation and outcomes of a faculty training to identify and mitigate bias in remote interviews.
Topics: Humans; United States; Nurse Practitioners; Schools, Nursing; Faculty
PubMed: 38042549
DOI: 10.1016/j.profnurs.2023.09.008 -
NASN School Nurse (Print) Nov 2023Skin infections in high school athletes pose a risk of transmission to other student athletes. Therefore, it is important to promptly identify possible skin infections...
Skin infections in high school athletes pose a risk of transmission to other student athletes. Therefore, it is important to promptly identify possible skin infections and refer them to the healthcare provider for treatment so athletes can return to play quickly and with little interruption to the team. Common skin infections include bacterial infections such as Streptococcus and Staphylococcus, viral infections such as herpes simplex and molluscum contagiosum, and fungal infections such as tinea corporis and capitis. The National Federation of State High School Associations provides guidance for the prevention of skin infections as well as return to play guidelines. The school nurse and high school athletic trainer are both healthcare professionals who play a role in preventing, identifying, monitoring, and caring for student athletes who contract skin infections.
Topics: Humans; School Nursing; Sports; Athletes
PubMed: 37746732
DOI: 10.1177/1942602X231199768 -
NASN School Nurse (Print) Sep 2023
Topics: Humans; School Nursing; Education, Continuing; Students, Nursing
PubMed: 37496426
DOI: 10.1177/1942602X231187211 -
The Journal of School Nursing : the... Nov 2023Youth between ages 13 and 25 who experience homelessness face numerous barriers to excellent health, including social stigma and discrimination. Applying... (Review)
Review
Youth between ages 13 and 25 who experience homelessness face numerous barriers to excellent health, including social stigma and discrimination. Applying socio-ecological model and intersectionality theory, an integrative literature review was conducted. Peer-reviewed studies (= 29) representing 808,296 participants extracted from four databases (CINAHL, MEDLINE, PsychINFO, SocINDEX) were analyzed. The studies included sources of discrimination and stigma from interpersonal interactions with support services staff upwards to policy and systemic levels with housing and justice systems. Health outcomes include poorer physical and behavioral health status from increased likeliness of denied access to support services, prolonged time spent being homeless, and higher incidences of experiencing violence. School nursing has power to push for recommended changes and support unhoused youth towards excellent health. Proposed changes include adapting Housing First framework, engaging with unhoused youth in program planning, policy writing, and public education that address the causes of poverty.
PubMed: 37994006
DOI: 10.1177/10598405231214061 -
Nurse Education Today Jun 2024Nursing students report facing inconsistencies between theoretical knowledge and actualities of clinical practice, and research indicates they witness missed nursing... (Review)
Review
BACKGROUND
Nursing students report facing inconsistencies between theoretical knowledge and actualities of clinical practice, and research indicates they witness missed nursing care during clinical practice. Understanding nursing students' experiences can inform improved clinical learning environments and enhance patient care quality. Recently, research has focused on students' views regarding missed care, yet comprehensive understandings of this phenomenon are lacking.
OBJECTIVE
This review explored what is known about missed nursing care from perspectives of nursing students.
DESIGN
A scoping review according to Arksey and O'Malley's framework and Joanna Briggs Institute methodology was undertaken.
DATA SOURCES
Key databases were searched, including Medline, Embase, CINAHL, Scopus, ProQuest, PsycINFO and Web of Science in August 2023.
REVIEW METHODS
The review included qualitative, quantitative, and structured literature reviews published in English between 2006 and 2023. Inclusion and exclusion criteria and keywords guided the search. Data screening and extraction were independently performed by two reviewers. Included studies were analysed using descriptive statistics and narrative synthesis. Findings are reported in accordance with the PRISMA-ScR.
RESULTS
Of the 5873 articles identified, nine were included in the review. Studies were conducted in seven countries. Themes in students' perceptions included negligence of patients' rights and dignity, living in limbo, and pragmatic acceptance. Reasons for missed care included ineffective teamwork, lack of interest in caring, and inefficient leadership. Missed nursing care adversely affected patient health, hindered student learning and professional growth. Strategies for improvement included enhancing teamwork, enforcing ethical issues, increasing supervision, and creating commitment to work.
CONCLUSION
Missed nursing care affects patient safety and education of nursing students. Incorporating practical training modules into curricula, establishing preceptorship programs, and incorporating ethics education into clinical practice are crucial to address missed nursing care. Further research in diverse settings is warranted.
Topics: Humans; Students, Nursing; Nursing Care; Learning; Curriculum; Clinical Competence
PubMed: 38518403
DOI: 10.1016/j.nedt.2024.106169 -
The Journal of School Health Oct 2023From a range of perspectives, scholars have demonstrated the value of school-based health centers (SBHCs) in recent decades, but few studies have examined the logistics...
BACKGROUND
From a range of perspectives, scholars have demonstrated the value of school-based health centers (SBHCs) in recent decades, but few studies have examined the logistics of establishing SBHCs.
METHODS
Semi-structured interviews were conducted with 9 hospital and 6 school employees involved in a network of SBHCs. After common themes were identified, cluster analysis was performed. Finally, quotes were identified within each thematic cluster for further qualitative analysis.
RESULTS
The most prominent themes were (1) differences in physical space (between schools and clinical settings), (2) collaboration and communication, and (3) privacy and compliance.
IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY
This study points to several high yield considerations for the practice of SBHCs. First, we identified three distinct needs: (1) clear funding streams for construction costs for health services on school grounds, (2) improved understanding of SBHC space needs, and (3) blueprints for collaborating within SBHCs. Second, this study points to a future in which new-build and renovated schools should include space for SBHCs.
CONCLUSIONS
This qualitative thematic analysis provides a picture of health and educational professionals engaged in creative, collaborative, and adaptive work to meet children's health care needs within SBHCs, but also highlights the challenges of navigating physical space, compliance, and collaboration within SBHCs.
Topics: Child; Humans; Adolescent; School Health Services; School Nursing; Adolescent Health Services; Schools; Health Policy
PubMed: 37356453
DOI: 10.1111/josh.13361 -
Nurse Education Today Aug 2023To improve health equity, nursing curricula should include content specific to the needs of marginalized and underserved communities, such as lesbian, gay, bisexual,...
BACKGROUND
To improve health equity, nursing curricula should include content specific to the needs of marginalized and underserved communities, such as lesbian, gay, bisexual, transgender, queer, and intersex groups (LGBTQI+). Harmful and absent academic discussions of LGBTQI+ patients lead to provider discomfort and inadequacy in treating this patient population. Nursing schools are well-positioned to increase comfort with LGBTQI+ content as part of pre-licensure curricula. This article presents a systematic evaluation of LGBTQI+ content in nursing pre-licensure textbooks and the nature and quality of the representations.
METHODS
A qualitative descriptive analysis of LGBTQI+ content from 14 nursing-specific textbooks required by a pre-licensure degree program at the Johns Hopkins School of Nursing was conducted by a student-led team with faculty oversight. A priori and iterative search terms were used to identify and extract text segments that referenced LGBTQI+ content in each textbook. An iterative codebook was developed, codes were applied, and analysis of the information and context in which the terms were presented was performed.
RESULTS
The research team observed gaps and notable patterns in distribution of LGBTQI+ terms and health content areas across the textbooks reviewed. The majority of LGBTQI+ search terms were identified in the following health content areas: social determinants of health, sexual/reproductive health, pediatric sexual & gender diversity, intersectionality, and infectious disease. Based on qualitative descriptive analyses, the data were organized into the following categories: a) Language; b) Medicalization; c) Vague, Incomplete, or Lacking Specificity; and d) Comprehensive Approach.
CONCLUSION
Findings highlight the need for increased academic exposure for pre-licensure nursing students regarding the care of LGBTQI+ patients. Thoughtful inclusion of LGBTQI+ content may better foster the delivery of evidence-based care for this patient population. These findings underscore the need for improved nursing curricula to support nurses in delivering affirming care for LGBTQI+ populations.
Topics: Female; Humans; Child; Sexual and Gender Minorities; Transgender Persons; Licensure, Nursing; Curriculum; Students, Nursing
PubMed: 37247591
DOI: 10.1016/j.nedt.2023.105858 -
The Journal of School Nursing : the... Nov 2023School nurses improve public health through vaccine promotion and mandate compliance. Despite recommendations and support for comprehensive adolescent HPV vaccination...
School nurses improve public health through vaccine promotion and mandate compliance. Despite recommendations and support for comprehensive adolescent HPV vaccination from organizations like the National Association of School Nurses as of 2023 only Virginia, Washington DC, Rhode Island, and Hawaii mandate HPV vaccine in schools. Virginia's mandate allows caregivers to opt out of vaccination. It is important to consider how school-level vaccine compliance is associated with school and community factors. A multilevel analysis explored the association between school and county-level factors and HPV vaccination rates. This study shows schools that report higher rates of economically disadvantaged students had higher HPV vaccine coverage. HPV vaccine rates increased from 2019 to 2021 after the implementation of a gender-inclusive mandate. Virginia HPV rates still lag behind states with no mandate. The results suggest that school nursing practice related to HPV vaccine compliance may be impacted by community factors like economic status.
PubMed: 38031333
DOI: 10.1177/10598405231214981