Frontline Staff Research Articles

Employee recognition giving in crisis: a study of healthcare workers during the COVID-19 pandemic

PurposeEmployee recognition systems are ubiquitous in organizations (WorldatWork, 2019) and have positive effects on work outcomes (e.g. Stajkovic and Luthans, 2001). However, psychologically meaningful recognition relies on the recognition giver being motivated to observe and recognize coworkers. Crises such as the COVID-19 pandemic may impact recognition giving in varying ways, yet little research considers this possibility.Design/methodology/approachThis longitudinal field study examined the impact of the COVID-19 crisis on recognition and acknowledgment giving among frontline and nonfrontline healthcare workers at daily and aggregated levels. We tested the relationships between publicly available daily indicators of COVID-19 and objectively measured daily recognition and acknowledgment giving within a web-based platform.FindingsWe found that the amount of daily recognition giving was no different during the crisis compared to the year before, but fewer employees gave recognition, and significantly more recognition was given on days when COVID-19 indicators were relatively high. In contrast, the amount of acknowledgment giving was significantly lower in frontline staff and significantly higher in nonfrontline staff during the pandemic than before, but on a daily-level, acknowledgment was unrelated to COVID-19 indicators.Practical implicationsOur results suggest that organizational crises may at once inhibit and stimulate employee recognition and acknowledgment.Originality/valueOur research is the first to empirically demonstrate that situational factors associated with a crisis can impact recognition giving behavior, and they do so in ways consistent with ostensibly contradictory theories.

Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review.

Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.

Lessons Learned from a National Hospital Antibiotic Stewardship Implementation Project

BackgroundThe goal of antibiotic stewardship programs (ASPs) is to ensure patients receive effective therapy while minimizing adverse events. To overcome barriers commonly faced in implementing successful ASPs, AHRQ established a multifaceted, nationwide Safety Program for Improving Antibiotic Use in 2018. This report summarizes the lessons learned from the implementation of this initiative based on structured interviews with ASP leaders. MethodsAt the completion of the one-year initiative, semi-structured exit interviews were conducted with site leaders at 151 of the 402 hospitals that participated. These interviews consisted of open-ended questions about the perceived effectiveness of components of the Safety Program. Qualitative analyses incorporated both deductive coding themes (based on existing literature) and an iteratively developed inductive coding framework (based on salient themes that emerged from a subset of interviews). ResultsSeveral components of the Safety Program were identified as effective in expanding local stewardship activities, including techniques and strategies to implement sustainable ASPs, access to Implementation Advisors to keep sites engaged, provision of local benchmarked antibiotic use data to compare to similar hospitals, and Safety Program materials such as the antibiotic time-out tool to integrate stewardship techniques into daily work flows. The biggest challenges to greater effectiveness were suboptimal frontline staff engagement and difficulty changing antibiotic prescribing culture. Some approaches used to overcome these barriers (i.e., peer-to-peer communication and education through team huddles, identifying physician champions, informal rounds to enhance collegiality and buy-in, and engagement of hospital leadership) were also identified. ConclusionsLessons learned from the Safety Program can be applied by other teams looking to promote an effective ASP at their hospital or system. The themes that emerged in this study likely also have relevance across a wide range of large-scale quality improvement initiatives.

Promoting Nursing Home Success: A Business Model Supporting Frontline Staff Retention and Resident Outcomes

Promoting Nursing Home Success: A Business Model Supporting Frontline Staff Retention and Resident Outcomes

Youth Unemployment in Kenya

Young people have been greatly affected by unemployment which has led them to criminal activities as they try to earn a living. This research article seeks to explore the status of youth unemployment in Kenya, with reference to Kondele sub-county, Kisumu County of Kenya. The descriptive survey research design was employed in this treatise to determine the influence of World Vision International organization labor practices on youth unemployment in the aforementioned area, as well as the country at large. The study population comprised of the middle level employees working at World Vision International in Kisumu County. The population also comprised of the youth in Kondele Sub-county, Kisumu County. The selection of middle-level employees at World Vision International in Kisumu County as the population for the study is justified by their pivotal role in organizational operations. Middle-level employees form a crucial link between top-level management and front-line staff, often overseeing critical functions and decision-making processes. In the context of this research article, the focus was on the 77 mid-tier employees of World Vision International located in Kisumu County. Based on the research findings, it was recommended that World Vision International should identify emerging industries in the region and design skills training programs that equip youth with the specific competencies and knowledge required for these sectors. This will enhance their employability in growing fields and promote economic diversification.

Unwitting Accomplices: Equal Treatment and the Perpetuation of Racialized Information Inequality in School Choice

Abstract In public education, racially segregated schools are now often understood as a natural result of a messy mix of failed policies and parent decisions. However, parent decisions and school choice are both constrained by districts. In the case of Boston Public Schools (BPS), the staff hired to support “well-informed choices” do not provide information to families—including those who need it most—even when it could mitigate known inequities. Using data from semi-structured interviews with 37 staff, participant observation in registration sites, a supplemental survey of 1,887 registering families, and district administrative data on all registering families, I find that BPS constrains the actions of frontline staff, making them unwitting proponents of the fallacy of choice. The equal treatment of families who come with unequal access to the registration and choice systems protects racial privilege in relation to schools and harms both families of color and the staff of color who work with them. This racism of omission enacted within the choice apparatus causes staff and families to focus on the selection process rather than the limited and racialized access to the public good of schools.

Legal Needs Arising in Mental Health Settings and Staff Capability and Support to Respond.

Legal issues are known to affect and be affected by mental health. But to what extent do legal issues surface in mental health settings and what do staff feel they need to support clients experiencing these issues? These questions were explored by a national mental health service interested in the potential for health justice partnership with local community based legal services. A survey of 999 frontline staff of a national mental health organisation. 146 staff (15%) responded from 70 service sites across Australia, including peer support workers (47%), support workers (20%), team leaders (17%) and clinicians (15%). Staff identified a wide range of legal issues experienced by their clients (commonly referred to by staff as consumers), most commonly credit, debt and social security issues, housing, family law and family violence. Two-thirds (67%) of respondents indicated that they spent around 50% or more of their time 'responding to these types of issues'. Respondents indicated that they need more support to address legal issues facing their clients, particularly more knowledge of other services, connections with professionals in other organisations and connections with community. They also felt they could benefit from additional processes, tools, and resources, and time to manage their case load. While there is an emerging field of research exploring the legal capability of citizens, this study explores what mental health service staff feel they need to support consumers experiencing legal issues that can interact with mental health.

Scaling up effective juvenile delinquency programs by focusing on change levers: Evidence from a large meta‐analysis

AbstractResearch summaryThe primary outcome desired for juvenile delinquency programs is the cessation of delinquent and related problematic behaviors. However, this outcome is almost always pursued by attempting to change intermediate outcomes, such as family functioning, improved mental health, or peer relations. We can conceptualize intermediate outcomes that are related to reduced delinquency as change levers for effective intervention. A large meta‐analysis identified several school‐related change levers, including school engagement (i.e., improved attendance and reduced truancy), nondelinquent problem behaviors, and attitudes about school and teachers. In addition, family functioning and reducing substance use were also effective change levers. In contrast, effects on youth getting/keeping a job, peer relationships, and academic achievement were not associated with reduced delinquency.Policy implicationsOnly a small percentage of rehabilitative programs provided to youth involved in the juvenile justice system have been established as evidence based. Moreover, there are constraints on what local policy makers and practitioners can do regarding the selection, adoption, and implementation of programs from the available lists of evidence‐based programs. Adopting programs that focus on effective change levers and avoiding those that concentrate on ineffective ones has the potential to increase the likelihood that a local agency is engaged in effective programming. Based on our data, programs known to improve family functioning, attachment to and involvement in schooling, and reducing substance use are justified by the change lever evidence, even if these programs’ effectiveness in reducing delinquency has not been directly proven. In contrast, programs focusing on vocational skills, academic achievement, and peer relations are less likely to be beneficial. Furthermore, a change lever perspective can help frontline staff select appropriate programs for different juvenile offenders and focus their quality control efforts on those aspects of a program that are likely to be essential to maintaining effectiveness.

An implementation strategy postmortem method developed in the VA rural Transitions Nurse Program to inform spread and scale-up.

High-quality implementation evaluations report on intervention fidelity and adaptations made, but a practical process for evaluating implementation strategies is needed. A retrospective method for evaluating implementation strategies is also required as prospective methods can be resource intensive. This study aimed to establish an implementation strategy postmortem method to identify the implementation strategies used, when, and their perceived importance. We used the rural Transitions Nurse Program (TNP) as a case study, a national care coordination intervention implemented at 11 hospitals over three years. The postmortem used a retrospective, mixed method, phased approach. Implementation team and front-line staff characterized the implementation strategies used, their timing, frequency, ease of use, and their importance to implementation success. The Expert Recommendations for Implementing Change (ERIC) compilation, the Quality Enhancement Research Initiative phases, and Proctor and colleagues' guidance were used to operationalize the strategies. Survey data were analyzed descriptively, and qualitative data were analyzed using matrix content analysis. The postmortem method identified 45 of 73 ERIC strategies introduced, including 41 during pre-implementation, 37 during implementation, and 27 during sustainment. External facilitation, centralized technical assistance, and clinical supervision were ranked as the most important and frequently used strategies. Implementation strategies were more intensively applied in the beginning of the study and tapered over time. The postmortem method identified that more strategies were used in TNP than planned and identified the most important strategies from the perspective of the implementation team and front-line staff. The findings can inform other implementation studies as well as dissemination of the TNP intervention.

Building a communication and support network among quality improvement teams in nursing homes: a longitudinal study of the SCOPE trial

BackgroundWe applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams.MethodsFourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a 1-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, 1 month after the first, and 6 months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at 2 months, and at 9 months.ResultsOver time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties.ConclusionsOur findings suggest the importance of network-altering activities to the formation of collaboration networks among QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements.

Perceived Stress Among Nurses at a Tertiary Care Teaching Hospital in Saudi Arabia During the COVID-19 Pandemic.

The stress level of nurses, especially frontline staff, directly impacts their physical and mental health as well as work efficiency. However, few studies have been conductedto understand the stress level of nurses related to the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to assess the level of perceived stress among nurses at a tertiary care teaching hospital (King Abdulaziz University Hospital, Jeddah) in Saudi Arabia during the COVID-19 pandemic. A cross-sectional survey-based descriptive study involved 1044 nurses working at a tertiary care/teaching hospital in Saudi Arabia. The Perceived Stress Scale (PSS) was used to assess nurses' stress levels. The study was conducted in July 2021 by selecting clinical nurses from different nursing units. Considering the current situation of social isolation, an online cross-sectional survey using Google Forms was used. Data analysis was performed using IBMSPSSStatistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Out of 1044 nursing professionals, 93 (8.9%) reported experiencing low levels of stress, 915 (87.6%) reported moderate levels of stress, and 36 (3.4%) reported high perceived stress during the COVID-19 pandemic. The study found that gender (p=0.001) and nationality (p=0.016) had significant effects on stress levels. The three major causes of stress identified by the nurses were workload, lack of resources, and fear of contracting COVID-19. Job-related stress continues to be an issue in the nursing workforce. The effects of stress experienced by nurses impact job satisfaction and retention, which, in turn, can affect the quality of patient care. This study highlights that nurses in a tertiary care (COVID care) teaching hospital in our setting often experience stress and anxiety during the pandemic. It is worth noting that this is the first study conducted to understand the level of stress perceived by nursing staff during the COVID-19 pandemic in our current study setting. The findings indicate that a considerable number of nurses experienced moderate levels of stress during COVID-19, which can have implications for patient care. Recognizing and understanding the job-related stressors of nurses can help nurse leaders implement more effective strategies aimed at reducing nurses' stress and subsequently improving patient outcomes.

Models of care insight study showcases need for better change management and a renewed focus on staffing and retention

It is incredibly tough working in healthcare these days. People are feeling overworked, stressed out, burned out and, at times, traumatised. These challenges are driving huge employee turnover rates in many organisations. Alarmed by this unfolding crisis, many organisations are working hard to create better experiences for caregivers and patients alike. They seek to answer the question How do you create a healthcare system that’s sustainable for both the human element and the financial side? This paper overviews the Models of Care Insight Study, which was conducted with nurses and nurse leaders in response to these issues to identify new models of care, identify disconnects inside organisations, and ultimately use the ideas and data to improve working conditions for all in healthcare. It presents some of the important findings of the study, zeroing in on the widespread resistance to change, the differences between the perceptions of leadership and front-line staff, and the need for more emphasis on and clarity around development opportunities. Finally, the paper delves into some solutions. It provides some best practices for helping organisations overcome resistance to needed change and moving people through the defiance, compliance, reliance cycle. And it tackles the turnover issue head on, sharing tactics for improving staff retention by creating a sense of belonging from the very beginning of the interview process.

Workplace trauma and professional quality of Life in clinical and forensic psychiatry: the CRITIC study.

Frontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL). The Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling. The CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals. The CRITIC study has been approved by the Medical Ethical Committee of the Erasmus Medical Centre, under trial registration number NL73417.078.20.

‘All about the NHS and what about the rest of us?’: Exploring how low‐paid health and social care workers construct key stakeholders and account for the UK's response to the COVID‐19 pandemic

AbstractGood practice on disaster response emphasises the importance of leadership and cohesive group identities. The COVID‐19 pandemic provided an opportunity to explore how low‐paid health and social care workers (HSCWs) accounted for the UK government's response, given worker's limited resources and disproportionate impact on their lives. Thirteen semi‐structured interviews took place with low‐paid HSCWs in England. Interviews were analysed using critical reflexive thematic analysis that is influenced by discursive psychology and membership categorisation analysis to explore the construction of identities and how they are used to account for the pandemic response. Three themes were generated from the data: (1) ‘They kind of knew what was coming’: UK government slow to react to pandemic developments; (2) ‘the right thing kept changing every five minutes: Frustrations with changing guidelines and (3) ‘all about the NHS and what about the rest of us?’: Private sector HSCWs presented as inferior. This research highlights the importance of addressing the minimisation of low‐paid HSCWs through communications and access to material resources. There is a need to address economic disparities within the social care sector and for the UK government to plan future crisis management with all frontline staff at the forefront to form a collective identity.

Improving safety and preventing falls using an evidence-based, front-line staff huddling practice: protocol for a pragmatic trial to increase quality of care in State Veterans Homes

IntroductionFalls in nursing homes are a major cause for decreases in residents’ quality of life and overall health. This study aims to reduce resident falls by implementing the LOCK Falls...

The value of implementing a nursing and midwifery clinical accreditation programme at two NHS trusts.

Unit/ward accreditation programmes have been widely implemented by nursing and midwifery teams across healthcare providers in the UK over the recent years and have many associated benefits. These include promoting quality improvement on a wider scale across the organisation, strengthening oversight and accountability of quality and safety from ward to board and vice versa, promoting shared learning, and providing opportunities for sharing and celebrating excellence. The Royal Wolverhampton NHS Trust and Walsall Healthcare NHS Trust have recognised the value of this approach, launching a clinical accreditation programme in April 2023. This initially focused on nursing and midwifery, with plans to widen the approach to other disciplines and specialist teams. Up to the time of writing, 56 visits had been undertaken with 30 clinical areas accredited. The remaining visited areas are awaiting their accreditation outcome. The approach has positively contributed to improvements in patient outcomes, such as more patient observations being completed on time, a reduction in patient falls and improvements in pressure ulcers. Colleagues participating in the programme and frontline staff working in the clinical areas assessed have reported how positive the approach has been, providing opportunities for shared learning and celebrating excellence.

Waiting as sociality – relational waithood in Norwegian activation

ABSTRACT In research on waiting and unemployment, waiting tends to be described as an asymmetrical power relation between those who wait and those who impose waiting within institutional contexts. This paper applies the concepts ‘waiting for’ and ‘waiting on’ to unravel waiting as a specific form of sociality and presence in an employment support context in Norway. Drawing on qualitative interviews with frontline staff and young participants in in-house activity centres, we find that waiting takes different forms; the counsellors not only wait for the participants to comply with the activity requirements, they also wait on them, to interact. Similarly, the young participants wait for ‘something to happen’, like a job opportunity, but they also wait on staff in the centres. Hence, both actors experience waiting in relation to rules, employment etc., but also as subjects with agency. We argue that activation can involve waiting as a form of sociality and presence, a dimension that receives scant attention in the literature on waiting and power.

Specifying cross-system collaboration strategies for implementation: a multi-site qualitative study with child welfare and behavioral health organizations

BackgroundCross-system interventions that integrate health, behavioral health, and social services can improve client outcomes and expand community impact. Successful implementation of these interventions depends on the extent to which service partners can align frontline services and organizational operations. However, collaboration strategies linking multiple implementation contexts have received limited empirical attention. This study identifies, describes, and specifies multi-level collaboration strategies used during the implementation of Ohio Sobriety Treatment and Reducing Trauma (Ohio START), a cross-system intervention that integrates services across two systems (child welfare and evidence-based behavioral health services) for families that are affected by co-occurring child maltreatment and parental substance use disorders.MethodsIn phase 1, we used a multi-site qualitative design with 17 counties that implemented Ohio START. Qualitative data were gathered from 104 staff from child welfare agencies, behavioral health treatment organizations, and regional behavioral health boards involved in implementation via 48 small group interviews about collaborative approaches to implementation. To examine cross-system collaboration strategies, qualitative data were analyzed using an iterative template approach and content analysis. In phase 2, a 16-member expert panel met to validate and specify the cross-system collaboration strategies identified in the interviews. The panel was comprised of key child welfare and behavioral health partners and scholars.ResultsIn phase 1, we identified seven cross-system collaboration strategies used for implementation. Three strategies were used to staff the program: (1) contract for expertise, (2) provide joint supervision, and (3) co-locate staff. Two strategies were used to promote service access: (4) referral protocols and (5) expedited access agreements. Two strategies were used to align case plans: (6) shared decision-making meetings, and (7) sharing data. In phase 2, expert panelists specified operational details of the cross-system collaboration strategies, and explained the processes by which strategies were perceived to improve implementation and service system outcomes.ConclusionsWe identified a range of cross-system collaboration strategies that show promise for improving staffing, service access, and case planning. Leaders, supervisors, and frontline staff used these strategies during all phases of implementation. These findings lay the foundation for future experimental and quasi-experimental studies that test the effectiveness of cross-system collaboration strategies.

Variations in services and intervention pathways for traumatic stress in Welsh prisons: A national survey.

Both Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder are prevalent in prison settings. Both often go undetected and untreated, while prisoners who already suffered previous trauma may be re-traumatised upon imprisonment. The current study aimed to conduct a national survey of all Welsh prisons to gather information about existing services and treatments for traumatic stress. The survey identified variation within Welsh prisons with regard to NICE-recommended evidence-based therapies. It is therefore recommended that there needs to be development of a pathway of Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder in the prison system which should be achieved through a consensus process of both frontline staff and experts in the field.

Abstract 35: Integrating Clinical Trials Into Comprehensive Stroke Education for Inpatient Nurses

Introduction: A major challenge in the implementation of clinical trials is the lack of integration of research into the clinical practice of frontline staff. The University of Minnesota partnered with the M Health Fairview (MHFV) System to incorporate stroke clinical trials into the annual comprehensive stroke education courses. While not required by the stroke accreditation curriculum standards, embedding research topics into ongoing stroke education is a novel practice that broadly increases awareness of clinical research with the frontline staff caring for stroke patients. Methods: In 2019, the comprehensive stroke class was updated to include a section for stroke trials. The research topics include: a brief description of study team roles, an overview of the impact of clinical trials on EBP, results for published trials, updates on current clinical trials, and the impact on nursing workflow. The number of attendees for each session from 2019-June 2023 were recorded along with anonymous comments about the presentation. The total number of subjects enrolled in acute, inpatient, and outpatient stroke trials in MHFV were compiled. Results: The comprehensive stroke class was attended by MHFV nurses 1,667 times. Interest in research was noted 77 times in the comments and research was ranked 3rd “most interesting” topic presented in 2019. A total of 276 patients were enrolled in stroke research in that timeframe. Conclusion: While no direct correlation can be drawn to trial enrollment, the volume of learners demonstrates broad dissemination of stroke trials information to frontline staff caring for stroke patients and the collection of positive feedback shows an interest in the topic. Incorporating clinical trials education into established comprehensive stroke education increases awareness of clinical trials and facilitates integration of research into clinical workflows with a higher acceptance of clinical trial efforts by frontline staff.