Integrative Review of Mindfulness-Based Stress Reduction in Caregivers of Cancer Patients

https://digitalcommons.psjhealth.org/other_pubs/1130/thumbnail.jp

Medication Safety Zone to Promote Uninterrupted Medication Administration

https://digitalcommons.psjhealth.org/other_pubs/1132/thumbnail.jp

Utilizing a Social Media Platform to Increase Participation in a Virtual Journal Club

Background: A virtual journal club (VJC) is a place where nurses can read, synthesize, and discuss research and evidence-based practice articles. There is a well-known time lag of disseminating this knowledge from bench to bedside. In 2016, a 300-bed community hospital constructed a VJC to educate nurses on the latest studies. In 2016 and 2017, this VJC was used via an intranet-based platform with little success. Main barriers included (1) no access outside of work and (2) difficulty following threads leading to in-cohesive interactions. In 2018, a website was created. This platform had one fatal flaw, a multistep verification process to gain access, with the verification email being routed into spam. In late 2018, a literature search was done to identify best practices. A number of articles were reviewed with results indicating that the utilization of a social media platform increased participation. Purpose/Aim: The purpose of this evidence-based practice project was to offer a social media platform for all nursing staff to participate in a VJC. Aim 1: To set up an organizationally approved social media account for the VJC. Aim 2: For the participants to have access to the VJC at home and at work. Aim 3: To increase the number of participants using the VJC. Approach: The Nursing Research Council used the Rosswurm and Larrabee model as a systematic evidence-based practice process. Step one, assess the need for change, was done mid-2018 when platform problems were identified. Steps two and three: link problem with interventions and outcomes, and synthesize best evidence, was done at the end of 2018. Step 4, design a plan, was discussed in detailed early in 2019, and a number of traditional social media platforms were reviewed but did not meet institutional security measures. One social media platform that the organization already used was identified. Step 5, implementing and evaluating a plan, involved three phases. Phase one was exploratory. An account was created with basic information. Council members and the Education team were invited to test out the accessibility (i.e., desktop and phone application). Phase two included a soft-opening with the VJC completely set up, and Council members each did an initial post and a response. All potential barriers were evaluated and addressed. Phase 3, hospital go-live in May, included a number of promotional techniques (i.e., QR codes, emails, signs). Stage 6, integrate and maintain is discussed below. Results: Aim 1 and Aim 2 were successfully met by identifying a user-friendly social media platform, that resembles the basic principles of a traditional social media news feed. Aim 3 was measured by number of total members and posts. Compared to 2018, 2019 increased in VJC members from 22 to 44 and total number of posts from 46 to 106. Conclusion & Implications: Advances in nursing practice need to be communicated quickly. Utilizing a social media platform versus an internet-based platform has increased participation within the VJC. Thus this practice change has been deemed successful, and continues to be maintained by the Nursing Research Council.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1031/thumbnail.jp

Podium Presentation: OR Nurses Psychological Well-being and Redeployment During the COVID-19 Pandemic

Background: Throughout the COVID-19 pandemic, Operating Room (OR) nurses were redeployed to patient care units during times of maximal surge capacity in hospitals caring for patients with the novel coronavirus. Hospital bed and staffing needs caused hospitals to cancel elective surgeries, allowing for conservation of bed space and nurses to accommodate the patient influx. Despite the highly specialized nature and skill set of OR nursing, OR nurses were expected to function in traditional patient care roles, where levels of self-assessed competence vary based on experience and training. There is a paucity of literature on the psychological impact of redeployment of OR nurses, however, previous literature indicates negative experiences when nurses felt a mismatch between levels of support and increased clinical demands as well as workplace expectations. Purpose: Monitor and describe the psychological well-being of OR nurses throughout the COVID-19 pandemic. Methods/Approach: The present project is an ongoing national longitudinal, descriptive correlational study. Recruitment was completed via email sent by the Association of periOperative Registered Nurses to members within the United States and territories, and by word of mouth. Consented participants completed a questionnaire that included demographics, redeployment experience, and three valid and reliable psychological well-being questionnaires: The Impact of Event Scale – Revised (IES-R), measuring post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD-7) measuring anxiety, and Posttraumatic Growth Inventory – Short Form (PTGI-SF), measuring the positive impact of a traumatic event. Initial data collection (T1) started in March 2021, while timepoint 2 (T2) began in September 2021, and the final timepoint (T3) commenced in March2022. Results: A total of 102 nurses from 33 states completed demographics. Participants were 82.4% female, 77.5% Caucasian, and 79.4% hold at least a bachelor\u27s degree. Most participants (n = 74) were redeployed during COVID--19. Attrition from the T1 to T2 response rate was noted: IES-R (n = 48, n = 42), GAD-7 (n = 67, n = 42), and PTGI-SF (n = 67, n = 39). There were no statistical differences between T1 and T2 in any well-being measure when looked at as a group (redeployed and non-redeployed). In OR nurses who were redeployed there was a statistically significant downward change in mean scores of both IES-R (p = 0.001) and GAD-7 (p =0.026) from T1 to T2. Of particular interest was the PTSD scores of redeployed OR nurses, which showed scores consistent with clinical symptoms of PTSD, which decreased between T1 and T2. There was a clinically noteworthy but statistically insignificant increase in PTSD scores between T1 and T2 among non-redeployed OR nurses. Conclusion: Redeployed nurses showed evidence of trauma, stress, and post traumatic growth at T1, with a decrease in PTSD and anxiety scores over a 6-month period. Implications for practice: Potentially traumatic situations should be proactively addressed to combat psychological distress in the workplace

IMPACT OF MORAL INJURY ON WORK PERFORMANCE IN NURSES FOLLOWING THE COVID-19 SURGES

Background Moral Injury (MI) was defined by Jonathan Shay in 1994 as committing acts that betray one’s moral compass in high-stakes situations, while under the authority of another, that severely affect one’s well-being. MI was measured solely in the military prior to the COVID pandemic. Aims 1.Explore the relationship between moral injury (MI) and perceived work performance in hospital nurses following the pandemic surges. 2. Determine relationships between MI and select participant demographics and between work performance and select demographics. Sample A convenience sample of 191 nurses from seven Southern California Hospitals participated in the study from March to June 2022. The mean years of experience of participants was 15, 84% worked full-time, 53% were Caucasian, and 97% cared for COVID-19 patients. Design Cross-sectional multi-site survey. Variables and Instruments The DV was MI. The IVs were work performance and nurse demographics. The Moral Injury Symptom Scale was revised for use with Health Professionals (MISS-HP) and used in this study. Perceived work performance was measured using the Nurse Performance Index (NPI). Data Analysis Descriptive analysis was used to calculate scale scores and demographics. Correlational and linear regression analysis were used to examine relationships between dependent and independent variables and specifically to determine if MISS-HP scores were a predictor of NPI scores. Findings Increased levels of moral injury were a significant predictor of decreased levels of perceived work performance. Younger and less experienced nurses had greater levels of moral injury. Levels of MI due to the traumatic situations that nurses experienced during the pandemic negatively affected self-reported work performance. Nurses reported at times having to modify their standards to get their work done. Implications Nurse well-being programs and improved working conditions for nurses are needful to avoid compromising quality nursing care and patient safety. In-hospital care programs for nurses that include sacred spaces like Tea for the Soul, serenity lounges, and provision for consistent break times with adequate staffing, are imperative in optimizing nurse performance and thus optimizing patient care outcomes as well as organizational outcomes