Expert-Type Content Validity Applications to Doctor of Nursing Practice Projects.

Background: Developing rigorous doctor of nursing practice (DNP) projects continues to challenge faculty and doctoral students. To address project rigor, expert content validity methods have been applied to clinical projects. Students implement expert content validity processes to literature-based project components. Objectives: The objectives of this study are to describe some of the developmental phases of DNP projects during the courses of one DNP program and to explore one strategy for increasing the rigor of DNP projects, review details on expert-type content validity methods, and examine literature for projects implementing an alternate application of expert-type content validity and scoring approaches to components of DNP projects. Methods: Expert content validity methods are described for DNP projects, such as guidelines, teaching plans, support groups, and algorithms. They are used to judge components generated from initial content analysis strategies. Types of expert panelists and descriptions of scoring ranks on project components are presented to represent different expert content validity strategies. Results The steps are presented to support expert content validity processes. Conclusions: DNP projects challenge faculty and students to create systematically constructed quality improvement projects on important and interesting clinical problems. The expert context validity process is one approach of enhancing project rigor. Implications for Nursing: An outline offers steps to establish expert content validity for translational DNP projects.

Components of Professional Practice Models.

OBJECTIVE: This study describes common components of nursing professional practice models (NPPMs) of Magnet ® -designated nursing service organizations. BACKGROUND: Components of professional practice models have not been consistently analyzed, suggesting a need to identify their concepts. Evidence-based guidelines may be unavailable to assist in the creation and revision of models. METHODS: A checklist was used to analyze 56 Web-based NPPMs of Magnet-designated nursing departments. RESULTS: Checklist items showed a match with parent organizations, an emphasis on patient- or family-centered care, a commitment to quality nursing services, and nursing's professional distinctiveness. Responses indicated engagement in shared governance and support of nursing staff's professional development. The concepts of health, care of sick and well people, and scope of nursing services were inconsistently addressed and call for further research. CONCLUSION: Nurse leaders should examine concepts in NPPMs and the extent they distinguish nursing's professional identity both within and externally to the organization.

Developing an Effective Professional Panel.

Plenary panel planning and implementation, carried out by temporary teams, are described for nursing organizations and professional development across settings. The conference or meeting theme and objectives frame panel member selection and moderator focus. Panelist conversations highlight different career trajectories and connect with attendees. [J Contin Educ Nurs. 2020;51(3):100-102.].

Best Practices to Decrease Infusion-Associated Medication Errors.

Infusion-associated medication errors have the potential to cause the greatest patient harm. A 21-year review of errors and near-miss reports from a national medication error-reporting program found that infusion-associated medication errors resulted in the identification of numerous best practices that support patient safety. A content analysis revealed that most errors involved improper dosage, mistaken drug choice, knowledge-based mistakes, skill-based slips, and memory lapses. The multifaceted nature of administering medications via infusions was highlighted. Opportunities for improvements include best practices such as developing learning cultures and reinforcing the independent double-check process on medications. Staff will likely benefit from education on specific medications, prescription details, and smart pump technology.

Relationship Between Perceived Nurse Caring and Patient Satisfaction in Patients in a Psychiatric Acute Care Setting.

Patients admitted to psychiatric acute care settings benefit from interactions and caring relationships with hospital staff. The current study describes the association between patients' perceptions of nurse caring and their satisfaction with care at an inpatient psychiatric-mental health unit. The relationship between patients' perceptions of nurse caring and two measures of satisfaction with care were explored. A convenience sample of patients (N = 169) completed the Caring Behaviors Inventory-16 and Client Satisfaction Survey. Data were collected at the time of discharge from the hospital. The associations between perceived nurse caring and satisfaction with care and overall satisfaction with care resulted in strong, positive, statistically significant correlations. Treating patient information confidentially and giving treatments and medications on time were highly ranked, along with feeling safe during the hospitalization and satisfaction with nursing care. Additional research on patients' perception of nurse caring and satisfaction with care is needed. [Journal of Psychosocial Nursing and Mental Health Services, 57(7), 29-38.].

Strategies to Reduce Patient Harm From Infusion-Associated Medication Errors: A Scoping Review.

A scoping review of the literature examined strategies to prevent infusion-associated medication errors. Twenty articles were appraised and revealed studies using different research designs and types of literature reviews. Most were rated low quality. Observations in clinical agencies and laboratory settings were sites of some investigations. The work environment-including staffing, health care providers' education and supervision, standardizing equipment, protocols that supported medication decision-making and administration processes, medication lists, computerized devices, and cognitive aids-were addressed as strategies. The array of studies points to aspects of the complexity of the administration process for infusion-associated medications.

Nursing center-Health Intervention Program in Philadelphia: Program evaluation and outcomes.

BACKGROUND: The La Salle Neighborhood Nursing Center provided the Health Intervention Program (HIP) for vulnerable children with special needs, and families in Philadelphia challenged by chronic physical, developmental, behavioral, and emotional conditions and low incomes. AIMS: We evaluated the effectiveness of HIP for a 5-year period and the consistency of quarterly and annual reports as a quality improvement initiative. METHODS: Using program evaluation, secondary analysis design, the effect of a city-wide, family support home visiting program was assessed. Consistency of documentation of program outcomes on annual reports was described. Data were obtained from reports, framed by program objectives submitted via the ETO® database to the Department of Public Health. Components of the HIP consisted of case management, supportive services, information, and referrals provided by a multidisciplinary healthcare team. RESULTS: Family services, program outcomes, referrals, community meetings, and themes demonstrated program complexity and effectiveness. Reports showed inconsistent documentation on 19 outcomes for program objectives. CONCLUSIONS: Children with special needs and their families shared challenges and barriers to their health. The institution staff should create a table to report outcomes on program objectives to evaluate trends across funding years and establish interrater reliability on quarterly and annual reports.

Medication Errors Involving the Intravenous Administration Route: Characteristics of Voluntarily Reported Medication Errors.

Characteristics of medication errors involving the intravenous (IV) route of administration were analyzed in reports from 1995 to 2013. This was accomplished through a voluntary medication error reporting program. A retrospective case study design analyzed reports by practitioners or consumers on IV-associated medication errors (N = 975) affecting patients. Patterns in error accounts reflected cultural changes in health care organizations. Equipment, labeling, incorrect route of administration, types of errors, patient outcomes, and causal agents represented major codes. Results point to health care provider and consumer knowledge, the need for ongoing education of nursing staff, and interdisciplinary strategies for preventing IV-associated medication errors.

Bathing Disability and Bathing Persons with Dementia.

Bathing disability, evidence of functional decline, predicts admission to long-term care facilities following acute care hospitalizations. Nurses are challenged to assess bathing disability in hospitalized older persons and those with dementia to support their maximal functional performance and implement diverse bathing strategies.

Community-based abstinence education project: program outcomes.

PROBLEM: Middle school and adolescent populations demonstrate high rates of unintended pregnancies and sexually transmitted infections, with young people in inner cities in the United States especially vulnerable. Teen births remain high, and youth are affected physically, mentally, socially, and economically. METHODS: The Sex After Marriage primary prevention program, a federally funded, community-based abstinence education (CBAE) initiative, was implemented for 3 years in Philadelphia neighborhoods with vulnerable youth 12 to 18 years of age, supporting adults, healthcare professionals, and the general public. The three-tiered program offered a middle school curriculum, Sex Can Wait, at 16 different sites. The CBAE program delivered by the university's nursing center attempted to support vulnerable youths' decisions to postpone sexual activity by matching the interests of young people through an established curriculum, by holding workshops for supporting adults, and by creating a multimedia approach to supplement abstinence education initiatives including public service announcements and a website. Youth and college ambassadors and community colleagues were trained in the curriculum with a focus on healthy lifestyles. Youth and parents in experimental and control groups completed self-report surveys before and after program implementation. FINDINGS: The project achieved most of its objectives on program evaluation. Youth (n = 1,428) 12 to 18 years of age received services, with most completing ≥75% of the program. Parents (n = 338) and other participating adults (n = 486) also received education or services. CONCLUSIONS: The need for risk reduction programs persists for youth in light of pregnancy, birth, and sexually transmitted disease statistics. Bailey Wolf.

Nursing practice breakdowns: good and bad nursing.

Nurses' responsibility to provide good patient care is explored. Nursing practice breakdowns are examined, differentiating unintentional errors from intentional acts. Good and bad nursing care is portrayed through an emerging classification of intentional practice breakdowns.

Risk assessment profile and strategies for success instrument: determining prelicensure nursing students' risk for academic success.

The ultimate outcomes for succeeding in a collegiate prelicensure nursing program are earning a Bachelor of Science in Nursing degree and passing the NCLEX-RN®. The Risk Assessment Profile, Strategies for Success (RAPSS) is a criterion-based instrument that incorporates demographic and academic risk indicators. A convenience sample (N = 255) obtained retrospectively from student files was used to determine whether the RAPSS could be used to predict whether completers of a baccalaureate, prelicensure program will pass or fail the NCLEX-RN. Results indicate that the scale does discriminate between candidates who fail and pass, even with as few as three of the 13 items.

Locating nursing students' chronicles.

Analysis of students' stories and reflections has contributed to faculty members' knowledge of the student experience. Examining different sources of nursing students' narratives might lead to further understanding of what they think, feel, and perceive during their educational pursuits. Whereas some texts provide ample insights into student life, others are fragmentary or not recorded, evaluated, or systematically investigated. To achieve a different appreciation of stories and other texts calls for faculty research. What is discovered might change teaching approaches.

Analyzing student complaints against nursing programs: taxonomies of complaints and outcomes.

National accrediting organizations require that complaints against nursing programs receive careful review consistent with policies, established systems, and continuous quality improvement approaches. Program administrators must manage complaints equitably and professionally so that the conduct of programs does not violate programs' and accrediting organizations' standards or procedures. This descriptive study analyzed a convenience sample (N = 98) of complaints submitted by undergraduate and graduate nursing students attending an urban, private university and by students' parents. After establishing interrater reliability of the coding scheme, investigators established taxonomic domains of type of complaints, complaint outcomes, and complainants. Undergraduate nursing students made the most complaints; failure and dismissal from the program was the most frequent taxon, with grading, teaching, and testing the next highest. Administrator discussion with stakeholders occurred most frequently. The investigators hoped that study results would assist nursing programs to accomplish continuous improvement, to change practices, and possibly to reduce the number of future complaints by early intervention with complainants and process improvement activities.

Development and testing of the patient safety test: current concepts.

To explore patient safety concepts applicable to clinical teaching in the current healthcare environment, the Patient Safety Test was created. Patient Safety Test assists nursing faculty members to assess their knowledge of safety and quality information. The authors discussed test development, implementation, and results.

Teaching baccalaureate nursing students in clinical settings: development and testing of the Clinical Teaching Knowledge Test.

Seasoned clinical teachers are in short supply and high demand. Although many nursing programs have developed orientation programs for new clinical teachers, many issues arise when students are assigned to health care and community agencies. This study developed and tested the Clinical Teaching Knowledge Test (CTKT), a 40-item multiple-choice test. Items were based on clinical teaching literature and clinical vignettes provided by experienced nursing faculty. A convenience sample (n = 160) of faculty who taught prelicensure students attending baccalaureate programs completed the second version of the test. Proportion correct index, point biserial correlation, and Kuder-Richardson 20 statistics are reported. Proportion correct indexes less than .75 revealed that items testing legal responsibilities to patients, student-faculty relations, counseling approaches, education theory in clinical teaching, students' legal rights, and nursing administrators' rights and responsibilities challenged participants. Results of future testing may help faculty members plan workshops that foster explorations of areas to improve clinical teaching and provide a stimulus for ongoing conversation and reflection about clinical teaching. Additional testing of the CTKT is necessary.

Nursing student medication errors involving tubing and catheters: a descriptive study.

This retrospective case study examined reports (N=27) of medication errors made by nursing students involving tubing and catheter misconnections. Characteristics of misconnection errors included attributes of events recorded on MEDMARX error reports of the United States Pharmacopeia. Two near miss errors or Category B errors (medication error occurred, did not reach patient) were identified, with 21 Category C medication errors (occurred, with no resulting patient harm), and four Category D errors (need for increased patient monitoring, no patient harm) reported. Reported intravenous tubing errors were more frequent than other type of tubing errors and problems with clamps were present in 12 error reports. Registered nurses discovered most of the errors; some were implicated in the mistakes along with the students.

Nurses' stories: discovering essential nursing.

Stories help nurses share their nursing culture. They reveal the nature of nursing work, including its challenges, uniqueness, and privileged place. Stories are worth telling and recording, not only to supply material for research but also to help nurses better understand their lives at work.