Annual review of nursing research最新文献

This chapter discusses the current state of hospital-based simulation, including the unprecedented events of 2020's global COVID-19 pandemic. Hospital-based simulation training requires a new approach. The realities of social distancing and the operational demands of hospital staffing ratios warrant creative adaptations of traditional simulation training methods. Hospitals used simulation to improve patient outcomes by training healthcare staff and students through telesimulation, and tested systems and equipment using in situ simulation (ISS). Latent safety threats (LSTs) were identified and corrected to improve patient outcomes. Hospital-based simulation has been incorporated into newly licensed registered nurses (NLRNs) residency programs to prepare them for competent practice. Simulations are also used for preparing staff for low-incidence, high-risk medical emergencies or disasters, such as active shooter events. Hospital-based simulation training adds value to healthcare systems, but requires more evidence of its quantitative and qualitative impacts.

Climate change poses significant health risks. Nurses assess, treat, and educate patients about health risks. However, nurses' level of awareness, motivation, and behaviors related to climate change and health is not known. This study developed and tested a novel tool measuring these elements. Three hundred fifty-seven nurses responded to the overall survey. Exploratory factor analysis (EFA) assessed the factor structure of the 22-item CHANT survey and Cronbach's alpha estimated internal consistency. A five-factor model was retained through the EFA, demonstrating good model fit (comparative fit index [CFI] = .95, root mean square error of approximation [RMSEA] = .04, standardized root mean square residual [SRMR] = .09), and items were internally consistent (Cronbach's alpha for each subscale >.70). CHANT has been developed and psychometrically examined and is ready for further use and study.

This chapter addresses the development and advancement of the Center for Climate Change, Climate Justice, and Health (CCCCJH) in the School of Nursing at the MGH Institute of Health Professions, the first nurse-led center emerged from the overwhelming evidence of climate change and its associated deleterious health consequences. The Center steering committee developed a mission, vision, and core values as well as a logo to guide the first year of initiatives and galvanize the efforts for the future. Workshop and symposium development, implementation, and evaluation are discussed. Future directions and the importance of educational initiatives aimed at expanding nursing and interprofessional knowledge of the intersection of climate and health are discussed.

Healthcare contributes significant pollution to the natural environment. Nurses are obligated by professional commitment, to avoid causing harm in their care processes and decisions, including environmental harm. Nurse awareness of healthcare-generated pollution is growing but nurses may lack an understanding of how nursing contributes specifically to this pollution and what nurses can do within their scope and span to address it. This chapter introduces the concept "Nurse-Sensitive Environmental Indicators" as a proposal to identify, measure, and reduce the unintended harm of nursing practice that contributes to healthcare-generated pollution. It discusses the environmental problem, environmental health, and healthcare. The chapter explains what environmental stewardship has to do with nursing and describes nurse sensitive indicators. As has been the case with other quality outcomes measures, identifying agreed-upon environmental outcomes measures may give the nursing profession tools to measure and then address environmental impacts arising from nursing practice.

Nurse scientists are ideally positioned to perform environmental health research and it is critical that the role of omics in the complex relationships between environmental exposures and an individual's unique physiology in human health outcomes be appreciated. Importantly, omics can offer nurse scientists a tool to measure exposure, demonstrate molecular phenotypic changes associated with exposure, and potentially uncover mechanisms of exposure-related disease or negative health outcomes. The purpose of this summary is to serve as an overview of omics methodologies for nurse scientists conducting environmental health research and provides future directions of this work as well as exemplar funding opportunities that demonstrate the growing need and interest in this area. The intersection of nursing and exposure science will accelerate the work in environmental health and bring forth translation of research findings into clinical and community practice. Importantly, this information can better help us understand the variation in response to the environment and support environmental health policy change at the local, state, and federal level to improve community health and well-being.

The chemical composition of air changes from moment to moment. While the atmosphere may appear clear and cloudless to the human eye, gases, aerosols, and particulates are in constant interaction with Earth's surface under the influence of meteorological conditions. The recent emergence of low-cost, dense environmental air quality monitoring networks suggests growing interest in highly granular temporospatial exposure assessments by scientists and citizens. This chapter describes the utility of leveraging partnerships and resources to collocate a dense network of low-cost air quality sensors with meteorological sensors across a predominantly rural state located in the southeastern U.S. Construction of the network will improve knowledge on the daily, diurnal, and seasonal variations of pollutant exposures in rural and urban areas, the public health impact of extreme climatological and atmospheric events, and socioeconomic factors that heighten risk of exposures and health outcomes.

Respiratory diseases affect millions of people across the United States annually. Two of the most common respiratory diseases are chronic obstructive pulmonary disease (COPD) and asthma. Mortality rates due to COPD have increased by an estimated 30% between 1980 and 2014, with significant variances among geographic regions. Both acute and chronic ambient exposures to fine particulate matter (PM_2.5) and ozone have been associated with exacerbations of respiratory diseases in numerous studies, and exposure to air pollutants are considered as the largest health risk factor globally. This study adds to the current literature by reporting the results of a time series analysis of the impact of PM_2.5 and ozone on prevalence rates of asthma and mortality rates for COPD at regional and county levels across the southeastern United States for the years 2005-2014. While general reductions in levels of PM_2.5 and ozone were demonstrated across all years, a distributed lag model showed continued strong associations between PM_2.5 and prevalence of asthma and mortality due to COPD, even at relatively small increases in ambient exposure (<1 μg/m³) across the southeastern United States. The results of the study support the need for additional research that considers factors such as patient demographics, medical histories, and health disparities in combination with ambient exposures to known pollutants.

Public health practice and ethics address both individual and environmental health, in order to optimize the well-being of an entire population. Consideration of environmental health equity (EHE) is an evolving component of environmental ethics and public health, with evidence of disparities in exposure to vulnerable communities. Related terms for studying EHE include elements of justice, social determinants of health (SDOH), disparities, and environmental racism. The unequal protection from environmental exposures, specifically considering vulnerable and marginalized populations is significant to science, society, and health. Analyzing the environmental impact includes examining equity principles to assist policy and decision-making in the public arena, in order to address unfair burdens placed on vulnerable populations. However, the lack of a common and precise term for the idea makes it to instruct and evaluate the experiences of inequities in diverse populations. The purpose of this research is to use a concept analysis to examine the idea, utility, and conditions surrounding "EHE" for use in public health, nursing, environmental ethics, policy development, and interprofessional collaboration. A concept analysis will be conducted following the eight-step method developed by Walker and Avant (2011) Data sources will include empirical and descriptive literature; and the results will identify defining attributes of the concept. A set of operationalized standards for EHE is established through this concept analysis. This study proposes an examination of the concept in order to assess and evaluate the ethics and experiences in EHE, and determine how this impacts population health outcomes.

This chapter outlines the guiding theoretical framework of EcoJustice Education (EJE), research questions, semistructured interviews with nursing scholars that begin to question the perceptions that lead us to the crisis and recommendations of how sustainability efforts can help to address the vital relationality of human beings to water. It highlights the profession of nursing education in order for nurses to understand their roles within the context of the crises. The EJE theoretical framework will help nurse educators reimagine a new understanding and a powerful discovery that includes the awareness of a broad set of historically constructed and politically motivated power knowledge relations in nursing. The chapter provides examples and discussions of four dominant discourses predominant within the Flint Water Crisis and Detroit Water Shutoffs: anthropocentrism, ethnocentrism, individualism, and mechanism. These discourses are related to nursing education to further explain how they are pervaded in nursing.

Climate change has been labeled the greatest threat to public health and to global health in the 21st century. Addressing climate change has also been reframed as the greatest opportunity for global health in the 21st century, providing a more proactive lens through which to plan and implement actions. Significant climate change impacts to human health are numerous and mounting, including the direct effects of heatwaves, thermal stress and changed frequency or intensity of other extreme weather events. Climate change has been termed a complex public health issue affecting all areas of nursing practice dealing with individuals, families, communities, and the national health arena, and is therefore deserving of inclusion into nursing curricula throughout the entirety of prelicensure coursework. Nursing education programs that include this content will better prepare future nurses to face projected environmental challenges to human health.