Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review.

OBJECTIVE: The objective of the scoping review was to explore the evidence and describe what is known about perinatal bereavement care guidelines provided within health care facilities prior to discharge. Additionally, the review sought to identify what is known about parents' mental health outcomes, and map these outcomes to the characteristics of the bereavement care guidelines. INTRODUCTION: Perinatal loss poses a serious risk of emotional trauma and mental health sequelae. Conflicting evidence for international bereavement care guidelines and inconsistent implementation, a lack of experimental studies, and older syntheses with a limited focus or population made synthesis complex. Therefore, a scoping review was undertaken to determine the breadth and depth of the existing literature on this topic. INCLUSION CRITERIA: Sources pertaining to bereavement care guidelines used in health care facilities immediately after perinatal loss (miscarriage, stillbirth, or neonatal death) and parents' mental health outcomes were included. Sources pertaining to family members other than parents, perinatal loss occurring outside of a health care facility, and physical care guidelines were excluded. METHODS: The review was conducted using JBI methodology for scoping reviews. The team considered quantitative and qualitative studies, practice guidelines, case reports, expert opinions, systematic reviews, professional organization websites, and gray literature. CINAHL (EBSCOhost), PsycINFO (EBSCOhost), SocINDEX (EBSCOhost), Cochrane Library, JBI Evidence-based Practice Database (Ovid), Embase, PubMed (NLM), ProQuest Dissertations and Theses A&I (ProQuest), Web of Science Core Collection, and Epistemonikos were the major databases searched. OpenGrey, Google Scholar, and organizational websites were also searched. The earliest empirical study publication found (1976) served as the starting date limit. After pilot-testing the screening process, data were extracted, collated, and presented in narrative form as well as in tables and figures. The search was first conducted in September and October 2021, and an updated search was performed on February 9, 2023. RESULTS: The results provide a broad view of bereavement care guidelines to support grieving parents' mental health. The included sources (n = 195) were comprised of 28 syntheses, 96 primary studies, and 71 literature review/text and opinion. From the studies that specified the number of participants, 33,834 participants were included. Key characteristics of bereavement care guidelines were categorized as i) making meaning/memories, ii) good communication, iii) shared decision-making, iv) effective emotional and social support, and v) organizational response. Parents' reported mental health outcomes included both negative outcomes, such as depression, anxiety, anger, and helplessness, and positive outcomes, including coping, healing, recovery, and well-being. CONCLUSIONS: Conceptually the characteristics of published guidelines are fairly consistent across settings, with cultural variations in specific components of the guidelines. Despite the exponential increase in research pertaining to bereavement care after perinatal loss, there is a gap in research pertaining to certain characteristics of bereavement care guidelines accepted as best practice to support parents' mental health outcomes. This review provides support for future research given the trauma and mental health risks following perinatal loss. Policies ensuring consistent and appropriate implementation of bereavement care guidelines are essential to improve parents' mental health outcomes.

Wound-healing properties of Stryphnodendron adstringens (barbatimão) in skin and mucosa injuries: a scoping review protocol.

OBJECTIVE: This review will map the literature on the types of research and methods used to investigate the wound-healing properties of Stryphnodendron adstringens ( barbatimão ) in skin and mucosa injuries. INTRODUCTION: Barbatimão is a Brazilian native plant and its wound-healing properties have been described in literature since the colonial period. It is one of the 71 plants included in the Brazilian health system's national list of medicinal plants of interest. However, existing literature reviews on the subject are limited, not comprehensive, lack a search strategy, and lack peer review. INCLUSION CRITERIA: This scoping review will include all types of published and unpublished sources that investigate the wound-healing properties of barbatimão to treat any type of skin or mucosa injury in humans, animals, or in vitro, in any context. METHODS: A scoping review will be conducted following JBI methodology. The main databases to be searched will include Embase (EBSCOhost), CINAHL (EBSCOhost), Scopus, PubMed (EBSCOhost), ScienceDirect, Lilacs, SciELO, CUIDEN, MOSAICO, Web of Science, Epistemonikos, and Google Scholar. Unpublished studies will also be considered. Two independent reviewers will examine titles and abstracts and select and read full-text sources for possible inclusion. Subsequently, the reviewers will extract and synthesize the data, which will be presented as a map, diagram, or table, according to the review objectives. REVIEW REGISTRATION: Open Science Framework osf.io/w57m4.

Cultural adaptation and reliability testing of the Chinese version of evidence-based practice knowledge assessment in nursing: A cross-sectional study.

Objective: The EKAN is a reliable and validated tool for objectively measuring the evidence-based practice (EBP) knowledge of nurses. Thus, we set out to translate and culturally modify the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN), and then evaluate its validity and reliability among Chinese practicing nurses. Methods: This cross-sectional study consisted of two phases. The first phase involved translating the EKAN into Chinese (EKAN-Chinese), using a process of forward translation, back translation, review, cultural adjustment as well as a pilot study. The second phase aimed to assess the psychometric properties of the EKAN-Chinese and establish a baseline measure of EBP knowledge among 120 nurses from a large general hospital in Beijing, China. Data were collected from August to November 2022 and analyzed with Rasch software. This study was reported using the cross-sectional STROBE checklist. Results: The newly translated, EKAN-Chinese was pilot-tested after slight modification of four items without altering the intended meaning. The outfit unweighted mean square was 1.03 (SD = -0.13), the infit weighted mean square was 1.00 (-0.17), and the mean difficulty index ranged from -3.43 to 2.85 according to validity indices. The results of the reliability indices revealed low person reliability (0.49), high item reliability (0.96), moderate person separation index (0.99), and sufficient item separation index (4.71). The mean EKAN-Chinese sum score was 9.8 (max score = 20, SD = 2.9). Conclusion: The newly translated EKAN-Chinese showed sufficient psychometric evidence to support use in practicing Chinese nurses. The EKAN-Chinese can be used by nurse leaders in China as a potential screening tool to 1) objectively identify nurses who need educational training in evidence-based nursing practice, and 2) gauge the effectiveness of education and training programs to improve EBP knowledge and ultimately, evidence-based care.

Methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia: a scoping review protocol.

OBJECTIVE: This scoping review will present a profile of methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia. INTRODUCTION: An ideal clinical practice guideline is evidence-based and the product of a rigorous and robust literature-vetted process, yet reports show that rigor is not being achieved. Moreover, a new vulnerable population has been identified due to COVID-19, increasing the need for high quality clinical practice guidelines. Preliminary searches yielded no scoping or systematic reviews on methodological rigor and reporting quality of clinical practice guidelines used for managing bacterial pneumonia in hospitalized adults. INCLUSION CRITERIA: This review will consider current national and international clinical practice guidelines for management of hospitalized adult patients with either suspected or confirmed primary bacterial pneumonia. The review will include adult patients with multiple diagnoses if there is a clearly delineated clinical practice guideline for pneumonia. METHODS: A 3-step search strategy will be conducted using JBI methodology for scoping reviews. After an initial MEDLINE search for keywords, a broad search of 7 databases, 1 simultaneous platform, gray literature, specialty organizations, and international guideline groups will be conducted from 2017 to the present, in any language. Reference lists will be screened for additional sources. A 2-step screening process will be used to identify eligible clinical practice guidelines. Three reviewers will independently extract data using a standardized form. Domain scores will be analyzed and presented as percentages, and the results will be interpreted as map trends. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/eucqy/.

An analysis of data sources and study registries used in systematic reviews.

BACKGROUND: Reporting standards for data sources in systematic reviews (SRs) have been developed, yet research shows varying compliance in the methods section. When this happens, replication of search results is difficult and creates ambiguous and biased data sources. AIMS: This study captured author practices in choosing English and non-English-language databases, listing all the databases searched, and incorporating study registries as part of the search strategy. METHODS: Using an analytic, cross-sectional, study design, volunteer data collectors (n = 107) searched one of two assigned English language platforms for SRs on specified health conditions. All the data sources found in the methods section of each SR were documented and analyzed for patterns using bibliographic techniques. RESULTS: The final sample size of the SRs reviewed was N = 199. The mean number of data sources seen in the SRs was 3.9 (SD 2), with a range of 1-10. Eighteen records (9%) used a single data source to conduct the SRs. Four leading language platforms were seen in the SRs: English (100% of occurrences), up to 8% used Chinese data sources, and 4% included Spanish or Portuguese. The four most frequently used data sources were: (1) Medline (98%), (2) Embase (65%), (3) Cochrane Library (56%), and (4) Web of Science (33%). The percentage of SRs listing study registries was 30%. LINKING EVIDENCE TO ACTION: Strategies to reduce bias and increase the rigor and reliability of SRs include comprehensive search practices by exploring non-English-language databases, using multiple data sources, and searching study registries. By following PRISMA-S guidelines to report data sources correctly, reproducibility can be accomplished.

Burnout, Self-Efficacy, and Resilience in Haitian Nurses: A Cross-Sectional Study.

Purpose of Study: Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. In a context of multiple personal, social, and environmental challenges, this study assessed burnout and associated factors among Haitian nurses. Design of Study: A multi-site cross-sectional study. Methods: A survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (emotional exhaustion [EE], depersonalization [DP], personal accomplishment [PA]), self-efficacy, nursing work environment, resilience, and demographics. Findings: Haitian nurses (N = 179) self-reported moderate EE (M = 21, SD = 11.18), low DP (Mdn = 2.0, range = 29), and high personal accomplishment (Mdn = 41.0, range = 33). General self-efficacy (M = 32.31, SD = 4.27) and resilience (M = 26.68, SD = 5.86) were high. Dissatisfaction with salary, autonomy, and staffing were evident. Conclusions: It is noteworthy that burnout was lower than expected given the scarce resource, difficult socio-politico-economic environment. High levels of self-efficacy and resilience likely mitigated a higher level of burnout. Adaptation enables these nurses to manage their critical conditions and practice holistic nursing, which may inspire hope among nurses in similar contexts.

Bereavement care immediately after perinatal loss in health care facilities: a scoping review protocol.

OBJECTIVE: This scoping review will summarize what is known about formal and informal perinatal bereavement care guidelines used in health care facilities before discharge, and map the mental health outcomes of parents against characteristics of the guidelines. INTRODUCTION: Conflicting evidence for bereavement care guidelines, the lack of randomized controlled trials and experimental studies, and older synthesized information with a limited focus or population make synthesis complex. A scoping review will help determine the breadth and depth of the literature. INCLUSION CRITERIA: Sources pertaining to bereavement care guidelines used in health care facilities immediately after perinatal loss (miscarriage, stillbirth, or neonatal death) and measuring parents' mental health outcomes will be included. Sources relating to family members other than parents, perinatal loss occurring outside of a health care facility, and physical care guidelines will be excluded. METHODS: The proposed review will be conducted using the JBI methodology for scoping reviews. The team will consider quantitative and qualitative studies, practice guidelines, case reports, expert opinions, systematic reviews, professional organization websites, and gray literature. Databases to be searched will include CINAHL, PsycINFO, SocINDEX, Cochrane Library, Embase, MEDLINE, and Web of Science. The earliest empirical study found (1976) will serve as the starting date limit. After pilot testing, the two-step screening process (titles and abstracts, then full-text articles), data will be extracted, collated, and presented in narrative form as well as in tables and diagrams. The results will provide facilities with a broad view of bereavement care to support grieving parents' mental health.

Validation of the Brazilian Portuguese version of Evidence-based Practice Knowledge Assessment in Nursing (EKAN).

OBJECTIVE: The Evidence-based Practice Knowledge Assessment in Nursing (EKAN) is an objective measure of evidence-based practice (EBP) knowledge. The aims of the project were to translate the EKAN instrument into Brazilian Portuguese, test its psychometric properties, and document a baseline assessment of students' EBP knowledge. METHOD: This study used methodological design. The EKAN-Brazilian Portuguese was administered to nursing students from two baccalaureate programs. Data were analyzed using Rasch procedures. RESULTS: 123 students participated (87% ranged 19-25 years old; 60% were juniors; 38% perceived having no exposure to EBP). Validity indices showed the mean difficulty index = -2.48 to 2.07, the Infit (WMS) mean was.985 (SD = 2.13), and the Outfit (UMS) mean was.975 (SD = 0.17). Reliability indices showed sufficient item separation index (4.47); moderate person separation index (.47); high item reliability (.95); and low person reliability (.18). The mean EKAN sum score (max = 20) was 7.6 (SD = 2.13). CONCLUSION: This study on the EKAN-Brazilian Portuguese version provided sufficient evidence for validity and reliability; the person reliabilities showed the need for improvement in incorporating EBP concepts and content in nursing programs.

Effectiveness of telemonitoring on self-care behaviors among community-dwelling adults with heart failure: a quantitative systematic review.

OBJECTIVE: This review examined the effectiveness of telemonitoring versus usual care on self-care behaviors among community-dwelling adults with heart failure. INTRODUCTION: Heart failure is a global health crisis. There is a body of high-level evidence demonstrating that telemonitoring is an appropriate and effective therapy for many chronic conditions, including heart failure. The focus has been on traditional measures such as rehospitalizations, length of stay, cost analyses, patient satisfaction, quality of life, and death rates. What has not been systematically evaluated is the effectiveness of telemonitoring on self-care behaviors. Involving patients in self-care is an important heart failure management strategy. INCLUSION CRITERIA: This review included studies on adult participants (18 years and older), diagnosed with heart failure (New York Heart Association Class I - IV), who used telemonitoring in the ambulatory setting. Studies among pediatric patients with heart failure, adult patients with heart failure in acute care settings, or those residing in a care facility were excluded. METHODS: Eight databases, including CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Epistemonikos, ProQuest Dissertations and Theses, PsycINFO, and Web of Science were systematically searched for English-language studies between 1997 and 2019. Studies selected for retrieval were assessed by two independent reviewers for methodological quality using critical appraisal checklists appropriate to the study design. Those meeting a priori quality standards of medium or high quality were included in the review. RESULTS: Twelve publications were included in this review (N = 1923). Nine of the 12 studies were randomized controlled trials and three were quasi-experimental studies. Based on appropriate JBI critical appraisal tools, the quality of included studies was deemed moderate to high. In a majority of the studies, a potential source of bias was related to lack of blinding of treatment assignment. Telemonitoring programs ranged from telephone-based support, interactive websites, and mobile apps to remote monitoring systems and devices. Self-care outcomes were measured with the European Heart Failure Self-care Behaviour Scale in nine studies and with the Self-care of Heart Failure Index in three studies. Telemonitoring improved self-care behaviors across 10 of these studies, achieving statistical significance. Clinical significance was also observed in nine of the 12 studies. All studies utilized one of two validated instruments that specifically measure self-care behaviors among patients with heart failure. However, in some studies, variation in interpretation and reporting was observed in the use of one instrument. CONCLUSIONS: Overall, telemonitoring had a positive effect on self-care behavior among adult, community-dwelling patients with heart failure; however, there is insufficient and conflicting evidence to determine how long the effectiveness lasts. Longitudinal studies are needed to determine the sustained effect of telemonitoring on self-care behaviors. In addition, the limitations of the current studies (eg, inadequate sample size, study design, incomplete statistical reporting, self-report bias) should be taken into account when designing future studies. This review provides evidence for the use of telemonitoring, which is poised for dramatic expansion given the current clinical environment encouraging reduced face-to-face visits. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019131852.

Dedication in a Difficult Context: Faith-Based Nursing in Haiti.

ABSTRACT: Haitian nurses live in a precarious environment, with healthcare disparity and low wages. In the presence of significant politico-social-economic disparities, adverse effects of natural disasters, deleterious infrastructure, challenged self-boundaries, and the burden of caring for high-need patients, the authors sought a better understanding of nurses' perspective of the situation. During qualitative interviews, Haitian nurses in two faith-based hospitals (N = 17) reported feeling powerless yet exhibited resilience and dedication to nursing as a calling. These conditions cry out for support of nurses' self-care needs. Future interventions may help nurses identify better resources to care for themselves and guide their practice.

Validation of the Brazilian Portuguese version of Evidence-based Practice Knowledge Assessment in Nursing (EKAN) / Validação da versão Brasileira da Evidence-based Practice Knowledge Assessment in Nursing (EKAN) / Validación de versión brasileña de la Evidence-based Practice Knowledge Assessment in Nursing (EKAN)

ABSTRACT Objective The Evidence-based Practice Knowledge Assessment in Nursing (EKAN) is an objective measure of evidence-based practice (EBP) knowledge. The aims of the project were to translate the EKAN instrument into Brazilian Portuguese, test its psychometric properties, and document a baseline assessment of students' EBP knowledge. Method This study used methodological design. The EKAN-Brazilian Portuguese was administered to nursing students from two baccalaureate programs. Data were analyzed using Rasch procedures. Results 123 students participated (87% ranged 19-25 years old; 60% were juniors; 38% perceived having no exposure to EBP). Validity indices showed the mean difficulty index = -2.48 to 2.07, the Infit (WMS) mean was.985 (SD = 2.13), and the Outfit (UMS) mean was.975 (SD = 0.17). Reliability indices showed sufficient item separation index (4.47); moderate person separation index (.47); high item reliability (.95); and low person reliability (.18). The mean EKAN sum score (max = 20) was 7.6 (SD = 2.13). Conclusion This study on the EKAN-Brazilian Portuguese version provided sufficient evidence for validity and reliability; the person reliabilities showed the need for improvement in incorporating EBP concepts and content in nursing programs.

RESUMO Objetivo A Evidence-based Practice Knowledge Assessment in Nursing (EKAN) é uma medida objetiva do conhecimento sobre prática baseada em evidência (PBE). Os objetivos do projeto foram traduzir a EKAN para o português do Brasil, testar suas propriedades psicométricas e documentar avaliação de linha de base do conhecimento de estudantes sobre a PBE. Método A EKAN-Versão Brasileira foi aplicada a estudantes de dois programas de bacharelado em enfermagem e os dados foram submetidos a análise de Rasch. Resultados Participaram 123 estudantes (87%-idades entre 19-25 anos; 60%-primeiro ano; 38% sem exposição prévia a conteúdo de PBE). Índices de validade: dificuldade média = -2,48 a 2,07; Infit (WMS) médio = 0,985 (DP = 2,13); Outfit (UMS) médio = 0,975 (DP = 0,17). Índices de confiabilidade mostraram índice de separação suficiente (4,47); de separação de pessoa moderado (0,47); alta confiabilidade dos itens (0,95); baixa confiabilidade de pessoas (0,18). O escore médio na EKAN (máximo = 20) foi 7,6 (DP = 2,13). Conclusão Esse estudo produziu evidências de validade e confiabilidade da EKAN-Versão Brasileira; a confiabilidade de pessoas mostrou a necessidade de incorporar conceitos e conteúdos sobre a PBE nos programas de enfermagem.

RESUMEN Objetivo La Evidence-based Practice Knowledge Assessment in Nursing (EKAN) es una medida objetiva del conocimiento sobre práctica basada en la evidencia (PBE). Los objetivos del proyecto fueron traducir el EKAN al portugués brasileño, testear sus propiedades psicométricas y documentar una evaluación de línea de base del conocimiento de estudiantes sobre la PBE. Método El EKAN-Versión Brasileña fue aplicado a estudiantes de dos programas de licenciatura en enfermería, los datos fueron sometidos a análisis de Rasch. Resultados Participaron 123 estudiantes (87%-edades entre 19-25 años; 60%-primer año; 38% sin contacto previo con material sobre PBE). Índices de validez: dificultad promedio = -2,48 a 2,07; Infit (WMS) promedio = 0,985 (SD = 2,13); Outfit (UMS) promedio = 0,975 (SD = 0,17). Los índices de confiabilidad mostraron índice de separación suficiente (4,47); de separación de persona moderado (0,47); alta confiabilidad de ítems (0,95); baja confiabilidad de personas (0,18). El puntaje promedio en la EKAN (máximo = 20) fue 7,6 (SD = 2,13). Conclusión El estudio produjo evidencias de validez y confiabilidad de la EKAN-Versión Brasileña; la confiabilidad de personas mostró necesidad de incorporar conceptos y contenidos sobre PBE en los programas de enfermería.

Effect of telemonitoring on self-care behaviors among community-dwelling adults with heart failure: a quantitative systematic review protocol.

OBJECTIVE: This systematic review seeks to synthesize evidence to determine the effect of telemonitoring on self-care behaviors of adults with heart failure. INTRODUCTION: There is a high-level body of evidence demonstrating that telemonitoring is an appropriate and effective therapy for many chronic conditions and, specifically, for patients with heart failure. However, the effect of telemonitoring on self-care behaviors in the adult population with heart failure is unknown. INCLUSION CRITERIA: This review will include studies on adult participants (18 years and over) diagnosed with heart failure who use telemonitoring in the ambulatory setting. Studies of pediatric heart failure patients, and adult heart failure patients in acute care settings or in a care facility, will be excluded. METHODS: The search for studies will include English language studies published from 1997. Search terms will include heart failure, telemonitoring, self-care, and outpatient/ambulatory care, and will be used in three key sources: CINAHL, Embase, and PubMed. For the full review, Epistomonikos, ProQuest, PsycINFO, and Web of Science will also be searched. Using inclusion/exclusion criteria, two reviewers will select studies based on a three-step process. Methodological quality will be determined using critical appraisal checklists appropriate to the study design. Data extraction will include populations, study designs and methods, interventions, and outcomes related to self-care behaviors. Pooled studies will allow calculation of meta-analysis, while calculated effect sizes and confidence intervals will inform impact and precision of effect. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019131852.

Establishing A Global EBP Tool to Measure Evidence-Based Practice Knowledge: Translating and Testing the French Version of EKAN.

BACKGROUND AND PURPOSE: Government and professional organizations around the world have issued a call for evidence-based practice (EBP), affecting nursing globally. This study aimed to establish a baseline measure of EBP knowledge in French-speaking, baccalaureate nursing students and test the psychometric performance of a newly translated instrument. METHODS: For the cross-sectional, descriptive, correlational study, 103 baccalaureate nursing students from Haiti were included in the analysis. RESULTS: Rasch analysis showed strong evidence of validity (Weighted MS M = 984; Unweighted MS M = 1.01). Individual items showed item reliability (.94). The mean EBP knowledge score was 5.9 (SD = 1.93; Range = 2-10 points). CONCLUSIONS: This study provides initial psychometric evidence for an EBP knowledge measure that can be used as a catalyst for research in 29 French-speaking countries.

A Global Approach to Promoting Evidence-Based Practice Knowledge: Validating the Translated Version of the Evidence-Based Practice Knowledge Assessment in Nursing Into Spanish.

BACKGROUND: Government and professional organizations have issued a call for evidence-based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians. AIMS: This study sought to translate the Evidence-based Practice Knowledge Assessment in Nursing (EKAN) instrument into Spanish, evaluate the psychometric performance of the newly translated instrument, and establish a baseline measure of EBP knowledge of baccalaureate nursing (BSN) students for future program improvement. METHODS: This study utilized a cross-sectional, descriptive, correlational design. A total of 139 BSN students were recruited from a single study site in the Dominican Republic. Subjects completed the 20-item EKAN-Spanish, which was translated and back-translated to promote semantic accuracy. RESULTS AND FINDINGS: Infit and outfit statistics for the sample centered around 1.0 (weighted mean square = 0.978; unweighted mean square = 0.988), indicating strong evidence of validity. The individual items on the EKAN-Spanish showed item reliability of 0.94. The mean EBP knowledge score was 6.52 (SD = 2.03) with scores ranging from 2 to 12 points (20 points maximum). Differential item functioning (DIF) analysis supported translational accuracy. DISCUSSION: This study provides validation support for an objective assessment of EBP knowledge in the Spanish language and will be useful for future studies of EBP in over 21 Spanish-speaking countries. LINKING EVIDENCE TO ACTION: While EBP is a global nursing concept, there has been no instrument to objectively measure EBP knowledge across levels of education in academe and practice in Spanish-speaking countries until just recently. The availability of a validated instrument will promote global consistency in assessing EBP knowledge. Further, this will promote a collaborative approach in teaching EBP to nursing students and practicing nurses.

Dealing with academic dishonesty: a redemptive approach.

Studies reveal that as many as 80% of college students cheat; over half do not think cheating is a serious transgression. Developing integrity in nursing students is crucial, as their later actions impact patients' lives. How can educators foster academic integrity? Two educators from a Christian university relay how they approached a student's cheating and the transformative lessons they learned.

Connecting in distance mentoring: communication practices that work.

BACKGROUND: As nursing and healthcare become more global, supported by technology, the opportunities for distance mentoring increase. Mentorship is critical to nurse educator recruitment and retention. STUDY OBJECTIVE: The purpose of this study was to identify communication practices of nurse educators involved in mentoring at a distance. DESIGN/SETTINGS: A qualitative design, utilizing in-person or telephone interviews was used. Participants were twenty-three protégés or mentors who were part of a yearlong distance mentoring program. ANALYSIS METHOD: An iterative process of hermeneutic analysis identified three themes; this paper focuses on the theme of connectedness. RESULTS: Participant narratives illuminate practices of connecting at a distance: meeting face-to-face, sharing personal information, experiencing reciprocity, journaling, being vulnerable, establishing one's presence, and appreciating different perspectives. CONCLUSION: Distance does not appear to limit the connecting potential leading to a meaningful mentoring relationship; rather, it offers possibilities that local mentoring relationships may not. Nurse educators in under-resourced countries, those in small programs without a cadre of senior faculty, and students in distance programs are among those who stand to benefit from distance mentoring relationships.

From committee to commission: the history of the NLN's Academic Certified Nurse Educator Program.

AIM: To describe the historical events surrounding the development of the National League for Nursing (NLN) Academic Nurse Educator Certification Program (ANECP) and document its transition from a committee to a commission. BACKGROUND: During the latter half of the 20th century, certification became a demonstrated standard of excellence in nursing. A few visionaries suggested that nursing education itself was a specialty, but the timing for certification was not right. METHOD: The events have been studied through three primary sources: archived minutes, oral interviews, and the authors' eyewitness accounts. RESULTS: Growing pains, personnel changes and the rapid growth from committee to commission occurred during a few short years. While the NLN made sound decisions during the change process by seeking evidence and the guidance of experts and consultants, unexpected challenges occurred. CONCLUSION: The tremendous growth of the ANECP in its first years demonstrated that change was clearly desired so long as it was anchored in an evidence-based process focused on quality.

Best practices in academic mentoring: a model for excellence.

Mentoring is important for the recruitment and retention of qualified nurse faculty, their ongoing career development, and leadership development. However, what are current best practices of mentoring? The purpose of this paper is to provide an overview of a model for excellence in establishing a formal mentoring program for academic nurse educators. Six themes for establishing a formal mentoring program are presented, highlighting best practices in mentoring as culled from experience and the literature. Themes reflect aims to achieve appropriately matched dyads, establish clear mentorship purpose and goals, solidify the dyad relationship, advocate for and guide the protégé, integrate the protégé into the academic culture, and mobilize institutional resources for mentoring support. Attending to the six themes will help mentors achieve important protégé outcomes, such as orientation to the educator role, integration into the academic community, development of teaching, scholarship, and service skills, as well as leadership development. The model is intended to be generalizable for faculty teaching in a variety of academic nursing institution types and sizes. Mentoring that integrates the six themes assists faculty members to better navigate the academic environment and more easily transition to new roles and responsibilities.

Open access part I: the movement, the issues, and the benefits.

The advent of Open Access (OA) has changed the landscape of accessing digital information globally. OA offers valuable free, full-text, online resources for all health-related professionals, regardless of the practice setting. Because much scholarly information may now be accessed without charge, nurses worldwide can reach a higher level of information competency-a prime requirement for evidence-based practice. This article provides a brief account of the OA movement, introduces new terminology, discusses various publishing models, and elucidates issues surrounding the choice to publish in OA journals. Many stakeholders derive benefits from Open Access. Nursing must take action to participate in and promote the OA movement in order to derive the maximum gain for our science.

Deep tendon reflexes, magnesium, and calcium: assessments and implications.

The perinatal nurse, in collaboration with physicians, can use deep tendon reflexes as a powerful tool in determining the need to start, adjust, or stop magnesium infusion. Toxicity can be detected using physical manifestations as a guide. Clinical signs may be a better indicator than serum levels of tissue levels of magnesium. Whether magnesium is given to prevent seizures or for tocolysis, patients in both situations are at risk for developing toxicity and must be assessed regularly to ensure patient safety.