Challenges of assessing critical thinking and clinical judgment in nurse practitioner students.

The purpose of this study was to determine whether there was a relationship between critical thinking skills and clinical judgment in nurse practitioner students. The study used a convenience, nonprobability sampling technique, engaging participants from across the United States. Correlational analysis demonstrated no statistically significant relationship between critical thinking skills and examination-style questions, critical thinking skills and scores on the evaluation and reevaluation of consequences subscale of the Clinical Decision Making in Nursing Scale, and critical thinking skills and the preceptor evaluation tool. The study found no statistically significant relationships between critical thinking skills and clinical judgment. Educators and practitioners could consider further research in these areas to gain insight into how critical thinking is and could be measured, to gain insight into the clinical decision making skills of nurse practitioner students, and to gain insight into the development and measurement of critical thinking skills in advanced practice educational programs.

Learning through collaboration: the NEXus consortium as a winning collaborative.

The Nursing Education Exchange (NEXus) is a consortium of academic doctoral programs in nursing, initiated in response to a national shortage of well-qualified nurse educators and the need to increase the number of doctoral faculty in nursing programs across the United States. The vision for the consortium was to use distance-accessible delivery methods to provide rural nurse educators and clinical nurses with access to quality doctoral programs in nursing while remaining in their home environments. In addition, smaller or newly established doctoral programs would be able to offer a wider variety of elective coursework without recruiting and hiring additional faculty, further decreasing their limited available resources. This article describes the initiation and implementation of a successful nursing education collaborative that has gained increasing influence across the country and is recognized by its acronym, NEXus.

Do they really care? How trauma patients perceive nurses' caring behaviors.

Applying the theory of Nursing as Caring can help the nurse provide care that is perceived as caring by moderately to severely injured trauma patients. The Caring Behaviors Inventory was administered in a 1-to-1 interview format to hospitalized trauma patients in a level 2 trauma center. Nurses were positively perceived in their caring behaviors with some variation based on gender and ethnicity. The modified Caring Behaviors Inventory is quick to use and is reliable and valid.

Faculty advising in nursing education: necessary evil or opportunity for excellence?

Understanding the components of faculty workload is critical to recruitment and retention of nurse educators and to success and sustainability of nursing education programs. The role of faculty advisors has been linked to student retention and success in nursing undergraduate education. Despite the importance of academic advising, there is a paucity of research examining the impact of advising on the workload of nurse educators. When faculty roles, such as academic advising, are ostensibly valued by the institution and result in higher levels of student success, but are unrecognized and unrewarded as part of the workload formula, faculty stress and burnout can result. Recommendations for faculty advising are offered, based on current evidence regarding the importance of faculty advising and the impact of advising on the workload of nurse educators. Implications for redefining nursing faculty workload formulas are discussed.

"Helping them understand": nurses' caring behaviors as perceived by family members of trauma patients.

This qualitative study explored family members' perceptions of nurses' caring behaviors. Semistructured interviews were conducted with 10 family members of moderately to severely injured trauma patients cared for at a level II trauma center. The dominant behavior identified as being caring was explaining what was going on and interpreting medical jargon. Appearing hurried and abrupt was noted as behavior that was not caring. In a highly stressful situation such as trauma, the interpersonal relationship the nurse develops with the family influences the perception of the care received.

Perceptions of nurses' caring behaviors by trauma patients.

A descriptive study of moderately to severely injured patients' perceptions of nurses' caring behaviors was conducted at a level I trauma center. Seventy patients older than 18 years admitted through the trauma resuscitation unit were included. The participants were interviewed in their rooms/cubicles by the research team to complete the Caring Behaviors Inventory. The average rating for the sample was 4.8. Patients receiving care through trauma services expressed an overall positive perception of caring from the nursing staff while there was room for improvement in some areas.

Pediatric spinal injuries.

Spinal injuries in children present unique challenges. The anatomy of the growing child affects injury patterns and subsequent care. There are many challenges for the child and family, but current research is providing hope for the future.

Bicycle injury prevention and safety in senior riders.

Senior bicycle riders have special safety and injury prevention needs. They are at greater risk for injury and mortality. Very few educational materials have been developed to assist this group in improving their riding abilities and preventing injury to themselves. This article reviews the risks encountered by older bicyclists, discusses injury revention, and describes the development of an educational video developed especially for senior riders consistent with the goals of the National Bicycle Safety Conference.

Evidence-based practice and heat loss prevention in trauma patients.

This article describes a quality management process used to develop an evidence-based protocol for heat loss prevention in trauma patients. The quality management tool applied was the ADDIE process (Assess the problem, Determine the root cause, Design a solution, Implement the solution, and Evaluate the outcome). Use of this process required multiple applications and resulted in the identification of a multifactorial root cause. Ongoing changes and additions to the action plans were implemented.

Liver enzymes as predictors of liver damage due to blunt abdominal trauma in children.

BACKGROUND: Blunt abdominal trauma in children can result in injury to the liver. In hemodynamically stable patients, initial evaluation of liver transaminase levels may be useful in determining the need for computed tomography (CT). METHODS: We reviewed the medical records of 44 hemodynamically stable children who had abdominal CT and who also had liver enzyme determinations as the initial workup. RESULTS: Liver enzymes were found to be elevated in all but one patient with CT confirmed hepatic injury. The sensitivity and specificity of elevated liver enzyme levels were 92.9% and 100%, respectively, for predicting liver injury. CONCLUSION: When hemodynamically stable pediatric patients with blunt abdominal trauma have AST levels >400 and/or ALT levels >250 IU/L, abdominal CT is indicated. Children in this study with serum transaminase levels below these values were at decreased risk of liver injury.

Thermal efficiency of prewarmed cotton, reflective, and forced-warm-air inflatable blankets in trauma patients.

PURPOSE: To compare the thermal efficiency of 3 methods of heat-loss prevention in trauma patients undergoing resuscitation in the emergency department and the nurses' attitude toward the use of each method. DESIGN: A quasi-experimental design was used to compare 3 interventions for heat-loss prevention: 3 prewarmed cotton blankets, a reflective blanket with a head covering over 1 prewarmed cotton blanket, and a forced-warm-air inflatable blanket. All patients (n = 298) admitted in trauma-alert status and who were not hypothermic at the time of admission were randomly assigned to 1 of the interventions. Temperatures were recorded every 15 minutes for the first hour, then hourly until the patient was transferred from the emergency department. Nurses were asked to comment on and rate each method for ease of use, convenience, and access to the patient during care. FINDINGS: Analysis of variance results showed no significant differences in temperature change among the groups. Nurses significantly preferred the prewarmed cotton and reflective blankets to the warm-air inflatable blanket. CONCLUSIONS: The 3 modes of temperature conservation equally maintained body temperature in trauma patients who were not hypothermic on admission. The nurses surveyed had a preference for not using the more mechanical intervention.

Five-year follow-up of rural Jamaican children whose mothers used marijuana during pregnancy

This research provides data on the development of 59 Jamaican children, from birth to age 5 years, whose mothers used marijuana during pregnancy. Approximately one-half of the sample used marijuana during pregnancy and were matched with non-users according to age, parity, and socioeconomic status. Testing of the children was done at 1, 3, and 30 days of age with the Brazelton Neonatal Behavioral Assessment Scales and at ages 3 and 5 years with the McCarthy Scales of Children's Abilities. Data about the child's home environment and temperament were collected from direct observations as well as from standardized questionnaires. The results show no significant differences in developmental testing outcomes between children of marijuana-using and non-using mothers except at 30 days of age when the babies of users had more favourable scores on two clusters of the Brazelton Scales: autonomic stability and reflexes. The developmental scores at ages 4 and 5 were significantly correlated to certain aspects of the home environment and to regularity of basic school (preschool) attendance. (AU)

Newborn outcomes with maternal marihuana use in Jamaican women

Cluster scores on Brazelton Neonatal Behavior Assessment Scales (BNBAS) are analyzed for babies whose mother used marihuana during pregnancy and compared to a control group. Environmental variables explained significant differences in BNBAS scores. (AU)