The 2019 Novel Coronavirus (COVID-19) pandemic has necessitated the implementation of various infectious disease control measures, including the closure of non-essential businesses, social distancing, and the virtualization of schools and universities. As final year nursing students at the University of Washington (UW) adjust to virtual learning and social distancing, certain students working in healthcare may also face the threat of contracting the virus. Little is known about the psychological implications of the COVID-19 pandemic on this population, and there is a need to fill this knowledge gap. This study first aims to capture the perceived stress levels of final year nursing students at the UW amid the COVID-19 pandemic. It secondly aims to explore associations between perceived stress and factors such as COVID-19 testing history, living situation, and healthcare work history. We administered an online survey to final year UW nursing students that inquires about their COVID-19 testing history, living situation, and healthcare work history since March 1, 2020. The survey also includes the 10-item Perceived Stress Scale, which questions students’ feelings and thoughts over the past month. We will analyze the data for associations between scores on the Perceived Stress Scale and students’ testing history, living situation, and work history. Overall, we expect to find moderate to high perceived stress levels among nursing students. We also anticipate that several factors may be associated with higher stress levels among nursing students, including having a history of COVID-19 testing, living with more individuals, and working more hours in healthcare positions. The results of this study may indicate a need for increased psychosocial support in final year nursing students at the UW, as they complete the nursing program and join the nursing workforce to help combat the COVID-19 pandemic.

Fall prevention in hospitals and long-term care facilities in the community setting depends on staff being trained in best practices. However, little is known about the cost, availability, and accuracy of online trainings on fall prevention for nursing staff. The type of education given can be outdated, incorrect or unnecessary depending on what organization that the nursing staff belongs to. The purpose of this research is to identify and evaluate existing online fall prevention training programs and provide the findings to the Washington State Department of Health (DOH) for them to present options to provider organizations as part of the State’s Fall Prevention Strategic Plan. Materials evaluated were previously used for staff education in hospitals and long-term facilities. The criteria for evaluating the websites and educational learning resources (ELRs) were: authority, objectivity, authenticity, reliability, timeliness, relevance and efficiency. Cost was also considered in the evaluation as a factor. Following the evaluation, ELRs were classified by two independent reviewers as either highly recommended, recommended, partially recommended or not recommended for use. From our initial findings, we identified two ELRs that are highly recommended for use, two that were recommended, and three that were partially recommended out of 24 ELRs. After finalizing our results, we will randomly select modules to be evaluated by a group of University of Washington Nursing students for verification of our assessment in reliability and validity of the ratings. We will disseminate findings and recommendations to WA DOH Older Adult Fall Prevention Program and clinical partners through a webinar. This should improve training provided to health providers of care to older adults in hospitals and long-term care facilities. This evaluation method can also be applied to other ELRs to improve the quality of these offerings and assist providers in choosing the best available programs.

The opioid epidemic in the United States has dramatically increased the prevalence of opioid use disorder (OUD) in pregnant women and the number of newborns at risk for neonatal opioid withdrawal syndrome. Pregnant and parenting women with OUD encounter many challenges in receiving healthcare, including stigmatization by healthcare professionals. Nurses’ stigmatizing attitudes can interfere with maternal engagement in newborn care and impede the development of the mother-infant relationship. Limited research has examined the experiences of nurses caring for childbearing families affected by OUD, and the role of stigma in nursing care for this population is largely unknown. The purpose of this study was to explore the relationships between training, compassion, stigma towards women with OUD, and personal experience with substance use. Data were collected via anonymous surveys of perinatal nurses in an urban hospital in the Pacific Northwest. Measures included stigma (Opening Minds Stigma Scale for Health Care Providers), compassion satisfaction (Professional Quality of Life Scale), and investigator-developed items to measure training and knowledge in substance use disorder. Pearson’s correlation coefficient was used to assess the relationship among variables. Comfort caring for mothers with OUD was positively correlated with compassion scores (r = .513, p < 0.001) and negatively correlated with stigma scores (r = -.338, p = 0.002). Stigma and compassion were not significantly correlated with nurses' personal experience with substance use, nor with increased training on caring for women within this population. While the origins of stigma by nursing professionals are still not well understood, these findings support the negative relationship between stigma and compassion. Reducing stigma towards women with OUD may be important to increase the quality of nursing care and improve maternal-newborn relationship development.

In inpatient hospital settings, daily interprofessional rounds are when multiple health care professionals come together as an interprofessional team to create a care plan with patients and their families. Despite the promise of coordinated care during interprofessional rounds, poor care coordination and communication is a major contributor to medical errors, which are the third leading cause of death in the United States. A key literature gap is how to implement sustainable observation and feedback processes for interprofessional rounds. To address this challenge, my research focuses on developing and testing an effective process to evaluate communication during interprofessional rounds. I hypothesized that if pre-health undergraduate students can shadow interprofessional rounds with a structured observation tool, there will be benefits for pre-health students, interprofessional teams, and patients and their families. Specifically, pre-health students participate in an active and engaging shadowing experience while providing interprofessional teams with relevant feedback about interprofessional rounds that can be used to improve interprofessional communication. To test my hypothesis, I used a Plan-Do-Study-Act cycle methodology commonly practiced in quality improvement research. The first cycle tested if a single pre-health undergraduate student could train for and use a structured observation tool, leading to a second cycle which expanded that same process to a cohort of pre-health students. The observation data was analyzed into two categories: 1) quantitative tool topics (with inter-rater reliability data) and 2) qualitative comments. When comparing the quantitative versus qualitative data, the main conclusion was that pre-health students offer insightful and relevant qualitative comment feedback that allow interprofessional teams to reflect on ways to improve their communication during interprofessional rounds. This suggests additional cycles are necessary to test a tool that focuses more on qualitative data. The expansion of my research is key to improve interprofessional rounds in order to continually improve the patient care experience.

Asthma is one of the most common chronic pediatric illnesses, affecting nearly 10% of school-aged children in the United States and disproportionally impacting low-income populations and people of color. More than 50% of childhood asthma cases in the United States are uncontrolled, characterized by frequent, severe symptoms that contribute to missed school days, sleep disturbance, and hospitalization. Outcomes can be improved by rigorous daily management. However, due to both individual and system level factors, adherence to treatment regimens is low. Several studies have suggested a relationship between family functioning and asthma morbidity, making it a promising target to improve asthma outcomes. The purpose of this study was to further elucidate the relationship between family functioning and asthma control in school-aged children. This study involved a cross-sectional, secondary analysis of baseline data collected as part of a larger intervention trial. Thirty-three children aged 6-11 years old and their caregiver completed the Childhood Asthma Control Test. Caregivers completed the Family Assessment Device to assess family functioning. Analyses compared family functioning in children with controlled versus uncontrolled asthma. Fifty-one percent of participants had asthma that was uncontrolled. Asthma control was positively correlated with family functioning, r(32)=.41, p=.02, such that those with better asthma control had better family functioning. However, there was no significant difference in family functioning between children with controlled versus uncontrolled asthma, nor was asthma control predictive of family functioning. Although there appears to be an association between asthma control and family functioning, the nature of that relationship is still unclear. It is possible that our sample size was too small to detect a predictive relationship. Future studies could continue to explore this relationship with a larger sample size and consider additional potentially modifiable variables that may predict asthma control.

Public health nurses and leaders who work for small, rural health departments (LHDs) face unique challenges that prevent the effective use of data to understand and address health equities. Among these is limited access to high-quality training in data utilization. In response, Solutions in Health Analytics for Rural Equity across the Northwest (SHARE-NW) is developing an online learning hub that contains accessible training modules for LHD leaders and practitioners to use and interpret data easier. The purpose of this study is to determine gaps in the quality of the trainings available to rural LHD practitioners in six top health priority areas: obesity, diabetes, tobacco, mental/behavioral health, violence and injury, and oral health, in order to improve population-level health equity. To date, approximately 30 training modules have been evaluated using 25 items from the Quality Standards for Training Design and Delivery tool by the Public Health Learning Network, and approximately 50 webinars have been evaluated using a set of 6 criteria. Next we will identify the patterns of gaps across the evaluation criteria and top health priority areas. Once patterns are identified, we will conduct semi-structured interviews with public health practitioners to assist in the interpretation of identified patterns. Preliminary findings suggest a lack of training activities that assist LHD leaders and practitioners to learn about data utilization in several to health priority areas. By identifying the patterns of gaps in available trainings, we aim to help busy, low-resourced rural LHDs utilize the highest quality trainings to improve their ability to interpret data and address health disparities.