The rate of COVID-19 vaccination uptake by U.S nursing home staff remains low despite the increased risks of viral transmission and related morbidity and mortality in this setting. This study describes vaccine uptake activities including a COVID-19 Vaccination Condition of Employment (COE) policy in one community nursing home. This case study summarizes the timeline of vaccination uptake activities, staff vaccination rates over time, and stakeholder perspectives around the implementation of a COVID-19 Vaccine COE. Organizational data were used to calculate vaccination rates from January 1st, 2021 until May 1, 2021 among all nursing home staff. Interviews were held with the executive leadership team, human resources leadership, and nursing home staff to understand the process of implementation. During a 4-month period, nursing home leaders provided 8 written handouts about COVID-19 to all staff, hosted 5 on-site vaccination clinics in partnership with area pharmacies, conducted 2 virtual presentations for staff in addition to individual outreach and internal communications. Fewer than half of the staff were vaccinated prior to the decision to pursue a Vaccine COE on February 9 th , 2021. The decision to pursue a COVID-19 Vaccine COE was supported by executive leadership and nursing home staff to protect the health and safety of each other and their residents. By May 1 st , 2021 a total of 221 of the 246 (89.8%) nursing home staff members received a COVID-19 vaccination. The facility reached 100% compliance with the Vaccine COE policy with 18 people who chose to resign and 7 people who were exempt or on a leave of absence. In combination with frequent, personalized outreach, a COVID-19 Vaccine COE resulted in high staff vaccination rates and minimal staff turnover. This case study provides a detailed summary of vaccination uptake activities within an organizational context to inform efforts at other healthcare facilities.

AIM The purpose of this study was to determine gap areas where North Carolina should implement strategies to promote the Institute of Medicine’s recommendation of an 80 percent bachelor of science workforce. BACKGROUND The North Carolina Action Coalition sought information about the nursing BSN and higher degree workforce and about human resource policies/strategies that promote BSN and higher degree education. METHOD An electronic survey was used to query 120 acute care hospital chief nursing officers over a four-year period and 100 public health chief nursing officers over a two-year period. RESULTS A majority of acute care and a minority of public health institutions had policies promoting BSN education. Barriers included lack of tuition reimbursement, scheduling/staffing issues, lack of local universities, and a perceived lack of value for nurses. A minority of respondents reported an 80 percent BSN workforce. CONCLUSION Strategies are needed statewide to support nursing academic progression.

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Vascular headache pathophysiology and manifestations are reviewed along with the role that calcium channel blocking agents play in prevention of these vascular headaches. Of the calcium channel blockers presently marketed in the U.S., verapamil has been the most widely studied. Verapamil has been shown to produce a significant improvement in frequency and duration of migraine as compared with placebo. Calcium channel blocking agents that have been studied and used outside of the U.S. are flunarizine and nimodipine, both of which provide significant improvement in measures of migraine severity, duration, frequency, and other pain and severity indices. There have been no controlled trials comparing these agents with each other as with beta-blocking agents and other prophylactic agents presently marketed in the U.S. Calcium channel blocking agents may become the drugs of first choice in migraine prophylaxis due to their effectiveness and mild side effect profile.