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Best NC, Nichols AO, Pierre-Louis B, Hernandez J. Exploration of Factors Associated with Reported Medication Administration Errors in North Carolina Public School Districts. J Sch Nurs 2024; 40:504-513. [PMID: 36131393 PMCID: PMC11395164 DOI: 10.1177/10598405221127453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
School nurses are pivotal to the safety of school-aged children, particularly those who receive medications in the school setting. The purpose of this study was to explore factors associated with medication administration errors in North Carolina school districts between 2012/2013 and 2017/2018. A longitudinal study using repeated measures analysis of school health services data collected in the North Carolina Annual School Health Services and Programs Survey was conducted. Over time, the number of medication errors (p = .001) and number of medication corrective action plans (p < .0001) trended upwards. There was also an increase in medication errors when the number of schools in a district was higher (p < .0001). Conversely, there was a decrease in corrective action plans when school nurses were directly employed by the school district (p = .0471). We implore school disticts to consider the important role of school nurses to keep kids safe, healthy, and ready to learn.
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Affiliation(s)
- Nakia C Best
- Sue & Bill Gross School of Nursing, The University of California, Irvine, Irvine, CA, USA
| | - Ann O Nichols
- Retd., Division of Public Health, Children & Youth Branch, NC Department of Health & Human Services, Raleigh, NC, USA
| | | | - Jessica Hernandez
- Sue & Bill Gross School of Nursing, The University of California, Irvine, Irvine, CA, USA
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Chang SO, Chaung SK, Sohng KY, Kim K, Won J, Choi MJ. Priority analysis of educational needs for new nurses in the intensive care unit: A cross-sectional study. Nurs Crit Care 2024; 29:1162-1173. [PMID: 38972724 DOI: 10.1111/nicc.13122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/21/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND New intensive care unit (ICU) nurses often experience stress because of concerns about potentially harming their patients in a work environment that demands the rapid development of several skills in a limited training period. AIM This study aimed to investigate the prioritisation of educational needs within adult ICUs, focusing on how new nurses evaluate their current knowledge and perceive the most critical competencies. STUDY DESIGN A cross-sectional study was conducted among a convenience sample of 102 new ICU nurses in general and tertiary hospitals in South Korea. Educational needs were assessed using a structured questionnaire for new ICU nurses. This study investigated educational needs using paired t-tests, Borich's assessment model and the Locus for Focus model. RESULTS Only 48% of participants were satisfied with their education. The highest-rated educational content included preparing to use a defibrillator (95% CI = 2.44-3.28, p < .001), administering emergency drugs for cardiopulmonary resuscitation (CPR) (95% CI = 2.09-2.91, p < .001), starting and maintaining continuous renal replacement therapy (95% CI = 1.50-2.42, p < .001), applying and maintaining a ventilator (95% CI = 1.42-2.08, p < .001), preparing for intubation (95% CI = 1.23-1.97, p < .001), reporting to the emergency team, preparing equipment for CPR (95% CI = 1.12-1.94, p < .001) and drug calculation (95% CI = 0.87-1.53, p < .001). CONCLUSIONS These findings indicate that educational programmes for new ICU nurses should be developed considering the aforementioned priorities. Furthermore, nurse educators should adopt a practical and active instructional method to repeatedly clarify content, prioritising the improvement of knowledge and performance of new ICU nurses. RELEVANCE TO CLINICAL PRACTICE This study guides clinical educators and managers in focusing on areas where new ICU nurses need additional training. Effective nurse residency programmes tailored to the specific needs of new ICU nurses can enhance their confidence and ability to handle ICU nursing challenges.
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Affiliation(s)
- Sung Ok Chang
- College of Nursing and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Seung-Kyo Chaung
- Department of Nursing, Semyung University, Jecheon, Republic of Korea
| | - Kyeong-Yae Sohng
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyunghee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Jongsoon Won
- College of Nursing, Eulji University, Seongnam, Republic of Korea
| | - Min-Jung Choi
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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Griffis L, Probst N, Leite M. Hardwiring nurse excellence: Building a culture to promote nurse certification. Nurs Manag (Harrow) 2023; 54:7-9. [PMID: 37401552 DOI: 10.1097/nmg.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Affiliation(s)
- Leigh Griffis
- At Huntington Hospital/Northwell Health in Huntington, N.Y., Leigh Griffis is the Magnet program director and a nurse scientist, Nicole Probst is the director of clinical professional development, and Melinda Leite is the assistant director of nursing quality
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Peutere L, Terho K, Pentti J, Ropponen A, Kivimäki M, Härmä M, Krutova O, Ervasti J, Koskinen A, Virtanen M. Nurse Staffing Level, Length of Work Experience, and Risk of Health Care-Associated Infections Among Hospital Patients: A Prospective Record Linkage Study. Med Care 2023; 61:279-287. [PMID: 36939226 PMCID: PMC10079297 DOI: 10.1097/mlr.0000000000001843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Nurse understaffing may have several adverse consequences for patients in hospitals, such as health care-associated infections (HAIs), but there is little longitudinal evidence available on staffing levels and HAIs with consideration of incubation times to confirm this. Using daily longitudinal data, we analyzed temporal associations between nurse understaffing and limited work experience, and the risk of HAIs. METHODS The study was based on administrative data of 40 units and 261,067 inpatient periods for a hospital district in Finland in 2013-2019. Survival analyses with moving time windows were used to examine the association of nurse understaffing and limited work experience with the risk of an HAI 2 days after exposure, adjusting for individual risk factors. We reported hazard ratios (HRs) with 95% CIs. RESULTS Neither nurse understaffing nor limited work experience were associated with the overall risk of HAIs. The results were inconsistent across staffing measures and types of HAIs, and many of the associations were weak. Regarding specific HAI types, 1-day exposure to low proportion of nurses with >3 years of in-hospital experience and low proportion of nurses more than 25 years old were associated with increased risk of bloodstream infections (HR=1.30; 95% CI: 1.04-1.62 and HR=1.40; 95% CI: 1.07-1.83). Two-day exposure to low nursing hours relative to target hours was associated with an increased risk of surgical-site infections (HR=2.64, 95% CI: 1.66-4.20). CONCLUSIONS Data from time-varying analyses suggest that nursing staff shortages and limited work experience do not always increase the risk of HAI among patients.
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Affiliation(s)
- Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu
- Finnish Institute of Occupational Health, Helsinki
| | - Kirsi Terho
- Department of Hospital Hygiene and Infection Control, Turku University Hospital Turku
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku Finland
| | - Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki
| | | | | | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Dillon-Bleich K, Dolansky MA, Burant CJ, Madigan EA, Singh MK. Safety Competency: Exploring the Impact of Environmental and Personal Factors on the Nurse's Ability to Deliver Safe Care. J Nurs Care Qual 2023; 38:82-88. [PMID: 36112974 DOI: 10.1097/ncq.0000000000000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patient safety is a priority in health care systems. Nurses' safety competence along with environmental and personal factors plays a role in patient safety. PURPOSE The purpose of this study was to explore the relationships among safety competency, structural empowerment, systems thinking, level of education, and certification. METHODS A cross-sectional exploratory design was used to collect data from nurses (n = 163) practicing in a large Midwestern hospital system. RESULTS There were significant positive correlations between safety competency and ( a ) structural empowerment, ( b ) systems thinking, and ( c ) certification. Systems thinking explained 12.9% of the variance in the knowledge component of safety competency and 6.8% of the variance in the skill component of safety competency. Certification explained 2.4% of the variance in the skill component of safety competency. CONCLUSIONS Understanding factors that affect safety competency supports the development of effective interventions that may improve safety.
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Affiliation(s)
- Kimberly Dillon-Bleich
- Breen School of Nursing and Health Professions, Ursuline College, Pepper Pike, Ohio (Dr Dillon-Bleich); QSEN Institute (Dr Dolansky), Frances Payne Bolton School of Nursing (Drs Burant and Madigan), and Department of Population and Quantitative Health Sciences (Dr Dolansky), School of Medicine (Dr Singh), Case Western Reserve University, Cleveland, Ohio; VA Quality Scholars Program, Cleveland, Ohio (Dr Dolansky); Geriatric Research Education and Clinical Center, Louis Stokes VAMC, Cleveland, Ohio (Dr Burant); and VA Northeast Ohio Healthcare System, Cleveland (Dr Singh)
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Assessing Professional Competencies Among Undergraduate Nurses: An Exploratory Study. Nurs Educ Perspect 2022; 44:E10-E14. [PMID: 36730701 DOI: 10.1097/01.nep.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM The study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies. BACKGROUND Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies. METHOD Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form. RESULTS The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies. CONCLUSION The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula.
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Halverson CC, Scott Tilley D. Creating a culture of support for nursing surveillance. Nurs Forum 2022; 57:1204-1212. [PMID: 36308313 DOI: 10.1111/nuf.12823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/26/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND An estimated 98,000 deaths annually result from medical errors. Preventing these deaths must be a US healthcare goal. Surveillance decreases adverse events. Surveillance is essential for patient safety. Creating a unit culture that supports surveillance requires attention to its antecedents (nurse education, nurse expertise, nurse staffing, as well as organizational culture). METHOD The current literature on topics salient to creating a culture of nursing surveillance including its antecedents and its attributes were reviewed. The findings are summarized and presented. DISCUSSION Suggestions and tools enhancing a culture of safety allow the transition from one set of behaviors to another. An organizational culture that strives for excellence promotes surveillance which results in improved patient outcomes and better qualified nurses. CONCLUSION Unit change resulting in support for surveillance can minimize failure to rescue and promote interruption of adverse events. The patient outcomes include decreased morbidity and mortality.
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Affiliation(s)
| | - Donna Scott Tilley
- Research and Clinical Scholarship, College of Nursing, Texas Woman's University, Denton, Texas, USA
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Professional Self-Concept and Self-Confidence for Nurses Dealing with COVID-19 Patients. J Pers Med 2022; 12:jpm12020134. [PMID: 35207624 PMCID: PMC8878634 DOI: 10.3390/jpm12020134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 01/17/2023] Open
Abstract
Purpose: To identify the impact of dealing with COVID-19 patients in clinical areas on nurses’ professional self-concept and self-confidence. Background: Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement. Design: Descriptive, comparative study. Methods: The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19- and non-COVID-19-designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses’ Self-Concept Instrument and Self-Confidence Scale. Results: The professional self-concept level among the group exposed to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept. Conclusions: Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.
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Gibney RN, Blackman C, Gauthier M, Fan E, Fowler R, Johnston C, Jeremy Katulka R, Marcushamer S, Menon K, Miller T, Paunovic B, Tanguay T. COVID-19 pandemic: the impact on Canada’s intensive care units. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity. The impact of the pandemic on ICUs varied significantly across the country with provinces that implemented public health measures later and relaxed them sooner being impacted more severely. Pediatric ICUs routinely admitted adult patients. Non-ICU areas were converted to ICUs and staff were redeployed from other essential service areas. Faced with a lack of critical care capacity, triage plans for ICU admission were developed and nearly implemented in some provinces. Twenty eight percent of patients in Canadian ICUs who required mechanical ventilation died. Surviving patients have required prolonged ICU admission, hospitalization and extensive ongoing rehabilitation. Family members of patients were not permitted to visit, resulting in additional psychological stresses to patients, families, and healthcare teams. ICU professionals also experienced extreme psychological stresses from caring for such large numbers of critically ill patients, often in sub-standard conditions. This resulted in large numbers of health workers leaving their professions. This pandemic is not yet over, and it is likely that new pandemics will follow. A review and recommendations for the future are provided.
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Affiliation(s)
- R.T. Noel Gibney
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Cynthia Blackman
- Dr. Cynthia Blackman and Associates, Edmonton, AB M5R 3R8, Canada
| | - Melanie Gauthier
- Faculty of Nursing, McGill University, Montréal, QC Canada
- President, Canadian Association of Critical Care Nurses, Quebec, QC, Canada
| | - Eddy Fan
- Interdisciplinary Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Robert Fowler
- Interdisciplinary Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Medicine, Sunnybrook Hospital, Toronto, ON M5S 1A1, Canada
| | - Curtis Johnston
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
| | - R. Jeremy Katulka
- Department of Medicine, Royal University Hospital, Saskatoon, SK S7N 0W8, Canada
| | - Samuel Marcushamer
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
| | - Kusum Menon
- Paediatric Intensive Care Unit, Children’s Hospital of Eastern Ontario, Ottawa, ON K1N 6N5, Canada
- Paediatric Intensive Care Unit, Department of Pediatrics, University of Ottawa, Ottawa, ON T6G 2R3, Canada
| | - Tracey Miller
- Intensive Care Unit, Royal Columbian Hospital, New Westminster, BC V3L 3W7, Canada
| | - Bojan Paunovic
- Department of Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- President, Canadian Critical Care Society, Winnipeg, MB R3T 2N2, Canada
| | - Teddie Tanguay
- Intensive Care Unit, Royal Alexandra Hospital, Edmonton, AB T6G 2R3, Canada
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Kennedy E, Kennedy P, Hernandez J, Shakoor K, Munyan K. Understanding Redeployment During the COVID-19 Pandemic: A Qualitative Analysis of Nurse Reported Experiences. SAGE Open Nurs 2022; 8:23779608221114985. [PMID: 35899038 PMCID: PMC9310283 DOI: 10.1177/23779608221114985] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The COVID-19 pandemic disrupted healthcare working conditions causing the redeployment
of nurses. Redeployment refers to assigning healthcare workers to units or specialty
areas where they do not regularly work. Objective The purpose of this study was to explore the lived experiences of redeployed nurses
during the COVID-19 pandemic from April 27, 2020 to May 7, 2020. Methods Data collection occurred through a cross-sectional survey with demographic items and a
single open-ended item. This open-ended item was part of a larger study regarding work
conditions during the initial COVID-19 surge in the spring of 2020 in the Midwest United
States (US). This analysis was performed separately due to the volume of qualitative
responses and details provided. The survey was posted in private social media groups,
and 298 nurses participated, 117 shared open-ended responses. Participants were asked
what type of unit they worked on before COVID-19 and what unit they were deployed
to. Findings Twenty-three (19.7%) reported deployment to COVID-designated units. Twenty-eight
(23.9%) participants reported deployment to a unit outside of their specialty. Sixteen
(13.7%) reported deployment from a non-critical care unit to an intensive care unit.
Three major themes developed from the open-ended responses: (1) challenges related to
their scope of practice and specialization, (2) challenges with interpersonal dynamics,
and (3) challenges related to the environment. Conclusion The described challenges caused some nurses to report primarily negative experiences
regarding redeployment during the COVID-19 pandemic. The findings add to the existing
literature regarding redeployment and the vulnerability hospitals and their staff face
during a disaster or pandemic-related events, such as COVID-19. Ultimately, aiding in
the development of new policies to facilitate effective pandemic response in the future
that would support nurses to participate in redeployment in a safe and nontraumatic way,
is necessary.
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Affiliation(s)
- Erin Kennedy
- School of Nursing, Oakland University, Rochester, MI, USA
| | | | | | - Kelly Shakoor
- School of Nursing, Oakland University, Rochester, MI, USA
| | - Kristen Munyan
- School of Nursing, Oakland University, Rochester, MI, USA
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Ma HL, Godwin C, McNeely HL, Ramirez J. Board Certification: A Role for the Nurse Educator. J Contin Educ Nurs 2021; 52:497-499. [PMID: 34723723 DOI: 10.3928/00220124-20211008-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nurse educators are essential to the success of other nurses by supporting the attainment of professional competencies, knowledge, and continual development. In addition, board-certified nurse educators are also role models in lifelong learning. They are in an optimal position to promote and support others in pursuit of board certification. [J Contin Educ Nurs. 2021;52(11):497-499.].
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Monden KR, Hidden J, Eagye CB, Hammond FM, Kolakowsky-Hayner SA, Whiteneck GG. Relationship of patient characteristics and inpatient rehabilitation services to 5-year outcomes following spinal cord injury: A follow up of the SCIRehab project. J Spinal Cord Med 2021; 44:870-885. [PMID: 33705276 PMCID: PMC8725682 DOI: 10.1080/10790268.2021.1881875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To examine associations of patient characteristics and treatment quantity delivered during inpatient spinal cord injury (SCI) rehabilitation with outcomes at 5 years post-injury and compare them to the associations found at 1 year post-injury. DESIGN Observational study using Practice-Based Evidence research methodology in which clinicians documented treatment details. Regression modeling was used to predict outcomes. SETTING Five inpatient SCI rehabilitation centers in the US. PARTICIPANTS Participants were 792 SCIRehab participants who were >12 years of age, gave informed consent, and completed both a 1-year and 5-year post-injury interview. OUTCOME MEASURES Outcome data were derived from Spinal Cord Injury Model Systems (SCIMS) follow-up interviews at 5 years post-injury and, similar to the 1-year SCIMS outcomes, included measures of physical independence, societal participation, life satisfaction, and depressive symptoms, as well as place of residence, school/work attendance, rehospitalization, and presence of pressure ulcers. RESULTS Consistent with 1-year findings, patient characteristics continue to be strong predictors of outcomes 5-years post-injury, although several variables add to the prediction of some of the outcomes. More time in physical therapy and therapeutic recreation were positive predictors of 1-year outcomes, which held less true at 5 years. Greater time spent with psychology and social work/case management predicted greater depressive symptomatology 5-years post-injury. Greater clinician experience was a predictor at both 1- and 5 -years, although the related positive outcomes varied across years. CONCLUSION Various outcomes 5-years post-injury were primarily explained by pre-and post-injury characteristics, with little additional variance offered by the quantity of treatment received during inpatient rehabilitation.
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Affiliation(s)
- Kimberley R. Monden
- Craig Hospital, Englewood, Colorado, USA
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | | | - Flora M. Hammond
- Department of Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
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Okumura M, Ishigaki T, Mori K, Fujiwara Y. Personality traits affect critical care nursing competence: A multicentre cross-sectional study. Intensive Crit Care Nurs 2021; 68:103128. [PMID: 34391627 DOI: 10.1016/j.iccn.2021.103128] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 06/11/2021] [Accepted: 07/25/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the relationship between personality traits and critical care nursing competence among critical care nurses. RESEARCH METHODOLOGY/DESIGN Multicentre cross-sectional survey using a self-report questionnaire and path modelling, from August 2017 to December 2018. SETTING Six intensive care units in Japan. MAIN OUTCOME MEASURES We assessed relationships among the Big Five personality traits and four critical care nursing competencies in nurses. FINDINGS We included 211 nurses (77.7% women, 59.2% in their 20 s); 62.6% had 1-5 years' critical care nursing experience. Among the four competencies, principles of nursing care had a direct positive effect on decision-making (0.77, p < 0.001); decision-making had a direct positive effect on collaboration (0.74, p < 0.001) and nursing interventions (0.77, p < 0.001). The personality traits openness to experience, agreeableness, and extraversion had a significantly positive effect (0.17, p < 0.05; 0.43, p < 0.001; 0.29, p < 0.01; respectively) on principles of nursing care, the key competency. The personality trait neuroticism had a direct or indirect negative effect on all four nursing competencies. CONCLUSION Nursing competence in the critical care setting is affected by personality traits. Our findings can be applied in nursing education to improve competence based on individual personality traits.
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Affiliation(s)
- Masatoshi Okumura
- Department of Anesthesiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Tomonori Ishigaki
- Department of Business Administration, Nanzan University, 18 Yamazato-cho, Showa-ku, Nagoya, Aichi 466-8673, Japan.
| | - Kazunao Mori
- Division of Nursing, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yoshihiro Fujiwara
- Department of Anesthesiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
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Munangatire T, McInerney P. Nursing students' conceptions of competence and the learning processes that support the development of competence: a phenomenographic study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1113-1132. [PMID: 33730296 DOI: 10.1007/s10459-021-10041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies support the development of competence among student nurses, but the level of competence at the point of graduation remains below expected standards. Therefore, more research is needed to find strategies that can enhance the development of competence among students. The study explored students' conceptions of competence and the learning processes that support the development of competence in nursing practice. Gaining an understanding of learning and competence from the student's perspective can improve our current understanding of the development of competence. Utilising a phenomenographic approach, in-depth interviews and focus group discussions were conducted among purposively sampled groups of nursing students. The analysis of data was managed through ATLAS. ti 8.1 and followed the process of familiarisation, condensation, comparison, grouping, articulating labelling and contrasting of excerpts to generate the students' conceptions of learning. Five categories of description emerged and showed that the development of competence involves students increasing their understanding of what competence is, hence changing their learning strategies to meet the level of competence, as they understood it. In order of hierarchy from the lowest, the categories of description were: competence is understood as task completion; competence is understood as passing assessments /satisfying facilitators; competence is understood as applying theory to practice; competence is understood as performance of nursing according to clinical standards/guidelines; and competence is understood as performance that yields positive health outcomes.
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Affiliation(s)
- Takaedza Munangatire
- Faculty of Health Sciences, Department of Nursing, University of Namibia, Rundu, Namibia.
| | - Patricia McInerney
- Faculty of Health Sciences, Centre for Health Sciences Education, University of Witwatersrand, Johannesburg, South Africa
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Tölli S, Kontio R, Partanen P, Häggman-Laitila A. Conceptual framework for a comprehensive competence in managing challenging behaviour: The views of trained instructors. J Psychiatr Ment Health Nurs 2021; 28:692-705. [PMID: 33295055 DOI: 10.1111/jpm.12722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/10/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is body of knowledge available about the harms associated with restrictive interventions used in behaviour management, service users' perceptions of the use of restraints, and staff competence in behaviour management. The staff perspective has been studied in terms of staff exposure, responses to and prevention of aggression, staff-related factors associated with service user aggression, and staff attitudes and perceptions towards violence. The definitions of competence in behaviour management provided in training interventions are fragmented and based on unilateral measurements. Training interventions with the purpose of enhancing staff competence in behaviour management are organized regularly, yet there is a lack of clarity on how effective these interventions are. Inadequate conceptual understanding of behaviour management can weaken the effectiveness of these interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our study produced new knowledge by providing a preliminary conceptual framework that can be used to comprehensively describe and assess competence in managing challenging behaviour and to cover safely the whole care process. Humane care and ethical sensitivity should be the premises of interaction with people in distress. We also pointed out the needs for conceptual clarification of the concepts of confidence, support and restraint. We provide important new insight into the leadership and cultural issues of behaviour management that is relevant for patients, staff members and healthcare organizations. We found that staff members do not consider service user safety and workplace safety as opposing issues. Further, we provide new perspectives for prevention, the risk assessment process and effective communication in the context of behaviour management. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A comprehensive understanding of the competences related to behaviour management will foster universal definitions for "support" and "restraint," which can then be used to ensure that the best practices are used for behaviour management. Organizational culture and participative leadership on behaviour management should be developed with a special focus on safety issues, common understanding of comprehensive competence, risk assessment and prevention, views regarding the use of restraints, and teamwork. ABSTRACT: Introduction Previous research concerning staff views of behaviour management has not considered instructors' views. The definitions of competence in behaviour management are fragmented, which can undermine the effectiveness of training interventions. Aim/Question This study aimed to describe Finnish and British Management of Actual or Potential Aggression instructors' perceptions of safety and behaviour management-related competences and create a conceptual framework for comprehensive competence. Method An explorative-descriptive qualitative approach with purposive sampling (N = 22), semi-structured interviews and abductive content analysis. Results Conceptual framework of comprehensive competence in managing challenging behaviour includes five categories-knowledge, skills, attitude, confidence and ethical sensitivity-and 21 subcategories. Competent staff and supportive leadership ensured safety, while inconsistent risk management culture, the health and behaviour of service users, and inadequate staff orientation endangered safety. Discussion The study produced new knowledge of safety issues and competences from the perspective of the instructors who deliver behaviour management training. Implications for practice Competence to manage challenging behaviour should be developed based on our conceptual framework to provide an effective and safe training. Prevention, the risk assessment process, alternative communication, and the definitions of "confidence," "support" and "restraint" should all be sufficiently addressed in future training.
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Affiliation(s)
- Sirpa Tölli
- University of Eastern Finland, Kuopio, Finland.,Oulu University of Applied Sciences, Oulu, Finland
| | - Raija Kontio
- Director Hyvinkää Hospital, Adjunct Professor Helsinki University, Helsinki, Finland
| | | | - Arja Häggman-Laitila
- University of Eastern Finland, Kuopio, Finland.,Social and Health Care, City of Helsinki, Helsinki, Finland
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16
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Abstract
BACKGROUND Thirty-five years ago, Benner defined an expert nurse as one who applies deep knowledge and experience across different contexts and clinical situations. Since that time, there has been little exploration of expertise in cancer nursing. OBJECTIVES To explore and describe characteristics of expert cancer nurses and to consider whether Benner's typology of an expert nurse remains relevant in today's complex oncology settings. METHODS An exploratory, descriptive study using audio-recorded focus group methodology was undertaken. Audio-recordings were transcribed, and an inductive thematic analysis approach applied to the data. Nurses also documented key characteristics of expert practice on Post-it notes to illustrate dominant characteristics. RESULTS Twenty-four registered nurses from a comprehensive cancer center in Australia took part in 1 of 3 focus groups. Seven key themes were identified: knowledge, leadership, adaptability, communication, motivation, patient-centered care, organization, and culture. Key word cloud characteristics included knowledge, compassion, motivation, experience, and communication. CONCLUSIONS Many of the expert characteristics identified in this study reflect traits common to other nursing specialty groups. Of particular relevance to cancer nurses was "adaptability," reflecting the complexity of contemporary cancer care and reaffirming Benner's definition of an expert nurse as one who can fluidly connect knowledge and experience to unfamiliar practice contexts. IMPLICATIONS FOR PRACTICE Understanding characteristics of expert cancer nurses may help inform and support professional practice advancement and guide future research about select characteristics of expert cancer nurses to patient- and system-level outcomes.
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Kerari A, Innab A. The Influence of Nurses' Characteristics on Medication Administration Errors: An Integrative Review. SAGE Open Nurs 2021; 7:23779608211025802. [PMID: 34222653 PMCID: PMC8223601 DOI: 10.1177/23779608211025802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022] Open
Abstract
Background Medication administration errors (MAEs) are a frequent cause of morbidity and mortality in acute care settings and can result in a prolonged hospital stay. The WHO estimated that medication errors cost up to $42 billion globally per a year. Therefore, MAEs was among the most common medical errors to occur in acute care settings. Studies of medication error usually focus on system factors, thus creating a gap between what researchers know about the causes of MAEs, and what frontline nurses actually do in the clinical setting. The purpose of this review is to fill a gap in the existing literature by focusing on the relationship between nurses' characteristics and MAEs. Methods Online databases were accessed, including CINAHL, PsycINFO, PubMed, Scopus, and Google Scholar from 2007-2020 period. This review was guided by the methods described by Whittemore and Knafl. Studies that addressed the occurrence of medication errors based on RN demographics were included in this review. The included studies were reviewed and analyzed by the two authors. Results Of the 1141 publications retrieved, 19 studies met inclusion criteria. The result provided strong evidence that nurses' level of education, length of experience, and attendance at training courses, are directly associated with the occurrence of MAEs. There is weak evidence of MAEs being influenced by the age and gender of nurses. Other nurse characteristics, such as cognitive load, frustration with technology, negligence, lack of attentiveness, and nurse ethnicity, are not adequately examined across the reviewed studies necessitates further research. Conclusion Focusing on nurses' characteristics might facilitate other researchers to suggest appropriate interventions that may reduce the incidence of MAEs. Interventional studies may provide convincing evidence as to whether one variable has a causal effect on another variable, and control the influence of confounding variables to enhance the generalizability of the findings.
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Affiliation(s)
- Ali Kerari
- Medical Surgical Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Adnan Innab
- Nursing Administration and Education Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
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18
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White KB, Combs RM, Decker HR. Board certification of professional chaplains: a qualitative study of stakeholder perspectives. J Health Care Chaplain 2021; 28:443-466. [PMID: 34061726 DOI: 10.1080/08854726.2021.1916334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many professional chaplaincy organizations in the United States have board certified healthcare chaplains since the 1920s and documented how they have adapted their process as the profession has grown. In 2019, the Association of Professional Chaplains and the National Association of Catholic Chaplains sought the perspectives of key stakeholders about professional chaplaincy board certification. This study reports the results from 50 semi-structured interviews with certification candidates, certification committee members, and chaplaincy managers in the United States. Participants discussed the preparation of the certification application, the certification interview, the ease and difficulty of certification competencies, and the evolving workforce. This study demonstrated divergent views on many aspects of board certification, but participants predominately respected and valued the process. Chaplains with varying levels of experience discussed how board certification strengthens multidisciplinary respect and collaboration. Participants reported difficulties with competencies that required translating between theory and practice.
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Affiliation(s)
- Kelsey B White
- Department of Health Management and System Sciences, University of Louisville, Louisville, KY, USA
| | - Ryan M Combs
- Department of Health Promotion and Behavior Sciences, School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA
| | - Hallie R Decker
- Department of Health Promotion and Behavior Sciences, School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA
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19
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Dierkes AM, Schlak AE, French R, McHugh MD, Aiken L. Why Some Nurses Obtain Specialty Certification and Others Do Not. J Nurs Adm 2021; 51:249-256. [PMID: 33882552 PMCID: PMC8064627 DOI: 10.1097/nna.0000000000001009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether there are modifiable characteristics of nurses and hospitals associated with nurse specialty certification. BACKGROUND Hospitals, nurses, and patients benefit from nurse specialty certification, but little actionable evidence guides administrators seeking higher hospital certification rates. METHODS This is a cross-sectional, secondary data analysis of 20 454 nurses in 471 hospitals across 4 states. RESULTS Rates of certified nurses varied significantly across hospitals. Higher odds of certification were associated with Magnet® recognition and better hospital work environments at the facility level, and with BSN education, unit type (most notably, oncology), older age, more years of experience, and full-time employment at the individual nurse level. CONCLUSION Two strategies that hold promise for increasing nurse specialty certification are improving hospital work environments and preferentially hiring BSN nurses.
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Affiliation(s)
- Andrew M Dierkes
- Author Affiliations: Assistant Professor (Dr Dierkes), Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pennsylvania; Postdoctoral Fellow (Dr Schlak), School of Nursing, Columbia University, New York, New York; and Predoctoral Fellow (Ms French), Associate Director (Dr McHugh), and Director (Dr Aiken), Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia
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20
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Olds D, Cramer E. Predictors of physical restraint use on critical care units: An observational structural equation modeling approach. Int J Nurs Stud 2021; 118:103925. [PMID: 33853022 DOI: 10.1016/j.ijnurstu.2021.103925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Modifiable unit characteristics, including nurse work environment, education, certification, and staffing have been shown to impact patient safety. Physical restraints are an important patient safety issue, however the relationships between these modifiable unit characteristics and physical restraint use on critical care units has not been explored. OBJECTIVES Our objective was to determine the role of nursing work environment, nurse education and certification, and nurse staffing on physical restraint use. DESIGN The study was a secondary analysis of 2017-2018 unit-level restraint rates from the National Database of Nursing Quality Indicators linked to Registered Nurse survey and hospital characteristics data. METHODS Work environment was examined at the unit-level using total Practice Environment Scale of the Nursing Work Index and subscale scores. Unit-level nurse expertise included the percent of nurses with at least a Bachelor of Science in Nursing degree and percent with certification. Nurse staffing was the unit-level Registered Nurse hours per patient day and skill mix. Analyses included descriptive statistics, bivariate correlations, and Structural Equation Modeling. We used a first order model to estimate predicted restraint use from the five subscales of the Practice Environment Scale of the Nursing Work Index. A higher order model predicted restraint use from a total work environment factor score. RESULTS The sample included 408 critical care units from 226 hospitals. Mean restraint rate was 15% (SD 12, range 0-53%). In the first-order model, the Collegial Nurse-Physician Relations subscale had a positive relationship with restraint use (β = 0.167, 95% confidence interval 0.010-0.333). In the higher order model, the total work environment score had a negative relationship with restraint use (β = -0.088, 95% confidence -0.178- -0.014). Registered Nurse hours per patient day had a negative relationship to restraint use in both the first order (β = -0.114, 95% confidence interval -0.222--0.025) and higher order models (β = -0.117, 95% confidence interval -0.223- -0.012). CONCLUSION We found that better nurse-physician relationships were associated with higher restraint use. This finding is supported by previous literature and may reflect physician trust in nursing judgement when using restraints. However, a better work environment overall was associated with lower restraint rates. Further, Registered Nurse hours per patient day, but not skill mix, was associated with lower restraint rates. We conclude that improving the overall nurse work environment and nurse staffing, as well as using interprofessional interventions, may be successful in decreasing restraint use on critical care units.
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Affiliation(s)
- Danielle Olds
- Research Assistant Professor, University of Kansas School of Nursing USA.
| | - Emily Cramer
- Research Associate Professor, University of Kansas School of Nursing USA
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21
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Affiliation(s)
- Margo A. Halm
- Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon
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22
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Abstract
There is no quantitative evidence as to how plastic and aesthetic nurses perceive the value of certification. The aim of this study was to determine how certified and noncertified plastic and aesthetic registered nurses (RNs), who are members of the International Society of Plastic and Aesthetic Nurses (ISPAN), perceive the value of certification. A secondary study aim was to compare perceptions of nurses who hold a CPSN (Certified Plastic Surgical Nurse), CANS (Certified Aesthetic Nurse Specialist), or both certifications with nurses who do not hold these certifications. Upon approval of the ISPAN Board of Directors, the researchers prepared a survey. The survey collected demographic information sufficient to capture a picture of the nurses participating in the survey and to compare profiles of certified and noncertified nurses. The Perceived Value of Certification Tool (PVCT)-12 was used to obtain information about the nurses' perceived extrinsic and intrinsic values of certification. Overall, the highest level of agreement was found with the intrinsic value statements. Across all 12 items of the PVCT-12, participants who held a CPSN and/or CANS certification reported greater perceptions of the value of the CPSN and CANS certifications than participants who did not hold a CPSN or CANS certification. Certified participants' intrinsic and extrinsic value scores were found to be significantly higher than noncertified participants' scores. The extrinsic value statements of the PVCT-12 were the least endorsed. Extrinsic rewards in combination with added support and recognition for nurses may be what is necessary to increase the proportion of certified nurses.
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23
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Lasater KB, Clark RRS, McCabe MA, Frankenberger WD, Agosto PM, Riman KA, Aiken LH. Predictors of specialty certification among paediatric hospital nurses. J Clin Nurs 2020; 30:200-206. [PMID: 33090594 DOI: 10.1111/jocn.15540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To evaluate differences in hospitals' proportion of specialty certified nurses and to determine whether and to what extent individual nurse characteristics and organisational hospital characteristics are associated with a nurse's likelihood of having specialty certification. BACKGROUND Prior research has shown that patients in hospitals with high proportions of specialty certified nurses have better outcomes including lower mortality and fewer adverse events, yet less is known about what motivates nurses to obtain specialty certification. METHODS AND DESIGN Cross-sectional study of paediatric nurses in 119 acute care hospitals. Multivariate logistic regression models were used to determine the association between individual nurse characteristics, organisational hospital characteristics and an individual nurses' likelihood of holding a specialty certification. STROBE was followed. RESULTS The proportion of certified nurses varies substantially among hospitals, with Magnet® hospitals being significantly more likely, on average, to have higher proportions of certified nurses. Nurses in children's hospitals were no more likely than paediatric nurses in general hospitals to be certified. A nurse's years of experience and bachelors-preparation were significantly associated with higher odds of having certification. The strongest predictors of certification were favourable nurse work environments and Magnet® -designation of the hospital. CONCLUSIONS While individual attributes of the nurse were associated with a nurse's likelihood of having a specialty certification, the strongest predictors of certification were modifiable attributes of the hospital-a favourable nurse work environment and Magnet® -designation. RELEVANCE TO CLINICAL PRACTICE Hospital administrators seeking to increase the proportion of specialty certified nurses in their organisation should look to improvements in the organisation's nurse work environment as a possible mechanism.
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Affiliation(s)
- Karen B Lasater
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca R S Clark
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret A McCabe
- Center for Pediatric Nursing Research and Evidenced-Based Practice, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Paula M Agosto
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kathryn A Riman
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Nursing students' clinical performance issues and the facilitator's perspective: A scoping review. Nurse Educ Pract 2020; 48:102890. [PMID: 33007690 DOI: 10.1016/j.nepr.2020.102890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 11/09/2019] [Accepted: 09/18/2020] [Indexed: 11/21/2022]
Abstract
Clinical placement experience is an integral component of nursing education as students acquire the essential knowledge and skills through learning in a supervised clinical environment. The role of the facilitator is pivotal to ensure students are practising safely and competently. The aim of this review was to explore the clinical performance issues identified by clinical facilitators, examine the relationship between students' academic and clinical performance, and factors influencing performance and attrition. A scoping review was undertaken to identify relevant literature, emerging themes and gaps in the literature, searching five electronic databases for primary and secondary papers, and the grey literature. No date limit was set for the review. Fifteen papers met the inclusion criteria. The top three themes relating to clinical performance issues included: i) Poor communication skills, ii) Inadequate knowledge or clinical incompetence and, iii) Unprofessional behaviour. The review also identified the relationship between academic and clinical performance, and negative experiences influencing students' decisions to leave the course. This scoping review highlighted the paucity of literature relating to clinical performance from the perspective of the facilitator, as well as the relationship between student characteristics and clinical performance and attrition.
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25
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A longitudinal examination of nurses’ need satisfaction profiles: A latent transition analysis. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00972-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Using observational simulation teaching methods in professional development to address patient safety. Collegian 2020. [DOI: 10.1016/j.colegn.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Bam V, Diji AKA, Asante E, Lomotey AY, Adade P, Akyeampong BA. Self-assessed competencies of nurses at an emergency department in Ghana. Afr J Emerg Med 2020; 10:8-12. [PMID: 32161705 PMCID: PMC7058887 DOI: 10.1016/j.afjem.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 07/12/2019] [Accepted: 09/12/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction The nature and scope of emergency nursing exposes nurses to a wide array of patient populations with rapidly changing and unexpected clinical conditions, sophisticated logistics and procedures. Hence, emergency centre (EC) nurses ought to be ready to face diverse clinical challenges and deliver care to patients in a timely cost-effective manner and with the needed competence. The current study aimed at examining the self-assessed competencies of nurses, and comparing ratings among certified emergency nurses (ENs) and general nurses (GNs) working at an EC of a tertiary hospital in Ghana. Methods A descriptive cross-sectional quantitative study was carried out among 109 conveniently sampled nurses. Participants evaluated their perceived competencies on a validated instrument under five domains, namely: diagnostic function (DF), administering and monitoring therapeutic interventions (AMTI), effective management of rapidly changing situations (EMRCS), organisational and work load competency (OWLC), and the helping role (HR). Descriptive and inferential data analyses were by SPSS version 25. Results Participants generally had good competencies in the performance of emergency nursing procedures. Highest scores were obtained in OWLC (median score of 83.3%) while EMRCS recorded the least scores (median score of 57.9%). With the exception of the DF domain (p = 0.166), ENs perceived themselves as significantly more competent than their counterpart GNs in 4 (OWLC, HR, AMTI, EMRCS) out of the five studied domains (p < 0.05). Discussion Specialist training enhances nurses' perceived competences in emergency nursing procedures. This reiterates the need for regular theory and practice-based education for GNs on intermediate and advanced procedures as they prepare to enrol in specialist programmes. As nurses take on expanded professional roles in this emerging nursing specialty in low- and middle-income countries, it is important the needed capacity is developed to adequately address the needs of patients and families that require services in ECs.
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Affiliation(s)
- Victoria Bam
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
- Corresponding author.
| | | | - Ernest Asante
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Pearl Adade
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - Berlinda Asante Akyeampong
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
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Suclupe S, Martinez-Zapata MJ, Mancebo J, Font-Vaquer A, Castillo-Masa AM, Viñolas I, Morán I, Robleda G. Medication errors in prescription and administration in critically ill patients. J Adv Nurs 2020; 76:1192-1200. [PMID: 32030796 DOI: 10.1111/jan.14322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/16/2019] [Accepted: 01/29/2020] [Indexed: 11/28/2022]
Abstract
AIM To determine the prevalence and magnitude of medication errors and their association with patients' sociodemographic and clinical characteristics and nurses' work conditions. DESIGN An observational, analytical, cross-sectional and ambispective study was conducted in critically ill adult patients. METHODS Data concerning prescription errors were collected retrospectively from medical records and administration errors were identified through direct observation of nurses during drug administration. Those data were collected between April and July 2015. RESULTS A total of 650 prescription errors were identified for 961 drugs in 90 patients (mean error 7[SD 4.1] per patient) and prevalence of 47.1% (95% CI 44-50). The most frequent error was omission of the prescribed medication. Intensive care unit stay was a risk factor associated with omission error (OR 2.14; 1.46-3.14: p < .01). A total of 294 administration errors were identified for 249 drugs in 52 patients (mean error 6 [SD 6.7] per patient) and prevalence of 73.5% (95% CI 68-79). The most frequent error was interruption during drug administration. Admission to the intensive care unit (OR 0.37; 0.21-0.66: p < .01), nurses' morning shift (OR 2.15; 1.10-4.18: p = .02) and workload perception (OR 3.64; 2.09-6.35: p < .01) were risk factors associated with interruption. CONCLUSIONS Medication errors in prescription and administration were frequent. Timely detection of errors and promotion of a medication safety culture are necessary to reduce them and ensure the quality of care in critically ill patients. IMPACT Medication errors occur frequently in the intensive care unit but are not always identified. Due to the vulnerability of seriously ill patients and the specialized care they require, an error can result in serious adverse events. The study shows that medication errors in prescription and administration are recurrent but preventable. These findings contribute to promote awareness in the proper use of medications and guarantee the quality of nursing care.
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Affiliation(s)
- Stefanie Suclupe
- Iberoamerican Cochrane Centre, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Jose Martinez-Zapata
- Iberoamerican Cochrane Centre, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau, (IIB Sant Pau), Barcelona, Spain
| | - Jordi Mancebo
- Intensive Care Unit, University Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Assumpta Font-Vaquer
- Intermediate Care Unit, University Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | | | - Iris Viñolas
- Intensive Care Unit, University Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Indalecio Morán
- Intensive Care Unit, University Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Gemma Robleda
- Iberoamerican Cochrane Centre, Barcelona, Spain.,Mar University School of Nursing - Pompeu Fabra University, Barcelona, Spain
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Lee KC, Ho CH, Yu CC, Chao YF. The development of a six-station OSCE for evaluating the clinical competency of the student nurses before graduation: A validity and reliability analysis. NURSE EDUCATION TODAY 2020; 84:104247. [PMID: 31689585 DOI: 10.1016/j.nedt.2019.104247] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/10/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Assessing clinical competency in undergraduate nursing students is essential before they enter clinical practice. The objective structured clinical examination (OSCE) is widely used and is part of clinical competency assessment. Aim The aim of this study was to develop and validate a six-station OSCE for evaluating the clinical competency of the student nurses before graduation. METHODS One-group longitudinal observational study. An OSCE of 6 stations of 10 min each was adopted. Blueprint setting, checklist development, and standard patient and examiner training were conducted. The mean, standard deviation, item scale (item-total correlation) and comparisons of extreme groups for item analysis. The inter-coder of examiners and inter-case of students were used to test reliability. Content Validity and concurrent validity were used to evaluate validity of OSCE. RESULTS One hundred nursing students participated in this study. The mean OSCE score of students who passed the registered nurses' examination was significantly higher than that of students who failed. Significant differences in OSCE score between students who remain versus left clinical job were observed at 3, 6 and 9 months after graduation. CONCLUSION The OSCE is predictable method for assessing undergraduate students' first year clinical retention.
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Affiliation(s)
- Kwo-Chen Lee
- School of Nursing, China Medical University, Taichung, Taiwan.
| | - Ching-Hsuan Ho
- Department of Education and Training, China Medical University Hospital, Taichung, Taiwan.
| | - Chin-Ching Yu
- Department of Nursing, Central Taiwan University of Science and Technology, Taiwan.
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Abstract
In January 2017, the Emergency Trauma Advocate (ETA) program was piloted at our Level 1 trauma center to promote patient advocacy, particularly in pediatric patients. The goal was to empower emergency department nurses by improving their knowledge base through interactive didactic sessions. This study reviews the preliminary findings of the program. Surveys were administered after each teaching session to participating ETA nurses to determine their personal academic interests and how to improve the program. We then performed a retrospective review of pediatric trauma admissions from January 2017 through April 2017 to delineate the most common injury patterns. Survey responses demonstrated the greatest nursing interest in learning critical care (n = 11), orthopedic management (n = 11), and neurosurgical trauma education (n = 9). During this study period, 113 pediatric patients arrived and had a mean age of 7.8 ± 5.2 years. The most common injury patterns were orthopedic (n = 38) and neurosurgical (n = 28), and 35 patients required critical care management. Bivariate analysis revealed a significant and positive relationship between injury frequency and educational interests (R = 98.8%, p = .0057). A nurse's interest in educational topics directly correlates with recent pediatric trauma injury patterns. Future work should focus on determining what impact the ETA program has had on pediatric outcomes.
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Change Over Time in Ratings of New Nurses on the Appraisal of Nursing Practice. ACTA ACUST UNITED AC 2019; 49:503-508. [DOI: 10.1097/nna.0000000000000794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Criteria for Critical Care Infants and Children: PICU Admission, Discharge, and Triage Practice Statement and Levels of Care Guidance. Pediatr Crit Care Med 2019; 20:847-887. [PMID: 31483379 DOI: 10.1097/pcc.0000000000001963] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To update the American Academy of Pediatrics and Society of Critical Care Medicine's 2004 Guidelines and levels of care for PICU. DESIGN A task force was appointed by the American College of Critical Care Medicine to follow a standardized and systematic review of the literature using an evidence-based approach. The 2004 Admission, Discharge and Triage Guidelines served as the starting point, and searches in Medline (Ovid), Embase (Ovid), and PubMed resulted in 329 articles published from 2004 to 2016. Only 21 pediatric studies evaluating outcomes related to pediatric level of care, specialized PICU, patient volume, or personnel. Of these, 13 studies were large retrospective registry data analyses, six small single-center studies, and two multicenter survey analyses. Limited high-quality evidence was found, and therefore, a modified Delphi process was used. Liaisons from the American Academy of Pediatrics were included in the panel representing critical care, surgical, and hospital medicine expertise for the development of this practice guidance. The title was amended to "practice statement" and "guidance" because Grading of Recommendations, Assessment, Development, and Evaluation methodology was not possible in this administrative work and to align with requirements put forth by the American Academy of Pediatrics. METHODS The panel consisted of two groups: a voting group and a writing group. The panel used an iterative collaborative approach to formulate statements on the basis of the literature review and common practice of the pediatric critical care bedside experts and administrators on the task force. Statements were then formulated and presented via an online anonymous voting tool to a voting group using a three-cycle interactive forecasting Delphi method. With each cycle of voting, statements were refined on the basis of votes received and on comments. Voting was conducted between the months of January 2017 and March 2017. The consensus was deemed achieved once 80% or higher scores from the voting group were recorded on any given statement or where there was consensus upon review of comments provided by voters. The Voting Panel was required to vote in all three forecasting events for the final evaluation of the data and inclusion in this work. The writing panel developed admission recommendations by level of care on the basis of voting results. RESULTS The panel voted on 30 statements, five of which were multicomponent statements addressing characteristics specific to PICU level of care including team structure, technology, education and training, academic pursuits, and indications for transfer to tertiary or quaternary PICU. Of the remaining 25 statements, 17 reached consensus cutoff score. Following a review of the Delphi results and consensus, the recommendations were written. CONCLUSIONS This practice statement and level of care guidance manuscript addresses important specifications for each PICU level of care, including the team structure and resources, technology and equipment, education and training, quality metrics, admission and discharge criteria, and indications for transfer to a higher level of care. The sparse high-quality evidence led the panel to use a modified Delphi process to seek expert opinion to develop consensus-based recommendations where gaps in the evidence exist. Despite this limitation, the members of the Task Force believe that these recommendations will provide guidance to practitioners in making informed decisions regarding pediatric admission or transfer to the appropriate level of care to achieve best outcomes.
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Thomson L. The Evolution of Hypnosis in the Profession of Nursing: We've Come a Long Way, Baby, and Still Have a Long Way to Go. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2019; 61:370-393. [PMID: 31017544 DOI: 10.1080/00029157.2018.1500879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Registered nurses (RNs) are the largest, most diverse, and most respected of all healthcare professions in the United States, numbering over 3.5 million (Gallup poll, 2017). Nurses have evolved from being the handmaidens of physicians and bedpan handlers to highly trained and educated clinicians who have assumed an important, integral, and indispensable role in the healthcare system. The capabilities of nurses to expand the excellent care they can provide has historically been thwarted by others in the healthcare field, including in the area of hypnosis. This article begins with a historical perspective on the education, training, and ever-expanding profession of nursing. The multiplicity of settings where nurses have the opportunity to incorporate clinical hypnosis into the care of their patients is discussed.
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Affiliation(s)
- Linda Thomson
- Springfield Medical Care Systems, Springfield, Vermont, USA
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Abstract
BACKGROUND Calculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review aims to examine current approaches to the issue across many disciplines. DESIGN The approach taken is iterative and in the form of a hermeneutic review. 769 pieces of evidence were reviewed from across disciplines such as nursing, medicine, engineering, statistics, population science, computer science and mathematics where hospital nurse staffing was the subject of the study. RESULTS A number of themes emerged. The first iteration showed the predominance of unit base approaches (eg, nurse numbers, ratios, activity and workload) and the second was the development of methodologies. Subsequent iterations examined issues such as demand, safety, nurse education, turnover, patient outcomes, patient or staff satisfaction, workload and activity. The majority of studies examined (n=767) demonstrated some association between staffing (units or type/skill) and various factors such as staff or patient satisfaction, working conditions, safety parameters, outcomes complexity of work achieved, work left undone or other factors. Many potential areas such as operational safety research were not utilised. CONCLUSION Although the relationship between staffing in acute care and factors such as units, safety or workload is complex, the evidence suggests an interdependent relationship which should only be dismissed with caution. The nature of these relationships should be further examined in order to determine nurse staffing. The body of knowledge appears substantial and complex yet appears to have little impact on policy.
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Affiliation(s)
- Alison Leary
- School of Health and Social Care, London South Bank University, London, UK
- School of Health, University of South Eastern Norway, Oslo, Norway
| | - Geoffrey Punshon
- School of Health and Social Care, London South Bank University, London, UK
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Jansson MM, Syrjälä HP, Ala-Kokko TI. Association of nurse staffing and nursing workload with ventilator-associated pneumonia and mortality: a prospective, single-center cohort study. J Hosp Infect 2019; 101:257-263. [DOI: 10.1016/j.jhin.2018.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/03/2018] [Indexed: 11/27/2022]
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Relationship Between Nurse Certification and Clinical Patient Outcomes: A Systematic Literature Review. J Nurs Care Qual 2019; 35:E1-E5. [PMID: 30817408 DOI: 10.1097/ncq.0000000000000397] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Certification of nurses has been identified as a strategy to improve health care quality. However, the impact nursing certification has on clinical patient outcomes remains unclear. PURPOSE The purpose was to examine the relationship between nursing certification and clinical outcomes. METHODS A systematic review of the literature was conducted through the search of relevant bibliographic databases (CINAHL Plus, PubMed, Medline, and Cochrane Collaboration). RESULTS Nursing certification was found to have a significant inverse relationship to patient falls and health care-associated infections. Significant correlations were not established in outcomes such as pressure injuries and mortality. CONCLUSIONS The validation of knowledge through nursing certification has an impact on specific outcomes such as patients falls and health care-associated infections.
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Whitehead L, Ghosh M, Walker DK, Bloxsome D, Vafeas C, Wilkinson A. The relationship between specialty nurse certification and patient, nurse and organizational outcomes: A systematic review. Int J Nurs Stud 2019; 93:1-11. [PMID: 30822555 DOI: 10.1016/j.ijnurstu.2019.02.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/04/2018] [Accepted: 02/01/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To review the current evidence on the relationship between specialty nurse certification and outcomes. DESIGN A structured and comprehensive systematic review was undertaken using the Joanna Briggs Institute framework to include both published research studies and expert opinion papers. DATA SOURCES Four electronic databases CINAHL, MEDLINE, PubMed, and PsychINFO were searched between 2000 and 2018. The search for expert opinion papers included nursing organizations, OaLster, Grey Literature Report, and The National Database of Nursing Quality Indicators. REVIEW METHODS The records generated through the search were exported to EndNote X8 and duplicates were removed. Title and abstracts of the records were screened by three reviewers for eligibility using the selection criteria. In the absence of an abstract, records were retained for full text review. Full text assessment of each paper was conducted by two reviewers with a third referee, if necessary, to review any discrepancies. In the case of multiple articles drawing on one set of primary data, only one article was included. A review of each article was completed using the JBI Quality Appraisal checklists to assess internal and external reliability and validity. Both quality appraisal and data extraction were conducted by the review team independently and were validated by one other member of the team. Discrepancies were resolved through rigorous discussion between the reviewers. RESULTS Forty one original research studies were included in the final analysis of the literature. The findings from the included articles were synthesized into three major categories and subsequent sub-categories: Patient outcomes, nurse outcomes and organizational outcomes. Twenty seven findings contributed to the sub-category of specialty nurse certification and patient outcomes. Patient outcomes were further classified into nurse sensitive outcomes, patient mortality and patient satisfaction. Fifty-four findings related to nurse outcomes with the sub-categories: personal and professional factors, knowledge and skills, organizational commitment, job satisfaction, empowerment and confidence. Six findings related to organizational benefits: including the sub-categories of nursing turnover and vacancy rates, perception of healthcare, and costs to the organization. CONCLUSIONS The current model risks driving further proliferation of specialty certifications and certifying organizations without questioning the assumptions underlying the goals of certification. The challenges of measuring impact and the cost and value to individual nurses and healthcare organizations are key areas for consideration.
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Affiliation(s)
- Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Western Australia.
| | - Manonita Ghosh
- School of Nursing and Midwifery, Edith Cowan University, Western Australia
| | | | - Dianne Bloxsome
- School of Nursing and Midwifery, Edith Cowan University, Western Australia
| | - Caroline Vafeas
- School of Nursing and Midwifery, Edith Cowan University, Western Australia
| | - Anne Wilkinson
- School of Nursing and Midwifery, Edith Cowan University, Western Australia
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Constructing a Sensitizing Definition of Certification in Nursing for Research Purposes. ACTA ACUST UNITED AC 2019; 49:12-18. [DOI: 10.1097/nna.0000000000000701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farzi S, Saghaei M, Irajpour A, Ravaghi H. The most frequent and important events that threaten patient safety in intensive care units from the perspective of health-care professionals'. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:104. [PMID: 30693039 PMCID: PMC6327678 DOI: 10.4103/jrms.jrms_140_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/08/2018] [Accepted: 09/18/2018] [Indexed: 12/26/2022]
Abstract
Background Patient safety is a priority in all health-care centers across the world. This study aimed to determine the frequency of events that threaten patient safety and the grade threating of events from the perspective of the health-care professionals in the intensive care units (ICUs). Materials and Methods This cross-sectional study was conducted in 2016. The participants were 306 members of health-care professionals (physicians and nurses) with at least 1 year of work experience in ICUs of educational hospitals affiliated to Isfahan University of Medical Sciences. Data were collected using a three-section self-made questionnaire. Data analysis was done using descriptive statistics (frequency distribution and percentage) and version 16 of SPSS software. Results A total of 306 questionnaires were completed out of 320 questionnaires handed out among participants. During the last month, 91.2% of the participants had reported at least a case of medication error, 75.6% had reported at least a case of ventilator-associated pneumonia, and 74.2% had reported at least a case of catheter-induced urinary infection in ICUs. Conclusion The occurrence of events threatening the patient safety in ICUs warrants proper planning by administrators of health-care centers. Medication error was the most frequent and important event of threat to patient safety and falling was the least frequent event of threat to patient safety in ICUs. Considering the frequency and magnitude of medication error in ICUs, a well-adjusted preventive plan should be designed and implemented to improve the patient safety.
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Affiliation(s)
- Sedigheh Farzi
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Saghaei
- Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Irajpour
- Critical Care Nursing, Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Ravaghi
- Department of Health Services Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
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Constructing a Sensitizing Definition of Certification in Nursing: A Consensus-Based Approach. J Nurs Adm 2018; 49:1-3. [PMID: 30531340 DOI: 10.1097/nna.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The relationship between perceived competence and perceived workplace bullying among registered nurses: A cross sectional survey. Int J Nurs Stud 2018; 88:71-78. [PMID: 30212747 DOI: 10.1016/j.ijnurstu.2018.08.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Workplace bullying is one of the most prevalent work-related psychological and physical issues in health care facilities. Workplace bullying has detrimental effects not only on the bullied person/persons but also on health care facilities and care quality and patient safety. AIMS To examine the prevalence of workplace bullying and the relationship between workplace bullying and perceived competence among Jordanian registered nurses working in private hospitals DESIGN: A cross-sectional survey study. SETTING Data were collected from registered nurses working in seven private hospitals in the Capital of Amman. PARTICIPANTS Participants were 269 registered nurses who had a minimum of a bachelor degree, passed the hospital's competency nursing examinations, able to read and understand English, and were able and willing to complete the survey. METHODS The Negative Act Questionnaire-Revised, and Nurse Professional Competence scale were used for data collection. Multiple linear regression analysis was conducted to assess predictors of greater reporting of perceived workplace bullying. FINDINGS Almost 43% of the participants perceived themselves to be victims of severe workplace bullying while more than 31% perceived themselves to be victims of occasional workplace bullying. Person-related bullying was the most frequently reported type of workplace bullying followed by work-related bullying. Age, gender, and sum score on Nurse Professional Competence scale explained significant amount of variance in perceived workplace bullying. CONCLUSION The majority of Jordanian nurses working in private hospitals perceive themselves as victims of either occasional or severe workplace bullying. Amongst all related variables, perceived competence is the most significant predictor of perceived workplace bullying.
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DeGrande H, Liu F, Greene P, Stankus JA. Developing professional competence among critical care nurses: An integrative review of literature. Intensive Crit Care Nurs 2018; 49:65-71. [PMID: 30166231 DOI: 10.1016/j.iccn.2018.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 07/06/2018] [Accepted: 07/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Professional competence is the ability to base clinical decisions on prior experiences with particular clinical situations. METHODS An integrative review of the literature using the methodology of Whittemore and Knafl. The guiding question was: What is the extent and nature of the published literature on intensive care nurses developing professional competence? RESULTS This review analysed 21 peer-reviewed articles obtained from electronic databases. The three main domains of professional competence were managing situations, decision-making and teamwork. Three instruments, the Critical Care Competency Assessment instrument, the Self-Assessment Competence Tool, and the Intensive and Critical Care Nursing Competence Scale (intensive care unit), measure professional and/or clinical competence. Demographic factors are experience, education, age, figure tow near here certification status, gender and location. CONCLUSION Perception of self-competence, seeing beyond the technical aspects of care to the patient, and perceptions of and bonding with intensive care patients and their families are other facets of professional competence that warrant further study.
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Affiliation(s)
- Heather DeGrande
- Texas A&M University: CONHS, 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Fuqin Liu
- Texas Woman's University: CON, 304 Administration Dr., Denton, TX 76204, United States.
| | - Pamela Greene
- Texas A&M University: CONHS, 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Jo-Ann Stankus
- Texas Woman's University: CON, 304 Administration Dr., Denton, TX 76204, United States.
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Evangelou E, Lambrinou E, Kouta C, Middleton N. Identifying validated nursing quality indicators for the intensive care unit: an integrative review. ACTA ACUST UNITED AC 2018. [DOI: 10.1891/1748-6254.12.2.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
SUMMARYBackground: Quality indicators (QIs) play an important role in evaluating quality improvement initiatives. A generally accepted set of QIs specific to the nursing care in the intensive care unit (ICU) is not available.Aim: To identify QIs associated with nursing care for adult ICU in the literature. The methodological quality of QIs was assessed and associated variables of quality and quantity of nursing care were also identified.Methods: We employed an integrative literature review. A focused search of electronic databases was applied. Inclusion and exclusion criteria were used for the selection of relevant articles. Quality assessment of the included studies was based on the guidance document of domains and elements suggested by the Agency of Health Care Research and Quality. QIs’ methodological quality was assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument.Results: The review identified 13 studies and 45 QIs associated with nursing care in the ICU. The set of QIs assessed in each study, the type of nurse staffing measure as well as morbidity and mortality rates varied considerably. Findings suggest that quality and quantity of nursing care are strongly associated with higher rates of adverse events, mortality, infections and complications in adult ICUs. Methodological quality of the QIs also differed considerably. Higher AIRE scores, indicating higher scientific evidence of methodological quality, can be used to select evidence-based and valid QIs.Conclusions: A number of QIs quantifying nursing care in the ICU have been identified. These QIs could be combined to form a tool which would allow to the quantification and assessment of the quality of ICU nursing care provided in a regular basis.
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Myers H, Pugh JD, Twigg DE. Identifying nurse-sensitive indicators for stand-alone high acuity areas: A systematic review. Collegian 2018. [DOI: 10.1016/j.colegn.2017.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Exploring the Relationship Between Nursing Specialty Certification and Surgical Site Infections. J Nurs Adm 2018; 48:400-406. [PMID: 30028816 DOI: 10.1097/nna.0000000000000636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study is to explore the relationship between nursing specialty certification and surgical site infections (SSIs) for colon (COLO) and abdominal hysterectomy (HYST) surgical procedures. BACKGROUND SSI following COLO and HYST procedures is a preventable complication now included in the Centers for Medicare & Medicaid Services' Hospital Inpatient Quality Reporting Program. METHODS Data from 69 hospitals, 346 units, and 6585 RNs participating in the National Database of Nursing Quality Indicators and SSI data on 22 188 patient COLO and HYST procedures from the National Healthcare Safety Network were examined in multivariate logistic regression analysis. RESULTS Magnet® status was associated with lower SSI occurrence after adjusting for other variables. Higher American Society of Anesthesiologists scores, longer surgical procedure time, and wound class were associated with higher SSI occurrence. CONCLUSIONS Future theory-based research should examine the association of nursing specialty certification with patient outcomes and investigate the effect of Magnet status on SSI.
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Mitchell BG, Gardner A, Stone PW, Hall L, Pogorzelska-Maziarz M. Hospital Staffing and Health Care-Associated Infections: A Systematic Review of the Literature. Jt Comm J Qual Patient Saf 2018; 44:613-622. [PMID: 30064955 DOI: 10.1016/j.jcjq.2018.02.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/20/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous literature has linked the level and types of staffing of health facilities to the risk of acquiring a health care-associated infection (HAI). Investigating this relationship is challenging because of the lack of rigorous study designs and the use of varying definitions and measures of both staffing and HAIs. METHODS The objective of this study was to understand and synthesize the most recent research on the relationship of hospital staffing and HAI risk. A systematic review was undertaken. Electronic databases MEDLINE, PubMed, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for studies published between January 1, 2000, and November 30, 2015. RESULTS Fifty-four articles were included in the review. The majority of studies examined the relationship between nurse staffing and HAIs (n = 50, 92.6%) and found nurse staffing variables to be associated with an increase in HAI rates (n = 40, 74.1%). Only 5 studies addressed non-nurse staffing, and those had mixed results. Physician staffing was associated with an increased HAI risk in 1 of 3 studies. Studies varied in design and methodology, as well as in their use of operational definitions and measures of staffing and HAIs. CONCLUSION Despite the lack of consistency of the included studies, overall, the results of this systematic review demonstrate that increased staffing is related to decreased risk of acquiring HAIs. More rigorous and consistent research designs, definitions, and risk-adjusted HAI data are needed in future studies exploring this area.
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Baxter R, Edvardsson D. Impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence: A quasi-experimental study. NURSE EDUCATION TODAY 2018; 65:156-161. [PMID: 29579568 DOI: 10.1016/j.nedt.2018.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/08/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Postgraduate education is said to support the development of nurses' professional competence and confidence, essential to the delivery of safe and effective care. However, there is a shortness of empirical evidence to demonstrate an increase to nurses' self-reported confidence and competence on completion of critical care postgraduate certificate-level education. OBJECTIVES To explore the impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence. To explore the psychometric properties and performance of the Critical Care Competence and Confidence Questionnaire. DESIGN A quasi-experimental pre/post-test design. PARTICIPANTS A total population sample of nurses completing a critical care postgraduate certificate course at an Australian University. METHODS The Critical Care Competence and Confidence Questionnaire was developed for this study to measure nurses' self-reported competence and confidence at baseline and follow up. Descriptive and inferential statistics were used to explore sample characteristics and changes between baseline and follow-up. Reliability of the questionnaire was explored using Cronbach's Alpha and item-total correlations. RESULTS There was a statistically significant increase in competence and confidence between baseline and follow-up across all questionnaire domains. Satisfactory reliability estimates were found for the questionnaire. CONCLUSIONS Completion of a critical care postgraduate certificate course significantly increased nurses' perceived competence and confidence. The Critical Care Competence and Confidence Questionnaire was found to be psychometrically sound for measuring nurses' self-reported competence and confidence.
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Affiliation(s)
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden; School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Nurses' decision making in heart failure management based on heart failure certification status. Heart Lung 2018; 47:184-191. [DOI: 10.1016/j.hrtlng.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/02/2018] [Indexed: 02/08/2023]
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Conceptualization and Operationalization of Certification in the US and Canadian Nursing Literature. ACTA ACUST UNITED AC 2018; 48:238-246. [DOI: 10.1097/nna.0000000000000608] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Audet LA, Bourgault P, Rochefort CM. Associations between nurse education and experience and the risk of mortality and adverse events in acute care hospitals: A systematic review of observational studies. Int J Nurs Stud 2018; 80:128-146. [PMID: 29407346 DOI: 10.1016/j.ijnurstu.2018.01.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/29/2017] [Accepted: 01/16/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To provide knowledge from the summarization of the evidence on the: a) associations between nurse education and experience and the occurrence of mortality and adverse events in acute care hospitals, and; b) benefits to patients and organizations of the recent Institute of Medicine's recommendation that 80% of registered nurses should be educated at the baccalaureate degree by 2020. DATA SOURCES A systematic search of English and French literature was conducted in six electronic databases: 1) Medline, 2) PubMed, 3) CINAHL, 4) Scopus, 5) Campbell, and 6) Cochrane databases. Additional studies were identified by searching bibliographies, prior reviews, and by contacting authors. REVIEW METHOD Studies were included if they: a) were published between January 1996 and August 2017; b) were based on a quantitative research design; c) examined the associations between registered nurse education or experience and at least one independently measured adverse event, and; d) were conducted in an adult acute care setting. Data were independently extracted, analysed, and synthesized by two authors and discrepancies were resolved by consensus. The methodological heterogeneity of the reviewed studies precluded the use of meta-analysis techniques. However, the methodological quality of each study was assessed using the STROBE criteria. FINDINGS Among 2109 retrieved articles, 27 studies (24 cross-sectional and three longitudinal studies) met our inclusion criteria. These studies examined 18 distinct adverse events, with mortality and failure to rescue being the most frequently investigated events. Overall, higher levels of education were associated with lower risks of failure to rescue and mortality in 75% and 61.1% of the reviewed studies pertaining to these adverse events, respectively. Nurse education was inconsistently related to the occurrence of the other events, which were the focus of only a small number of studies. Only one study examined the 80% threshold proposed by the Institute of Medicine and found evidence that it is associated with lower odds of hospital readmission and shorter lengths of stay, but unrelated to mortality. Nurse experience was inconsistently related to adverse event occurrence. CONCLUSION While evidence suggests that higher nurse education is associated with lower risks of mortality and failure to rescue, longitudinal studies are needed to better ascertain these associations and determine the specific thresholds that minimize risks. Further studies are needed to better document the association of nurse education and experience with other nursing-sensitive adverse events, as well as the benefits to patients and organizations of the Institute of Medicine's recommendation.
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Affiliation(s)
- Li-Anne Audet
- University of Sherbrooke, School of Nursing, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada; Centre de recherche de l'Hôpital Charles-Le Moyne, Longueuil, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patricia Bourgault
- University of Sherbrooke, School of Nursing, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian M Rochefort
- University of Sherbrooke, School of Nursing, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada; Centre de recherche de l'Hôpital Charles-Le Moyne, Longueuil, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
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