Effects of Vibration Therapy in Pediatric Immunizations.

A randomized clinical trial of 100 children (52 boys, 48 girls) ages 2 months to 7 years was conducted to evaluate the effect of vibration therapy without cold analgesia on pain. A convenience sample was recruited at two sites: a publicly funded, free immunization clinic and a private group pediatric practice. Participants were randomly assigned to receive vibration therapy via a specialized vibrating device or standard care. All children regardless of intervention group were allowed to be distracted and soothed by the parent. Pain was evaluated using the FLACC score, which two nurses assessed at three points in time: prior to, during, and after the injection(s). Data were analyzed using a two-independent samples-paired t-test. Results show that vibration therapy had no effect on pain scores in the younger age groups studied (2 months ≤ 1 year, > 1 year ≤ 4 years). In the oldest age group (> 4 to 7 years of age), a heightened pain reading was found in the period from preinjection to post-injection periods (p = 0.045). These results indicate that the addition of vibration therapy (without cold analgesia) to standard soothing techniques is no more effective in reducing immunization pain than standard soothing techniques alone, and thus, is not indicated for use with immunization pain. Recommendations include further evaluation of interventions.

A practical guide to prevention for forensic nursing.

Interpersonal violence (IPV) is a pervasive issue across the United States, affecting one in five women and costing the nation up to $750 billion per year in additional healthcare spending. Prevention of IPV by forensic nurses may be an underrecognized and underutilized activity as forensic nursing emphasizes collection of evidence and provision of acute care to victims of violence. The "Upstream Adage" parable has been used to identify activities that can be applied to the care of victims. Forensic nurses can expand their practice activities into an "upstream" focus by targeting communities and individuals at different levels of risk and participating in key interventions before violence occurs. The role for forensic nurses to inform, participate, and implement primary, secondary, and tertiary prevention activities can have positive influences on the problem of IPV that extends well beyond the provision of direct care.

Nursing student perceptions of reflective journaling: a conjoint value analysis.

This study used a statistical technique, conjoint value analysis, to determine student perceptions related to the importance of predetermined reflective journaling attributes. An expert Delphi panel determined these attributes and integrated them into a survey which presented students with multiple journaling experiences from which they had to choose. After obtaining IRB approval, a convenience sample of 66 baccalaureate nursing students completed the survey. The relative importance of the attributes varied from a low of 16.75% (format) to a high of 23.58% (time). The model explained 77% of the variability of student journaling preferences (r(2) = 0.77). Students preferred shorter time, complete confidentiality, one-time complete feedback, semistructured format, and behavior recognition. Students with more experience had a much greater preference for a free-form format (P < .05) when compared to students with less journaling experience. Additionally, the results of English as a second language students were significantly different from the rest of the sample. In order to better serve them, educators must consider the relative importance of these attributes when developing journaling experiences for their students.

Group exercise mode and health-related quality of life among healthy adults.

AIM: This paper is a report of a study conducted to identify the difference between mode of group exercise and health-related quality of life (HRQOL), to determine the associations between mode of group exercise chosen by participants and their demographic characteristics, and to identify themes from narrative comments for each group exercise modality. BACKGROUND: Regular exercise has been shown to improve HRQOL in the general population. However, few studies have compared mode of exercise--Pilates, step aerobics, and strength training--and their impact on HRQOL. METHOD: A comparison was conducted in 2009 between three groups of participants who met regularly at a fitness facility. The English version of the RAND 36-Item Health Survey (SF-36) was used to collect data. One open-ended question was analysed by content analysis. RESULTS: In total, 143 adults participated in the study. There was a statistically significant association between mode of exercise and length of time the participants had been exercising (χ(2)=33.42, d.f.=4, P<0.001). There was a statistically significant difference in the Energy/Fatigue domain of the SF-36 between two modes of exercise: Strength Training and Pilates (z=-2.67, d.f.=2, P=0.008). Qualitative data revealed two themes that motivated healthy behaviours: personal, and interpersonal. CONCLUSION: Modes of group exercise influence HRQOL domains among adults. Healthcare providers need to understand what mode of exercise people are participating in order to educate them to achieve a better quality of life and to motivate those who are inactive.

Self-efficacy-based training for research literature appraisal: a competency for evidence-based practice.

Evidence-based practice requires nurses to integrate research findings into patient care. The lack of skill and confidence in effective literature appraisal remains a barrier for many nurses. The author describes a self-efficacy-based pilot project designed to enhance nurses' skill and confidence, thus increasing their ability and willingness to critically evaluate research findings. After the intervention, nurses were better prepared to critically appraise the literature and, through enhanced readiness, were more inclined to make evidence-based practice a clinical reality. This approach may be beneficial to staff development educators to develop and enhance an evidence-based practice culture.

Medical error reporting in America: a changing landscape.

Should the United States require mandatory reporting of medical errors within the health care system? Many barriers to medical error reporting currently exist and have made it difficult to establish a nationwide reporting system. As such, individual states have begun to address this issue one state at a time. This article reviews the barriers to nationwide reporting, provides a brief historical perspective on quality initiatives including medical error reporting, examines what the individual states have initiated, and considers these implications from a nursing perspective. Finally, the hands of "big money" stakeholders are presented and considered throughout the entire discussion.

Prescription drug re-importation: a balanced look.

The rising cost of prescription drugs has decreased access for some older adults to purchase needed medications. For this reason, some older adults are purchasing prescriptions from foreign and Internet mail-order sites. There are two main concerns related to drug re-importation--price and safety. Therefore, should the federal government allow the re-importation of prescription drugs with Food and Drug Administration (FDA) safeguards? This article presents some of the facts about this issue including the history, chronology, and stakeholders for and against drug re-importation. Implications of drug re-importation to older adults, nurses, and public health policy are given.

Optimization techniques: industrial production tools with applications in nurse staffing efficiency research.

Registered nurses (RNs) are one of many inputs that produce patient outcomes at some level of quality for a price. Optimal levels of any input are those that produce the most efficient outcome with relation to quality and cost. Through the use of optimization techniques, efficient staffing levels can be calculated to either minimize negative outcomes or maximize positive outcomes. Thus, the value of RNs can be established empirically and be precisely measured against other staffing inputs.