Student experiences of interprofessional simulation: Findings from a qualitative study.

Interprofessional simulation provides healthcare profession students an opportunity to collaborate in a team. The purpose of this study was to examine student perspectives of an interprofessional simulation experience within the fields of nursing, physical therapy, nutrition, and social work. An exploratory case study design was employed, using open-ended interview questions post-simulation to generate information about the student's perceptions of the experience. Based on the content analysis of reflection articles submitted by 100 students across professions, three themes emerged from the data: increased understanding of the role of other professionals, increased sense of confidence and ability to improve patient outcomes, and increased appreciation for inter-professional simulation as a valuable learning experience. Participants felt a sense of comfort in working as a team, which in turn fostered confidence in their own role. This is an important finding, as confidence in one's own role in conjunction with increased willingness to work in a team is a powerful force for changing the ways in which professions interact with one another. Interprofessional simulation is a teaching strategy that shows great promise for promoting teamwork among the healthcare professions.

Preventing Opioid Misuse and Potential Abuse: The Nurse's Role in Patient Education.

Nurses play a vital role in providing patient education for proper use of opioids. This descriptive study was designed to explore nurses' knowledge of opioids. Nurses in two large urban East Coast medical centers in the United States were invited to participate in the study, and 133 nurses completed the survey in its entirety. Registered nurses' knowledge of and attitudes about opioid use were assessed using a 48-item web-based questionnaire sent via e-mail. Frequencies were computed for all items on the questionnaire. Chi-squared testing was used to analyze data for all questions that fewer than 50% of participants answered correctly. The results of this study revealed a pain management knowledge gap among nurses caring for patients who are receiving opioid analgesics. This gap includes patient assessment; pharmacologic management; use of adjuvant medications; risks of addiction; risks of respiratory depression; and disposal and storage of opioid analgesics. Only 25% of the nurses answered 50% of the survey questions correctly. Demographic variables such as experience working as a nurse and length of time as a nurse did not influence how nurses performed on the questionnaire, nor did educational level. However, nurses who received education on opioids as a separate class of medication answered a higher percentage of questions correctly than those who did not receive education on opioids. The results of this study reveal a knowledge gap and nurses' lack of sufficient information about opioids that may affect their ability to provide effective medication instructions to their patients.

Management of the hospitalized patient experiencing acute on chronic pain: a case study.

The ability to balance the patient's level of comfort while minimizing adverse outcomes related to overdosing remains the key to providing excellent post operative care for the patient with chronic pain. This article presents the case of a hospitalized patient with severe pain and the challenges her care presented to the nursing staff.

Comparison of yeast-derived commercial feed additives on Salmonella Enteritidis survival and microbiota populations in rooster cecal in vitro incubations.

Yeast-derived products have become more of an interest in the poultry industry as of late because of their use in modulating the gastrointestinal tract (GIT) microbiome to both improve production parameters and prevent infection. This study aimed to evaluate the effects of various yeast-derived products on Salmonella enterica inoculation in un in vitro rooster cecal incubations and associated effects on the cecal microbiome. Cecal contents were obtained from 53-wk old White Leghorn H & N Nick Chick roosters (n = 3) fed a wheat-based, commercial-type basal diet. Cecal contents were diluted 1:3000 in anaerobic dilution solution (ADS) in an anaerobic chamber, with 20 mL aliquoted to each serum bottle. There were three controls (n = 3): basal diet only, diluted cecal contents only, and basal diet and diluted cecal contents; and five treatments containing the basal diet and diluted cecal contents (n = 3): Citristim® (ADM), ImmunoWall® (ICC), Maxi-Gen Plus® (CBS Bio Platforms), Hilyses® (ICC), and Original XPC® (Diamond V). All treatments were applied at a rate of 2.5 kg/tonne or less. All groups were inoculated with a nalidixic acid-resistant strain of Salmonella Enteritidis at 10^7 CFU/mL and incubated at 37 deg C. Samples were collected at 0, 24, and 48 h for S. Enteritidis enumeration and 16S rDNA microbial sequencing. Salmonella data were log-transformed and analyzed in a two-way ANOVA with means separated using Tukey's HSD (P≤0.05). Genomic DNA was extracted, and resulting libraries were prepared and sequenced using an Illumina MiSeq. Sequencing data were analyzed in QIIME2 (2021.4) with diversity metrics (alpha and beta), and an analysis of the composition of microbiomes (ANCOM) was performed. Main effects were considered significant at P≤0.05, with pairwise differences considered significant at Q≤0.05. There was an interaction of treatment and time on the enumeration of Salmonella where treatments of Citristim, Immunowall, Hilyses, and XPC reduced Salmonella by 1 log CFU/mL compared to the controls. At 48 h, each yeast product treatment reduced Salmonella by 3 log CFU/mL compared to the controls. There was no main effect of treatment on the alpha diversity metrics, richness, or evenness (P > 0.05). Treatment affected the beta diversity, abundance, and phylogenetic differences, but there were no pairwise differences (P>0.05, Q>0.05). Using ANCOM at the genus level, the taxa Synergistes, Alloprevotella, Sutterella, and Megasphaera abundance were significantly different (W = 154,147,145,140, respectively). These results demonstrate the potential of these yeast-derived products to reduce foodborne pathogens, such as Salmonella Enteriditis, in vitro, without negatively disrupting the cecal microbiome.

Nurses' Self-Identified Characteristics and Behaviors Contributing to Patients' Positive Perceptions of Their Nursing Care.

This qualitative study was designed to uncover the characteristics and behaviors of nurses identified by patients as providing exceptional nursing care. "Being present" and "Knowing the patient" were the major themes that captured the nurses' experience. Four subthemes were identified: looking for commonalities, sharing personal experiences, use of humor, and caring for the spiritual needs of patients.

Prescription Opioid Analgesics: Promoting Patient Safety with Better Patient Education.

Patients expect and deserve adequate postoperative pain relief. Opioid analgesics are widely used and effective in controlling postoperative pain, but their use poses risks that many patients don't understand and that all too often result in adverse outcomes. Inappropriate and often dangerous use of prescription medication has increased sharply in the past two decades in the United States. Patients and caregivers must have an adequate understanding of safe use, storage, and disposal of opioids to prevent adverse drug events in patients and others. Nurses play a key role in providing this patient education. This article provides a case study that highlights the risks and important aspects of opioid medication use in the postoperative patient.

The use of simulation to instruct students on the provision of spiritual care: a pilot study.

Providing spiritual care is recognized as a significant aspect of nursing practice. This pilot study was designed to determine if simulation is an effective method for instructing nursing students in the provision of spiritual care. Fifty-two students participated in a simulation exercise that introduced concepts of spiritual care. Simulation was successful in improving students' attitudes toward patient spirituality, assessment of spiritual needs, ability to refer patients to the appropriate spiritual caregivers, and communication skills. Incorporating spiritual care instruction into curricula may prove to be valuable in increasing students' awareness of spiritual care for patients and incorporation of such care into their practice.

The use of simulation in medication calculation instruction: a pilot study.

Mathematical competency is essential to students' understanding of medication calculation. A simulation instruction improved students' medication calculation test grades from baseline.