Emory Authors: Implementing Cognitive Rehearsal Training With Nursing Students to Counter Incivility in the Clinical Setting as Students and New Nurses.

“Incivility is prevalent in the clinical workplace and can lead to reduced self-confidence, adverse health effects, and negative implications for patient care. Cognitive rehearsal training (CRT) serves as a mental plan that individuals can use to counter incivility. This mixed-methods study examined select outcomes related to experiencing incivility for nursing students before and after receiving CRT and early into their professional practice. Many participants described experiencing incivility. Most found CRT useful and implemented the general approach of pausing and thinking before responding. Incorporating CRT into prelicensure education has potential for decreasing the effects of incivility and protecting professional well-being.”

“COGNITIVE REHEARSAL TRAINING Following the training structure developed by Griffin (2004), CRT included one hour of didactic presentation on incivility and its consequences and one hour of interactive small-group role-play, during which participants practiced first
pausing after experiencing an uncivil remark or gesture and then utilizing a scripted response to address the incivility. The pause mitigates emotional reaction, and the use of a scripted response reduces cognitive burden in the moment.”

“SIMULATION-BASED LEARNING EXPERIENCE Students participated in the SBLE one to three weeks following CRT. The objectives of the SBLE were for students to work in small groups to provide care to multiple patients, recognize incivility, and utilize CRT strategies to
deflect incivility. The SBLE was designed following standards of best practice for simulation by a certified health care simulation educator.”

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Car Seat Challenges for Low Birth Weight InfantsEarly pumping and postpartum hemorrhage

“Hospital adherence to car seat tolerance screening (CSTS) recommendations was high, and failed screens were relatively common. Routine CSTS was not associated with reduced health care utilization and may prolong hospital LOS, particularly in the NICU/floor. Prospective trials are needed to evaluate this routine practice for otherwise low-risk infants.” (Harrison)

Harrison
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Early pumping and effect on breastfeeding

“The benefits of breastfeeding (BF) are universally acknowledged. Breastmilk has nutritional, gastrointestinal, anti-infective, psychological, and long term benefits for intellectual development of the infant. Breastfeeding is one of the most cost-effective measures to reduce neonatal morbidity and mortality in preterm infants.

“In this pilot study, short term benefit in the form of significantly increased milk volumes during individual power pumping session was observed. However, power pumping
for 1 wk did not show a statistically significant improvement in the exclusive breastfeeding rates at discharge in mothers of VLBW infants with low milk output compared to routine
pumping.”

Kalathingal, T., et al (2023). Comparison of two pumping strategies to improve exclusive breastfeeding at discharge in mothers of VLBW infants with low milk output-a pilot randomized controlled trial. Indian Journal of Pediatrics, 1-7.

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