Nurse-Family Partnership

In Brief To drive system strategy and compensate nurses for their contributions to patient outcomes and quality metrics, a large healthcare system in Texas designed and implemented a new pay program to reward nursing staff.

The study aimed to examine the association between cross-sector collaboration in Nurse-Family Partnership (NFP), a model home visiting program, and participant retention. We used the 2018 NFP Collaboration Survey that measured agency-level collaboration, operationalized as relational coordination and structural integration, among nine community provider types (including obstetrics care, substance use treatment, child welfare). This dataset was linked to 2014-2018 NFP program implementation data (n = 36,900). We used random-intercept models with nurse-level random effects to examine the associations between provider-specific collaborations and participant retention adjusting for client, nurse, and agency characteristics. The adjusted models suggest that stronger relational coordination between nurses and substance use treatment providers (OR:1.177, 95% CI: 1.09-1.26) and greater structural integration with child welfare (OR: 1.062, CI: 1.04-1.09) were positively associated with participant retention at birth. Stronger structural integration between other home visiting programs and supplemental nutrition for women, infants, and children was negatively associated with participant retention at birth (OR: 0.985, CI: 0.97-0.99). Structural integration with child welfare remained significantly associated with participant retention at 12-month postpartum (OR: 1.032, CI: 1.01-1.05). In terms of client-level characteristics, clients who were unmarried, African-American, or visited by nurses who ceased NFP employment prior to their infant's birth were more likely to drop out of the NFP program. Older clients and high school graduates were more likely to remain in NFP. Visits by a nurse with a master's degree, agency rurality, and healthcare systems that implement the program were associated with participant retention. Cross-sector collaboration in a home visiting setting that bridges healthcare and addresses social determinants of health has potential to improve participant retention. This study sets the groundwork for future research to explore the implications of collaborative activities between preventive services and community providers.

In Brief Patients with behavioral health disorders (BHD) often present in EDs, but many EDs are not fully equipped to provide the needed level of advanced care. This article describes a process improvement project that demonstrates the use of evidence-based tools and systems to improve the care of patients with BHD.

AimThe aim of this work is to evaluate nurses' experiences, barriers, and facilitators in participating in digital storytelling workshopsBackgroundNurses face ever‐increasing demands and work time spent in isolation, leading to burnout. Storytelling—narrative skills of listening and creativity—may encourage meaningful connections with others, especially during the COVID‐19 pandemic. However, evaluation of the user experiences of storytelling among nurses has been limited.MethodThe methods used are semistructured individual interviews with 13 nurses from a public health nursing organization who participated in a 3‐day digital storytelling workshop in 2019. The interviews were audio‐recorded, transcribed verbatim, and thematically analysed using NVivo12.ResultsAll participants were women and half were white. Healing, human connection, and nursing pedagogy were the three main themes. Participants highlighted the organizational support in providing a safe and dedicated “space” for nurses' well‐being. They also expressed desire and willingness to participate in additional workshops outside of work hours.ConclusionFurther studies using a larger sample are needed to examine the scalability and efficacy of storytelling at work.Implications for Nursing ManagementNurses rated storytelling positively and suggested a brief version to be incorporated into nursing practice. Establishing the culture of organizational support and psychological safety was identified as the necessary antecedents.

The purpose of this article is to describe the process used to create the Mental Health Innovation (MHI), a multicomponent implementation strategy that integrates evidence-based mental health interventions into the Nurse-Family Partnership (NFP), a national home visiting program delivered by nurses to low-income mothers. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework outlines the multistep, stakeholder-engaged process used to develop the MHI. Engaging stakeholders provided an in-depth understanding of NFP infrastructure and the needs of NFP nurses and their clients. This understanding was key to designing a multicomponent implementation strategy to integrate mental health interventions within national and local NFP infrastructure and existing care processes. Application of implementation frameworks such as EPIS provides a guide to integrating evidence-based interventions in a systematic, intentional, and rigorous manner, which in turn may promote their wide scale use and long-term sustainability.

This modified Delphi study determined consensus on core nurse competency program components that apply across the continuum of transition to initial practice, to new specialty practice, to a new role, or within general nursing orientation. The literature review found no published agreement on support and systems for universal transition programs. This broad-based study addressed this gap by identifying core elements within a competency or transition program and then ranking their importance within program structure.

Abstract In this study, relationships between the processing, microstructure, and properties of barium niobate (Ba 5 Nb 4 O 15 ) are investigated. The milling of a Ba 5 Nb 4 O 15 powder in water is effective with respect to size reduction. However, after milling in water, BaCO 3 is formed within the slurry. With the increase in the amount of BaCO 3 formed, the aspect ratio of the elongated Ba 5 Nb 4 O 15 grains increases. The formation of the elongated Ba 5 Nb 4 O 15 grains prohibits the densification. Hence, the microwave dielectric properties, including permittivity and quality factor, are poor because of the low density. In addition, milling in ethanol is carried out for comparison: A lower amount of BaCO 3 is formed after milling in ethanol; the extent of anisotropic grain growth is thus reduced.

Systemic immunosuppressive treatment of pediatric chronic anterior uveitis (CAU), both juvenile idiopathic arthritis-associated and idiopathic anterior uveitis, varies, making it difficult to identify best treatments. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans (CTPs) for CAU for the purpose of reducing practice variability and allowing future comparison of treatments using comparative effectiveness analysis techniques. A core group of pediatric rheumatologists, ophthalmologists with uveitis expertise, and a lay advisor comprised the CARRA uveitis workgroup that performed a literature review on pharmacologic treatments, held teleconferences, and developed a case-based survey administered to the CARRA membership to delineate treatment practices. We held 3 face-to-face consensus meetings using nominal group technique to develop CTPs. The survey identified areas of treatment practice variability. We developed 2 CTPs for the treatment of CAU, case definitions, and monitoring parameters. The first CTP is directed at children who are naive to steroid-sparing medication, and the second at children initiating biologic therapy, with options for methotrexate, adalimumab, and infliximab. We defined a core data set and outcome measures, with data collection at 3 and 6 months after therapy initiation. The CARRA membership voted to accept the CTPs with a >95% approval (n = 233). Using consensus methodology, 2 standardized CTPs were developed for systemic immunosuppressive treatment of CAU. These CTPs are not meant as treatment guidelines, but are designed for further pragmatic research within the CARRA research network. Use of these CTPs in a prospective comparison effectiveness study should improve outcomes by identifying best practice options.