Specialty Certification for Burn Nursing: Value, Beliefs, and Benefits.

Specialty certification for burn nursing will be available in 2023. This review outlines the path taken from specialty recognition by the American Nurses Association to the Certified Burn Registered Nurse certification. Clinical expertise, knowledge, skill, mastery of professional issues, and competence are hallmark features of a nurse specialty certification. A review of resources will illustrate the evolution of burn nursing practice with the development of burn nursing standards, competencies, and characteristics of the professional burn nurse. Resources are identified which outline the value of specialty certification, providing an overview for the impact of burn nursing certification on professional development, nurse satisfaction, and patient outcomes. Burn nurses play a key role in the care and recovery of the burn-injured patient. Since 2017, members of the burn nurse community have taken steps to confirm the role of the modern burn nurse and document standards. As a community, we are now poised to advance our specialty one step further and support the development of a national burn nurse certification examination. This paper provides a historical account of the path taken for burn nurse specialty recognition and national certification to date. The value and impact of specialty certification in general is outlined, thus providing a comprehensive overview for the value and impact of certification on professional development, nurse satisfaction, and patient outcomes.

Building Capacity for Nursing and Midwifery Education Through an Asynchronous Online Course.

BACKGROUND: Global organizations urge toward transformative, lifelong learning for nurses and midwives. Throughout Latin America and the Caribbean, strengthening the quality of nursing and midwifery education is top priority. A regional partnership of World Health Organization Collaborating Centers aimed to develop a user-friendly, culturally relevant, and adaptable educational quality improvement intervention. METHOD: Following the five-step ADDIE process, experts analyzed objectives and needs, designed activities and assessments, and determined optimum delivery of course content. A self-directed, asynchronous online course was developed, in line with regional needs and mandates. Three sequential online educational modules for English-speaking and Spanish-speaking nurse and midwife educators focused on (a) principles of teaching and learning, (b) instructional strategies, and (c) methods to evaluate students and courses. Content and design were externally reviewed and culturally adapted. CONCLUSION: Upon completion of pilot testing and evaluation, final course versions in both languages are expected to become freely accessible. [J Nurs Educ. 2020;59(1):38-41.].

Medical Adhesive-Related Skin Injury Following Emergent Appendectomy: A Case Study of MARSI and Missed Opportunities in Nursing Care.

BACKGROUND: The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives. CASE: A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI). The largest of the 3 wounds was a Class III skin tear based on the Payne-Martin Classification System. It measured (L) 4.4 cm × (W) 1.8 cm × (D) 0.3 cm and required 3 months to heal. CONCLUSIONS: Experiences with this case revealed the need for evidence-based practice innovations to prevent physical, emotional, and economic cost resulting from MARSI. We recommend early identification and careful documentation of susceptibility to MARSI prior to surgery and implementation of consensus-based recommendations for prevention of MARSI as advocated by the MARSI consensus group when preparing patients for surgery and treating wounds.

Chairman's choice: "slip sliding away"--the importance of quality performance in wound care products.

We outline how a change in the manufacturing of an impregnated gauze dressing product impacts upon wound healing and describe the steps taken by the manufacturer and by the University of Alabama at Birmingham (UAB) in the identification and resolution of the problem. After a change in name and manufacturing vendors, the Burn Dressing Team at the UAB Burn Center noted that the newly named product was stretching, rolling, appeared to have more ointment on it, and created sloughing of skin grafts. Using the Seven-Step Method, the manufacturer and the Burn Dressing Team identified the problem and facilitated a process improvement activity. The UAB validated the redesigned product, and the new product was standardized for production and distribution. This experience at UAB demonstrates businesses working together to achieve a common goal. Such process improvement activities are invaluable to healthcare providers for maintaining standards of healthcare and achieving desired patient outcomes.

Role of outer membrane lipopolysaccharides in the protection of Salmonella enterica serovar Typhimurium from desiccation damage.

The ability to survive desiccation between hosts is often essential to the success of pathogenic bacteria. The bacterial outer membrane is both the cellular interface with hostile environments and the focus of much of the drying-induced damage. This study examined the contribution of outer membrane-associated polysaccharides to the survival of Salmonella enterica serovar Typhimurium in air-dried blood droplets following growth in high and low osmolarity medium and under conditions known to induce expression of these polysaccharides. Strains lacking the O polysaccharide (OPS) element of the outer membrane lipopolysaccharide were more sensitive to desiccation. Lipopolysaccharide core mutation further to OPS loss did not result in increased susceptibility to drying. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed lipopolysaccharide profiles that supported the hypothesis that OPS expression is required for optimal drying resistance in S. Typhimurium. The role of O antigen in Salmonella spp. in maintaining a hydrated layer around the dried cell or in slowing the rate of dehydration and rehydration is discussed.

Subpopulation characteristics of egg-contaminating Salmonella enterica serovar Enteritidis as defined by the lipopolysaccharide O chain.

Characterization of Salmonella enterica serovar Enteritidis was refined by incorporating new data from isolates obtained from avian sources, from the spleens of naturally infected mice, and from the United Kingdom into an existing lipopolysaccharide (LPS) O-chain compositional database. From least to greatest, the probability of avian isolates producing high-molecular-mass LPS O chain ranked as follows: pooled kidney, liver, and spleen; intestine; cecum; ovary and oviduct; albumen; yolk; and whole egg. Mouse isolates were most like avian intestinal samples, whereas United Kingdom isolates were most like those from the avian reproductive tract and egg. Non-reproductive tract organ isolates had significant loss of O chain. Isogenic isolates that varied in ability to make biofilm and to be orally invasive produced different O-chain structures at 25 degrees C but not at 37 degrees C. Hens infected at a 91:9 biofilm-positive/-negative colony phenotype ratio yielded only the negative phenotype from eggs. These results indicate that the environment within the hen applies stringent selection pressure on subpopulations of S. enterica serovar Enteritidis at certain points in the infection pathway that ends in egg contamination. The avian cecum, rather than the intestines, is the early interface between the environment and the host that supports emergence of subpopulation diversity. These results suggest that diet and other factors that alter cecal physiology should be investigated as a means to reduce egg contamination.