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It's Time! The Path for Nursing Reimbursement Reform. 是时候了!护理报销改革之路。
IF 0.7 Q4 NURSING Pub Date : 2024-02-01 Epub Date: 2024-02-13 DOI: 10.1177/10784535241228546
Katie Boston-Leary, Olga Yakusheva

Since the COVID-19 pandemic, nurses and nurse leaders are increasingly vocal about chronic understaffing and the impact the staffing crisis continues to have on nurses' well-being and patient outcomes. The American Nurses Association's Nurse Staffing Task Force addressed the importance of staffing standards as a critically needed step toward improving patient and population health outcomes. Against the backdrop of ongoing nursing shortages, hospital leaders have been hesitant to embrace staffing ratios, expressing concerns about their ability to hire and retain sufficient nursing staff, as operational revenue margins remain thin and nursing labor is costly. This article explicates structural issues within the current nursing reimbursement model that harms hospitals' business case for investments in nurse staffing and work environments. We argue that nurses must advocate for nursing reimbursement reform to increase the nursing workforce and improve nurse staffing and work environments. Such reform is necessary to support sustained hospital investments, financial philosophies, and approaches to meaningfully address and improve nurse staffing.

自 COVID-19 大流行以来,护士和护士领导对长期人员不足以及人员配备危机对护士福祉和患者治疗效果的影响的呼声越来越高。美国护士协会的护士人员配备特别工作组将人员配备标准的重要性视为改善患者和人群健康状况的亟需步骤。在护理人员持续短缺的背景下,医院领导对采用人员配备比率一直犹豫不决,他们担心自己是否有能力雇佣和留住足够的护理人员,因为运营收入利润仍然微薄,护理劳动力成本高昂。本文阐述了当前护理报销模式中存在的结构性问题,这些问题损害了医院在护士人员配备和工作环境方面进行投资的商业理由。我们认为,护士必须倡导护理报销改革,以增加护理人员队伍,改善护士配置和工作环境。这种改革对于支持医院的持续投资、财务理念以及有意义地解决和改善护士配置的方法是必要的。
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引用次数: 0
Dialectical Pluralism for Nursing Knowledge Development. 护理知识发展的辩证多元化。
IF 0.7 Q4 NURSING Pub Date : 2024-02-01 Epub Date: 2023-11-19 DOI: 10.1177/10784535231213843
Shahzad Inayat, Graham McCaffrey

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts. DP can help nurses appreciate the diversity of worldviews and recognize the importance of implicit worldviews to generate more practical nursing knowledge. DP as a philosophical approach can enable nurses to communicate between diverse worldviews, become tolerant of conflicting differences, and develop an array of nursing knowledge.

本文的目的是探讨辩证多元化(DP)在护理知识发展中的潜力。护理学者讨论了发展护理知识的方法,探索了知识发展的各种世界观的适合性和相关性,并检查了知识发展的动态和永恒的过程。学者们认为,知识的发展是在研究者所坚持的某种世界观下发生的。许多护士采用不同的世界观,这可能会引起本体论和认识论的冲突。DP可以帮助护士欣赏世界观的多样性,并认识到内隐世界观对产生更多实用护理知识的重要性。DP作为一种哲学方法,可以使护士在不同的世界观之间进行沟通,对冲突的差异变得宽容,并发展一系列护理知识。
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引用次数: 0
Life on the Margins 边缘生活
IF 0.7 Q4 NURSING Pub Date : 2023-12-07 DOI: 10.1177/10784535231217612
Marty Lewis-Hunstiger
This editorial reviews the events of Creative Nursing's 2023 publication year, importantly our transition to Sage Publishing, and the expanded opportunities this new relationship provides in 2024 and beyond. The 11 articles in this theme issue about marginalization are summarized and connected.
这篇社论回顾了《创意护理》2023年出版的事件,重要的是我们向Sage出版社的过渡,以及这种新关系在2024年及以后提供的更多机会。本文对本期关于边缘化问题的11篇文章进行了总结和衔接。
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引用次数: 0
Creating a Pathway to Health-Care Professions for Historically Marginalized Students. 为历史上处于边缘地位的学生创造一条进入医疗保健专业的途径。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-05 DOI: 10.1177/10784535231212474
Kellie Bryant, Allison Lee

Developing a diverse talent pool starting at the high-school level, while students are making future education and career decisions, should be a national priority, given the need to build a diverse health-care workforce. This article describes a 6-week immersive simulation-based summer program to introduce 20 junior high-school students (13-15 years old) to the range of health professions. Because precollege students typically receive limited exposure to clinical settings, high-fidelity simulation is an excellent surrogate for providing realistic experiences in health care. Students heard lectures on health careers, earned basic life support certification, learned to perform basic vital signs measurement, practiced the management of acute asthma, and received an introduction to the daily activities in the life of a nurse and an anesthesiologist. They researched, developed, and presented public service announcement videos about a health-care issue affecting their community. Participants reported being excited about health careers. Future programs will focus on longitudinal support and mentoring, essential for mitigating the higher rates of attrition from health professions among minoritized individuals.

鉴于需要建立一支多样化的医疗保健队伍,在学生们做出未来教育和职业决策的同时,从高中开始培养多样化的人才库应该是国家的优先事项。本文介绍了一个为期6周的沉浸式模拟暑期计划,向20名初中生(13-15岁)介绍各种健康职业。由于大学前的学生通常只接触有限的临床环境,高保真度模拟是提供医疗保健现实体验的绝佳替代品。学生们听取了关于健康职业的讲座,获得了基本生命支持证书,学会了进行基本生命体征测量,练习了急性哮喘的管理,并介绍了护士和麻醉师的日常活动。他们研究、开发并展示了有关影响社区的医疗保健问题的公共服务公告视频。参与者表示对健康事业感到兴奋。未来的项目将侧重于纵向支持和指导,这对于缓解少数族裔中卫生专业人员流失率较高的问题至关重要。
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引用次数: 0
The Lived Experience of African American Persons with Cystic Fibrosis. 非裔美国人囊性纤维化的生活经验。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-21 DOI: 10.1177/10784535231216461
Sigrid Ladores, Brittany M Woods, Leslie N Pitts, Deyana Belay, Lauren Washington, Leigh Ann Bray

Background: Cystic fibrosis (CF) is a rare genetic disease affecting approximately 30,000 people in the United States (US). African American persons with CF are even rarer, comprising approximately 5% of this population. Purpose: The purpose of this study was to explore the lived experiences of African American persons with CF to identify potential disparities in health care. Methods: Descriptive phenomenology was used to explore lived experiences of African American persons with CF over age 18 recruited from CF Foundation-accredited Centers in the US, CF-specific social media, and via snowball sampling. Study data was obtained through telephone interviews that were audio-recorded, transcribed verbatim, and analyzed using Colaizzi's method of thematic analysis. Results: Six men and six women (ages 23-45) completed the study. Interviews revealed three themes: (1) Accepting a Diagnosis of CF; (2) Desiring a Normal Life while Living with an Invisible Disease; and 3) A Slippery Slope of Subtle Racism. Each theme had 2-3 subthemes. Conclusions: It is critical to explore the unique challenges faced by African American persons with CF in order to develop interventions that improve their daily lives and create better futures. Implications for Practice: Findings highlight the unique challenges faced by underrepresented groups with CF and the need to address health inequities to improve care delivery.

背景:囊性纤维化(CF)是一种罕见的遗传性疾病,在美国约有30,000人患有此病。非裔美国人CF患者更为罕见,约占该人群的5%。目的:本研究的目的是探讨非裔美国人CF患者的生活经历,以确定医疗保健方面的潜在差异。方法:采用描述现象学方法,通过滚雪球抽样,从美国CF基金会认可的中心、CF特定的社交媒体中招募18岁以上的非裔美国CF患者,探讨他们的生活经历。研究数据通过电话访谈获得,录音,逐字转录,并使用Colaizzi的主题分析方法进行分析。结果:6名男性和6名女性(23-45岁)完成了研究。访谈揭示了三个主题:(1)接受CF的诊断;(2)带着看不见的疾病,渴望正常的生活;3)微妙种族主义的滑坡。每个主题有2-3个子主题。结论:探索非裔美国人CF患者所面临的独特挑战,以制定改善其日常生活和创造更美好未来的干预措施至关重要。对实践的影响:研究结果强调了代表性不足的CF群体面临的独特挑战,以及解决卫生不平等问题以改善护理服务的必要性。
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引用次数: 0
Overcoming Marginalization by Creating a Sense of Belonging. 通过创造归属感来克服边缘化。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.1177/10784535231216464
Brigit M Carter, Danica Fulbright Sumpter, Wanda Thruston

Marginalization encompasses structural, interpersonal, and intergroup dynamics that perpetuate inequality and exclusion. This manuscript advocates that the solution to marginalization lies in fostering a sense of belonging. Belonging is a fundamental human need, critical for mental well-being, academic success, and personal growth. It significantly impacts engagement, retention, and overall development, especially in health professional education settings like nursing schools. When individuals feel they belong, they are more likely to seek support, engage actively in learning, and perform better academically. However, achieving a sense of belonging is not straightforward, and many challenges at both individual and institutional levels hinder its realization. Individual challenges include resistance to change, implicit biases, and lack of awareness of the disparities caused by marginalization. Institutional challenges include insufficient commitment, inadequate resource allocation, and lack of representation from marginalized groups. In the United States, recent legislation obstructing initiatives toward diversity, equity, and inclusion poses additional obstacles. To overcome these challenges and promote belonging, this manuscript offers strategies that highlight the importance of aligning institutional values with policies and practices, recognizing and rewarding inclusive efforts, and actively seeking diverse perspectives.

边缘化包括使不平等和排斥永久化的结构、人际关系和群体间动态。这篇手稿主张,解决边缘化的办法在于培养归属感。归属感是人类的基本需求,对心理健康、学业成功和个人成长至关重要。它极大地影响了参与、保留和整体发展,特别是在护理学校等卫生专业教育环境中。当个体感到归属感时,他们更有可能寻求支持,积极参与学习,并在学业上表现得更好。然而,实现归属感并不简单,个人和机构层面的许多挑战阻碍了它的实现。个人面临的挑战包括抵制变革、隐性偏见以及对边缘化造成的差异缺乏认识。体制方面的挑战包括承诺不足、资源分配不足以及缺乏边缘化群体的代表。在美国,最近的立法阻碍了多元化、平等和包容的倡议,这带来了更多的障碍。为了克服这些挑战并促进归属感,本文提出了一些策略,强调了将制度价值观与政策和实践相结合的重要性,承认和奖励包容性努力,并积极寻求不同的观点。
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引用次数: 0
The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together, by Heather McGhee. 《我们的总和:种族主义让每个人付出的代价以及我们如何共同繁荣》,希瑟·麦吉著。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-21 DOI: 10.1177/10784535231212472
Lacrecia Mebans Bell

In her book, The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together, historian Heather McGhee tallies the cost of racism and identifies a zero-sum thinking for everyone who engages in the us-versus-them ideology. Chronicling racial hierarchy dating back to colonial America, McGhee uncovers the impact of racism in almost every societal sector including politics, the economy, education, housing, criminal justice, and climate change. McGhee challenges the fallacy that racial equity is only for people of color, demonstrating that political, socioeconomic, and financial equity for Black and Brown people is equity for all people.

历史学家希瑟·麦吉在她的书《我们的总和:种族主义给每个人带来的代价以及我们如何共同繁荣》中计算了种族主义的代价,并为每个参与“我们对他们”意识形态的人确定了一种零和思维。麦吉记录了美国殖民时期的种族等级制度,揭示了种族主义在几乎所有社会领域的影响,包括政治、经济、教育、住房、刑事司法和气候变化。McGhee挑战了种族平等只适用于有色人种的谬论,证明黑人和棕色人种的政治、社会经济和金融平等就是所有人的平等。
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引用次数: 0
Utilizing Simulation to Address Structural Racism in the Health-Care System. 利用模拟解决结构性种族主义在医疗保健系统。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-29 DOI: 10.1177/10784535231216462
Susan L Huehn

Aim: To fill the gap in research that historically has been limited by focusing on the health problems experienced by people of color. Method: A simulation exercise was developed for senior pre-licensure nursing students in their senior year of a pre-licensure nursing program at a Midwest liberal arts college to intervene when a health-care provider in the hospital acted in an oppressive manner toward a client. Results: Qualitative findings suggest the value of addressing structural racism during a simulated learning experience to facilitate an understanding of the extent of racism inherent in the health-care system and biases that can be perpetuated by health-care providers. Conclusions and Implication for Practice: This simulation on the topic of implicit bias and racism in the health-care system provided an opportunity to open and deepen important conversations about equity, belonging, and justice. Additional work is needed in training professional nurses to lead meaningful change in dealing with the current inequities in our health-care system.

目的:填补历史上由于关注有色人种的健康问题而受到限制的研究空白。方法:在中西部一所文理学院的高级护理预备课程的高年级学生中进行了模拟练习,以干预当医院的卫生保健提供者以压迫性的方式对待客户时。结果:定性研究结果表明,在模拟学习经验中解决结构性种族主义的价值,有助于了解卫生保健系统中固有的种族主义程度以及卫生保健提供者可能长期存在的偏见。结论和对实践的启示:这个关于医疗系统中隐性偏见和种族主义主题的模拟提供了一个开放和深化关于公平、归属感和正义的重要对话的机会。在培训专业护士方面需要做更多的工作,以领导有意义的变革,处理我们医疗保健系统中目前的不平等现象。
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引用次数: 0
Evaluation of Social Determinants of Health in Nursing Education through Service Learning. 通过服务学习评估护理教育中健康的社会决定因素。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-21 DOI: 10.1177/10784535231212410
Desi M Newberry, Lori A Spies, Jennifer J Jones, Patricia Yvonne Perez

Background: This manuscript describes an in-state nursing student global health-care experience. The 2021 Rio Grande Valley service learning team at Louise Herrington School of Nursing at Baylor University traveled from Dallas to McAllen, Texas to volunteer in a COVID vaccination clinic and refugee respite center on the U.S.-Mexican border. Method: A competency-based evaluation utilized the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education Featured Concepts, with a focus on social determinants of health, as a framework. Results: The evaluation of the service learning trip through the lens of social determinants of health and the Core Competencies can serve as a guideline for the design of future trips. Conclusion: The Rio Grande Valley service learning trip contributed to nursing students' self-reports of competency in global health education, in identifying the social determinants of health that characterized the immigrants and refugees, and in service and advocacy.

背景:这篇论文描述了一个州内护理学生的全球卫生保健经验。贝勒大学路易斯·赫灵顿护理学院2021年里奥格兰德河谷服务学习团队从达拉斯前往德克萨斯州麦卡伦,在美国-墨西哥边境的COVID疫苗接种诊所和难民救济中心做志愿者。方法:以能力为基础的评估利用了美国护理学院协会的要点:专业护理教育特色概念的核心能力,重点是健康的社会决定因素,作为框架。结果:从健康的社会决定因素和核心竞争力的角度对服务学习之旅进行评估,可为未来服务学习之旅的设计提供指导。结论:里奥格兰德河谷服务学习之旅有助于护生对全球健康教育能力的自我报告,有助于识别移民和难民特征的健康社会决定因素,有助于服务和宣传。
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引用次数: 0
A Mentoring Initiative for Students at Historically Black Colleges and Universities: One Strategy to Increase Nursing Workforce Diversity and Advance Health Equity. 对传统黑人学院和大学学生的指导倡议:增加护理人员多样性和促进健康公平的一项战略。
IF 0.7 Q4 NURSING Pub Date : 2023-11-01 Epub Date: 2023-11-29 DOI: 10.1177/10784535231212463
Vernell P DeWitty, Jazmine Cooper, Deborah Stamps

This article addresses low retention and graduation rates among historically marginalized students in nursing programs at Historically Black Colleges and Universities (HBCUs). Mentoring is a proven success strategy to support systems for historically marginalized students, helping them navigate challenges, improving academic outcomes, and increasing the diversity of the nursing workforce. The article highlights the mentoring initiative of AARP's Center for Health Equity through Nursing and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation, and the outcomes of this collaboration. The paper details the implementation of a mentoring initiative to enhance graduation rates and National Council Licensure Examination (NCLEX) success among historically marginalized students and emphasizes collaboration among institutions and organizations, as well as strategies for funding, mentor recruitment, and NCLEX preparation. Recommendations include promoting robust mentoring programs, preparing mentors, and conducting further research on the effects of mentoring on student outcomes in HBCUs.

本文讨论了传统黑人学院和大学护理专业中历史边缘化学生的低保留率和毕业率。导师制是一种行之有效的策略,可以为历史上被边缘化的学生提供支持,帮助他们应对挑战,提高学业成绩,并增加护理人员的多样性。这篇文章强调了美国退休人员协会的护理健康公平中心的指导倡议和护理的未来:行动运动,这是美国退休人员协会基金会、美国退休人员协会和罗伯特伍德约翰逊基金会的一项倡议,以及这项合作的成果。本文详细介绍了指导计划的实施情况,以提高历史上边缘化学生的毕业率和全国委员会执照考试(NCLEX)的成功率,并强调了机构和组织之间的合作,以及资助、导师招聘和NCLEX准备的战略。建议包括促进健全的指导计划,培养导师,并进一步研究指导对hbcu学生成绩的影响。
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引用次数: 1
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Creative Nursing
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