Childbirth Educators’ Role Regarding Pregnant Women and Cervical Cancer Prevention

Childbirth educators play an important role in educating pregnant women regarding their health. They bridge the gap between pregnant women and healthcare providers. A paucity of information exists on the benefits that pregnant women derive from interactions with childbirth educators regarding early cervical cancer detection. The purpose of our cross-sectional study was to investigate the association among education during early pregnancy offered by the childbirth educators, access to childbirth educators, availability of childbirth educators in the United States and survival from cervical cancer. Secondary data from the Surveillance, Epidemiology, and End Results (SEER) on 520,153 women were analyzed using logistic regression. Childbirth education delivered by childbirth educators during early pregnancy was associated with significantly fewer cervical cancer deaths (odds ratio = .917, <em>CI</em> = .896–.939, <em>P</em> = .000). Women with late-stage diagnosis had an increased likelihood of dying when diagnosed with cervical cancer (odds ratio = 1.043, <em>CI </em>= 1.042– 1.044, <em>P</em> = .000). Childbirth educators are effective at increasing awareness of cervical cancer among women in the early stages of pregnancy; this can improve survival and lead to positive social change.

Content Analysis of Hospital Reviews From Differing Sources: Does Review Source Matter?

Social media has had an impact on how patients find and evaluate medical professionals and their experiences of modern healthcare. Qualitative research in healthcare has increased its focus on social media. The present study examined 497 reviews of hospitals in the Pittsburgh area across three websites: Google, Yelp, and Healthgrades. Using computerized content analysis tools (CATA), we analyzed positive and negative comments to identify key themes. Key themes and words included “doctor,” “hospital,” “staff,” and “time.” These findings highlight the importance of medical staff to patient experience. Results indicated that Yelp had the lowest average rating. CATA also revealed that the central term for Google reviews was “hospital,” for Healthgrades reviews it was “doctor,” and the central term for Yelp reviews was “patient.” These central terms reflect the focus of each website. The present study highlights the importance of healthcare professionals understanding the source of reviews and being cautious about how social media comments are used in decision-making about the practice. Future research should try to expand this approach to other cities and countries to evaluate cross-cultural effects on social media comments.

Developing a Clinical Practice Guideline for Surgical Diabetic Patients

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and a lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients have been shown to improve quality care, decrease complications, increase the efficiency, and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which are recognized risk factors for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the northeast United States. The purpose of this project was to develop a clinical practice guideline for elective surgery patients in this hospital outlining the acceptable HgbA1C level for surgical clearance. The five attributes of change, individual and collective leadership, operational support, fostering relationships, organizational learning, and balance, framed the development of this project. Based on the current evidence, the HgbA1C level approved to be acceptable for surgery clearance was 8.5% mg/dL. An 18-member expert panel consisting of anesthesiologists, nurse anesthetists, an endocrinologist, a diabetic nurse educator, an administrator, physician assistants, nurse practitioners, and surgeons reviewed the proposed guideline using the AGREE II tool. Using a scale of 1 to 7 (strongly disagree to strongly agree), the team members agreed with the proposed guideline, with a score of 6 or higher in each domain. Utilization of this guideline may promote positive social change by addressing the gap in practice at this hospital and significantly reducing the number of surgery cancellations among diabetic patients.

Registered Nurses’ Self-Assessment of Their Clinical Leadership Knowledge and Competence

Clinical nurses play an important role in the healthcare team. The practice question for this Doctor of Nursing Practice project explored the perceptions of RNs about their clinical leadership knowledge and competencies at a 160-bed rehabilitation hospital in a metropolitan city in the southeast United States. Thirty RNs completed the following three surveys: an 8-question clinical leadership knowledge assessment, a 17-question leadership competency assessment, and a 6-question emotional intelligence self-assessment. Fifty percent or more of clinical nurses believed that they were knowledgeable in identified components of clinical leadership. The leadership competency skills assessment revealed a wide range: from 3–6% of participants who indicated that they were not at all competent to 33–57% of participants who indicated that they felt very competent. Seventy-six percent of the participants felt positive about their emotional intelligence abilities. Recommendations to nursing leadership included workshops for clinical staff RNs on the various components of the Academy of Medical-Surgical Nurses’ model of clinical leadership: clinical practice, environment practice, emotional intelligence, and leadership competencies.

Managing Uncertainty in Chronic Illness From Patient Perspectives

Chronic illness is an increasing concern in the United States as the Centers for Disease Control and Prevention reports that 50% of adults have at least one chronic illness. When individuals must adjust to chronic illness, they may experience uncertainty regarding the illness, prognosis, and symptoms. The purpose of this qualitative, phenomenological study was to explore the management strategies of uncertainty in chronic illness from patients’ perspectives. Merle Mishel’s uncertainty in illness theory was the framework used to explore the lives of individuals diagnosed and living with chronic illness. In-depth interviews were conducted with eight individuals who have chronic disease. Results revealed themes that individuals with chronic illness do experience uncertainty and that it impacts almost all aspects of their lives. Some of the themes identified were chronic illness, uncertainty, impact of uncertainty on daily living, coping or managing uncertainty, and communication from the healthcare team about uncertainty. The individuals expressed changes in daily activities and retraining their minds to accept their new normal. This study offers coping and management strategies that healthcare professionals can implement into treatment plans to improve the quality of life for individuals with uncertainty in chronic illness. The information produced from this study will aid healthcare providers in understanding the need to address the uncertainty at diagnoses and offer ways to assist patients in coping and managing uncertainty

Impact of Nurse Manager Peer Mentorship Program on Job Satisfaction and Intention to Stay

Nurse managers (NMs) play a vital role in patient outcomes by providing a stable work environment for teams. Numerous factors influence a NM’s job satisfaction and intent to remain in a job. The purpose of this project was to develop an evidence-based formal mentorship program for NMs in an effort to impact retention rates. A secondary purpose was to evaluate the impact that a formal mentorship program has on NMs’ job satisfaction and intent to stay. Across two hospitals in the Pacific Northwest, 15 NMs participated in a 6-month mentorship program. The program was guided by both the mentorship enactment theory and Kouzes and Posner’s exemplary leadership framework. Using the Leadership Practices Inventory and the Nurse Manager Practice Environment scale, job satisfaction, intent to stay in a job, and transformational leadership behaviors were measured before and after the program, Results were analyzed using a paired-samples <em>t</em> test. There were statistically significant differences between the preprogram Leadership Practices Inventory scores (<em>M </em>= 212.27, <em>SD </em>= 37.8) and postprogram scores (<em>M </em>= 232.47, <em>SD </em>= 25.28); <em>t</em>(14) = –2.83, <em>p </em>= .013. There were also statistically significant differences between the preprogram Nurse Manager Practice Environment Scale–Culture of Generativity subscale (<em>M </em>= 23.20, <em>SD </em>= 4.65) and post-program scores (<em>M</em> = 26.20, <em>SD</em> = 4.74); <em>t</em>(14) = –2.40, <em>p</em> = .032. The results demonstrated a significant increase in job satisfaction, intent to stay, and transformational leadership behaviors. Implementation of this pilot program supported positive social change through reduced NM turnover, resulting in a reduction of healthcare spending on replacement costs in addition to improved patient outcomes

Impact of Acculturation on Body Mass Index in Haitians

Longer term immigrants residing in the United States exhibit physical health decline related to higher body mass index (BMI). Theories on immigrant acculturation have been used to examine health patterns by length of stay in the United States. The purpose of this cross-sectional study, guided by the Schwartz model of acculturation, was to examine the effect of acculturation and length of stay in the United States on BMI in a sample of Haitian immigrants living in a northeast metropolitan area. The research question was developed to examine the effects of acculturation and how long immigrants reside in the United States on BMI. The Participants included a convenience sample of 116 Haitian men and women, aged 18 years and older, who had relocated to the United States for 3 years or more. Data were collected using a demographic questionnaire and medical records from a participating health clinic and then analyzed by conducting multiple linear regression statistical analyses. Results revealed that acculturation, length of stay in the United States, age, gender, and physical activity were not significant predictors of BMI change. An ancillary analysis using the subscales of acculturation revealed similar results. This study may provide positive social change by enabling health providers to understand the beliefs, values, and practices of Haitian immigrant groups and the acculturation pattern of individuals when providing care for this population.

Translation and Validation of the HPLP-II From English to Armenian

As the focus of healthcare shifts toward the social determinants of health, more information about health disparities between different ethnic communities is needed. The Health Promoting Lifestyle Profile II (HPLP-II) is an instrument that measures health promotion behavior across various cultural lines. This article describes the translation and validation of the HPLP-II from English to Armenian for the purpose of studying health promotion behavior among the hypertensive and normotensive Armenian American population and addressing health disparities among this community. Translating the HPLP-II required a multistep process to capture cultural linguistic adjustment. First, the researcher, a local bilingual professor, and a professional translation company each created a forward-translation. These three translations were combined by an editor to create one translation with the highest clarity. The researcher then submitted this translation to two bilingual community members for back-translation. A committee composed of the researcher, the community members, and a bilingual healthcare worker reviewed each back-translated item and adjusted those that lost their meanings. Another committee reviewed each item for clarity and consistency. The instrument was then given to five native speakers who were asked to read each question and verbally express what they understood it to be asking. After the researcher made adjustments based on this feedback, the instrument was given to a committee of nine bilingual experts, who reviewed each item and scored it.This multistep, iterative process resulted in an instrument with an item content validity index score of 0.90 (>0.78) and a scale content validity index of 0.96 (>0.90), and Cronbach’s a = 0.936, suggesting a high level of reliability. The HPLP-II can now be used in future studies regarding health promotion behavior among Armenian Americans.

A Special Message to Students and Graduates About Publishing in a Journal

The Journal of Excellence in Nursing and Healthcare Practice (JENHP) was created to promote innovations, translation, and dissemination of evidence supporting improved outcomes in the nursing practice environment. The journal welcomes manuscripts focusing on topics such as national and international workforce issues, quality improvement projects, evidenced-based practice initiatives, nursing research studies, interprofessional practice, educational issues, improvements in technology, innovative practice problem solutions, and the impact of social change in society. Although we accept submissions from all types of researchers, both new and experienced, one central purpose of this journal is to provide an outlet for research conducted by students. Hence, individuals from doctoral, master’s, and baccalaureate programs are especially welcomed to submit manuscripts based on scholarly projects or papers completed while in or after graduating from an accredited program.