Decreasing the Incidence of Residual Neuromuscular Blockade

The presence of muscle weakness after the administration of a neuromuscular reversal agent is described as a residual neuromuscular blockade (RNMB) due to an incomplete antagonism of a neuromuscular blocker. To decrease the incidence of RNMB, the American Society of Anesthesiologists (ASA) strongly recommends quantitatively monitoring the degree of neuromuscular blockade perioperatively and extubating the patient when the train-of-four (TOF) ratio is greater than or equal to 0.9 at the adductor pollicis. There are acceleromyography (AMG) based and electromyography (EMG) based quantitative monitors; the limitations of AMG have been addressed by EMG

Addressing the Nursing Shortage in Africa: Strategies for Retention and Workforce Sustainability

The nursing workforce is the backbone of Africa’s healthcare system, yet the continent faces a critical shortage of nurses. This shortage is exacerbated by high attrition rates, inadequate training and working conditions, migration of skilled professionals, and insufficient investment in workforce development. Without urgent intervention, achieving Sustainable Development Goal 3 (SDG 3: Good Health and Well-being) will remain a challenge, particularly in ensuring universal health coverage (UHC) and improving maternal and child health outcomes. This side event at ARFSD-11 provides a platform to discuss sustainable strategies for nursing retention and workforce development. It aligns with the forum’s broader objectives by addressing key policies, financing mechanisms, and capacity-building initiatives needed to strengthen Africa’s healthcare systems

Exploring LGBTQ+ Health: Insights from Ireland

This webinar explores key issues in LGBTQ+ health in Ireland, highlighting challenges, progress, and opportunities for inclusive healthcare. Dr. John Gilmore will share research insights, policy developments, and best practices to improve health outcomes for LGBTQ+ communities. Ideal for healthcare professionals, researchers, and advocates committed to equitable care

Implementation of the Montreal Cognitive Assessment (MOCA) Tool for Early Detection of Dementia

As the population ages, the prevalence of cognitive impairment increases (Hilsabeck et al., 2024). There are about 10 million new cases reported annually, and over 55 million people worldwide are currently living with dementia, a number projected to increase to 78 million by 2030 (WHO, 2023). Dementia is a growing public health concern that is often underdiagnosed in primary care, leading to missed opportunities for early intervention, care coordination, and patient support. Early detection of dementia is crucial for timely intervention, effective care planning, and enhanced patient outcomes. Early identification of cognitive impairment is critical in improving patient outcomes, enhancing quality of life, and enabling timely intervention and care planning for individuals at risk of dementia. The project aimed to utilize the Montreal Cognitive Assessment (MoCA) as a standardized cognitive screening tool for adults aged 55 and older in a primary care outpatient clinic to screen patients for cognitive impairment and refer them for further evaluation. Results demonstrated a significant increase in the rate of cognitive screenings, improved provider confidence in identifying early cognitive decline, and enhanced referral patterns to specialists for further evaluation. The findings support that the MoCA is a feasible and effective tool for routine cognitive screening in primary care settings. Ongoing use of standardized screening can aid in early recognition of dementia, facilitate timely intervention, and improve outcomes

Enhancing ER Resident and Preceptor Effectiveness: A Trainer Program Pilot Study

Background: Emergency departments (EDs) present a challenging environment for new graduate nurses (residents), often impacting proficiency and retention. This pilot study aimed to evaluate the effectiveness of an ED Train the Trainer (T3) program, emphasizing the novel IIAR Identify, Intervene, Assess and Reassess model, in improving resident proficiency, confidence, and retention, as well as preceptor confidence. The program addressed the transitional gap between academic preparation and clinical practice by focusing on critical thinking and task management skills.Methods: After IRB approval, a time-series design was employed. The T3 program incorporated various learning modalities, including face-to-face sessions, instructional videos, and hands-on skills practice, centered around the IIAR methodology. Preceptors learned to utilize a checklist to observe and evaluate residents, linking their performance to specific modules. Monthly meetings were held for ongoing support. The primary outcome was resident proficiency, defined as the completion of tasks within a 4-room patient assignment in 30-60 minutes. Confidence levels of both residents and preceptors were also assessed pre, mid, and post-course.Results: The T3 program, with its emphasis on the IIAR model, demonstrated a positive impact on resident proficiency, confidence, and overall preparedness for the challenging ED environment. Qualitative data revealed a significant improvement in critical thinking skills, with residents reporting a greater ability to think critically and what could be the worst case for my patients and quickly assess and prioritize patients based on urgency. Residents also expressed heightened confidence in their decision-making abilities.Pre-survey data further supports these findings. Initially, only 40% of residents felt somewhat confident in taking on a 4-room assignment, and 33% reported rarely completing initial physician orders within the target time frame. Post-training data indicated marked improvements in these areas.Limitations: This pilot study was limited by its small sample size and short duration, potentially hindering generalizability and long-term impact assessment.Conclusion: The results of this pilot study suggest that the ED T3 program, particularly its focus on the novel IIAR methodology, may be effective in fostering critical thinking and task management skills in resident nurses, facilitating a smoother transition into the challenging ED setting

Increasing Nursing Professional Development Specialty Certification Rates amongst the Nursing Professional Development and Informatics Department

Problem: Nursing specialty certification promotes professionalism, demonstrates commitment and accountability for lifelong learning and professional development, is associated with improved knowledge and skills, and is linked to improved organizational and patient outcomes. Despite these benefits, certification rates remain low, and nurses still face barriers in obtaining certification. Intervention: The project intervention was to offer a one-hour introductory class followed by three weekly one-hour Nurse Professional Development (NPD) certification prep courses through Microsoft Teams to the NPD and Informatics Department. The prep course followed the blueprint of the exam and focused on different topics each week. Measures: Through pre- and post-surveys, this study compared the likelihood of the NPD and Informatics Department to sit for the NPD certification exam within the next year, confidence level of passing the exam, and four perceived barriers to pursuing certification before and after completing a NPD certification prep course. Results: An independent sample t-test showed no statistically significant improvement in reported likelihood or confidence levels when comparing the pre-survey scores (M = 2.5, SD = .94, n = 9) and post-survey scores (M = 2.5, SD = .78, n = 6); t = 0, p = 1, and no statistically significant improvement in reported barriers to pursuing certification when comparing the pre-survey scores (M = 2.42, SD =.97, n = 9) and post-survey scores (M = 2.52, SD = .89, n = 6); t =.15, p =.89. Conclusions: Small sample size and confounding variables likely contributed to the lack of statistical significance. Additional outcome data that could be considered for future implication

Psychological Stress and Coping Strategies among Nursing Students during the Covid-19 Pandemic: A Cross-Sectional Study

Nursing students encountered distinctive obstacles during their academic careers due to the COVID-19 pandemic. An increase in mental health concerns was the consequence of the pandemic, which necessitated numerous modifications to their daily routines. Subsequently, students have implemented distinct stress-management strategies that are contingent upon their individual perspectives. Objective: This study aimed to investigate the psychological stress levels and coping strategies employed by nursing students during this time. Materials and Methods: This cross-sectional investigation was implemented online. The data were gathered through online surveys, which encompassed assessments of stress perception and coping strategies. The survey was divided into three sections: Part A collected demographic data, Part B employed the Perceived Stress Scale(PSS), and Part C employed the Coping Strategies Scale. Results: The study included a total of 220 respondents, who were between the ages of 18 and 25. Among undergraduate students, Year 4 had the maximum representation (35%), followed by Year 1 (22.2%), Years 2 and 3 (21.4%), and so forth. Moderate worry was reported by the majority of students (70.9%). The mean (±SD) score on the Perceived Stress Scale was 20.54 (±6.062), and the mean (±SD) score on the Coping Strategies Scale was 39.47 (±5.848). Conclusion: The study did not identify any correlation or impact between the perceived stress scale, coping strategies, or any of the sociodemographic factors among nursing students. The examination of these factors will enhance comprehension of the mental health obstacles encountered by nursing students during the pandemic. This information can guide the development of targeted interventions by healthcare providers and educational institutions, including stress management workshops, enhanced access to mental health resources, and modifications to curriculum delivery to more effectively support student well-being during future crises

RAAS Inhibitor-Induced Refractory Hypotension in Anesthetized Patients

Refractory hypotension is an increasing perioperative concern most prominently seen in patients on chronic renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), or a combination of the two therapies are common first-line medications used to treat primary hypertension. Despite the benefit of managing hypertension, such therapies do not come without complications. The principal mechanism of RAAS inhibitors is by inducing vasodilation by decreasing angiotensin II. However, this poses limitations during surgical events managed under general anesthesia..

Fostering a Healthy Work Environment: Assessing and Implementing AACN Standards

This project examines the need for enhancing healthcare work environments. Healthy work environments (HWEs) provide increased job satisfaction, retention, and most importantly improved patient outcomes. Unhealthy work environments can lead to job dissatisfaction and poor performance, burnout, high levels of stress, and poor patient care. “To foster healthy work environments, the American Association of Critical-Care Nurses (AACN) established six standards, which include skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership” (AACN, 2016). To further study HWEs, the current work environment of a cardiac telemetry unit was assessed by way of interviews, a pre-survey, professional development sessions, and a post-survey. The pre-survey overall findings of this quality improvement project resulted in a moderately healthy standing, with the standard of true collaboration ranking lowest. Based on the pre-survey results, the project managers held professional development sessions for staff to review the pre-survey results and discuss how to improve the current work environment. A post-survey was then sent to the staff for feedback on the professional development session and lessons learned. Future recommendations, the long-term evaluation, and the significance of improving healthcare work environments were also all addressed. Continued practice and implementation of the AACN’s six standards into healthcare organizations will not only have an overall benefit, but also improvement in staff retention, satisfaction, and patient safety. Fostering a healthy work environment needs to be a priority for the future of healthcare

Beyond Recruitment: Sustainable Strategies to Retain and Develop International Nurses

An insightful webinar series designed to educate nurse leaders about the intricacies of international nurse staffing to help build a resilient and adaptable nursing workforce