Development and psychometric testing of an instrument to measure applicants' desire to work in nursing.

Nursing applicants' desire to work in nursing has been identified as an important aspect to consider in nursing student selection, but relevant instruments are missing.To describe the development and psychometric testing of the Desire to Work in Nursing instrument.A mixed-methods design.The development phase included the collection and analysis of two types of data. First, three focus group interviews were organised with volunteer nursing applicants (n = 18) after the entrance exams of three universities of applied sciences (UAS) (in 2016). The interviews were analysed inductively. Second, scoping review data from four electronic databases were collected. Thirteen full-text articles (published between 2008 and 2019) were included in the review and analysed deductively based on the results of the focus group interviews. The items for the instrument were generated by synthesising the results of the focus group interviews and the scoping review. The testing phase included 841 nursing applicants who participated in the entrance exams of four UAS on 31 October 2018. The psychometric properties were analysed by examining internal consistency reliability and construct validity by principal component analysis (PCA).The desire to work in nursing was classified into four categories: nature of the work, career opportunities, suitability for nursing and previous experiences. The internal consistency reliability of the four subscales was satisfactory. The PCA found only one factor with an eigenvalue over one, explaining 76% of the total variance.The instrument can be considered reliable and valid. Although theoretically the instrument contains four categories, a one-factor solution should be considered in the future.Evaluation of applicants' desire to work in nursing may provide a strategy to retain students. Individuals choose the nursing profession for variety of reasons. However, there is very little understanding of why nursing applicants desire to work in nursing. With the current challenges in the adequate staffing in the nursing workforce, it is important to understand any aspects that may be associated with student recruitment and retention. In this study, it was identified that nursing applicants desire to work in nursing because of the nature of the work, career opportunities, being suitable for nursing and of previous experiences. Instrument to measure this desire was developed and tested. The tests revealed that the instrument can be used reliably in this context. It is suggested that the developed instrument could be used as a pre-screening or self-assessment tool before applying to nursing education to provide further insights to applicants about their reasons for applying and an opportunity to reflect on their decision.

Collaborating with nurse leaders to develop patient safety practices.

Purpose The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system failures. However, little is known about how frontline leader and director teams can be supported to develop patient safety practices. The purpose of this study is to describe the patient safety development process carried out by nursing leaders and directors. The research questions were: how the chosen development areas progressed in six months' time and how nursing leaders view the participatory development process. Design/methodology/approach Participatory action research was used to engage frontline nursing leaders and directors into developing patient safety practices. Semi-structured group interviews ( N = 10) were used in data collection at the end of a six-month action cycle, and data were analysed using content analysis. Findings The participatory development process enhanced collaboration and gave leaders insights into patient safety as a part of the hospital system and their role in advancing it. The chosen development areas advanced to different extents, with the greatest improvements in those areas with simple guidelines to follow and in which the leaders were most participative. The features of high-reliability organisation were moderately identified in the nursing leaders' actions and views. For example, acting as a change agent to implement patient safety practices was challenging. Participatory methods can be used to support leaders into advancing patient safety. However, it is important that the participants are familiar with the method, and there are enough facilitators to steer development processes. Originality/value Research brings more knowledge of how leaders can increase their effectiveness in advancing patient safety and promoting high-reliability organisation features in the healthcare organisation.

Nursing Staff's Perceptions of Patient Safety in Psychiatric Inpatient Care.

PURPOSE: This study aims to explore nursing staff's perceptions of patient safety in psychiatric inpatient care. DESIGN AND METHODS: Nurses were asked to describe their perceptions in semi-structured interviews, and their responses were analyzed by inductive content analysis. FINDINGS: Nurses addressed two sets of factors: one related to the experiences of safety and the other related to the implementation of safe care. PRACTICE IMPLICATIONS: The views of the nurses contribute to formalization of organizational policies and strategies. In particular, they highlight the importance of continual training for the staff and management, considering patients' views, and treating patients as collaborators in their care.

Enabling Low Cost Biopharmaceuticals: A Systematic Approach to Delete Proteases from a Well-Known Protein Production Host Trichoderma reesei.

The filamentous fungus Trichoderma reesei has tremendous capability to secrete proteins. Therefore, it would be an excellent host for producing high levels of therapeutic proteins at low cost. Developing a filamentous fungus to produce sensitive therapeutic proteins requires that protease secretion is drastically reduced. We have identified 13 major secreted proteases that are related to degradation of therapeutic antibodies, interferon alpha 2b, and insulin like growth factor. The major proteases observed were aspartic, glutamic, subtilisin-like, and trypsin-like proteases. The seven most problematic proteases were sequentially removed from a strain to develop it for producing therapeutic proteins. After this the protease activity in the supernatant was dramatically reduced down to 4% of the original level based upon a casein substrate. When antibody was incubated in the six protease deletion strain supernatant, the heavy chain remained fully intact and no degradation products were observed. Interferon alpha 2b and insulin like growth factor were less stable in the same supernatant, but full length proteins remained when incubated overnight, in contrast to the original strain. As additional benefits, the multiple protease deletions have led to faster strain growth and higher levels of total protein in the culture supernatant.

Experiences of the fairness of recruitment from unsuccessful applicants in the field of nursing.

AIM: The purpose of this study was to describe the experiences of unsuccessful applicants for permanent nursing positions with regard to the fairness of the recruitment process. BACKGROUND: The international shortage of recruits in nursing and the rapidly increasing number of nurses retiring implies new challenges for recruitment. The nurses' experiences of fairness affect the availability of nurses and the attractiveness of the organization. The recruitment process is approached through traditional organizational justice theories. METHODS: The material was gathered from thematic interviews with 12 nurses who had applied for a permanent nursing position but were not selected. The material was analysed using theory-driven content analysis. RESULTS: The nurses felt differently about the result of the recruitment process. The experience of distributive justice alone was not significant in terms of the general sense of justice, since other dimensions of justice compensated for it. The effect of applicants' experiences of fair treatment in the recruitment process affected their future behaviour positively, negatively or not at all. CONCLUSIONS: and implications for nursing management It is crucial to recognize applicants' experiences of the fairness of the recruitment process, because unsuccessful applicants constitute a pool of potential new employees. Furthermore, applicants with different experiences cannot be seen as a homogenous group. For example, internal applicants with negative experiences pose challenges for nursing management with regard to retaining them in the organization.

RAFAELA Patient Classification System as a tool for management.

The RAFAELA Patient Classification System offers tools for the managers to follow the adequacy of resourcing through the Nursing Care Intensity per Nurse (NCI/N). The basic idea of the RAFAELA system is that the workload expressed as NCI/N is compared with the optimal NCI level for the ward. By creating systematic reporting on this indicator, managers can follow the workload level on different wards. The measurement tool is available to all nurses as well as to managers. Thus the staff can follow the results of the daily use of patient classification. Managers can use the data for staff allocation between different wards. As a result, the workload can be discussed and analyzed, and the consequences of challenging situations can be resolved. Together with the staff the managers can look for different solutions for the problems. The overall workload can be too high or too low or the variations of the workload can be too large. The overall aim is a workload on an optimal level. RAFAELA offers a multitude of solutions finding new ways to allocate working hours, networking with different wards, discussions with the persons who guide patient flow in the hospital or changing the number of nurses in the ward.

Double recoverable block of function--a molecular control of transgene flow with enhanced reliability.

Despite all the achieved benefits and potential promises from recombinant DNA technology of plants, the potential of transgene spread to wild relatives and to non-transgenic crops is still of a wide-spread concern. We continue to develop recoverable block of function (RBF) technology for gene flow control in transgenic plants. RBF consists of two elements: blocking construct (BC) and recovering construct (RC). Natural expression of the BC (barnase) in embryos and sprouts blocks a physiological function essential for survival or reproduction of the transgenic plant (mRNA synthesis and germination). Artificially induced (heat shock treatment) RC (barstar) recovers the blocked function enabling transgenic plant to reproduce. In natural conditions without artificial induction of RC the transgenic plant can not reproduce itself. However, a single RBF may still fail because of the potential for mutations and gene silencing of the inserted constructs. To minimize the frequency of such an inactivation, we developed a double RBF, in which a single insert comprising two BC, flanking a transgene of interest, was constructed and transferred into tobacco (Nicotiana tabacum (L.)). We used a barstar gene driven by a heat shock or 35S promoter as a RC, and two different promoters were used for barnase genes in the BC. One BC contained a seed germination specific cysteine endopeptidase promoter (BC1) and the other contained the cruciferin promoter (BC2), which is active during fruit development and embryogenesis. Three alternative constructs of double RBF are described, and a segregating two-insert as well as a one-insert cassettes, were compared. One-insert system comprising two BC with different nucleotide sequences but degenerate codons that expressed the same Barnase protein appeared to be the most reliable choice. The biological and molecular data obtained suggest that double RBF is a potent transgene containment technique that can safely be applied in agriculture.