Integrating wellness into curricula using the ten dimensions of wellness as a framework

Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.

Enhancing Pediatric Mental Health Care in an Outpatient Primary Care Setting Using the Keep Your Children/Yourself Safe and Secure (KySS) Program: A Multidisciplinary Quality Improvement Project

INTRODUCTION

This project aimed to enhance access to pediatric mental primary health care.

METHOD

The Keep Your Children/Yourself Safe and Secure (KySS) training was offered to a multidisciplinary team at a Federally Qualified Health Clinic in the Midwest United States. Confidence was measured using the Healthcare Provider Confidence Scale (HPCS). Frequencies of visits and mental health referrals were compared preintervention/postintervention. HPCS scores were compared using Wilcoxon rank-sum and Cohen's d.

RESULTS

Referrals in 2022 were greater than in 2020 but less than in 2021 (p = .25). The total number of visits declined from 431 in 2021 to 385 in 2022. HPCS (n = 9) scores trended higher following the KySS Program in prescribing and general positive beliefs.

DISCUSSION

Referrals to mental health providers increased, although not significantly. The number of mental health visits varied between 2020-2022. Provider confidence was not significantly affected, whereas beliefs in prescribing did increase significantly. More work is necessary to understand the impact of delivery to a multidisciplinary team.

Identifying best practices for virtual nursing clinical education: A scoping review

BACKGROUND

COVID-19 forced nurse educators across the world to rapidly shift clinical experiences from face-to-face to the virtual world without identification of best practices to guide this transition.

PURPOSE

The purpose of this review was to identify best practices in virtual clinical experiences for undergraduate and graduate nursing students using the Community of Inquiry model as a framework.

METHOD

A scoping review was conducted using the Joanna Briggs Institute Scoping Review process. Ten databases were searched systematically for literature related to virtual nursing student clinical experiences. The 36 articles retained for review were appraised using evidence-based rapid critical appraisal tools.

RESULTS

The literature suggests virtual clinical experiences may positively impact clinical reasoning and judgement; knowledge gain, retention, and application; affective learning; communication and teamwork; competence; engagement; confidence; and satisfaction. However, increased anxiety, frustration with technology and access, difficulty asking questions, and increased cost were reported. Additional considerations included appropriate faculty training, student support, and accreditation and board certification requirements. Standards related to virtual clinical experiences and simulation for advanced practice registered nurses needs further study.

CONCLUSION

Virtual clinical experiences resulted in positive student learning outcomes. Through the provision of quality virtual clinical experiences, nurse educators have the potential to maximize student learning and professional growth.

An Innovative Well-Child Video Project to Teach Developmental Surveillance and Anticipatory Guidance

BACKGROUND

Learning to implement developmental surveillance and anticipatory guidance are critical components of clinical nursing education.

METHOD

The purpose of the Well-Child Video Project was to provide nursing students opportunities to develop confidence in providing early childhood health supervision. The faculty team curated more than 100 video clips of children age 0 to 6 years demonstrating key developmental milestones. Nurse practitioner students (N = 33) enrolled in an online course participated in a collaborative learning activity and completed pre- and post-assignment surveys assessing their level of confidence and evaluating their engagement.

RESULTS

Students reported increased confidence in their ability to perform developmental surveillance and deliver anticipatory guidance following the clinical learning activity. Students (93.75%) agreed that the video strategy enhanced their learning.

CONCLUSION

The Well-Child Video Project served as a cost-effective, easily accessible, user-friendly digital resource for designing innovative learning activities to increase student engagement in practicing developmental surveillance and anticipatory guidance. [J Nurs Educ. 2023;62(X):XXX-XXX.].

Clinical Competence for Youth Suicide: Use of Simulation in Pediatric and Psychiatric-Mental Health Nurse Practitioner Programs

Approximately one in five adolescents in the United States has a mental health concern and suicide is the second leading cause of death in this population. It is vital to prepare nurse practitioner (NP) students with the required skills to assess and manage youth with suicidal ideation. Unfortunately, it is challenging for NP students to accumulate these critical competencies due to limited preceptors and the infrequent presentation of suicidality in certain clinical sites. Furthermore, the serious nature of a child in mental health crisis often requires students to take a passive role while deferring direct patient care to the clinical preceptor. Objective structured clinical examinations (OSCEs) can deliver high-quality, simulated, active-learning experiences necessary to build the skills and confidence needed to care for youth with suicidal ideation. The current article discusses the collaborative development and implementation of an innovative OSCE designed for pediatric and psychiatric-mental health NP students. [Journal of Psychosocial Nursing and Mental Health Services, 59(8), 7-13.].

Implementation of Universal Adolescent Depression Screening: Quality Improvement Outcomes

INTRODUCTION

Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening.

METHOD

The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12-18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression.

RESULTS

Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant.

DISCUSSION

Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression.

Decreasing Opioid Use in Pediatric Lower Extremity Trauma: A Quality Improvement Project

INTRODUCTION

Perioperative anxiety increases postoperative pain and the risk of complications in hospitalized children. Nonpharmacologic pain resources provided by Certified Child Life Specialists (CCLS) are a viable adjunct for pain management.

METHOD

A routine CCLS consult was implemented for patients admitted to the orthopedic service with traumatic lower extremity injuries requiring surgery. A retrospective chart review compared patients who did not receive a CCLS consult. Daily pain rating scores, total doses of opioid and nonopioid pain medication, number of physical therapy attempts, length of stay, and demographics were compared for both groups.

RESULTS

A clinically significant improvement was seen for decreased pain rating scores and opioid use after a routine CCLS consult was implemented.

DISCUSSION

Adopting a routine CCLS consult for children with unplanned admissions because of trauma reduces the number of opioids used, provides children with pain management resources, and promotes coping skills that may be used in the future.

Child Sexual Abuse Perpetrators: What Forensic Nurses Need to Know

Child sexual abuse is a problem of epidemic proportions resulting in lifelong physical and mental health consequences for victims. Most child sexual abuse victims never disclose and do not receive needed treatment. Clearly, pediatric healthcare providers must understand the dynamics of child sexual abuse to better identify and protect potential victims. Forensic nurses are at the forefront of caring for victims of sexual abuse and are strong voices in the education of parents, community members, and other healthcare professionals regarding sexual abuse. Forensic nurses with a deeper understanding of child sexual abuse perpetrators will be better able to educate the public and advocate for children at risk for sexual abuse. In this article, specific types of child sexual abuse perpetration will be explored, and implications for forensic nursing will be discussed.