Joanne Noone

The Diversity Imperative: Strategies to Address a Diverse Nursing Workforce

TOPIC There has been a call to action for the need to create a more diverse nursing workforce. PURPOSE The purpose of this article is to outline and review strategies that schools of nursing education can use to increase the recruitment, retention, and success of a diverse nursing student body. SOURCES OF INFORMATION A review of the nursing literature was performed using CINAHL and hand-searching references. Abstracts were reviewed and articles included if the topic of the article referred to strategies to increase the diversity of nursing students. CONCLUSIONS A variety of strategies are being used to address this issue. A multifaceted approach is recommended.

Spiraling evidence-based practice and outcomes management concepts in an undergraduate curriculum: a systematic approach.

Preparing undergraduate nursing students to practice nursing in the 21st century requires a focus on the development of evidence-based practice and outcomes management knowledge and skills throughout the nursing curriculum. To this end, seven learning activities were created that spiral and increase in complexity while building on previously acquired skills. Working in teams and practicing team-building techniques, students learned how to develop a clinical question, search the literature, synthesize the current knowledge, identify the significance of the issue in an ecological model, decipher existing quality data and compare that data to national benchmarks, investigate a health care quality issue using quality improvement methods, and draft a proposal for implementation of a continuous quality improvement initiative. Work was presented in both written and oral presentation formats, with emphasis on engaging various audiences in a compelling health care issue.

Listening to women: culturally tailoring the violence prevention guidelines from the put prevention into practice program.

Purpose To develop five reliable and valid (culturally tailored) guidelines focused on the prevention of violence as presented in the violence prevention guideline of the Put Prevention into Practice Clinicians Handbook on Preventative Services (PPIP). Data Sources The data collection for this qualitative, descriptive design of naturalistic inquiry was focus group interviews with five different ethnic groups of women (Caucasian, Filipino, Hawaiian, Japanese and Hispanic) using a semi‐structured interview guide. Conclusions The women interviewed provided a variety of suggestions for adaptations to the guideline. Cultural similarities and differences are presented. Development of a nonjudgmental and trusting relationship is key to disclosure. Implications for Practice Violence against women is recognized as a major public health problem. Little is known about the effectiveness of standardized interventions such as those contained in the PPIP Handbook. Even less is known about the efficacy of such protocols within culturally diverse populations. Providers should consider adaptation of the guideline based on the individual relationship with the client. The next phase of this research is to implement the culturally tailored adaptations of these guidelines and test their effectiveness.

Teaching to the three apprenticeships: designing learning activities for professional practice in an undergraduate curriculum.

The Carnegie Foundation for the Advancement of Teaching recently completed a series of comparative studies that examined components and best practices in professional education and practice across five professions (clergy, law, medicine, nursing, and engineering). Across these disciplines, three apprenticeships were identified as necessary components of education for professional practice: an intellectual or cognitive apprenticeship, a skill-based apprenticeship related to clinical judgment and practice, and an apprenticeship to the ethical comportment or behavior of the profession. Although nursing education has a strong theory and clinical practice base historically, the comparative study of nursing education by the Carnegie Foundation found limited integration of the apprenticeships. Using an exemplar, this article discusses intentional design of learning objectives and activities to integrate learning across the three apprenticeships with an emphasis on key elements for professional practice in nursing.

Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception

CONTEXT The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play an even more vital role in assisting them to navigate decisions about and access to contraception. PURPOSE To examine rural womens perspectives on how living in a rural area impacts issues surrounding pregnancy prevention for their daughters and parent-child communication regarding pregnancy prevention. METHODS Open-ended interviews were conducted with 30 mothers of adolescent women in 3 rural counties in southern Oregon. Thematic analysis within and across interviews using constant comparative analysis was used to explore barriers, facilitators and strategies mothers identified in talking with their daughters about contraception. FINDINGS Specific themes found that related to the rural environment included (1) conservatism, (2) isolation, (3) lack of privacy, (4) stigma, (5) the paradox of the rural environment, and (6) the uniqueness of rural life. CONCLUSIONS The context of living in a rural environment may present unique barriers to facilitate parent-child communication when discussing intimate topics. The design of interventions needs to take into consideration these issues, particularly when attempting to serve hard-to-reach populations.

Diagnosis and treatment of leptospirosis in the primary care setting.

Leptospirosis is an infectious illness that usually develops 1 to 2 weeks after indirect or direct exposure to the urine of infected animals. Infection occurs through open cuts, absorption through intact mucous membranes, and drinking contaminated water. The typical presentation is a flulike syndrome of sudden onset that tends to resolve within 2 weeks. A mild immunologic phase usually presents as an aseptic meningitis. A more severe immunologic phase (Wells syndrome) can result in jaundice, renal failure, adult respiratory distress syndrome, disseminated intravascular coagulation, and death. Laboratory tests take too long to replace clinical diagnosis, which is imperative so that antibiotic therapy can begin before the forth day of illness. Although leptospirosis is more common in tropical climates, detection in the continental United States is increasing. Early, accurate detection and treatment in the primary care setting are vital for limiting life-threatening complications.

Reducing health disparities by improving quality of care: lessons learned from culturally diverse women.

Disparities in healthcare for culturally diverse populations in the United States lead to poorer health outcomes. This article focuses on decreasing health disparities by improving the quality of care for culturally diverse women. Findings from 3 pilot studies are organized using Fongwas Quality of Care Model, which demonstrate specific modifications suggested by culturally diverse women that can potentially improve healthcare services for these women.

Escuchando a Nuestros Jóvenes: a latino youth photovoice project on teen pregnancy.

Half of Latina teens in the United States will become pregnant at least once by age 20 years. The purpose of this study was to explore a Pacific Northwest communitys strengths and weaknesses, through photovoice, as viewed by Latino youth to understand their concerns related to teen pregnancy. Participants were asked to take photographs of what they believe contributes to preventing or increasing the risk of teen pregnancy. There were 14 Latino youth, ages 15-20 years, who enrolled in the study, and 9 completed all aspects of the project including public dissemination. The themes were categorized as (a) risks for teens, (b) pressure, (c) education is key, (d) community resources, and (e) Latino values. Presentations to the community generated dialogue and problem solving and laid the groundwork for planning interventions.

Pilot test of interactive theater to improve parent communication on pregnancy prevention

Purpose: Over 80% of pregnancies in American women aged 15–19 are unintended. Parental communication is vital to assist adolescents to navigate decisions about sexuality. This study evaluated an intervention using interactive theater to facilitate parent communication with adolescents about sexuality. Methods: Teen actors educated 26 parents in a community theater setting. Process evaluations and measures of communication, comfort, self-efficacy and intention to communicate were administered. Findings:. Significant improvements in communication (p < .001), comfort (p < .05) and self efficacy (p < .05) occurred at 3-month follow up. Intention to communication scores improved but were nonsignificant. Participants rated the acceptability of the intervention as a mean of 4.69, with 1 meaning “Strongly Disagree” to 5 meaning “Strongly Agree”. Conclusions: An interactive theater intervention facilitated parent–adolescent communication about sexuality. Theater interventions can reach participants of varying literacy levels to produce behavior change through vicarious experience as well as active participation.

Advancing Health Equity Through Student Empowerment and Professional Success: A Statewide Approach

BACKGROUND A lack of diversity in the nursing workforce nationally has been identified by Oregon state leaders as a factor contributing to health inequity. METHOD The goal of Advancing Health Equity Through Student Empowerment and Professional Success (HealthE STEPS) is to graduate nursing students from disadvantaged backgrounds to improve health equity within their communities. A comprehensive plan of evidence-based strategies was developed based on social determinants of health and addresses academic socialization, learning support, financial resources, networking, curriculum development, and campus culture. RESULTS Ninety undergraduate nursing students participated in the program during a 2-year period. Retention of participants was 97% with graduation rates of 94%. First-time licensure pass rates were 82% and 96% of participating graduates employed in a medically underserved community. CONCLUSION This comprehensive innovative program of evidence-based strategies addresses health equity by developing a diverse nursing workforce to practice in medically underserved communities. [J Nurs Educ. 2016;55(6):316-322.].