Attitudes of adult/adolescent sexual assault nurse examiners and caring for younger patients.

INTRODUCTION: Sexual Assault Nurse Examiners (SANEs) are specialized nurses who provide sexual assault (SA) examinations and forensic evidence collection. Currently, Adult/Adolescent (A/A) SANEs in Massachusetts are trained and certified to care only for patients 12 years and older who present acutely to EDs. The purpose of this study was to describe the attitudes of SANEs regarding the possibility of cross-training to care for younger patients (<12 years). METHODS: This qualitative, descriptive study included a sample of 45 A/A SANEs who participated in a series of 6 focus groups. The focus groups were audiotape-recorded and transcribed verbatim. Content analysis was used to analyze the raw data. Units of in vivo coding assisted in the identification of initial broad categories that were winnowed to represent final themes that described the participants' attitudes. RESULTS: Although the majority of SANEs enthusiastically endorsed the option of pediatric cross-training, a smaller portion of participants expressed strong opposition to the proposal. The SANEs' concerns included the emotional toll of caring for children who have been sexually assaulted, and the need for an adequate infrastructure within the SANE Program to educate, train, and support the cross-training effort. DISCUSSION: This research fills a gap in the forensic and ED nursing literature by providing insights into the attitudes and concerns of SANEs who care for some of the most vulnerable patients. The findings of this study can inform the acute care and evidence collection practices that are used when caring for pediatric patients who have experienced SA.

[Liability of pediatric nurses for professional negligence in Taiwan: a case study].

BACKGROUND: Liability attribution and professional negligence in pediatric nursing are topics that have been neglected in Taiwan. PURPOSE: (1) Identify the definitions of related criminal activities in accordance with domestic criminal law; (2) Elucidate the facts and the dispute in a current case involving a pediatric nurse; (3) Elucidate the principle of 'no punishment without law'; (4) Explore the reasons why the pediatric nurse in the current case received a verdict of 'not guilty'. METHODS: A literature review and case study approach were used to analyze a sentence reconsideration of the first instance No. 1 (2011) issued by the Taiwan high court, Kaohsiung branch court. RESULTS: The conditions for the scrutiny of criminal activity under Taiwan criminal law are statement of facts, illegality (justifiable cause), and liability (excuse). In this case, the pediatric nurse was accused of failing to prevent an infant from suffocation and of not discharging her obligations as a nurse. The pediatric nurse rebutted the charge of criminal negligence. The intervening behaviors of the pediatric nurse were found to be legal and not culpable. In this case, the High Court and Supreme Court made a final criminal judgment based on the presumption of innocence, and the pediatric nurse was pronounced innocent of the charge. CONCLUSIONS: This article intends to assist pediatric nurses understand their liabilities under Taiwan's criminal law. Pediatric nurses should gain a better understanding of the nature of liability for professional negligence in order to clarify how actions that may be illegal do not necessarily make nurses culpable.

The Sexual Offences (NI) Order 2008: implications for nurses.

This article outlines the changes to the definition of sexual offences in Northern Ireland following the implementation of the Sexual Offences Northern Ireland Order 2008 in 2009, and its implications for nurses working with sexually active children in a range of clinical settings. The paper outlines the key changes for practice and addresses the needs of children in three different age groups with emphasis on children aged 13-15 years, and reviews mandatory reporting, the difference between the rights of children to consent and confidentiality, developmental sexual experimentation and sexual health protection. It reviews related policy and guidance and makes clear the differences between sexual abuse and exploitation, and experimentation. It seeks to advise the Safeguarding Committee of the Department of Health Northern Ireland on how best to support nurses working with sexually active children and when this activity should be discussed with line managers and safeguarding specialists or referred to the safeguarding authorities.

Statewide and national impact of California's Staffing Law on pediatric cardiac surgery outcomes.

OBJECTIVE: The objective of the study was to examine the impact of staffing ratios on risk-adjusted outcomes for pediatric cardiac surgery programs in California and relative to other states combined. BACKGROUND: California performs 20% of the nation's pediatric cardiac surgery and is the only state with a nurse ratio law. Understanding the imposition of mandated ratios on pediatric outcomes is necessary to inform the debate about nurse staffing. DATA SOURCES: Patient variables were extracted from the Healthcare Cost and Utilization Project Kids' Inpatient Database. The American Hospital Association database was used for institutional variables. METHODS: Descriptive analyses were used to identify and describe patient, nursing, and hospital characteristics. Changes in nursing ratios and full-time equivalents (FTEs) between 2003 and 2006 were examined. Associations between nursing characteristics and each outcome variable were examined using general estimating equation models. The RACHS-1 (Risk Adjustment for Congenital Heart Surgery) risk adjustment method was used for mortality. RESULTS: Hospitals in California significantly increased RN FTEs (P = .025) and RN ratios (P = .036) after enactment of AB 394 in 2006. Neither RN FTEs nor RN ratios were associated with mortality, complications, or resource utilization after risk adjustment. After the law, California's standardized mortality ratio (SMR) decreased more (33%) than in all other states combined (29%). Standardized complication ratio (SCR) increased by 5% but decreased by 5% for all other states combined, and the increase in charge differential ($53,443) was more than twice the increase ($23,119) for other states combined. CONCLUSION: Hospitals in California made upward adjustments in nursing FTEs and ratios after enactment of AB 394. There was a substantial increase in California's charge differential, a decrease in SMR, and an increase in SCR after enactment of the legislation.

Safe patient handling and movement in a pediatric setting.

Although evidence-based practice exists to apply the principles of safe patient handling and movement (SPHM) to prevent nursing musculoskeletal injuries in the workplace, nurses and nursing staff continue to use "body mechanics" when moving, lifting, and transferring patients. In this day of a nursing shortage, one that will continue to worsen, valued professionals must remain on the job and free from preventable, work-related injuries. As states enact laws requiring health care facilities to develop and institute SPHM programs, hospitals will be held to task to produce SPHM policies, procedures, plans, and protocols in their institutions.