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Mindfulness Practice to DevelopEmotional Intelligence in

Pre-Licensure Nursing StudentsBy: Kristin Weston, BSN, RN / Project Advisor: Anne Schoening PhD, RN, CNE

Results• 22 relevant sources• 4 Level I6, 7, 8, 9

• 1 Level II10

• 7 Level IV11, 12, 13, 14, 15, 16, 17

• 2 Level V18, 19

• 6 Level VI20, 21, 22, 23, 24

• 3 Level VII25, 26, 27

Reflective Journaling• Promotes development of critical thinking24

• Promotes self understanding25

• Promotes reflection21

Meditation• Improves mental capacities – self-regulation of

emotion27

• Encourages concentration28

• Develops emotional positivity28

• Develops non-judgmental awareness28

Yoga• Exercising mind & body through movement &

meditation6

• Improves self regulation10

• Assists in stress adaption10

• Decreases emotional exhaustion10

Purpose The purpose of this scholarly project is to review and synthesize the available literature on increasing emotional intelligence by teaching mindfulness practice to pre-licensure nursing students. Evidence-based recommendations for nurse educators will be made.

Background• New nurses at risk for burnout1

• Decreased job satisfaction2

• Increased nurse turnover3

• Increased cost to employers4

• Increasing emotional intelligence helps prevent burnout5

Methods• CINAHL, PubMed, Google Scholar, Ebscohost• Keywords: emotional intelligence, mindfulness

practice, turnover, nurse burnout, mindfulness in nursing curriculum

• Time period: 2015-2020, extended to 2010-2020

Theoretical Framework• Social Cognitive Theory – Albert Bandura29

• Behavior is affected by environment & personal factors29

• Self-efficacy – thought patterns are self-aiding or self-hindering29

• High self-efficacy → high goal setting → firm commitment29

• Students see potential benefits of mindfulness practices

Recommendations• Add mindfulness practices into curriculum19

• Add entire course during first year• Begin to incorporate throughout program• Incorporate into clinical rotations

Course DescriptionStudents in this course will gain knowledge and understanding of the importance of mindfulness practice. Emphasis will be placed on various mindful practices and how they can assist students in their future nursing career. Students will apply knowledge of mindfulness practice and evaluate their growth.

References available upon request

(Vega, 2020)

(Langevin, 2020)

(Rice, 2020)

Nurse Leadership Development: How to Prepare Emerging Nurse Leaders for

Leadership Roles

Molly King, BSN, RNC-MNN

Nurse managers face a growing challenge to fully learn and embrace all aspects of their role. Hospitals have two reasons for focusing on nursing leadership development. 1) Offering support during the first year of transition,

hospitals help mitigate NM burnout and improving unit morale, which ultimately influences staff morale and patient care.

2) Hospitals can enhance their succession planning and decrease costs for NM recruitment and transition.

Background Conclusion

Purpose

Nurses are expected to be leaders from the bedside to boardroom, however, promotions into nurse leader roles are based on seniority or clinical expertise rather than leadership abilities. Nursing leadership, especially the Nurse Manager is a wide-reaching role and influential over many areas of unit/department function including nursing retention rates, nurse engagement, patient satisfaction, quality/safety, and decreased adverse events

The purpose of this scholarly project is to complete a comprehensive review of literature in order to define leadership, understand the influence of nurse leaders, describe how nurse leaders are currently trained, and explain why leadership development programs build prepared and resilient nurse leaders.

To best prepare and support nurse managers/leaders and to meet guidelines laid out in the American Organization for Nursing Leadership’s for Nurse Manager Competencies, it is recommended that hospitals create and implement nurse leadership development programs to help increase effectiveness of unit manager, decrease costs of hiring for NM roles, and improve patient outcomes.

Conceptual Framework

Implications for Practice

Leadership

Evidence

AuthorLevel of

EvidenceFindings

Gilbert et al. (2017) Level V Successful nurse managers balance human and social capital (relationship building and clinical expertise)

Schuettner et al. (2015) Level VWithout advanced education, nurse managers are ill-prepared to carry out all competencies for the role, specifically financial acumen, human resources management, and systems-level leadership.

Anderson & Garman (2014) Level VI Surveyed 100 hospitals and found only 30% had formal processes for training leaders

Dyess et al. (2016) Level VIConducted focus groups with 44 nurses enrolled in master's programs. Students reported learning ways to develop cohesive teams.

Loveridge (2017) Level VI Interviewed 12 nurse managers who reported limited training, burnout, and lack of work-life balance. Loveridge (2020) Level VI Survey of 12 nurse managers who reported little support for learning their role or understanding expectations.

Mackoff & Triolo (2008) Level VIInterviewed 30 nurse managers and executives who struggled with developing competencies, setting boundaries, and work-life balance.

Paterson et al. (2015) Level VIConducted pre/post surveys of 79 nurses who attended leadership development workshops which lead to increased interest in future leadership opportunities.

Phillips et al. (2017) Level VI By focusing on internal leadership development programs, hospitals can decrease recruiting and orientation costs. Pine & Tart (2007) Level VI The cost of replacing a nurse manager is 75%-125% their average salary

Ramseur et al. (2018) Level VI Found participants in leadership development more likely to pursue advanced degrees and seek out leadership roles.

Steege et al. (2017) Level VIInterviewed 10 nurse managers and 11 nurse executives reported difficulty with understanding all aspects of their roles.

Swearingen (2009) Level VIFound a 25% reduction rate in turnover and a more robust list of candidates aware of hospital's culture through leadership development.

Warshawsky & Havens (2014) Level VI Found that nearly 70% of 291 nurse managers planned to leave job within five years, related to burnout. AONL (2015) Level VII Define key attributes/competencies for nurse managers

Cathcart (2020) Level VIINurse managers who manage units well earn staff trust and motivate staff to help support environments that focus on patient care.

Doria (2015) Level VIIClinical leadership roles, such as charge nurse, do not fully prepare nurse for leadership, specifically manager positions. Without formal training, nurse managers find burdens of leadership overwhelming, leading to burnout and turnover.

Joseph & Huber (2015) Level VII Master's level curriculum can take years to develop or change to current healthcare realities. Shirey (2006) Level VII Hospitals are not prepared for expected nurse manager vacancies, which were estimated to be 67,000 in 2020.

Titzer et al. (2013) Level VIISurveyed 12 emerging leaders who reported 100% retention rate of employees and 75% advancing into leadership roles. Focusing on internal professional development, hospitals can decrease transition time and manager turnover.

Gatekeeper Training for Suicide Prevention in Youth Megan Downing, RN, Katie Kinser, RN

Holly Sak, BSN-RN, Dr. Linda Hughes, PhD

NEBRASKA METHODIST COLLEGE

Background | Problem

Purpose

PICO Question

Search Plan

Conceptual Framework

Implications | RecommendationsAttitude

Subjective Norm

Perceived Control

Intention Behavior

AZJEN’S THEORY OF PLANNED BEHAVIOR

REFERENCES

• Suicide is the second leading cause of death in youth ages

10 to 24 with rising rates globally.

• Adolescent mental health and violence prevention are critical

issues in need of research and response.

• Gatekeeper Training enables designated professionals to

identify suicidal individuals, counsel, and provide mental

health referrals.

• Comparative rates of suicide present significantly lower

suicide rates in counties with funded Gatekeeper Training.1

• Current best practice with RN Gatekeepers is unclear.

The aim of this project explores Gatekeeper Training

programs compared to no training and the effectiveness of

nurses’ abilities to identify suicidal adolescents.

• Primary Outcome: assess whether Gatekeeper Training

programs correlate with decreased rates of youth suicide.

• Secondary Outcome: assess whether Gatekeepers

display increased behavioral interventions including

recognition behaviors, action-oriented behaviors, and

referring behaviors.

In youth, ages 10-24 years (P), how do interventions based

on a Gatekeeper Suicide Prevention Training program for

nurses (I) compared to no training (C) affect suicide rates (O)?

Method

Three-database search: CINAHL, Medline Complete, and

Academic Search Elite.

• Search terms included keywords such as “gatekeeper”,

“prevention”, “training”, and “suicide prevention”.

• Search limiters included peer reviewed, research, full text,

published in English, quantitative studies and published

dates of 2010-2020 resulting in 4 articles.

• Exclusion criteria: inpatient settings, research not addressing

the PICO, duplicates, persons <10 or >25

• A manual scan of the best articles resulted in 2 additional

articles (n=6).

• Intervention programs in various settings can be effective for decreasing suicidality in

youth, with the strongest statistical support evidenced in school settings.2,3,4,5,6

• Gatekeepers are statistically correlated with a positive effect on knowledge and

referral interventions with youth. 2,3,4,5

• Trained professionals in frequent contact with youth result in stronger positive

intervention effects. 3,4

• All meta studies on Gatekeeper training methods, setting, and roles identified gaps in

efficiency due to ethical constraints and study limitations. 2,5

• Overall, the research promotes both the primary and secondary PICO outcomes of

interest with this study. 2,3,4,6

Results

• Gatekeeper programs differ in cost and length of training yet are universally rooted in

evidence from clinical psychology and the theory of planned behavior. 7

• Gatekeeper Training programs effectively counter suicidality in youth across settings.

• Refresher training courses should be considered with strategies to mitigate the

attrition of Gatekeeper knowledge over time. 3,7

• Gatekeeper training for nurses aligns with QSEN Patient-centered Care and

Evidence-Based Practice competencies.

• Recommendations should include training for nurses that work in community settings

with youth and should involve long-term retention and skills maintenance planning.

Additional high-quality long-term studies are warranted to address:

which Gatekeeper Training program/s provide nurses the optimal

cost-benefit to society?

1 Kuhlman, S. T., Walch, S. E., Bauer, K. N., & Glenn, A. D., (2017). Intention to enact and enactment of gatekeeper

behaviors for suicide prevention: an application of the theory of planned behavior. Prevention Science, 18, 704-715.2 Calear, A., Christensen, H., Freeman, A., Fenton, K., Busby Grant, J., van Spijker, B., & Donker, T. (2016). A

systematic review of psychosocial suicide prevention interventions for youth. European Child & Adolescent

Psychiatry, 25(5), 467–482.

3 Condron, D. S., Garraza, L. G., Walrath, C. M., McKeon, R., Goldston, D. B., & Heilbron, N. S. (2015). Identifying and referring youths at risk for suicide following participation in school-based Gatekeeper training. Suicide & Life-Threatening Behavior, 45(4), 461–476.4 Cross, W. F., Seaburn, D., Gibbs, D., Schmeelk-Cone, K., White, A. M., & Caine, E. D. (2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. The Journal of Primary Prevention, 32(3-4), 195– 211.5 Isaac, M., Elias, B., Katz, L. Y., Belik, S.-L., Deane, F. P., Enns, M. W., & Sareen, J. (2009). Gatekeeper training as a preventative intervention for suicide: a systematic review. Canadian Journal of Psychiatry, 54(4), 260–268.

6 Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., Pirkis, J., Condron, P., &

Hetrick, S. (2018). What works in youth suicide prevention? A systematic review and

meta-analysis. EClinicalMedicine, 4–5, 52–91. 7 Hangartner, R. B., Totura, C. M. W., Labouliere, C. D., Gryglewicz, K., & Karver, M. S. (2019).

Benchmarking the “Question, Persuade, Refer” program against evaluations of established suicide

prevention Gatekeeper trainings. Suicide & Life-Threatening Behavior, 49(2), 353–370.

Questions?

Presenter Contact Info:

Sabau, Liz G <LizSabau@creighton.edu>;

Weston, Kristin C <KristinWeston@creighton.edu>;

King, Molly M <MollyHendricks@creighton.edu>;

Sak, Holly C <HollySak@creighton.edu>