Michele DeGrazia is director of nursing research in the neonatal intensive care unit, Boston Children's Hospital, Boston, Massachusetts, and an assistant professor in the Department of Pediatrics, Harvard Medical School, Boston.
Courtney Porter is a program administrative manager III in Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital.
Am J Crit Care. 2021 Mar 1;30(2):95-102. doi: 10.4037/ajcc2021534.
Findings from 3 nurse-led research studies conducted in a large pediatric institution resulted in a call to action to support intensive and progressive care nurses experiencing moral and ethical challenges.
To evaluate the feasibility of and satisfaction with implementation of a Nurse Education and Support Team (NEST) coach role.
An interdisciplinary work group identified solutions for just-in-time support, including a new NEST coach role. This role was implemented in January 2017 to provide peer-to-peer support for nurses. The NEST coaches provide coverage 5 days per week in 4 intensive care units and 1 progressive care unit. Feasibility of the role was evaluated by assessing the number, type, length, and outcome of NEST coach consultations. Staff satisfaction was evaluated 6 months and 1.5 years after implementation.
A total of 6262 NEST coach consultations occurred across the units from January 2017 through November 2019. At both evaluation periods, more than 85% of respondents indicated that they were satisfied with their interactions with the NEST coach and nearly 80% indicated that they would seek consultation again.
Pediatric intensive and progressive care nurses experience many challenges in their practice environments. The innovative NEST coach role enabled access to just-in-time support and guidance through morally and ethically challenging situations. As evidenced by the number of consultations and the positive staff response, intensive and progressive care nurses have embraced and integrated the NEST coach role into their culture and practice.
在一家大型儿科机构进行的 3 项护士主导的研究结果呼吁采取行动,为经历道德和伦理挑战的重症和渐进式护理护士提供支持。
评估护士教育和支持小组(NEST)教练角色实施的可行性和满意度。
一个跨学科工作组确定了即时支持的解决方案,包括一个新的 NEST 教练角色。该角色于 2017 年 1 月实施,为护士提供同行支持。NEST 教练每周 5 天在 4 个重症监护病房和 1 个渐进式护理病房提供服务。通过评估 NEST 教练咨询的数量、类型、时长和结果来评估该角色的可行性。在实施后 6 个月和 1.5 年评估员工满意度。
从 2017 年 1 月到 2019 年 11 月,各单位共进行了 6262 次 NEST 教练咨询。在两个评估期内,超过 85%的受访者表示对与 NEST 教练的互动感到满意,近 80%的受访者表示他们会再次寻求咨询。
儿科重症和渐进式护理护士在其工作环境中面临许多挑战。创新的 NEST 教练角色使他们能够在道德和伦理方面面临挑战的情况下获得即时支持和指导。从咨询次数和员工的积极反应来看,重症和渐进式护理护士已经接受并将 NEST 教练角色融入他们的文化和实践中。