Lila de Tantillo

Managing screening and diagnosis of Zika in the Emergency Department

Zika has emerged as a rapidly spreading infection worldwide. Clinicians in many parts of the world must be prepared to screen for symptoms and diagnose patients with this disease. In particular, pregnant women who may have experienced exposure to Zika must be treated with care and sensitivity due to serious risk for pregnancy complications among those who contract the infection. In response to the outbreak, patient management guidelines have been established for all who may be symptomatic or potentially at risk of infection with Zika. Clinicians globally can prepare to implement such protocols to help contain this disease.

Developing Minority Nursing Students: Evaluation of an Innovative Mentorship and Leadership Program

BACKGROUND There is disparity in the nursing work-force of minority leaders. The aim of this article is to describe and evaluate an innovative program designed to provide mentorship and increase leadership skills of minority nursing students. METHOD An innovative mentorship program was developed including coordination of financial aid meetings, incorporating technology, enacting an online preimmersion course, choosing and training mentors, hosting a lunch-and-lead leadership series, and using intensive review sessions and tutoring. Program evaluation data were analyzed using mixed methods. RESULTS All 40 participants passed the NCLEX-RN and had obtained employment after the program. Of the 20 respondents, 25% already had obtained a leadership role in nursing. Qualitative data about the program revealed categories of leadership, networking, mentorship, more time, and gratitude. CONCLUSION This program was successful in promoting retention, graduation, and development of future minority nurse leaders. [J Nurs Educ. 2018;57(9):526-534.].

Implementation of an in-hospital stroke simulation protocol

Purpose A major component of hospital stroke care involves prompt identification of stroke in admitted patients. Delays in recognizing stroke symptoms and initiating treatment for in-hospital stroke can adversely impact patient outcomes. This quality improvement intervention used simulation together with a traditional lecture to instruct nurses at a university hospital about a new stroke protocol being implemented to increase rapid recognition of stroke and meet Joint Commission National Hospital Inpatient Quality Measures. The paper aims to discuss these issues. Design/methodology/approach In total, 86 registered nurses from the neurology and cardiology units attended a lecture and participated in a simulation scenario with a standardized patient exhibiting stroke symptoms. Participants completed a ten-item pre-test to measure their knowledge of stroke care prior to the lecture; they repeated the test pre-simulation and once again post-simulation to evaluate changes in knowledge. Findings Overall mean stroke knowledge scores increased significantly from pre-lecture to pre-simulation, and from pre-simulation to post-simulation. Simulation plus lecture was more effective than lecture alone in increasing knowledge about hospital stroke protocol despite assigned unit (cardiology or neurology), years of experience, or previous exposure to simulation. Research limitations/implications All eligible nurses who agreed to participate received training, making it impossible to compare improvements in knowledge to those who did not receive the training. Originality/value A diverse array of nursing professionals and their patients may benefit from simulation training. This quality improvement intervention provides a feasible model for establishing new care protocols in a hospital setting.

Evaluating a Culturally Tailored HIV Risk Reduction Intervention Among Hispanic Women Delivered in a Real-World Setting by Community Agency Personnel:

Purpose: To evaluate the effectiveness of Salud, Educación, Prevención, y Autocuidad/Health, Education, Prevention and Self-care (SEPA) to increase human immunodeficiency virus (HIV)/sexually transmitted infections (STI) prevention behaviors for Hispanic women delivered in a real-world setting. Design: Randomized controlled trial. Setting: Participants were recruited from the Miami Refugee Center, the Florida Department of Health, and public locations in Miami. Participants: Three hundred twenty Hispanic women. Intervention: The SEPA is a culturally tailored intervention developed to address HIV/STI risk behaviors among Hispanic women. The SEPA intervention consisted of three 2.5 hour sessions per week conducted with small groups. The SEPA sessions consisted of group discussions, role playing, negotiation skills, partner communication, and skills building as part of the methodology. Measures: Acculturation, HIV/STI risk behaviors, HIV knowledge, partner communication, intimate partner violence, drug/alcohol use, condom use. Analysis: Differences at baseline by group were assessed using Wilcoxon rank sum test, χ2, and a negative-binomial model. Changes in dependent variables, compared to baseline, were analyzed in separate models. Log-binomial models and negative binomial models were used for dichotomous and count/rate-type dependent variables. Results: Significant outcome improvements were observed in the SEPA group at 6 and 12 months follow-up. The adjusted prevalence of any condom use was 30% and 37% higher at each follow-up. The adjusted prevalence of answering 10/12 HIV knowledge questions correctly rose by 57% and 63% at each follow-up. Intimate partner violence was significantly lower at each subsequent time point (62% and 41% of baseline). Moderate depressive symptoms were reduced to 50% and 42%, getting drunk was reduced to 20% and 30%, and condom use self-efficacy was significantly higher (84% and 96%). Conclusion: The SEPA intervention reduced HIV/STI risk-related behaviors when delivered in a real-world setting. The results suggest that SEPA can be implemented in various settings to reach Hispanic women, and that SEPA could reach large numbers of women in an efficient, cost-effective way.