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Purpose: Hepatitis C incidence is higher among American Indian/Alaskan Native populations than any other racial or ethnic group in the United States. Chronic Hepatitis C complications include cirrhosis of the liver, end stage liver disease, and hepatocellular cancer. Direct acting antiviral treatment taken orally results in > 90% cure, yet rural primary care providers lack the training and confidence to treat and monitor patients with chronic Hepatitis C. Rural patients are reluctant to travel to urban areas for Hepatitis C treatment. Project ECHO is an innovative tele-mentoring program where specialists mentor primary care providers via videoconferencing to treat diseases they would otherwise be unable to manage. The purpose of this quality improvement project was to increase Hepatitis C treatment at a rural Navajo health clinic through partnership with Project ECHO specialists. Methods: This quality improvement project was guided by Lippitt’s Phases of Change Theory. The systematic process plan included a protocol for roles and expectations of all members of the healthcare team, a documentation and communication plan, and a tracking system for monitoring patient progress through the plan of care. Outcomes were analyzed by descriptive statistics. Findings: Following partnership with Project ECHO, six patients (31.6%) consented to receiving Hepatitis C treatment at the rural Navajo health clinic. All six were contacted by outreach staff at multiple points during the project. Five (26.3%) completed the full course of drug therapy. Four (21.1%) completed follow-up lab work, of which three (15.8%) had a documented cure by sustained virologic response. Conclusions: Hepatitis C care via Project ECHO-rural clinic partnership was affordable, feasible and not excessively time consuming for a facility with substantial patient outreach resources. Key words: Rural health clinic, Hepatitis C, Project ECHO, tele-mentoring, Native American

Objective Aims of this study were to identify the Association of Community/Public Health Nursing Educators members' demographics, educational preparation, and research competencies; and, to complete a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Methods A descriptive-correlational design was employed. Primary data collection was via electronic survey. Authors developed a survey focusing on demographics and aligning Benner's theory with research skills/experience. SWOT and gap analyses were performed. Results A 27.2% response rate (N = 352) revealed a lack of diversity among 70% doctorally prepared membership, perceived competence with interprofessional collaboration (80%), and applying research to practice (80%). Doctorally prepared members reported experience using longitudinal designs (p = .05). PhD-prepared members reported experience using psychometrics and evaluations (p = .05). SWOT revealed a lack of service engagement. Gap analysis offered solutions to execute strategic goals. Conclusions Association of Community/Public Health Nursing Educators may enhance future direction by advancing member diversity, professional development, collaborative scholarship, and mentoring.

Background: As the largest health care workforce, nursing is positioned to improve the health of populations using health information technology (HIT). Nurse graduates often lack confidence using HIT in practice, specifically, the electronic health record (EHR). Nurse scholars endorse the use of an academic electronic health record (AEHR) in nursing programs to provide students a safe learning platform to build levels of confidence using an EHR. Method: A quality improvement project was completed to evaluate student learning outcomes, satisfaction, and sustainability of an AEHR. Using an interprofessional approach, nurse educators incorporated the Systems Life Cycle Model to adopt an AEHR in two prelicensure nursing programs. Results: Students' levels of confidence using an EHR in clinical settings increased markedly. Satisfaction rates for using an AEHR were high. Conclusion: Integration of an AEHR in nursing education contributes to building a proficient nursing workforce confident in using HIT for health care quality. [ J Nurs Educ . 2021;60(6):337–341.] .

The Omaha System is the hallmark evidence-based clinical information management system used in nursing education, research, and practice. Multiple education documents guide public health workforce preparation. This qualitative study identified similarities and gaps between the Omaha System and seven guiding documents commonly used by nurse educators. A crosswalk design was employed. The setting was virtually based using online technology. Recommendations are for public health nurse educators to update their teaching practices using evidence-based approaches.

High school students experience a variety of stressors. Mental health issues are critical to their health. The “Adolescent Stress Treatment (AST) Study: A Cluster Randomized Trial” compared the efficacy of two stress reduction devices, the EnergyPod™ and the SleepWing™. The EnergyPod™ is a device that provides a semiprivate acoustical and visual environment for rest, stress reduction, and sleep. The SleepWing™ is a smaller device offering similar benefits. High school students were offered the opportunity to participate in the AST study when they exhibited signs of agitation. The students completed the Profile of Mood States–Short Form (POMS-SF) pre- and postintervention. Total Mood Disturbance (TMD) was measured from the POMS-SF and significant improvement postintervention ( p < .001), regardless of intervention used. POMS-SF subscales were all significantly improved no matter which device was used. All participants in the study dramatically improved their mood after being in either therapeutic device.

The interactions in mental health involve a significant exchange of information to identify symptoms and formulate a working diagnosis. The inability of patients to communicate due to language limitations may lead to situations that will be detrimental, such as receiving the wrong diagnosis or treatment due to the inadequate translation from English to Spanish. A practice change was proposed where health care personnel utilized mobile technology such as the Canopy Translation App to assess the psychiatric symptoms of Spanish-speaking patients with limited English proficiency. Participants completed the System Usability Scale (SUS) to determine whether they found the Canopy Translation App useful during their assessments of Spanish-speaking patients. According to the SUS scores, participants found the Canopy Translation App useful during their interactions with Spanish-speaking patients. The findings emphasize the importance of exploring new resources and technologies to ameliorate language barriers.

Background and Purpose: Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time. Methods: Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using analysis of variance (ANOVA) and Fisher’s exact tests. Results: Two hundred twenty-seven youth were seen for MI-based discussions by 4 PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a 2- to 3-month period (p < .001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p < .01). Implications for Practice: This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions such as obesity (ClinicalTrials.gov Number NCT02502383).

In this study we incorporate depression screening questionnaires/tools and a screening protocol into primary care practice. The effectiveness of the intervention was evaluated in establishing depression screening practice in the clinic. Implementation of the depression screening questionnaires in patients' electronic health records along with the depression screening protocol resulted in increased screening. Using this approach led to increased detection of depression risk in adult patients with chronic medical conditions, such as type 2 diabetes, in the primary care setting. Our study findings show that integration of the intake screening questionnaires into the electronic health record makes the screening process easier and more efficient in the primary care setting.

BACKGROUND Students' word choice when writing in a reflective journal may reveal their emotional development, sense of belonging, cognitive processing, and ability to appraise their own growth and understanding. New linguistic analysis software can scan and categorize these journals for the use of pronouns, positive and negative emotions, and cognitive keywords. METHODS A retrospective study design evaluated student journaling from a psychiatric clinical course. Journal entries from weeks 1 and 12 were compared by z-score analysis. FINDINGS Significant increases were found in the use of "we" (P = .001), positive emotions (P < .001), inclusion words (P < .001), and insight words (P = .004), whereas the use of cause and self-discrepancy words were not significantly different. CONCLUSION Identification of learning as expressed in words could have an impact on how student assignments are designed by including the use of the Linguistic Inquiry and Word Count software to assess changes in student cognition.

Asthma action plans should be standard practice amongst asthmatics. According to a new report from the American Academy of Pediatrics, a lack of AAP implementations could lead to increased asthma-related hospitalizations. Many written AAPs are written at a seventh to ninth grade reading level leading to less control of asthma symptoms, potentially resulting in increased asthma-related hospitalizations. A pictorial-based curriculum and its benefits will be discussed, along with background information concerning the implementation of such intervention and desired goal to increase asthma control. Implementation of a Pictorial Asthma Action Plan and Curriculum to improve Asthma Control utilizing “Iggy and the Inhalers'' by Booster Shot Media was conducted in a predominantly Spanish speaking and low income-based population. Iggy and the inhalers have published results of implementing their Pictorial Asthma Action Plan and Curriculum and improved outcomes documented on their site. The objective of implementation was to determine whether incorporating a pictorial based approach would improve control and knowledge amongst students with asthma in a special population. All identifiable participant information was kept private per site guidelines with exception to age and grade range and demographic information. Sixteen children participated in the implementation. Nine participants scored in the "well controlled" category while seven participants were "not controlled" according to ACT guidelines. Overall, five of seven (71%) improved their asthma control enough to bring them into the "controlled" state according to the ACT. Of those who improved, 16 (81%) improved with the Asthma Knowledge test. Conclusion: By utilizing appropriate educational methods, you can also increase participation and engagement, which results in increased compliance and control. Control and knowledge of asthma were improved because of this implementation project. Recommendation is that a PAAP curriculum should be promoted system wide.

CONTEXT: Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes. OBJECTIVE: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes. DATA SOURCES: We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Web of Science, Cochrane Library, and Google Scholar from January 1997 to April 2018. STUDY SELECTION: Four authors reviewed titles, abstracts, and full-text articles. DATA EXTRACTION: Two authors abstracted data and assessed risk of bias and quality of evidence. RESULTS: Seventeen studies met inclusion criteria; 11 were included in the meta-analysis. There were nonsignificant effects on reducing BMI (mean difference [MD] −0.27; 95% confidence interval −0.98 to 0.44) and BMI percentile (MD −1.07; confidence interval −3.63 to 1.48) and no discernable effects on BMI z score, waist circumference, glucose, triglycerides, cholesterol, or fasting insulin. Optimal information size necessary for detecting statistically significant MDs was not met for any outcome. Qualitative synthesis suggests MI may improve health-related behaviors, especially when added to complementary interventions. LIMITATIONS: Small sample sizes, overall moderate risk of bias, and short follow-up periods. CONCLUSIONS: MI alone does not seem effective for treating overweight and obesity in adolescents, but sample size and study dose, delivery, and duration issues complicate interpretation of the results. Larger, longer duration studies may be needed to properly assess MI for weight management in adolescents.

Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

Postoperative nausea and vomiting (PONV) remains a common postoperative complication that causes patient discomfort and increases health care costs. Clinicians use the American Society of PeriAnesthesia Nurses (ASPAN) guideline to help prevent and treat PONV. However, the lack of standardized terminology in the electronic health record (EHR) and the lack of clinical decision support tools make it difficult for clinicians to document guideline implementation and to determine the effects of nursing care on PONV. To address this, we created a concept map of the Perioperative Nursing Data Set (PNDS) that illustrates the relationship between elements of this standardized nursing terminology and the ASPAN guideline, using the Systematized Nomenclature of Medicine-Clinical Terms multidisciplinary terminology to fill any gaps. This mapping results in a standardized dataset specific to PONV for use in an EHR, which links nursing care to nursing diagnoses, interventions, and outcomes. The mapping and documentation in the EHR also allows standardized data collection for research, evaluation, and benchmarking, which makes perioperative nursing care of patients who are at risk for or experiencing PONV measureable and visible. Distributing this information to perioperative and perianesthesia nursing personnel, in addition to implementing risk assessment tools for PONV and clinical support alerts in electronic documentation systems, will help support implementation of the PONV clinical practice guideline in the EHR.