Wendy M. Woith

Perceptions of Academic Integrity Among Nursing Students

PURPOSE Academic dishonesty is growing among nursing students. Reasons for this growth can be categorized into student, faculty, and system factors. Nursing faculty designed a study to explore this problem. CONCLUSIONS We identified three themes: characteristics of students with academic integrity, patient safety, and professional outcomes. Exploring student perceptions of academic integrity can help faculty design measures to prevent dishonesty in these three areas. PRACTICE IMPLICATIONS We recommend fostering culture change through strategies that target students, faculty, and systems. These strategies include peer mentoring, role modeling integrity, enhancing awareness of what constitutes cheating, and developing policies that promote honesty.

Barriers and motivators affecting tuberculosis infection control practices of Russian health care workers.

SETTING Five in-patient and out-patient tuberculosis (TB) care facilities in two regions of Russia. OBJECTIVE To identify barriers and motivators to the use of infection control measures among Russian TB health care workers. DESIGN In this qualitative study, a convenience sample of 96 health care workers (HCWs) was used to generate 15 homogeneous focus groups, consisting of physicians, nurses, and laboratory or support staff. RESULTS Barriers and motivators related to knowledge, attitudes and beliefs, and practices were identified. The three main barriers were 1) knowledge deficits, including the belief that TB was transmitted by dust, linens and eating utensils; 2) negative attitudes related to the discomfort of respirators; and 3) practices with respect to quality and care of respirators. Education and training, fear of infecting loved ones, and fear of punishment were the main motivators. CONCLUSIONS Our results point to the need for evaluation of current educational programs. Positive health promotion messages that appeal to fear might also be successful in promoting TB infection control. Individualized rewards based on personal motivators or group rewards that build on collectivist theory could be explored.

Perceptions of New Nurses Concerning Incivility in the Workplace.

BACKGROUND Although an atmosphere of civility in which nurses respect and value each other is crucial to health care, incivility continues to be widespread. METHOD New graduate nurses completed an online questionnaire in which they described incivility and discussed its impact on new nurses and patients. RESULTS Findings were categorized according to the impact of incivility on new nurses and patients. Embedded in these categories are rich descriptions of incivility in health care. CONCLUSIONS The participants witnessed uncivil interactions that negatively impacted them emotionally, professionally, and physically. They also discussed the harmful effects of incivility on patients, whose care may be impeded or their faith in caregivers eroded in hostile, uncivil care environments. Nurses in professional development play a crucial role in promoting a culture of civility through raising awareness, supporting nurses new to the profession, and helping health care workers to better cope with incivility.

Methods to determine the internal length of nasogastric feeding tubes: An integrative review

OBJECTIVES Improper placement of nasogastric tube used for feeding may lead to serious complications, including death of the patient. There are several different methods used to determine the appropriate length of nasogastric tube for optimal placement in adults. This integrative review of the literature was designed to identify the most accurate method to determine the internal length of nasogastric feeding tube in adults. DESIGN An integrative review of the research literature (1979-2015) using the population-intervention-comparison-outcomes strategy. DATA SOURCES The literature search included the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Joanna Briggs, PubMed (MEDLINE), SCOPUS, and Web of Science electronic databases. REVIEW METHODS Two researchers evaluated the literature to determine if an article met inclusion and exclusion criteria. The quality of the evidence was assessed using the Johns Hopkins Strength of the Evidence critical appraisal tool. RESULTS Twenty studies, published between 1979 and 2014, met inclusion criteria. Of these, nine articles were expert opinion, seven were original research, three were review articles, and one was a guideline. Despite seven original research papers being found, only five reports were about the methods to determine the internal length of nasogastric feeding tube in adults. The literature suggests that four different methods for measuring the tube length are likely to result in proper placement of the tip of the tube in the stomach and all side ports inside it: [nose-to-ear-to-xiphisternum - 50]cm/2+50cm]; [gender-weight and nose-umbilicus-flat]; [xiphisternum-to-ear-to-nose+10cm]; [earlobe to xiphisternum to umbilicus - tip of the nose to earlobe]. Four studies found nose-to-ear-to-xiphisternum was most likely to result in a tube that is positioned incorrectly, either ending in the esophagus, in the stomach but too close to the esophagus, or too far into the stomach or duodenum. CONCLUSIONS The nose-to-ear-to-xiphisternum and Hanson method should no longer be taught in nursing programs or used in practice by the nurse. The [gender-weight and nose-umbilicus-flat] method has been shown to be safer.

Non-Critical-Care Nurses' Perceptions of Facilitators and Barriers to Rapid Response Team Activation.

Rapid response teams can save lives but are only effective when activated. We surveyed 50 nurses for their perceptions of facilitators and barriers to activation. Findings showed that participants need more education on their role and when to activate the rapid response team. Nurses who comprise the team need help building their communication skills. We recommend nursing professional development specialists increase the frequency of offerings and expand the focus on roles, activation criteria, and communication skills.

Emotional representation of tuberculosis with stigma, treatment delay, and medication adherence in Russia

This descriptive cross-sectional study aimed to explore emotional representation and illness coherence, the understanding a person has about an illness which helps them make sense of the experience, in Russians with tuberculosis. In a secondary analysis of questionnaires from 105 Russians treated for pulmonary tuberculosis, social isolation and disease consequences were predictors of negative emotions related to tuberculosis and accounted for 49 percent of the variance. Participants who scored higher on illness coherence were less likely to experience negative emotions. Development of programs to help patients understand tuberculosis and to manage emotional responses and stigma is suggested.

Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self‐Care Behaviors, and Barriers to Care

BACKGROUND Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses. PURPOSE The purpose of this study was to explore homeless peoples perceptions of their interactions with nurses. METHOD In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis. RESULTS Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care. CONCLUSIONS AND IMPLICATIONS Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless.

Why can't we all just get along? A Civility Journal Club intervention.

Nursing faculty aim to provide an environment in which students learn theoretical concepts and critical thinking. Incivility is a barrier to learning and has been a growing problem in nursing for several decades. Incivility can negatively affect patient safety, work environments, and nurse retention. Exposure to incivility in nursing begins during undergraduate education. Examples of student incivility vary from inattention and lack of preparation in class to verbal or physical abuse. Uncivil behaviors reported in clinical practice include sabotage by gossiping or withholding crucial information and overt acts of verbal or physical hostility. Civility is a key component of professional nursing, and faculty members are responsible for socializing students into professional roles.

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya: An Ethnography

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all.

Social capital, health, health behavior, and utilization of healthcare services among older adults: A conceptual framework

Meeting the health needs of Americans must change as the population continues to live longer. A strategy that considers social well-being is necessary. One way to improve social well-being is through increased social capital, which includes networks among individuals and norms of reciprocity and trust between them. Supporting attainment of bonding social capital from close-knit groups, such as family, and bridging or linking social capital from those who are dissimilar are vital. Research shows there is a relationship among social capital and self-reported mental and physical health, health behaviors, healthcare utilization, and mortality. Because older adults are often dependent on others for their healthcare needs, it is posited that social capital plays a key role. Nurses can be instrumental in investigating levels of social capital for individuals and determining what type of social support is needed and who in the individuals network will provide that support. When support is absent, the nurse serves as the link between patients and available resources. The purpose of this article is to introduce a conceptual framework that can assist nurses and other healthcare providers to consider social capital in older adults in the context of relationships and the social environments to which they belong.