Use of the step-up action research model to improve trauma-related nursing educational practice.

BACKGROUND: A lack of authentic learning opportunities influence the quality of emergency training of nursing students. The purpose of this article is to describe how the step-up action research model was used to improve the quality of trauma-related educational practice of undergraduate nursing students. OBJECTIVES: To reduce deaths caused by trauma, healthcare workers should be competent to provide emergency care and collaborate effectively with one another. METHOD: A simulated mass casualty incident, structured to support the integration of theory into practice, became a more rigorous action research activity which focused on the quality improvement of the mass casualty incident. RESULTS: The results indicated improved student learning; partnership appreciation; improved student coping mechanisms, and increased student exposure. Quality emergency training thus results in better real-life collaboration in emergency contexts. CONCLUSION: The step-up action research model proved to be a collaborative and flexible process. To improve the quality and rigour of educational programmes it is therefore recommended that the step-up action research model be routinely used in the execution of educational practices.

Evaluation of the Determine™ fourth generation HIV rapid assay.

Assays that detect p24 antigen reduce the diagnostic window period of HIV testing. Most point-of-care HIV assays have poor sensitivity to diagnose acute HIV infection as they only detect antibodies against HIV-1 and HIV-2 (HIV-1/2). This was a cross-sectional laboratory-based study that evaluated the performance of the Determine™ HIV-1/2 Ag/Ab Combo fourth generation rapid strip - currently the only rapid assay that detects both HIV-1/2 antibodies and p24 antigen. A total of 79 serum specimens (29 positive for HIV antibodies only, 14 positive for HIV antibodies and p24 antigen, 20 HIV-negative, and 16 positive for p24 antigen only) were used for the evaluation. Results were compared with those from validated fourth generation HIV ELISAs. The Determine™ Combo rapid strips had a sensitivity of 90.7% and a specificity of 100% for the detection of HIV-1/2 antibodies. Its sensitivity for the detection of p24 antigen was only 10% (3 out of 30 p24 antigen positive specimens). This implies that most acute HIV infections will be missed with this assay. The need for a point-of-care assay which can detect acute HIV infection reliably still remains, particularly for use in a high prevalence setting such as South Africa.