<p> <b>Background:</b> Clinical leaders are faced with making the decision to utilize products with varied designs without enough evidence to make an informed decision. An example of this problem is the decision regarding whether to change from uncoated to antimicrobial or antibiotic catheters to prevent Central Line Associated Blood Stream Infection (CLABSI). </p><p> <b>Purpose:</b> This study compares the effectiveness of three types of central venous catheters (CVC): (1) non-coated (2) antimicrobial (silver) and (3) antibiotic coated. The four CLABSI outcome measures were: (1) CLABSI rate per 1,000 catheter days, (2) gram positive organism cultures per total admissions (3) gram negative organism cultures per total admissions, (4) yeast organism cultures per total admissions. </p><p> <b>Methods:</b> This retrospective study assessed the comparative effectiveness of CVCs in a trauma hospital population (n = 10,680) admitted between July 01, 2006 and June 30th, 2011. Monthly data were obtained for the time periods when each catheter type was purchased. Linear mixed models (LMMs), with data nested within units, were used to examine differences among the three periods in BSI rates and frequency of organism type. </p><p> <b>Results:</b> Antibiotic coated catheters reduced BSI rates (beta=4.054, p &lt;0.001) and gram negative organisms (beta=6.608, p &lt;0.001). Silver impregnated catheters reduced gram negative organisms (beta= 3.194, p=0.009) compared with uncoated catheters. </p><p> <b>Conclusion:</b> Further improvement in CVC technology is required to be effective for broad spectrum of organisms. Large prospective randomized clinical trials are needed to determine the effectiveness of devices to inform purchasing decisions.</p>

<p> The purpose of this study was to examine the relationship between socio-demographic characteristics, dispositional factors (academic characteristics, motivation, emotional outlook, physical well-being, and past performances), situational factors (social support, financial status, time commitments, job responsibilities, and family needs), and institutional factors (social integration, faculty support, academic enrichment programs, and program characteristics) and students' successful retention at the end of the first semester in associate degree nursing programs in North Carolina. Additionally, as a newly developed instrument was used, the reliability factor structure and psychometric properties of the instrument were tested and compared to the original study in which the instrument was developed. A secondary aim of this study was to explore the relationship between institutional factors and first semester retention rates of associate degree programs. The study sample consisted of 439 nursing students attending 8 associate degree nursing programs in North Carolina. The relationship between socio-demographic characteristics, dispositional factors, situational factors, and institutional factors and students' successful retention at the end of the first semester was measured by specific items and factors on the Dispositional, Situational, and Institutional Questionnaire (Seago et al., 2008).</p><p> Data revealed a relationship between ethnicity, related courses completed, number of developmental courses, and other family members financially dependent and first semester retention. There was also a significant relationship between retention and autonomy, confidence in ability, and flexibility. Students not retained were 3.1 times more likely to have family members financially dependent on them compared to retained students. Students not retained were 2.3 times more likely to not have completed all their related courses compared to retained students and non-retained students were 2.1 times more likely to have taken 2 or more developmental or remedial courses compared to retained students. </p><p> Understanding and predicting student retention is a challenge. This study represents a beginning understanding of this relationship and provides implications for nurse educators when reviewing nursing admission requirements and orienting new nursing students to the program and college. With the nursing shortage expected to worsen over the next several years, nursing programs must not only attract qualified students but also employ strategies to retain students and graduate competent professionals.</p>

<p>The operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority. </p><p> The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR. </p><p> The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the </p><p> positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR. </p><p> The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses. </p>

<p> The purpose of this study was to evaluate student outcomes following implementation of a clinical scholar model of clinical education in one of four placement sites of a college of nursing grounded in a caring philosophy. The question guiding the study was to determine if the clinical scholar model has an influence on student perceptions and outcomes when used with second-degree accelerated BSN students.</p><p> Watson&rsquo;s Human Caring theory, based on ten caritas processes, serves as the theoretical framework for this study (Watson, 2007). A sequential mixed-methods approach that combined quantitative and qualitative data collection techniques was implemented using a pre-experimental, post-test only design with non-equivalent groups to determine differences between the Traditional Model (TM) and Clinical Scholar Model (CSM) in clinical nursing education.</p><p> Participants in this study completed four scales to assess their perception of: 1) caring efficacy using the Caring Efficacy Scale (Coates, 1997), 2) clinical learning environment using the Student Evaluation of the Clinical Education Environment (Sand-Jecklin, 2009), 3) clinical faculty caring through the Nursing Students&rsquo; Perceptions of Instructor Caring (Wade &amp; Kasper, 2006), and 4) socialization to the professional role, measured by the Lawler-Stone Health Care Professional Attitude Inventory (Lawler, 1988). T-tests were completed on data to determine differences between CSM and TM students on the scales. Additionally, a focus group of four CSM students was completed, transcribed and analyzed for qualitative themes.</p><p> There were no significant differences between CSM and TM students on caring efficacy, overall perceptions of the clinical learning environment, and overall socialization to the professional role. There were significant differences between scores on instructor facilitation of learning, perceptions of instructor caring, compassion, superordinate and impatience for change. </p><p> Limitations of this study include low sample size and are partially due to limitations of the class size and low survey participation. Additionally, only CSM students attended a focus group, which prevented comparisons of qualitative feedback between groups. Even with these limitations CSM students scored as well or better than TM students, indicating that the CSM could be a viable model for nursing clinical education.</p>

<p> Workplace incivility is becoming commonplace in all work environments including health care. Research highlights the dangerous, distressing, and costly side effects of lateral workplace incivility (LWPI) including nursing staff's overall health, organizational commitment, and intent to stay. Historically, organizations have been considered safe work environments but LWPI has increased over the last several decades. There has also been limited research related to LWPI as it affects psychiatric healthcare staff and no study recommending a needs assessment or developing a position to educate and assist victims. The purpose of this project was to assess psychiatric healthcare staff's understanding and exposure to lateral workplace incivility, develop and provide education on LWPI, and develop a position for a LWPI Nurse Liaison to develop zero tolerance policies, provide immediate intervention when LWPI occurs, and develop processes of progressive action in response to repeated acts of incivility.</p><p> <i>Keywords:</i> lateral workplace incivility, horizontal incivility, bullying, nurses, job satisfaction, job commitment, intent to stay, role development, zero tolerance policy.</p>

<p> Academic failure has been described as endemic in nursing education. Although, associate degree nursing programs graduate the largest number of nurses each year, the on-time graduation rate is 59%. Every semester students fail nursing courses and are required to successfully repeat the course before they can progress in the nursing program. Students who re-take a failed course are often called "repeaters." This qualitative Grounded Theory research explored the process of overcoming failure and becoming a successful student repeater. This emergent mode grounded theory study applied qualitative analysis techniques to prospectively verify and refine this emergent concept by delineating dimensions embedded in overcoming failure. Through the constant comparative method of data analysis, selective and theoretical coding, the Grounded Theory <i>Reconciling Life Balance </i> emerged. </p><p> <i>Reconciling Life Balance</i> represents the basic social-psychological process of nursing students who failed a course, repeated the course successfully and continued to complete their nursing program. Two substantive categories emerged from this data: 1) acknowledging, which included the concepts of the unexpected and failure and 2) becoming a successful repeater, which included the concepts of managing emotions, asking for help and adjusting their work-life balance. By focusing on human interaction and emotional connections, <i> Reconciling Life Balance </i> has the potential to transform current approaches to nursing education and facilitate student success.</p>

<p> National health initiatives directed towards promoting the health and wellbeing of people with intellectual and developmental disabilities (I/DDs), across their life span, are reflective of the larger evolving process of social inclusive policy and normalization for people with I/DDs. Despite these initiatives, a gap in the literature exists when examining health promotion from the perspective of the person with the disability.</p><p> This study explored perceptions of facilitators and barriers to health and wellness shared by adults with I/DDs through photographs and corresponding narratives. A critical social theory lens supported the approach and analysis of this study. Participants, 11 adults with I/DDs, were given cameras in order to take pictures of situations, experiences, people, and things that affect their health. Through one-on-one interviews, the participants were able to share the meaning of the photo in relation to facilitators and barriers to their health. This technique of taking photos followed by describing photos is known as Photovoice. It has been an especially useful technique to gather data with vulnerable or marginalized populations who often times are not able to find voice or are represented by proxy voice. In addition, nine people who support the participants living an independent life, also known as direct support professionals (DSPs) participated in a focus group meeting. The purpose of that meeting was to share their perceptions around health and wellness for the individuals they support.</p><p> Overall, themes generated around facilitators and barriers to health and wellness were similar to those of the general population. However, a more crucial observation was that people with disabilities were able to generate the study data, thus changing how one comes to know about health and wellness for people with disabilities, through an authentic voice. Implications for policy, research, education, and practice are discussed.</p>

<p> Approximately 15-25 percent of students admitted to Citizens School of Nursing are identified as "high-risk for failure" by the school's admission criteria. Remediation plans may be too little, too late to help those students succeed. The use of study groups can be of assistance for them but have disadvantages. Conversations other than content often find their way into discussions and can be a distraction. Financial constraints such as child care may prevent students from committing to study, and work schedules conflict with study groups. Social media in education may be used as an adjunct to course work with YouTube videos and email. </p><p> The purpose of the study was to see if the use of Facebook as a study group helped high-risk students in a diploma nursing school succeed. Students chosen randomly by the rotation course to which they were assigned after completion of the basic Nursing courses. During the term, the experimental group utilized Facebook in a private study group accessed only by the students and instructor. At the end of the term, the grade point averages (GPSs) and pass-fail numbers were analyzed. The control group had lower overall grades, four failures, and one withdrawal during the study. The experimental group had no failures and an overall increase of one point five-percentage points from the basic Nursing courses. </p><p> Further investigation of this type of intervention is indicated as this pilot study only looked at a small group of students over three rotation courses. It may be beneficial to begin a similar study at the beginning of the program and monitor it over the course of the two-year program. </p>

<p> The purpose of this project was to develop and test a pilot competency assessment tool for sexual assault nurses. The content for the competency assessment was based on available evidence, primarily targeting current standards of sexual assault nurse examiner (SANE) practice. Descriptive statistics from a regional crime lab allowed the researcher to identify areas for improvement in the evidence-collection technique. This information was then used to develop the content of the competency assessment. A team of experts helped inform the development of an online competency assessment using a web-based platform. The competency assessment was tested on a small sample of sexual-assault nurse examiners. The instrument demonstrated a reasonable level of consistency and reliability (KR20 was 0.66) for an initial assessment. The aim of developing and testing an online instrument to serve as a baseline for establishing a valid and reliable competency assessment for sexual assault nurse examiners was achieved.</p>

Although the concept of caring is widely accepted as an essential component of nursing, little is known about the behaviors that communicate caring, especially from the family's perspective. Such practical attention to the concept of caring in critical care is crucial to the therapeutic nurse-family relationship. The purpose of this study was to design and test an instrument to measure the perceptions of family members and nurses about the relative importance of 50 nurse-caring behaviors towards family members in critical care. / The Family Care-Q Instrument (FCQI) was originally based on the Care-Q Caring Assessment Instrument designed by Larson (1981). Items not relevant to family nursing in critical care were eliminated from Larson's instrument and new ones were formulated. The newly designed instrument identifies two categories of nurse-caring behaviors, expressive and instrumental, which were further delineated into six sub-categories based on Watson's Theory of Caring and the literature on caring behaviors. The FCQI was translated into French. Evidence of internal consistency, stability and validity was established partially during the development and testing of the FCQI. / A pilot study using the instrument was conducted. Perceptions of 20 family members and 38 critical care nurses of most and least important nurse-caring behaviors towards family members in critical care were assessed. Similarities and differences in perceptions were identified between nurses and family members in specific behaviors and in the most and least important behaviors. Overall, critical care nurses ranked the category of instrumental caring behaviors as most important, while family members identified the expressive category as most important.