Joan Esper Kuhnly

Enhancing Empathy in Undergraduate Nursing Students: An Experiential Ostomate Simulation

AIM The aim of this study was to implement and evaluate an experiential learning simulation created to enhance nursing students’ empathy during patient care encounters. BACKGROUND The investigators proposed that an ostomy simulation experience would be an efficient method for providing this educational content. METHOD Content analysis was conducted on essays using Krippendorffs technique to quantify the simulation. RESULTS Each unit of measure, or paper, contained between 1 to 14 empathic comments. Of the total sample, 22.8 percent had three or five empathic comments; 10 percent had four, and 9 percent had six or more comments per paper. Eighty‐five percent of participants felt this simulation experience was beneficial for enhancing empathy in clinical practice. CONCLUSION The assignment was an effective, objective method that utilized simulation to teach empathy to baccalaureate nursing students.

Qualitative Analysis of Registered Nurses’ Perceptions of Lactation Assessment Tools: Why and How They Are Completed:

Background: Although lactation assessment tools are consistently used in clinical practice, there is no evidence describing registered nurses’ perspectives regarding the purpose and thought processes involved when conducting a breastfeeding assessment. Research aim: This study aimed to explore registered nurses’ perceptions on the purpose of lactation assessment tools and the thought processes involved in completing one. Methods: Seven focus groups were held from April 2015 through July 2015, in coordination with regional and international lactation and perinatal conferences. Participants included 28 hospital-based registered nurses who routinely used a lactation assessment tool to assess postpartum mothers with healthy breastfeeding newborns. Focus groups were audiotaped, transcribed verbatim, and content analyzed by two lactation researchers to identify relevant themes and subthemes. Results: The analyses identified four different purposes of breastfeeding assessment tools (Teaching and Assessing Simultaneously, Infant Safety, Standardized Practice, and “It’s Your Job!”) and four themes related to the thought processes used in completing the tool (Novice vs. Expert, Real-Time vs. Recalled Documentation, Observation or Not, and “Fudging the Score”). Conclusion: Registered nurses found lactation assessment tool completion to be an essential part of their job and that it ensured infant safety, standardized care, maternal instruction, and lactation assessment. Differences in the lactation assessment tool completion process were described, based on staff expertise, workload, hospital policies, and varying degrees of compliance with established protocols. These findings provide critical insight for the development of future breastfeeding assessment tools.

Strategies to Support Sustained Breastfeeding of Late Preterm Multiple Birth Infants

Strategies to support sustained breastfeeding in late preterm multiple birth infants include developing a family-centered feeding plan in collaboration with the medical team, assessing and supporting breastfeeding sessions, promoting lactogenesis with pumping or manual expression, and activating a support system for families.

The Development and Implementation of a Prenatal Education Program for Expectant Parents of Multiples

ABSTRACT Preparing expectant parents of multiples required a unique prenatal education program. A thorough explanation of the course layout, curriculum, and content the faculty developed for this unique 9-hour program is presented. The unique implications for parenting multiples was highlighted throughout the program, which included expectations for late pregnancy, preparation for labor and birth, assuring infant safety, learning how to provide infant care, identifying sources of support, breastfeeding information and support, potential for neonatal intensive care, postpartum depression, and providing a multiple parent’s personal perspective. All classes were interactive and used active learner-based teaching strategies.

Lactation Assessment Tools: A Qualitative Analysis of Registered Nurses’ Perceptions of Tool Limitations and Suggested Improvements:

Background Several lactation assessment tools are available for in-hospital assessment of breastfeeding dyads, and their components vary widely. To date, no research has evaluated the perceptions of registered nurses (RNs) regarding the limitations and future improvements of these tools. Research Aim The aim was to describe RNs’ perceptions of the limitations of currently used lactation assessment tools and how these tools could be enhanced. Methods Focus groups (n = 7) were conducted with RNs (N = 28) whose current responsibilities included in-hospital breastfeeding assessment. Recruitment occurred from April through July 2015 at regional and international lactation conferences. Focus groups were audiotaped and transcribed verbatim. Two lactation researchers analyzed the transcripts to identify emerging themes and subthemes. Results RNs identified three key limitations of the tools included being too subjective and time-consuming, difficulty in assessing audible swallows, and missing the big picture (e.g., overemphasizing numbers, being a snapshot in time). Suggested improvements focused on maternal characteristics (evolving breasts and nipples, holding it together, “got milk?,” risk factors, embracing the role), infant characteristics (day of life, latch/suck/swallow, baby’s “driving the bus,” risk factors for supplemental feeding), their interaction (two to tango, positioning, better qualitative descriptors), and tool organization (formatting and multiple versions). Conclusions RNs suggested novel components for consideration when developing future lactation assessment scales, including removing audible swallowing, adding mother/infant interactions, infant output, and expressible colostrum, and developing criteria specific to infant age. Future research should translate these suggestions into evidence-based indicators and evaluate the resulting proposed tools for reliability and validity.