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PURPOSE: To provide guidance to nurses caring for families with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). In addition, we wanted to identify gaps in the terminologies and potential new nursing diagnoses, outcomes, and interventions for future development related to nurse roles in family care during a pandemic. METHODS: Using a consensus process, seven nurse experts created the linkages focused on families during the COVID-19 pandemic using the following steps: (1) creating an initial list of potential nursing diagnoses, (2) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (3) identifying relevant nursing interventions. FINDINGS: We identified a total of seven NANDA-I nursing diagnoses as the basis for the linkage work. These are distributed in three NANDA-I Domains and based in the psychosocial dimension of the Nursing Care in Response to Pandemics model. Eighty-nine different NOC outcomes were identified to guide care based on the nursing diagnoses, and 54 different NIC interventions were suggested as possible interventions. Fifteen new proposed concepts were identified for future development across the three classifications. CONCLUSIONS: The linkages of nursing diagnoses, outcomes, and interventions provide a guide to enhance nursing practice and care documentation that could quantify the impact of nursing care to patient outcomes for families at risk for or infected by COVID-19. IMPLICATIONS FOR NURSING PRACTICE: NANDA-I, NOC, and NIC linkages identified in this paper provide resources to support clinical decisions and guide critical thinking for nurses encountering care needs of families with COVID-19. Documentation of these linkages provides data that can create new knowledge to enhance the care of families impacted by COVID-19.

When conducting research measuring behavioral change, it is important to assess the true relationship between the independent and dependent variable, while identifying and minimizing the modifying and extraneous effects associated with intervention delivery (Resnick et al., 2005). Treatment fidelity is the degree in which interventions are delivered as outlined by the program developers (Bellg et al., 2004; Carroll et al., 2007). While the use of fidelity monitoring and fidelity checklists have been documented in behavioral intervention research (Leeuw, Goossens, de Vet, & Vlaeyen, 2009), there have been no publications documenting a systematic process for modifying fidelity checklists. The purpose of this article is to describe the systematic adaptation of the Fidelity Checklist (FC)-a valid and reliable tool for measuring treatment fidelity-for fidelity assessment of a group-based community opioid overdose prevention program (OOPP). Specifically, we will:^ Define treatment fidelity and describe the need for measuring treatment fidelity in behavioral change interventions;^ Provide an overview of the FC (Breitenstein et al., 2010), including a description of the tool, a discussion of its purpose, and a report of initial findings from early testing of the tool;^ Describe the modification of the FC for use in a groupbased community OOPP.Fidelity measurement may assist with the translation of interventions into clinical practice. The process described in this article will assist researchers with the measurement of fidelity across different interventional settings.BackgroundTreatment fidelity is an important source of variation that affects both the utility of interventions and the credibility of findings (Carroll et al., 2007; Kubiak, Fedock, Tillander, Kim, & Bybee, 2014). Fidelity is determined by three factors: (a) clinicians' adherence to the manual or protocol, (b) clinicians' competency in skills supporting the intervention, and (c) the participants' responsiveness during the intervention (Breitenstein et al., 2010; Carroll et al., 2007). Researchers have used various terms to describe treatment fidelity, including but not limited to intervention fidelity, implementation fidelity, and integrity fidelity, all with the purpose to describe the core elements of the intervention required to ensure replication. For the purposes of this article, the term treatment fidelity will be used and the processes associated with ensuring the integrity of treatment delivery will be discussed.Researchers have suggested differing and similar components of treatment fidelity. The National Institutes of Health Behavioral Change Consortium (BCC) described five components of treatment fidelity: design, training, delivery, receipt, and enactment (Bellg et al., 2004). Similarly, Gearing et al. (2011) discussed the "major ingredients" of fidelity as design, training, delivery, and receipt, and provide definitions for each of the elements. The focus of the present work is the fidelity component of delivery and is defined as the processes to monitor and improve the delivery of the intervention so that it is delivered as intended by the developers.The ability of the interventionist to skillfully deliver the treatment and engage participants may impact outcomes (knowledge or other measured behavior change) associated with the intervention. As such, both adherence and competence assessments are necessary to determine fidelity (Santacroce, Maccarelli, & Grey, 2004), and can be measured using subscales of the FC (Breitenstein et al., 2010).The Fidelity ChecklistThe FC was developed to measure group leader implementation of the Chicago Parent Program (CPP; doubleblind review). The CPP is a 12-session, group-based behavioral parenting program delivered in community settings. The FC was established to assess group leaders' maintenance of the weekly CPP protocol (adherence) and their group facilitation and process skills (competence). …

The evaluation and maintenance of treatment fidelity is an important methodological consideration in intervention research. Treatment fidelity is the degree to which interventions are delivered as outlined by the program developers. A lack of fidelity to the intervention model has the potential to be a large source of error, including type I and type II error. Monitoring and assuring fidelity is critical to assuring the validity of the interventions. The Fidelity Checklist is a reliable and valid tool designed to measure fidelity in a group-based parenting program. The Fidelity Checklist assesses group leaders' maintenance of the intervention protocol (adherence) and their group facilitation and process skills (competence).The purpose of this article is to describe the systematic process of modifying the Fidelity Checklist for use in a community-based opioid overdose prevention group educational intervention.A biphasic approach was used to modify the Fidelity Checklist. Phase 1 included engaging key stakeholders during a full-day meeting to determine adherence subscale components. Phase 2 included: (a) the modification of the competence subscale of the Fidelity Checklist, (b) adaptation of the coding manual defining the components of the Fidelity Checklist, and (c) creating a fidelity checklist to guide interventionists.The biphasic systematic modification approach resulted in a revised Fidelity Checklist that was successfully used to measure treatment fidelity in a community-based opioid overdose prevention program.The findings of this study provide information for nurse researchers and nurse educators for modifying a fidelity checklist that can be used to enhance community-based educational interventions.

BACKGROUND Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of adverse health outcomes due to their intense caregiver demands. OBJECTIVE The aim of this study was to describe adverse health outcomes in parents of children who survived an allogeneic HSCT done within the past 1 to 10 years. METHODS This cross-sectional study, conducted at a children's hospital in the western United States, enrolled English- and Spanish-speaking parents of children who survived allogeneic HSCT between 2005 and 2015. Outcome measures included Beck Anxiety and Depression Inventories, Perceived Stress and Parent Stress Scales, Physical Symptom Inventory, and Short-Form 36 version 2. Parent scores were compared with normative means. Subsequently, the parent sample was stratified by the amount of time since their child's HSCT for comparison between groups. RESULTS Fifty-four mothers and 7 fathers (n = 61) were enrolled. Global mental health scores were lower for parents in the sample compared with norms (P = .003). Parents in the sample reported moderate anxiety and depression (20% and 23%, respectively), yet reported less parenting stress and superior health outcomes compared with norms (P < .001). Social functioning and general health scores were lower for parents whose children survived an allogeneic HSCT done within the past 1 to 4.99 years (P = .012). CONCLUSION Parents of survivors of allogeneic HSCT may concurrently experience posttraumatic growth and stress following their child's HSCT. IMPLICATIONS FOR PRACTICE Health screening and psychological support for parents of children post-HSCT may help to identify parents at risk of adverse outcomes and allow for early, targeted interventions.

Background: In 2008, the American Psychiatric Nurses Association and the International Society for Psychiatric Nursing jointed developed Psychiatric Mental Health Nursing competencies for BSN students. In the newly created accelerated track of the BSN program, students spend less time than traditional students in psychiatric mental health (PMH) clinical practica. Objectives: The primary objective was to discover how the PMH practicum experience influences BSN students’ perceptions of their confidence in performing PMH clinical skills. Design: An evaluation design was used in this study. Results: There was significant improvement in students’ confidence performing PMH clinical competencies after completing the PMH nursing practicum. The current structure of clinical provides students with experiences that promote their confidence. Conclusions: Students self-assessment about learning needs and skill level should be assessed preclinically to allow for practice to gain confidence.