Pressure injury screening in the emergency department: A concept analysis.

AIM: This concept analysis analyzes pressure injury screening in the emergency department setting using Walker and Avant's approach. BACKGROUND: Pressure injury treatment cost in the United States totals over 11 billion dollars annually. Although a pressure injury could develop in the few hours a patient is in the emergency department, there is little guidance on how an emergency department should screen, prevent, and treat patients. DATA SOURCE: Five sources resulted from database searches of CINAHL full-text, Health Business FullTEXT, and MEDLINE with Full Text. Key search terms used to narrow the search consist of the following terminology: "pressure injury" OR "pressure ulcer" AND "screening" AND "risk factors" AND "emergency room" OR "emergency department. REVIEW METHODS: Walker and Avant's method of concept analysis was used to clarify the concept of pressure injury screening in the emergency department. RESULTS: The concept analysis identified two attributes of pressure injury screening in the emergency department: patient length of stay and the cost of pressure injury treatment. Antecedents identified are patient risk factors: age, mobility status, sensory perception, comorbidities, and pre-existing pressure injuries. Positive consequences identified are increased patient comfort, increased staff satisfaction, decreased hospital-acquired pressure injuries, and increased adherence to established treatment protocols. CONCLUSIONS: This concept analysis may help to guide evidence-based practice for pressure injury screening in the emergency setting. Perhaps screening in the emergency department, if adopted globally, is the missing element needed to finally see a reduction in pressure injury rates.

Clinical Transition: RN to BSN Students' Perceptions of Their Abilities to Meet Program Outcomes.

ABSTRACT: The purpose of this study was to analyze RN to BSN students' perceptions of their abilities to meet program outcomes through their clinical experiences with a clinical teaching associate and after assuming responsibility for planning and directing clinical learning activities. A mixed-methods approach was used. Most students (87 percent) reported achievement of program outcome measures. Students demonstrated real-world learning and application through clinical experiences and successfully met program outcomes.

Building the Science to Guide Nursing Administration and Leadership Decision Making.

OBJECTIVE: The aim of this study was to identify the challenges, barriers, and solutions for conducting nursing administration and leadership science (NALS) research. BACKGROUND: Evidence from leadership science should be at the forefront of nurse leaders' decision making. Yet, challenges remain in building the evidence and moving it into nursing administration and leadership practice. METHODS: This study used a Delphi technique with open-ended questions and direct content analysis to evaluate survey responses of members of the Association for Leadership Science in Nursing and American Organization for Nursing Leadership. RESULTS: Open-ended responses were coded to yield super categories and supportive codes for areas with limited evidence to guide leadership practice and the challenges for conducting NALS research. CONCLUSIONS: These findings provide future directions for continuously driving NALS research and for building and leveraging leadership science to support nursing administration decision making.

An Examination of Factors Associated With Student Resiliency.

BACKGROUND: Student resiliency, success, and retention are top priorities for nursing programs. PURPOSE: The purpose of the cross-sectional descriptive study was to identify factors associated with the resiliency level and physical and mental health of nursing students. METHODS: A cross-sectional descriptive study design was used with a convenience sample of 199 nursing students from organizations that comprise the Community Patient Safety Coalition Nursing Research Consortium. Resiliency was measured with the Connor Davidson Resiliency Scale. Physical and mental health was measured with the Patient Reported Outcomes Measurement Information System Global Health Short Form. RESULTS: Most of the nursing students in the sample were female (92%), White (94%), and in BSN programs (74.4%). Students had low resiliency (P < .0001) and low physical and mental health (P < .0001) compared with the general population. CONCLUSIONS: Student resilience was positively correlated to self-perception of physical and mental health.

Filling the Knowledge Gap for Nurse Leaders: Next Steps Following COVID-19.

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.

Impact of Nurse Peer Review on a Culture of Safety.

BACKGROUND: Nursing peer review (NPR) is essential in evaluating nursing practice. A common theme throughout the literature is that NPR holds nurses accountable for their practice. PROBLEM: The nursing profession has struggled to conduct peer review consistently due to lack of a standardized framework. APPROACH: A NPR program was developed, implemented, and evaluated in a 355-bed acute care hospital in the Midwestern United States. OUTCOMES: A pre- and postdesign using the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used for evaluation. Paired t test results revealed statistically significant differences in group means for 2 questions: mistakes have led to positive changes here (P < .001, d = 1.31), and staff will freely speak up (P = .002, d = 0.67). Clinically significant differences in group means were noted for the remaining survey items. CONCLUSIONS: Implementation of an NPR program is a promising means to improve the culture of safety in health care institutions.

Exploring, defining, and illustrating a concept: Structural and psychological empowerment in the workplace.

AIM: The aim of this concept analysis is to clarify the meaning and relationship of psychological and structural empowerment. BACKGROUND: Empowerment is linked to positive organizational and individual constructs and outcomes. Improving the work environment may assist in sustaining a fragile and essential workforce. DESIGN: Walker and Avant's method was used to guide an analysis of this concept. DATA SOURCE: Resources published from 1970 to 2018 were identified via electronic databases, empirical works, and modern operational usage of the terms. REVIEW METHODS: A literature review and search for concept maps were completed and analyzed to identify uses and definitions of the concept: attributes, antecedents, consequences, and empirical referents. It also includes identifying model, borderline, and contrary cases to differentiate empowerment from other related concepts. RESULTS: A comprehensive, inclusive review of empowerment must include both constructs, structural and psychological. A conceptual map of these akin constructs illustrates their syndication. CONCLUSIONS: The concept of examining empowerment from both constructs, structural and psychological, is necessary to develop evidence-based practice strategies and improve the work environment and workforce.

Spiritual Immersion: Developing and Evaluating a Simulation Exercise to Teach Spiritual Care to Undergraduate Nursing Students.

This article describes the development, implementation, and evaluation of a simulation exercise designed to teach spiritual care to prelicensure nursing students. Participation in a spiritual care simulation resulted in improved knowledge and attitudes relating to spirituality and spiritual care. The results from this study demonstrate the value of using simulation and spiritual assessment to teach students how to recognize and respond therapeutically to spiritual needs.

Advance directives in the provision of care for incarcerated adults: a scoping review protocol.

SCOPING REVIEW QUESTION/OBJECTIVE: The objective of this review is to map the available evidence around advance directives in the care of incarcerated adults in terms of what has been undertaken, what outcomes have been reported, and what research gaps exist.The specific areas of investigation will include:Practices, policies or interventions used with incarcerated adults concerning advanced directives.Prisoners' experiences with advanced directives when receiving care.Barriers to establishing and implementing advanced directives.Healthcare providers' experiences with implementing advanced directives while providing care.The specific questions for this scoping review are:What types of research related to advanced directives in the provision of care for incarcerated adults have been conducted and reported?What research gaps exist in this area? CENTER CONDUCTING THE REVIEW: The Indiana Centre for Evidence-Based Nursing Practice: a Collaborating Centre of the Joanna Briggs Institute.

The Oncology Nursing Society Leadership Competency project: developing a road map to professional excellence.

Combining the recommendations of the Institute of Medicine's report on the future of nursing, an Oncology Nursing Society (ONS) leadership think tank, and current evidence, the ONS Leadership Competencies were developed to provide all nurses with a pathway to advance their leadership skills and abilities. Generated through a systematic approach of literature review, data synthesis, and peer and expert review, the ONS Leadership Competencies are divided into five domains: vision, knowledge, interpersonal effectiveness, systems thinking, and personal mastery. Each of the competencies can be measured at the individual, group, and governance levels. They serve as a means of self-assessment, growth, future planning, and professional development. This article describes the process used to develop the ONS Leadership Competencies and offers examples of how they may be used in practice.

Expanding the concept of patient care: analysis of postmortem policies in California hospitals.

Postmortem care is a component of every clinical specialty in nursing. Yet little systematic study of evidence-based practice has been done on postmortem care. This study analyzed the postmortem policies in some California hospitals in order to describe the current practice. Results showed hospital polices focus primarily on the "must and shalls" of legal procedures and physical preparation of the body. Additional areas of focus are suggested for consideration.

A criminal trial simulation: pathway to transformative learning.

Simulation is gaining popularity as an instructional method in education. The authors describe the simulation of a criminal trial stemming from a medication error. The simulation took place as a collaborative effort between undergraduate and graduate faculty teaching an issues and trends course. Bradshaw's model of transformative learning was used to design the simulation. Graduate students role played the individuals involved in the trial, and the undergraduate students acted as jurors. The curriculum design, the preparation, and the debriefing process are discussed. Lessons learned and suggestions for future simulated learning experiences are provided.

Formalized new-faculty orientation programs: necessity or luxury?

Formalized new-faculty orientation programs are not a luxury but rather a crucial necessity to recruit and retain competent and qualified faculty. The author describes the contents of what might be contained in such a program. Specific educational purposes and their link to mission, vision, and values are discussed. Selection of topics and objectives will also be explored, along with learning experiences, program organization, and outcome evaluation.