Creating a quadruple aim model for nursing education Krumwiede, Kelly A.; Eardley, Debra L.; DeBlieck, Conni J. ...
Public health Nursing,
May/June 2023, 2023 May-Jun, 2023-05-00, 20230501, Volume:
40, Issue:
3
Journal Article
Peer reviewed
Baccalaureate nursing education is moving to adopt the new American Association of Colleges of Nursing Essentials for Professional Nursing Education. As identified in two of the six domains of the ...essentials, graduates need to be prepared to address population health and utilize informatics and healthcare technologies. Community/public health nursing also has eight domains for generalist nurses linked to population health which will help prepare a skilled nursing workforce for the 21st century. The Institute for Healthcare Improvement's Triple Aim which evolved into the Quadruple Aim is focused on improving health outcomes within healthcare delivery. Through a literature review, a need for a Quadruple Aim model for nursing education was identified. Mirroring the Institute for Healthcare Improvement's Triple Aim for healthcare delivery, a Quadruple Aim for Nursing Education Model was developed. The model dimensions include (1) Population‐focused Care, (2) Maximize Student Learning Experience, (3) Cost‐effective Pedagogy, and (4) Nurse Educator Well‐being. The Quadruple Aim for Nursing Education Model supports nursing education to prepare future nurses effectively and efficiently bridging population health concepts and issues with nursing informatics. Nurse educators are encouraged to utilize the model to transform nursing education.
Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy ...lifestyle changes.
Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes.
We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Web of Science, Cochrane Library, and Google Scholar from January 1997 to April 2018.
Four authors reviewed titles, abstracts, and full-text articles.
Two authors abstracted data and assessed risk of bias and quality of evidence.
Seventeen studies met inclusion criteria; 11 were included in the meta-analysis. There were nonsignificant effects on reducing BMI (mean difference MD -0.27; 95% confidence interval -0.98 to 0.44) and BMI percentile (MD -1.07; confidence interval -3.63 to 1.48) and no discernable effects on BMI
score, waist circumference, glucose, triglycerides, cholesterol, or fasting insulin. Optimal information size necessary for detecting statistically significant MDs was not met for any outcome. Qualitative synthesis suggests MI may improve health-related behaviors, especially when added to complementary interventions.
Small sample sizes, overall moderate risk of bias, and short follow-up periods.
MI alone does not seem effective for treating overweight and obesity in adolescents, but sample size and study dose, delivery, and duration issues complicate interpretation of the results. Larger, longer duration studies may be needed to properly assess MI for weight management in adolescents.
To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. ...Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.
The Omaha System is the hallmark evidence‐based clinical information management system used in nursing education, research, and practice. Multiple education documents guide public health workforce ...preparation. This qualitative study identified similarities and gaps between the Omaha System and seven guiding documents commonly used by nurse educators. A crosswalk design was employed. The setting was virtually based using online technology. Recommendations are for public health nurse educators to update their teaching practices using evidence‐based approaches.
Students' word choice when writing in a reflective journal may reveal their emotional development, sense of belonging, cognitive processing, and ability to appraise their own growth and ...understanding. New linguistic analysis software can scan and categorize these journals for the use of pronouns, positive and negative emotions, and cognitive keywords.
A retrospective study design evaluated student journaling from a psychiatric clinical course. Journal entries from weeks 1 and 12 were compared by z-score analysis.
Significant increases were found in the use of "we" (P = .001), positive emotions (P < .001), inclusion words (P < .001), and insight words (P = .004), whereas the use of cause and self-discrepancy words were not significantly different.
Identification of learning as expressed in words could have an impact on how student assignments are designed by including the use of the Linguistic Inquiry and Word Count software to assess changes in student cognition.
Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express ...discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time.
Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using analysis of variance (ANOVA) and Fisher's exact tests.
Two hundred twenty-seven youth were seen for MI-based discussions by 4 PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a 2- to 3-month period (p< .001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p< .01).
This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions such as obesity (ClinicalTrials.gov Number NCT02502383).
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