Nursing Outlook

Medicaid payment reforms and delivery model innovations are needed to fully transform U.S. healthcare structuring and provision. A study in Nursing Outlook synthesizes nurse-led models of care and their implications for improving health care access, quality, and reducing costs for Medicaid recipients. The authors write: "The nurse-led model of care presented here has the potential to widely improve the health status, distribution of health resources, and social conditions of individuals, families, and communities across the United States. The model represents a sorely needed framework to bridge the gap between traditional siloed models of screening and referral to services, and new models for health care delivery and financing that achieve the goals of reducing inequity and promoting whole-person health. Within Medicaid, numerous pathways exist for implementing these models (e.g., Section 1115 waivers). Medicaid financing could provide greater incentives to establish value-based expectations by leveraging directed payments. Alternatively, population-based global budget financing (as in Maryland’s Total Cost of Care Model) has the potential for cost-saving and innovation. As part of this, financing should incentivize whole-person, coordinated, and equity-focused care models, particularly the implementation of evidence-based, nurse-led programming for addressing the SDOH. The proposed model of care integrates clinical practice components to transform how care is delivered, shifting from a fee-for-sick care model to whole-person preventive and restorative care. In the future, statewide Medicaid waiver demonstration projects should evaluate the development and scale-up of nurse-led programs." Read the full study, including more about the nine components informing the proposed integrated framework for a nurse-led model of care, in Nursing Outlook: https://lnkd.in/gF_M_3pf Figure 1. Components of a nurse-led model of care. The nine components of nursing practice displayed here inform the proposed integrated framework for the Center for Latino Adolescent and Family Health (CLAFH) Nurse-led Model of Care that can be applied across health care settings to advance health equity.

Despite high levels of burnout and psychological distress among nurses, few studies have evaluated these outcomes among Hispanic nurses. A new study in Nursing Outlook evaluates the differences in job-related and psychological well-being outcomes for Hispanic and non-Hispanic White nurses and the association of nurse work environments, finding that equity-driven solutions to support the well-being of Hispanic nurses should consider a focus on the needs of young Hispanic nurses and include increased support in work environments. The study reveals that among the nearly 800 Hispanic nurses who responded to the survey, over 55% reported burnout and one in three reported an intention to leave their current employers within the next year. Psychological distress, including higher rates of depression and COVID-related PTSD among Hispanic nurses, suggests that the toll of the pandemic was not born equally. Read the full study in Nursing Outlook: https://lnkd.in/gsWsaaVz Figure 1. Differences in job outcomes and psychological well-being measures between Hispanic and non-Hispanic White nurses. Note. *p < .05, **p < .01, ***p < .001. PTSD, post-traumatic stress disorder. Authors: Margo Brooks Carthon, Heather Brom, Alexandra Maye, MSN, RN, Christin Iroegbu, PhD, RN, Jennifer Gil, MSN, RN, John Rizzo, Kelvin Amenyedor, Wanda Montalvo, PhD, RN, FAAN, FADLN, and Antonia M. Villarruel, PhD, RN, FAAN

A scoping review in Nursing Outlook explores literature on the preparedness of the primary healthcare (PHC) nursing workforce for extreme weather events and identifies gaps in knowledge and practice. "Enhancing primary healthcare nurses’ preparedness for climate-induced extreme weather events" finds that strengthening PHC nurses' resilience against extreme weather requires targeted professional development, mental health support, comprehensive planning, and collaborative efforts. Future strategies should enhance PHC nurses' capacity through training, support, and policy development. Read the full review in Nursing Outlook: https://lnkd.in/gwtn_x9w

"Deployed at sea amidst the pandemic: Insights from 30 United States Navy nurses", a new paper in Nursing Outlook, contains data analysis of semistructured interviews with Navy nurses about overcoming unprecedented challenges to protect the health of their crew, all the while preserving operational readiness, during the COVID-19 pandemic. Multiple Public Health Interventions (PHI) were utilized to improve the public health of those on Navy ships during the height of the pandemic. Data were coded using directed (deductive) content analyses whereby remarks were categorized according to the red, green, blue, orange, and yellow PHI wedges of the MDH’s (2019) Intervention Wheel. Speaking to the red wheel PHIs of surveillance, disease and health threat investigation, one participant offered insight into contact tracing on the ship, along with some humor: "I would say the biggest thing is the really thorough contact tracing. If you have anybody that you are even suspicious of … maybe it’s allergies, but it's not going to hurt to go ahead and isolate them and go ahead and pull everybody that they've had close contact with. Because worst case scenario, you lose a day's worth of work instead of taking out an entire work station if somebody does pop positive … we joked that it was almost like an episode of the Body Snatchers. We would wake up, and three people's bunks are empty, because in the middle of the night, the corpsmen were pulling them … be like, “You're close contact. Get off the ship.” Read the full article in Nursing Outlook: https://lnkd.in/gCcXJ9FZ Figure 1. Minnesota Department of Health Intervention Wheel (MDH, 2019 ). Thank you to authors Catherine Wilson Cox, PhD, RN, CEN, CNE, FAAN, ANEF, Shawna Grover, Susan Mojica, Monica Dignam, Inna Kouper, and Lilian Yahng.

The Nursing Outlook special issue on Nursing in the AI Era: A Roadmap for Leadership, Equity, and Innovation has extended its deadline for manuscript submissions to October 1, 2024.   This is a unique opportunity to contribute to a pivotal collection that will guide the nursing community through AI’s uncharted territory. We're calling for insightful submissions that explore strategic leadership in AI integration, nursing's role in AI policy advocacy, cross-sector partnerships for innovation, AI's impact on health equity, and the future path of nursing in an AI-integrated healthcare system.   Submit your manuscripts at Nursing Outlook and help shape the future of nursing in the AI era. For more details, visit the Nursing Outlook website or reach out to the guest editors at: Michael Cary, PhD, RN, FAAN: michael.cary@duke.edu Kay Lytle, DNP, RN-BC S. Lytle, DNP, RN, NI-BC, NEA-BC, CPHIMS, ACHIP, FHIMSS, FAMIA: kay.lytle@duke.edu Ian Wolfe, PhD, MA, RN, HEC-C: ian.wolfe@childrensmn.org   Don't miss the chance to make a lasting impact on the nursing profession's engagement with AI. 📅 #AIinNursing #HealthEquity #NursingLeadership #InnovationInNursing#AIEthics4Nurses

Read the oral histories in Nursing Outlook: https://lnkd.in/g7ystkwD

A new study by Wallena Gould, EdD, CRNA, FADLN, FAANA, FAAN and Jiale Hu evaluates a national mentorship program supporting underrepresented nurses’ applications for nurse anesthesia education programs to increase the racial and ethnic diversity of student cohorts. Although racial and ethnic diversity within the nursing profession, along with Certified National Nurse Anesthetists, does not reflect the changing racial and ethnic demographics in the United States, the study finds that the national initiative is a promising intervention to help underrepresented nurses get ready for nurse anesthesia education program applications. Read the full study and results of the cross-sectional survey in Nursing Outlook: https://lnkd.in/g7289855

The phenomenon of loneliness among healthcare providers, particularly nurses, has garnered increasing attention due to its detrimental effects on individual well-being and professional retention. The isolation experienced by nurses has been linked to heightened turnover rates and intentions to leave the profession, posing significant challenges to healthcare systems globally. Recognizing loneliness as an epidemic in 2023, the U.S. Surgeon General highlighted the urgency of addressing this issue within the healthcare workforce. A new paper in Nursing Outlook explores evidence-based strategies—including peer support programs, mentorship initiatives, wellness activities, and fostering open communication—to mitigate loneliness and promote social connectedness among nurses, drawing insights from various stakeholders. It aims to offer actionable recommendations to enhance the nursing experience and retain professionals in the field. Read the paper here: https://lnkd.in/gCQQBmuk Thank you to authors Jihane Frangieh, Vickie Hughes, Angela Edwards-Capello, Katherine G. Humphrey, DNP, PMHNP-BC, FNP-BC, CRNP, Christina Lammey, and Laura Lucas from the Johns Hopkins School of Nursing. Figure 1. Factors Fostering Belonging Among Nurses.

In "Student-led Doctor of Nursing Practice projects in the clinical environment: Viewpoint from hospital-based nurse scientists and leaders", authors identify opportunities to strengthen collaboration between academic and clinical stakeholders to better support DNP projects and education. They found that facilitating a DNP project requires significant investment of time, resources, and funds from the healthcare institution; discord has arisen due to unclear responsibilities or decision-making ability for clinical stakeholders, ethical dilemmas for students who are also employees of the clinical site, and mismatched priorities between clinical need and student/academic project desires; and clinical leaders have raised significant concerns about DNP project proposals that are research-focused, diverge from healthcare institution goals, and lack a sustainability plan. Read the full article in Nursing Outlook: https://lnkd.in/ecPNmSrj Authors: Clifton Thornton, PhD, Catherine Haut, Maria Yefimova, Dr. Margaret Gettis, Christina Calamaro, Julie Ginsberg DNP, CRNP, CPNP-PC, NEA-BC, CPPS, Margaret Ann McCabe, MHA.

New in Nursing Outlook: "Reject the “Practice Readiness Myth”: Ask if systems are ready for nursing graduates instead". Abstract: The nursing profession is engaged in robust national dialogue on how to implement competency-based education. This dialogue often conflates the concept of “competency-based education” with nursing “competence” or “practice readiness.” Our aim is to discuss the potential harms of conflating “competency-based education” with “competence” or “practice readiness.” This commentary explores the possible risks of issue conflation. Risks include (a) suggesting that nurses who have successfully obtained licensure are not “competent” or “ready to practice,” and (b) de-emphasizing the importance of safe and sustainable work environments for new graduate nurses. We discuss the need to separate conversations about “competency-based education” and “practice readiness”; the need to increase the clarity and specificity of discourse surrounding competency-based education; and the need for strategic alignment across academia and practice. Thank you to authors Beth Ann Swan, Kim Dupree Jones, Rose Hayes, MA, RN, BSN, Lalita Kaligotla, Carrie McDermott, Jeannie Rodriguez, and Linda McCauley. Read the full article here: https://lnkd.in/eqd2gYuz