Promoting System Thinking and Professionalism Through Simulated Hospital Experiences for Nursing and Clinical Laboratory Science Students.

ABSTRACT: A simulation laboratory was developed for prelicensure nursing and undergraduate clinical laboratory science students using scripted patient cases with laboratory test results. The experience was guided by TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). Participants ( n = 66) completed the modified Interprofessional Professionalism Assessment pre- and postsimulation. Journal reflections provided qualitative data. All aspects of interprofessional professionalism increased after the simulation; the most significant gain was confidence in working with other health care professionals. Analysis of journal themes indicated the students perceived increased communication and collaboration skills concerning patient care and safety.

Pediatric minor head injury related return visits to the emergency department and their outcome.

BACKGROUND: Minor head injury (MHI) in children is a common emergency department (ED) presentation. It is well established that majority of these patients don't require imaging and can be safely discharged. What is less known is how often these children come back to the ED and the outcome of their revisits? The objective of this study was to describe the frequency and outcome of unscheduled return visits (RVs) for MHI in a pediatric ED. METHODS: A retrospective chart review of emergency department RV's database was conducted from August 2016 to July 2019. MHI patients <18 years of age who came back to the ED within 72 h of their index visit - for head injury related complaints - were eligible for inclusion. RESULTS: Return visit rate for MHI was around 1% (61/6225). Of these, 55.7% (34/61) were female and 85.5% (53/61) were in the age group 2-17 years. Three-fourths of the revisits were for concussion-related symptoms. Nearly two-thirds of the patients required one or more interventions upon revisit. Missed clinically important traumatic brain injury was rare. Only one patient required operative intervention upon revisit. Though largely unpreventable, 5% (3/61) of the revisits were deemed potentially avoidable. CONCLUSION(S): RVs secondary to MHI in children remain low and are associated with good outcomes.

A Comparison of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and Pain Assessment in Advanced Dementia Scale (PAINAD).

BACKGROUND: There is currently no gold standard instrument for assessing pain in severely cognitively impaired adults who are unable to provide self-report. AIMS: To determine interrater reliability of the PACSLAC and PAINAD in assessing pain behaviors in patients with the same pain stimulus, determine the consistency of the reliable changes between and within the instruments and assess nurse preference for either instrument. DESIGN: A single-group, within-subjects repeated-measures design was implemented. SETTING: The study took place in a small suburban hospital. PARTICIPANTS/SUBJECTS: Pain levels were observed at 24, 48, and 72 hours postsurgery using two instruments: Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and Pain Assessment in Advanced Dementia Scale (PAINAD). These instruments were selected because they are among the most commonly recommended tools for clinical use. Interrater reliability was analyzed along with reliable changes in pain for each period, and the study concluded with the nurse raters completing a preference survey. METHODS: A convenience sample of 30 patients was used with a diagnosis of severe dementia rendering the patient unable to reliably express pain, 60+ years of age, recovering from hip fracture surgery. RESULTS: Greater interrater reliability was found for the PACSLAC, with reliable change potentially affected by the type and level of pain medication. The nurses' preference for the tool was split. CONCLUSIONS: The results of this study indicate that the PACSLAC may be the more reliable tool over the PAINAD; however, rater training and familiarity with the tool is critical.

The Medical Library Association (MLA) voter: a survey of attitudes, perceptions, and voting practices in MLA national elections.

OBJECTIVE: Voting in professional associations is critical for selecting leaders who will implement a desirable vision for an association. Members of the Medical Library Association (MLA) were surveyed to assess their attitudes and perceptions of the voting process to elect the MLA national offices of president and members of the Board of Directors and Nominating Committee. Survey data were also used to test the hypothesis that committed MLA members are more likely to always vote. METHODS: SurveyMonkey was used to deliver a 46-question survey to 2,671 email addresses of MLA members who were eligible to vote. Survey data were analyzed using quantitative and qualitative approaches. RESULTS: A total of 676 responses were received, resulting in a 25% response rate. Respondents indicated that the most desired qualities in candidates included experience in professional positions, contributions to MLA, and a vision for the association, whereas candidates' personal characteristics were rarely considered. Respondents expressed doubts about the use of a single slate, had positive views of campaigning but were doubtful about its impact, and were generally accepting of the current voting process. Committed MLA members were significantly more likely to always vote in MLA national elections. CONCLUSIONS: The survey results provide insight into understanding the concerns and motivations of MLA voters and add to the limited literature on professional association voting.

Nursing roles and responsibilities conducted by registered nurse/BSN student dyads across ambulatory clinical sites in medically underserved communities.

BACKGROUND: Increasingly, registered nurses (RNs) are incorporated into ambulatory care teams. Yet, limited research exists on the roles of RNs across these settings. PURPOSE: The purpose of this study was to examine the roles performed by RNs (and their senior BSN students) in primary care and public health settings. METHODS: Working with nine RN preceptors, 15 students tracked all patient visits during a 150-h immersion experience using the Typhon™ clinical-tracking software. RESULTS: The BSN student/RN dyads conducted 1218 patient visits completing 8536 RN roles in 15 distinct categories. Most patients were African American and female (n = 736; 60.1 %) with an average age of 38.4 (SD 22.12). Patient demographics varied by site. The most common roles performed by the RN/student dyad were health assessment, behavioral health screening, and telehealth. Roles of the RNs and the student level of independence were significantly different across sites (Fisher's Exact test [p < .001]). CONCLUSIONS: Our results argue that RNs are providing substantial value to these FQHC and public heath settings. An academic/practice partnership, including a shared curricular review, can provide a strategic advantage for educators to ensure that health systems realize the unique roles for RNs and educators provide 21st century education.

When Holistic Admissions Review Is Not Enough: Barriers to Diversity.

BACKGROUND: Patient populations are increasingly diverse; however, the health care workforce often fails to reflect the diversity of the populations it serves. Holistic admission review (HAR) has been proposed as a strategy to diversify the student body and create a more diverse workforce. METHOD: This article describes the development, application, and evaluation of a holistic admissions process for freshman undergraduates admitted directly to a College of Nursing located in a nonaffirmative action state. RESULTS: There was an increase in the diversity of applicants; however, the selected metric of SAT (Scholastic Aptitude Test)/ACT (American College Test) scores resulted in a decrease in the number of qualified applicants. This decrease disproportionately affected underrepresented students, illustrating that the inability to consider race, ethnicity, or gender continues to restrict the admission of a diverse student body even with HAR. CONCLUSION: Our findings highlight the need to consider all aspects of HAR, particularly the effect of the chosen metrics on the applicant pool. [J Nurs Educ. 2022;61(7):375-382.].

Novel biphasic gels can mimic and replace animal fat in fully-cooked coarse-ground sausage.

Four biphasic gels (BPG) were developed and tested as pork fat replacers in coarse-ground fully-cooked sausages. An oleogel (OG) phase (92.5% high-oleic soybean oil, 7.5% rice bran wax) and one of two hydrogel (HG) phases (water and 7% or 8% gelatin) were combined in 7:3 or 6:4 OG:HG ratios, for a total of four test formulations. Control sausages were formulated to 27.5% fat and stored at 0-2 °C for 98 d. BPGs allowed for fat reductions of up to 26%. Visually, all BPGs resembled pork fat. There were no differences in external L* and a* but, internally, controls were darker and redder. Except for one control, there were no differences in Texture Profile Analysis (TPA) hardness, cohesiveness, springiness, and chewiness. Warner-Bratzler Shear (WBS) force was highest in 6:4 samples, which were also highest in Sensory First Bite Firmness and lowest in Smoked Sausage Aroma and Smoked Sausage Flavor. TBARS values remained steady, with no rancid flavors detected by the sensory panel.