Prioritizing the Fundamentals of Care Within the Prelicensure Nursing Curriculum.

BACKGROUND: Little empirical research exists on how best to teach fundamentals of care to prelicensure nursing students. This pilot aims to develop this evidence base. METHOD: A 6-week intervention embedded fundamentals of care explicitly, focusing on the integrated nature of such care, within a first-year prelicensure nursing curriculum at an Australian university. The intervention involved two components: (a) using the fundamentals of care framework to structure and guide teaching and shape students' conceptual understanding of the fundamentals of care, and (b) restructuring clinical skills sessions to reinforce this conceptual understanding. RESULTS: Preliminary observations show that the intervention offers a practical and effective way to teach the fundamentals of care to prelicensure students, helping them to see the value of the fundamentals of care and to provide quality care for patients' fundamental needs. CONCLUSION: Explicitly embedding the fundamentals of care within accredited nursing curricula is feasible and has observable, positive effects. [J Nurs Educ. 2018;57(8):498-501.].

Use of a syndromic surveillance system to describe the trend in cycling-related presentations to emergency departments in Sydney.

OBJECTIVES: To describe population-based trends in cycling-related presentations to EDs over the past decade. METHODS: A retrospective cohort of road trauma patients (motor vehicle, motor cyclist, cyclist and pedestrian) presenting to EDs in the Sydney Greater Metropolitan Area between 2004 and 2013 was obtained using the Public Health Real-time Emergency Department Surveillance System. The outcomes of interest were the cycling-related ED presentation rate per 1000 population, as well as the proportion of cycling-related presentations that died in ED or were admitted to a critical care ward. Trends in ED presentation rates based on presentation counts and Sydney population data were plotted and described. RESULTS: There were 68,438 cycling-related presentations identified, representing 30% of all road trauma patients presenting to EDs in Sydney. There was a 91% increase in cycling-related presentations for the 35 to 64-year-old age group and a 123% increase in cycling-related presentations in the 65-year-old and over age group. All other age groups were associated with a stable or decrease in cycling-related ED presentation rates. The proportion of presentations requiring critical care ward admission or death in ED has decreased by 20%. CONCLUSION: Using an ED syndromic surveillance system, cycling-related ED presentation rates in Sydney Australia have increased in those aged 35 years and over the past 10 years, with a relative decrease in the proportion of deaths in ED or those requiring critical care admission.

Mechanisms, injuries and helmet use in cyclists presenting to an inner city emergency department.

OBJECTIVES: The objectives of the present study were to describe the injury profiles of cyclists presenting to an ED and determine the risk of significant head injury associated with bicycle helmet use. METHODS: This was a retrospective single trauma centre study of all adult cyclists presenting to an inner city ED and undergoing a trauma team review between January 2012 and June 2014. The outcome of interest was significant head injury defined as any head injury with an Abbreviated Injury Scale score of two or more. Variables analysed included demographic characteristics, helmet use at time of incident, location, time and the presence of intoxication. RESULTS: The most common body regions were upper limb injuries (57%), followed by head injuries (43%), facial injuries (30%) and lower limb injuries (24%). A lower proportion of people wearing helmets had significant head injury (17% vs 31%, P = 0.018) or facial injury (26% vs 48%, P = 0.0017) compared with non-helmet users. After adjustment for important covariates, helmet use was associated with a 70% decrease in the odds of significant head injury (odds ratio 0.34, 95% confidence interval 0.15, 0.76, P = 0.008). CONCLUSIONS: Head injuries were common after inner city cycling incidents. The use of helmets was associated with a reduction in significant head injury.