BACKGROUNDIn early 2020, 19.9% of the population of Galveston, Texas, was living below the poverty level, and 24.7% (est. 12 470) was deemed to be uninsured or underinsured. 1 As of December 2020, the city faced an unemployment rate (8.3%) more than twice its annual average. Now, because of the COVID-19 pandemic, more than 22% of Galveston's population lives below the poverty level, with almost 16 000 residents under-or uninsured. 1 Many residents are considered at high risk for poor health outcomes due, in part, to experiencing chronic diseases (ie, diabetes, heart failure, and hypertension). In addition, these patients are unlikely to seek nonemergent medical treatment due to a lack of health care insurance or self-pay resources. Thus, many of them seek their health care at a local community-based nurse-managed clinic supported by a large academic health system. The clinic's advanced practice registered nurses (APRNs) treat more than 3000 patients yearly but are seeing an increase in patient volume due to the socioeconomic effects of the COVID-19 pandemic. Historical data show that approximately 30% of patients fail to keep scheduled follow-up appointments with the APRNs. As more than 17% of these patients are experiencing at least one of the chronic medical conditions listed above, routine follow-up care is
Patient safety has been at the forefront of nursing research since the release of the Institute of Medicine's report estimating the number of preventable adverse events in hospital settings; yet no research to date has incorporated the perspectives of bedside nurses using classical grounded theory (CGT) methodology. This CGT study explored the perceptions of bedside registered nurses regarding patient safety in adult acute care hospitals. Data analysis used three techniques unique to CGT-the constant comparative method, coding, and memoing-to explore the values, realities, and beliefs of bedside nurses about patient safety. The analysis resulted in a substantive theory, Exerting Capacity, which explained how bedside nurses balance the demands of keeping their patients safe. Exerting Capacity has implications for health care organization leaders, nursing leaders, and bedside nurses; it also has indications for future research into the concept of patient safety.
Background: The COVID-19 pandemic challenged all healthcare professionals to re-think how patient care is provided. Faculty in nursing schools faced similar challenges in offering adequate clinical hours to nursing students, because of the limited availability of clinical placements. Methods: A faculty in one school of nursing introduced virtual simulation resources to supplement in-person clinical hours. The faculty developed a revised clinical curriculum for students that included weekly objectives and deliverables for virtual simulations. The Simulation Effectiveness Tool-Modified (SET-M) was utilized to evaluate the effectiveness of the virtual simulations. Results: 130 students (88.4%) completed the post-implementation survey. After using the virtual simulations, 50% of the students reported feeling confident in providing interventions that foster patient safety. Furthermore, students reported a sound understanding of disease pathophysiology (60%) and medications (53.8%). The qualitative data indicated that students found the virtual simulations beneficial and a safe learning environment. Conclusion: Pre-pandemic virtual simulations were not used by this school of nursing to replace the traditional in-person clinical experiences. However, the pandemic demonstrated that the utilization of innovative virtual simulations are effective methods for student learning to augment traditional clinical experiences.
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