Evaluation of Resilience of randomized RNS implementation

Randomized moduli in Residue Number System (RNS) generate effectively large noise and make quite difficult to attack a secret key $K$ from only few observations of Hamming distances $H=(H_0, ..., H_{d-1})$ that result from the changes on the state variable. Since Hamming distances have gaussian distribution and most of the statistic tests, like NIST\u27s ones, evaluate discrete and uniform distribution, we choose to use side-channel attacks as a tool in order to evaluate randomisation of Hamming distances . This paper analyses the resilience against Correlation Power Analysis (CPA), Differential Power Analysis (DPA) when the cryptographic system is protected against Simple Power Analysis (SPA) by a Montgomery Powering Ladder (MPL). While both analysis use only information on the current state, DPA Square crosses the information of all the states. We emphasize that DPA Square performs better than DPA and CPA and we show that the number of observations $S$ needed to perform an attack increases with respect to the number of moduli $n$. For Elliptic Curves Cryptography (ECC) and using a Monte Carlo simulation, we conjecture that $S = O((2n)!/(n!)^2)$

Therapeutic/Expressive Writing and Resilience Promotion for Nurses to Reduce Burnout Syndrome

COVID-19 accelerated the rate in which nurses were unable to maintain resilience and reduce burnout. This evidence-based DNP project obtained data from a therapeutic/expressive writing intervention and group resilience discussion with Women’s Care Center (WCC) nurses to improve resilience acuity and reduce symptoms associated with burnout syndrome. A review of previous studies indicated therapeutic/expressive writing and group resilience discussions have been beneficial in improving resilience and reducing burnout. A demographic and two preintervention surveys were completed by WCC nurses in the hospital relaxation room or skills lab. The Connor-Davidson RISC-25© was used to determine resilience scores for morning and evening shift nurses. The Maslach Burnout Inventory© (MBI) Survey for Medical Personnel was used to assess emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA) in the same groups. Participants (n =20) nurses completed the pre-intervention resilience and burnout surveys. Day and night shift nurses (n= 19) resilience mean average increased after the intervention 2.65 mean score (M = 83.31, SD =9.86) for the Connor-Davidson RISC-25© survey which is in the intermediate range: 50% of the population. The burnout mean for the morning shift nurses, EE (M = 21.88), DP (M = 4.88), and PA (M = 39.27) which indicated moderate burnout for all categories. The burnout means for evening shift nurses, EE (M = 17.33), DP (M = 7.22), and PA (M = 40.00), which fell within the moderate burnout range

Use of a Mindfulness-Based Resiliency Intervention to Reduce Nurse Intention to Quit the Organization

Practice Problem: Nurse turnover is a rapidly growing problem that affects the healthcare industry worldwide. Nursing shortages created by increased turnover have a negative effect on patients and staff and create a financial strain on healthcare organizations. PICOT: For registered nurses within a select pilot group, does implementation of a mindfulness-based resiliency (MBR) intervention, compared to no intervention, reduce nurse intent to quit over an eight-week period? Evidence: The positive impact of resiliency on turnover was best described in eight articles and two doctoral papers. Studies using MBR interventions have been shown to improve the coping skills of nurses, and to decrease stress and reduce intention to quit. Intervention: The implementation of a MBR intervention was the selected intervention completed over an eight-week period. Participants completed a Personal and Organizational Quality Assessment-(POQA-R4) designed to measure personal and job‐related constructs pre and post intervention. Outcome: “Intent to quit” did not show a statistically significant change post-implementation of the MBR intervention. The result of the two-tailed paired samples t-test” was not significant (p=.179, alpha=0.05). However, clinical significance was achieved with reduction of stress for the 10 project participants. Conclusion: Reducing the intention to quit achieved clinical significance by promoting nurse well-being. Consideration should be given for implementation of the MBR intervention with a larger group of nurses

Nursing Anxiety Self-Evaluation and Resiliency Methods

Abstract Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention. Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation. Results: The pre- post-SISS showed statistical significance in reducing work stress (t(7)=2.76, p=0.03). The pre-post-intervention BAIS did not show statistical significance in the reduction of nurses’ anxiety after a 30-day intervention. Discussion: Stress and anxiety are separate phenomena. The MICU nurses had low levels of anxiety in both the pre-and post-intervention BAIS. However, a reduction in work related stress levels was seen following a four-week intervention of regular exercise and meditation

CONDUCTING A NEEDS ASSESSMENT TO INFORM THE DEVELOPMENT OF A BURNOUT MITIGATION PROGRAM FOR CRITICAL CARE NURSES

Burnout among nurses is at monumental levels, contributing to high levels of job dissatisfaction and turnover. Some interventions existed in the literature to support burnout reduction programming among nurses; however, the literature failed to identify effective burnout reduction interventions based upon the specific needs of critical care nurses who face unique stressors related to high patient acuity and other environmental considerations. This project aimed to explore critical care nurses\u27 needs and strategies designed to mitigate burnout in the clinical setting. Outcomes from this assessment would inform future interventions for the early identification and prevention of burnout among critical care nurses. The setting for this project was two intensive care units in a large, suburban hospital in the Rocky Mountain region of the United States. The subjects were nurses with at least one year of experience in the critical care setting. This project used a single-center, descriptive design. This project was guided by the advancing research and clinical practice through close collaboration model—an evidence-based, system-wide model used to advance evidence-based practice implementation and sustainability. An evidence-based needs assessment was created and implemented to measure the current level of burnout and the unmet needs of critical care nurses at the project site. The results were analyzed using descriptive statistical procedures. Based on iv the findings, an organization-specific burnout mitigation plan will be presented to the project site stakeholders

Conducting a Needs Assessment to Inform The Development of a Burnout Mitigation Program for Critical Care Nurses

Burnout among nurses is at monumental levels, contributing to high levels of job dissatisfaction and turnover. Some interventions existed in the literature to support burnout reduction programming among nurses; however, the literature failed to identify effective burnout reduction interventions based upon the specific needs of critical care nurses who face unique stressors related to high patient acuity and other environmental considerations. This project aimed to explore critical care nurses\u27 needs and strategies designed to mitigate burnout in the clinical setting. Outcomes from this assessment would inform future interventions for the early identification and prevention of burnout among critical care nurses. The setting for this project was two intensive care units in a large, suburban hospital in the Rocky Mountain region of the United States. The subjects were nurses with at least one year of experience in the critical care setting. This project used a single-center, descriptive design. This project was guided by the advancing research and clinical practice through close collaboration model—an evidence-based, system-wide model used to advance evidence-based practice implementation and sustainability. An evidence-based needs assessment was created and implemented to measure the current level of burnout and the unmet needs of critical care nurses at the project site. The results were analyzed using descriptive statistical procedures. Based on the findings, an organization-specific burnout mitigation plan will be presented to the project site stakeholders

Mindfulness-Based Stress Reduction to Decrease Burnout in Emergency Nurses: A Quality Improvement Project at an Academic Medical Center

Nursing burnout, categorized by increased emotional exhaustion (EE), depersonalization (DE), or decreased personal achievement (PA), is rising in the United States. Emergency Department (ED) nurses at an academic medical center in the western United States experience burnout related to workplace violence and trauma exposure exacerbated by a global pandemic. Burnout can lead to adverse health impacts for nurses, increased institutional costs, and adverse patient outcomes. Improving mindfulness or awareness of the present can reduce burnout in ED nurses. A mindfulness pilot project was conducted with staff nurses (n=20) and nurse leaders (n=4) in the ED. Participants attended Mindfulness-Based Stress Reduction (MBSR) classes for eight weeks and practiced mindfulness outside of class. The impact of MBSR was measured before and after the pilot using the Five-Facet Mindfulness Questionnaire Short Form and Maslach Burnout Inventory for Medical Personnel. Overall, ED staff nurses experienced an 11% improvement in mindfulness, a 1% decrease in EE, a 6% decrease in DE, and a 10% increase in PA. ED nurse leaders experienced a 7% improvement in mindfulness, 14% reduction in EE, 36% decrease in DE, and 4% improvement in PA. This pilot project suggests that MBSR is an effective way to increase mindfulness and reduce burnout. Engagement with MBSR classes and participation in mindfulness activities outside of class improved mindfulness and reduced burnout among participants. Due to the promising outcome, this work is recommended to be repeated in the ED setting and expanded to other high-stress environments

Organizational Strategies to Promote Nurse Resilience in the Acute Care Hospital Inpatient Setting: An Integrative Review

Nurses practicing in acute care hospital environments are exposed to constant stressors from a variety of sources. Workplace stress can lead to unhealthy coping behaviors, illness, and burnout, with intent to leave the organization or the nursing profession altogether. Resilience-building strategies can be employed to foster coping, improve nurse wellbeing, increase job satisfaction, promote retention, and enhance quality patient outcomes. This integrative review provides a synthesis of scholarly publications on nursing resilience from January 2014 through October 2020. Themes to promote nursing resilience occurred at three levels: personal or individual, unit or group, and organizational. This paper will provide a summary of resilience-building concepts at these three levels, an overview of integrative review methodology, and recommendations for further research on nursing resilience

Managing Burnout in Nursing

Burnout is a widespread phenomenon characterized by a reduction in energy that manifests in exhaustion, lack of inspiration, and feelings of frustration which may lead to reduced work efficacy and multiple absences. In the nursing profession, long hours, the pressure of quick decision-making, and the stress of caring for patients who may have poor outcomes may contribute to burnout. This integrative review was conducted to identify variables that contribute to nurse burnout and discover strategies organizations can implement to reduce or prevent nurse burnout

Decreasing nurses’ stress in the emergency room utilizing mindfulness meditation

Background: Emergency Room (ER) nurses are challenged both physically and emotionally, and are repeatedly exposed to severe occupational stress (d\u27Ettorre & Greco, 2016; Duffy et al., 2015). For example, some stressors are demands from patients and physicians, long hours, complex diagnoses, and a fast pace (Hunsaker et al., 2015). A considerable number of nurses experience work-related interpersonal conflict, secondary traumatic stress, and other stress disorders, which negatively affects the quality of patient care they deliver (Westphal et al., 2015). Purpose: The purpose of this evidence-based practice project was to implement a mindfulness meditation intervention to decrease emergency room nurses’ stress. Theoretical Framework: Watson’s theory of human caring (J. Watson, 2008) was utilized as the theoretical framework for this project, focusing on the nurse’s self-care regarding stress. Methods: This project used a pre-test post-test design to evaluate the effect of an evidence-based mindfulness meditation intervention by obtaining blood pressure and pulse measures as well as the Profile of Mood States Second Edition-Short Form (POMS2-SF) questionnaire. Results: Using mindfulness meditation participants experienced a statistically significant lowering in stress levels: the mean post-POMS (M = 39.4) was statistically significantly lower (p \u3c0.001) than the mean pre-POMS (M = 47.2). The results also indicated that means of the post-systolic BP (M = 115.7) and the post-diastolic BP (M = 69.4) were statistically significantly lower (p \u3c 0.001) than the means of pre-systolic BP (M=126.7) and the pre-diastolic BP (75.6). The mean of post-intervention pulse (M = 65) was statistically significantly lower (p = 0.005) than the mean of pre-pulse (M = 68.7). Conclusions: Mindfulness meditation should be considered as a modality to reduce nurses’ stress levels in clinical settings. During the DNP project, 18 ER nurses, who are employed at the implementation site, listened to a 15-minute mindfulness meditation CD by Dr. Jean Watson. Before and after the intervention, the DNP student measured the blood pressure and heart rate and completed the POMS2-SF questionnaire to record the stress indicators of participants. Findings indicated that mindfulness meditation intervention reduced blood pressure, heart rate, and POMS2-SF stress indicators