The factors contributing to missed care and non-compliance in infection prevention and control practices of nurses: A scoping review.

Background: There is growing concern about missed nursing care and its negative impacts on patient care and nursing and organisational outcomes. Research in the area continues to grow, with a greater focus on reliable measurement, evidence-based interventions and sensitive outcomes. The relationship between missed care and adverse patient outcomes is undeniable, including increased mortality levels, and hospital acquired infections. The link between hospital acquired infections and non-compliance with infection prevention and control guidelines is also widely acknowledged. The idea of non-compliance as an element of missed nursing care has not been closely examined and this relationship is explored in this review. Objectives: The aim of this study is to identify the shared factors related to both nurse non-compliance with infection prevention and control practices and the recognised research field of missed nursing care, here in relation to infection prevention and control. Methods: A scoping review methodology was selected to help explore and map the research evidence on non-compliance with infection prevention and control practices, and missed nursing care in relation to infection prevention and control. Results: Five key themes were identified which impact on both missed nursing care and non-compliance in the area of infection prevention and control. These included (1) Organisation of Nursing Staff and Resources; (2) Workplace Environment; (3) Nursing Care Context; (4) Managerial and Inter-Professional Relationships; and (5) Individual Nurse Factors. These shared themes underline the relationship between the concepts and suggest a shared research area. Conclusion: Missed nursing care in the area of infection prevention and control, overlaps significantly with the research area of infection prevention and control non-compliance. This suggests that rather than being approached as separate or distinct entities, these research areas should be acknowledged as related or overlapping, enabling more focused attention to reducing levels of both.Tweetable abstractMissed nursing care in the area of infection control, overlaps significantly with the research area of non-compliance with infection prevention and control guidelines.Contribution of the PaperWhat is already known about the topic?• Missed nursing care has been linked over many years with increased rates of Healthcare Associated Infection rates.• Healthcare Associated Infections can result in higher rates of morbidity and mortality, but they are largely preventable.• Infection prevention and control guidelines are designed to protect both patients and healthcare workers from infection in healthcare settings, but non-compliance with these guidelines is an on-going concern.What this paper adds?• Factors influencing missed nursing care in general, and specifically missed infection prevention and control care, are similar to factors influencing non-compliance rates with infection prevention and control guidelines.• The concepts of missed nursing care in infection prevention and control, and non-compliance with infection prevention and control guidelines are essentially the same thing and should be treated as such by nurses, researchers, and healthcare organisations. This would enable a more focused and strategic response to infection prevention and control practices, ultimately helping to reduce preventable healthcare associated infections.

Pharmacist and pharmacy intern perceptions of adolescent vaccination administration.

OBJECTIVES: To characterize pharmacists' and pharmacy interns' perceptions of administering adolescent vaccinations. Secondary objectives were to model the association between 1) perceptions and respondent demographic information and 2) pre- and post-training survey responses. DESIGN: A 12-item survey, on the basis of the Theory of Self-Perception, was used to collect respondents' perceptions of adolescent vaccination administration retrospectively before and after pharmacist and pharmacy intern completion of Online training. The training reviewed Center for Disease Control and Advisory Committee on Immunization Practice recommendations for vaccination schedules, vaccine administration, managing adverse reactions, finding vaccine-related information, the importance of vaccinating, and dispelling common misconceptions. SETTING AND PARTICIPANTS: Pharmacists and pharmacy interns representing 114 Indiana community pharmacy locations within a national supermarket chain were eligible to complete an Online survey between March and April 2019. OUTCOME MEASURES: Descriptive statistics were used to characterize pharmacists' and pharmacy interns' perceptions of adolescent vaccination administration. A multivariable regression analysis was used to determine the association between perceptions and respondent demographic information. Differences in perceptions before and after the training module were evaluated using paired t tests. RESULTS: Of the 293 eligible pharmacists and pharmacy interns, 138 (47.1%) completed the survey and 124 (42.3%) responses were included for analysis. Pharmacists and pharmacy interns had positive perceptions of adolescent vaccination administration. There was a negative relationship between the number of years that a pharmacist had been in practice and their baseline perceptions of adolescent vaccination administration (P = 0.02). There was a statistically significant increase in perceptions following completion of the training module (P < 0.001). CONCLUSION: Pharmacists and pharmacy interns, specifically those who have been in practice for few years, had positive perceptions about adolescent vaccination administration but their perceptions were strengthened with additional training. Further research is needed to determine the relationship between additional training and vaccination rates.

A SCOPING REVIEW: The role of the nurse manager as represented in the missed care literature.

AIM: To examine how the nurse manager role is represented in the literature on missed nursing care and what is known about the impact of the nurse manager on missed care levels. BACKGROUND: The literature to date on missed nursing care is focused primarily on structural and organizational antecedents, and on outcomes for patients, nurses and organizations. Very little research exists on the role of the nurse manager in relation to missed care. EVALUATION: A scoping review using studies from four databases was conducted in 2019. KEY ISSUES: Nurse managers have a role to play in relation to missed nursing care. Greater transparency around missed care, effective leadership skills and supportive relationships with staff can help reduce missed care. CONCLUSION: Nurse managers are ideally placed to influence levels of missed care. How they enact their leadership and management roles can help reduce incidents. By paying attention to nurses' concerns, managers may be better placed to understand levels of missed care. IMPLICATIONS FOR NURSE MANAGERS: Guidance for nurse managers on monitoring levels of missed care, and the skills required to influence levels within their units are necessary.

Development and Use of Assay Conditions Suited to Screening for and Profiling of SET-Domain-Targeted Inhibitors of the MLL/SET1 Family of Lysine Methyltransferases.

Methylation of histone H3 lysine-4 (H3K4) is an important, regulatory, epigenetic post-translational modification associated with actively transcribed genes. In humans, the principal mediators of this modification are part of the MLL/SET1 family of methyltransferases, which comprises six members, MLLs1-4 and SET1A/SET1B. Aberrations in the structure, expression, and regulation of these enzymes are implicated in various disease states, making them important potential targets for drug discovery, particularly for oncology indications. The MLL/SET1 family members are most enzymatically active when part of a "core complex," the catalytic SET-domain-containing subunits bound to a subcomplex consisting of the proteins WDR5, RbBP5, Ash2L and a homodimer of DPY-30 (WRAD2). The necessity of MLL/SET1 members to bind WRAD2 for full activity is the basis of a particular drug development strategy, which seeks to disrupt the interaction between the MLL/SET1 subunits and WDR5. This strategy is not without its theoretical and practical drawbacks, some of which relate to the ease with which complexes of Escherichia coli-expressed MLL/SET1 and WRAD2 fall apart. As an alternative strategy, we explore ways to stabilize the complex, focusing on the use of an excess of WRAD2 to drive the binding equilibria toward complex formation while maintaining low concentrations of the catalytic subunits. The purpose of this approach is to seek inhibitors that bind the SET domain, an approach proven successful with the related, but inherently more stable, enhancer of zeste homolog 2 (EZH2) complex.