Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project.

Purpose: The purpose of this quality improvement project was to develop guidance for safe patient handling and mobility efforts to prevent pressure injuries (PIs) within the Veterans Health Administration (VHA) when slings and other transfer devices are left under patients.

Participants And Setting: Health care staff (n = 112) in patient safety and nursing at 77 unique VHA facilities responded to surveys between November and December 2019. Interviews (n = 24) were conducted using purposive sampling with VHA staff at facilities with highest and lowest PI rates (n = 9) between January and March 2021.

Library Value Studies in Veterans Health Administration Hospitals, 2010-2023.

Veterans Health Administration (VHA) hospital libraries provide research to support and improve patient care and health outcomes. This report reviews and compares the results of a series of 6 studies conducted between 2010 and 2023 by Veterans Health Administration (VHA) hospital libraries to evaluate the information patrons received from their libraries in response to reference requests. The results found that the libraries' reference responses were relevant and timely and had a positive effect on patient care while saving staff time.

Cluster-randomized implementation trial of two facilitation strategies to implement a novel information and communications technology at the Veterans Health Administration.

Background: Information and communication technologies (ICTs) improve quality and efficiency of healthcare, but effective practices for implementing new ICTs are unknown. From 2019 to 2021, the Veterans Health Administration (VHA) implemented FLOW3, an ICT that facilitates prosthetic limb care. The goal of this study was to compare the impact of two facilitation strategies on FLOW3 adoption, implementation, and sustainment.

Original Research: What Health Care Staff Who Experienced Assisted Patient Falls Can Teach Us: Implications for Fall and Fall Injury Risk.

Purpose: This quality improvement project had three aims: to identify common assisted falls scenarios, describe staff members' experiences with and risk perceptions of such falls, and explore factors that influenced their perceptions. The overarching goal was to gain useful insight for the development of assisted fall-related strategies and policies.

Methods: In the fall of 2020, 16 staff members from 13 health care facilities were purposively recruited and interviewed.

Assessing Nurse Competency in the Veterans Health Administration Registered Nurse Transition-to-Practice Residency Program: Item Pool Content Validation.

Background: New graduate registered nurse (RN) competencies are complex and difficult to measure. Psychometrically sound tools are needed to evaluate competencies for nurses participating in nurse residencies.

Purpose: Project aims were to develop an item pool for a tool to measure new graduate RN competencies for the Veterans Health Administration RN Transition-to-Practice Residency Program; validate item pool content; and use consensus methods to improve item pool content validity.

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data.

Aims: To investigate factors affecting non-completion by registered nurses (RNs) participating in degree programs supported by the scholarship program of the National Nursing Education Initiative of the United States Veterans Health Administration. Secondarily, to assess overall retention in the scholarship program over time.

Design: Retrospective longitudinal design using administrative data.

Enhancing Veteran Community Reintegration Research (ENCORE): Protocol for a Mixed Methods and Stakeholder Engagement Project.

Background: Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service.

Objective: Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration's Health Service Research and Development Service.

Staff Low Back Injury Risk During Assisted Falls Virtual Reality Simulations.

Background: Assisted falls occur when staff try to minimize the impact of falls by slowing a patient's descent. Assisting a patient fall may decrease patient injury risk, but biomechanical risk of injury to staff has not been evaluated. Assisted falls virtual reality (VR) simulations were conducted to examine staff low back injury risk during common assisted falls scenarios.

Multisite Agricultural Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) Pilot Program: Protocol for a Responsive Mixed Methods Evaluation Study.

Background: Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) is an innovative pilot program to provide supportive resources for veterans with interests in agricultural vocations. Implemented at 10 pilot sites, VA FARMS will provide mental health services and resources for veterans while supporting training in gardening and agriculture. As each pilot site project has unique goals, outreach strategies, and implementation efforts based on the local environment and veteran population, evaluating the pilot program provides a unique challenge for evaluators.

Primary care virtual resource use prior and post COVID-19 pandemic onset.

Background: The COVID-19 pandemic has been a catalyst for rapid uptake of virtual care through the use of virtual health resources (VHR). In the Department of Veterans Affairs (VA) Healthcare System, virtual care has been critical to maintaining healthcare access for patients during COVID-19. In the current study we describe primary care patient aligned care team (PACT) VHR use patterns within one VA medical center (i.

Provider reported value and use of virtual resources in extended primary care prior to and during COVID-19.

Background: A proactive approach to delivering care using virtual resources, while reducing in-person contact, is needed during the COVID-19 pandemic.

Objective: In the current study we describe pre- to post- COVID-19 pandemic onset related changes in electronic delivery of primary care.

Methods: A longitudinal, pre-post within-subjects design was used.

Reliability and validity of the Veterans Administration Mobility Screening and Solutions Tool.

Objectives: The Veterans Administration (VA) Mobility Screening and Solutions Tool (VA MSST) was developed to screen a patient's safe mobility level 'in the moment' and provide clinical decision support related to the use of safe patient handling and mobility (SPHM) equipment. This evidence-based flowchart tool is a common language tool that enables any healthcare worker at any time to accurately measure and communicate patient mobility and transfer equipment needs across disciplines and settings.

Methods: The VA MSST has four levels and differentiates between the need for powered and non-powered equipment depending on the patient's independence.

Barriers and Facilitators to Accessing Rehabilitation Health Care: A Veterans Affairs Traumatic Brain Injury Model Systems Qualitative Study.

Objective: To compare barriers and facilitators to accessing health care services among service members and veterans (SMVs) by traumatic brain injury (TBI) severity groups.

Design: Qualitative descriptive study guided by an access to health care services conceptual framework.

Setting: Five Veterans Affairs (VA) polytrauma rehabilitation centers.

Evaluation of a new assistive technology: the StandBar.

Purpose: Evaluate the potential of a wheelchair assistive technology (StandBar) to promote power wheelchair users' ability to safely stand independently from their power wheelchair and determine the impact of the device use on psychological well-being for both power wheelchair users and their caregivers.

Materials And Methods: A convenience sample of 11 power wheelchair users and caregiver dyads provided study data. Participants included power wheelchair users who were existing StandBar users or currently in training with the StandBar as part of their rehabilitation.

Veterans with Traumatic Brain Injury-related Ocular Injury and Vision Dysfunction: Recommendations for Rehabilitation.

Significance: We know the prevalence of traumatic brain injury (TBI)-related vision impairment and ocular injury symptoms. Lacking is an understanding of health care utilization to treat these symptoms. Utilization knowledge is important to structuring access to treatment, identifying clinical training needs, and providing evidence of the effectiveness of treatment.

The epidemiology, demographics, and comorbidities of pulmonary and extra-pulmonary non-tuberculous mycobacterial infections at a large central Florida Academic Hospital.

Rationale: In the United States, non-tuberculous mycobacterium (NTM) infections are considered an important cause of morbidity and mortality, especially in people with progressive lung disease. The state of Florida has an extremely high incidence and prevalence of NTM disease which is likely a rapidly emerging infection in the state due to environmental and demographic factors.

Objectives: Adjemian et al.

Exploring the role complexity and workforce needs of doctoral-prepared nurses.

Veterans Health Administration (VHA) Office of Nursing Services (ONS) is committed to encouraging and sustaining a positive culture that values doctoral-prepared nurses. Responding to needs cited in open-ended responses from the first ever survey of VHA's doctoral-prepared nurse workforce will require: providing and encouraging formal advanced degree achievement recognition; further opportunities for professional development and potential promotion; and support for nurse research activities at the local and national level. ONS recognizes the need for further research and evaluation related to VHA doctoral-prepared nurses to better understand both the outcomes they drive and what drives them.

A preliminary evaluation of full practice authority of advance practice registered nurses in the Veterans Health Administration.

Background: Responding to National Academy of Medicine and National Council of State Boards of Nursing recommendations, the Department of Veterans Health Affairs (VHA) implemented full practice authority (FPA) for Advanced Practice Registered Nurses in VHA medical centers (VAMCs) in 2017.

Purpose: To evaluate FPA policy implementation's impact on quality indicators including access to care as measured by new patient appointments in primary, specialty and mental health services.

Methods: Linear growth models compared early (n = 85) vs.

An evaluation of the Veterans Health Administration National Nursing Education Initiative.

Background: Since 1999, the Veterans Health Administration's (VHA) National Nursing Education Initiative (NNEI) has provided 16,294 scholarships for registered nurses to attain baccalaureate and advanced nursing degrees.

Purpose: The goal of this evaluation was to determine factors that enhanced or hindered a scholarship recipient in the completion of their degree and service obligation.

Methods: A regression analysis was performed to identify predictors of degree completion for 10,043 participants in 162 VHA facilities.

Risk Factors for Hospital-Acquired Pressure Injury in Surgical Critical Care Patients.

Background: Hospital-acquired pressure injuries disproportionately affect critical care patients. Although risk factors such as moisture, illness severity, and inadequate perfusion have been recognized, nursing skin assessment data remain unexamined in relation to the risk for hospital-acquired pressure injuries.

Objective: To identify factors associated with hospital-acquired pressure injuries among surgical critical care patients.

Pressure Injury Prevention Considerations for Older Adults.

There are well-documented physiologic changes that occur in the human body during the aging process, such as decreased body fat, decreased muscle mass, cellular senescence, changes in skin pH, decreased metabolism, decreased immune function, vascular changes, altered tissue perfusion, nutritional status changes, and poor hydration. These changes affect skin integrity and wound healing, and raise the risk of pressure-related skin injury. This article discusses aging as a risk factor for pressure injury (PrI).

Best Practice in Pressure Injury Prevention Among Critical Care Patients.

Pressure injuries are areas of damage to the skin and underlying tissue caused by pressure or pressure in combination with shear. Pressure injury prevention in the critical care population necessitates risk assessment, selection of appropriate preventive interventions, and ongoing assessment to determine the adequacy of the preventive interventions. Best practices in preventive interventions among critical care patients, including skin and tissue assessment, skin care, repositioning, nutrition, support surfaces, and early mobilization, are described.

A Literature Review of Nursing Extern Program Outcomes.

This literature review gathers in one place recent published literature on extern programs. Fourteen extern articles published between 2009 and 2019 were identified, and program information was extracted. Student benefits were increased in confidence, clinical skills, and learning the nursing environment.

Factors associated with past and current employment of veterans with spinal cord injury.

The purpose of this study was to examine variables predictive of post-SCI return to employment and current employment among a large cohort of veterans with Spinal Cord Injury (SCI) treated within the Veterans Health Administration (VHA) SCI System of Care. Cross sectional analysis of data obtained during in-person baseline interviews and follow-up phone interviews. Seven SCI Centers within Veteran Affairs Medical Centers.

30 Years After the Americans with Disabilities Act: Perspectives on Employment for Persons with Spinal Cord Injury.

The Americans with Disabilities Act, passed in 1990, represented landmark legislation and led to significant improvements in accessibility, such as prohibiting discrimination based on disability in public life, including employment. Now 30 years later, however, employment rates for persons with disabilities, including spinal cord injury, remain low. This article discusses why employment is so important for persons with spinal cord injury and challenges that remain.