Inpatient Practice Settings Research Articles

Characterizing the role and associated stakeholder perceptions of a novel pharmacy experiential education facilitator role within the inpatient practice setting

IntroductionTo address practicum challenges commonly reported in inpatient pharmacy practice settings, a novel experiential education facilitator (EEF) role was created and implemented to provide on-the-ground support for students and practice educators (PEs). This article characterizes the daily activities of the EEF and associated perceptions of their role by students and PEs. MethodsIn this prospective, descriptive study, EEFs, students, and PEs involved with inpatient advanced pharmacy practice experiences (APPEs) participated. Day-to-day activities were captured by EEFs through completion of logs, and student and PE perceptions of the EEF role were collected through surveys. ResultsSeven EEFs, 14 students, and 20 PEs participated. During the practicum, EEFs frequently organized student activities, provided education to PEs, assisted with student evaluations, and provided logistical support. Orienting students to the site and providing teaching sessions took the greatest amount of time. These activities were perceived to be beneficial by students and PEs, and 12 of 14 (86%) students stated that they felt more confident in their clinical skills after working with their EEF. The majority of students and PEs did not experience challenges with the EEF role. The main challenge identified by both groups was inaccessibility to the EEF due to illness, vacation, or competing clinical responsibilities. ConclusionsEEFs within inpatient practice settings are valued for their involvement in providing on-site support for students and PEs. Orientating students to the site, facilitating teaching sessions, and supporting student evaluation were perceived as beneficial and addressed some of the key needs identified by inpatient stakeholders.

Measuring moral distress in nurses during a pandemic: Development and validation of the COVID-MDS.

The COVID‐19 pandemic created novel patient care circumstances that may have increased nurses' moral distress, including COVID‐19 transmission risk and end‐of‐life care without family present. Well‐established moral distress instruments do not capture these novel aspects of pandemic nursing care. The purpose of this study was to develop and evaluate the psychometric properties of the COVID‐19 Moral Distress Scale (COVID‐MDS), which was designed to provide a short MDS that includes both general and COVID‐19‐specific content. Researcher‐developed COVID‐19 items were evaluated for content validity by six nurse ethicist experts. This study comprised a pilot phase and a validation phase. The pilot sample comprised 329 respondents from inpatient practice settings and the emergency department in two academic medical centers. Exploratory factor analysis (EFA) was conducted with the pilot data. The EFA results were tested in a confirmatory factor analysis (CFA) using the validation data. The validation sample comprised 5042 nurses in 107 hospitals throughout the United States. Construct validity was evaluated through CFA and known groups comparisons. Reliability was assessed by the omega coefficient from the CFA and Cronbach's alpha. A two‐factor CFA model had good model fit and strong loadings, providing evidence of a COVID‐19‐specific dimension of moral distress. Reliability for both the general and COVID‐19‐specific moral distress subscales was satisfactory. Known groups comparisons identified statistically significant correlations as theorized. The COVID‐MDS is a valid and reliable short tool for measuring moral distress in nurses including both broad systemic sources and COVID‐19 specific sources.

Surface microbiology of the iPad tablet computer and the potential to serve as a fomite in both inpatient practice settings as well as outside of the hospital environment.

BackgroundThe use of tablet computers and other touch screen technology within the healthcare system has rapidly expanded. It has been reported that these devices can harbor pathogens in hospitals; however, much less is known about what pathogens they can harbor when used outside the hospital environment compared to hospital practice.MethodsThirty iPads belonging to faculty with a variety of practice settings were sampled to determine the presence and quantity of clinically-relevant organisms. Flocked nylon swabs and neutralizer solution were used to sample the surface of each iPad. Samples were then plated on a variety of selective agars for presence and quantity of selected pathogens. In addition, faculty members were surveyed to classify the physical location of their practice settings and usage patterns. Continuous variables were compared via an unpaired Student's t test with two-tailed distribution; categorical variables were compared with the Fisher's exact test.ResultsOf the iPads sampled, 16 belonged to faculty practicing within a hospital and 14 belonged to a faculty member practicing outside a hospital. More faculty within the hospital group used their iPads at their practice sites (78.6% vs. 31.3%; p = 0.014) and within patient care areas (71.4% vs. 18.8%; p = 0.009) than the non-hospital group. There were no differences in the presence, absence, or quantity of, any of the pathogens selectively isolated between groups. Problematic nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and P. aeruginosa were isolated from both hospital and non-hospital faculty iPads.ConclusionsGram positive and Gram negative organisms were recovered from the surfaces of iPads regardless of practice setting; these included problematic multidrug-resistant pathogens like MRSA, VRE, and Pseudomonas aeruginosa. Healthcare personnel in all settings should be aware of the potential for tablet computers to serve as a nidus for microorganism transmission.