Developing and psychometric properties of the caring behaviors assessment tool-patient version-short form.

PURPOSE: To develop and examine the psychometric properties of the caring behaviors assessment tool-patient version-short form (CBAP-SF) based on Human Caring Theory to evaluate caring behaviors by patients. METHODS: This methodological study was conducted with 400 patients. The data were analyzed with SPSS 23.0 and LISREL 8.80. FINDINGS: It was found that the scale with 27 items had good fit indices. The Cronbach's α was 0.96 for the scale and 0.77-0.94 for the subdimensions. Also, the item-total score correlation of the scale was 0.531-0.847. PRACTICE IMPLICATIONS: The CBAP-SF was a valid and reliable tool to evaluate caring behaviors by patients.

Crossing Boundaries to Advance Nursing Research Education.

Nursing professional development specialists may find it challenging time and cost-wise to meet the educational needs of nurses in the areas of research and evidence-based practice amidst competing education priorities. Furthermore, it may be difficult to find presenters with the necessary knowledge and expertise to do so. Collaboration among local hospitals to provide a high-quality research education program can advance scholarly work within the community and can help each organization meet selected Magnet® requirements in an economical way.

Evaluating the Influence of a Standardized Bedside Handoff Process in a Medical-Surgical Unit.

BACKGROUND: Patient safety is a national and global concern. In the United States, medical errors result in more than 50,000 unnecessary patient deaths annually and contribute to billions of dollars in health care costs. The purpose of this project was to evaluate a standardized bedside handoff process and its influence in a medical-surgical unit. METHOD: A quality improvement project was performed in a medical-surgical unit and consisted of development, implementation, and evaluation of a standardized bedside handoff. The project included surveying nurses, a web-based educational program, and observations using the SBAR (T) competency checklist tool. Data were analyzed for trends. RESULTS: Results identified an improved perception of communication among the nurses as it relates to shift report and a reduction in length of handoff time after the education intervention. CONCLUSION: Continual nurse education and audits by nurse leaders are vital to the sustainment of positive outcomes. J Contin Educ Nurs. 2018;49(4):157-163.

A Tool to Identify Key Behaviors and Attributes of High-Performing Nurses.

OBJECTIVE: The purpose of this project was to identify key behaviors and attributes that distinguish high-performing nurses to develop a tool for employment screening, staff development, and performance management. BACKGROUND: Selecting nurses who will complement an organization's mission and philosophy is a key step toward achieving quality and safety goals, ensuring patient and family satisfaction, and improving retention rates and overall costs. METHODS: Focus group methodology was used to determine perceptions of high-performing nurses' behaviors and attributes. Content analysis of the meeting transcripts was performed to aggregate data into categories and items. RESULTS: Following several phases of testing with various groups, a 16-item scale has been developed. CONCLUSIONS: This tool has received positive ratings from nurse managers currently using it to interview nurse applicants who best "fit" into the organization's nursing culture. Results will be monitored over time including hiring decisions, preceptor ratings, and retention rates.

A Descriptive Study of Nursing Peer-Review Programs in US Magnet® Hospitals.

OBJECTIVE: The goal of this study was to assess the types of nursing peer review (NPR) programs in US Magnet® organizations. BACKGROUND: The 2 most predominant models of NPR programs in the literature are performance evaluation and clinical peer review. The literature on clinical peer review is primarily descriptive, outlining structures and anecdotal outcomes. METHODS: Participants from hospitals holding Magnet recognition were selected using a stratified random-sampling method. A survey developed by the researchers assessed the presence of NPR. If clinical NPR was in place, program design, evaluation measurements, and barriers were explored. RESULTS: Findings suggest wide variability in NPR models. More than one-third of the respondents conduct peer evaluation as the only mechanism of NPR. Most hospitals with a clinical peer-review program reported a case review structure and process measurements not supported by data. CONCLUSIONS: The variations noted in this study suggest more research is needed to measure the effectiveness of NPR models and associated outcomes.

Anguish, Yearning, and Identity: Toward a Better Understanding of the Pregnant Hispanic Woman's Prenatal Care Experience.

The purpose of this phenomenological study was to seek a better understanding of needs and access issues among pregnant, low-income Hispanic women. Hispanic women who attended a community prenatal education program participated in follow-up focus groups to explore their experiences regarding prenatal education, pregnancy resources, access to, and satisfaction with, the care available to them. Focus groups were facilitated by a leader, bilingual in English and Spanish, with knowledge of the Hispanic culture. Sessions were audiotaped, then translated into English for transcription. Data were analyzed according to guidelines by Colaizzi and three themes emerged: pregnant Hispanic women experienced a sense of anguish (la angustia) from questions and unknowns rampant during pregnancy, leading to a yearning (el anhelo) to learn and understand more, but with a desire to do so without sacrificing native identity (la identidad). Implications of these themes for improving prenatal care for this population are explored.

Effects of Controlled Breathing, With or Without Aromatherapy, in the Treatment of Postoperative Nausea.

PURPOSE: The purpose of this study was to compare the effectiveness of controlled breathing (CB), with and without aromatherapy (isopropyl alcohol [IPA]), in the treatment of postoperative nausea (PON) in adult females undergoing elective outpatient laparoscopic procedures. DESIGN: A prospective randomized two-group quasi-experimental design was used. METHODS: A convenience sample was used. Patients were consented and assigned to either a control (CB) or treatment (IPA) group. Symptomatic patients rated nausea severity before and at 2 and 5 minutes after receiving either CB or CB with IPA. FINDINGS: Complete data for one episode of nausea were obtained on 82 patients (41 in each group). Results showed that although nausea severity decreased significantly over time, there was no significant difference in PON treatment effectiveness between the two groups, nor was there a difference in requests for rescue medications. CONCLUSIONS: Patients who experience PON should be encouraged to take slow deep breaths as an initial response to symptoms. This approach has no side effects or costs and could also aid the patient to self-manage symptoms after discharge.

Validation of the critical-care pain observation tool in adult critically ill patients.

BACKGROUND: Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. OBJECTIVE: The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients. METHODS: Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale. RESULTS: Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65). DISCUSSION: The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.

Differences in manual and automatic blood pressures in telemetry patients with atrial fibrillation.

The purpose of this study was to evaluate the differences between automated and manual blood pressure results in patients with atrial fibrillation. Data collection took place on 3 telemetry units at a 519-bed community hospital. Findings indicate that there are statistically significant differences between automated and manual blood pressures in this patient population; however, the results are not clinically significant.

Improving staff compliance with isolation precautions through use of an educational intervention and behavioral contract.

Hospital-acquired infections negatively impact patient outcomes, length of stay, and the economy. Health care systems must find ways to decrease the spread of infection and the development of infection with the use of isolation precautions in an acute care setting. All staff members must be aware of ways to decrease or prevent the spread of infection by the appropriate use of isolation precautions. This article describes a successful program that improved the use of isolation precautions among nursing personnel through the implementation of an educational intervention and behavioral contract.

Infection prevention and control competencies for hospital-based health care personnel.

BACKGROUND: Infection prevention and control education for hospital-based health care personnel has differed across organizations because of a lack of identified practice competencies. This gap also has resulted in variation of the educational curriculum in the academic setting and a lack of consistent preparation for emergency responses. The purpose of this study was to develop a list of competencies and measurable activities, or terminal objectives, for hospital-based health care personnel applicable for use during routine patient care activities as well as during natural and man-made disasters. METHODS: Competencies and terminal objectives related to infection prevention and control were developed using an evidence-based approach comprising the following steps: (a) review of the literature, (b) review of existing competencies and published curricula/training objectives, (c) synthesis of new competencies and terminal objectives, (d) expert panel review and competency refinement using the Delphi survey process, and (e) delineation of competencies by occupation. The 8 disciplines addressed were nurses (RNs and LPNs), nursing assistants, physicians, respiratory therapists, physical and occupational therapists, environmental services, laboratory professionals, and ancillary staff. RESULTS: An initial list of competency statements and terminal objectives were compiled and then vetted by a Delphi panel of experts in infection prevention and control until > 80% agreement was achieved on all competency statements and terminal objectives. CONCLUSION: The final matrix of competencies and terminal objectives developed through this process may be used as a content framework for educational curricula and training materials for hospital-based health care personnel. The process also may be of use in determining the core competencies and terminal objectives regarding infection prevention and control for health care personnel in other settings. Validation of these results is an important next step.

Revitalizing an established rapid response team.

It is estimated that only 17% of patients survive an in-hospital cardiac arrest. Yet, more lives could be saved if the early signs of clinical deterioration were detected and promptly addressed on a consistent basis. Current evidence suggests that the creation and implementation of a rapid response team can have a positive effect on mortality and morbidity. However, to achieve these results, bedside caregivers must have access to a highly functioning, efficient team with whom they consult regularly in appropriate patient care situations. This article describes one hospital's efforts to rejuvenate its team to achieve the best possible outcomes for its patients and staff.

The problem of plagiarism.

Unfortunately, the frequency of plagiarism is increasing in the nursing profession. We are encouraged to write, especially those of us in academia, and we all live very active lives. Pressure to publish, especially when coupled with lack of time, can lead to plagiarism, whether inadvertent or not. This article will discuss the problem of plagiarism and provide tips on how to avoid it in your own work.

Prepare to draw Magnet recognition.

Key nursing representatives from Jewish Hospital of Louisville, Ky., share techniques for garnering a successful Magnet appraisal.

Delirium: elders tell their stories and guide nursing practice.

Delirium is one of the most serious and prevalent cognitive disorders among hospitalized elders. Fourteen elders participated in this phenomenologic study describing the "lived experience" of delirium from the patient's perspective. Implications for nursing practice are derived from their reality and insight.

The problem of plagiarism.

Unfortunately, the frequency of plagiarism is increasing in the nursing profession. We are encouraged to write, especially those of us in academia, and we all live very active lives. Pressure to publish, especially when coupled with lack of time, can lead to plagiarism, whether inadvertent or not. This article will discuss the problem of plagiarism and provide tips on how to avoid it in your own work.