The Basics of Artificial Intelligence in Nursing: Fundamentals and Recommendations for Educators.

BACKGROUND: Artificial intelligence (AI) offers exciting possibilities; however, AI is a double-edged sword. The adoption of this technology offers many benefits but also presents risks to academic integrity and appropriately prepared graduates. Many of today's nurse educators are from generations that are unlikely to possess an understanding of AI. This article provides fundamental knowledge needed to understand the current state of AI in nursing and offers recommendations to nurse educators on ways to responsibly incorporate AI technologies into nursing curricula. METHOD: AI literature from PubMed, CINAHL, and Google Scholar was reviewed and synthesized. RESULTS: Definitions, explanations, and applications to nursing education are outlined. Recommendations are made for AI implementation, along with ideas to avoid potential AI-enabled plagiarism and academic dishonesty. CONCLUSION: As professionals, nurse educators should understand the basics of AI and be able to judge the appropriateness of integration and also recognize opportunities to embrace future application. [J Nurs Educ. 2023;62(12):716-720.].

Medication administration behaviors in prelicensure nursing students: A longitudinal, cohort study.

AIM: This longitudinal study identified changes in safe medication administration behaviors in a single cohort of students followed over four semesters of nursing school. BACKGROUND: Over 40% of a nurse's shift is dedicated to the processes of medication administration, placing them in a position to interrupt costly medication errors. Yet, despite efforts to decrease medication errors, including electronic medical records, smart pumps, and standardized processes, 5% of hospitalized patients experience adverse drug events and the sequela costs billions of dollars annually. One cognitive aid first introduced in nursing school to help nurses administer medications safely is the rights method, including the foundational five (patient, medication, dose, route, and time). However, facility restrictions, complicated electronic health records, and high faculty-to-student ratios are limiting opportunities to apply these rights and develop safe medication administration competency. Although nursing faculty and clinical partners expect competency when initially licensed as professionals, graduating nursing students are not competent and new graduates feel ill prepared to deliver medications safely. Previous studies report findings on safe medication administration in different cohorts of nursing students, but none has followed the same cohort of students throughout nursing school. DESIGN: Using a non-experimental design, the same cohort of nursing students was followed over four semesters and observed independently administering medications in simulation scenarios. METHODS: Each semester, this cohort of students self-selected into 10-12 simulation groups. One student from each group was randomized to the role of primary nurse. Guided by the NLN/Jeffries simulation theory and the International Nursing Association for Clinical Simulation and Learning's Standards of Best Practice: SimulationSM, students participated in four simulations that required the primary nurse to deliver medications as part of clinical care. A single investigator completed an observational checklist during the simulations on verification of the foundational five rights in these students. RESULTS: Verification of most rights varied each semester, but students consistently did poorly verifying right dose. One hundred percent of students observed in the first semester did not verify all five rights. At the time of graduation, 80% of students observed did not verify all five rights prior to medication administration. CONCLUSIONS: These concerning findings align with previous research showing that students are not safely administering medications in patient care settings. Educators, administrators, and healthcare systems need to ensure that students receive consistent, high-quality experiences vital to training future nurses for competency in safe medication administration.

Operationalizing a simulation program: Practical information for leadership.

Failure to ensure organizational readiness for curricular integration of simulation can result in a costly and ineffective simulation program. Organizational leaders who are aware of the principles of changemaker leadership and specific operational considerations are best positioned to ensure a quality simulation program. To assist these leaders, this article provides practical information derived from dissection of the Standard of Best Practice: SimulationSM : Operations, including topics of strategic planning, financial resources, expert personnel, resource management systems, policies and procedures, and systems integration. Additionally, an introduction to a foundational tool to spearhead change is offered, and characteristics of the changemaker leader needed to develop and sustain an effective and efficient simulation program are highlighted. Understanding the criteria necessary for effective simulation operations and early recognition of the conditions and variables that can influence organizational culture is of utmost importance to ensure programmatic success.

Using simulations to identify nursing student behaviors: a longitudinal study of medication administration.

The Centers for Disease Control and Prevention recognizes adverse drug events as a serious public health problem. Nurses routinely administer patient medications and must be safe when delivering care. Typically, students are taught the traditional rights method (RM) of safe medication administration in the skills laboratory and through the use of high-fidelity simulation scenarios. The RM includes measures of ensuring the right patient, right medication, right dose, right time, and right route. This pilot study demonstrates changes in verification of the rights among junior and senior nursing students in four simulation scenarios over the course of one academic year. The findings suggest that students become more neglectful in verification of the rights prior to medication administration as they progress through the curriculum. This study should help educators identify significant focus areas for clinical supervisors, including the importance of increased verification of the rights of safe medication administration in the clinical setting.

Pediatric hemoglobinopathies: from the bench to the bedside.

The beta-chain hemoglobinopathies affect the beta-globin gene on chromosome 11 and comprise some of the most prevalent genetic disorders in humans, including sickle cell disease (SCD) and beta-thalassemia. The mutations associated with these diseases cause various symptoms and degrees of severity. Extensive research has sought to identify physiologic and genetic factors responsible for these variations, including the role of fetal hemoglobin (HbF) and its importance in the alleviation of symptoms. This chapter on the genomics of hemoglobinopathies addresses the interests of both the researcher and the caregiver. The pathophysiology of SCD and thalassemia are reviewed, as well as the state of the science on the regulation of HbF, including newly identified quantitative trait loci (QTLs), single nucleotide polymorphisms (SNPs), and suggested genetic mechanisms. Studies on the current therapies of hemoglobinopathies, both pharmacologic and non-pharmacologic, are also reviewed. Research reviews relevant to the care of children include physical and psychological sequelae, genetic counseling, and effects on learning. With a thorough understanding of the normal physiology of hemoglobin, the pathophysiology of SCD and the thalassemias, and the associated physical and psychological sequela, nurses can improve the quality of life for children and families living with these diseases.

Role of cyclic nucleotides in fetal hemoglobin induction in cultured CD34+ cells.

OBJECTIVE: In vivo, several drugs have been shown to increase fetal hemoglobin (HbF), including 5-azacytidine (AZA), sodium butyrate (SB), and hydroxyurea (HU). Studies in K562 cells suggest that cyclic guanosine monophosphate (cGMP) is required for HbF induction; however, the role of cyclic nucleotides in HbF induction in primary erythroid cultures has not been established. METHODS: CD34-selected peripheral blood monocytes cultured in a semi-solid serum-free system that mimics in vivo F-cell production are utilized to explore the role of cyclic adenosine monophosphate (cAMP) and cGMP in HbF induction in response to HU, AZA, and SB. RESULTS: In serum-free CD34 cultures, HU, SB, and AZA all markedly stimulate FNRBC production up to 30-fold, associated with induction of gamma-globin mRNA and total HbF protein. Guanylate cyclase inhibition results in only minimal blunting of HbF induction by each agent. In contrast, adenylate cyclase inhibition markedly reduces HU, SB, and AZA-mediated FNRBC induction and gamma-globin mRNA induction. The adenylate cyclase activator forskolin modestly induces FNRBC production and augments the action of standard induction agents. HU, AZA, and SB, however, fail to significantly stimulate adenylate cyclase themselves. CONCLUSIONS: In human CD34(+) cultures, cAMP production is required for full induction of HbF by HU, SB, and AZA, while perturbation of cGMP production has only minimal effects. These findings are in marked contrast to data in K562 cells where cGMP production is critical for HbF induction while cAMP stimulation blunts HbF response, and suggest that these agents may share a common induction pathway.