President’s Pen...Volume 65 • No. 2 THE OFFICIAL PUBLICATION OF THE KENTUCKY NURSES ASSOCIATION...
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The Kentucky Nurses Association (KNA) wishes to thank Maureen Keenan JD, MAT, for her many years of commitment and leadership as the Executive Director (ED) of the KNA. Maureen’s 15 years of dedication and expertise made a positive contribution to the growth of our organization. Maureen was actively engaged in many activities, including her role as an Editor of the Kentucky Nurse. In addition to her ED duties, Maureen presented KNA information to nursing classes, provided legislative updates, participated with the Kentucky Board of Nursing and other organizations for vacancies on boards, participated in the KNA School Nurse Initiative, and activities with the Kentucky Center for Nursing and the Kentucky Nurses Foundation. She planned and participated in the ANA President’s visit to Kentucky, assisted with the coordination of Surviving Your First Year for nursing students, participated in the KNA Cabinets and Committees activities, made improvements to the KNA website, and assisted with the development of the Doctoral Scholarship program. She was instrumental in the transition of districts to chapters for the KNA. She was respected by other organizations, and her opinion was frequently sought for matters requiring diplomacy and negotiation skills. Maureen regularly participated in American Nurse current resident or Presort Standard US Postage PAID Permit #14 Princeton, MN 55371 Index Volume 65 • No. 2 April, May, June 2017 THE OFFICIAL PUBLICATION OF THE KENTUCKY NURSES ASSOCIATION Quarterly publication direct mailed to approximately 83,000 Registered Nurses & LPNs in Kentucky If you are not a KNA member, how can we make you ‘want to be?’ If you are a member – thank you for ‘saying yes.’ Please ensure your email and profile information are current at www.nursingworld.org. We want to make sure you are getting the latest information about nursing, meetings, and events. Together, we can make a difference in speaking for Kentucky Nurses and the Commonwealth of Kentucky. If you are not a KNA member and would like to join please visit: President’s Pen President’s Pen continued on page 3 Advanced Directives and Advanced Care Planning for Healthcare Professionals Page 6 Student Spotlight Combating Obesity: Teaching Children to Eat Right Page 10 Chapter News Page 4 Save the Dates: KNA Convention 2017 November 2nd, 2017 – Louisville November 3rd, 2017 – Lexington Are you a member yet? www.JoinANA.org Kathy Hager Teresa Huber President’s Pen . . .................. 1, 3 Chapter News ..................... 4-5 Promoting Influenza Immunizations for Seniors in South Central Kentucky .... 6 Calendar of Events ................... 7 Heroin Epidemic: Impact on Foster Care ............ 8-9 Combating Obesity: Teaching Children to Eat Right .... 10-11 Accent on Research ............... 12-19 Members of the 2017 KNA Leadership Retreat
Transcript of President’s Pen...Volume 65 • No. 2 THE OFFICIAL PUBLICATION OF THE KENTUCKY NURSES ASSOCIATION...
The Kentucky Nurses Association (KNA) wishes to thank Maureen Keenan JD, MAT, for her many years of commitment and leadership as the Executive Director (ED) of the KNA. Maureen’s 15 years of dedication and expertise made a positive contribution to the growth of our organization. Maureen was actively engaged in many activities, including her role as an Editor of the Kentucky Nurse. In addition to her ED duties, Maureen presented KNA information to nursing classes, provided legislative updates, participated with the Kentucky Board of Nursing and other organizations for vacancies on boards, participated in the KNA School Nurse Initiative, and activities with the Kentucky Center for Nursing and the Kentucky Nurses Foundation. She planned and participated in the ANA President’s visit to Kentucky, assisted with the coordination of Surviving Your First Year for nursing students, participated in the KNA Cabinets and Committees activities, made improvements to the KNA website, and assisted with the development of the Doctoral Scholarship program. She was instrumental in the transition of districts to chapters for the KNA. She was respected by other organizations, and her opinion was frequently sought for matters requiring diplomacy and negotiation skills. Maureen regularly participated in American Nurse
current resident or
Presort StandardUS Postage
PAIDPermit #14
Princeton, MN55371
Index
Volume 65 • No. 2 April, May, June 2017THE OFFICIAL PUBLICATION OF THE KENTUCKY NURSES ASSOCIATIONQuarterly publication direct mailed to approximately 83,000 Registered Nurses & LPNs in Kentucky
If you are not a KNA member, how can we make you ‘want to be?’ If you are a member – thank you for ‘saying yes.’ Please ensure your email and profile information are current at www.nursingworld.org. We want to make sure you are getting the latest information about nursing, meetings, and events. Together, we can make a difference in speaking for Kentucky Nurses and the Commonwealth of Kentucky. If you are not a KNA member and would like to join please visit:
President’s Pen
President’s Pen continued on page 3
Advanced Directives and Advanced Care Planning for
Healthcare ProfessionalsPage 6
Student SpotlightCombating Obesity:
Teaching Children to Eat RightPage 10
Chapter NewsPage 4
Save the Dates: KNA Convention 2017
November 2nd, 2017 – LouisvilleNovember 3rd, 2017 – Lexington
Are you a member yet?
www.JoinANA.org
Kathy Hager
Teresa Huber
President’s Pen . . . . . . . . . . . . . . . . . . . . 1, 3
Chapter News . . . . . . . . . . . . . . . . . . . . . 4-5
Promoting Influenza Immunizations for
Seniors in South Central Kentucky . . . . 6
Calendar of Events . . . . . . . . . . . . . . . . . . . 7
Heroin Epidemic:
Impact on Foster Care . . . . . . . . . . . . 8-9
Combating Obesity:
Teaching Children to Eat Right . . . .10-11
Accent on Research . . . . . . . . . . . . . . .12-19
Members of the 2017 KNA Leadership Retreat
Page 2 • Kentucky Nurse April, May, June 2017
Published by:Arthur L. Davis
Publishing Agency, Inc.
www.kentucky-nurses.org
“The purpose of the Kentucky Nurse shall be to convey information relevant to KNA members and the profession of nursing and practice of nursing in Kentucky.”
Copyright #TX1-333-346For advertising rates and information, please contact Arthur L.
Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. KNA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.
Acceptance of advertising does not imply endorsement or approval by the Kentucky Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. KNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of KNA or those of the national or local associations.
The Kentucky Nurse is published quarterly every January, April, July and October by Arthur L. Davis Publishing Agency, Inc. for Kentucky Nurses Association, P.O. Box 2616, Louisville, KY 40201, a constituent member of the American Nurses Association. Subscriptions available at $18.00 per year. The KNA organization subscription rate will be $6.00 per year except for one free issue to be received at the KNA Annual Convention. Members of KNA receive the newsletter as part of their membership services. Any material appearing herein may be reprinted with permission of KNA. (For advertising information call 1-800-626-4081, [email protected].) 16mm microfilm, 35mm microfilm, 105mm microfiche and article copies are available through University Microfilms International, 300 North Zeeb Road, Ann Arbor, Michigan 48106.
EDITORIAL BOARD 2016 - 2017
EDITORSIda Slusher, PhD, RN, CNE (2016-2019)
MEMBERSPatricia Calico, PhD, RN (2015-2018)
Sherill Cronin, PhD, RN-BC (2014-2017)Summer Cross, PhD, APRN, FNP-BC (2016-2019)Vickie Ann Miracle, RN, EdD, CCRC (2016-2019)
Kim Hawkins, PhD, APRN, CHSE (2014-2017)Cathy H. Abell, PhD, MSN, MS, RN, CNE (2016-2019)
REVIEWERSTiffany Cabibbo MSN, BSN, RN, CENP
Deborah Chilcote MSN, RNC, BADawn Garrett-Wright, PhD, RN
Elizabeth “Beth” Johnson, PhD, RNConnie Lamb, PhD, RN, CNE
KNA BOARD OF DIRECTORS
PRESIDENTKathy Hager, DNP, APRN, FNP-BC, CDE (2016–2018)
IMMEDIATE PAST PRESIDENTTeresa H. Huber, DNP, MSN, RN (2014–2016)
VICE-PRESIDENTDana Todd, PhD, APRN (2015-2017)
SECRETARYBeverly D. Rowland, PhD, RN, CNE (2015-2017)
TREASURERJoe B. Middleton, DNP, APRN, NP-C, CEN, CC/NRP (2016-2018)
DIRECTORS-AT-LARGETeena L. Darnell, DNP, RN (2015–2017)
Dr. Michael Wayne Rager, PhD, DNP, MSN, FNP-BC, APRN(2015-2017)
Liz Sturgeon, PhD, RN, CNE (2016-2018)Kathy Mershon, RN, MSN, CNAA, ANEF, FAAN (2016-2018)
EDUCATION & RESEARCH CABINETJudy Ponder, DNP, MSN, RN (2016-2018)
GOVERNMENTAL AFFAIRS CABINETAmy Herrington, DNP, RN, CEN (2016-2018)
PROFESSIONAL NURSING PRACTICE &ADVOCACY CABINET
Karen Blythe, MSN, RN, NE-BC (2015-2017)
KNA CE AdministratorJudy Ponder, DNP, MSN, RN
KNF PRESIDENTJo Singleton, DNP, MSN, RN-BC
KANS CONSULTANTChristy Ralston, RN, BSN, CCMC
KNA STAFF
EXECUTIVE DIRECTORMelissa Mershon
DIRECTOR OF COMMUNICATIONSMichelle Lasley
ADMINISTRATIVE COORDINATORLisa Snyder
Chapters Presidents and Treasurers - 2016–2017RIVER CITY CHAPTER (FORMERLY DISTRICT 1)
CO-PRESIDENTS: Megan Carter, MSN, RN, PCCN-CMC, CNML (2016-2018) P: 972-989-5705 W: 502-897-8373 12517 Live Oak Drive Louisville, KY 40243 Email: [email protected]
Christy Ralston, RN, BSN, CCMC P: 502-386-7261 W: 502-629-3617 4300 Forest Bend PL Louisville, KY 40245 E-mail: [email protected]
TREASURER: TBA
BLUEGRASS CHAPTER (FORMERLY CHAPTER 2)
PRESIDENT: Ida Slusher, RN 231 Churchill Xing Nicholasville, KY 40356 E-Mail: [email protected]
SECOND VICE-PRESIDENT : Kendra Foreman, MSN, RN 859-550-3491 571 Longview Dr. Lexington, KY 40503 E-mail: [email protected]
TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529 Lexington, KY 40515 W: 859-323-0733
NORTHERN KENTUCKY CHAPTER (FORMERLY DISTRICT 3)
PRESIDENT: Teresa Williams, MSN, RN, NE-BC H: 859-384-7170 10019 Golden Pond Dr. Union, KY 41091 E-Mail: [email protected]
TREASURER: Mary A. Crowell H: 859-727-4340 3504 Susan Lewis Dr W: 859-371-9393 Erlanger, KY 41018
SECRETARY: Monica Meier, MSN, RN, AHN-BC 859-620-4464 625 Brandtly Ridge Dr. Covington, KY 41015-4227 E-Mail: [email protected]
HEARTLAND CHAPTER (FORMERLY DISTRICT 4)
PRESIDENT: Janice Elder, MSN, RN H: 270-756-6415 PO Box 834 Hardinsburg, KY 40143 E-Mail: [email protected]
TREASURER: Susan E. Nesmith, APRN, RN H: 270-300-4062 1623 Hutcherson Lane W: 270-706-1683 Elizabethtown, KY 42701-8977
SECRETARY : Anne Sahingoz, MSN, RN H : 502-549-3028 239 Ridgeview Dr. New Haven, KY 40051 E-Mail: [email protected] [email protected]
WEST KENTUCKY CHAPTER (FORMERLY DISTRICT 5)
PRESIDENT: Nancy Armstrong, MSN, RN H: 270-435-4466 1881 Furches Trail W: 270-809-4576 Murray, KY 42071 E-Mail: [email protected]
TREASURER: Katy Garth, PhD, RN H: 270-435-4544 358 Butterworth Road W: 270-762-6669 Murray, KY 42071
KENTUCKY NURSES REACH - RESEARCH, EDUCATE, ADVOCATE, CARE, HELP (FORMERLY DISTRICT 7)
PRESIDENT: Kim Bourne, MSN, RN, CNE C: 270-404-6189 147 Bulldog Road O: 270-745-3052 Glasgow, KY 42141-8845 E-Mail: [email protected]
TREASURER: Carol Evans, H: 270-526-3450 230 Otis Embry Rd O: 270-745-4589 Morgantown, KY 42261
SECRETARY : Dawn Garrett-Wright, PhD, MSN, RN O: 270-745-3800 1819 Smallhouse Rd. Bowling Green, KY 42104 E-Mail: [email protected]
GREEN RIVER CHAPTER (FORMERLY DISTRICT 8)
PRESIDENT: Amy Wimsatt H: 270-316-4262 6789 Kingston Dr. Owensboro, KY 42303 E-Mail: [email protected]
TREASURER: Carol Murch, MSN, RNAPRN H: 270-521-9980 18143 Upper Delaware Road W: 270-831-9787 Henderson, KY 42420
SECRETARY: Marlena Buchanan E-Mail: [email protected]
NIGHTINGALE CHAPTER (FORMERLY DISTRICT 9)
PRESIDENT: Patricia Calico, PhD, RN (Interim President) 85 Henry Clay Rd Stanford, KY 40484 E-Mail: [email protected] Phone: 606-669-3638
TREASURER: Charlene Maddox, BSN, RN H: 859-236-6336 PO Box 2055 Danville, KY 40423
SECRETARY : Denise Alvey, MSN, RN-BC 502-353-4223 1009 Bunker Hill Dr. Lawrenceburg, KY 40342 E-Mail: [email protected]
NORTHEASTERN CHAPTER (FORMERLY DISTRICT 10)
PRESIDENT: Christa Thompson W : 606-783-6603 940 E Midland Trl Grayson, KY 41143-1716 E-Mail: [email protected]
TREASURER: Phelan Bailey, BSN, RN, CEN, CPEN W: 606-356-8158 404 Jewell Ln Morehead, KY 40351-8842
SCHOOL NURSES IN EVERY KENTUCKY SCHOOL CHAPTER
CO-PRESIDENTS: Mary Burch, RN, ADN P:859-341-8337 340 Creekwood Dr Edgewood, KY 41017 E-mail: [email protected]
Eva Stone, MSN, APRN P: 859-583-5078 106 Hubble Rd Danville, KY 40422 E-mail: [email protected]
TREASURER: Sandi Clark P: 502-424-2335 1809 Addalyne Ct Lawrencebury,KY 40342
SECRETARY: Pat Glass, RN P: 859-305-6008 418 Hickory Hill Dr Nicholasville, KY 40356 E-mail: [email protected]
EX OFFICIO MEMBER FOR ALL KNA CHAPTERS
Kathy Hager, DNP, APRN, FNP-BC, CDE (2016-2018) W: 502-272-8103 1508 Main Street C: 502-682-0651 Shelbyville, KY 40065 Bellarmine University E-Mail: [email protected]
Job Board: Search job listingsin all 50 states.
Publications: New publicationsand articles added weekly!
Events: Find events for nursing professionals in your area.
www.nursingALD.com
Stay up-to-date and find your dream job!
April, May, June 2017 Kentucky Nurse • Page 3
Information for Authors• Kentucky Nurse Editorial Board welcomes
submission articles to be reviewed and considered for publication in Kentucky Nurse.
• Articlesmaybesubmittedinoneofthreecategories:• Personalopinion/experience,anecdotal(Editorial
Review)• Research/scholarship/clinical/professionalissue
(Classic Peer Review)• ResearchReview(EditorialReview)
• InformationaboutIRBorEthicalBoardapprovalis a requirement for Quality Improvement projects, evidence practice based projects, and research studies.
• Allarticles,exceptresearchabstracts,mustbeaccompanied by a signed Kentucky Nurse transfer of copyright form (available from KNA office or on website www.Kentucky-Nurses.org) when submitted for review.
Association events as required, including Membership Assembly, formerly known as the House of Delegates. The Kentucky Nurses Association thanks Maureen and wishes her success and happiness in future endeavors.
Future endeavors for the KNA include a warm welcome to our newly hired Interim Executive Director, Melissa Mershon. Melissa comes to us as the past Executive Director for Supplies Over Seas. She will lead us until an ED Search is complete, projected for summer, 2017. KNA has also negotiated with Dr. Sheila Schuster to return to us, as our lobbyist, working closely with our Governmental Affairs Cabinet and Board of Directors.
Nursing Leadership, including Committee and Cabinet members, as well as Chapter officers, met at My Old Kentucky Home, for a Leadership Retreat, focused on the mission, vision and core values of our organization. It was an exciting day for all of us, as we defined our organization and our roles. We will be sending out invites for many different positions throughout the coming year. Many of you have already said yes…. Thank you… and let’s do this:
VISIONTo be the voice for nurses and work for a healthier
Kentucky
MISSIONAdvocating for, engaging with and advancing
the professional practice of nursing through;• LeadershipDevelopment• EvidenceBasedPractice• Education
President’s Pen continued from page 1
• Articleswillbereviewedonly if accompanied by the signed transfer of copyright form and will be considered for publication on condi tion that they are submitted solely to the Kentucky Nurse.
• Articlesshouldbetypewrittenwithdoublespacingononesideof81/2x11inchwhitepaperandsubmitted in triplicate. Maximum length is five (5) typewritten pages.
• Articlesshouldalsobesubmittedelectronically• Articlesshouldincludeacoverpagewiththeauthor’s
name(s), title(s), affiliation(s), and complete address.• StylemustconformtothePublicationManualofthe
APA, 6th edi tion.• Monetarypaymentisnotprovidedforarticles.• Receiptofarticleswillbeacknowledgedbyemailto
the author(s). Following review, the author(s) will be notified of acceptance or re jection.
• TheKentucky Nurse editors reserve the right to make final editorial changes to meet publication deadlines.
• Pleasecompleteamanuscriptchecklisttoensureallrequirements are met. You must provide a completed checklist when a manuscript is submitted. The Manuscript Checklist can be found at www.kentucky-nurses.org.
• Articlesshouldbemailed,faxedoremailedto:
Editor, Kentucky Nurse, Kentucky Nurses Association, 305 Townepark Circle, Suite 100, Louisville, KY 40243
(502)245-2843•Fax(502)245-2844•oremail:[email protected]
• Research• MembershipGrowth• HealthPolicy
Through our actions, Nurses will promote quality health care, strengthen health awareness and direct health promotion leading to improved health outcomes.
CORE VALUESOur Core Values Include:• DiversityandInclusivity• HighEthicalStandards• LifeLongLearning• Accountability• Stewardship
If our mission, vision and core values match yours, please join us! We need lots of help! We hope to have KNA members all around the state, representing nurses and the health of our commonwealth, at every health related event in Kentucky. Please come join us.
Kathy Hager, DNP, APRN, FNP-BC, CDEKNA President
Teresa Huber, DNP, MSN, RNKNA Immediate Past-President
Executive Director Job Opening at the Kentucky Nurses Association
The Kentucky Nurses Association (KNA) is seeking an experienced and energetic professional to fill the position of Executive
Director. This is a full-time, exempt position that reports to the KNA Executive Committee and the KNA Board of Directors.
The focus of this position requires strategic planning to promote the following: The KNA mission through outreach; Outstanding
internal and external communications; Efficient use of technology and resources; Recruitment of new membership and
retention of existing members and innovative programming that provides value and promotes KNA.
Deadline to Apply is April 14, 2017
For Job Description and How to Apply, go to www.kentucky-nurses.org. Job Posting is under KNA Business in the center of the page.
Page 4 • Kentucky Nurse April, May, June 2017
Chapter NewsBluegrass Chapter:November KNA BG meeting 2016:
• The “first”KarenSextonawardwaspresentedto Ms. Kim Wilder. Ms. Wilder currently works at Baptist Health-Lexington and is a member of the Board of Directors of our Bluegrass Chapter. This is a well-deserved recognition for Ms. Wilders’ hard work and dedication in the provisions of care for patients. Congratulations, Kim!!!
• Our guest speaker Mr. Edwards gavea presentation on: 21st Century Acute Pain Management: A Paradigm Shift. The presentation included clinical importance regarding decreasing the amount of opioids for post-operative pain and replacing with other non-narcotic pharmaceuticals. Based on the presentation, Mr. Edwards and colleagues at Baptist Health-Lexington are having good results with their change in pain treatment modalities.
• Meetings are held every month on the 3rdTuesday beginning with a Social-gathering at 5:30pm. Meeting begins at 6pm. The Chop House, Richmond Rd., Lexington will continue to be the site for the meetings. Our next board meeting is Tuesday Februrary 21st.
January KNA BG member meeting 2017:• CEpresentationandspeaker–ZohnCentimole,
PhD, CRNA, at the Chandler Medical Center (UKMC) presented findings of his recently completed PhD research study “CognitiveFunctionandAnesthetics.”The findingsofhisstudy identified a significant correlation on the effect of cognitive function in clients who have received certain anesthesia medications during surgical procedures. The findings are valuable to current anesthesia care practice.
Green River Chapter:The Green River Chapter met in the fall three
times with the last meeting November 16th electing officers for the 2017 year and exchanging gifts in celebration of Christmas. The chapter is busy working on the upcoming NCLEX challenge where area nursing programs compete with teams representing each one for the prize of a traveling trophy and all will have an opportunity that evening to become more prepared to take the NCLEX after graduation in May. Student certificates will be awarded for attendance and/orparticipation and CE of 1.5 contact hours to RNs who attend. Our goal is to increase funds so that we can offer increased scholarship opportunities and to fund a future CE focusing on the issue with drug misuse and addiction in Kentucky. The chapter will be meeting the second Thursday of each month through May at 6pm, rotating between sites in Owensboro and Henderson. The next meeting will be March the 9th in Owensboro at Olive Garden. You can follow our chapter on Facebook. KNA-Green River chapter-formerly District 8.
Marlena Buchanan RN,MSN,CNS
Heartland Chapter:A huge thank you goes to Anne Sahingoz, the new
Heartland Chapter Secretary, for her technological talent and ability to create, not only an email address for the Heartland Chapter, but also an electronic newsletter called “The Pulse,” a Chapter website, aFacebook page, and most recently an e-repository archive for the Chapter minutes and other Heartland related items.
A CE program was co-sponsored by Campbellsville University during the month of October 2016 on Human Trafficking. In addition, we had student nurses participating with us as honorary members during the Project. Our tentative plans for future CEU programs consist of possibly working in conjunction with Hardin Memorial Hospital.
A draft survey will be sent to all members to solicit ideas/needs/information regarding the planning offuture meetings. Since many members find it difficult to attend meetings, one option being explored is the possibility of holding meetings via web-conferencing. A successful trial run of conferencing via web and telephone was completed on February 8, 2017.
The 2017 Chapter Meeting Dates are: February 16, 2017, May 18, 2017, August 17, 2017, and November 16, 2017. The time and location is set for 6:00 pm EST atHardinMemorialHospital–3rdfloorclassroom.
Some of the chapter goals for 2017 consist of (1) participating in some form of community volunteer service such as collecting food for a county food bank or the Feed America food distribution program
and (2) reaching out to the chapter members via teleconferencing to help members stay updated and increase attendance at the chapter meetings.
Respectfully submitted, Janice Elder, MSN, RN, CNOR, Heartland Chapter President
Kentucky Nurses REACH ChapterMet Sept 2016. Presentation from area
attorney who spoke on medical malpractice and documentation. Attendance included students and nurses (approx 50 people). Collected stuffed animals for ERs.
Met Nov 2016. Presentation by local epidemiologist who discussed the public health concern and response to emerging infections. Hosted by Greenview Regional Hospital. Attendance included students and nurses (approx 50 people). Collected toys for Toys for Tots.
Met Feb 2017. Presentation by Bowling Green/Warren County drug Task force officer on dangerous drugs of abuse-keeping up with the trends. Attended by students and nurses (approx 60 people). Collected items for local nursing home.
Next meeting will be held Tuesday, April 18 at the WKU/Medical Center Health Science Complex inBowling Green, KY from 5-7pm CST.
Nightingale Chapter:• PatriciaCalicoisnowinterimchairandDenise
Alvey is secretary. • ChapterleadersattendedtheJanuary2017KNA
Leadership retreat at My Old Kentucky Home. • Stay connected with us and like us on
our new Facebook page: https://facebook.com/nightingalechapter/. If you have any communications to share with the chapter, send an email to [email protected].
• Spring scholarship applications are now beingaccepted. Deadline for submission is April 25, 2017. To be eligible, an applicant must be enrolled in an A.D.N., BSN, MSN or Doctoral program and reside or be employed within Chapter boundaries. Contact Denise Alvey at [email protected] for further details and an application.
• The next meeting will be May 11 at EphraimMcDowell Hospital at 6:30 pm. The scholarship will be presented to the winner at this meeting and a CE offering will be included at the meeting. More details will be available soon.
• FallmeetingsarewillbeAugust10andOctober12.
LPNs, KMAs, SRNAs needed.
Sign on bonus for full time. 12 and 8 hour shifts available.
39 FERNDALE APTS. RD PINEVILLE, KY 40977 606-337-7071
www.mountainviewnursingcenter.com
April, May, June 2017 Kentucky Nurse • Page 5
Chapter News
Pictured Left to Right: Pat Calico, Charlene Maddox, Denise Alvey
Northeastern ChapterThe purpose of the chapter is to improve health
for the communities we serve and inspire nurses to achieve nursing excellence. We are devoted to high quality patient care, patient safety, evidence-based practice and advancing community health.
We’re currently scheduling CPR learning events which will be offered free to the public.
Interestedinjoiningourchapterand/orattendinga meeting then please contact Christa Thompson, Chapter President at 606-316-7495.
Northern Kentucky Chapter:Our first meeting of the year will occur on April 5,
2017. We will be focusing on providing CE offerings at meetings, establishing the ongoing meeting schedule, recruitment, and Civic engagements. We will also focus on KNA topics involving: medical marijuana, human trafficking, smoking cessation, substance abuse and the Nurse in Every School Initiative.
Contact Person:Teresa WilliamsEmail: [email protected]
River City Chapter: Greetings River City members!We wanted to take a moment to introduce
ourselves to you as your new Co-Presidents and to outline our vision for the next year.
The River City chapter of the Kentucky Nurses’ Association is under new leadership with Megan Carter and Christi Ralston. Our vision this year is to have several events where you can network with each other, tell us what you would like to see from this chapter and to help the people in our community.
We have several events planned, including a Knowledge Bowl, a Nurses’ Week themed event, a Derby event and a wine tasting night with a special guest speaker who can translate healthcare policy changes to us in our profession.
Our goal is to initially build a strong foundation of highly energetic and engaged nurses who we can
help empower through our chapter membership to improve the lives of our patients and each other. Once we establish this and hear from all of you, we will set routine meetings as a chapter to make our vision a reality in this community.
If you are interested in playing a more active role in the design and roll-out of the River City chapter, please email Megan Carter ([email protected]) and Christi Ralston ([email protected]) for more information.
About us:
Megan Carter MSN, RN, PCCN-CMC, CNML:
I am currently the Nurse Director for Critical Care and Respiratory Therapy at Baptist Health Louisville. I joined KNA when I moved to Kentucky over a year ago and have been very impressed by their passion and vision for affecting positive change. I chose to take this role because I believe very strongly in the power of nurses coming
together and making a difference at all levels: in our workplace, our community and especially our nation’s policies. I am a servant leader and am ready to serve this chapter in any way you see fit.
Christy Ralston BSN, RN,
CCMC:As the Director of
Workforce Development for Norton Healthcare, I find joy assisting students find their passion and career path. I am very involved in workforce analytics, career progression, and curriculum development to assist nurses and other healthcare professionals elevate their practice to support our
patients and the community. Nurses are the core of our community, together we have an opportunity to change outcomes, improve health and happiness, and leverage our collective resources for the good of all. Megan and I look forward to serving you, the nurses of the River City Chapter, helping you take your priorities to the next level, providing a voice and creating meaningful and sustainable change for nursing practice. Come join us!! It will be a wonderful journey together!
School Nurses in Every Kentucky School Chapter:
The chapter set meeting dates for 2017 which have been sent out to those who have expressed an interest in working with the group. Our first meeting for 2017 was held in January in Lexington. We
reviewed the strategic plan and discussed next steps as far as preparing for the eventual introduction of legislation. Senator Reggie Thomas called into the group to give some updates on his work. Senator Thomas introduced SB 84 in January which calls for the position of School Health Coordinators (which are required in school districts) to be filled by a Registered Nurse. The legislature was not in session when he called and the bill had not yet seen any movement.
The executive committee met in February and discussed action steps to increase awareness and garner support for the need to have nurses in schools. We also worked on planning for a school nurse summit in June with the intent to educate legislators and educators about the school nurse initiative. An information brochure is being updated and will be sent out to KNA members for review and distribution to legislators, parents and friends is encouraged.
We welcome any interested nurses who want to be part of this mission. The remainder of this year will be spent educating legislators, educators, and the public about the need for school nurses. We will be working on a plan to introduce legislation as we move this initiative forward. If you want to be part of the group please contact Mary Burch at [email protected] or Eva Stone at [email protected].
West Kentucky Chapter:The West Kentucky Chapter had a meeting the
end of February to discuss the Presentation on the Opioid epidemic in Kentucky. Pam Hagan from the Kentucky Board of Nursing presented. Please visit the KNA website, www.nursing-world.org, Calendar of Events, for upcoming meetings for this Chapter. If you have any questions or concerns please contact Chapter President, Nancy Armstrong at: [email protected].
Megan Carter
Christy RalstonLPN and RN
positions for Owsley Co. Health Care Facility located in
Booneville KY.
Owsley Co offers excellent benefits, pay for experience and weekend shift differential,
education assistance, Retirement Benefits. This non-profit community facility is located in the
beautiful mountains of eastern Kentucky.
Contact: Whittney Younts, [email protected]
Owsley Co. Health Care Center20 County Barn Rd. Booneville, KY 41314Phone 606-593-6302 | Fax 606-593-6078
OPEN Faculty Positionsat Kentucky State University
Kentucky State University is seeking qualified individuals for open faculty positions.
Doctorally Prepared positions in Adult Geriatric Primary Care Doctorate of Nursing Practice Program
Contact Dr. Elizabeth Jones, Coordinator DNP Program, at [email protected] or 502.597.5957 for
more information on graduate positions.
Undergraduate positions in:Maternal Child (2) | Nursing of Children (2)
Medical Surgical Nursing (1) | Behavioral Health (1)Undergraduate positions require a minimum of Masters
Degree in Nursing with specialty focus and current/recent clinical experience in area of specialty.
Contact Professor Rebecca McCoy at [email protected] or 502.597.5957 for more information on undergraduate positions.
For additional information about the university, visit
WWW.KYSU.EDU
Page 6 • Kentucky Nurse April, May, June 2017
Promoting Influenza Immunizations for Seniors in South Central Kentucky
M. Susan Jones, PhD, RN, CNE, ANEFMatthew L. Hunt, MA
Sujaya Thogaru, BDS, MPH Student
Western Kentucky UniversityInstitute for Rural Health
College of Health and Human Services1906 College Heights Blvd. # 21038
Bowling Green, KY 42101
IntroductionInfluenza is a major health problem causing
250,000 to 500,000 deaths worldwide each year (WHO, 2016). It is estimated that between 71 and 85% of all influenza-related deaths, along with 54 to 70% of influenza-related hospitalizations, are in seniors age 65 or older (CDC, 2016a). In the United States, the death rate has been 823.7 deaths per 100,000 population (CDC, 2016b). Episodes of influenza can exacerbate chronic medical conditions and lead to secondary bacterial pneumonias (Nagata et al., 2013). Influenza has a huge impact not only on the individual but also on society imposing significant economic burden in terms of hospitalization and treatment (WHO, 2003). The key to preventing these unnecessary hospitalizations and premature deaths due to influenza is to increase immunizations among the senior population.
The World Health Organization endorses seasonal influenza vaccination for seniors (WHO, 2016). Immunization is recommended as the first and most effective strategy in preventing influenza; however, the influenza immunization rate among seniors is approximately 60.4% (CDC, 2016b). In addition, studies reveal no significant increase in immunization rates for this population over the past several influenza seasons. Global preventive interventions include measures to increase adherence to influenza immunization recommendations (Nagata et al., 2013). A national health goal identified by Healthy People 2010 is to increase immunization rates in seniors age 65 and older to 90% by the year 2020 (Huminston et al., 2011). Multi-strategy interventions are more effective than a single strategy intervention at increasing influenza immunization rates (Huminston et al., 2011). However, there are limited studies that examine behaviors of seniors residing in south central Kentucky regarding being immunized for influenza and the factors that most influence their decision to “take” or “not take” aninfluenza immunization. The purposes of this descriptive study were to: 1) describe the influenza immunization rate of seniors visiting a senior center in south central Kentucky, 2) describe the
past influenza history of the participating seniors, 3) determine the factor that most influenced the seniors to be immunized for influenza, and 4) determine the rationale of seniors visiting a senior center who elected not to be immunized for influenza.
MethodsFollowing institutional review board (IRB)
approval at Western Kentucky University (WKU), a cross-sectional descriptive study was conducted at five senior centers located in south central Kentucky (Allen, Edmonson, Logan, Simpson, and Warren counties.). The sample for the study was recruited from attendees at an Immunization Day hosted by the Institute for Rural Health (IRH) in collaboration with the senior centers in each of the counties. Informational f lyers announcing the immunizations were free of charge and highlighting the myths and facts about influenza immunization were widely distributed at the senior centers and other familiar sites to seniors in each local community. Upon arrival at the senior center, each potential participant was asked if they would like to participate in a research study by answering four questions to determine their immunization history and factors that influence theirdecisionsto“take”or“nottake”theinfluenzaimmunization. Following consent, each participant was screened using the inclusion criteria of 65 years of age or over, reside in the service area of the local senior center, and understand the English language. As an incentive, participants completing the questionnaire had the opportunity to enter their name in a drawing for a $25.00 shopping card. Data were entered into RED-Cap then exported to SPSS 23 software to analyze using descriptive statistics.
ResultsNinety-one participants completed the
questionnaire with an age range of 65 to 90 years. Seventy percent of the participants were between the age of 65 to 75. The gender mix was 34 (37.36%) male and 57 (62.64%) female. Seventy-seven (84.62%) of the participants reported receiving the influenza immunization the previous year with seventy-six (83.52%) receiving the immunization at the IRH’s scheduled immunization event. Factors influencing the decision of the seniors to take the influenza immunization included publicity (n= 67, 73.63%), educational flyer (n= 31, 34.07%), free service (n=45, 49.45%), and the availability in the local community (n=74; 81.32%). Offering the service in the local community was reported to be the most important factor influencing the decision to take the immunization. Of the total 91 participants, 14 (15.38%) participants reported not taking the immunization the previous year. Primary factors influencing their behavior included the fear of becoming ill or experiencing an allergic reaction or not recognizing the need for the immunization.
Discussion Findings from this pilot study support those from
a previous study which found that multi-strategy interventions are preferred to a single intervention in increasing influenza immunizations among seniors (Huminston et al, 2011). In this study, local availability was the factor that most influenced seniors to take the influenza immunization. Providing the immunization service in the local communities of the seniors eliminated the potential barriers of inconvenience and distance to a health care provider. These findings suggest it may be beneficial to make influenza immunizations available at local sites where seniors visit frequently such as churches, libraries, adult education classes, local pharmacies, and grocery stores. The availability in the local communities and targeted educational programs for seniors may be successful in increasing the rate of adult vaccinations. Publicity of scheduled immunization events should be a focus to provide continual awareness of the availability of the immunization. Also, efforts to limit the cost burden barrier of the immunization are essential as many seniors are on limited incomes.
A review of the literature showed that lack of knowledge, personal beliefs, and other factors led to perceived fears, risks and barriers regarding immunization. Literacy, insurance status, cost,
transportation, gender, occupational roles, fear of legal status, lack of trust in the healthcare system, inconvenience and risk perceptions such as belief that immunization could cause harm are some of the barriers (Daniels et al., 2004). Among the participating senior centers, 15 out of the 91 (16.48%) seniors visiting the centers the day of the event elected to “not take” theinfluenza immunization. These seniors reported the factors influencing this behavior was 1) the fear of becoming ill following the immunization, 2) the fear of experiencing an allergic reaction, or 3) being unaware of the importance of the influenza immunization. Levels of awareness and knowledge about vaccines play a critical role in terms of acceptance. (D’ Souza et al., 2011). The challenge is to develop a creative educational intervention such as social media along with an effective marketing plan to reach all seniors to address the benefits of immunizations and eliminate fears of immunization that are perceived as barriers. Electronic health records and online health portals of seniors may be one avenue to promote awareness and provide education for the need for the influenza immunization.
Limitations/Recommendations The study was limited in scope and design
failing to survey seniors who refuse the influenza immunization each year. The study should be replicated with a larger sample size and at a different venue to capture seniors who “do nottake”influenzaimmunizations.Thequestionswereclosed-ended which restricted the seniors to choose among the given options. An open-ended survey would have identified other factors that influence their decision.
Conclusion The results of this pilot study support offering
influenza immunizations in local communities at a minimum cost (eliminating barriers), education to increase awareness of the benefits of immunization and the ill-effects of not being immunized, and publicity for the immunization events. Findings also identified the need for creative interventions to eliminate the fears and myths associated with the influenza immunization which curtail seniors from engaging in an important preventive practice. Increasing the influenza immunization rate of seniors is a major public health challenge and will require multiple, diverse strategies and collaboration among diverse health care professionals to determine the most effective intervention.
References CDC (2016a). What you should know and do this flu season
if you are 65 years and older. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/flu/about/disease/65over.htm
CDC (2016b). National early season flu vaccination coverage, United States, November 2015. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/flu/fluvaxview/nifs-estimates-nov2015.htm#age-adults
Daniels, N. A., Juarbe, T., Rangel-Lugo, M., Moreno-John, G., & Pérez-Stable, E. J. (2004). Focus group interviews on racial and ethnic attitudes regarding adult vaccinations. Journal of the National Medical Association, 96(11),1455–1461.
D’Souza, C., Zyngier, S., Robinson, P., Schlotterlein, M.,& Sullivan-Mort, G. (2011). Health Belief Model: Evaluating Marketing Promotion in a Public Vaccination Program. Journal Of Nonprofit & Public Sector Marketing, 23(2), 134-157.doi:10.1080/10495142.2011.572668
Humiston, S. G., Bennett, N. M., Long, C., Eberly, S., Arvelo, L., Stankaitis, J., & Szilagyi, P. G. (2011). Increasing Inner-City Adult Influenza Vaccination Rates: A Randomized Controlled Trial. Public Health Reports, 126(Suppl 2), 39–47. Doi:10.1177/00333549111260S206
Nagata, J. M., Hernández-Ramos, I., Kurup, A. S., Albrecht, D., Vivas-Torrealba, C., & Franco-Paredes, C. (2013). Social determinants of health and seasonal influenza vaccination in adults 65 years: a systematic review of qualitative and quantitative data. BMC Public Health, 13(1), 1-25. Doi: 10.1186/1471-2458-13-388.
World Health Organization (2003) World Health Organization 56th World Health Assembly – Prevention and Control of Influenza Pandemics and Annual Epidemics 2003. World Health Organization, Geneva.
World Health Organization (2016). Vaccine use. World Health Organization. Retrieved from http://www.who.int/influenza/vaccines/use/en/
April, May, June 2017 Kentucky Nurse • Page 7
Calendar of Events
April 2017
6 10:30 AM-3:30 PM Kentucky Board of Nursing Meeting 11 Kentucky Nursing Deans & Directors Meeting 13 KNA Green River Chapter Meeting, 6:00 PM. 18 Kentucky Center for Smoke-free Policy Conference, Doubletree Suites, Lexington, KY 18 KNA REACH Chapter Meeting,5:00–7:00PMattheWKU/Medical Center Health Sciences Complex, Bowling Green. 20 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 19-22 Kentucky Coalition of Nurse Practitioners & Nurse Midwives Annual Conference, Covington, KY 26 KNA Education & Research Cabinet Meeting,4:00PM–5:00PM, Conference Call 27 Healthcare Implications of the Drug Overdose Epidemic in Kentucky; Midway University; For more information email: [email protected] 28 KNA Ethics & Human Rights Committee Meeting.2:00–4:00PM. LocationTBD.Formoreinformationcontact–[email protected] or [email protected]
May 2017
1 Kentucky Center for Nursing Meeting 8 Materials due to KNA office for July issue of KY Nurse newsletter 11 KNA Green River Chapter Meeting, 6:00 PM. 11 KNA Nightingale Chapter Meeting, 6:30 PM, Ephraim McDowell Hospital 16 KNA Bluegrass Chapter Meeting,5:30PM(Socialtime)/6:00PM (Meeting time) Chop House on Richmond Road, Lexington, KY 18 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 18 KNA Heartland Chapter meeting; 6:00 PM EST; Hardin Memorial Hospital, 3rd Floor Classroom 19 9:00 AM Kentucky Board of Nursing Committee Meeting 19 10:00AM–2:00PM:KentuckyOrganizationofNurseLeaders Meeting; Lexington Convention Center
June 2017
15 10:30 AM-3:30 PM Kentucky Board of Nursing Meeting 15 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 23 KNA Ethics & Human Rights Committee Meeting.2:00–4:00PM. LocationTBD.Formoreinformationcontact–[email protected] or [email protected] 28 KNA Education & Research Cabinet Meeting,4:00PM–5:00PM, Conference Call
July 2017
18 KNA Bluegrass Chapter Meeting,5:30PM(Socialtime)/6:00PM (Meeting time) Chop House on Richmond Road, Lexington, KY 20 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room
August 2017
2 Materials due to KNA office for October issue of KY Nurse newsletter 10 10:30 AM-3:30 PM Kentucky Board of Nursing Meeting 11 KNA Nightingale Chapter Meeting, 6:30 PM, Location TBD 17 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 17 KNA Heartland Chapter meeting; 6:00 PM EST; Hardin Memorial Hospital 23 KNA Education & Research Cabinet Meeting,4:00PM–5:00PM, Conference Call 25 KNA Ethics & Human Rights Committee Meeting.2:00–4:00PM. LocationTBD.Formoreinformationcontact–[email protected] or [email protected] 30 Kentucky Center for Nursing Meeting
September 2017
15 9:00 AM Kentucky Board of Nursing Committee Meeting 19 KNA Bluegrass Chapter Meeting,5:30PM(Socialtime)/6:00PM (Meeting time) Chop House on Richmond Road, Lexington, KY 21 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 21-22 Kentucky Organization of Nurse Leaders Leadership Conference; Holiday Inn Louisville East Sept 30 – Oct 1 KANS–AnnualConference–FirstweekendinOctoberat Knicely Center in Bowling Green
October 2017
12 KNA Nightingale Chapter Meeting, 6:30 PM, Location TBD 19 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 19-20 KBN Meeting 25 KNA Education & Research Cabinet Meeting,4:00PM–5:00PM, Conference Call 26 Kentucky Center for Nursing Meeting 27 KNA Ethics & Human Rights Committee Meeting.2:00–4:00PM. LocationTBD.Formoreinformationcontact–[email protected] or [email protected]
November 2017
3 KNA Summit Annual Meeting 16 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 16 KNA Heartland Chapter Meeting; 6:00 PM EST; Hardin Memorial Hospital, 3rd floor classroom 17 9:00 AM Kentucky Board of Nursing Committee Meeting 21 KNA Bluegrass Chapter Meeting,5:30PM(Socialtime)/6:00PM (Meeting time) Chop House on Richmond Road, Lexington, KY
December 2017
1 KNA Leadership Retreat. Location: My Old Kentucky Home 7 10:30 AM-3:30 PM Kentucky Board of Nursing Meeting 21 KYANNA Black Nurses Association Meeting, 5:30 PM, Medical Towers South Conference Room 27 KNA Education & Research Cabinet Meeting,4:00PM–5:00PM, Conference Call
March 2018
1 Call for KBN Nominations due to KNA office
April 2018
1 Call for November 2018 Elections Nominations due to KNA office 16-21 Kentucky Coalition of Nurse Practitioners & Nurse Midwives Annual Conference, Lexington, KY
April 2019
22-27 Kentucky Coalition of Nurse Practitioners & Nurse Midwives Annual Conference, Covington, KY
KNA Governmental Affairs Cabinet: First Monday of every Month, 11:30 am-12:30 pm, conference call
KNA Board of Directors Meeting: First Friday of the Month
***All members are invited to attend KNA Board of Directors meetings. Please call the KNA office first to assure seating, meeting location, time and date.
Page 8 • Kentucky Nurse April, May, June 2017
Student SpotlightHeroin Epidemic: Impact on Foster Care
La Sananikone, Montez Hogue, Melody Gramig, Sailé Davis, Beth Korkin, Crystal Owens, Lyndsay Strohmeier, Samantha Burger
Bellarmine Nursing StudentsBellarmine University’s Lansing School of Nursing and Health Sciences
2001 Newburg Road, Louisville, KY 40205
The rise of parental heroin abuse has negatively affected children. Abuse and neglect, impaired psychological development, and finding permanent home placement are some of the obstacles foster children face. The goal of this article is to educate the community about children who are in foster care because of abuse and neglect related to the heroin epidemic.
The heroin epidemic began when pharmaceutical companies started encouraging the sale of opiates in the early 1990s (C. Miller, personal communication, November 1, 2016). This movement encouraged doctors to prescribe opiates due to the financial incentives and false claim that they were “non-addictive”painkillers.Duetotheincreasingexpenseofobtainingopiates,people began to look for an alternative. Heroin and other drugs are easily obtainable and cheaper than prescription painkillers. Because of this epidemic, there has been a rise in the number of children in foster care related to parental drug use over the past 10 years.
Parental addiction starteda cycle ofhomeplacementdisruption. “In recentyears, there have been large increases both in the number of children reported to the childprotectionsystemand in thenumberplaced inout-of-homecare”(Taplin & Mattick, 2015, p. 32). Social services get involved when a child’s living situation is deemed unfit resulting in the child being placed in local authority care (Gilchrist & Taylor, 2009). Abuse and neglect manifests differently on a case-by-case basis. “As a result, heroin tears parents from children, erasesstability, and steals innocence, joy and any sense of safety. Instead of getting the love and attention they need to grow, children of heroin become secondary totheaddict’sendlessquestforthenexthigh”(Ungar,2016,p.A1).
With Kentucky having the number one rating per capita, of death due to child abuse and/or neglect, the importance of removing children fromthe living situation as soon as possible should be paramount (Tam, 2016). Unfortunately, abuse and neglect do not have one particular “hallmark
sign” when it comes to the welfare of children. This is a main contributingfactor why there are so many children suffering from neglect and abuse for so long before they can be removed from their living situations. Neglect is multifaceted, and can range from a broken bone, to being malnourished, to being left at home for hours on end. Although very different, they all have negative effects in the psychological development of these children. “Onehundred percent of the children at St. Joseph Children’s Home (SJCH), that have been removed from the home due to parental drug use have experienced some form of neglect” (C. Miller, personal communication, November 1st,2016). This staggering statistic, coming from just one foster care facility in Louisville, KY shows the devastating relationship between drug-addicted parents and the foster care system.
Drug use by the parents has had significant psychological and developmental impacts on their children. “Childrenwhosemothers continue tousedrugsdoless well cognitively and behaviorally” (Topley, Windsor, &Williams, 2007, p.75). These children go to school with psychological problems, such as ADHD, behavioral issues, learning difficulties, and emotional instability. In addition to these problems, children exhibit sleep disturbances that contribute to poor academic performance. One approach to these problems is prescribing medications such as Clonidine, Vyvanse, Zoloft, Melatonin, and Ritalin.Alternative therapies include counseling, individualized education plans, tutoring, and vocational rehabilitation.
It is difficult to find a permanent home for children in foster care because, “children may experience rage and grief, an indication that their emotionregulation, social relatedness, and behavioral development, have been further disrupted throughouthomeplacements” (Marquis,Leschied,Chiodo,&O’Neil,2008, p. 9). A majority of failed adoptions stem from the psychological issues that these children face. According to the Children and Youth Services Review, “Children of parentswith substance abuse issues tend to enter foster care atyounger ages, stay in foster care longer, are less likely to be reunified with theirparents,andaremore likely to reenter thechildwelfaresystem” (Green,Rockhill, & Furrer, 2006, p. 461; Brook & McDonald, 2008, p. 195). Successful reunification and avoidance of foster care re-entry is particularly important for veryyoungchildren,as“issuesofsafetyandstabilitymaybeespeciallycrucialfor infants and toddlers, given their extreme vulnerability and the rapid pace of their physical, affective, and cognitive development” (Kimberlin, Anthony,& Austin, 2009, p.473). Moving forward, permanent home placement helps to remove psychological barriers and promote healthy attachments and building blocks for relationships.
Not all children remain in the foster care system; some return to their parents. In order to regain custody of their children, parents have minimal standardsasdeterminedby theStateGovernment.These “standards” includemaintaining full time employment, negative drug test, required therapies, and viablehousing.Usedloosely,theterm“viablehousing”doesnotrequirethatahome be free of infestations, nor have air conditioning or heating. Until the state
April, May, June 2017 Kentucky Nurse • Page 9
Student Spotlightdeems a living situation suitable, children will continue to fall victim to this broken system (C. Miller, personal communication, November 1, 2016).
Victims of abuse and neglect, many children are removed from their situation and placed in foster care facilities, such as St. Joseph Children’s Home (St. Joseph Children’s Home, 2016). Founded in 1849, this non-profit organizationislocatedinLouisville,KY,withthemissionof“GivingChildrenaHome.”Throughouttheyears,SJCHhasservedover70,000childrenwhoseinnocence, childhood years, and basic needs of life have been denied. The average length of stay with a foster family is 310 days, and SJCH placed 38 children with foster families in 2014 (St. Joseph Children’s Home, 2016). SJCH has a 94% success rate in finding children their “final home”, whereas thestate of Kentucky had a 60% success rate (St. Joseph Children’s Home, 2016). The main goal of SJCH is to provide a home for children to grow, heal and learn. To achieve this, they have a multitude of services available including art therapy, weekly group and individual psychotherapy sessions, access to personal psychologists, medical intervention, and the opportunity for an individual education plan.
A goal found in Healthy People 2020, states to, “reduce substance abuseto protect the health, safety, and quality of life for all, especially children”(Healthy People 2020, 2016). While substance abuse has a large impact within the community, it also has a major impact on individuals and their families, especially children. Advocating for the Healthy People 2020 goals, St. Joseph Children’s Home has strengthened their mission to, “Give Children a Home”, even with the rising cases of the heroin epidemicvictims, especially children. St. Joseph Children’s Home has created new cottages to provide stable, safe, and caring homes for the children of the community that have fallen victim to abuse and neglect. (C. Miller, personal communication, November 1, 2016).
The heroin epidemic is destructive to families and continues to leave children in unstable environments and ultimately, foster care. These foster care children are often victims of abuse, neglect, psychological problems, and difficulty finding permanent homes. Fortunately, the non-profit organization SJCH is determined to provide services for foster care children that are essential in helpingthemlearn,grow,andfindforeverhomes.“Ifwefailtomeettheneedsofthe children of drug using parents, we shall have lost an opportunity to break the cycle of familial adversity that will see many of them becoming the drug usersoftomorrow”(McKeganey,Bernard,&McIntosh,2002,p.244).
ReferencesBrook, J. & McDonald, T. (2009). The impact of parental substance abuse on the stability
of family reunifications from foster-care. Children and Youth Services Review, 3(2), 193-198.
Gilchrist, G., & Taylor, A. (2009). Drug-using mothers: Factors associated with retaining care of their children. Drug and Alcohol Review, 28(2), 175-185.
Green, B. L., Rockhill, A., & Furrer, C. (2007). Does substance abuse treatment make a difference for child welfare case outcomes? A statewide longitudinal analysis. Children and Youth Services Review, 29(4), 460-473.
Healthy People 2020. (2016). Substance abuse. Retrieved November 08, 2016, from https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse
Kimberlin, S. E., Anthony, E. K., & Austin, M. J. (2008). Re-entering foster care: Trends, evidence, and implication. Children and Youth Services Review, 471-481. Retrieved October 25, 2016.
Marquis, R. A., Leschied, A. W., Chiodo, D., & O’Neill, A. (2008). The relationship of child neglect and physical maltreatment to placement outcomes and behavioral adjustment in children in foster care: A Canadian perspective. Child Welfare, 87(5), 5-25.
McKeganey, N., Barnard, M., & McIntosh, J. (2002). Paying the price for their parents’ addiction: MDrugs: Education, Prevention & Policy, 9(3), 233-246. doi:10.1080/09687630210122508
St. Joseph Children’s Home. (2016). Retrieved November 8, 2016, from www.sjkids.orgTam, J. (2016). KY ranks No. 1 in child abuse death rate. Retrieved November 08, 2016,
from http://www.wdrb.com/story/11357339/ky-ranks-no-1-in-child-abuse-death-rate
Taplin, S., & Mattick, R. P. (2015). The nature and extent of child protection involvement among heroin-using mothers in treatment: High rates of reports, removals at birth and children in care. Drug & Alcohol Review, 34(1),31-37.doi:10.1111/dar.12165
Topley, J., Windsor, D., & Williams, R. (2008). Behavioural, developmental and child protection outcomes following exposure to class A drugs in pregnancy. Child Care, Health & Development, 34(1),71-76.doi:10.1111/j.1365-2214.2007.00768.x
Ungar, L. (2016, June 12). Heroin’s grip: Epidemic scars generations of kids. The Courier Journal, p. A1.
When disaster strikes,who will respond?
The Kentucky Department for Public Health is seeking nurses to register and train as Medical Reserve Corps (MRC) volunteers. When events such as ice storms, flooding or pandemics occur in Kentucky, our citizens need nurses to provide compassionate care. Register to volunteer and receive training from your local MRC unit today. By doing so, you can be prepared to serve your community, family and neighbors when they need it most.
To learn more, go online at
www.kentuckyhelps.com
LEARNING RESOURCE COORDINATORRequirements: Master of Science in Nursing Required
UNDERGRADUATE COORDINATORRequirements: - PhD Preferred; MSN Required- 2 Years teaching experience on Undergraduate Level - Knowledge of Accreditation Requirements for ACEN- Knowledge of Curriculum Development which includes: Syllabi
Development; Program Development; ADN; BSN; RN-BSN
Send Resumé/CV; 3 Letters of Reference and Original Transcripts:400 East Main Street | Kentucky State UniversitySchool of Nursing | Frankfort, KY 40601
Contact School of Nursing: Nakea Dreux, Administrative Assistant, at [email protected] or 502-597-5957.
RECRUITING STUDENTS for our:- BSN-DNP Adult-Gerontology Primary Care Nurse Practitioner- NEW: Generic BSN Program
Apply online @ kysu.edu/nursing.Application Deadline May 1, 2017 for Fall Admission.
KYSU.EDU
Page 10 • Kentucky Nurse April, May, June 2017
Student SpotlightScott Cook, SN, Samantha Gerber, SN,
Kayla Heines, SN, Cayla Martin, SN, Bailey Reeder, SN, Sadie Schmidt, SN
Emily Sidebottom, SN, & Sara Wimsatt, SN
Bellarmine University2001 Newburg Road
Louisville, Kentucky 40205
The United States is one of the most obese nations in the world. The State of Kentucky currently ranks fifth in the nation for overall obesity, with 1 in 5 (18%) children in the obese category with a body mass index (BMI) greater than 30 (Trust for America’s Health, 2016). Our lifestyle, eating habits, cultural values, and access to sugar laden foods create a perfect environment to promote obesity. As nursing students in our community clinical,
we have encountered an overwhelming amount of obese children within Metro Louisville. As part of the experience, we explored youth based nutrition education programs through Louisville’s farm to table initiative. Unless drastic lifestyle changes are made, obesity rates and comorbidities will continue to rise and be seen in our children later in life.
Since the 1980s, the number of children nationwide (age 6-11) who are classified as obese has tripled from 6.5% to 19.6% (Lueke, 2011). Long term health consequences associated with childhood obesity include diabetes, heart disease, and obesity related cancers. In 2010, there were 264,958 cases of heart disease in Kentucky (Trust for America’s Health, 2016). If the current obesity trend continues, this number is expected to increase to a projected 1.3 million cases in 2030 (Trust for America’s Health, 2016). Obesity may also lead to negative psychosocial effects such as low self-esteem,
Combating Obesity: Teaching Children to Eat Rightdepression, discrimination, and an increased risk of bullying (American Academy of Pediatrics [AAP], 2015). Besides the major health consequences, obesity also carries an increased economic burden on healthcare resources. Due to the severity of these consequences, the preventable obesity epidemic cannot be ignored; therefore, it is imperative that we implement proactive interventions, including nutrition education and youth programs to curb the evolving American culture of obesity.
Healthy People 2020, the nation’s health initiative, aims to prevent health problems caused by unhealthy lifestyles by increasing comprehensive school education in elementary, middle, and senior high schools (United States Department of Health and Human Services [DHHS], 2016). Nutrition education must be incorporated into the educational curriculum to empower children to make healthier food choices (Lueke, 2011). If we can
April, May, June 2017 Kentucky Nurse • Page 11
Student Spotlightchange nutritional related behaviors and beliefs among children, we can prevent the cycle of obesity throughout the lifespan. Adult lifestyle behaviors have a direct influence on children’s nutrition patterns. The education effort must be collaborative among adults, including teachers and parents. According to the American Heart Association (AHA), it is important to educate children on the benefits of an active lifestyle along with a healthy diet (American Heart Association, 2016). Several policies and programs have been put into place nationwide to provide nutrition based education and make healthy food options more accessible to all people.
Many school-aged children rely on government programs for their basic nutritional needs. The National School Lunch Program provides nutritionally balanced and low cost, or free meals to public schools, depending on financial need (Gross, 2011). In 2010, the Healthy Hunger-Free Kids Act increased the number of meals provided and set healthier nutrition standards for schools (Gross, 2011). Farm to school programs are another intervention aimed at combating childhood obesity. These programs allow school districts the ability to bring fresh fruits and vegetables from local farms into their schools (Gross, 2011). Several communities have implemented community gardens and farms to bring healthy food options into the home for both children and their families to enjoy (Gross, 2011). For example, The Grow Food, Grow Hope initiative in Ohio provides 40 community garden plots for low-income families to gain access to fresh produce and learn about sustainable farming (Gross, 2011). In Connecticut, Ambler Farm functions as an 18-acre community owned teaching operation (Gross, 2011). It houses a large food garden that provides fresh fruits and vegetables to the local market as well as providing youth and adult education programs, fresh food stands and more (Gross, 2011). These efforts to curbing obesity in children emphasize a return to farming while creating a positive perception of farm fresh foods.
Kentucky is striving to educate children on the benefits of eating fresh fruits and vegetables and how to cultivate them within the urban community. The Food Literacy Project (FLP) began in 2006 as a nonprofit organization located in Louisville, Kentucky on the Field Day Family Farm (Shulhafer, 2016). The organization’s mission is to create a community that is knowledgeable and active in achieving a healthy lifestyle with fresh food (Shulhafer, 2016). The FLP targets educating children, specifically underserved youth. Participants receive a hands-on experience by planting, harvesting, tasting, and cooking healthy food on the farm (Shulhafer, 2016). This empowers children and families with the proper knowledge and skills to live a healthier lifestyle.
Jefferson County Public Schools have partnered with the FLP creating the Youth Community Agriculture Program (YCAP) (Shulhafer, 2016). During the summer months the FLP employs several high school students from areas in Louisville lacking access to fresh produce (Shulhafer, 2016). During the program the teens work on the farm harvesting fresh vegetables and brainstorming creative ideas that create food justice and food security within their own communities. The employees of the YCAP helped to launch the FLP’s newest form of healthy eating education: Louisville’s Truck Farm (Shulhafer, 2016). The teens helped to construct a garden on wheels in the bed of a 1995 Chevrolet truck (Shulhafer, 2016). The Truck Farm was built to travel across Louisville to markets, schools, and community events to show that a garden can be started anywhere, including urban cities (Shulhafer, 2016). It enables people to discover where their food comes from and explore the smells, appearance, and taste of fresh food.
The members of YCAP have become ambassadors of healthy eating to the people within their communities and have inspired changes such as creating gardens at schools and churches within the food deserts (Shulhafer, 2016). The FLP and its program of YCAP and Louisville’s Food Truck not only provide education about healthy eating, but also engage people to change their local food systems. In October 2013, KentuckyOne Health (2015), in collaboration with the FLP, used a $200,000 grant provided by the Johnson & Johnson Community Health Care Program for the Prevention of Childhood Obesity, to start a Farm to Family Initiative (KentuckyOne Health, 2015). After 15 months of evaluating the results seen in Louisville’s Hazelwood and Wellington Elementary Schools, the program has proven itself to be a substantial success (KentuckyOne Health, 2015). Students reported consuming at least five daily servings of fruits and vegetables (18% increase), engaging in more than 60 minutes of daily physical activity (28% increase), obtaining knowledge of how to prepare a healthy recipe (31% increase), and experiencing eating a vegetable they picked themselves (30% increase) (KentuckyOne Health, 2015). This project is connecting underserved youth in the midst of a food desert with fresh and healthy food options. It provides education about nutrition and how to prepare healthy meals with fresh ingredients. The collaboration of the Farm to Family Initiative and the FLP is successfully empowering students within their own community with the skills and knowledge they need to make informed and healthy decisions.
Education may be the key to preventing the growing epidemic of childhood obesity. As future
generation healthcare providers, it is our duty to focus on upstream thinking to provide education for disease prevention and health promotion. The Food Literacy Project has proven to be a successful means of health promotion to combat obesity by teaching children to eat right. We strongly urge Kentucky nurses to be proactive in the fight against childhood obesity, by promoting programs in your area such as the Food Literacy Project. For more information on the programs it offers, visit foodliteracyproject.org.
ReferencesAmerican Academy of Pediatrics. (2015, November 21).
The emotional toll of obesity. Retrieved from https://www.healthychildren.org/English/health-issues/conditions/obesity/Pages/The-Emotional-Toll-of-Obesity.aspx
American Heart Association. (2016). Preventing childhood obesity: tips for parents and caretakers. Retrieved from http://www.heart.org/HEARTORG/HealthyLiving/Hea lt hyK ids/Ch i ldhoodObes i t y/P revent i ng-Childhood-Obesity-Tips-for-Parents-and-Caretakers_UCM_456118_Article.jsp#.WCOS8iTnhQ8
Gross,A.(2011,January/February).Currents:Thegrowingfresh food movement. E: The Environmental Magazine 22(1), 12-14. Retrieved from Medline NLM UID: 101086128.
KentuckyOne Health, (2015, February 23). Childhood obesity prevention project shows early success. Retrieved from http://www.kentuckyonehealth.org/body.cfm?id=18&action=detail&ref=605
Lueke, L. (2011). Devouring childhood obesity by helping children help themselves. Journal of Legal Medicine, 32,205-20.doi:10.1080/01947648.2011.576621
Shulhafer, R. (2016, September 05). In this food desert, kids learn to farm veggies-out of the back of a truck. Yes! Magazine. Retrieved from http://www.yesmagazine.org/people-power/in-this-food-desert-kids-learn-to-farm-veggies-out-of-the-back-of-a-truck-20160905
Trust for America’s Health. (2016). Obesity rates and trends overview. Retrieved from http://stateofobesity.org/obesity-rates-trends-overview/
Trust for America’s Health. (2016, September). The state of obesity in Kentucky. Retrieved from http://stateofobesity.org/states/ky/
U.S. Department of Health and Human Services. (2016, November 09). Education and community-based programs. Retrieved from https://www.healthypeople.gov/node/3496/objectives#4231
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Knowledge for Life
Page 12 • Kentucky Nurse April, May, June 2017
Accent on Research
Online Patient Portal Use by Older Adults in Rural KentuckyCainan Jones, RN-BSN, DNP Graduate Student
Research Objective: The objective of this project was to evaluate the receptiveness of patients, at a rural primary care clinic in Kentucky, to online patient portals. Emphasis was placed on the reactions of older adults to evaluate if this population suffered from barriers not present in other subsets.
Background: Online patient portals are a technology that is being utilized by healthcare providers to allow patients to have access to their healthcare information and increased access to their healthcare providers. Due to the services online patient portals offer, they are steadily gaining acceptance as the standard in family practice and hospitals around the country. With the large influx of healthcare providers offering online patient portals, it is important to ensure that their patients are able to utilize and comprehend them effectively. While the older adult population, 60 and older, make up a large portion of active healthcare consumers, they are often negatively stereotyped as the least able to adapt to the use of these new technologies. Due to this, it is important that this specific population receives evaluation to ensure that they do not suffer from any avoidable barriers.
Significance in the Field of Nursing: The significance of this project to nursing lies in the need to ensure equality and reliability of services offered across the lifespan. Identifying barriers to use of online patient portals for older adults could lead to a change in how this technology is offered improving best practice knowledge.
Method: Data collection utilized voluntary participant-completed questionnaires offered at regular primary care visits.
Findings: Findings indicated that older adults are open to using online patient portals but require extra education/support and do not have reliable
internet or computer access. This was the only age group to have internet or computer barriers.
Implications: This implies that if the barriers of computer and internet access are mitigated, this population is capable and willing to use online patient portals with support and education. In such cases that those barriers are unavoidable, other methods of healthcare provider access must be offered to ensure best practice across all patient groups.
Ambulatory Risk Safety Gap Analysis
Karen Beaton, JD, MSN; Paula Fowler, MSBC, BSN, CPHRN;
Larry Poague, LPN, ARM, RSO, COEE
Across the ambulatory setting locations, workplace safety/security measures includingtraining, education, and physical layout are not standardized. Therefore, the objective was to create a safer work environment for nursing and all healthcare workers by identifying low/high risksafety categories. A tool was created which provides a score that determines what security measures will be implemented. In addition to the tool, a gap analysis was conducted at 7 of the 187 practices.
A basic survey was conducted for the staff’s perception of safety. A best evidence search was conducted using key words: security, violence, threats and physician practices but provided minimal results. Therefore, a multidisciplinary task force was formed who developed a risk safety tool using information from Occupational Safety and Health Administration of the United States and the internal loss control expertise of Lockton Companies. Seven locations were selected based on the following criteria: free-standing, hospital campus or an office building, past violent events, open versus closed floor plan, parking and crime index. The tool was utilized by the team at these locations and a safety gap analysis identified strengths and weakness. A post safety debriefing was conducted for the following findings and conclusions. The practices were generally neat, clean and cordial, staff knew to report any workplace violence, local 911 responses were 5 to 10 minutes, repairs to the equipment or building were prompt and weekly
safety calls were conducted at all practices. There was much variability such as number of employees, staff turn-over, badge versus key door access, drug seeking patient volume, patient dismissal volume, crime index, staff parking with departures after dark, storage of cash, panic buttons, cameras and employee lockers.
The tool was found to be consistent during the trial and was able to numerically measure the following categories: Violent Risk Score, Property Risk Score, Risk Assessment Score, Administrative Controls Score and Physical Controls Score. This tool will be used to identify low/high risk safetycategories for appropriate security measures throughout NMG.
Innovation at Work: Reader’s Theater Influences the Health
and Safety of a Vulnerable Working Population
Deborah B. Reed, PhD, RN, FAAOHN, FAAN
ABSTRACTBackground: Production agriculture suffers the
highest worker fatality rates of any industry (Myers, Layne, Marsh, 2009) and the oldest workforce with an average age of 58.3 (USDA, 2014). Previous efforts to reduce rates among middle-aged and senior farmers have failed. Our cutting edge intervention is based on evidence from our previous research (Reed & Claunch, 2015) and is directly responsive to the farm community. The goal of this project is to change work behavior to improve health and prevent injury.
Method: Working with Agriculture Extension, Commodity groups and Farm Safety Organizations, we develop theater that is tailored to the region and delivered by the farmers (“actors”) during adinner theater event. Couples (with persons age 45 and over) are recruited as 95% of America’s farms are family operations. Three short plays focused on work health behaviors (such as stress, wearing seat belts on machinery, sunscreen and hearing protection) and consequences, supplemented by brief discussions led by the project leader, comprise the event. Evaluation of receptivity and subsequent
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Accent on Research continued on page 14
behavior change is tracked through telephone interviews two weeks and two months post-event.
Results: To date, 274 persons (mean age: 63 years) have participated across four theaters. Participants rated the event as highly realistic, enjoyable, and they reported that it helped them understand the interactions of aging and health and work injury. 57% reported at least one substantial change in their health or work behavior based on the information they received. Examples of changes included focusing on single tasks, fatigue prevention strategies, hydration, improved communication, and skin and hearing protection.
Conclusions: This format promises to be effective for starting health behavior conversations among families, and for producing substantial behavior changes that can reduce illness and injury among a highly vulnerable work group. It is relatively inexpensive and can be tailored to specific topics and settings. The format may be applicable in other settings where role modeling and oral traditions are prominent, or among groups where low literacy is a barrier to most other interventions.
ReferencesMyers, J.R., Layne, L.A., & Marsh, S.M. (2009).
Injuries and fatalities to U.S. farmers and farm workers 55 years and older. American Journal of Industrial Medicine, 52(3), 185-194.
Reed. D.B. & Claunch, D.T. (2015). Protecting ourselves from harm: voices of aging farmers. Journal of Agricultural Safety and Health, 21(4): 269-279.Doi:10.13031/jash.21.11100).
USDA. (2014). 2012 Census of Agriculture. Preliminary report highlights: U.S. farms and farmers. Washington, D.C.: USDA National Agricultural Statistics Service. Retrieved from www.agcensus.usda.gov/Publications/2012/Preliminary_Report/Highlights.pdf.
How does Standardized Testing and a Structured
Remediation Plan Affect ATI Second Attempt Assessment
Scores and Student Self-Efficacy?
Angela Harlan, MSN, RN, DNP Student
ABSTRACTAbstract: Helping students complete a nursing
program and achieve success on the National Council Licensure Examination (NCLEX-RN) has continued to be a high priority for nursing faculty and students.
The purpose of this study was to determine if the use of standardized testing with a structured remediation plan will improve ATI standardized assessment scores and self-efficacy, ultimately leading to improved student success.
There is a considerable amount of discussion in the literature regarding standardized testing and its use in nursing schools. Many nursing schools use standardized tests as high stakes testing, and these types of policies are controversial and not supported in the literature (Harding, 2010). The purpose of these exams should be to assess students’ preparedness for NCLEX-RN and identify at-risk students early in order to plan methods such as remediation to assist students in passing the licensing exam (Harding, 2010; Heroff, 2009). Even though the literature identifies the need for methodical remediation plans, development of successful remediation efforts for at-risk students continues to be a (Makhani et al., 2012). Although one unified remediation plan was not identified in the literature, a list of characteristics to be included in successful remediation plans was found. These characteristics include a remediation plan which includes early identification of at-risk students, is individualized, is written, is faculty guided, is mandatory, includes regular feedback and continuous monitoring, includes a variety of learning activities, and is structured and consistent.
A one-group pretest-posttest quasi-experimental design was used in the study. The study showed the group mean and median of all exams did increase with the use of the remediation between exam attempts and found the remediation statistically increased exam scores in two of the four exams administered. This study examined the use of standardized testing and structured remediation in order to increase student success. Developing projects which will increase student success in nursing programs and on NCLEX-RN will directly increase the number of available nursing graduates who are available to fill vacant positions (Heroff, 2009). This will help address nursing shortages which will benefit not only nursing programs and students but the healthcare industry as a whole.
ReferencesHarding, M. (2010). Predictability associated with exit
examinations: A literature review. Journal of Nursing Education, 49(9), 493-497. doi:http://dx.doi.org.proxy1.nku.edu/10.3928/01484834-20100730-01
Heroff, K. (2009). Guidelines for a progression and remediation policy using standardized tests to prepare associate degree nursing students for the NCLEX-RN at a rural community college. Teaching and Learning in Nursing, 4(3),79-86.doi:10.1016/j.teln.2008.12.002
Makhani, L., Bradley, R., Wong, J., Krynski, E., Jarvis, A., & Szumacher, E. (2012). A framework for successful remediation within allied health
programs: Strategies based on existing literature. Journal of Medical Imaging and Radiation Sciences, 43,112-120.doi:10.1016/j.jmir.2011.12.006
High Fidelity Simulation to Evaluate Emergency
Management in Urgent Care Centers
Megan Tabor, MSN, RN and Brooke L. Vaughn, Simulation Educator, MSN, RN
ABSTRACTA large amount of literature discusses the use
of simulation in academic and acute care settings, but few report the use of simulation in the urgent care setting or to train unlicensed personnel. Staff members in this setting are responsible for managing emergencies until emergency medical services (EMS) respond. Cardiac emergencies in the urgent care setting are reported as acute low volume events, creating difficulties in preparation of staff. Inconsistencies were discovered with staff in managing emergency situations at twelve urgent care centers in the metropolitan area. A clinical educator partnered with a university simulation educator to develop an in-situ cardiac emergency scenario. The researchers evaluated the effect of simulation on competency of urgent care staff in managing a cardiac emergency prior to the arrival of EMS.
A convenience sample of 128 urgent care staff precipitated in a chest pain scenario using a high fidelity simulator. It was completed one time at each urgent care center. Participants included: RNs, LPNs, medical assistants, radiology technicians and receptionists. Scenario objectives included: recognizing a potentially life-threatening patient condition, implementing center protocol to notify EMS, management of a patient with basic life support upon arrival of EMS and evaluation of the team’s performance. The Simulation Effectiveness Tool and Creighton
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Competency Evaluation Instrument (CCEI) were used to evaluate the experience. Participants were highly engaged, reflecting on all aspects of the simulation. Opportunities for learning were identified by participants relating to the CCEI criteria, including thorough system processes and effective communication with the team. Competent behaviors in managing emergencies did not correlate with previous experience in managing cardiac emergencies or years of experience in employee role. These reasons indicate a need for continued simulation experiences in the urgent care setting. It is recommended that health care systems continue to collaborate with universities to implement simulation. Simulation was found to be an effective way to identify areas for continued education and simultaneously provide quality training for unlicensed personnel to produce better patient outcomes in the urgent care setting.
Happiness Is Life: Influence of Healthcare Professions Faculty
Happiness and Perceived Stress Impact on Students
Elizabeth Cryer, BSN Student Bryan Woods, BSN Student
Objective: The purpose of this study was to assess happiness ratings of Northern Kentucky University faculty in the College of Health Professions. Our goal was to use the results of our survey to compare each profession. We assessed other factors that could affect happiness such as stress and employment status.
Background: Within healthcare professions there are many factors, such as stress and work load, that are destructive to happiness. Abdollahi, Abu Talib, Yaacob, and Ismail identified stress and hardiness as indicators of individual’s level of happiness. Ozkara conducted research to explore the concept of nurses’ happiness and consider the impacts of nurses’ happiness. Most of the research was
specifically directed at the nurses. Our study was intended to see if other healthcare professions had the same correlations.
Significance to the Field of Nursing: A nurse’s level of happiness is often displayed in how they act in the clinical setting and treat their patients. This research was intended to analyze levels of happiness/stress to see if there is a futureneed foreducation. Faculty with higher happiness levels could treat student nurses better. This could be essential in improving the quality of care for patients.
Method: A survey was sent out to faculty members in the College of Health Professions. The survey contained two background questions, six happiness related questions and six stress related questions.
Findings: Overall the results of this study were not enough to prove significant relationship between stress, happiness, and profession. In the sample collected, nursing faculty ranked higher in happiness and stress.
Implications: It is challenging to absolutely infer that stress and happiness have a strong correlation. The average happiness scores could have been higher and stress levels could have been lowered with stress management exercises.
References:Abdollahi, A., Abu Talib, M., Yaacob, S. N., & Ismail,
Z. (2014). Hardiness as a mediator betweenperceived stress and happiness in nurses. Journal of Psychiatric & Mental Health Nursing, 21(9), (p.789-796). John Wiley & Sons Ltd.
Ozkara San, E. (2015). Concept analysis of nurses’ happiness. Nursing Forum, 50(1), (p. 55-62).
Exploration of the Use of Mobile Technology in an
ADN ProgramMichele Dickens, PhD RN
Research Objective: The purpose of this basic qualitative study was to explore experiences of nursing educators as they integrated mobile technology in the classroom.
Background: Nurses continually rely on up-to-date practice information. Integration of mobile technology in the nursing curriculum allows nurse educators the opportunity to foster and develop mobile technology in the classroom and clinical setting. Few studies addressed the integration of technology as an active learning tool in an associate degree nursing (ADN) program. In addition to the lack of studies, a gap exists in the literature regarding how technology is used as an active learning tool in nursing curriculum and specifically how mobile technology is used in ADN programs.
Significance to the Field of Nursing: A lack of mobile technology use in the ADN classroom as an active learning tool emerged from the results, and lack of use of technology as an active learning tool was also evident in the literature review. A gap was noted related to the lack of universal consistency of integration within ADN programs and the curriculum. The IOM (2010) reported that students should have instant access to EBP information. This has caused an emergence of informatics in nursing practice. However, the introduction of technology into the curriculum has been slow and has had mixed results of acceptance by educators and students. Cibulka and Crane-Wider (2011) stated that although the NLN (2008) and the 10M (2010) advocate for point-of-care access to reference materials in patient care settings, there was a lack of studies describing how these practices are introduced into nursing curricula of an ADN program. The main implication for nurse educators, based on the current study findings, is the need for ADN programs to devise an innovative curriculum to include the use of mobile technology as an active learning tool.
Method: The research design chosen for the study was a basic qualitative design.
Findings: The themes illustrating the beliefs and attitudes of nurse educators who used mobile technology as an active learning tool. The major themes reported, listed according to frequency, were: (1) lack of faculty development on technology, (2) active learning tools used, (3) inclusion of technology in the classroom and clinical setting, and (4) student engagement. Two minor themes were also identified: (1) how the use of mobile technology aligns with the mission and vision of the organization, and (2) student learning outcomes.
Implications: The rationale for the study relates to the challenges that nurse’s face with the changing health care arena and the use of mobile technology to provide health care. The study will add to the knowledge in the field of nursing related to technology as an active learning tool in the ADN program.
Every School Needs A NurseTeena Darnell, DNP, RN and
Kathy K Hager, DNP, APRN, FNP-BC, CDE
ABSTRACTObjective: The purpose of this first study was to
identify whether the presence of a nurse in the public high school setting was associated with improved graduation rates, better attendance rates, and higher ACT scores. Data gleaned from the study will be used to enact legislative policy mandating the presence of a nurse in all public schools in the state of Kentucky.
Background: Nurses employed in the school setting support both the educational mission of the institution, as well as the health of students. Studies have explored the relationships between school nurse presence and student health. It has been suggested that when children experience poor health, their academic performance declines. There is a lack of scientifically driven data in the literature connecting school nurse presence and student academic outcomes.
Methods: This was a cross-sectional study that included cohort data from Kentucky public high schools (n=230). Data were collected by survey. Respondents answered three multiple-choice questions to assess the presence of a daily nurse, length of employment, and typical daily functions. Outcomes from public high schools that had access to a full-time nurse from 2009-2013 were compared to those that did not have access to a nurse.
Results: Of the 232 schools contacted, 99.1%
Accent on ResearchAccent on Research continued from page 13
April, May, June 2017 Kentucky Nurse • Page 15
Accent on Research continued on page 16
participated. Among the 230 responding schools, 42.2% had a full-time (FT) nurse (n=97), 37.4% had a part-time (PT) nurse (n=86) and 20.4% did not have a nurse (n=47). When compared to schools without access to a FT nurse, those with a daily nurse had a lower absence rate (6.3 vs. 6.8, p < 0.05) and higher graduation rates (83% vs. 78%, p = 0.0002). After controlling for gender, ethnicity, and economic variables, ACT scores were also found to be higher among students with a FT nurse (p = 0.04) and PT nurse (p = 0.002) when compared to students with no nurse.
The Kentucky Nurses Association, in collaboration with stakeholders across the state, is continuing to gather information on student outcomes, chronic disease management, and health promotion behaviors, documenting the value of the school nurse.
Enhancing RN to BSN Student Awareness of the Public Health Nurse Role
Hartley Carmichael Feld, RN, MSN, PHCNS and Frances Hardin Fanning, PhD, RN
ABSTRACTObjective: The purpose of this study was to explore RN-BSN Public Health
students’ perception of an experiential clinical project designed to promote comprehension of the Public Health nurse role in rural Appalachian counties with disproportionately high morbidity and mortality rates.
Background: Public health nursing competency includes an understanding of environmental impact on health outcomes as well as interpretation of epidemiological data. Most nurses use information technology but only 25% report confidence in using research databases.
Significance to Nursing: Experiential learning activities in baccalaureate nursing courses increase awareness of the scope of urban public health practice and policy. Rural communities have disproportionately higher rates of chronic disease. Evidence-based rural public health measures must be implemented within the context of finite resources and geographic isolation and BSN programs should prepare graduates for this reality.
Methods: Student volunteers in the RN to BSN program completed community assessments, windshield and grocery store surveys, and key informant interviews in several rural Appalachian counties. Assessments required that students access epidemiological databases and interpret data in the context of developing, implementing and evaluating a community health intervention. Students partnered with schools, churches, cooperative extensions, libraries and local clinics for delivery of their interventions (e.g., digestive health, increased physical activity, promotion of fresh fruit and vegetable consumption). Lectures on rural health policy, impact of rurality on health outcomes, health disparities and health impact of geographical isolation were presented by senior researchers.
Findings: Students reported the experience helped them understand the health impact of environment, provided a realistic comprehension of public health nursing, gave insight into how nurses could address disparities and improve health outcomes, and gave them a greater sense of purpose than other clinical courses. Students had autonomy and flexibility in how they completed clinical hours and developed community projects.
Implications: Education and experience as registered nurses helped to facilitate these projects. Based on the degree of expertise required for these projects, we recommend this type of experience be limited to RN to BSN students. Students enrolled in traditional BSN programs may require more supervision than is conducive to this type of experience.
Effects of an Educational Intervention on RN to BSN Students’ Knowledge of Palliative Care
Carol Evans, DNP, RN, CNE
(In-progress- will be completed Dec. 2016)Abstract: The American Nurses’ Association (ANA) (2016) Registered Nurses
Roles and Responsibilities in Providing Care and Support at the EOL state that the nurse is expected to attain a basic knowledge of palliative care. Nursing schools should incorporate percepts of palliative care into the nursing curriculum and have basic and specialist End-of-Life Nursing Consortium (ELNEC) resources (ANA, 2016). The purpose of this research was to investigate the effects of an educational intervention on registered nurses (RNs) to Bachelor of Science (BSN) students’ knowledge of palliative care. A quantitative descriptive study was utilized with a convenience sample of registered nurses to Bachelor of Science
students enrolled at a south-central Kentucky university. Demographical data was utilized to describe the study subjects, and the Palliative Care Knowledge Test (PCKT) (Nakazawa et al., 2009) was utilized to measure the subjects’ knowledge of palliative care. Descriptive statistics and a paired sample t-test were used for analysis.
Nurses cannot practice what the nurse does not know. Subjects achieved a total score of 56% out of 100% with a mean of 11.3 (SD = 1.89) on the PCKT pre-intervention and the subjects achieved a total score of 61% out of 100% with a mean of 12.2 (SD = 3.3) on the PCKT post-intervention. There was no statistically significant difference in scores pre-educational intervention (M = 11.3, SD = 1.89) to post-educational intervention (M = 12.2, SD = 3.3), t (61) = -1.74, p = .09 (two tailed). The mean increase in PCKT scores was 1.77 with a 95% confidence interval ranging from 1.91 to 0.14. The eta squared statistic (.83) indicated a large effect size. There was a statistically significant difference on the PCKT’s subsets of philosophy of palliative care, management of pain, dyspnea, and psychosocial issues from the pre to post educational intervention. The incorporation of palliative care content across nursing curriculum may be needed to ensure quality end of life nursing care for our patients.
ReferencesAmerican Nurses Association {ANA}. (2016). Position Statement: Nurses’ roles and
responsibilities in providing care and support at the end of life. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/EndofLife-PositionStatement.pdf
Nakazawa, Y., Miyashita, M., Morita, T., Umeda, M., Oyagi, Y., & Ogasawara, T. (2009). The palliative care knowledge test: reliability and validity of an instrument to measure palliative care knowledge among health professionals. Palliative Medicine, 23(8),754-766.doi:10.1177/0269216309106871
Do Not Disturb: Vital Sign Monitoring as a Predictor of Clinical Deterioration in Monitored
PatientsSusan Newman, RN, MSN, PCCN
ABSTRACTDescription/background: Early detection and intervention in cases of
potential clinical deterioration are important to guide treatment and prevent significant adverse advents. However, the frequency and timing of assessments remains a matter of custom and opinion. Evidence indicates that sleep disruption has measurable and often persistent harmful effects, particularly in elderly patients. Finding the best balance between safety and undisturbed rest has important implications for nursing practice. The purpose of this study was to review adverse events such as arrests and rapid response calls to determine the interval between the event and the last previous vital signs recorded.
Review of Literature:Flynnnotedthat“nursesneedtostopusingpracticeinterventionsthatarebasedsolelyontradition.”Timelyandappropriateclinicalobservation of patients is a cornerstone of nursing practice. Observation serves
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to detect adverse changes, to guide and evaluate care, and to provide comfort and reassurance. Nurses play a vital role in the evolution of health care based upon evidence-based practices rather than tradition. Patients on transitional care units often have multiple and complex health problems which put them at increased risk of such occurrences. However, the frequency and timing of assessments remains a matter of custom and opinion with few supporting studies to provide substantiation.
While any patient has the potential to experience a sudden change in condition, certain characteristics often present in the transitional care patient population are associated with greater instability: newly admitted, recently transferred (from higher or lower level of care), or a recent procedure (Schulman and Staul 2010). Others in the patient population on TCU, such as those improving and close to discharge, have a decreased risk of sudden adverse event. Several studies have examined the value of MEWS (modified early warning score) values in predicting these events. Churpak et al, in a study reviewing 88 cardiac arrests, found significantly higher scores in the 48 hours preceding the event. Meester et al reviewed more than 500 patient records at Antwerp University hospital and concluded there was a significant difference in mean MEWS scores in patients experiencing a serious adverse event compared to patients without such an event. Ludikhuize et al reviewed 204 cases in Amsterdam, noting that 80% of cases had an increased MEWS score during the 48 hours before a serious adverse event. Yoder et al noted that patients with lower risk as determined by MEWS score had significantly fewer adverse events, but were awakened at night just as often as higher-risk patients.
Determining how often assessment should be performed at night is a topic of particular concern, given the increasing evidence that sleep disruption has measurable and often persistent harmful effects. Several studies have confirmed measurable physiological effects related to interrupted sleep. Older adults whose amount of daytime sleep increased in the six months following return home from a rehabilitation facility were found to have worsening cognitive function, while those with less daytime sleep demonstrated improved function (Dzierzewski). Sleep disruption has been associated with impaired physical and cognitive function, fatigue, and exacerbation of symptoms. (Flynn). Watson et al noted that sleep deprivation has been associated with a number of physiological disruptions including immune response, cardiac regulation, metabolic and endocrine regulation, and pain response. He also cites studies indicating that interrupted or insufficient sleep is associated with delirium in ICU patients, and that sleep-promoting medications may contribute to the development of delirium. Scientific evidence supports the fact that frequent interruptions can result in sleep deprivation to such an extent that the patient’s health and recovery are adversely affected.
Action: A retrospective descriptive study was used to examine the frequency and type of significant adverse events occurring on the night shift on five transitional care units for one year. Data included the type, cause and outcome of event and last previous vital signs assessment.
Outcomes and Takeaways: Forty-six codes and one hundred sixty-eight rapid response events occurred. The rate of events declined over the length of time since last assessment. It was determined that 38% of events occurred within one hour of the previous assessment, and 85% within less than the four-hour interval for performing a scheduled assessment. The findings indicate that sudden unexpected clinical deterioration is uncommon in this constantly monitored patient population. Patients, particularly older clients, are vulnerable to harmful effects from interrupted sleep. Guidelines to lengthen the permitted interval between nighttime assessments, along with a coordinated effort to combine necessary sleep interruptions, would minimize these effects.
ReferencesChurpek M, Yuen T, Huber M et al. Predicting
Cardiac Arrest on the Wards: A Nested Case-Control Study. Chest 2012; 141(5):1170-1176.
Dzierzewski JM, Fung CH, Jouldjian S, et al. Decrease in Daytime Sleeping is Associated with Improvement in Cognition after Hospital Discharge in Older Adults. Journal of the American Geriatrics Society 2014; 62:47-53.
Flynn MB, Rauen C, Watson R, et al. Examining the Evidence to Guide Practice: Challenging Practice Habits. Critical Care Nurse 2014; 34(2):28-44.
Fontana CJ, Pittiglio LI. Sleep Deprivation Among Critical Care Patients. Critical Care Nursing Quarterly 2010; 33(1):75-81.
Klnouye S et al. Delirium in Elderly People. Lancet 2014; 383: 911-922. August 28, 2013
Ludikhuize J, Smorenburg S, Rooij, S. Identification of deteriorating patients on general wards; measurement of vital parameters and potential effectiveness of the Modified Early Warning Score. Journal of Critical Care 2012; 27: 424.e7-424.e13.
Lytle J, Mwatha C, Davis KK. Effect of Lavender Aromatherapy on Vital Signs and Perceived Quality of Sleep in the Intermediate Care Unit: A Pilot Study. American Journal of Critical Care 2014; 23(1):24-29.
Meester D, Hellemans D, Verbruggles W. Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge. Resuscitation 2013; 84:184-188.
Pilkington S. Causes and Consequences of Sleep Deprivation in Hospitalised Patients. Nursing Standard 2013: 27(49):35-42.
Radtke K, Obermann K, Teymer L. Nursing Knowledge of Physiological and Psychological Outcomes Related to Patient Sleep Deprivation in the Acute Care Setting. MedSurg Nursing May-June 2014; 23(3):178-184.
Schulman C & Staul S. Standards for Frequency of Measurement and Documentation of Vital Signs and Physical Assessments. Critical Care Nurse 2010; 30(3):74-76.
Watson P, Ceriana P, Fanfulla F. Delirium: Is Sleep Important? Best Practice and Research Anaesthesiology 2012; 26:355-366.
Yoder J, Yuen T, Churpek M. Nighttime Vital Sign Monitoring Frequency and Risk of Clinical
Accent on ResearchAccent on Research continued from page 15
The Human Touch
Copyright1980|Limited Edition Prints by Marjorie Glaser Bindner RN Artist
Limited Edition Full Color Print | Overall size 14 x 18 | Signed and numbered (750)—SOLD OUTSigned Only (1,250)—$20.00 | Note Cards—5 per package for $6.50
THE PAINTING“The Human Touch” is an original oil painting 12” x 16”on canvas which was the titled painting of Marge’s first art exhibit honoring colleagues in nursing. Prompted by many requests from nurses and others, she published a limited edition of full color prints. These may be obtained from the Kentucky Nurses Association.
The Human Touch
Her step is heavyHer spirit is highHer gait is slowHer breath is quickHer stature is smallHer heart is big.She is an old womanAt the end of her lifeShe needs support and strengthFrom another.
The other woman offers her handShe supports her arm
She walks at her paceShe listens intentlyShe looks at her face.She is a young woman at theBeginning of her life,But she is already an expert in caring.
RN PoetBeckie Stewart*
*I wrote this poem to describe the painting, The Human Touch
byMarge.”Edmonds, Washington 1994
FOR MAIL OR FAX ORDERSI would like to order an art print of “The Human Touch”©
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Accent on Research continued on page 18
Deterioration. Journal of American Medical Association: Internal Medicine 2013; 173(16):1554-1555
Creating Positive Impact on Nursing Education in an Online
RN-BSN Program through Curriculum Development
Dr. Cailen Wattenbarger Baker, DNP, MSN, RN; Dr. Claudia Mitchell, PhD, MSN, RN;
Yalanda Scalf, MSN, RN
ABSTRACTBackground: The Department of Nursing at
University of the Cumberlands has recently applied teaching strategies utilizing evaluative research through the presentation, data collection, data synthesis, and reaction to data gathered regarding the use of pre-developed course cartridges made available via text publishing companies. Chassemi (2016) lends support to faculty experience that the use of multiple teaching modalities respond to diverse learning styles in the classroom and can increase learning in the classroom.
Research Objective: The purpose of this project was to evaluate and compare student satisfaction and achievement of course learning outcomes following implementation of faculty driven interactive learning modules versus standardized pre-developed course cartridges created via publishing vendor. The research hypothesis is original course content material, developed by faculty teaching the course and incorporating several learning styles, will increase student satisfaction, and learning in the online learning environment.
Significance to the Field of Nursing: This example of curriculum evaluation and data driven decision-making is of paramount importance in achievement implementation of best practice nursing education and contribution to the nursing body of knowledge.
Methods: The method for conducting the project was via curriculum evaluation. Data was collected related to student satisfaction and key benchmark learning outcomes for two terms using the standardized course cartridges and two terms following faculty created learning modules. Both subjective and objective data were collected via methods such as: student and faculty feedback, end of course evaluations, an internally developed course cartridge survey, and student forums.
Findings: The data revealed higher student satisfaction and at least equal or greater learning outcome scores. The findings indicated students struggled grasping content presented in the pre-developed course cartridge materials, were not as active in the online learning environment, and did not feel a personal connection with their instructors.
Implications: The research presented implications to practice include the presentation of lessons learned, application of the research process in the online learning environment, and developing a positive impact on nursing education and perception of nurses returning to school for their RN-BSN degree.
ReferencesChassemi, A. E. (2016). Innovation in a Mental
Health Course Design: Increasing Student Engagement and Interaction. Journal Of The New York State Nurses Association, 44(2), 20-27.
Comparison and Accuracy of Pulse Oximetry at
Three Different Body Sites Versus Arterial Blood Gas
OxygenationDebbie Alford, BSN, RN; Catherine Brug-Reeves,
RN, BSN, BS; Linda Schuler, BSN, RN, CCRN
ABSTRACTBackground: Measuring the amount of oxygen
is an important indicator of respiratory status. This
measurement is accomplished via arterial blood gas measurements (ABGs). Noninvasive methods such as pulse oximetry are now used to assess oxygenation. The Masimo SPO2TM sensor is not indicated for the use on the forehead; however, if a reading is difficult to obtain, the forehead is used. The purpose of this study was to compare the accuracy of pulse oximetry using the Masimo sensor at three sites (forehead, and nailbeds of the finger and toe) and comparing it to the ABG.
Significance: Patients in intensive care units (ICU) have pulse oximetry checked frequently. These patients are often on vasopressors, which can cause a decrease in blood flow to the extremities limiting the usefulness of the pulse oximetry. It is important to determine whether alternate sites can be used to assess blood oxygenation.
Method: A quantitative study was conducted comparing pulse oximetry at the forehead, finger, and toe with the ABG. These measurements were completed within an average of 4 minutes from the ABG draw.
Results: The results were based on 24 sets of data. A repeated measures ANOVA was calculated to determine any differences between the three pulse oximeter readings. The results were not significant, F = 0.135, p= 0.875, indicating that the forehead and toe are acceptable to use for pulse oximeter readings.
Paired t-tests were also calculated to determine whether there was a difference between the pulse oximeter sites and the ABG. The results were significant (p = 0.004-0.029). This indicates that all three sites are significantly different from the ABG. This is not unexpected, as the literature cites examples of needing an SPO2 of 94% or above to have a SaO2 of 90% (Van de Louw, 2001).
Conclusions: In this preliminary study, the Masimo sensor on the forehead and toe were found to be viable alternatives to the finger for SpO2 monitoring. However, when using pulse oximeters, it is important to understand that they generally have higher readings than the ABG and caution should be used when basing clinical judgments on these readings.
Childhood Bullying: Assessment Practices and
Predictive Factors Associated with Assessing for Bullying by
Health Care ProvidersVicki Hensley, PhD, APRN-PNP
ABSTRACTChildhood bullying affects over 25% of today’s
youth and causes up to 160,000 missed school days per year. Bullying causes short and long term adverse effects to both mental and physical health. Many organizations encourage healthcare providers to take an active role in bullying prevention. However, there has been little research into the role of primary healthcare providers regarding childhood bullying and the effectiveness of different approaches to screening and management of bullying.
Accent on Research KNA Centennial VideoLest We Forget
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Therefore the purpose of this research was to explore childhood bullying and the role of healthcare providers in bullying prevention. Pediatric healthcare providers were asked to participate in this study if they conducted well-child exams on a weekly basis. Information on the provider’s current bullying assessment practices, attitudes, self-confidence, and knowledge regarding bullying was gathered. Results indicated that approximately one-half (46.6%, n=55) of the healthcare providers reported assessing their patients for bullying behaviors during well-child exams. The strongest predictor of positively assessing for bullying was attitudes, recording an odds ratio of 1.24. This indicated for every one-unit increase in attitudes score, the odds of assessing for bullying will be 24% higher. The odds ratio of self-efficacy or self-confidence was 1.18, indicating that for every one-unit increase in self-efficacy score, the odds of assessing for bullying will be 18% higher.
This research is significant to the field of nursing in many ways. This is the first study to examine healthcare providers’ childhood bullying assessment practices and factors that predict the probability of healthcare providers assessing for bullying. Findings from the current study add to the body of literature concerning childhood bullying, assessing for bullying in the primary care setting, and factors that may increase the likelihood of healthcare providers assessing for bullying. Future research is needed to further explore the phenomena of the healthcare provider’s role in bullying prevention and intervention. Researchers should focus on repeating this study in a larger population and with different populations, such as school nurses. Results of future studies could then be used to develop an intervention to increase healthcare provider’s assessment of bullying.
Boot Camp: Enhancing Clinical Reasoning Skills in MedVet to BSN Students
Angela B. Grubbs, DNP, APRN
ABSTRACTObjective: The purpose of a 3-day boot camp
was to improve MedVet students’ clinical reasoning skills.
Background: Medically trained veterans have experience in triage and stabilization of trauma patients. Much of their expertise does not require clinical reasoning. Assessment of clinical reasoning skills in new graduate nurses shows that 70
percent demonstrate “unsafe” decision-making inemergent situations (Levett-Jones, et al., 2010). In our cohort of medic-veterans, the need to enhance clinical reasoning skills was identified via student focus groups, faculty feedback, and current student exam scores. A 3-day “Boot Camp”was created toenhance the clinical reasoning skill set.
Methods: Students participated in instructor-facilitated clinical reasoning activities. Learning outcomes included: (1) Describe what clinical reasoning is and explain the necessity to master the skill for effective and efficient bedside nursing, (2) Explain how information obtained through clinical reasoning can be used in various patient populations, (3) Apply clinical reasoning strategies to scrutinize scenarios using clinical reasoning to correctly solve problems, (4) Analyze the critical steps in the organized process of clinical reasoning, (5) Summarize information using clinical reasoning to cluster priority data, (6) Evaluate the use of SBAR communication that was organized using clinical reasoning to share information with others, and (7) Justify appropriate assumptions made in solving clinical reasoning problems.
Results: At the end of the boot camp, students were able to successfully define and identify the steps of clinical reasoning and apply them to NCLEX-style exam questions. The students were also able to effectively and appropriately communicate using the SBAR technique.
Implications: The skills obtained by the student veterans during the 3-day boot camp can be tailored to any student cohort. Student veterans will be able to respond to critical situations at the bedside more effectively using their clinical reasoning skills.
Assessing Competencies Needed to Lead in an
ACA WorldDee Beckman, MBA, MSN, RN, NE-BC and
Nora Warshawsky, PhD, RN, CNE
ABSTRACTBackground: Baptist Healthcare System created
a new strategic plan built on five priorities that will position Baptist Health System to respond to the Affordable Care Act’s (2010) demand for expanded access to services, improved health outcomes, and reduced healthcare costs. This requires a new emphasis on population health and intervening at the societal level. Achieving these outcomes requires new competencies for healthcare leaders from the bedside to boardroom. Baptist Health Lexington has had a longstanding leadership competency development program, namely, the Evolving Leaders Program (Hill, 2003). With the
radical transformation demanded by changes in the healthcare environment, it was necessary to evaluate the program.
Purpose: The purpose of this presentation is to describe the self-assessed competencies for leaders at the bedside, unit level, and department level.
Design: This descriptive study used an electronic survey was administered using Qualtrics© (Salt Lake City, UT). Recruitment emails were sent to 393 frontline, unit leaders, and departmental leaders. The survey period was March 17, 2016 to April 11, 2016.
Sample: Data from 93 participants were retained for analysis. The sample included 41% Nursing and 57% Non-Nursing leaders with an average of 12.73 (SD=8.75) years of experience.
Measurement: A total of 50 competencies were identified from AONE Executive Leader competencies (AONE, 2016) to support each of the strategic goals. The survey was reviewed by a panel of six experts. Participants were asked to score each competency for their degree of experience with the competency (None, Some Experience, Very Experienced).
Data Analysis: Frequency distributions were used to describe the degree of experience for each competency.
Results: Participants reported greatest experience with competencies related to valuing the people and culture and improving the patient experience. Competencies with greatest need for development were those introduced to respond to the ACA such as serving the community and population health.
Implication and Findings: Evolving Leaders program can support the new strategic plan by increasing attention to competencies related to healthcare finance, economics, and delivery models. Additional competencies to develop included evidence-based practice, risk taking, innovation, and use of reflective practice. Mentoring and active learning strategies are recommended for program delivery.
ReferencesAmerican Organization of Nurse Executives
(AONE). (2016). Nurse Executive Competencies Retrieved from: http://www.aone.org/resources/nec.pdf
Hill, K. (2003). Development of leadership competencies as a team. Journal of Nursing Administration, 33, 639-642.
PPACA. (2010). Patient Protection and Affordable Care Act. 42 U.S.C. section 18001 et seq.
Academic-Practice Collaboration: Extending
Research into the Community Tina Volz, PhD, RN
ABSTRACTThe Research Collaborative was founded in
2006 as a partnership between the local chapter of Sigma Theta Tau International (STTI) Nursing Honor Society, a local hospital, university, and health department. The purpose of the research collaborative is to positively impact healthcare outcomes within the region through implementation of community driven interventions based on interdisciplinary research methods, quality improvement initiatives, and application of best practices. A major focus is to increase the interest of registered nurses in research regardless of educational background. The collaborative was developed through a University Community Partnership Grant. Since 2006, the collaborative has expanded and now provides structured workshops, seminars, and professional meetings that focus on utilization and application of research by nurses.
Nursing Research Conferences were started in 2006. Initially, the research conferences were designed to educate staff on designing research proposals, designing posters, and how to write for publication. The research conferences are now
Accent on ResearchAccent on Research continued from page 17
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Accent on Research
focused on sharing research findings, evidence-based practice projects and to stimulate increased interest and participation of nurses in nursing research. Conferences are presented on an annual basis. In 2012, writing workshops were developed and implemented. In 2013, a series of five research workshops were created. Both workshops are offered to hospital employees, university faculty and nursing students. Workshops provide “handson”experiencedesignedtoguidenoviceresearchersthrough the research process and to prepare manuscripts for publication in peer-reviewed journals.
Five publications were completed by faculty and nurses attending the writing for publication workshops. Several research studies are in various stages of development. Regional research conferences have grown in size since 2008. The 2016 research conference had 110 registrations and a waiting list. Plans are in place to change the venue in 2017 to accommodate increased numbers of conference participants. Our STTI chapter twice received the International Research Award given at The Honor Society of Nursing, Sigma Theta Tau International (STTI). The STTI awards were directly related to the work that has been initiated and completed through the collaborative.
Academic Support Strategies for MedVet - BSN
StudentsDarlene Welsh, PhD, MSN, RN
Objective: The purpose of this mixed-methods study was to identify student learning needs and develop appropriate strategies to enhance student success
Background: In 2013, over 75,000 enlisted military personnel worked in collaboration with nurses and physicians to provide patient care services (US Department of Labor, Bureau of Labor Statistics, 2013). Included in this group are soldier medics, who provide emergency medical treatments to troops in the field and more routine care for soldiers and their families at home. Emergency medical training and military leadership skills provide the military medic with a strong foundation for attainment of a nursing degree.
Methods: A grant from the Health Resources and Services Administration (HRSA) funded the development of a 5 semester MedVet Option in our baccalaureate nursing program for soldiers with military medic training. One goal of the Option is to assemble a network of support to promote academic success among members of this student group. The first two cohorts in the MedVet Option (N=5) participated in focus group sessions to determine their learning needs. A review of focus group comments and consideration of other educational variables resulted in the creation of specific learning resources for the MedVet students. In addition to longstanding resources for academic enhancement, faculty developed MedVet specific activities such as Study Buddy Hour, the MedVet Boot Camp, Peer Tutors Initiative, scientific writing modules, and exam preparation modules to promote student success.
Results: Qualitative comments from focus group discussions and information about student use and ratings of these academic supports will be presented.
Significance: Student veterans often have unique needs when their prerequisite collegiate education has occurred in the remote past. The delivery and evaluation of academic success strategies will likely enhance the matriculation of this student population into the health care work force.
Implications: The projected availability of RNs to meet the future health care demands of the public varies by state. Ideally, nursing education for experienced military medics can provide career opportunities for veterans who have served our country while exerting a positive influence on the nursing shortage.
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Monthly Electronic Deduction | Payment Authorization Signature*
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*By signing the Monthly Electronic Payment Deduction Authorization, orthe Automatic Annual Credit Card Payment Authorization, you areauthorizing ANA to change the amount by giving the above signed thirty(30) days advance written notice. Above signed may cancel thisauthorization upon receipt by ANA of written notification of terminationtwenty (20) days prior to deduction date designated above. Membershipwill continue unless this notification is received. ANA will charge a $5 fee forany returned drafts or chargebacks. Full and Direct members must havebeen a member for six consecutive months or pay the full annual dues to beeligible for the ANCC certification discounts.
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Ways to PayMonthly Payment: $15.00
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ANA and State Membership Dues: $15.00 Monthly or $174.00 Annual
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Clinical Nurse/Staff NurseNurse Manager/Nurse Executive (including Director/CNO)Nurse Educator or ProfessorNot currently working in nursingAdvanced Practice Registered Nurse (NP, CNS, CRNA)Other nursing position
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Stay informed from coast to coast!
• Access over 600 issues of official state nurses publications, to make your research easier.
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www.nursingALD.com
Page 20 • Kentucky Nurse April, May, June 2017
Job OpportunitiesIn KentuckyBluegrass Community HospitalVersailles, Kentucky BluegrassCommunityHospital.com
Bourbon Community HospitalParis, KentuckyBourbonHospital.com
Clark Regional Medical Center Winchester, KentuckyClarkRegional.org
Fleming County HospitalFlemingsburg, KentuckyFlemingCountyHospital.org
Georgetown Community HospitalGeorgetown, Kentucky GeorgetownCommunityHospital.com
Jackson Purchase Medical Center Mayfield, KentuckyJacksonPurchase.com
Lake Cumberland Regional HospitalSomerset, Kentucky LakeCumberlandHospital.com
Logan Memorial HospitalRussellville, KentuckyLoganMemorial.com
Meadowview Regional Medical Center Maysville, KentuckyMeadowviewRegional.com
Spring View HospitalLebanon, KentuckySpringViewHospital.net
We are equal opportunity employers. We believe our employees are our most valuable assets.We do not discriminate against any person on the basis of race, color, national origin, disability or age in admission, treatment, or participation in our programs, services and activities, or employment.
Nurses, thank you for putting the “care” in healthcare.
During National Nurses Week and throughout the year, we recognize the integral role our nurses
play in making communities healthier.
Learn more about exciting full-time and PRN opportunities for nurses at patient-centered, quality-driven hospitals across Kentucky. Registered Nurses (RNs), Licensed Practice Nurses (LPNs) and Certified Nursing Assistants (CNAs) are needed in the following vibrant communities and hometowns:
