Rachel L. DiFazio

Bullying, Harassment, and Horizontal Violence in the Nursing Workforce The State of the Science

In the complex health care workplace of nurses, intra/interprofessional ideals intersect with the expectations of patients, families, students, and coworkers in a context of managed care environments, academia, and other health care enterprises. Integral to quality assessment, management, and assurance is collegial and respectful communication. Decades of reported descriptive and anecdotal data on intra/inter professional and on client communication, describe the antithesis of these ideals. Specifically, increasing frequency and rates of persistent bullying, harassment, or horizontal violence (BHHV) have shown to yield detrimental effects on workplace satisfaction, workforce retention, and the psychological and physical health of nurses as well as implied effects on quality of patient care and risk of poor health outcomes. Persistent BHHV among nurses is a serious concern. In advancing the science of description and explanation to a level of prevention intervention, explanatory models from biology, developmental psychology, intra/interpersonal interactionism are described along with theoretical explanations for the prevalence of BHHV in nurse workplaces. Making the connection between explanatory models and creative solutions to address BHHV through multiple levels of behavioral influence such as individual, environmental, interpersonal, and cultural contexts is key to advancing the science of the relationship between professional behavior and client/family/community health care outcomes.

Measuring the Youth Bullying Experience: A Systematic Review of the Psychometric Properties of Available Instruments.

BACKGROUND Bullying is a significant problem in schools and measuring this concept remains problematic. The purposes of this study were to (1) identify the published self-report measures developed to assess youth bullying; (2) evaluate their psychometric properties and instrument characteristics; and (3) evaluate the quality of identified psychometric papers evaluating youth bullying measures. METHODS A systematic review of the literature was conducted using 4 electronic databases. Data extraction and appraisal of identified instruments were completed using a standardized method and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Thirty-one articles describing 27 self-report instruments were evaluated in our analysis. Quality assessments ranged from 18% to 91%, with 6 papers reaching or exceeding a quality score of 75%. Limited evidence supporting the reliability, validity, and responsiveness of existing youth bullying measures was identified. CONCLUSIONS Evidence supporting the psychometric soundness of the instruments identified was limited. Many measures were in early development and additional evaluation is necessary to validate their psychometric properties. A pool of instruments possesses acceptable initial psychometric dependability for selected assessment purposes. These findings have significant implications for assessing youth bullying and designing and evaluating school-based interventions.

Incidence of skin complications and associated charges in children treated with hip spica casts for femur fractures.

Background Spica cast immobilization remains the treatment of choice for femur fractures in children aged 6 months to 6 years. The incidence of skin complications and their associated charges have not been well described. This studys purposes were to: (1) determine the rate of skin complications in children treated with spica casts for femur fractures, (2) identify predictors, and (3) calculate the charges associated with skin complications. Methods Health records for all patients treated with immediate spica casting for a femur fracture at a major tertiary-care childrens hospital from 2003 to 2009 were reviewed and relevant data were abstracted. Descriptive statistics and univariate and multiple logistic regression analyses were used to compare children with and without skin complications and to identify predictors of skin complications. The total charges for skin complications leading to a cast change and early bivalving and lining were calculated. Results Of the 300 spica cast applications in 297 patients, 77 subjects (28%) had skin complications. Twenty-four (31%) of these 77 patients underwent a cast change in the operating room, 34 (44%) required early bivalving and lining and 19 (25%) required cast trimming and/or skin care. Predictors of skin complications included: child abuse as mechanism of injury, younger age, and cast time more than 40 days. Sex, weight, fracture location, and total number of clinic visits were not statistically significant predictors of skin complications. The median charge for patients who required cast changes for skin complications was

Youth bullying: A review of the science and call to action

12,719 (

Waterproof casts for immobilization of children's fractures and sprains.

8632 to

Nonmedical Out-of-Pocket Expenses: A Hidden Cost of Hospitalization

53,768), whereas the median charge for bivalving and lining was

Effect of Hip Reconstructive Surgery on Health-Related Quality of Life of Non-Ambulatory Children with Cerebral Palsy.

416.51 (

Non-medical out-of-pocket expenses incurred by families during their child’s hospitalization

403.32 to

Postoperative Complications After Hip Surgery in Patients With Cerebral Palsy: A Retrospective Matched Cohort Study.

449.00). Conclusions Spica cast treatment is associated with numerous skin complications and additional charges. Victims of child abuse may benefit from additional clinical oversight. Future research needs to investigate patient education and casting interventions that reduce skin complications. Level of Evidence Prognostic Level III—case-control study with patient identified based on outcome—skin complications versus no skin complications.

Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation.

Recognized as a critical public health problem, youth bullying is reportedly experienced by approximately 20% of todays youths. In the last decade, attention to bullying has increased and the scientific knowledge base relevant for practitioners who treat youths, research their issues, and create policy has expanded. The purpose of this review is to highlight key developments related to the health effects of bullying, interventions aimed at curbing bullying behaviors, the measurement of bullying, and nursings disciplinary response to this phenomenon. A call to action for nurses involved in caring for youths across settings and roles is offered and strategic actions for nursing professionals are provided.