Intravenous Smart Pumps at the Point of Care: A Descriptive, Observational Study.

OBJECTIVE: This study was conducted to advance understanding of intravenous (IV) smart pump medication administration practices using the Baxter Spectrum IQ. The primary objective was to observe adherence with manufacturer required IV smart pump system setup at the point of care during actual clinical use. METHODS: The study was conducted in a 285-bed acute care community hospital near Boston, Massachusetts. The study design was observational and noninterventional, and all data were collected by a single observer. Observations included measurement and documentation of adherence with the Baxter Spectrum IQ system setup requirements. RESULTS: A total of 200 primary and secondary IV medication administration observations were included: 101 in critical care and 99 in medical-surgical. Overall adherence was found to be: 6.5% with IV smart pump position relative to the patient (aim 1); 6.5% with required position of the primary infusion bag (aim 2); and 69.5% adherence with required position of the secondary medication infusion bag (aim 3). Additional exploratory data were also collected. CONCLUSIONS: These results add to the emerging body of knowledge, which support that adherence to required system setup for head-height dependent IV smart pumps is low and difficult to achieve during actual clinical use. Consideration of alternative human factors-designed technology to replace the current manual setup requirements is needed to improve the process of acute care IV medication administration in this very important area of patient safety.

Impact of a Dedicated Education Unit Experience on Critical Thinking Development in Nursing Students.

AIM: The purpose of this study was to identify the impact of the dedicated education unit (DEU) on nursing students' critical thinking ability. BACKGROUND: The DEU is an innovative approach to clinical education, which uses clinical nurses with expert practice consistently in a competency-based experience. METHOD: Participants (intervention and control groups) completed the Nursing Executive Center's Critical Thinking Diagnostic Assessment tool before and after clinical experience. RESULTS: Participants included 243 students with 179 non-DEU and 64 DEU students. There were significant increases in total pretest and posttest score means (P < .05) for the DEU (intervention) group. A significant change (P < .0001) was seen in critical thinking scores by category for both groups and in the intervention group on pretest and posttest scores, even after controlling for pretest scores (P < .0001). CONCLUSIONS: Results support the efficacy of the DEU model in developing critical thinking. Prior DEU studies have focused on implementation and satisfaction with the model.

Vision Screening in Underserved and Vulnerable Populations in Kenya, Africa.

Eye and vision disorders are seen as serious health concerns in HIV-positive children. The vision screening project was developed, planned, and implemented as a first-step pilot project to address a dire need for vision care in the high risk HIV-positive child. This field report describes the Eye Camp where 1,349 people were screened as a collaborative endeavor with a non-profit program for HIV/AIDS infected children located in Kenya.

Identifying and Describing Nurse Faculty Workload Issues: A Looming Faculty Shortage.

AIM: The purpose of this project was to address factors contributing to the nurse faculty shortage. BACKGROUND: There is a demonstrated need to sustain and stabilize faculty currently in the workforce to avoid exacerbating the current and future faculty shortage in nursing. Recommendations of previous studies focus on strategies for recruitment, retention, and ongoing faculty development. METHOD: A survey was employed to identify and describe the workload of nurse faculty and identify the impact of retirement and other retention issues. RESULTS: Findings showed an aging and nondiverse nursing faculty with increased and variable workload. There was no standard means of calculating workload. With identification of increased workload, faculty are considering retirement at a higher than projected rate. CONCLUSION: Four primary areas to address the nursing faculty shortage include focus on diversity balance, development of collaborative positions (joint appointments), and clear identification of nursing faculty workload.

FOCUS on excellence: making a difference through global initiatives.

The Center of Excellence (COE) designation in the category of"student learning and professional development" has hallmarked Regis College as having nursing programs that create environments for students to excel academically, professionally, and personally. As a designated COE nursing program, our efforts have focused on creating and sustaining a curriculum that has a strong enculturation of diversity, with numerous local, regional, national, and international learning experiences. Examples of learning opportunities through global outreach health initiatives are included, demonstrating how the COE designation has provided recognition and led to further opportunities for faculty and students to become involved in health-related activities.

Focus on retention: Identifying barriers to nurse faculty satisfaction.

There has been a great deal of attention focused upon the professional and faculty nursing shortage. Retirement rates of seasoned nurse faculty, fewer nurses pursuing academic roles as nursing faculty, and insufficient numbers of nurses in doctoral programs hinder the ability to educate willing students to become professional nurses. The aim of this descriptive, quantitative study in the New England region was to determine barriers to job satisfaction as reported by nurse faculty. A 32-item survey was used with questions about workload, satisfaction, and identified barriers to satisfaction. Responses from 226 nurse faculty support findings regarding factors essential to job satisfaction, including work environment and workload. Implications for the study findings include the need for attention to the complexity of the academic work environment, specifically in nursing education.

Unraveling care omissions.

Evidence points to the omission of required nursing care as a pervasive problem in acute care hospitals. Labor and material resource constraints, increasing patient complexity, ineffective delegation, and poor communication have been identified as contributing factors. Nurse executives should examine the degree and causes of missed care in their organizations. Action plans should be developed based on identification of issues contributing to this serious concern, thus promoting safe patient care.

Critical thinking, delegation, and missed care in nursing practice.

OBJECTIVE: The aim of this study was to understand how nurses use critical thinking to delegate nursing care. BACKGROUND: Nurses must synthesize large amounts of information and think through complex and often emergent clinical situations when making critical decisions about patient care, including delegation. METHOD: A qualitative, descriptive study was used in this article. FINDINGS: Before delegating, nurses reported considering patient condition, competency, experience, and workload of unlicensed assistive personnel (UAP). Nurses expected UAP to report significant findings and have higher level knowledge, including assessment and prioritizing skills. Successful delegation was dependent on the relationship between the RN and the UAP, communication, system support, and nursing leadership. Nurses reported frequent instances of missed or omitted routine care. CONCLUSION: Findings from this project provide insight into factors that influence delegation effectiveness. These can guide CNOs and frontline nurse leaders to focus on implementing strategies to mitigate the consequence of missed care. Ineffective delegation of basic nursing care can result in poor patient outcomes, potentially impacting quality measures, satisfaction, and reimbursement for the institution.