Save Your Back: Comparison of the Compressive Force on the Lower Back Based on Differences in the Training Techniques.

INTRODUCTION: Musculoskeletal injury prevention for nurses is aimed at removing the need to manually position patients. In the ED, this is not always possible or practical. The purpose of this study is to compare the calculated estimated compressive force on the lumbar spine between recommended lifting techniques and the SHAPE lifting method during the horizontal transfer of a patient. METHODS: Twenty-one student nurses completed the horizontal transfer of a simulated patient while motion was collected using inertial measurement units. Motion data were analyzed to calculate an estimated compressive force on the lumbar spine while completing the movement based on current recommended lifting methods and while using the SHAPE lifting method. RESULTS: A significant reduction in estimated peak and average compressive force at the lumbar spine was found during both the push and the pull portions (P < .001) of the horizontal transfer. DISCUSSION: While the optimal way to limit musculoskeletal injury among nurses is to eliminate the need for manual handling of a patient, this is not always possible in the ED. It is critical that when emergency nurses must reposition a patient, they perform the movement in the most biomechanically sound method while using a friction reduction. These findings, coupled with the previous biomechanical risk factor reduction related to the SHAPE lifting intervention, gives promise to a safer lifting strategy for emergency nurses moving forward.

Determining Clinical Judgment Among Emergency Nurses During a Complex Simulation.

INTRODUCTION: Clinical judgment is imperative for the emergency nurse caring for the acutely ill patients often seen in the emergency department. Without optimal clinical judgment in the emergency department, patients are at risk of medical errors and a failure to rescue. METHODS: A descriptive observational approach using the Lasater Clinical Judgment Rubric evaluated nurses during a task that required recognition of clinical signs of deterioration and appropriate clinical care for simulated patients. RESULTS: A total of 18 practicing emergency nurses completed only 44.6% of the patient assessments leading to low levels of clinical judgment throughout the simulation. Nurses expressed 4 levels of clinical judgment: exemplary (n = 1), accomplishing (n = 6), developing (n = 9), and beginning (n = 2). On average, nurses completed 69% of required tasks. DISCUSSION: Assessments were completed less than half the time, demonstrating a breakdown in the noticing phase of clinical judgment. The nurses shifted to task completion focus with minimal use of clinical judgment. As the nurses remained task oriented, several medication and medical errors were noted while caring for the simulated patients. Experience and education did not influence observed clinical judgment among the participants. Given the extreme demands placed on the emergency nurse, it cannot be assumed that nurses have developed or can use clinical judgment when caring for their patients. Time and training targeting clinical judgment are essential for emergency nurse development.

Calories and control: Eating habits, behaviors, and motivations of Generation Z females.

OBJECTIVE: This qualitative phenomenological study explored eating habits, behaviors, and motivations of Gen Z females (born 1996-2002). PARTICIPANTS: Ten participants met selection criteria: female aged 18-24 (thus, part of Gen Z), enrolled full-time at the University and able to share experiences. Maximum variation was sought for race/ethnicity, Greek life/sorority involvement and hometown regional area. METHODS: Semi-structured interviews elicited detailed descriptions of lived experiences. Data consisted of five face-to-face interviews and five Internet-based teleconferenced interviews. Saldana's First Cycle/Second Cycle constant comparative method was used for data analysis. RESULTS: Four themes and four subthemes were identified: Blurred Lines (healthy versus disordered behaviors), Rationalizing Behaviors (Denial), Technological Influences (Social Media; Self-Worth), and Pandemic Influence. CONCLUSION: Gen Z represents a pivotal population with diverse characteristics. These findings are helpful to health professionals, faculty, academic administrators, and others with vested interests in promoting healthier living, learning and work environments for this population.

"Black out or back out": Understanding the alcohol habits, behaviors, and motivations of generation Z students.

OBJECTIVE: This qualitative phenomenological study explored alcohol habits, behaviors, and motivations of Gen Z students (born 1996-2010). Participants: Thirteen participants met selection criteria: aged 18-24 years (thus, part of Gen Z), enrolled as at either the University or community college, and able to share experiences. Maximum variation was sought for race/ethnicity, Greek life/sorority involvement and hometown regional area. Methods: Semi-structured interviews elicited detailed descriptions of lived experiences. Saldana's First Cycle/Second Cycle constant comparative method was used for data analysis. Results: Five themes were identified: Motivations to Drink, Know My Limits, Exceeding Limits Leads to Risky Behaviors, Hangover Anxiety ("Hangxiety"), and Greek Life Influence. Additionally, the subtheme Internal Thoughts and Rationalizations was identified. Conclusion: Unique characteristics and unprecedented times contribute to alcohol consumption behaviors of Gen Z students. These findings hold an awareness to assist in the provision of education, support, and needed resources.

Development and Feasibility Testing of a Contextual Patient Movement Intervention.

INTRODUCTION: Nurses and emergency medical services workers frequently suffer musculoskeletal injuries at a disproportionate rate in relation to the rest of the population. The most common form of this musculoskeletal injury is lumbar spine injury. The purpose of this study was to develop and conduct phase 1 feasibility testing of a contextual lifting intervention that reduces the risks of low back injury. METHODS: This study was an intervention development and phase 1 feasibility test. The intervention was created on the basis of weightlifting techniques to specifically reduce the incidence injury related to valgus knee, asymmetrical lifting technique, and rotation of the trunk and pelvis. Motion capture technology (Xsens; Xsens Technologies) was used while 17 nursing students completed the direct patient lift from the floor, the lift from the floor with a manikin attached to a rigid spine board, the push portion of the horizontal transfer, and the pull portion of the horizontal transfer. Pre- and postintervention data were collected. Linear mixed model regression, with pairwise comparisons, was conducted for each lift at the time points of preintervention, immediately after the intervention, and 1-month postintervention. RESULTS: Significant changes were noted between the initial lifting techniques used and those used after the intervention. The maximum lever arm distance, defined as the distance from L5-S1 to the center of the force applied to the load, showed a significant reduction after the intervention in 3 of the 4 movements. DISCUSSION: Our results support the idea that injury risk can be reduced through appropriate contextual training methods.