The quality of clinician and student quality improvement reports: An analysis of 8 years of submissions.

INTRODUCTION: Many papers reporting on QI projects are not publishable for a variety of reasons. We compared manuscripts submitted as QI reports between June 2014 and June 2016 (prior to publication of the revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) with papers submitted to the American Journal of Nursing between July 2016 and December 2022). The aim was to evaluate any changes in the quality of manuscripts and identify problems that led to rejection; we also compared the quality of students with non-student submissions. METHODS: We conducted a non-randomized descriptive study to evaluate 349 papers submitted as QI project reports between June 2014 and December 2022 using screening templates based on the SQUIRE 2.0 checklist and findings of the INANE Working Group on Student Papers. RESULTS: Manuscripts designated as QI reports accepted for publication increased from 4% during 2014-2016 (T1) to 14% during 2016-2022 (T2); one student submission was accepted. There was a slight decrease in submissions designated as QI that were not QI: 36% of student submissions during T1 and 31% of student submissions during T2. Among clinician submissions, 44% in T1 designated as QI reports were not QI versus 31% submitted during T2. There was a decrease in student submissions that followed the SQUIRE guidelines (36% during T1 to 24% during T2). CONCLUSIONS: Findings demonstrate that by following the SQUIRE 2.0 guidelines, authors submit more complete manuscripts with fewer missing components. However, there are still misconceptions about what constitutes QI versus research and how to report QI initiatives. After comparing the findings from both periods, it is noteworthy that there is essentially the same level of inaccuracy and lack of acceptable manuscripts. CLINICAL RELEVANCE: Sharing findings from QI activities through presentations and publications is a vital way of helping spread the learnings from these projects and improve health care for a wider audience. Clinicians, academicians, and students must understand the elements of the SQUIRE guidelines and ensure that this framework is used for both designing and submitting QI projects for publication.

Model analysis of post-fire management and potential reburn fire behavior.

Recent trends in wildfire area burned have been characterized by large patches with high densities of standing dead trees, well outside of historical range of variability in many areas and presenting forest managers with difficult decisions regarding post-fire management. Post-fire tree harvesting, commonly called salvage logging, is a controversial management tactic that is often undertaken to recoup economic loss and, more recently, also to reduce future fuel hazard, especially when coupled with surface fuel reduction. It is unclear, however, whether the reductions in future fuels translate to meaningful changes to reburn fire behavior, particularly in the context of potentially detrimental effects of harvest on other ecosystem services. We used observed post-fire snag structure in four high severity burn scars located in the Western United States that had variable post-fire snag basal area (13.3-63.9 mg ha-2) to initialize a simulation study of future coarse and fine woody fuel hazard and associated reburn fire behavior and effects. We compared untreated controls to intensive and intermediate intensity harvest treatments, both simulated and actual. All treatments showed some number of years of extreme fire behavior during which flame lengths exceeded thresholds associated with wildfire resistance to control, implying that future fuel reductions achieved by the treatments did not translate to conditions conducive for effective reburn fire management. Harvested stands had less severe soil fire effects (soil heating and smoldering duration) than untreated controls, explained by lower predicted peak coarse woody fuels (CWD) in the harvested stands. At higher pre-treatment snag basal area, harvested stands better maintained CWD within the range desired to maintain ecosystem functions such as nutrient cycling and wildlife habitat. These simulation results indicate that, even with reduced fuel hazard, salvage treatments may still be associated with severe fire behavior for some time after wildfire, but achieved reductions in coarse woody fuels may also reduce some soil fire effects. Tradeoffs in the effects of post-fire harvest must be considered carefully in the context of forest regeneration, local conditions that govern salvage methods, snag fall and decomposition, and associated potential reburn fire effects.

Activism Is an Essential Nursing Role.

ABSTRACT: Nursing has a long history of activism, yet nurses are often heard to express their dislike of "politics" and their desire to stay away from the tense and contentious situations associated with political activism. Nurses, however, have a fundamental duty to advocate on behalf of their patients and communities. In this article, the authors discuss the rationale for and roots of political activism in nursing, the values that shape it, and the importance of nursing's stance on policies related to the health and well-being of those they serve. The authors also present exemplars of political activism and approaches nurses can use to address the pressing health care challenges of our time.

Consistent spatial scaling of high-severity wildfire can inform expected future patterns of burn severity.

Increasing wildfire activity in forests worldwide has driven urgency in understanding current and future fire regimes. Spatial patterns of area burned at high severity strongly shape forest resilience and constitute a key dimension of fire regimes, yet remain difficult to predict. To characterize the range of burn severity patterns expected within contemporary fire regimes, we quantified scaling relationships relating fire size to patterns of burn severity. Using 1615 fires occurring across the Northwest United States between 1985 and 2020, we evaluated scaling relationships within fire regimes and tested whether relationships vary across space and time. Patterns of high-severity fire demonstrate consistent scaling behaviour; as fire size increases, high-severity patches consistently increase in size and homogeneity. Scaling relationships did not differ substantially across space or time at the scales considered here, suggesting that as fire-size distributions potentially shift, stationarity in patch-size scaling can be used to infer future patterns of burn severity.

Beyond Onboarding: Retaining Staff by Supporting Professional Growth.

Onboarding new nurses is but one role of nurse professional development practitioners during this nursing shortage; those in staff development need to develop strategies that will help retain experienced nurses. This article reviews recent reports on acute care staffing and focuses on nurse involvement in quality improvement initiatives and reporting as a means for engaging experienced staff.

The Top Nursing News Story of 2022: Acute Care Workforce Under Stress.

Weak institutional support hampers nursing's recovery from COVID.

End Notes.

An editor-in-chief steps down, with gratitude.

Making It Through March.

After a bleak winter, the hopefulness of spring is just around the corner.

History Is What We Make It.

And we need to make it one we're proud of.

2021: A Year of Hope and Heartbreak.

Optimism that the pandemic would be over was short lived.

Nursing Is No Day at the Beach.

But more than ever, nurses need one.

Finding Joy in the Dark.

But it will be short lived if nurses aren't protected against increasing violence.

Getting on Board with Vaccinations.

Nurses need to support the evidence, not the myths.

The Nursing Crisis in Acute Care.

Who will ensure safe care if nurses leave hospitals?

On the Road Again to Nursing's Future.

But how do we get there from here?

Moving Forward Together.

Advances against COVID-19 offer hope, but work remains before we can fully move on.

A Most Welcome Spring.

The end of this year's winter brings much-needed hope.

Where Do We Go from Here?

What's next for nursing after the pandemic.

Building Trust.

Nurses can help change the course of the COVID-19 pandemic.

2020: A Year of Let Down and Loss.

Looking forward to a fresh start.