Sally Northam

Pain Management Knowledge and Attitudes of Baccalaureate Nursing Students and Faculty

Pain affects approximately 76 million adults in the US. Though pain management has been targeted as a top priority, it continues to be inadequately addressed. Nursing faculty are in a unique position to significantly address the problem through facilitating the acquisition and utilization of knowledge by student nurses. The purpose of this study was to determine the knowledge of and attitudes toward pain in baccalaureate nursing students and faculty to establish a foundation for a systematic and comprehensive integration of pain content in the curricula. The descriptive design included a sample of 162 junior and senior students enrolled in a baccalaureate nursing program in Texas and 16 nursing faculty. The Knowledge and Attitudes Survey Regarding Pain (KASRP) was used to measure knowledge and attitudes toward pain. A direct correlation was found between the level of education and the percentage correct score. Differences found in knowledge and attitudes among the three levels of students and faculty were significant (df = 3.173; F = 14.07, p < .001). Senior students nearing graduation scored only 68% (SD = 6.8) with faculty scoring only slightly better with a mean of 71% (SD = 13). Significant differences also were found in assessment of pain through case scenarios of a patient who was smiling and talking as compared to a patient who was lying quietly and grimacing (X2 = 37.13, p < .05 (df = 24). Reevaluation of the way pain assessment and treatment are taught is indicated. Further studies are needed to assess changes in knowledge and attitudes toward pain as curricular revisions are made.

Journal Editor Survey: Information to Help Authors Publish

Faculty are expected to publish but often do not know how to write a manuscript that avoids major reasons for subsequent rejection. The authors share the results of a survey of 63 journal editors who reported journal characteristics and reasons for rejection of manuscripts. Suggestions to improve the acceptance rate of faculty publications are offered.

Discrepancies among physicians regarding knowledge, attitudes, and practices in end-of-life care

Physicians often dominate end-of-life decisions, and findings vary on their personal and patient advance directive decisions. Little is known about the relationships among physician spirituality, expectations for patient survival and quality of life, and treatment intensity. A survey design examined the knowledge, attitudes, and decision-making practices of 187 physicians in Northeast Texas. Race, sex, specialty, age group, and spirituality did not differ among physicians with and without advance directive, nor were there significant relationships among spirituality, intensity of the treatment of a terminal patient, and age. Significant relationships were found between expectations for survival and the intensity of the treatment of the terminally ill patient and between expectations for meaningful patient life in 6 months and treatment intensity. Forty-one percent worried about the legal consequences with advance directives. Most (66%) viewed morphine as appropriate even if it hastened death, 41% viewed tube feedings as heroic, and 21% viewed physician-assisted suicide as acceptable for terminally ill patients in extreme pain or distress. Hope for the survival and quality of life of terminally ill patients was common. Nursing implications are derived from awareness of physician perspectives and in facilitating patient autonomy, dignity, and respect for individual wishes at end of life.

Child Sex-Trafficking Recognition, Intervention, and Referral: An Educational Framework for the Development of Health-Care-Provider Education Programs

ABSTRACT Purpose: The purpose of this Delphi study was to obtain consensus among an international, multidisciplinary panel of child sex-trafficking experts and child sex-trafficking survivors on the most important elements needed in a comprehensive, interdisciplinary health-care-provider education program on the recognition, intervention, and referral of child sex-trafficking victims and survivors. Methods: A two-round Delphi method was utilized to identify the most important elements of a child sex-trafficking health-care-provider education program. A content validity index score was utilized to determine consensus and order importance of each element. Results: Eight content areas including 63 subcontent areas were identified by an international panel of 23 subject-matter experts representing clinical professions, law enforcement, academia, and community support organizations as important for inclusion in comprehensive health-care-provider education programs. Three content areas and 19 subcontent areas were identified by 10 survivors as important for inclusion in comprehensive health-care-provider education programs. The Individual Content Validity Index (I-CVI) was utilized to determine consensus and rank importance. Conclusion: The findings of this Delphi study provide the first scientifically based framework to guide the development of comprehensive, interdisciplinary education programs for health care providers on the recognition, intervention, and treatment and referral of child sex-trafficking victims and survivors. The use of the I-CVI allows the program developer to tailor the education-program components to the time and scope of the program under development.

Early Term Birth The Impact of Practice Patterns on Rates and Outcomes

The American College of Obstetricians and Gynecologists guidelines discourage elective deliveries before 39 weeks gestation, but clinicians continue to schedule elective inductions and cesareans resulting in births at 37 0/7 to 38 6/7 weeks gestation. These “early term” (ET) infants incur more morbidity and mortality than their 39-to-41-week counterparts. Using the Quality Health Outcomes Model, four hypotheses were tested: Among hospitals in one southwestern U.S. county, there are different rates of ET births, ET births preceded by elective labor induction, ET births preceded by elective cesarean section, and Neonatal Intensive Care Unit (NICU) admissions of ET infants. Analyses of 75,625 birth certificates involved 26,199 ET and 49,426 full term births in 16 hospitals. Chi-square analyses revealed significant differences in rates among hospitals for ET births, ET births preceded by elective labor induction, and ET births preceded by elective cesarean section, but no significant differences in NICU admissions. Wide variance across hospitals demonstrated practice patterns amenable to improvements.

Publication Opportunities in Nonnursing Journals

The purpose of this article was to identify nonnursing journals that have relevance to nursing, that publish articles that cite the nursing literature and may offer excellent but seldom-considered publication opportunities for nurses. Using 22 indicators derived through citation analysis, 64 nonnursing journals that are highly related to nursing were identified. The authors provide information about these 64 journals related to their subject matter, number of issues annually, and their 2008 impact factor.

Nursing journal editor survey results to help nurses publish

This study gathered data from 61 nursing journal editors (31% response rate) on 7 variables. The information is designed to help novice and seasoned authors make decisions about journal selection for article submission. Variables include the average number of submitted manuscripts annually, the percentage of initially accepted and resubmitted manuscripts, weeks from submission to decision, number of reviewers, types of accepted manuscripts, and top reasons for rejection.

Tunnelled central venous catheter-related bloodstream infection in Canadian blood stem cell transplant recipients: Associated costs

Pr o b l e m: Ce ntr a l ca the te r -re lat e d bloodstr ea m i nf ec t i on ( CR BSI ) is ass oc iat e d with i n c re a s e d h ea l t h car e c osts a nd pa t ie nt m orbidi ty . The pur p ose of the stu d y w a s to es t i mate the dir ec t inpatient c h arge s o f CRB S I in Ca n a dian blood a nd ma r row ce ll tr a nspl a nt rec ip ie nts with a tunn e lled cent ra l v e nous c a thet e r (CVC). Me tho d : A ca se -c ontro l led c ompa r ison of p a t ie nt r ec ords f r om a si ng le ce ntr e was completed . R ec ords ind ica t i ng CR BS I we re pa ir e d for c ompa r ison t o pa t ie nt r eco rds not ind ica t i ng C RBS I in the following domains: len gth of st ay , lab o r a to r y tes t s, di ag nostic te st s , medi ca t i ons used, c onsultations to a sp ec ia lt y p hy sici a n, ca thet e r rep la ce ment c ost s , a nd leng th of st a y in t he i ntensi v e c a re unit. R e s u lts: C a s e s st aye d o n a v e rage a n ex tra 19.37 d ay s in t he hospital. E x tra ch ar g e s for dia g nosi n g a nd t rea t in g CR BS I average d

Analysis of Costs and Benefits of Transparent, Gauze, or No Dressing for a Tunnelled Central Venous Catheter in Canadian Stem Cell Transplant Recipients

4,739 . 9 5 . The to ta l esti ma ted b urd e n of C RBS I in C a n a dian blood a nd ma rr ow t ra nspl a nt for the 20 1 3 fis ca l yea r wa s

Impact factors in nursing journals.

44,81 6 .48 p e r incid e nt. In f ec t i ons a lso re du c ed t he le ng th of ca t h eter use t i me b y a n av erag e of 1 8. 68 d ay s. K ey words: c atheter related b loodstr ea m in f ec t i on,cost, s tem c e llt ra nspl a nt