Janice Selekman

Success in NCLEX-RN: Identifying Predictors and Optimal Timing for Intervention

This ex post facto study was designed to identify predictors of success in the NCLEX-RN and determine the optimal point in time for identifying students at risk. The convenience sample consisted of 407 graduates of an integrated, upper division, baccalaureate nursing program, 1984-1987. Prematriculation (total lower division GPA, science GPA, type of lower division College, age, and sex), junior year (three Nursing theory course grades) and pre graduation variables (three senior year nursing theory course grades and Mosby ASSESSTEST) were analyzed for predictive value. Nursing theory courses at the junior and senior year and the Mosby ASSESSTEST strongly correlated (p less than .0001) with NCLEX performance. Discriminant analysis enabled successful classification of 62% of the sample at prematriculation, 81% at the end of the junior year, and 86% at the end of the senior year. The study indicates that students at high risk can be identified at the end of the junior year so that enrichment and support programs can be introduced at that time.

Identification of Desired Outcomes for School Nursing Practice.

The Scope and Standards of Professional School Nursing Practice states that school nurses should evaluate the quality and effectiveness of their practice. School nurses have not yet identified and adopted outcomes by which this effectiveness can be measured. This study used focus groups during a national meeting of school nurse leaders to identify the desired outcomes that could be used to measure the efficacy of school nursing practice. Ten desired outcome themes were identified with numerous specific indicators as possible ways to measure the desired outcome in each theme. The student-, school-, and nurse-focused outcome themes were as follows: (a) increased student seat time, (b) receipt of first aid and acute care measures, (c) receipt of competent health-related interventions or skills, (d) meeting of the comprehensive needs of children with chronic conditions, (e) enhanced school health via wellness promotion and disease prevention measures, (f) referrals, (g) safe environment, (h) enhanced school health via community outreach, (i) cost-effective school nurse services, and (j) student, parent, and staff satisfaction. The school nurse participants were supportive of having potential outcomes identified and unanimously endorsed the findings at the conclusion of the study. They have provided a comprehensive framework from which evaluation tools can be developed to measure the efficacy of school nursing.

Uses of and Alternatives to Restraints in Pediatric Settings

Restraints are a common component of pediatric nursing practice that currently have no empirical base. This article provides background information concerning the use of restraints with the pediatric population, the impact these devices have on children, and the possible alternatives that have been identified. It is hoped that by providing acute care nurses with recommendations concerning changes in this area of practice, the care that children receive in the inpatient setting may be improved.

Nursing Students With Learning Disabilities

Children with learning disabilities grow up to be adults with learning disabilities, who may go to nursing school. Nurse educators currently are faced with the same challenges as primary and secondary school teachers in meeting the education needs of individuals with learning disabilities. It is essential for nurse educators to be knowledgeable about learning disabilities, to understand the issues involved, and to use appropriate interventions to help these students succeed.

Difficulties in symptom recognition in infants

The subject of symptom recognition in infants is just beginning to be explored in nursing literature; the process may be more difficult that it originally appears. Because symptoms are subjective and their identification is dependent on communication between the client and the nurse or caretaker, it becomes important to assist nurses, parents, and other health care providers in this process. This article discusses the impact of cues, developmental aspects, and inferences as they influence the identification of symptoms experienced by infants.

Interprofessional Education Using a Palliative Care Simulation.

This quasi-experimental pretest-posttest study measured self-efficacy, attitudes toward physician-nurse collaboration, and interprofessional competencies as outcomes of a palliative care simulation. Based on experience level, teams of participants, 1 consisting of nursing/medical students and the other of nursing/medical health care professionals, completed a palliative care simulation as part of their education. Self-efficacy and attitudes toward physician-nurse collaboration were measured before and after simulation. Interprofessional competency was measured during the simulation. The results revealed a significant improvement in the previously mentioned measures, and interprofessional competency scores varied by profession and evaluator.

What Data Do States Collect Related to School Nurses, School Health, and the Health Care Provided?

School nurses collect data to report to their school district and state agencies. However, there is no national requirement or standard to collect specific data, and each state determines its own set of questions. This study resulted from a joint resolution between the National Association of State School Nurse Consultants and the National Association of School Nurses. The study sought to determine whether similar data points were collected so that comparisons could be made among states and to develop a framework to incorporate the data. Thirty-two states provided their questionnaires or reports. There were 855 data points that could be divided into data related to staff and to students. No categories were measured by all states. The most common data points were the number of students, health screenings, and the number of students with particular conditions for whom the district provided services. A framework for data collection is proposed.

Students With Chronic Conditions: Experiences and Challenges of Regular Education Teachers:

School nurses have observed the increasing prevalence of children with chronic conditions in the school setting; however, little is known about teacher experiences with these children in their regular classrooms. The purpose of this mixed-method study was to describe the experiences and challenges of regular education teachers when they have students with chronic conditions in their classroom and implications for the school nurse. The national sample consisted of regular education teachers. The methodologies consisted of focus groups and an online survey. Seven themes emerged: Teachers want to be informed about their students with chronic conditions, teachers lack information about the conditions, there is a lack of preparation in preteacher education programs about students with chronic conditions, teachers feel frustration and stress in working effectively with these students, teachers shared concerns about their students, teachers are asked to perform health-related tasks for students, and teachers made recommendations of what they need from the school nurse.

The New DSM-5 and Its Impact on the Mental Health Care of Children

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the premier resource in the diagnosis of mental health conditions, was published in June 2013. It contains many new diagnoses as well as changes to both the names and criteria for longstanding conditions. It is essential for pediatric nurses to understand the changes so that they can communicate effectively and advocate responsibly for their patients and families. This article discusses the changes, the criticisms voiced about them, and the implications for the pediatric nurse.

Maternal Experiences of Transitioning Their Emerging Adult With Type 1 Diabetes to College

Purpose The purpose of this study was to gain a deeper understanding about mothers’ experiences of transitioning their emerging adult with type 1 diabetes mellitus to college. Methods A descriptive, qualitative study was conducted with 9 mothers of high school seniors with type 1 diabetes (T1DM) using semi-structured questions via recorded telephone interviews. Results Among the 9 participants, 8 had daughters, and 1 had a son. The thematic analysis resulted in 4 themes: (1) concern for health and safety at college, (2) evolving roles of the parent and emerging adult dyad, (3) communication dynamics, and (4) social support systems. Conclusions Results indicate that mothers of emerging adults with T1DM experience heightened levels of concern during the college transition. These concerns are above and beyond those that are experienced by mothers of emerging adults without T1DM. Findings indicated that increasing levels of support for both parents as well as emerging adults with T1DM during the college transition may serve to decrease maternal stress and enhance the development of preparedness for diabetes self-management. Recommendations for diabetes educators in clinical practice include a family-centered approach focusing on the transition before the late adolescent period, interventions from colleges to promote a smooth transition, and interventions that address concerns of both the emerging adult with T1DM and the parent. Further research is necessary to identify barriers and facilitators to support parent/emerging adult dyads during the college transition period.