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AnteayerJournal of Nursing Scholarship

Issue Information

Journal of Nursing Scholarship, Volume 52, Issue 4, Page 339-340, July 2020.

A Maturity Matrix for Nurse Leaders to Facilitate and Benchmark Progress in Genomic Healthcare Policy, Infrastructure, Education, and Delivery

Abstract

Purpose

Nurse leaders driving strategic integration of genomics across nursing need tools and resources to evaluate their environment, guide strategies to address deficits, and benchmark progress. We describe the development and pilot testing of a self‐assessment maturity matrix (MM) that enables users to benchmark the current state of nursing genomic competency and integration for their country or nursing group; guides the development of a strategic course for improvement and implementation; and assesses change over time.

Design

Mixed‐methods participatory research and self‐assessment.

Methods

During a 3‐day workshop involving nursing experts in health care and genomics, a genomic integration MM grid was built by consensus using iterative participatory methods. Data were analyzed using descriptive techniques. This work built on an online survey involving the same participants to identify the critical elements needed for “effective nursing which promotes health outcomes globally through genomics.”

Findings

Experts from 19 countries across six continents and seven organizations participated in item development. The Assessment of Strategic Integration of Genomics across Nursing (ASIGN) MM incorporates 55 outcome‐focused items serving as subscales for six critical success factors (CSFs): education and workforce; effective nursing practice; infrastructure and resources; collaboration and communication; public/patient involvement; policy and leadership. Users select their current circumstances for each item against a 5‐point ordinal scale (precontemplation to leading). Nurses representing 17 countries undertook matrix pilot testing. Results demonstrate variation across CSFs, with many countries at the earliest stages of implementation.

Conclusions

The MM has the potential to guide the strategic integration of genomics across nursing and enables additional assessments within and between countries to be made.

Clinical Relevance

Nurse leadership and direction are essential to accelerate integration of genomics across nursing practice and education. The MM helps nurse leaders to benchmark progress and guide strategic planning to build global genomic nursing capacity.

Gender Differences Regarding the Impact of Change in Cognitive Function on the Functional Status of Intensive Care Unit Survivors: A Prospective Cohort Study

Abstract

Purpose

This study aimed to identify gender differences with regard to the impact of change in cognitive function on functional status 3 months after receiving critical care.

Design and Methods

This prospective cohort study investigated 152 intensive care unit (ICU) patients. Their functional status and cognitive function were assessed using the validated Korean version of the Modified Barthel Index and Mini‐Mental State Examination, respectively. Hierarchical regression was used to evaluate the impact of change in cognitive function on functional status in ICU survivors by gender.

Findings

The proportion of women suffering from consistent cognitive impairment was significantly higher than that of men. Women had a rate of improvement to normal cognitive function within 3 months after discharge that was higher than that of men. Functional status 3 months after discharge was significantly lower for patients whose cognitive impairment was consistent than that for those whose cognitive function was normal. The impact of change in cognitive function on men (R 2 change = .28) was greater than that on women (R 2 change = .13).

Conclusions

Persistent cognitive impairment after critical illness had a negative effect on functional status in ICU survivors. Importantly, the negative impact of consistent cognitive impairment was greater in men than in women.

Clinical Relevance

Early careful assessment of functional and cognitive status after critical illness is warranted. Strategies addressing the gender‐specific characteristics related to cognitive improvement should also be developed.

The Enabling, Enacting, and Elaborating Factors of Safety Culture Associated With Patient Safety: A Multilevel Analysis

Abstract

Purpose

Worldwide, 1 in 10 hospital patients is harmed while receiving care. Despite evidence that a culture of safety is associated with greater patient safety, these effects and the processes by which safety culture impacts patient safety are not yet clearly understood. Therefore, the purpose of this study was to examine the effects of various safety culture factors on nurses’ perceptions of patient safety using an innovative theoretical model.

Design

This descriptive, correlational study drew on deidentified, publicly available data from the 2018 Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. The study sample included 34,514 nurses who provided direct care to patients in medical and surgical units in 535 hospitals in the United States.

Methods

Multilevel linear regression was used to examine the effects of 11 safety culture factors on nurses’ overall perceptions of patient safety. The 11 safety culture factors were grouped as enabling, enacting, and elaborating processes, and entered in separate blocks.

Findings

All 11 safety culture factors were associated with nurse‐perceived patient safety, and all but two of the 11 factors uniquely predicted nurse‐perceived patient safety. Staffing adequacy was the strongest predictor of nurse‐perceived patient safety, followed by hospital management support for patient safety (both enabling processes), and continuous organizational learning and improvement (an elaborating process).

Conclusions

Hospital administrators and managers play a key role in promoting a safety culture and patient safety in healthcare organizations through enabling and elaborating processes.

Clinical Relevance

Organizational efforts should be made to provide sufficient staffing and hospital‐wide support for patient safety. However, all staff, administrators, and managers have a role to play in patient safety.

Effects of Combined Use of Mother’s Breast Milk, Heartbeat Sounds, and Non‐Nutritive Sucking on Preterm Infants’ Behavioral Stress During Venipuncture: A Randomized Controlled Trial

Abstract

Purpose

Even routine procedures can cause pain and stress, and can be harmful to the fast‐growing brain of preterm infants. Mitigating pain and stress with sucrose and analgesics has side effects; thus, an alternate choice is the use of natural breast milk and infants’ sensory capabilities. Therefore, this study examined the effects of different integrations of sensory experiences—mother’s breast milk odor and taste (BM‐OT), heartbeat sounds (HBs), and non‐nutritive sucking (NNS)—on preterm infant’s behavioral stress during venipuncture.

Design

This study was a prospective, randomized controlled trial.

Methods

Infants born preterm (<37 weeks’ gestational age) were enrolled in the study through convenience sampling, and randomly assigned to the following conditions: (condition 1) routine care (n = 36); (condition 2) BM‐OT (n = 33); (condition 3) BM‐OT + HBs (n = 33); or (condition 4) BM‐OT + HBs + NNS (n = 36). Crying duration from puncture to recovery period was recorded using a voice recorder. Facial actions and body movements were measured using an infant behavioral coding scheme and transformed into frequencies during seven stages: baseline (stage 0), disinfecting (stage 1), venipuncture (stage 2), and the recovery period for 10 minutes (stages 3–6).

Findings

Data were analyzed for 138 preterm infants. The corresponding median times to stop crying for conditions 1, 2, 3, and 4 were 137, 79, 81, and 39 s, respectively; the instantaneous occurrence rates of stopping crying for conditions 2, 3, and 4 were 1.469, 1.574, and 2.996 times greater than for condition 1, respectively. Infants receiving conditions 3 and 4 had significantly fewer occurrences of facial actions (stage 6 and stages 4–6, respectively) and body movements (stages 3–6 for both); however, there were no significant reductions in stress behaviors for condition 2 (BM‐OT).

Conclusions

The combination of BM‐OT, HBs, and NNS could be provided to preterm infants as interventions to prevent and reduce behavioral stress, and facilitate pain recovery during venipuncture procedures.

Clinical Relevance

Clinicians should be educated about how to recognize preterm infants’ behavioral stress, and to incorporate different sensory combinations of respective mothers’ BM, HBs, and NNS into painful procedures to help preterm infants recover from distress.

What Is the Perceived Value of Certification Among Registered Nurses? A Systematic Review

Abstract

Purpose

To explore how registered nurses (certified, noncertified, and managers) value certification as determined by the Perceived Value of Certification Tool, review the psychometric properties of the instrument, and ascertain the benefits and barriers to nursing specialty certification.

Design

Systematic review (without meta‐analysis) of 18 studies representing 26,534 registered nurses.

Methods

Rigorous processes were used to minimize bias; to identify, appraise, and synthesize studies to explore how registered nurses value certification; and to ascertain the benefits and barriers to nursing specialty certification. Psychometric properties of the Perceived Value of Certification Tool were also reviewed and evaluated. Methods and results are presented in accordance with the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines.

Findings

All studies included in the review were cross‐sectional studies with observational, descriptive designs published between 2003 and 2019. The average study participant was a 49‐year‐old Caucasian woman with a bachelor of science in nursing degree and 20 years of experience working as a staff nurse in a hospital. In accordance with the results reported in all studies included in the systematic review, the highest level of agreement and strong agreement occurred with the intrinsic value statements of enhances feeling of personal accomplishment (n = 16,697; 97.8%), provides personal satisfaction (n = 16,607; 92.7%), and validates specialized knowledge (n = 16,697; 97%). The lowest levels of agreement and strong agreement occurred with the extrinsic value statements of promotes recognition from employers (n = 16,607; 78.6%), increases consumer confidence (n = 16,607; 73.3%), and increases salary (n = 16,607; 41.9%).

Conclusions

The vigorous statistical work completed on the developmental study for the instrument conducted in 2003 has yet to be duplicated in the multiple studies published subsequently. The chiefly descriptive studies detailed in this systematic review are of limited usefulness in guiding future research. The Perceived Value of Certification Tool has proven useful in stimulating interest; however, a revision of the instrument is now required to promote research and patient outcome studies regarding the self‐perceived value of certification in nursing specialties.

Clinical Relevance

This report systematically reviews 18 studies that have used the Perceived Value of Certification Tool, a tool that has been widely used since 2003, to measure the perceptions of registered nurses regarding specialty certification. This review provides evidence that the instrument has potential for expanded use in patient outcomes studies and should be revised to better serve the needs of researchers.

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial

Abstract

Purpose

To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes.

Design

An assessor‐blinded prospective randomized controlled trial.

Methods

Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention‐matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT‐F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL).

Findings

VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05).

Conclusions

Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue.

Clinical Relevance

Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.

Sleep Quality as a Mediator of the Relationship Between Cyber Victimization and Depression

Abstract

Purpose

Cyber victimization is a national mental health concern, especially among adolescents who are digital natives. The current study examined sleep quality as a mediator of the association between cyber victimization and depressive symptoms among adolescents.

Design and Method

A prospective study design was utilized with a community sample of adolescents (N = 801; 57% female; mean age = 14.45, SD = .85) from the eastern United States. Participants completed (a) the Pittsburgh Sleep Quality Index; (b) the Cyber Victimization Scale; and (c) the Center for Epidemiologic Studies Depression Scale Revised via online surveys at baseline and 6‐month follow‐up. The inter‐relationship between variables was analyzed by Hayes’ mediation approach.

Findings

Cyber victimization was not directly associated with having depressive symptoms 6 months later when controlling for adolescents’ poor sleep quality, sex, and age (direct effect [c ’] = .012, t (676) = 1.12, p < .05, confidence interval [CI] ‐.008, .036). The mediation analysis indicated a significant indirect effect of poor sleep quality on the relationship between cyber victimization and depressive symptoms (ab = .005, bootstrapped standard error [SE ] = .003, bootstrapped CI .001, .011; a is the effect of cyber victimization on poor sleep quality; b is the effect of poor sleep quality on depressive symptoms). Specifically, adolescents’ cyber victimization led to poor sleep quality (a = .039, SE = .041, p < .05), which also led to increased depressive symptoms (b = .116, SE = .019, p < .001), after controlling for depressive symptoms at baseline, sex, and age. The indirect effect of cyber victimization on depressive symptoms was estimated through poor sleep quality (a*b = .039(.116) = .0045).

Conclusions

The findings suggest that poor sleep quality may be a mechanism through which cyber bullying is related prospectively to depressive symptoms. Interventions for cyber‐victimized adolescents should include assessment of sleep quality and incorporate sleep hygiene education.

Clinical Relevance

Adolescents should be screened for cyber victimization and sleep quality. Moreover, promotion of sleep hygiene among cyber‐victimized adolescents may help to reduce depression.

Adjunctive Intermittent Pneumatic Compression in Hospitalized Patients Receiving Pharmacologic Prophylaxis for Venous Thromboprophylaxis: A Systematic Review and Meta‐Analysis

Abstract

Objectives

This study assessed the effect of adjunctive intermittent pneumatic compression (IPC) on venous thromboembolism incidence in hospitalized patients receiving pharmacologic thromboprophylaxis.

Methods

We searched Medline, Embase, and the Cochrane Central Register with no language restrictions from inception until May 15, 2019, for randomized clinical trials comparing adjunctive IPC in pharmacologic thromboprophylaxis and pharmacologic thromboprophylaxis for venous thromboembolism. Two researchers extracted data from published reports independently. A meta‐analysis was conducted to calculate the risk ratio (RR) using random‐effects models. Primary outcomes were deep venous thrombosis (DVT) and pulmonary embolism (PE).

Results

Eight trials with a total of 7,354 participants were eligible for analysis. Addition of IPC to pharmacologic prophylaxis compared to pharmacologic prophylaxis alone reduced the risk of DVT by 43% (RR 0.57, 95% confidence interval [CI] 0.35–0.93; I2 = 0%), with benefit only seen in surgical patients (RR 0.30, 95% CI 0.15–0.59; I2 = 0%) and not in medical patients (RR 0.80, 95% CI 0.60–1.07; I2 = 0%; p for interaction = .008). Addition of IPC reduced the risk for PE by 54% (RR 0.46, 95% CI 0.30–0.72; I2 = 0%), with benefit only seen in surgical patients (RR 0.40, 95% CI 0.24–0.65; I2 = 0%) and not in medical patients (RR 0.82, 95% CI 0.32–2.26; I2 = 0%; p for interaction = .18)

Conclusions

Addition of IPC to pharmacologic prophylaxis confers moderate benefit on venous thromboembolism, with benefit confined to surgical patients. For medical patients, there was a trend toward reduced DVT with adjunctive IPC, which warrants further investigation.

Clinical Relevance

Venous thromboembolism is not unusual among hospitalized patients despite pharmacologic thromboprophylaxis. Nursing personnel should use adjunctive IPC in surgical patients receiving pharmacologic thromboprophylaxis to prevent venous thromboembolism.

The Leadership Mentoring in Nursing Research Program for Postdoctoral Nurses: A Development Paper

Abstract

Purpose

The Dutch Nursing Science Faculties developed the Leadership Mentoring in Nursing Research program, which aims to increase the cadre of nurse scientists, strengthen nursing research within universities, and improve the career development of postdoctoral nurses. The purpose of this article was to describe the development of the leadership and mentoring program to foster its replication and to present a formative program evaluation.

Design

The leadership mentoring program was developed using a three‐step procedure: a systematic review of the literature on successful leadership programs was conducted; theoretical underpinnings were identified and input; and feedback was solicited from national and international experts and changes made, resulting in the final program, which was executed from February 2016‐2018.

Findings

A 2‐year leadership and mentoring program for postdoctoral nurses working in research was developed and executed. Ten fellows completed the program and worked on their leadership development, developed their own research programs, and established research collaborations. Formative evaluations showed that the fellows highly valued the program sessions. We have learned several key lessons on how to structure, implement, and evaluate the leadership and mentoring program.

Conclusions

Through the leadership and mentoring program, the fellows are immersed in concerted leadership development focusing on the academic leadership role. Formative evaluations showed that the program was valued by the fellows and that several key lessons were learned.

Clinical Relevance

Through the leadership and mentoring program, 10 postdoctoral nurses strengthened their leadership in research and will further develop their role in healthcare research, clinical practice, and education.

Challenges, Extent of Involvement, and the Impact of Nurses’ Involvement in Politics and Policy Making in in Last Two Decades: An Integrative Review

Abstract

Purpose

To determine nurses' challenges, extent of involvement, and the impact of involvement in politics and policy making.

Organizing Construct: Nurses in politics and health policy making.

Methods

Literature was searched in PubMed, Scopus, Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID, and Open Grey using phrases comprising the following key words: “nurses”, “policy making”, “politics”, “health policy”, “nurses involvement in policy making/politics/health policy”, “nurses challenges in policy making/politics/policy”, and “impact of nursing policy making/politics/health policy”; 22 articles published from January 2000 to May 2019 were included.

Findings

The major challenges included intra‐ and interprofessional power dynamics, marginalization of nurses in policy making, and nursing profession–specific challenges. The extent of involvement was inadequate, and nurses mainly worked as policy implementers rather than as policy developers. Those nurses who participated in policy development focused on health promotion to build healthy communities and to empower nurses and the nursing profession.

Conclusions

Nurses' involvement in policy making has not improved over time. Nursing institutions and regulatory bodies should prepare and encourage nurses to work as policymakers rather than implementers and advocate for the rightful place of nurses at policy‐making forums.

Clinical Relevance

Preparation for health system policy making starts in the clinical settings. Educational institutions and nurse leaders should adequately prepare nurses for policy making, and nurses should participate in policy making at the organization, system, and national levels.

“On the Recovery Journey:” An Integrative Review of the Needs of Burn Patients From Immediate Pre‐Discharge to Post‐Discharge Period Using the Omaha System

Abstract

Background

To establish a conceptual understanding of the needs of burn patients, the specific research question asked is: “What are the needs of burn patients from 1‐week pre‐discharge to the post‐discharge period?”

Methods

Whittemore and Knafl's integrative review approach was used to answer the review question. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, and Scopus. Thirty‐two primary studies were retained at the end of the screening process. Directed content analysis was undertaken, with the Omaha system as an organizing framework.

Results

Recovery after burns is not a linear process, but an intricate one filled with varied needs in the physiological (pain, skin, neuro‐musculo‐skeletal, and infection), psychosocial (social contact, role changes, spirituality, grief, mental health, and sexuality), health‐related behavior (nutrition, sleep and rest patterns, and physical activity), and environmental (income) domains of the Omaha system. The nature and intensity of these needs change over time, suggesting that recovery for the burn patient is an ongoing process.

Conclusions

Several needs exist from 1 week before discharge to the post‐discharge period. The mutual relationship and evolving nature of these needs create an avenue for a flexible, regular, holistic transitional program, similar to the support offered to persons living with chronic conditions.

Clinical Relevance

Hospital discharge does not imply an end to the recovery of burn patients, and burn survivors still require holistic care even after discharge. The review shows the applicability of the Omaha system in exploring and classifying the needs of burn survivors and situates nursing at the core of such a program. It is possible that a nurse‐led program of care needs to be considered.

Intra‐Ethnic Differences in Chronic Pain and the Associated Factors: An Exploratory, Comparative Design

Abstract

Purpose

To describe and compare the levels of pain severity and pain interference, pain catastrophizing, and associated factors between elderly Koreans living in South Korea and Korean Americans living in the United States with chronic pain.

Methods

An exploratory, comparative design was used for this study. A total of 270 individuals (138 Koreans living in South Korea and 132 Korean Americans living in the United States), aged more than 65 years, with self‐reported chronic pain, and defined as at least 3 months of persistent musculoskeletal pain, is included. Outcome variables were pain severity, pain interference, and pain catastrophizing. Multivariate linear regression was conducted to examine factors associated with the outcome variables.

Results

In multivariate analysis, Korean Americans had higher levels of pain severity and pain catastrophizing than Koreans. Depressive symptoms, sleep quality, and health‐related quality of life were significant factors for pain severity, pain interference, and pain catastrophizing for both groups. Among those factors, health‐related quality of life was the most significant factor for predicting pain severity and pain interference, whereas depressive symptoms were the most significant factor for predicting pain catastrophizing for both groups.

Conclusions

Intra‐ethnic differences in pain severity and pain catastrophizing were found between elderly Koreans living in South Korea and Korean Americans living in the United States.

Clinical Relevance

Because unfamiliar sociocultural and environmental factors may influence the pain responses, cultural differences and language barriers should be taken into account in pain research and management strategies for Asian immigrants in the United States. Psychological factors, including depressive symptoms, sleep quality, and health‐related quality of life, should also be considered in chronic pain management for both elderly Koreans and Korean Americans.

Effects of Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta‐Analysis

Por: Yunxia Ni · Lin Ma · Jiping Li

Abstract

Purpose

The purpose of this study was to determine the effectiveness of mindfulness‐based stress reduction (MBSR) and mindfulness‐based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes.

Design

A systematic literature review and meta‐analysis was conducted.

Methods

Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included.

Findings

Nine studies described in 11 articles were included in the review. Meta‐analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference ‐0.84; 95% confidence interval [CI] ‐1.16 to ‐0.51; p < .0001), the mental health composite score of QoL (mean difference [MD ] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD ‐0.28; 95% CI ‐0.47 to ‐0.09; p = .004). However, effects on the physical health composite score of QoL have not been found.

Conclusions

MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well‐designed trials using longer follow‐up measurements are needed.

Clinical Relevance

MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

Screen Time Exposure and Altered Sleep in Young Children With Epilepsy

Abstract

Purpose

To examine the association between daily screen time exposure and both sleep patterns (sleep onset, sleep offset, and nighttime, and daily sleep durations) and sleep disturbances among a clinical sample of children with epilepsy.

Design

A cross‐sectional actigraphic sleep study.

Methods

A convenience sample of 141 children with epilepsy (1.5–6 years of age) was recruited from an outpatient pediatric neurology clinic of a university‐affiliated children's hospital in northern Taiwan. Participating families completed questionnaires and reported children's screen time use, with children wearing an actigraphy monitor for 7 days to assess sleep patterns. Multivariable linear regression analyses were conducted to examine the association of screen time exposure with the child's sleep patterns and sleep disturbance scores.

Findings

Mean minutes per day of screen time exposure was 89.79 ± 83.94 min, with 62 parents (44.0%) reporting their child having >1 hr of screen time daily. Mean daily sleep duration was 9.26 ± 1.01 hr, with 106 children (93.0%) sleeping <10 hr in a 24‐hr period. In multivariate regression models, daily screen time exposure of >1 hour was associated with 23.4‐min later sleep onset (b = 0.39, p = .02), 20.4‐min later sleep offset (b = 0.34, p = .04), and more severe sleep disturbances (b = 2.42, p = .04).

Conclusions

In toddlers and preschool‐age children with epilepsy, daily screen time exposure is greater and sleep duration is shorter than the recommended amount, with increased screen time exposure associated with disturbed sleep.

Clinical Relevance

Parents need to be informed about the possible adverse impact of screen time exposure on children's sleep and health as well as the importance of limiting screen time exposure to <1 hr per day for their toddlers and preschool‐age children with epilepsy.

Opioid Overdose and Addiction Treatment: A Collaborative Model of Compassion, Patience, and Respect

Abstract

Purpose

The purpose of this article is to describe the creation and outcomes of a collaborative model and care facility for opioid overdose and addiction treatment based on compassion, patience, and respect: The Maryhaven Addiction Stabilization Center (MASC).

Approach

MASC was created with the vision to serve clients who have recently overdosed on opioids. In this article, the research, planning, building, and implementation of an opioid treatment center composed of an admission and triage unit, inpatient withdrawal management unit, and inpatient residential unit are described. A multi‐agency and multi‐disciplinary approach were used to immediately engage patients and connect them to treatment for opioid addiction.

Findings

Implementation of a collaborative model of care offers patients who overdose on opioids with immediate access to admission for treatment. This has resulted in significantly higher numbers of patients seeking and staying in treatment.

Conclusions

Through multi‐agency collaboration and a shared commitment to addressing the challenges of the opioid epidemic in innovative ways, more patients who are struggling with addiction have increased opportunities to engage in treatment and move towards recovery.

Clinical Relevance

Clinicians, first responders, and communities can employ MASC principles to guide their approaches to serve patients who have recently overdosed on opioids or who are in active addiction.

Hydration Choices, Sugary Beverages, and Kidney Injury in Agricultural Workers in California

Abstract

Purpose

Agricultural workers working in high ambient temperatures are at risk for acute kidney injury. Despite recommendations to maintain hydration, workers likely do not drink enough to protect their renal function. Additionally, new research suggests that rehydration with sugary beverages adds additional risk to kidneys already stressed by high heat and workload. We assessed hydration choices during a work shift and tested associations of rehydration using sugary beverages with acute kidney injury.

Methods

We recruited a convenience sample of workers on farms over two summers. We estimated acute kidney injury via pre‐ and post‐shift serum creatinine readings from capillary blood samples. We used self‐reported measures of the volume and type of fluids workers consumed during their shifts. We also measured changes in core body temperature, ambient temperature, and workload. We used logistic regression to estimate associations of sugary drinks with acute kidney injury, while controlling for physiologic and occupational variables.

Findings

In our sample of 445 participants, we found that men drink more than women do overall, including more than a liter of water than women (2.9 L compared to 1.9 L, respectively). The total volume workers drank was associated with increased odds of acute kidney injury (adjusted odds ratio 1.47, 95% confidence interval 1.09–1.99). We found no association of sugary drinks with acute kidney injury.

Conclusions

These findings provide important information about what men and women use to hydrate during the work day and suggest that they do not drink enough to maintain adequate hydration. Increased fluid intake during the work day may be a result of vigorous workload, which could explain the increased risk for acute kidney injury. Nurses play an important role in educating agricultural workers about the importance of maintaining hydration at work.

Clinical Relevance

This study advances current knowledge of occupational risk factors for acute kidney injury in agricultural workers. Nurses may be the only point of care for this vulnerable population and are therefore in a unique position to educate on the importance of proper hydration during work.

Analysis of Citation Patterns and Impact of Predatory Sources in the Nursing Literature

Abstract

Purpose

This study was undertaken to learn how predatory journal articles were cited in articles published in legitimate (nonpredatory) nursing journals. The extent of citation and citation patterns were studied.

Design

A two‐phase approach was used.

Methods

In Phase 1, 204 articles published in legitimate nursing journals that cited a predatory publication were randomly selected for analysis from a list of 814 articles with predatory journal citations. In Phase 2, the four predatory journal articles that were cited most frequently were analyzed further to examine their citation patterns.

Findings

The majority (n = 148, 72.55%) of the articles that cited a predatory publication were research reports. Most commonly, the predatory article was only cited once (n = 117, 61.58%). Most (n = 158, 82.72%) of the predatory articles, though, were used substantively, that is, to provide a basis for the study or methods, describe the results, or explain the findings. The four articles in Phase 2 generated 38 citations in legitimate journals, published from 2011 to 2019, demonstrating persistence in citation. An evaluation of the quality of these articles was mixed.

Conclusions

The results of this study provide an understanding of the use and patterns of citations to predatory articles in legitimate nursing journals. Authors who choose predatory journals as the channel to disseminate their publications devalue the work that publishers, editors, and peer reviewers play in scholarly dissemination. Likewise, those who cite these works are also contributing to the problem of predatory publishing in nursing.

Clinical Relevance

Nurse authors should not publish their work in predatory journals and should avoid citing articles from these journals, which disseminates the content through the scholarly nursing literature.

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