The contributors to dosage calculation ability and its applicability to nursing education: An integrative review.

Medication errors are a major patient safety issue and account for 1-2 million hospitalizations and between 100,000 and 200,000 deaths annually. Approximately 41 % of all medication errors are due to improper dose calculations. Studies have shown mean scores on the medication dosage calculation test for nursing students range from 35 to 71 %. Despite new technology created to aid in dosage calculations, the issue is still prevalent among nurses. It is critical that the elements contributing to the nurses' ability to complete dosage calculations be determined so that calculation curriculum in nursing schools can be updated to better prepare students for practice. An integrative review was completed using the databases of PubMed, CINAHL, and Embase to answer the research question: What contributors impact nurses' and nursing students' ability to complete dosage calculations? Four articles met the specified inclusion criteria and were used for this review. The three most common contributing themes among the review sample included mathematical medication calculation ability, medication calculation frequencies, and dosage calculation education. Results from this review can inform the issue of dosage calculations and highlight the need for further research regarding the medication administration competencies taught in undergraduate nursing studies.

Shared Risk Factors Among Women for Intimate Partner Violence in the United States: A Secondary Analysis.

Multilevel risk factors may increase the risk of experiencing intimate partner violence among women. The overall goal of this study was to provide a comprehensive view of factors that may be associated with three forms of intimate partner violence. The primary aim was to explore associations between understudied factors and women's experiences of physical and sexual violence and stalking by an intimate partner. Secondary analysis of existing health registry data was conducted. Our evidence-driven strategy was based on a multipronged analytical approach informed by existing literature and the social-ecological model. We created an evidence-based hierarchical list comprised of three tiers. Three separate multiple logistic regression analyses were performed. Several shared risk factors were retained across all three forms including low levels of formal education, past experiences of non- partner sexual violence, residential instability, presence of children, experiences of a traumatic event and panic attacks, status of receiving US government benefits, and barriers to healthcare access. Results contribute to future research on intimate partner violence prevention by providing preliminary evidence of emerging factors associated with experiencing three forms of intimate partner violence.

Critical Care Nurses' Attitudes About Family Presence During Resuscitation: An Integrative Review.

BACKGROUND: Family presence during resuscitation was introduced into clinical practice 30 years ago. Despite adoption of family-centered care by several health organizations and support for family presence during resuscitation by professional organizations such as the American Heart Association, critical care nurses' attitudes about family presence during resuscitation vary widely. OBJECTIVE: To examine current evidence on critical care nurses' attitudes about, perceptions of, and behaviors related to practicing family presence during resuscitation. METHODS: The method of Whittemore and Knafl guided the integrative review. Databases searched were CINAHL, PubMed, and Scopus. Articles included were English-language studies published from 2008 to 2022 that examined the perceptions of critical and emergency care nurses from adult units regarding family presence during resuscitation. RESULTS: Twenty-two articles were included. Levels and strength of evidence were assessed with the Johns Hopkins nursing evidence-based model. The articles in this integrative review included a total sample size of 4780 health care professionals; 3808 were critical and acute care nurses. DISCUSSION: Themes synthesized from current evidence included attitudes, benefits, barriers, demographic influence, cultural influence, and facilitators. Barriers and facilitators were associated with nursing practice in rural versus urban settings, age-related factors, years of experience, and unit-based differences in practice. Developing interventions to address identified factors can increase the practice of family presence during resuscitation in critical care settings. CONCLUSIONS: Several factors influence the practice of family presence during resuscitation in critical care settings. Nurse leaders should consider these factors to enhance the practice of family presence during resuscitation.

The influences of sociocultural norms on women's decision to disclose intimate partner violence: Integrative review.

Sociocultural norms against women can contribute to promoting intimate partner violence (IPV) and shape women's decision to disclose IPV. A cross-cultural analysis of the existing literature is needed to present an overview of the influences of sociocultural norms on women's decisions regarding the disclosure of IPV across different cultural contexts. The purpose of the review was to synthesize published quantitative, qualitative, and mixed methods (MMs) studies to identify known sociocultural norms across different cultures that may influence women's decision to disclose IPV. The Whittemore and Knafl framework, Rayyan software, and PRISMA flow diagram were used. Databases included APA PsycInfo, CINAHL, PubMed, SocINDEX, and Women's Studies International. The quality of studies was assessed by the MMs appraisal tool. A total of 15 research articles written in English and published in peer-reviewed journals were included. Main categories emerged: (1) stigma surrounding IPV disclosure, victimization, and divorce; (2) gender roles; (3) preserving family honor; and (4) Children's well-being and future. A one-size-fits-all approach is not adequate for women who are considering disclosing IPV. Findings underscore that regardless of residing in individualistic countries, those sociocultural norms related to traditional gender roles and gender inequality are still important barriers to the disclosure of IPV among women with collectivist roots.

Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers.

Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].

Self-esteem in the context of intimate partner violence: A concept analysis.

AIM: To explore the meaning of self-esteem in the context of intimate partner violence (IPV). BACKGROUND: IPV is a preventable public health issue. The dynamic of IPV diminishes women's self-esteem. Defining self-esteem will guide the development of IPV interventions in healthcare settings. DESIGN: Walker and Avant's eight-step approach was used. DATA SOURCE: The search was conducted from Oxford Dictionary of English online, CINAHL, APA PsycInfo, PubMed, Women's Studies International, and Google Scholar. REVIEW METHODS: No limits on the year of publication were applied. RESULTS: Defining attributes of self-esteem are self-concept, self-affirmation, and self-respect. Antecedents of self-esteem are exposure to IPV and victim-blaming attitudes by healthcare professionals. Consequences include depression, substance abuse, and posttraumatic stress disorder. Empirical referents include self-worth, self-competence, self-blame, self-evaluation, self-confidence, and self-determination. CONCLUSIONS: Current literature is limited in its definition of self-esteem in the context of IPV. Women experiencing IPV with low self-esteem might not seek help for IPV from nurses. Nurses could develop culturally appropriate IPV screening tools that assess the changes in self-esteem among women from different sociodemographic and cultural backgrounds. The defining attributes could contribute to developing comprehensive IPV screening tools in healthcare settings.

Workplace Violence Prevention Training, Safety Resources, and Commitment to HHCWs' Safety.

BACKGROUND: The threat of workplace violence (WPV) is a primary safety concern for home health care workers (HHCWs). WPV prevention training is a critical tool for HHCWs' safety. Yet, most existing WPV prevention training is limited or not specific to HHCWs' environment, the patient's home, and neighborhood. The purpose of this study was to describe WPV prevention training, resources used, and commitment to HHCWs' safety. METHODS: Using a cross-sectional design, HHCWs from two sites located in Southwestern Ohio completed the Violence Against Home Healthcare and Hospice Workers survey, a 37-item survey used to describe frequency and characteristics of WPV prevention training and resources. Descriptive statistics were used to analyze the data. FINDINGS: Half (n = 25) of the HHCWs received WPV prevention training. Training content focused on characteristics of aggressive/violent patients and family members (n = 19, 82.6%), but limited content about characteristics of hazardous neighborhoods (n = 15, 65.2%). Cellular phones (n = 43, 97.7%) were primarily used as a resource to promote safety, few cellular phones (n = 1, 2.3%) were provided by the agency. CONCLUSIONS/APPLICATION TO PRACTICE: HHCWs described WPV prevention training content and resources used to promote safety. WPV prevention training is deficient in procedures for seeking psychological care, screening patients for violent behavior, skills for self-protection, characteristics of hazardous neighborhoods, and physical maneuvers and verbal methods to diffuse or avoid aggressive behavior. Access to WPV prevention training and resources for HHCWs needs to be strengthened. Occupational Health Nurses can assist their employers with developing WPV prevention training for HHCWs.

Perceptions of the Essential Components of Triage: A Qualitative Analysis.

INTRODUCTION: Triage is an important process to determine severity of illness and prioritize patient emergencies while also ensuring patient safety. The emergency nurse must use critical thinking and decision-making to identify life-threatening emergencies and improve patient outcomes. However, the addition of risk screenings and quality improvement initiatives has extended the triage process time, which may increase interruptions and opportunities for errors. The purpose of this descriptive qualitative study was to determine emergency nurse perceptions of current triage processes and categorize essential and nonessential triage components. METHODS: Focus groups of frontline emergency nurses who regularly conduct triage in the emergency department were conducted to discuss perceptions of triage assessments and questions. The 3 focus group discussions were digitally recorded and transcribed. Data analysis consisted of descriptive statistics of the sample and the conventional content analysis of the transcripts. RESULTS: A total of 12 emergency nurses participated in the study. The overall theme that emerged surrounding essential triage components was a perceived conflict between individualized care and maintaining systems and processes. This theme consisted of 4: (a) must ask, (b) actions of triage, (c) relevant but not urgent for triage, and (d) not perceived as relevant. CONCLUSION: This study identified the perceptions of emergency nurses surrounding the urgency of triage components in the emergency department. Emergency nurses perceived some assessments as essential to determining "sick versus not sick," and other triage components were able to be delayed, streamlining the triage process.

Emotions and feelings evoked in nursing students exposed to bullying behaviors in clinical settings.

BACKGROUND AND OBJECTIVE: Though not fully integrated into the profession, student nurses have been exposed to and experienced bullying behaviors with limited skills to mitigate the effects of the behaviors. This qualitative study analyzed the emotions evoked due to exposure to bullying behaviors. Desired to address the question: "How do student nurses feel when they are the recipient of bullying-type behaviors?" METHODS: DESIGN: Qualitative descriptive design. SETTING: A nursing college at an urban university in the Midwestern United States; PARTICIPANTS: Matriculated students enrolled in a pre-licensure nursing program. METHODS: As part of a larger mixed informed pilot study, each participant was assigned to either the control or intervention group. Participants in the intervention group received an educational intervention focused on bullying two weeks prior to a scheduled clinical simulation. Participants in both groups each completed an individual clinical simulation during which they were exposed to bullying-type behaviors meant to replicate behaviors they may encounter in actual clinical settings. All participants were informed of their right to disenroll from the study at any point. For the health and safety of participants, individuals were provided with safeguards during the study as well as upon conclusion of their participation. Immediately following the simulation, participants completed an individual debrief interview during which they were asked to describe how the simulation made them feel. Responses were audio recorded and transcribed verbatim. Data were analyzed using a descriptive qualitative to generate thematic results. RESULTS: The three major themes developed included Past Bullying-like Behavior, Feelings Experienced during Simulation, and Perceptions of the Simulation. Participants reported experiencing negative emotions due to the bullying behavior exposure despite receiving an educational intervention. Harmful emotions, such as sadness, led participants to question their ability to perform simple tasks. Student nurses possess the skills and knowledge to perform routine tasks; however, when bullying behaviors target nursing students, the negative behaviors have the potential to adversely affect the whole student. CONCLUSIONS: Further research is warranted to identify programs to aid students in overcoming the negative bullying behaviors in the clinical setting.

Standing up against workplace bullying behavior: Recommendations from newly licensed nurses.

OBJECTIVE: Workplace bullying exists in today's healthcare system and often targets newly licensed nurses. Experiences of workplace bullying behavior may negatively affect the nurses' physical and psychological health and impact job satisfaction and staff turnover rates at an organizational level. The purpose of this study was to explore strategies suggested by newly licensed nurses to prevent and intervene during incidents of workplace bullying behavior. METHODS: An exploratory qualitative design guided this study. Three open-ended questions asked included: What do you think could be done to prevent a future, similar incident of workplace bullying? If you or someone else attempted to the stop the bullying incident, please describe the actions taken. If you or someone else did not attempt to stop the bullying incident, please state what would need to happen for you to intervene on behalf of yourself or someone else. Surveys were distributed electronically to newly licensed nurses from three baccalaureate nursing programs who had participated in a workplace bullying education intervention study as students. A total of 79 responses were received. Responses to three open-ended questions about recent incidents of workplace bullying behavior were coded and analyzed. Then the Social-Ecological Model was used to organize results into individual, relationship, and organizational level strategies. RESULTS: Most respondents reported experiencing workplace bullying behaviors in the previous six months. Three domains of strategies were identified: Preventing Future Bullying Behavior, Stopping Incidents of Bullying Behavior, and Promoting Others to Act. CONCLUSIONS: Results indicated newly licensed nurses desire to be supported by their peers and organization as well as strategies to intervene when bullying behaviors occur. Implications for clinical practice and education are presented.

Interventions against bullying of prelicensure students and nursing professionals: An integrative review.

The problem of bullying is of such significance, health care accreditation agencies such as The Joint Commission have reiterated that these behaviors compromise on patient safety. Researchers demonstrate that much is known about the existence of bullying behaviors in health care and its detrimental effects on the profession of nursing. Leaders in health care and nursing education are beginning to tackle this issue. Guided by the methodology of Whittemore and Knafl, the purpose of this integrative review was to analyze literature discussing the interventions against bullying directed towards prelicensure nursing students and professionals.

Use of a Systematic Consultation Process to Facilitate Nursing Research Projects: An Exemplar.

PURPOSE/OBJECTIVES: The purpose of this article is to describe the use of a well-established, 5-stage consultation process, to advise a research team on planning strategies to engage domestic violence shelters (DVSs) as community partners in their study. The research team is testing a health promotion intervention for teens living in shelters with their parent and needed to enlist shelters as sites to recruit teens and conduct the intervention. Consultation aims were to (a) identify highly promising strategies described in peer-reviewed literature for identifying, recruiting, and collaborating with community organizations in research and (b) identify DVSs that would potentially serve as effective community partners for the study. METHODS: A clinical nurse specialist and a public health master's degree student led the consultation. The consultation process included (a) a systematic review of 29 peer-reviewed articles about research or program evaluation studies that engaged community partners and (b) a comprehensive online search of information about DVSs. OUTCOMES: Consultants identified 104 strategies used in studies to engage community partners and 10 specific DVSs most likely to effectively engage in the study. CONCLUSION: Clinical nurse specialists are well situated to provide consultation to research teams and should follow well-established consultation processes and systematic data collection procedures.

Seeing Students Squirm: Nursing Students' Experiences of Bullying Behaviors During Clinical Rotations.

BACKGROUND: Bullying remains a troubling problem in the nursing profession. Nursing students may encounter bullying behavior in clinical settings. However, they may not be adequately prepared to recognize and handle bullying behavior when it occurs. This study's purpose was to gain a greater understanding of nursing students' experiences of bullying behaviors in the clinical setting. METHOD: Using a descriptive qualitative approach, eight focus groups were held with 56 undergraduate baccalaureate nursing students from four college campuses. Focus group data were coded and analyzed for themes. RESULTS: Four categories were identified: Bullying Behaviors, Rationale for Bullying, Response to Bullying, and Recommendations to Address Bullying. Each category and its corresponding themes are presented. CONCLUSION: Interventions for nurse educators to address the bullying of nursing students in clinical settings are presented. [J Nurs Educ. 2016;55(9):505-513.].

Stimulating Research Interest and Ambitions in Undergraduate Nursing Students: The Research-Doctorate Pipeline Initiative.

BACKGROUND: Innovative strategies may support the Institute of Medicine's recommendation to increase the number of doctorally prepared nurses by 50% by 2020. Moreover, strategies implemented may increase the number and diversity of Doctor of Philosophy (PhD)-prepared nurses in particular. METHOD: The purpose of this article is to describe the approaches used by one college of nursing to enact a research-doctorate pipeline initiative to inspire a diverse pool of undergraduate students to consider pursuing a PhD degree. Principles that served as the foundation for this pipeline initiative are identified. RESULTS: Sixteen undergraduate students, with varying degrees of research interest, participated in this initiative. Students contributed an average of 35 hours as full members of research teams, and 94% completed the experience. Students with initial low interest in research reported enhanced interest after participation. Overall student experiences were positive and influenced future career plans. CONCLUSION: Lessons learned and future steps for the pipeline initiative are presented.

Adolescent Workers' Experiences of and Training for Workplace Violence.

Adolescent workers may not be aware that violence is a safety concern in the workplace. As part of a larger mixed-methods pilot study, investigators used a self-administered survey and individual interviews with 30 adolescent workers from a chain of food service stores in a Midwestern metropolitan area to explore experiences of workplace violence (WPV) and ways of learning WPV-specific information. Participants reported experiencing verbal and sexual harassment and robberies. Most participants reported awareness of WPV-specific policies and procedures at their workplace; the ways participants reported learning WPV-specific information varied. Findings support the need for occupational safety training to assist adolescent workers prevent and mitigate potential WPV.

Adolescents' experience with workplace aggression: school health implications.

Aggression exposure is a critical health issue facing adolescents in the United States. Exposure occurs in various settings including home, school, and the community. An emerging context for aggression exposure is in the workplace. Thirty adolescent employees age 16-18 participated in a qualitative study exploring proposed responses to future workplace aggression. Semistructured interviews were used to gather participants' proposed responses to a series of hypothetical aggressive incidents in the workplace. Conventional content analysis identified patterns and themes among the participants' responses. Results indicated adolescent employees' proposed responses to workplace aggression are similar to other forms of aggression such as peer-bullying and teen dating violence. Education and training are needed within the school setting to promote appropriate responses to various forms of aggression encountered by adolescents. Implications for school health professionals' involvement in addressing responses to such aggression and further research opportunities are explored.

Genetics/genomics advances to influence care for patients with chronic disease.

Rapid changes in the field of genetics/genomics are affecting the way we practice nursing. Staying current on this dynamic field is a challenge for all healthcare professionals. This article discusses genetics/genomics issues that are likely to have a strong influence on nurses who care for patients with chronic disease. Complex diseases involving the actions of genes and environment are the most common causes of morbidity and mortality. Pharmacogenetics/pharmacogenomics has the potential to alter the way we choose both medications and appropriate doses. Nutrigenomics promises to help us understand how diet affects gene expression and how genetic variants affect the way we use nutrients. Genetic testing can be purchased through the Internet and currently is being marketed directly to consumers. Each of these topics has present and future implications for all healthcare professionals, especially those caring for people with chronic disease.

Measuring sports participation decisional conflict in youth with cardiac pacemakers and/or ICDs.

AIMS: We examined the Decisional Conflict Scale to determine if it would be useful to measure conflict around sports participation decision-making in youth with cardiac pacemakers and/or implantable cardioverter defibrillators. BACKGROUND: Sports participation decisions made by parents and youth with implanted cardiac devices can have profound implications. Contact sports can result in damage to the device and leads, but the value of exercise is well documented and restriction from a cherished activity can increase resistance and distress in the young. The extent of this problem is unknown. METHODS: An explanatory mixed methods design was used with a convenience sample (N=35) of youth aged 12-21 (Mean=16.5; sd=3) years awaiting services at an electrophysiology clinic. Data were collected between 2007 and 2008. The Decisional Conflict Scale is a self-report measure, used worldwide in adult populations. Analyses and interviews determined the properties of the measure and whether the instrument captured conflict. RESULTS: The scale showed strong internal consistency (Cronbach alpha=0.87). Overall scores were low (Mean=17.31; SD=10.99; range=0-37). There was no statistically significant difference (P>0.05) in total scores between boys (n=25) and girls (n=10) using independent t-tests. Qualitative analysis documented conflict and non-adherence to clinician recommendation despite low scores. CONCLUSIONS: Analyses indicate that youth aged 12-21 years understand and can effectively complete the Decisional Conflict Scale, but this instrument alone did not capture all conflict. These results can guide study of the extent of this problem and eventual development of an intervention to support sports participation decision-making.