Faculty-student authorship practices in nursing: Cross-sectional study.

BACKGROUND: Academic institutions often encourage nursing students to submit scholarly work for publication. Oftentimes, faculty and students collaborate on scholarship during a student's enrollment in a nursing program. Although there are benefits to the faculty and students, there are also areas of conflict due to the lack of professional and institutional guidelines to ensure equitable gains. PURPOSE: The study explored authorship practices among nursing institutions in order to identify criteria for faculty-student authorship guidelines and policies. METHODS: A descriptive and cross-sectional study was utilized to describe nursing faculty's perception of best practices for faculty-student authorship and their level of comfort with specific components of the authorship process. RESULTS: There were several criteria that the faculty identified as warranting authorship credit, such as completing the review of the literature or making substantial contributions to analysis and interpretation of data. On the other hand, there were several criteria the faculty felt neutral or did not warrant authorship credit, such as providing general administration support or writing assistance. CONCLUSION: Most faculty felt comfortable discussing authorship criteria with students. However, their responses highlighted complexities inherent in faculty-student relationships when collaborating on scholarship. This accentuated the need for the nursing profession and institutions to develop and implement faculty-student authorship guidelines.

Faculty-student authorship: Opportunities and challenges.

Dissemination of nursing scholarship is of paramount importance as nurses continue to advance the profession. In academia, faculty and students frequently collaborate on scholarship leading to opportunities for publication. This paper explores the challenges and opportunities accompanying co-authorship between faculty and students. While several professional disciplines and organizations formulated guidelines and procedures specific to authorship practices between faculty and students, literature specific to authorship practices among nursing faculty and students is lacking. This paper explores the opportunities and challenges with faculty-student authorship and outlines current practices among other disciplines to aid in providing recommendations for faculty-student authorship collaboration in nursing. Future research on common practices for nursing faculty-student authorship needs to be explored.

Nursing faculty bullying: Concept analysis.

OBJECTIVE: The purpose of this review was to clarify the concept of nursing faculty bullying. Unlike published reviews that highlight incivility that involve students and faculty, the authors sought to develop the concept of nursing faculty bullying occurring in nursing schools. DESIGN: The systematic eight step approach to a concept analysis developed by Walker and Avant was the framework to explore nursing faculty bullying. DATA SOURCES: A review of existing literature on nursing faculty bullying was conducted using the electronic databases of Cumulative Index for Nursing and Allied Health, PubMed, ProQuest, and Ovid. Search terms included incivility, faculty to faculty incivility, social bullying, and faculty bullying. RESULTS: An operational definition and defining attributes were developed as well as a discussion of several model cases, antecedents, consequences, and empirical referents of nursing faculty bullying. CONCLUSIONS: The concept of nursing faculty bullying has several critical characteristics that help clarify its meaning, including the negative interactions between nursing faculty, repetitive behavior, purposeful harmful acts, and imbalance of power. The consequences of these characteristics can be emotionally and mentally harmful to nursing faculty affecting career development and advancement. Future research should explore interventions that could prevent these negative consequences.

Intravenous cefazolin plus oral probenecid versus oral cephalexin for the treatment of skin and soft tissue infections: a double-blind, non-inferiority, randomised controlled trial.

OBJECTIVE: The purpose of our study was to determine if cephalexin 500 mg orally four times daily was non-inferior to cefazolin 2 g intravenously daily plus probenecid 1 g orally daily in the management of patients with uncomplicated mild-moderate skin and soft tissue infection (SSTI) presenting to the ED. METHODS: This was a prospective, multicentre, double dummy-blind, randomised controlled non-inferiority trial conducted at two tertiary care teaching hospitals in Canada. Patients were enrolled if they presented to the ED with an uncomplicated SSTI, and randomly assigned in a 1:1 fashion to oral cephalexin or intravenous cefazolin plus oral probenecid for up to 7 days. The primary outcome was failure of therapy at 72 hours. Clinical cure at 7 days, intravenous to oral medication transition admission to hospital and adverse events were also evaluated. RESULTS: 206 patients were randomised with 104 patients in the cephalexin group and 102 in the cefazolin and probenecid group. The proportion of patients failing therapy at 72 hours was similar between the treatment groups (4.2% and 6.1%, risk difference 1.9%, 95% CI -3.7% to 7.6%). Clinical cure at 7 days was not significantly different (100% and 97.7%, risk difference -2.3%, 95% CI -6.7% to 0.8%). CONCLUSION: Cephalexin at appropriate doses appears to be a safe and effective alternative to outpatient parenteral cefazolin in the treatment of uncomplicated mild-moderate SSTIs who present to the ED. TRIAL REGISTRATION NUMBER: NCT01029782; Results.

Intensity of anticoagulation with warfarin and risk of adverse events in patients presenting to the emergency department.

BACKGROUND: The ability of patients receiving warfarin to maintain an international normalized ratio (INR) within the desired therapeutic range is important for both efficacy and risk of adverse events. It is unclear whether the desired INR is maintained in patients receiving warfarin who present to the emergency department (ED) and whether they have a higher rate of adverse events. OBJECTIVE: To evaluate the intensity of anticoagulation with warfarin and the risk of bleeding and thromboembolic complications in patients in the ED. METHODS: A prospective observational study was performed using a convenience sample of patients receiving warfarin and presenting to the ED over an 18-week period. Data were collected using a standardized form that included chief complaint, history of present illness, past medical history, medication history, and allergy status. Information from the physical examination, laboratory results, and other diagnostic tests obtained as part of routine assessment in the ED, was used as necessary. The primary outcome was the proportion of patients whose INR was within, above, or below the desired therapeutic range. Bleeding complications and thromboembolic events were recorded in an attempt to determine the relationship between the intensity of anticoagulation and adverse outcomes. RESULTS: Two hundred one patients were included, with a mean (SD) age of 74.0 (13.2) years; 53.7% were female. Primary indications for warfarin were atrial fibrillation (75.6%) and venous thromboembolic disease (14.9%). A therapeutic INR was observed in 88 patients (43.8%; 95% CI 37.1 to 50.7), while 45 patients (22.4%; 95% CI 17.2 to 28.7) and 68 patients (33.8%; 95% CI 27.6 to 40.6) had subtherapeutic and supratherapeutic INRs, respectively. Overall, there were 28 (18 major and 10 minor) bleeding complications (13.9%; 95% CI 9.8 to 19.4) and 4 thromboembolic events (2.0%; 95% CI 0.6 to 5.2). Among patients with a bleeding complication, 14 (50.0%) had a supratherapeutic INR, while 2 patients who experienced a thromboembolic event (50.0%) had a subtherapeutic INR. CONCLUSIONS: The majority of patients receiving warfarin on presentation to the ED had INRs outside the desired therapeutic range. By establishing the impact of warfarin-related adverse events in this population, focused interventions can be established in this setting to address factors that can be targeted to reduce these events.

Pap smear versus speculum examination: can we teach providers to educate patients?

OBJECTIVE: To test whether provider-based training in focused patient communication can improve patient knowledge about Pap screening as part of the speculum examination in an urban urgent care setting. METHODS: A separate samples pretest, posttest study evaluated the intervention. Before the intervention, we surveyed a convenience sample of 383 consecutive patients who received a speculum examination in a gynecology urgent care clinic of an urban public hospital about their understanding of the Pap smear and its correct use. The intervention trained healthcare providers to briefly explain speculum examinations and Pap smears. After the intervention, we surveyed 130 additional consecutive patients. RESULTS: The intervention was associated with improved identification that a Pap smear had not been performed (57.7% preintervention vs. 70.7% postintervention, p = 0.013) and improved knowledge that the Pap smear screens only for cervical cancer (12.0% preintervention vs. 23.8% postintervention, p = 0.002). In logistic regression analysis controlling for age and other potential confounders, being in the postintervention group and speaking Spanish predicted correct identification of Pap test use (odds ratio [OR], 95% confidence interval [CI] 2.70, 1.54-4.75, and 2.98, 1.48-5.98, respectively). CONCLUSIONS: In an urban urgent care setting, patients may lack awareness that screening tests are not being performed at the time of a problem-oriented pelvic examination. A targeted intervention to improve physician counseling was associated with partial improvement in patient awareness and knowledge.

Vaginal cleansing before cesarean delivery to reduce postoperative infectious morbidity: a randomized, controlled trial.

OBJECTIVE: The objective of the study was to determine whether vaginal preparation with povidone iodine before cesarean delivery decreased the risk of postoperative maternal morbidities. STUDY DESIGN: The design of the study was a randomized, controlled trial in women undergoing cesarean delivery with subjects assigned to have a preoperative vaginal cleansing with povidone iodine or to a standard care group (no vaginal wash). The primary outcome was a composite of postoperative fever, endometritis, sepsis, readmission, wound infection, or complication. RESULTS: There were 155 vaginal cleansing subjects and 145 control subjects. Overall, 9.0% developed the composite outcome, with fewer women in the cleansing group (6.5%) compared with the control group (11.7%), although the difference was not statistically significant (relative risk, 0.55; 95% confidence interval, 0.26-1.11; P = .11). Length of surgery, being in labor, and having a dilated cervix were all associated with the composite morbidity outcome. CONCLUSION: Vaginal cleansing with povidone iodine before cesarean delivery may decrease postoperative morbidities, although the reduction is not statistically significant.