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Nonvocal alert patients in the intensive care unit (ICU) setting often struggle to communicate due to inaccessible or unavailable tools for augmentative and alternative communication. Innovation of a hand-operated non-touchscreen communication system for nonvocal ICU patients was guided by design concepts including speech output, simplicity, and flexibility. A novel communication tool, the Manually Operated Communication System (MOCS), was developed for use in intensive care settings with patients unable to speak. MOCS is a speech-output technology designed for patients with manual dexterity impairments preventing legible writing. MOCS may have the potential to improve communication for nonvocal patients with limited manual dexterity.

Background: From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care–associated shootings also increased. The role of acute and critical care nurses during shootings is not well defined in the literature. Objective: To identify roles of acute and critical care nurses during mass shooting incidents and provide best-practice recommendations for shooting incidents within a hospital. Methods: The methods of Whittemore, Knafl, and Torraco informed this integrative review. Ovid MEDLINE, CINAHL, and Scopus databases were searched for publications related to acute and critical care nurses, mass shooting incidents, and hospital setting. Results: Of 13 589 articles retrieved, 27 were included; 63% were narrative reviews. The highest level of evidence was an expert consensus panel; next highest was a quasi-experimental study that simulated experiences to test mass casualty incident response. Third highest was a qualitative study that analyzed nurses' experiences during a mass casualty experience. Discussion: The evidence revealed 3 themes: prevention and preparedness, response to incident, and recovery phase. Education and training for acute and critical care nurses about mass shooting incidents are central to defining nurses' roles and best practices for these incidents. Nurses must know Stop the Bleed techniques and run-hide-fight protocols. Additionally, acute and critical care nurses need representation on hospital committees to develop and implement policies and procedures. Conclusions: Hospitals are not immune to mass shooting incidents. Acute and critical care nurses require education including simulations and drills on mass shooting incidents to ensure safety of nurses and patients. [ABSTRACT FROM AUTHOR]

This article presents the results of a study examining the highest implementers of the Schools to Watch (STW): School Transformation Network Project, and the impact the project had on their teaching/learning practices and outcomes. The project was funded by the U.S. Department of Education's Investing in Innovation (i3) grant program and was designed to improve the educational practices, experiences, and outcomes of 18 low-performing middle grades schools in California, Illinois, and North Carolina by offering a whole school reform model with a multilayered system of support. The framework for the project was the National Forum to Accelerate Middle-Grades Reform's STW criteria, a set of strategies and practices for middle grades schools. The data presented were collected as part of the project's evaluation which used a quasi-experimental design. Data are from the Forum's STW Rubric and the Center for Prevention Research and Development's (CPRD) Self-Study Teacher Survey from project schools, as well as student achievement test scores from project and comparison schools. The findings showed that the highest implemented STW Project schools achieved higher levels of implementation of the STW criteria, teacher collaboration, leadership practices, and best middle grades instructional practices, and showed significant improvement in mathematics achievement.

The COVID-19 pandemic exacerbated staffing challenges in intensive care units, with increased burnout and moral distress cited as major problems. A healthy work environment is critical to nurses' success and wellbeing. During the pandemic, a survey by the American Association of Critical-Care Nurses revealed decreased composite scores in each of the 6 critical elements of a healthy work environment. Hospital units that improved even 1 critical element reported higher job satisfaction. The use of telehealth tools by expert nurses expanded care delivery during the pandemic by improving response to acutely and critically ill patients while supporting hospital-based nurses. All of the critical elements of a healthy work environment are relevant to the tele–critical care nurse's role and challenges. This article describes how tele–critical care nurses were affected by the pandemic and how healthy work environment strategies promoted successful nurse and patient outcomes. [ABSTRACT FROM AUTHOR]

Advanced practice registered nurses and physician assistants, collectively termed advanced practice providers (APPs), have been part of telehealth for many years. During the COVID-19 pandemic, APPs experienced the growth in roles, responsibilities, and tools used for telehealth care delivery. This article uses examples from 3 health systems to highlight the ways in which telehealth use was expanded due to the pandemic, how APP roles were altered across the United States during and after the pandemic, and implications for future practice. [ABSTRACT FROM AUTHOR]

Too many educators avoid using data when making decisions because they believe it is too time-consuming to do so. The authors present five steps that make it easier to use data in making school decisions. The first step is to review school improvement plan to identify the most salient issues a school wants to improve. The second step is to determine how the data will be examined (that is, what groups in a school will be involved in reviewing the data). The final steps are in a cyclical three-part process: Identify the relevant data, examine and discuss the data, and set goals and evaluate progress. The five-step process for incorporating data into decisions is an excellent framework for schools to build on and to adapt for their unique structure. (Contains 1 figure and 1 table.)