Podium Presentation: Broadening the Lens: How Using a Multidisciplinary Approach to Increase Cultural Competency in Nurses

Background: Cultural competence is central to the development of healthy nurse-patient relationships. Considered an essential standard of professional practice for nursing and multiple disciplines world-wide, the use interdisciplinary materials from anthropology, philosophy and theology broaden the lens through which students can critically think about human diversity. The online course in Cultural Diversity was revised to enhance the cultural competence of nurses enrolled in an RN-BSN program of study. Drawing on global research conducted by cultural anthropologists provides students with a global look at key cultural concepts through which national cultures may be better understood. Video interviews with nursing theorist and cultural anthropologist, Madeline Leininger allow for exploration of key cultural concepts. Reading Henri Nouwen’s Life of the Beloved prompts reflection on one\u27s own belovedness as a human being and that of others differing from themselves. Selected readings from Miroslav Volf (Yale\u27s Center for Culture and Theology) allow for exploration of the impact of cross-cultural systems of values and beliefs and the concept of reconciliation through collective forgiveness. Reflections on the seminal work of these interdisciplinary scholars formulate the basis of course content intended to enhance student cultural competence. Purpose: The purpose of this study is to report the changes in cultural competency scores in nurses enrolled in a course in Cultural Diversity during a one-year period from 2020 - 2021. Methods: A quantitative, pre/post-test design was used. De-identified individually submitted scores from (n =33) RN-BSN students completing the Cultural Competency self-assessment section of the Maternal Child Health Self-Assessment (MCH) at baseline and end of course were entered into SPSS version 27. A paired t-test was used to analyze the difference in mean scores between time 1 and time 2 (8 weeks). Results: Statistically significant, positive changes in mean scores between time 1 and 2 were supported in all eight culturally competence areas: 1) awareness of one\u27s own conscious and unconscious biases and assumptions (t(31) = -4.06, p \u3c .005), d=.87); 2) literacy and linguistic competency (t(32)= -6.12, p \u3c .005), d= .79; 3) how ability, age, class, race, sex, gender identify, and sexual orientation impact heath (t(32) = -3.34, p \u3c .002), d=.83; 4) how social and cultural disparities may influence access (t(32) = -3.68, p \u3c .001), d=.75; 5) impact on cultural competence to health care access (t(32) = -2.88, p \u3c .007), d=.90; 6) conduct personal and/or organizational self-assessments regarding cultural competence (t(32) = -5.01, p \u3c .005), d=.97; 7) increased ability to assess, without making assumptions based on sensitivity to and respect for diverse backgrounds t(32) = -4.42, p \u3c .005), d=.94; and 8) ability to incorporate and appreciate differences and awareness of the potential for implicit bias t(32) = -5.88, p \u3c .005), d=.85. Conclusions: Findings suggest statistically improved cultural competence scores from baseline to course end with medium-large effect size. Nursing professional skilled in cultural competence are positioned to better influence health beliefs and behaviors in our communities and society. Implications for Practice: The use of an interdisciplinary curriculum may help to broaden the lens through which nurses can increase their cultural competence

Podium Presentation: Promoting Holistic Health: Impact of Vocati on the Spiritual and Moral Development in Youth

Background: Approximately one out of every six individuals are adolescents between the ages of 10 to 19. Promoting health and reducing risks for this age group has life-long health and societal consequences. Evidence suggests positive and negative risk-taking behaviors cluster in this population. Models for the promotion of positive youth development have shifted in focus from avoidance of risk-taking behaviors to emphasis on psychosocial competence and holistic well-being. Evidence suggests spiritual wellbeing, regardless of conceptual definition, is more often than not associated with positive health outcomes and development in youth. However, few studies have included spiritual and moral constructs in program interventions and outcome metrics in this population. Purpose/Aims: The purpose of this project is to discuss the impact of Vocati, a youth theological institute intervention on adolescent moral and spiritual formation as a component of holistic health promotion. Methods/Approach: This study used a mixed-methods design. In 2016-2020, 4 cohorts of adolescents (n=57), age 15 - 18 years, from 3 states participated in a week-long theological summer intensive followed by a year-long monthly online discussion culminating in the implementation of a service/missional project. The Defining Issues Test, Version 2 (DIT-2) based on Kohlberg\u27s Stages of Moral Development and the Vocati Instrument Questionnaire (VIQ) a Likert-type questionnaire with open-ended questions were administered at baseline and program endpoints. Results: Data were analyzed using a mixed-model approach. The DIT2 mean scores between baseline and program endpoint were analyzed from matched pairs using a paired sample t-test for statistical analysis. The results supported N2 mean scores differences to be significantly higher, medium effect size at program end as compared to baseline (M = -5.85, SD = 10.95), t (36) = -3.25, p = .002, d = -.535). N2 score represents the most sophisticated level of moral judgment and corresponds to Kohlberg\u27s stage 5-6. The Vocati N2 mean scores were significantly higher (M=33.17. SD=11.51), t (1.14) compared to National Normative scores (M=30.97), t (.89), F(1.660), (p=.02). Statistically significant changes from empirical data from VIQ scores also supported significant differences in mean scores in five of six areas of spiritual development. Narrative themes were analyzed using a descriptive interpretive approach and were linked to positive prosocial competence skills reported in the literature. Conclusions: Youth participating in Vocati experienced a statistically significant increase in spiritual and moral development from baseline to program endpoint and national norms. Moral reasoning increased in N2 scores, reflecting, according to Kohlberg\u27s stages of moral development, the most sophisticated shift in moral reasoning and in the measures associated with spiritual formation. This finding is of particular importance as the N2 mean scores significantly changed from baseline to program end and were also statistically higher than the national norm of this measurement in youth. Clinical Implications: Findings from Vocati suggest the positive role exposure to theological content and spiritual formation practices may play in accelerating the development of moral reasoning and social competence skills associated with youth well-being. Further incorporation of these constructs within nursing interventions aimed at holistic health promotion activities targeting youth should be considered

Bridging the Gap: An Innovative Web-Based Approach for Evaluating EBP Readiness in Direct Care Nurses

https://digitalcommons.psjhealth.org/summit_all/1048/thumbnail.jp

Exploring the Relationship Between COVID-19 Unit Designation and Nurse Burnout Syndrome

Background: The COVID-19 pandemic impacted healthcare due to surges in infected patient and respiratory failure. Nursing burnout syndrome (NBS) results from occupational factors leading to mental health problems. Nurses working in intensive care units (ICUs) dedicated to caring for COVID-19infected individuals may be even more susceptible to NBS due to increased burdens of futile care delivery and high mortality rates within overstretched healthcare systems. Identifying socio-demographic, work-related, and psychological predictors of NBS may help organizations mitigate, or at least minimize, the negative psychological impact on ICU nurses working during future pandemics. Purpose/Aims: The aim of this study was to compare burnout levels in ICU nurses providing direct care to COVID infected patients with nurses caring for non-COVID infected patients. Methods: An observational descriptive study was conducted using 1) a case-controlled prospective quantitative comparative design to compare neonatal and pediatric ICU to cardiac and medical ICU survey scores measuring nurse burnout, work-related, and psychological predictors of NBS and 2) across-sectional longitudinal quantitative causal and comparative study design comparing NBS scores for nurses working in a cardiac and medical ICU captured in 2019 prior to the COVID-19 pandemic to scores captured in the same units after conversion to dedicated COVID-19 ICUs in 2020. This study will explore the relationship between three subscales(Emotional Exhaustion, Depersonalization, and Personal Accomplishment) of the Maslach Burnout Inventory (MBI) as outcome variables and exposure to COVID-19 infected patients during 12-hour shifts worked as explanatory variables in a subset regression model. The study will also measure four subscales (Vocation, Finances, Health, and Social Relationships) associated with post-traumatic stress disorder using the Well Being Instrument(WBI) as control variables. A convenience sample of direct care registered nurses working in four ICUs in a large tertiary care hospital will be recruited to participate in the study. Female nurses working day shifts were surveyed in February and March 2019in two ICUs. In November 2020, four ICUs were used for sampling of both male and female nurses working either day or night 12-hour shifts based on designation as COVID-19 ICUs. Results: Researchers hypothesize burnout scores among nurses working in neonatal and pediatric ICUs will be less than burnout scores for nurses working in designated COVID ICUs. Additionally, investigators hypothesize nurse burnout measured in cardiac and medical ICUs in 2019 will be less than measurements obtained in 2020 after the same ICUs converted into COVID ICUs. This study will also analyze participant socio-demographic and work-related data for psychological predictors of NBS. Conclusion: NBS has been identified as a global problem facing ICU clinicians. Pinpointing associations betweenCOVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Implications for practice: Further research is required to establish relationships between socio-demographic and work-related psychological predictors of NBS. Understanding relationships between these variables may guide development of strategies to build nurse resilience and decrease NBS in ICU settings impacted during pandemics.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1009/thumbnail.jp

Catheter-Associated Urinary Tract Infection (CAUTI) Prevention Strategy Using Education in an Intensive Care Unit (ICU)

Purpose: To measure clinical impact of an evidence-based educational strategy on urinary tract infection (UTI) rates in a 900+ bed acute care facility located in a southwestern state in the United States (US). Clinical Question: Will a focu son staff education in the ICU on proper placement techniques, care, and early removal of urinary retention catheters reduce incidences of CAUTIs in an ICU setting

\u3cem\u3eOAS1\u3c/em\u3e Polymorphisms Are Associated with Susceptibility to West Nile Encephalitis in Horses

West Nile virus, first identified within the United States in 1999, has since spread across the continental states and infected birds, humans and domestic animals, resulting in numerous deaths. Previous studies in mice identified the Oas1b gene, a member of the OAS/RNASEL innate immune system, as a determining factor for resistance to West Nile virus (WNV) infection. A recent case-control association study described mutations of human OAS1 associated with clinical susceptibility to WNV infection. Similar studies in horses, a particularly susceptible species, have been lacking, in part, because of the difficulty in collecting populations sufficiently homogenous in their infection and disease states. The equine OAS gene cluster most closely resembles the human cluster, with single copies of OAS1, OAS3 and OAS2 in the same orientation. With naturally occurring susceptible and resistant sub-populations to lethal West Nile encephalitis, we undertook a case-control association study to investigate whether, similar to humans (OAS1) and mice (Oas1b), equine OAS1 plays a role in resistance to severe WNV infection. We identified naturally occurring single nucleotide mutations in equine (Equus caballus) OAS1 and RNASEL genes and, using Fisher\u27s Exact test, we provide evidence that mutations in equine OAS1 contribute to host susceptibility. Virtually all of the associated OAS1 polymorphisms were located within the interferon-inducible promoter, suggesting that differences in OAS1 gene expression may determine the host\u27s ability to resist clinical manifestations associated with WNV infection

OAS1 Polymorphisms Are Associated with Susceptibility to West Nile Encephalitis in Horses

West Nile virus, first identified within the United States in 1999, has since spread across the continental states and infected birds, humans and domestic animals, resulting in numerous deaths. Previous studies in mice identified the Oas1b gene, a member of the OAS/RNASEL innate immune system, as a determining factor for resistance to West Nile virus (WNV) infection. A recent case-control association study described mutations of human OAS1 associated with clinical susceptibility to WNV infection. Similar studies in horses, a particularly susceptible species, have been lacking, in part, because of the difficulty in collecting populations sufficiently homogenous in their infection and disease states. The equine OAS gene cluster most closely resembles the human cluster, with single copies of OAS1, OAS3 and OAS2 in the same orientation. With naturally occurring susceptible and resistant sub-populations to lethal West Nile encephalitis, we undertook a case-control association study to investigate whether, similar to humans (OAS1) and mice (Oas1b), equine OAS1 plays a role in resistance to severe WNV infection. We identified naturally occurring single nucleotide mutations in equine (Equus caballus) OAS1 and RNASEL genes and, using Fisher's Exact test, we provide evidence that mutations in equine OAS1 contribute to host susceptibility. Virtually all of the associated OAS1 polymorphisms were located within the interferon-inducible promoter, suggesting that differences in OAS1 gene expression may determine the host's ability to resist clinical manifestations associated with WNV infection