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JCN Online Extra: online only: education/practice

Proceedings of the 6th Biennial Innovations in Faith-Based Nursing Conference

Ihrke, Barbara

doi: 10.1097/CNJ.0000000000000553
  • Free

Welcome to Innovations

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On behalf of the IWU SON, the Eta Chi Chapter of Sigma, Nurses Christian Fellowship, Nurses Christian Fellowship USA, and our hard working conference planning committee, we are pleased to present the proceedings of the 6th Biennial Innovations in Faith-based Nursing Conference. This conference was blessed with many prayers and helping hands. We were honored to have the attendees here and look forward to our next Innovations Conference in June 2021.

The Innovations Conference goals include:

  • Explore Christian foundations and worldview in professional nursing.
  • Identify innovative strategies for nursing education and practice.
  • Embrace cultural attributes in the profession of nursing in local and global settings.
  • Experience networking in a Christian community.

As a pre-conference option, attendees to the conference could attend The Saline Process training taught by Professor Jill Steinke and Dr. Barbara Ihrke. This is a training program that equips healthcare workers to be a witness for Christ in their clinical settings. The Saline Process educates and coaches healthcare workers to skillfully and confidently assess the spiritual condition of a patient. It then provides practical tools the participants can utilize to share the love of Jesus according to each individual patient's needs.

The Saline Process uses IV solutions as a metaphor to characterize a nurse's spiritual influence in the workplace. The participants are asked to identify which IV solution they would be. Would they be characterized as :

  • 5.0% dextrose and water solution – sweet and loving, but ineffective in sharing the truth about Christ.
  • 3.0% saline solution – overbearing, sharing truth without love, and therefore building barriers between patients and God.
  • 0.9% normal saline solution – a healthy balance of truth and love, bringing patients closer to a relationship with Jesus Christ.

The goal is to be the right balance of “truth and love in the lives of others, in or out of the healthcare setting.” The session provides tools to help identify where a patient is on his or her faith journey and to help the healthcare provider be involved in cultivating, sowing, and harvesting disciples for Christ.

During the conference, we celebrated our Christian heritage and explored how it can impact every aspect of the way we teach. It is our hope the plenary keynote addresses, research presentations, demonstrations of innovative instructional strategies and informal networking will impact nursing in the 21st century. Keynote speakers for the event included Dr. David Stevens, Chief Executive Officer of Christian Medical & Dental Association, Dr. Kathy Schoonover-Shoffner, National Director and Editor-in-Chief of Nurses Christian Fellow-ship/USA and Journal of Christian Nursing, and Col. Marcia Potter of the United States Air Force.

Over one hundred attendees from all over the United States, Canada, Haiti and Indonesia learned, brainstormed, and fellowshipped with fellow faith-based nurse educators. There were over forty workshops for attendees to choose from. Topics of the conference included cultural awareness, educational strategies, nursing practice, and spiritual care. One attendee even noted, “The conference exceeded my expectation. It was very thought provoking and a great venue for networking with other faith-based professionals.” Each morning the conference began with a time of worship and devotions and the Holy Spirit's presence could be felt.

According to Jill Steinke, Program Chair, “It was great having teams of faculty from universities. One University brought 8 of their faculty! It was a fun, uplifting conference. People were excited to connect with friends from previous Innovation Conferences and about the opportunity to make new friends. The work of learning was balanced with a fun vendor marketplace (fair-trade jewelry, organic soaps, tupperware, etc.). The catered dinners, accompanied with live entertainment, provided a relaxing atmosphere to spend developing relationships. Multiple faculty commented on the joy of sharing faith stories and learning how to integrate faith into nursing curriculum.”

In His Care,

Barbara A. Ihrke, VPAA, School of Nursing, Indiana Wesleyan University

Keynote Sessions

Ethical Issues Challenging Christians in Healthcare presented by David

Stevens, MD, MA

Abstract: In a survey of over 2,500 Christian healthcare professionals, 40% said they have been pressured to violate their conscience and one out four revealed they had be discriminated against for their beliefs in their workplace. Do healthcare professionals have a right of conscience? If so, what is its ethical basis and how should it be exercised? How can it be defended in both the professional and public square? How should a nurse respond if their religious liberty is threatened? This presentation answered these and related questions as it addressed this foundational “rights” issue. Physician assisted suicide is legal in four states and tolerated in another. Last year legalization was successful in the District of Columbia and attempted in 38 other states. Legalizing Physician assisted suicide is not supported by scripture and is dangerous for healthcare professionals, patients, their families and for society. Attendees learned how to articulate these concerns. It is Christian healthcare professionals' responsibility to care for patients struggling with gender identity with sensitivity and compassion. Attempts to alter gender surgically or hormonally for psychological indications are medically inappropriate and they repudiate nature, are unsupported by the witness of Scripture, and are inconsistent with Christian thinking on gender in every prior age.

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Thriving in the Workplace presented by Kathy Schoonover-Shoffner, PhD, RN

Abstract: The challenge to thrive in the workplace has been around since the beginning of time (Genesis 13:5). Although God ordained work, the entrance of sin into the world (Genesis 2:15; 3) corrupted how we experience work and interact with others in the workplace. This presentation identified characteristics of toxic workplaces, three major problems that are common in unhealthy work environments, and offered biblical responses to deal with unhealthy work environments and workplace toxicity. Lasting solutions that can help build a healthy and vibrant workplace were discussed.

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The Bureaucratic Caring Theory presented by by Col. Marcia Potter, USAF, NC, RN, DNP, FNP-BC

Abstract: The theory was generated from qualitative research involving health professionals and patients in the hospital setting, and it implies that there is a dialectical relationship, between the human dimension of spiritual ethical caring and the structural (nursing, environment) dimensions of the bureaucracy or organizational culture (technological, economic, political, legal and social ). The Model is holographic, illuminating the holistic nature of caring & synthesis of the humanistic systems and technologic, economic, political, legal systems and permeates every context and role of Nursing, including Clinical Practice, Administration and Academia.

The Model: Applied to AFNC Practice Model includes a complex, transcultural, relational process, grounded in an ethical, spiritual context. Caring is the relationship between charity and right action, between love as compassion in response to human suffering and need, and justice or fairness in terms of what ought to be done. Caring occurs within a culture or society, including personal culture,hospital organizational culture, or society and global culture including Spiritual-Ethical Caring, Educational Caring, Physical Caring, Socio-cultural Caring, Legal Caring, Technological Caring, Economic Caring, and Political Caring.

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Workshop Sessions

Implications of the Adverse Childhood Experience (ACE) Study and Trauma Informed Approaches by Kristina Currier, DNP, FNP-C

Specific Aims or Objectives:

  • Educate nursing professionals on the prevalence of trauma in our society and how trauma impacts an individual's overall well being (physical, mental, emotional, and spiritual) • Discuss employing trauma informed approaches in nursing practice • Review Scripture as it relates to the value of human life and being created in His image

Rationale or Background:

  • In 1998 the landmark Adverse Childhood Experiences (ACE) Study was published. This study demonstrated the prevalence of childhood trauma in the US and how childhood trauma negatively impacts an individual's overall health into adulthood. Childhood trauma (as demonstrated by an ACE score in this study) is a predictor of adverse health outcome in adulthood. More than half of the study respondents had an ACE score of one and more than 25% reported a score of two or more. The study demonstrated a relationship of between the number of categories of childhood exposure and adult health risk behaviors and diseases.
  • Development of Idea or Description of Project:
  • Healthcare providers are caring for individuals daily in their practices who have experienced trauma. Trauma-informed approached need to be employed by those in the healthcare profession. Healthcare providers must value life and understand the patients they are caring for are valuable and created in the Image of God, understanding this principle will guide a practitioner's trauma informed approach. Implications for Practice:
  • Trauma is prevalent in our society. Nursing professionals will learn how to integrate trauma informed approaches integrating a biblical framework in their practices.

If We're Not Looking They'll Remain Missing by Kathleen Hackett, MSN, RN, SANE-P

Nursing education has been an eclectic mix of many theories of teaching and learning from competency Across the country, children under 18 are visiting emergency rooms for gynecological complaints without a guardianship being present or required. Healthcare providers are caring for missing minors without any knowledge of a possible risk of exploitation in emergency departments. The average age of a child introduced to sex trafficking is 12-14 (Polaris, 2016). Healthcare providers need to take a closer look at adolescents seeking medical care without the requirement for parental consent. Statistics confirm there are over 1.3 million missing and runaway children in the United States (“S.O.A.P. About,” 2016), and runaway children are particularly at risk for exploitation due to lack of shelter, food, clothing, and a sense of belonging. Youths in the United States run away from home for many reasons and view leaving as a better option than staying in their current environment. Skilled manipulators often reach vulnerable adolescents within hours of a child leaving their home. A runaway may find themselves unknowingly a victim of human trafficking and suddenly become restricted or cut off from social ties and, in most cases, are reported missing by guardians. Additionally, minors that are exploited into bondage will often contract sexually transmitted infections and are in need of treatment to continue providing services to meet the demand for sex. An undeniable problem has been identified, which is that emergency rooms are treating minors that are in fact missing and possibly being exploited. Because of this growing clinical problem, the following question is asked: How do caregivers' checking a missing person database, compared to not checking a missing person database, result in identifying a reported missing adolescent, during the time of treatment in the emergency room? Healthcare providers are in a unique position to provide safety and intervene when a child does not disclose their true situations due to fraud, threats, or coercion.

Health is a Spiritual Matter by Mary Stevens, MS, RN and Phyllis Jackson, RN, BS

It is well known that there are significant health outcome disparities for people of color and for those living in poverty. Pastor and RN, Phyllis Jackson, is working to change these health disparities through the work of The Interdenominational Health Ministry Coalition (IHMC) of Rochester, NY. IHMC has promoted an attitude shift within faith communities to believe that health is a spiritual matter and that stewarding one's health is part of one's faith walk. Because church members are already part of a faith community, prayer and emotional support for making lifestyle changes are built into the process. Although individual health ministers within churches may change, the church communities continue to support one another and move forward as a body, making this strategy sustainable. Based on IHMC's initial results within the churches, IHMC has received grant funding from the Greater Rochester Health Foundation to support their mission of establishing, expanding, and supporting functional health ministries in all churches and faith communities. IHMC has also partnered with Common Ground Health in participating in a Rochester Chamber of Commerce grant-funded study involving twelve churches. The study is analyzing the impact of faith (personal and collective) on helping individuals make healthy lifestyle choices, reduce blood pressure, and influence positive change in the health culture of the participating churches. The study goal is to confirm the efficacy of embedding health and wellness strategies within churches as a sustainable and effective way to improve health outcomes and reduce health disparities.

A Compassionate Approach for Nurse Faculty Burnout

by Cindy Thomas, EdD, MS, RN-BC, Constance McIntosh, EdD, MBA, RN, and Diana Bantz, PhD, FNP-BC

Nurse educators are not immune to experiencing chronic stress potentially leading to burnout. In fact, in 2010 the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN) recognized that nurse educator's chronic stress and eventual burnout negatively impacts the continuing educator shortage. Chronic stress may lead to physical, and emotional health issues such as irritability, isolation, lack of caring, and the loss of compassion for the job. In 1974 Freudenberger coined the term burnout to describe consequences of extreme stress individuals develop working in caring professions such as nursing. Burnout is related to a perception that the nurse has exhausted all energy to perform the job and cannot or has difficulty completing tasks. Burnout symbolizes a cognitive, emotional, and physical exhaustion. Not as much attention has been given to nurse educators in regards to chronic stress and burnout. Nurse educators are unique in that stress may come from department, college and university level pressures, as well as students, clinical environments and accreditation bodies, family issues and may also be self-imposed. Department directors/chairs as well as faculty peers should demonstrate compassion to nurses showing signs of burnout while offering helpful strategies as the affected nurse educator determines what course of action to consider. Participants will gain realistic strategies that may help nurse educators personally recognize the signs and symptoms of stress and burnout and how to make necessary changes to remain within or leave their area of practice.

Basic Simulation Design: An interactive teaching strategy (Part 1)

by Angela Bailey, PhD(c), MSN, RN-c

The simulation sessions will include a discussion of INACSL (International Nursing Association of Clinical Simulation and Learning) best practice standards, an introduction to prebriefing options, an opportunity to create and participate in a brief simulation, and application of debriefing techniques.

The Challenges of Ethical Integrity in Higher Education: A Lived Perspective

by Patricia Hartley, MSN, RN, Rebecca Hoffpauir, PhD, RN, Ruth Eby, DNP RNC, and Patricia Hodges, MSN, RN

Students bring an array of morals, values, and ethical prejudices into higher education that may be inconsistent with the values of faculty and standards of moral integrity expected in higher education. Findings from a (Phase One) qualitative phenomenological study suggest faculty desire to stop the erosion of moral values and restore integrity in academic practice (Eby, Hartley, Hodges, & Hoffpauir, 2017). Building on a pilot study by Gray (2008) and concept analysis by Eby et al. (2013) the perspectives of nursing faculty were explored by utilizing an online questionnaire. Findings of the study that may be applied to higher education revolve around:

(a) faculty maintaining integrity regardless of context of practice, (b) educators as role models to encourage future leaders to practice with high levels of integrity, and (c) the importance of a strategic plan to mentor new faculty. Four themes posed by the participants of this research-included environment, behaviors, ethical principles, and faculty suggestions, described as a faculty toolbox. Additionally, findings provide understanding of the issues surrounding moral integrity, methods educators may use to effectively cope with ethical dilemmas in the classroom, and strategies for equipping students to adhere to high standards of ethical practice with deliberate tenacity (Eby, Hartley, Hodges, & Hoffpauir, 2017). The study is currently being replicated (Phase Two) at a comparable public university to further examine faculty perceptions of ethical integrity in higher education. It is anticipated the current study (in progress) will add to the knowledge gained from the Phase One study.

Bridging the Gap: Using Faith Based Organizations for Hypertension Management Among African Americans by Lori Harvin, MSN, RN, CNE and Dorothea Winter, PhD, RN

According to the American Heart Association, in the United States African Americans have the highest prevalence of hypertension (2016). Patients are often faced with barriers to hypertension management while healthcare providers are challenged with identifying effective interventions that foster sustained management between office visits. These concerns contribute to the ongoing cycle of comorbidities associated with hypertension. Improved management of hypertension among African Americans require innovative and culturally appropriate interventions to foster improved health management behaviors (Lewis, 2011). Successful management of chronic diseases such as hypertension require self-care behaviors which will foster healthy outcomes and limit morbidities and mortalities related to uncontrolled hypertension. Faith based organizations (FBOs) offer an environment where African Americans are comfortable and can utilize religious based interventions to cope with health challenges (Lewis, 2011). The purpose of the project was to determine if a faith based self-management education program will improve self-care activities related to the management of hypertension among African American adults. Reed's self-transcendence theory provided the framework for this project, proposing that significant change in one's health will result in increased vulnerability, prompting one to become more aware of relationships with others, the environment, and spiritual aspects that can be utilized as coping mechanisms (Reed, 2008).

Basic Simulation Design: An interactive teaching strategy (Part 2) by Angela Bailey, PhD(c), MSN, RN-c

The simulation sessions will include a discussion of INACSL (International Nursing Association of Clinical Simulation and Learning) best practice standards, an introduction to prebriefing options, an opportunity to create and participate in a brief simulation, and application of debriefing techniques.

Interprofessional Service Learning Experience in the Dominican Republic to Promote IPEC Competencies by Megan Lieb, MSN, RN and Tina Liebrecht, DNP, RN

According to the Institute of Medicine, “all health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team”. Patient care is multifaceted, transcending any one discipline. The key to improved patient outcomes is collaborative practice. Service learning is one educational opportunity which allows students to work in partnership with learners from other health related disciplines to deliver care in underserved communities, and develop much needed competency in interprofessional collaboration. A mixed methods study was conducted to determine if participation in an interprofessional service learning experience will positively affect student achievement of interprofessional competencies. The IPEC Competency Self-Assessment survey was used in a one-group pretest-posttest design with a sample of students who participated in an international, interprofessional service learning experience in the Dominican Republic. Care provided in service learning experiences maximizes a focus on patient-centered care, occurring within the patient's community. An interprofessional approach allows for sharing of knowledge, experience, and ideas among students from varied disciplines to provide patient-centered care. The purpose of this mixed methods pilot study is to determine if participation in an interprofessional service learning experience will positively affect student achievement of interprofessional competencies. Significant differences were identified in both the interaction domain and values domain, supporting the use of service learning to develop interprofessional competencies.

Fulbright Specialist Opportunities by Susan Draine, EdD, MSN, MBA, RN and Sylvia Heinze, PhD, RN

The opportunity to serve as a nurse educator in an international setting may be afforded through the Fulbright programs. In many third world countries, there are an inadequate number of nurses, too few nurse educators, very few master's prepared nurses, and even fewer doctor prepared nurses to help guide the profession and contribute to building healthcare endeavors. Quality improvement and change is therefore slow, thus initiating and/or expanding services i.e. community health, long term care, etc. lags. The presenters will share the process of becoming Fulbright Specialists and serving as faculty internationally. The presentation will address the Fulbright opportunity as an intercultural practice experience and the rewards of serving internationally.

Navigating Mismatched Expectations on an International Nursing Service-Learning Trip by Stephanie Matthew, MSN, FNP-C, RN

Schools of nursing are increasingly utilizing international service-learning experiences to enhance the cultural competency of their nursing students. To realize the full potential of the experience, short-term international work should be conducted in a partnership with in-country organizations or local community members in order to create positive and lasting effects. Unfortunately, the expectations of these local partners sometimes may not align well with the goals of the trip participants. Additionally, nursing students or other trip members may have intrinsic expectations of which they are not fully aware until present on site in the field. These varied expectancies can cause communication difficulties, frustrations, or mutual dissatisfaction throughout the trip. This presentation will discuss examples of mismatched expectations on service-learning trips as experienced by two nursing professors leading students on cross-cultural experiences to Kenya, Nicaragua, and Haiti. Tips and tools will be provided to help anyone interested in leading or participating in a cross-cultural service experience. Suggestions will include how to negotiate conversations with cultural-sensitivity and encouragements for establishing open communication where all parties involved understand the need for flexibility. Short-term service-learning trips have the potential to create lasting impacts on all involved when expectations and objectives are clear and cohesive.

Saline Process “Infusion” by Angelia Mickle, DNP, FNP, PMHNP

The aim of this presentation is to disseminate strategies used in implementing Saline Process Curriculum University wide at a faith-based institution, using an Interprofessional health professions collaborative team approach. Background: Faith is important in healthcare; yet a survey conducted by the Christian Medical and Dental Association (CMDA) demonstrated sixty percent of healthcare professionals are uncertain on how to assess and discuss their patients' spiritual needs. This endeavor also serves as the foundation of Interprofessional Scholarship for University Faculty and students. Method: An Interprofessional Team comprised of six university faculty met for 12 months, evaluating Program Accreditation requirements and Interprofessional Education Collaborative (IPEC) Competencies. Team members identified Saline Process as a means of providing Interprofessional teaching and communication to students; while affording Interprofessional scholarship opportunities for faculty and students. The Interprofessional Team partnered with IHS global to train faculty in spring 2017; followed by the inaugural face-to-face student training session in Fall 17. Over two hundred undergraduate students were trained in a one day event. Implications: This process is foundational in equipping every nursing, pharmacy, and allied healthcare professional with tools to be witnesses for Christ in their daily healthcare practice settings. This is also foundational in Interprofessional Scholarship and IPEC opportunities. Conclusion: “Infusing” the Saline Process using this Interprofessional Collaborative approach aligns with our University's mission statement and can be a model replicated by other faith based institutions.

Creating Common Ground Through Medical Missions by Jamie Adam, DNP, RN, NP-C

Spirituality is an essential aspect of health. Nurses and other healthcare professionals that address spiritual needs are able to provide better patient care and improve patient outcomes. Effective interprofessional communication and teamwork skills are also essential to improving patient outcomes. By immersing students from a variety of healthcare professions into a medical mission experience, students have the opportunity to engage in real life patient situations as a team, addressing their own faith beliefs and those of the population they are serving. Each Spring, Nursing, Pharmacy, Occupational Therapy, Physical Therapy and Social work students from Belmont University embark on an 8 day mission trip to Guatemala to serve the medical needs of coffee workers and their families. Students provide health screenings, education, and prayer to each person and family they encounter. In the challenges of being away from familiar surroundings, with unfamiliar resources and a language barrier, students find common ground in faith and serving others. This presentation will address the intentional design of the missions experience as a strategy to address inter-professional and spiritual learning needs of nursing students. Student and faculty feedback from the experience and implications for curriculum design will be addressed.

Compassion as a Bridge to Cultural Sensitivity: Innovative= Strategies for Nurse Educators by Sharon Davis, MS, RN, CNE and Sandra Brzoza, MS, RN

Integrate cultural theory to practice while caring for culturally diverse clients Associate professors brainstormed the idea of working a cultural opportunity into the Community Health course for senior nursing students. After intense planning with the nursing leaders at Seneca Nation Health Center in Salamanca, NY and an Amish health care center serving the largest, most adherent, Old Order Amish community in the United States, these opportunities were identified as viable transcultural clinical experiences for students. The Seneca Nation of Indians, known as the “Keeper of the Western Door”, has a proud history and continues to be the largest of six Native American nations. Nursing students arrive on the Seneca Nation campus and receive an orientation that exposes students to the rich history of the Seneca as well as customs, health beliefs, language, and faith practices. Through clinical experiences students gained insight into health challenges of the Seneca people. Working with the DNP at a Health Clinic that serves Amish clients, students receive an in-depth orientation to the culture, customs and alternative health practices of the Amish. During the students' visit to this clinic they were able to identify life-threatening congenital anomalies specific to families in this population. On reflection, one student noted: “the job of the nurse in these communities is to provide patient-centered care that meets the specific cultural needs of the patients.” Another student added: “I think learning the history first helped to develop a better understanding of the client population”. This podium/poster presentation will discuss how to coordinate an alternative transcultural clinical experience for traditional nursing students that emphasizes awareness of cultural attributes in multiple settings.

Ancient Roots of a Modern Concept: Biblical Foundations of Teaching and Learning by Ruby Dunlap, EdD, MSN, APRNBC

Nursing education has been an eclectic mix of many theories of teaching and learning from competency to concept based and many variations in between. No one theory has been able to capture the whole of the complex dynamic of how learning takes place within the human psyche but learning has occurred since the beginning of humanity. The ancient record known as the Bible contains intriguing insights into the nature of teaching and learning. This presentation will explore some of those insights and the implications for modern nursing education both locally and around the world. How those insights have endured through the millennia and can be translated into modern teaching and learning contexts will be discussed. Using Scripture as data and concept analysis as methodology, concepts such as truth, objectivity, weights and measures, cross-cultural interaction, vulnerability, learner readiness, and goal setting will be examined. Implications for modern practice in nursing and education will be made. Failure to identify, understand, and commit to these Scriptural principles of teaching and learning increase the risk for the nurse and nurse educator to be influenced by whatever fad or fashion in education and healthcare comes along.

A Nursing Practice Model Based on Christ: The Agape Model by Nancy Eckerd, MS, RN

Nine out of ten American adults believe Jesus was a real person, and almost two-thirds have made a commitment to Jesus Christ. Research further supports that spiritual beliefs and religious practices influence overall health and well-being. In an effort to provide patients with care worthy of our commitment to Christ, the dedicated Christian nurse (kingdom nurse) must guide their care by utilizing best nursing practices delivered with behavior evidencing the indwelling of the Holy Spirit. The Agape Model, based on the agape love and characteristics of Christ, is a nursing model upon which kingdom nurses may align their practice to provide Christ-centered care. The Agape Model guides the practice of the kingdom nurse through spiritual and professional growth. encourages utilization of prayer, the leading of the Holy Spirit and use of individual spiritual gifts. At the point of care, as an offering to God, the kingdom nurse practices the Fruit of the Spirit; love, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control further emphasizing Christ's love. Display of the fruit sufficiently pleases God as evidence of godly attitudes and behavior. The Agape Model encourages refinement of character resulting in professional and personal excellence. Additionally, while the primary goal of the Agape Model is to emulate the character of Christ, the secondary goal results in elevated patient satisfaction and outcomes bringing excellence to our nursing profession. The Agape Model strategically embraces the Christian worldview, may be practiced domestically and globally, and proclaims Galatians 5:23(b) “...against which there is no law.”

God's Calling in Nursing Education: An unexpected journey by Christine Sommers, MN, RN, CNE

The purpose of this presentation is to share how God has worked in my life to prepare me for serving Him in nursing education internationally. Background: With globalization, there is an increase in nursing faculty teaching in programs outside of their passport country (Melby, Dodgson, & Tarrant, 2008; Secor, 2011). When teaching internationally, it is important to teach with excellence, and as believers, to teach from a Christian worldview (Romanowsi & McCarty, 2009). How we view the world will impact our teaching (Romanowski & McCarty, 2009). Description: I am currently teaching full-time as a dean in a large nursing program at a Christian university in Asia. God has used His Word, various experiences, and godly counselors to guide my family and I to where we are currently serving in Asia. It has been an unexpected journey with many surprises, blessings, and challenges. Implications: Throughout the journey, God demonstrates His faithfulness and continual guidance. Excellence in nursing education is an act of worship before God. He is honored by giving ourselves completely to Him for His service. God can use nursing education as a method to share His story throughout the world. Where is He asking you to serve? Where are you on your journey?

The Evaluation of a Community Based Program on Health Indicators in a Food Insecure Population by Mark Wilkinson, DNP MBS, RN

Food insecurity is a risk factor for diabetes, obesity, and hypertension. Research has shown community and faith-based programs aimed at increasing physical activity, screenings for health risks, and health education can have positive results in reducing the health disparities of the food insecure population. A faith-community based food distribution center implemented a holistic approach to meeting some of the needs of a food insecure population. The purpose of this study was to evaluate the health outcomes of a food insecure population that received health interventions including: health screenings (weight, BMI, systolic/diastolic blood pressure, and blood glucose readings), health education, dietary education, and increased physical activity. This study partnered RN-BSN students with a faith based organization to provide health promotion and prevention through screenings and education. Students had the opportunity to interact with this population and gain cultural awareness. Over 100 people were seen every Saturday. The records of 45 participants that had been in the program for at least 12 months and participated greater than 50% were reviewed. A paired samples t test was used to determine the effect of the intervention. Cohen's d was calculated to show a medium to large effect on the sample tested. Over the 12 months, the 45 participants, lowered BMI with a mean loss 0.982, and lowered blood pressure readings. The sample size was too low to determine effectiveness of the program related to blood sugar management. More research is needed to determine factors that result in improved health behaviors change population.

Increasing Faculty Involvement in Assessment: Assessment Fellows Model for Assessment in Higher Education by Karen Hoffman, DNP, RN

Many academic administrators identify the problem of getting faculty to participate in assessment as one of their top organizational problems. Assessment has historically been relegated to administration and entities not engaged directly with student learning. Faculty involvement in assessment is very often too little and thus use of results of assessment efforts to change teaching and learning practices is hampered. Without the involvement of faculty, assessment of student learning efforts can remain meaningless. While literature exists related to the problem, proposed solutions have been rare. This project helps to fill the gap between the need and solutions to meet it, and greatly improves the collection and use of assessment data to inform curriculum. The goal of this academic innovation was to find a way to involve faculty more meaningfully in gauging quality of offerings and student learning. A secondary goal was to support and drive the gathering and analysis of assessment data. Available assessment plans, data, and use of findings were scarce in the Indiana Wesleyan University School of Nursing prior to the project. In the fall of 2013, a project was undertaken to implement an Assessment Fellows model of assessment for the School of Nursing. The design and success of the project is evidenced by all programs having assessment plans and guiding documents, Assessment Fellows for each major and specialization that lead assessment within their disciplinary areas and annual assessment reports that provide analysis of data and evidences closing the loop in assessment, and significant faculty development in relation to assessment.

Spiritual Care Practices of APNs in the U.S. and Abroad by Beth DeKoninck, DNP, FNP-C

Spiritual care has always been at the core of nursing, however, the nursing profession moved away from this core tenet during the mid-to-late 1900s. It is only in the past twenty to thirty years that the focus has returned to spiritual care, both by the profession and governing bodies. Advanced practice nurses (APNs) have become instrumental to the healthcare system of the United States and the role is ever-expanding globally. Thus, it is important to examine spiritual care practices of APNs, both locally and globally. This presentation will discuss findings from a multinational study which examined spiritual care practices of APNs as well as barriers to spiritual care faced by APNs. The presentation will address how the project was developed, and the results as well as the need for research going forward.

Caring and Following Faithfully: Innovation in RN-BSN Education by Barbara Taylor, PhD, RN

The purpose of this project was to update and implement an innovative Registered Nurse – Bachelor of Science in Nursing (RN-BSN) curriculum in concurrence with the Institutes of Medicine (2010) goal of having 80% nurses prepared at the BSN level. To move beyond critical thinking and enhance clinical decision making, Benner, Sutphen, Leonard and Day (2010) speak to the necessity to re-evaluate and modify current nursing education practices. Furthermore, healthcare agencies in San Diego county are increasingly requiring the BSN as entry-level for hire and/or conditional for continued employment. Evidence identified by Sarver, Cichra and Kline (2015) supported the school of nursing's (SON) findings that the most significant barriers to advancing education related to time commitment and expenses (i.e. books/supplies, tuition). Subsequently, the SON updated the cumbersome and antiquated RN-BSN program to include a hybrid learning format, greatly reduced tuition, including access to textbooks, and completion in as few as 15 months. This innovative program partners five public community colleges and a faith-based, private University and provides for entry into Christian higher education. In order to achieve faith-informed learning outcomes, the program is taught by university faculty, on location at the community colleges. To fulfill the university general education requirements, the Biblical Perspectives course is taught online. The program began in the Summer of 2015 and to date, over 175 nurses have completed the program, 130 students are currently enrolled with a retention rate of 93%. Employment rates approach 100% for new graduates.

Predatory Publishing and Other Publishing Perils by Kathy Schoonover Shoffner, PhD, RN

The term predatory publishing, coined by academic librarian Jeffrey Beal, is a recent phenomenon that emerged out of the open access publishing model, where published articles are made available free online without paying any subscription or access fees. What are models of open access publishing? What is the difference between scholarly legitimate open access publishing and predatory publishing? Is open access publishing to blame for predatory publishing? How can authors evaluate publishers, as well as discern the best place to publish their work?

In addition to understanding various publishing models and how to choose a publisher for their work, how can nurse authors avoid unintentional but common unethical practices in professional writing such as plagiarism, copyright infringement, literature infractions, and author or disclosure failures.

This presentation will develop participants' understanding of publishing models, the process of publication, and critical issues involved in ethical, professional writing.

The Road Less Travelled; Integrating Faith and Mental Health in the African American Church by Phyllis Jackson, RN, BS and Mary Steens, MS, RN

We believe that mental wellness interventions should be applied at all stages of the lifespan, where people live, work, and pray. The lack of knowledge about mental health, and thus effective interventions, in the African American church has led to undiagnosed and devastating health consequences and disparities. Complex social and health problems are driven (and affected) by multiple causes (determinants) and require collaboration of faith traditions, multiple community systems, as well as professional/academic disciplines. Renewing of the Mind (ROM) is such a collaboration. ROM is a model, of a faith based initiative that incorporates, university, and community partnership, to addresses metal health concerns, in the church. We engage multiple stakeholders, in structured ways, to make a collective impact and sustainable change on the misinformation, negative perceptions and stigma attached to mental health, diagnoses and treatment, within the African American church and communities of color, at large. Our goals are to strengthen relationships and dialogue in the church among those who care about mental health; Increase understanding of the church's role in bringing about the integration of faith and medicine in mental health interventions; enhance faith -based and community efforts that address mental health disparities; offer educational opportunities to strengthen awareness, understanding and advocacy about mental health wellness and illness; empower and equip people to support resiliency by providing knowledge about potential referrals and community resources and obtain feedback on the curriculum and track participants learning and impact on mental health in their faith community

Whole Person Care to the Marginalized: Quantity vs Quality by Elizabeth Seunarine, Bsc, RN (PHC)

The presentation highlights qualitatively recorded provider experiences of marked patient/client improvement in health deficit indicators using intentional, focused, attentive therapeutic interactions. As Christians in health care, we cannot limit ourselves to traditional methodologies. The Symptom-Diagnosis-Medication mode of care which attends to merely physical symptoms is deficient in providing the type of ‘total-care’ modelled by Christ himself. Recognizing that every heart yearns for acceptance, grace, forgiveness, love, and a listening ear, justifies the use of ‘out- of- routine’ therapeutic actions. Health breakdown, in many cases, is due to compromised trust in oneself. Physiological immune systems are compromised by inner conflict. Health clinics serving marginalized populations with an Integral, w-holistic approach to care often result in consistent, ongoing improvements in physical, emotional and spiritual health. The presenter has over 30 years of global mission experience providing education to patients and training health personnel in outreach clinics. Each participant received education and the opportunity for counseling based on a Christ-centered model that recognizes the interrelatedness of the mind, body, environment, and spirit. This approach has yielded radical results which seem supernatural. One 13-year-old stopped bedwetting within days of receiving Integral Health Education and Counseling. Some smokers gave up their cigarettes telling others to do the same. With improved diet, others decreased need for insulin and lowered their risk of diabetic complications. Others attended clinic IHE department looking for tips to increase their water intake. Preventive and promotive health education provided within Christ-led, trust-building relationships can be more efficacious than allopathic strategies of symptom management.

Identifying and Removing Cultural Barriers to Nursing Education in a Four-Year BSN School of Nursing in a Developing Country by Janice Cotrone, DNP, MS, RN

While a fair amount of research and literature exist to assist nursing students in the delivery of culturally competent care, there is very little available for expatriate nursing professors striving to communicate from a platform of evidence-based practice while working with nursing students in developing countries. In the developed world, “nurse educators face challenges in how to teach and mentor an increasingly diverse student nurse population” (Morton-Miller, 2013). All the while, expatriate professors in developing countries may be unable to achieve expected and desired student outcomes due to actual and perceived cultural barriers. Critical to the increase in learner outcomes is the understanding of culture competence coupled with faculty teaching behaviors (Baghdadi, 2014). In collaboration with qualified expatriate nurse educators, a four-year baccalaureate program of nursing in Haiti developed and integrated into the curriculum numerous modalities to increased learner outcomes. Several of these follow guidelines of the National Association for Education and include valuing diversity, being culturally self-aware, understanding the students' culture, and adapting to diversity (2017). As professors were able to identify and remove cultural barriers, students successfully learned and practiced skills and techniques to positively impact patients in the inpatient hospital, outpatient clinic, and the surrounding community.

Long-Term Effects of Baccalaureate Students' International Nursing Experiences on Practicing Nurses by Gale Sewell, PhD, MSN, RN, CNE

In the 21st century, change has affected all levels of societies and cultures. In the United States, shifts in demographics, industry focus, technology, and international travel have contributed to the increased need for cultural competence in all facets of society. These changes affect healthcare and the profession of nursing, challenging nurses to incorporate culturally appropriate care to provide optimal care to all clients. Findings from an extensive literature review indicated international nursing experiences provided positive short-term effects. However, little research addressed long-term effects of international nursing experiences on nurses' beliefs and practice.

The purpose of this quantitative descriptive survey research was to investigate the long-term effects of baccalaureate students' international nursing experiences. There were 184 nurses across the United States who participated in the survey. The inclusion criteria incorporated registered nurses who completed an international nursing experience during their baccalaureate nursing education, practiced as a registered nurse for at least 18 months, and were working or volunteering as registered nurses when they completed the survey. This research describes nurses' perceptions of their baccalaureate international nursing experiences and its ability to affect current nursing practice. The research contributes to filling the gap in knowledge related to long-term effects of international nursing experiences and may provide support for inclusion or retention of international experiences in baccalaureate nursing curricula. Keywords: baccalaureate nursing education, cultural competence, diversity, immersion, international nursing experiences.

Preparing Students to Participate in International Medical Mission Trips through Simulation by Ashleigh Woods, EdD, MSN, RN, CNE

Cultural competence has been identified as a valuable skill for nurses.1 To improve cultural competence in new graduate nurses, schools have implemented international service learning opportunities (i.e. medical mission trips), local cross cultural service learning experiences, and simulations (an imitation of a scenario that a nurse may encounter) that incorporate cultural themes. 2-3 Although literature on cultural competence in simulation exits, no research study was found on using a simulation to prepare students going on an international medical mission trip. 4-8 Students often feel unprepared for the challenges of international medical mission trips. An innovative approach to fill this gap was developing a simulation (using actors as patients) to prepare nursing students for their upcoming trip. The simulation's focus was to train students in setting up a clinic in a variety of locations, in cultural competence in the country that they will be serving, in focused assessments using minimal technology, in triage, and in presenting the gospel to others. Utilizing several different spaces at a local church, students set up a functional clinic. Once the clinic was set up, students worked at different assigned stations (waiting area, triage station, treatment area, spiritual counseling, and pharmacy). Then students performed assigned tasks on the patients who had an assigned culture and physical ailment. After two patients, students then rotated roles to familiarize themselves with all the various assignments that they may participate in. This innovative simulation can improve cultural competence, decrease student anxiety, and was well received by the students.

HEAL: Healthy Eating and Active Living in All Saints Parish by Charlotte Connerton, EdD, RN, CNE and Elizabeth Ramos, RD, MS, CD

All Saints' Parish in Evansville, Indiana applied and received a pilot grant through the Welborn Baptist Foundation Upgrade Initiative of Healthy Eating and Active Living. Collaborative partnerships were built between the Welborn Baptist Foundation, All Saints' Parish, and University of Southern Indiana Health Care Professionals. Expansion of the health ministry team includes registered nurses, a registered dietitian, a psychiatric social worker, and the director of ministries. The health ministry team conducted parish surveys of health and facility needs of the congregation in May 2017. Approximately 88 parishioners completed the health needs survey. The top five health needs were weight control, stress, sleep problems, high blood pressure, and nutrition. The top five spiritual concerns were ability to let go of issues, anxiety/despair, forgiveness, loneliness, and grief/loss. All Saints' Parish established a water policy and healthy food offering along with purposeful movement for congregational meetings outside of Mass (church services). Through the training of the Faith Families curriculum, the parish will be offering nine educational sessions on healthy eating and active living. Nurses, food and nutrition students, and occupational therapy students will provide the educational sessions for the congregation and public at All Saints' Parish. All students will prepare lessons with demonstrations and evaluate the participants' learning. Participants attending the sessions will rate their understanding of content presented. After completion of the educational sessions, research will be conducted to determine if participants are making lifestyle modifications to improve health outcomes.

What Do We Know About the Influence of Culture on Learning? By Christine Sommers, MS, RN, CNE

Describe the influence of culture on learning, including implications for teaching. Background: To prepare nursing graduates to meet patient care needs globally, nurse educators should use culturally inclusive teaching strategies and know more about how culture influences learning (Sommers, 2014). Approaches and expectations in learning are entrenched in learners as part of sociocultural background (Brown, Ward-Panckhurst, & Cooper, 2013). Because of the different approaches and expectations, culturally appropriate evaluation systems should be used to evaluate learning (Henze & Zhu, 2012). The way students have learned in the past will influence their current learning preferences and expectations (Sommers, 2017). Therefore, nurse educators should understand the needs of diverse students and be prepared to develop culturally sensitive and supportive educational environments in multicultural classrooms (Billings, 2015; Jeffreys, 2015; Marzilli & Mastel-Smith, 2017; Veal, Bull, & Miller, 2012). Description: Nurse educators should consider the culture of themselves and their students when teaching. This will involve using culturally inclusive teaching strategies. Culturally inclusive teaching strategies include maintaining awareness, respecting culture, providing support programs, utilizing technology, and developing reflective practices (Sommers, 2017). Implications: More research is needed in nursing education regarding how using culturally inclusive teaching strategies better prepares nursing students for practice. Nurse educators, regardless of where they are teaching, need to be aware that the cultural background of students will influence learning and be willing to adapt and develop teaching strategies for use with diverse cultures to prepare graduates to meet complex healthcare needs of patients.

Nursing Faculty Experiences of Spirituality in Nursing Education by Candice Bruhjell, PhD, RN

The purpose of this study was to understand how associate degree nursing (ADN) faculty members in secular schools described their experiences related to spirituality into the nursing curriculum and what experiences they had with the integration of spirituality in their nursing courses. The guiding research questions were, 1) How do associate degree nursing faculty members in secular schools describe their experiences related to spirituality in the nursing curriculum? and 2) What experiences have associate degree nursing faculty members in secular schools had with the integration of spirituality in their nursing courses? Nursing faculty's experiences with the importance, necessity, and integration of spirituality into the nursing curriculum, and consequently into each course taught in nursing schools, is lacking in the literature. This study was conducted using a semi-structured interview approach where twelve participants offered thick, rich descriptions of their experiences with spirituality and the integration of spirituality into the courses they taught. The participants were faculty members of secular ADN schools located in the Midwestern United States. Eight themes emerged along with participant definitions of spirituality and religion. Based on the findings, the implications for nursing education include increasing faculty education in teaching spirituality, going back to the basics of holistic nursing, and recognizing the importance of role modeling. Spirituality is an integral part of holistic nursing and cannot be ignored. A similar study could be repeated in a different geographical area of the U.S. or globally where differing religious and/or spiritual beliefs are prevalent.

Creative Collaboration in a Global Learning Initiative

by Rebecca Hoffpauir, PhD, RN and Martha Hawkins, DNP, APRN, CPNP

Taylor, Pruitt, and Fasolino (2017) reported integrating service learning in nursing education promoted the potential for sustainable change within communities and fostered cultural competence. When cultural learning experiences are provided throughout the nursing curriculum, student's transcultural self-efficacy and ability to care effectively for multicultural clients increase (Curtis, Bultas, & Green, 2016). In recent decades, the call for evidence based nursing to improve quality of care and transform healthcare, has highlighted the imperative task of providing competent care that is culturally relevant and safe (Stevens, 2013). In 2017, an interprofessional intercultural team composed of nurses, nurse faculty, RN to BSN students, traditional undergraduate nursing students, graduate student nurses, a nurse practitioner, and a physician, developed and initiated a sustainable charting system for a mental health care facility in Belize, Central America. Presenters will describe how in using the Core Competencies for Health Professions, (IOM, 2003) and the Core Competencies of Interprofessional Collaborative Practice (2016) as a foundation, the interdisciplinary team utilized evidence based research to develop a system to promote patient centered care. Also discussed will be steps of actual implementation, challenges, and lessons learned. Recommendations will be provided for teams who would consider similar initiatives. At the conclusion of the presentation, attendees will be able to:

  • Recognize the effective collaboration of an interprofessional team in the development of a culturally sensitive, sustainable, and efficient charting system for a mental health facility in Belize.
  • Apply concepts learned to interprofessional teamwork in the development and implementation of culturally relevant initiatives.

Advancing Future Nursing Practice: The Evidence Base for Servant-Leadership in Nursing by Holly Hall, EdD, MSHA, RN

There is a demand for leadership to create a healthy work environment for nursing practice, which is crucial for maintaining an adequate workforce (Shirey, 2006). Rother and Lavizzo Mourey (2009) predicted that by 2025 the nursing shortage may reach as high as 500,000 U.S. nursing vacancies. This study examined the relationship between servant-leadership characteristics of nurse-leaders and the perceptions of empowerment among their followers. Servant-leadership has emerged as an effective leadership style that prioritizes developing the full potential of followers (Liden, 2013). Current research suggests an empirical link exists between servant-leadership and empowerment (Liden, Panaccio, Meuser, Hu, & Wayne, 2011; Van Dierendonck, 2011). An empowered workforce is able to handle unstable environments (Liden, 2013) such as the nursing shortage. In 2015, 51 nurse-leaders and 237 direct-reports from workplace units in a healthcare system completed the Servant-Leadership Scale and a demographic questionnaire. Direct-reports completed the Psychological Empowerment Inventory. Convenience sampling was utilized to assist in obtaining participants for this study. An independent samples t-test was used to analyze the data. It was found that a relationship existed between nurse-leaders that were rated as servant-leaders by their direct-reports, and the direct-reports' perception of empowerment.

Nurses in hospitals that feel more empowered have higher job satisfaction, more commitment to their organization, and are less likely to voluntarily quit. Nurses that are provided with strong leadership and are supported take risks and innovate to improve the quality and efficiency of care delivered are more likely to thrive during these challenging times.

Spiritual Nursing Care in Promoting Recovery in Mental Illness by Melissa Neathery, MSN, RN, CNE

Researchers have explored the provision of spiritual nursing in various medical settings, but little is known about spiritual nursing care in helping those with mental illnesses. With mental illness being the leading cause of disability (World Health Organization, 2011) and the National Institute of Mental Health making innovative treatments and personalized care a high priority (NIMH, 2015), all nurses must be familiar with the Recovery Model of Care and how addressing the spiritual need of people with mental illness promotes recovery. This presentation will review literature describing The Recovery Model of Care that views recovery as a non-linear, personal journey of experiencing a fulfilling and meaningful life in spite of having a mental illness. Rather than viewing recovery as an achieved state of being symptom-free, recovery capitalizes on key concepts: hope, meaning, empowerment, self-determination, overcoming stigma. Based on recent research by this presenter (2018), factors hindering and contributing to the provision of spiritual care by psychiatric mental health (PMH) nurses will be identified. The presenter's recent research obtained data from 171 PMH nurses from across the United States suggesting that personal spiritual perspectives (Spiritual Perspectives Scale, Reed, 1987) correlates with the provision of spiritual care (Nurses Spiritual Care Therapeutics Scale, Mamier & Taylor, 2014), but does not contribute to nurses' understanding of recovery in mental illness (Recovery Knowledge Inventory, Bedregal, 2006). To address this lack of understanding of how spiritual nursing care can promote recovery, this presentation will describe spiritual approaches to each component of the Recovery Model.

Integration of Spirituality in an Undergraduate Nursing Stress Management Assignment by Kathy McKinnon, MSN, RN, Chaplain

Emotional exhaustion has been identified as having a negative effect on nurses' professional commitment and can lead to nurses ending their career (Chan, Tam, Lung, Wong & Chau, 2013). Nurses, experiencing high levels of stress in their career, suffer from physiologic as well as psychologic disease, which can ultimately lead to patient dissatisfaction (Wright, 2014). The National Health Service (2017) reported 37% of healthcare staff felt unwell due to work related stress. In order to combat this epidemic, in a private, Christian university, an assignment was developed to help undergraduate nursing students assess, reflect, and implement a personal stress management plan. The aim of this assignment was to help students to decrease their stress and anxiety over the 16 week semester, while simultaneously increasing their faith and drawing them closer to God. Students were encouraged to continue with the implementation of their stress management plan throughout the remainder of nursing program, but more importantly into their careers as registered nurses. Over time, these Christian Nurses can instill hope and inspire their fellow nursing colleagues as they battle their own stress over the course of their careers.

Hospitals and University Partnerships: Meeting the Needs of Rural Indiana through Clinical Home Placement Model by Lana Watson, DNP, RN

Background: Small county hospitals are primary providers of care for rural areas of Indiana. These hospitals face the same challenges large urban tertiary centers face – shortage of qualified nursing personnel. With the increased demand for qualified nurses and limited number of clinical placement sites, university nursing programs must seek alternative and innovative strategies for clinical placements (Dapremont & Lee, 2013). Description and implications for education and practice: Students upon entry into the nursing program are placed in clinical groups associated with a specific “clinical home”, an acute care facility in one of the rural counties. During the course of nursing program, the students will complete majority of their clinical rotations within that county/hospital. Students receive full onboarding to the facility. Staff nurses that meet criteria for nurse preceptors are paired with a student during their clinical experience. This model is similar to “dedicated education units” that aims to enhance collaboration between academia and practice (Hunt, Milani, & Wilson, 2015). Students in clinical home receive more immersed clinical experience due to acclimation of the students to the environment (Hughes-Gay, 2013). Student becomes an integral part of the team on the nursing unit. This immersion facilitates application of learned knowledge in clinical setting. Hospitals in return have the ability to recruit and retain students educated in their respective hospitals with minimal onboarding needed upon hire. Current rate of nurse graduates staying within our region is 91.8%.

Extending Congregational Ministries of Health through Partnerships and Faith Community Nurses by Katora Campbell, DrPH, MSN, RN-BC

The importance of congregations and health organizations forming partnerships cannot be underestimated. At a time of rising costs and limited resources, ministries and healthcare are both challenged in meeting the growing health and faith needs of the individuals, families and communities. Efficient use of limited resources is needed to sustain or expand supportive caring services. Congregations and health organizations are developing partnerships and working with faith community nurses. They have been successful in extending their resources and services beyond what either can do alone. To effectively form partnerships, congregations will need information and key factors to form successful relationships with health organizations and faith community nurses to fulfill their mission and vision.

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Poster Presentations

Decreasing Falls at in Inpatient Psychiatric Facility by Emily Nissley, DNP, RNBC, CNE

This quality improvement project sought to decrease patient falls, and sought to answer the PICOT question, “How will the implementation of an evidence based fall prevention program utilizing the Morse Fall Scale and fall precaution interventions influence inpatient fall rates in 8 weeks?” The project utilized the Morse Fall Scale and fall interventions of fall risk armbands, door magnets, non-slip socks, bed and chair alarms, patient education, and universal fall precautions. Nursing leadership, charge nurses, staff nurses, and mental health technicians were educated on the fall scale and interventions. Charge nurses completed daily audits on compliance with assessment and intervention, and recorded any fall occurrences. The facility's benchmark for falls is 3 falls per 1,000 patient days. The goal of the project was a 10% reduction in falls and a 90% compliance rate with assessment and intervention. Eight-week pre-intervention data showed 11 falls for a fall rate of 3.90 falls per 1,000 patient days. Eight-week post-intervention data showed 6 falls for a fall rate of 1.99 falls per 1,000 patient days. Overall, the project showed a 97% compliance rate with assessment and intervention and a 51% reduction in falls. Decreasing falls impacts financial, quality, and efficiency measures.

Transitional Care after Hospital Discharge: A Part of Faith Community Nursing Practice by Katora Campbell, DrPH, MSN, RN-BC

Background: In 2011 hospitals became subject to payment penalties based on their readmissions rates, which precipitated them to seek transitional care methods to reduce readmissions. Faith community nurses (FCNs) are progressively caring for patients that are transitioning home from the hospital, yet there is limited research about their emerging role in transitional care.

Methods: A mixed method descriptive approach used a qualitative process to operationalize the concepts related to transitional care interventions and a quantitative design to count nominal categories of interventions. Documentation records were entered into an electronic program. A total of 986 nurse documentation records were analyzed with an average of 6.4 interventions per patient visit and 1556 total interventions documented. The Nursing Intervention Classification Analysis Program was used to align nursing intervention themes into the thirty Classes of NIC.

Results: Thirty-two NICs described the bulk of transitional care interventions provided by FCNs. The most frequent Classes of NIC were Coping Assistance, Communication Enhancement, Patient Education, Information Management, Health System Mediation, Physical Comfort Promotion, Lifespan Care, Behavioral Therapy, Activity and Exercise Management, Cognitive Therapy, Tissue Perfusion Management, Child rearing Care, Self- Care Facilitation, Drug Management, Nutrition Support, and Community Health Promotion. These intervention categories are in-line with previous evidence-based transitional care research. Implications for practice: The study offers further insight into the variety of evidence-based “priority” transitional care interventions provided by FCNs. In addition, FCNs' provide emotional and spiritual support interventions which may further help patients to cope with their illnesses, changes, and reduce readmissions.

Cross Cultural Patient Education: A Qualitative Study of Health Professional's Experiences by Cheryl Crotser, PhD, RN, NE-BC

Nurses provide care and education for patients from various cultural backgrounds in the United States and abroad. Healthcare professionals who have worked with patients in different cultural and geographical settings and across languages have practical experience that can help prepare others for this role. The purpose of this descriptive qualitative study is to understand techniques that are effective in providing patient education to individuals of other cultures. Specific aims include understanding the (a) experience of healthcare professionals in providing patient education to individuals of other cultures including barriers and facilitator and (b) strategies for healthcare professionals to prepare for this role. After IRB approval and using network sampling, in-depth individual interviews of nurses and other health professionals with experience in cross cultural patient education were conducted in person, by phone or email. A total of five interviews were completed of healthcare professionals with experience working with individuals from Africa, Central and South America, Southeast Asia, the Middle East and refugee populations in the US. Health promotion, prevention and self-management emerged as common educational needs. Overcoming barriers such as language and lack of resources were revealed. Health professionals used several strategies to facilitate learning. Preparation for the role included an attitude of cultural humility, immersion in the culture and the making emotional connections. Additionally, insights into the experiences of patients and families were uncovered. Along with humility, health professionals need to be realistic and identify sustainable solutions to health problems within the culture. Future research is needed on culture specific strategies.

An Exploration of Calling and Vocation in RN-BSN Students by Michelle Riingen, RN, DNP, CNS-BC

The purpose of this study was to explore the presence and development of calling and vocation among degree-completion students studying in an RN to BSN program. Students who confirm a calling tend to be more confident in their career choices; view their intended career more positively; and are more satisfied with their academic program. Little is known about the presence of calling and vocation related to the educational journey of nursing students. Using a prospective, correlational design, students in a 4-term RN to BSN program were sampled (n=201). Between July 2016 and May 2017, students were asked to participate in the completion of The Calling and Vocation Questionnaire (CVQ). This 24-item Likert-scale tool includes six subscales that identify the presence or search for calling and vocation. The demographic variables of term, years as an RN, RN licensure, current RN employment, previous non-nursing degree(s), age, race, and religiosity (via the Duke Religiosity Index) were collected. Bivariate correlations demonstrated significant positive relationships between calling and vocation and the following demographic variables (i.e. licensure, years as RN, employment as RN, previous degree, age, and religiosity). Interestingly, term in the program was not significant. These data suggest that previous life and nursing experience are significant contributors to calling and vocation in this population. These findings underscore the vital need to incorporate adult learning strategies into the classroom that further enhance the development of calling and vocation.

The Effects of Caretaker Training on the Emotional and Physical Needs of Institutionalized Orphans by Becky Le, PhD, RN, IBCLC

Purpose: The aim of this research was to determine if education and training on the developmental care of infants, based on Watson's Theory of Human Caring, could help orphanage workers improve the emotional and physical development of institutionalized African orphans up to the age of 66 months.

Methods: Participants of this quasi-experimental, cross-sectional study included children living in six orphanages located in one African village. Participating orphanage workers received a 2-hour researcher developed training based on Watson's Theory of Human Caring. The effectiveness of the training was assessed via preand post-test caregiver responses to the Ages and Stages

Questionnaire (ASQ-3), which measures children's communication, gross motor, fine motor, problem solving, and personal-social skills.

Findings: Results indicated significant benefits of the caretaker training for orphans of all age groups, across all sections of the ASQ-3.

Clinical Relevance: Nurses have unique opportunities to expand evidence-based pediatric practices into global communities. Nurse-led caregiver trainings in orphanages throughout the world may improve the conditions of orphaned children who have endured tragedies associated with abandonment and neglect. Results have important implications for orphans' physical and emotional well-being, quality of life, and abilities to become integrated, productive members of society.

Using Simulation to Teach Spiritual Care

by Christine Brockway, MSN, RN, CNE, Dawn Krist, BSN, RN, and Janelle Theisen, MSN, RN, CNE

Simulation as an education modality has become more utilized in the past decade. As this aspect of education has grown, there is a need to incorporate more into the simulations than just medical conditions. There have been several studies done that have called for more training of students in the art of spiritual care and have mentioned simulation as an acceptable modality to teach. In the spring of 2017 the University of Northwestern instituted 71 scenarios of simulation for the junior level nursing students. Along with incorporating various medical diagnoses, the nursing process, and a plethora of clinical nursing skills, the faculty integrated areas where spiritual care could be implemented by the nursing students, requiring them to critically think and look at the patient from more than just one perspective. The aim was to give the students a well-rounded simulation that incorporated all the aspects of clinical nursing the students would have in a clinical experience with a scheduled time to debrief and learn from each experience. Being able to examine the holistic care of a patient, not just the medical aspect or hands on nursing skills enabled the students to implement spiritual aspects of care, thereby, providing more comprehensive care for the patient.

Faith-nursing integration at Chaminade University by Olivia WeiLi, MSN, RN

This initiative demonstrates the value of nursing faculties' effort and articulations of faith-nursing integration at Bachelor of Science in Nursing Program. The focus of inquiry is the complex, human-organizational phenomenon of exemplary leadership to the mission and identity in the Catholic and Marianist tradition of one top-tier Chaminade University of Honolulu in the United States.

The objective is to understand and describe the essential meanings in the lived experiences of exemplary leaders and nursing faculties, presenting individual descriptions and collective syntheses of the phenomenon in focus. The intended audience includes leaders in Marianist and Catholic higher education; administrators involved in leadership development and mission and identity; and faculties in higher education, phenomenology, and interdisciplinary studies in leadership and organizational behavior.

This initiative describes three “streams” within the lived experience of the phenomenon, namely: faculty commitment, exemplary Marianist leadership, and the experience of Catholic and Marianist mission and identity. This innovation is important for the organization because this is consistent with the theological, educational and missional underpinning. Achievement of this new performance area would enable the organization to fulfil its mission of “offers its students an education in a collaborative learning environment that prepares them for life, service and successful careers. Guided by its Catholic, Marianist and liberal arts educational traditions, Chaminade encourages the development of moral character, personal competencies, and a commitment to build a just and peaceful society”. It sheds light on preserving the essence of Catholic legacy and offering “seeds” for deeper reflection, conversation, and action in higher education.

Caring for the Whole Person: Putting Cura Personalis into Action by Joanne Dunderdale

Background: Loyola University Chicago (LUC) Marcella Niehoff School of Nursing (MNSON) is an integral part of Chicago's Jesuit, Catholic University, a community seeking God in all things with a mission deeply grounded in the teachings of St. Ignatius Loyola. This teaching philosophy is based on six Magis (to do more for others) values that challenge one to strive for excellence, be women & men for and with others, share one's gifts, pursue justice, and have concern for the poor and marginalized through experience, action and reflection. The value of Cura Personalis, care for the entire person, is at the core of Ignatian nursing education (Connor, 2015).

Idea: The use of simulation is one way this faith-based approach to nursing education has been into integrated into school of nursing's curriculum. As part of the pre-briefing process, students read St. Ignatius' Legend of the Wolf and Kettle which challenges them to extend their generosity to human-kind though their intellect, heart, conscience and spirit. The University's mascot, a wolf, is a constant presence throughout the simulation day which encourages the students to recognize social injustices in patient populations especially in the areas of illness, addiction, mental disease race, creed, hunger, education and socio-economic support. Simulation scenarios contain spiritual and cultural dimensions. To guide reflective debriefing, simulation faculty developed and implemented a structured model that engages students in treating the spiritual aspect of patient care.

Implications: The use of simulation can be used as an effective teaching strategy to explore patient's culture and spirituality.

Improving the health of the world, one person, one nurse, one community at a time by Miriam Chickering

Nurses International (NI), a non-profit organization, is an alliance of advanced practice registered nurses, educators, and others with a desire to be the hands and feet of Jesus and fulfill the Great Commission. NI strives to reach the lost world and improve health by providing a faith-based nursing curriculum, sharing the Gospel, and providing spiritual mentors for nursing students and faculty around the world.

In developing countries, access is the primary barrier to education. Access to educators, resources, and opportunity. NI's goals is to provide access and opportunity to nursing students by using a three-pronged approach. We work with partners to establish new nursing programs where the need is great; we connect colleges and institutions with experts who can take their nursing programs to the next level; and we eliminate the barriers that stand between students and education. For example, nurse educators in the United States can teach students and mentor faculty in Africa, Asia, or Central American. The programs are accredited through the institution and governing bodies of the location in which it resides. NI meets or exceeds accreditation criteria in all countries in which it operates.

In the developing world, health and well-being are obtained not only by an absence of active disease, but also through the presence of adequate food, sanitation, just work environments, shelter, safety, friendship and faith. NI graduates become change-agents within their communities. They are equipped to improve all aspects of health and well-being for individuals, families, communities, and the country.

Nurse Practitioner Spiritual Caregiving: A Design for Unexplored Territory

by Leslie VanDover, MSN, PhD, PN, RN, FNP-BC

Spiritual care by nurses has a long history, and over several decades, many nursing scholars have been drawn to study spirituality and spiritual care for hospitalized patients. All nurses acknowledge the importance of multifaceted health care designed to address the patient's physical, mental, and spiritual needs. However, the experiences of Nurse Practitioners (NPs) working in primary care and other outpatient settings have not been fully examined. Written standard competencies for APRNs include the idea of responding to patients as spiritual beings, but how does the practicing NP conduct spiritual assessment and provide spiritual care?

Design: This study explores how experienced NPs define and describe spiritual care as they practice it, assess patients' spiritual needs, provide spiritual care, and facilitators or barriers they have experienced. The design uses focus group methodology with semi-structured interviews conducted by an experienced moderator.

Participants' inclusion criteria were: current California nursing license, graduated as NP for at least five years, have practiced for three of the last ten years, were able to read, speak, and write English, and self-identified as Christian. Instruments: In addition to the semi-structured interview, participants completed two standardized questionnaires assessing their personal spirituality. To date, data has been analyzed from two focus group interviews (total of 15 NPs).

Implications: Study results will inform NPs how experienced providers address spiritual needs and form the foundation for new curriculum and future research. Continued exploration of this key, unexplored aspect of whole person care will add to the evidence base for NP care.

The Benefits of Returning to Kangaroo care by Debra Parker, DNP, RN

Technology available to care for preterm infants has increased exponentially in the last decade. Even though the official definition of viability states that there is no definite gestational age or weight to determine the ability to live outside the womb, Perry, et al. (2014), states that infants born at 22 to 25 weeks gestation are considered to be on the threshold of viability. Birth at 22 to 25 weeks gestation results in being more susceptible to increased morbidity and mortality as compared with infants born at term. Nurses working with preterm and/or very low birthweight infants (VLBW) tend to rely heavily upon machines, mechanical devices and/or monitoring equipment to provide care. As technology increased, Kangaroo Care (KC), also known as skin-toskin care, has declined until recent years. A comprehensive review of literature addressing physiological and developmental effects of kangaroo care identify that preterm infants respond positively to this therapy. The purpose of this literature review and case study is to draw to the forefront the advantages and or benefits of returning to the practice of KC even with very low birth weight (VLBW) infants.

Spirituality: Dimensions of Nursing Practice by Ivreen Robinson, PhD, MSN, FNP-BC, RN

Background: The discussion of spirituality as it relates to health and well-being has become an important topic over the past 20 years. Spirituality helps individuals become aware of meaning and life purpose. A person exists in three dimensions, body, mind, and spirit. The spiritual component should not be overlooked because it contributes to the humanness of individuals. In 1998, the World Health Organization redefined the concept of health to include a spiritual component. Several accrediting and nursing organizations have mandated that a spiritual component of care be addressed during the delivery of health care services. Similarly, patients and their families anticipate that within the health care delivery system their spiritual concerns will be addressed.

Purpose: The purpose of this discussion is to create awareness of the importance of spirituality in nursing practice and how awareness of spiritual dimensions can transform the lives of patients and their families.

Conclusions: An understanding of spirituality is critical to address the components relevant to nursing practice. The spiritual dimensions of nursing practice are spiritual need, spiritual distress, spiritual care, and spiritual well-being. To attain spiritual well-being, spiritual care must be provided when a person has a spiritual need exists or experience spiritual distress.

Integrating Faith within a Baccalaureate Nursing Program: Preparing Community Nurses Through Service Learning by Dawn Frambles, PhD, RN

Purpose: This presentation provides a practical overview of strategies to integrate faith in the community practicum of a baccalaureate nursing program using a service learning model in conjunction with community based participatory research (CBPR). Background: Integrating faith into academic preparation of baccalaureate nursing students presents challenges in the practicum setting related to objectives addressing application and evaluation of student achievement of related course objectives.

Objectives: Upon completion of this presentation, participants will: 1. Describe the components of a faith-integrated community nursing curriculum within a baccalaureate program. 2. Examine differences between including faith in community nursing clinical practicums and practicing faith during community nursing clinical practicums. 3. Identify the role of the community nursing clinical instructor in facilitating faith-integrated clinical practicum student experiences.

Methods: Practical information and examples will be provided from the experience of a program that experientially prepares pre-licensure students to practice professional nursing through a Christian worldview. Areas of focus will include faculty preparation, development and maintenance of community partnerships, incorporating CBPR, and establishing course objectives with associated formative and summative evaluation. Implications for education: Educating students within a community nursing practicum course that integrates the Christian worldview and the combined strengths of community based participatory research and service learning supports not only student achievement, but also serves the members of the community. Students complete the program equipped to enter nursing practice that is founded on a Christian worldview.

Faith Community Nurses' Documentation Reveals Most Commonly Delivered and Attended Services by Lina Hixson, PhD, RN

Many older adults live with multiple co-morbidities that may not require inpatient or home care services. Therefore, other strategies to maintain health are needed. The purpose of this study was to describe ways in which Faith Community Nurses (FCNs) contribute to the health and well-being of older adults through health promotion and disease prevention. The conceptual framework used to guide the study was the multidimensional model of successful aging by Young, Frick, and Phelan (2009). This model captures the ability of older adults to adapt to physical limitations if psychological and/or social mechanisms are used. A secondary analysis of intervention data from a FCN web-based documentation system was conducted. Descriptive statistics were used to analyze the distribution of interventions across age groups, 0-65 years and 66 years and older. Data from the older age group was mapped to the theoretical model to reveal how FCNs contribute to the health and well-being of older adults. Across all age groups, FCNs are promoting health through education and support group activities. For the 66 years and older age group, there appears to be no specific education or support group. The unique specialty of FCNs becomes more evident in individual interventions where contacts with older adults more than double compared to the 0-65 age group. Greater than 60% of the care recipient clients in this study were age 66 and older. More effort could be put forth in promoting physical and mental health for this age group as well as providing social interaction exposure.

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InterVarsity Christian Fellowship