Notes

Repayment mechanism regarding institutional births in Nepal.
[J Contin Educ Nurs. 2020;51(12)574-580.].
The CRISP method is an effective, simple, and easy method for accurate ECG interpretation by nurses. The posttest scores of the participants, especially accurate interpretation of fatal arrhythmias, increased significantly after training. [J Contin Educ Nurs. 2020;51(12)574-580.].
To meet the health care challenges and increasing population health demands of today and the future, the Missouri Center for Nursing developed the Culture of Health Initiative Project (CHIP).

Phase one surveys examined 33 nurse leaders' responses to the population health knowledge and training needs of nurses in their organizations. In phase two, 71 nurse leaders' and practicing nurses' responses from the Population Health Nursing Skills Survey provided insight into the education needs of Missouri nurses.

Findings identified a lack of available education and resources related to nursing, limited knowledge of concepts among nursing leaders, and a need for flexibility in the format and content to educate nurses in all types of nursing practice.

Professional development practitioners must collaborate with nurses and nurse leaders, in all settings, to meet the learning needs necessary for Culture of Health competence. [J Contin Educ Nurs. 2020;51(12)568-573.].
Professional development practitioners must collaborate with nurses and nurse leaders, in all settings, to meet the learning needs necessary for Culture of Health competence. [J Contin Educ Nurs. 2020;51(12)568-573.].
The guarantee of nursing competence in prehospital urgent care requires the identification and delimitation of the specific competencies. This work describes the importance attributed by professors of Spanish universities to the competencies of prehospital nursing positions and indicates the most appropriate training level required to achieve them.

The current work consisted of a survey with an online questionnaire. Sixty competencies over 10 domains were studied.

The most valued domains were those of general and personal competencies. The competencies considered most important were "Recognizes the vital risk and knows how to perform basic and advanced life support maneuvers" and "Provides quality health care." The nursing degree is considered appropriate to train students to the required level in only eight competencies.

The proposed competencies can be considered as specific competencies necessary in prehospital emergency nursing. Effective performance requires training to a higher level than a nursing degree. [J Contin Educ Nurs. 2020;51(12)556-567.].
The proposed competencies can be considered as specific competencies necessary in prehospital emergency nursing. Effective performance requires training to a higher level than a nursing degree. [J Contin Educ Nurs. 2020;51(12)556-567.].
The implementation of a new wound care model of service delivery, including training and teleassistance, provided us with the opportunity to study nursing competencies in a primary health care context.

A mixed-methods study was chosen to address the complexity related to the development of competencies from two complementary perspectives.

Nurses' self-perceived knowledge and skills improved immediately after training. Factors identified as influencing the development process were grouped into three themes Acquired Skills and Knowledge, Personal Factors, and Work Organization Factors.

Our study demonstrates that the skills and knowledge can be enhanced through integrated continuing education efforts, and brings a deeper understanding of factors that influence the competency development. Finally, the research team highlighted the potential of telehealth technologies. [J Contin Educ Nurs. 2020;51(12)547-555.].
Our study demonstrates that the skills and knowledge can be enhanced through integrated continuing education efforts, and brings a deeper understanding of factors that influence the competency development. Finally, the research team highlighted the potential of telehealth technologies. [J Contin Educ Nurs. 2020;51(12)547-555.].Using technology can transform methodologies for staff education and clinical practice while addressing different learning styles and competency needs. Video can enhance competency standardization and policy use. Videos increase staff engagement and level of confidence when supplementing clinical education and policy management. [J Contin Educ Nurs. 2020;51(12)544-546.].The COVID-19 pandemic has created unprecedented opportunities for training and development to move to online formats. The discussion board is an essential online tool to advance leadership development. Both learner and educator tips are provided for discussion board optimization, including considerations for rubric development for learner evaluation. [J Contin Educ Nurs. 2020;51(12)541-543.].When we look back on 2020, it is hard not to focus on the COVID-19 pandemic that has affected everything from nursing practice to world politics. Along with those challenges, there has been tremendous opportunity for nursing professional development change and growth. 2020 brought several key issues into play related to nursing continuing professional development. This article highlights many of these important issues. [J Contin Educ Nurs. 2020;51(12)537-540.].Individuals with advanced dementias resulting from neurodegenerative disorders (NDs) occasionally surprise caregivers with episodes of clarity and cognitive function that are not usually present. Lucid episodes-aptly named paradoxical lucidity in the literature-seem to involve a return of the "old self" during advanced neurodegenerative changes. Lucid episodes pose a problem for theories of neurological degeneration, which position dementias as progressive, incurable, and irreversible. In addition, lucid episodes raise ethical questions about whether information gleaned during lucid episodes is appropriate to direct future patient-centered care. The concept requires analysis and clarification if it is to guide future theorizing and research. The underlying goals of the current concept analysis are twofold (a) to clarify the meaning of lucidity in the context of advanced NDs; and (b) to develop a theoretical definition that can guide future practice, research, and policy development. Walker and Avant's method is used to identify uses of the concept, defining attributes, antecedents, consequences, and empirical referents. [Journal of Gerontological Nursing, 46(12), 42-50.].The current study examined potential gender differences in the associations between informal caregiving, poor mental health, and subjective cognitive decline (SCD). Data were obtained from the U.S. Behavioral Risk Factor Surveillance System (N = 16,042; 9,410 women, 6,632 men). Multivariate linear and logistic regression models were used to obtain adjusted βs and odds ratios (ORs), and 95% confidence intervals (CIs) depicting the association between informal caregiving, poor mental health, and SCD overall and by gender. Caregiving was positively associated with poor mental health among men (adjusted β = 2.60; 95% CI [2.59, 2.62]) and women (adjusted β = 0.40; 95% CI [0.23, 0.57]). Poor mental health was positively associated with SCD among men (adjusted OR = 1.05; 95% CI [1.02, 1.08]) and women (adjusted OR = 1.07; 95% CI [1.04, 1.10]). Poor mental health may be associated with SCD, irrespective of gender, and additional studies are needed that will identify key variables influencing SCD among male and female informal caregivers. [Journal of Gerontological Nursing, 46(12), 31-41.].Long-term care (LTC) nurses are a critical nexus for patient communication and vital to advance care planning due to their professional role and breadth of patient relationships. The current study's aim was to explore the communication strategies Midwestern LTC nurses use to clarify patients' end-of-life (EOL) care preferences. Two focus groups used a phenomenological framework to elucidate the experiences of 14 RNs. Data analysis revealed two themes grounded in time (a) nurses use time to assess patients' EOL situation and assist patients to discern care options; and (b) nurses educate patients about EOL care, adjust care plans, and develop trusting relationships. Two themes were grounded in clinical experience (a) nurses become persistent advocates and educators to initiate and sustain EOL communication; and (b) nurses learn consistency in communication, including awareness of patients' nonverbal communication. Nurses shared that EOL communication is never "done"; time frames to assess, educate, and clarify are continuous. [Journal of Gerontological Nursing, 46(12), 23-29.].Physical activity is an important part of clinical assessment. However, objective measurement can be expensive and burdensome. The current study validated a single activity question for use in clinical assessment. Ninety-seven older women (mean age = 73.7 years, SE = 0.7) completed an activity questionnaire and measurement of anthropometrics, body composition, and strength. Activity level was reported as not active, somewhat active, active, and very active. Activity level was significantly related to hours of light, moderate, and vigorous activity; body mass index (BMI); waist circumference; percent fat and lean mass; and strength (p less then 0.05). When activity levels were collapsed into two groups (not active + somewhat active, and active + very active), women in the high activity group (n = 48) were significantly (p less then 0.05) more active, had healthier BMI and waist circumference values, less fat and more lean mass, and were stronger than women in the low activity group (n = 49). A single activity question is valid for use in clinical assessment. [Journal of Gerontological Nursing, 46(12), 15-22.].Age-friendly cities optimize opportunities for health, participation, and security to enhance quality of life as people age. The Age-Friendly Cities framework evaluates eight evidence-based domains, including outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. The COVID-19 pandemic has impacted each of these domains, necessitating reconsideration of opportunities to promote safety, wellness, and empowerment for older adults and persons with disabilities in this new reality. This qualitative descriptive study provides perspectives of gerontologists, senior service providers, and diverse older adults. Participants identified emerging issues and concerns related to the eight age-friendly domains, as well as highlighted best practices and potential solutions. The findings provide direction for gerontological nurses in practice and research who aim to address social determinants of health while promoting aging in place for older adults. [Journal of Gerontological Nursing, 46(12), 7-13.].
Gestational diabetes mellitus (GDM) affects approximately 1-14% of all pregnancies in the United States and has significant maternal and neonatal consequences. Developing GDM can increase a patient's risk of developing overt diabetes in the future which may impact a soldier's readiness. The purpose of this study is to compare the incidence of GDM in active duty females compared with civilian dependents.

This retrospective cohort analysis was performed at a military medical center with IRB approval. Active duty and dependent status women who delivered between June 1, 2014 and April 30, 2015 were identified along with incidence of GDM. Sample size calculation determined a need for 391 women in each group to observe a 5% difference in rate of GDM with a power of 80%. Chi-squared analysis was used to compare rates of GDM.

Rates of GDM were similar between the two cohorts (active duty = 9.95%, dependent = 9.72%, P = .91). Age, gravidity, and prepregnancy BMI were also similar between groups. The rate of diet-controlled GDM were different between the two cohorts (active duty = 53.
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