Medication discrepancies at transitions in pediatrics:a review of the literature

Medication reconciliation is an important process in reducing medication errors in many countries. Canada, the USA, and UK have incorporated medication reconciliation as a priority area for national patient safety initiatives and goals. The UK national guidance excludes the pediatric population. The aim of this review was to explore the occurrence of medication discrepancies in the pediatric population. The primary objective was to identify studies reporting the rate and clinical significance of the discrepancies and the secondary objective was to ascertain whether any specific interventions have been used for medication reconciliation in pediatric settings. The following electronic bibliographic databases were used to identify studies: PubMed, OVID EMBASE (1980 to 2012 week 1), ISI Web of Science, ISI Biosis, Cumulative Index to Nursing and Allied Health Literature, and OVID International Pharmaceutical Abstracts (1970 to January 2012). Primary studies were identified that observed medication discrepancies in children under 18 years of age upon hospital admission, transfer and discharge, or had reported medication reconciliation interventions. Two independent reviewers screened titles and abstracts for relevant articles and extracted data using pre-defined data fields, including risk of bias assessment. Ten studies were identified with variances in reportage of stage and rate of discrepancies. Studies were heterogeneous in definitions, methods, and patient populations. Most studies related to admissions and reported consistently high rates of discrepancies ranging from 22 to 72.3 % of patients (sample size ranging from 23 to 272). Seven of the studies were low-quality observational studies and three studies were 'grey literature' non-peer reviewed conference abstracts. Studies involving small numbers of patients have shown that medication discrepancies occur at all transitions of care in children. Further research is required to investigate and demonstrate how implementing medication reconciliation can reduce discrepancies and potential patient harm. © 2013 Springer International Publishing Switzerland.

The theory of margin as a predictor of success on the National Council Licensure Examination for Registered Nurses

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the examination that all graduates of nursing education programs must pass to attain the title of registered nurse. Currently the NCLEX-RN passing rate is at an all-time low (81%) for first-time test takers (NCSBN, 2004); amidst a nationwide shortage of registered nurses (Glabman, 2001). Because of the critical need to supply greater numbers of professional nurses, and the potential accreditation ramifications that low NCLEX-RN passing rates can have on schools of nursing and graduates, this research study tests the effectiveness of a predictor model. This model is based upon the theoretical framework of McClusky's (1959) theory of margin (ToM), with the hope that students found to be at-risk for NCLEX-RN failure can be identified and remediated prior to taking the actual licensure examination. To date no theory based predictor model has been identified that predicts success on the NCLEX-RN. ^ The model was tested using prerequisite course grades, nursing course grades and scores on standardized examinations for the 2003 associate degree nursing graduates at a urban community college (N = 235). Success was determined through the reporting of pass on the NCLEX-RN examination by the Florida Board of Nursing. Point biserial correlations tested model assumptions regarding variable relationships, while logistic regression was used to test the model's predictive power. ^ Correlations among variables were significant and the model accounted for 66% of variance in graduates' success on the NCLEX-RN with 98% prediction accuracy. Although certain prerequisite course grades and nursing course grades were found to be significant to NCLEX-RN success, the overall model was found to be most predictive at the conclusion of the academic program of study. The inclusion of the RN Assessment Examination, taken during the final semester of course work, was the most significant predictor of NCLEX-RN success. Success on the NCLEX-RN allows graduates to work as registered nurses, reflects positively on a school's academic performance record, and supports the appropriateness of the educational program's goals and objectives. The study's findings support potential other uses of McClusky's theory of margin as a predictor of program outcome in other venues of adult education. ^

The career development of Black female chief nurse executives

This qualitative study was designed to explore the career development of Black female chief nurse executives. Although a small proportion of Black female nurses have achieved positions at the nurse executive level, there remains a paucity of Black female nurse executives in this crucial position which raised the question of what factors contributed to this lack of advancement, but, more important, what factors have contributed to the success of the few who have achieved such level of success in healthcare organizations. The purpose of the study was to explore the career paths of Black female chief nurse executives with a view of understanding the factors which both facilitate and hinder the career development of these leaders in healthcare organizations. The guiding research question was, How do Black female nurse executives in this sample describe their career development? The participants in this study were Black female chief nurse executives located throughout the United States who, for the most part, were raised in segregation with a strong family foundation. To collect data, semistructured telephone interviews were conducted with 10 Black female chief nurse executives throughout the United States. The transcripts from the interviews were transcribed, coded, and analyzed. Using Super’s (1990, 1996), and Gottfredson’s (1981, 1996, 2002, 2005) career development theories and critical race theory (Crenshaw, 1995; Delgado, 2000) as the theoretical framework, the researcher found that the participants’ career development was influenced by (a) strong support system, (b) guidance, (c) influence of diversity, and (d) servant leadership. The findings help us understand the factors that have contributed to their successes as Black chief nurse executives. With the increasingly diverse population and concurrent increasing diversity in nursing and concerns about healthcare disparities, it is imperative that organizations attract, hire, develop, retain, and advance qualified Black nurses. Future studies addressing not only the career development of Black nurses but nurses in general might be informed by the present study’s findings. Recommendations are offered for nursing practice, education, and organizational policy.

Florida International University Summer 2011 Commencement Ceremony Session 1

Florida International University Commencement Ceremony August 13th,2011 at US Century Bank Arena ( Session 1) Colleges graduated: School of Hospitality and Tourism Management School of Journalism and Mass Communication College of EducationCollege of Nursing and Health SciencesCollege of Architecture + The ArtsCollege of Engineering and Computing

Florida International University Spring April 27,2010 Commencement Ceremony Session 4

Florida International University Commencement Ceremony April 27,2010 at US Century Bank Arena ( Session 4) Colleges graduated: College of Public Health and Social Work College of Nursing and Health Sciences

Florida International University Spring May 3,2011 Commencement Ceremony Session 3

Florida International University Commencement Ceremony May 3,2011 at US Century Bank Arena ( Session 3) Colleges graduated: Robert Stempel College of Public Health and Social Work College of Nursing and Health Science

Florida International University Spring April 30,2012 Commencement Ceremony Session 2

Florida International University Commencement Ceremony April 30,2012 at US Century Bank Arena ( Session 2) Colleges graduated: College of Public Health and Social Work College of Nursing and Health Sciences College of Arts and Sciences

Florida International University Fall December 14,2010 Commencement Ceremony Session 6

Florida International University Commencement Ceremony December 14,2010 at US Century Bank Arena ( Session 6) Colleges graduated: Robert Stempel College of Pubic Health and Social Work College of Nursing and Health Sciences

Florida International University Fall December 11,2012 Commencement Ceremony Session 4

Florida International University Commencement Ceremony December 11,2012 at US Century Bank Arena ( Session 4) Colleges graduated: College of Education Robert Stempel College of Public Health and Social Work College of Nursing and Health Sciences

Metodologia para gerenciamento de projetos em tecnologia da informação baseada no guia PMBOK: um estudo de caso na Secretaria de Estado da Saúde Pública do Rio Grande do Norte

Nowadays the search for growth makes organizations seeking competitive advantages, project management shares this goal, through techniques that assist in the search for an improved management of the various fields of knowledge through a design methodology. The world is driven by projects and the search for ways to better manage activities such as time, cost and term towards the success of a particular project is something constant. A major contribution that IT can make to the health sector is the support for the management area. IT can integrate processes, optimize the interconnection between the various sectors, make hospitals have access to inside information of good quality, as well as support in the healthcare area, sharing pictures, uniting the various aspects of nursing and nursing service. The major challenge faced by the SESAP Information Technology sector at present is in project management in IT , which does not exist makes investments in the area are increasingly difficult due to this deficiency in management develop their own systems without cost additional to the State. This study seeks to build and strengthen the Project Management within the Department of Health through the implementation of a project office that will manage the final result of this work methodology based on PMBOK, and still show the functionality applied to development the state Hospital Management System that will later be installed on all Regional Health Units and proposing measures for the sustainability and development of the sector amid the difficulties of the current public service. Such action will result in a savings of more than R$ 107,000.00 (one hundred seven thousand) regarding spending private software currently used by the assignment of invested by the State of Rio Grande do Norte user licenses, representing more than 5 % of the total budget of the State Department of Public Health of the State

A simulação realística como estratégica de ensino-aprendizagem em enfermagem

The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

Processo de cuidar de um centro de tratamento oncológico

The objective was to understand the process of caring for a center for cancer treatment from the perspective of nurses and patients. This is a qualitative research, xploratory and descriptive, performed in a cancer treatment center in Natal / RN / Brazil. Data collection occurred between August 2013 and February 2014, being effected by means of two techniques: photographic record and projective interviews with nurses and patients. Social actors included in the study were ten professional nursing and ten patients admitted to the surgical department of the institution. The criteria used for inclusion of professionals were: be professional in the field of nursing, being an employee of the hospital, to be inserted in the scale of nurses of the institution at the time of data collection. For the patients were included who had preserved their cognitive abilities and who were hospitalized and at any stage of treatment. We used content analysis proposed by Bardin, for the analysis of material collected during projective interview. The research followed the ethical and legal principles that govern scientific research on human beings, being conducted by the project approval by the Research Ethics Committee of the Northern League Against Cancer Riograndense with 295 673 and look CAAE 16104313.0.0000.5293. Referring to nurses, they demonstrated different views about care, which sprouted from a holistic, multidisciplinary approach and welcoming, as well as linked to the performance of procedures and compliance with the requirements technicality. Furthermore, these subjects also showed that care unfolds through the actions of management in carrying out the records in the humanization of care by meeting the needs of the patient and ambience. Front of patients, it is noteworthy that, for them, care happens through attitudes of caring and professional approach, and by performing procedures, being mentioned as a careless lack of structure of the institution and the discomfort caused by this condition factors. It was evident also that the actors involved in the care, the perception of professionals and patients, are represented by nurses, doctors, psychologists, nutritionists, as well as kitchen assistants and cleaners; beyond family companion, the individual himself as responsible for their care and volunteer caregiver. In this opportunity, it is concluded 9 that an understanding of care from the perspective of nurses and patients involves broad issues ranging from perceptions of care that embraces a dynamic complex elements and attitudes imbued with meanings, in which those involved can assume both the role of carers as care beings, even a carefully tied to prescribed routines and performing procedures. Thus, the findings described refer to reflections on the care provided to cancer patients and whether this, in fact, translates principles of a humane practice

Construção de um ambiente virtual de aprendizagem para aplicação do processo de enfermagem baseado na Nanda International, NOC, NIC e CIPE®

This study aimed to build a virtual learning environment for application of the nursing process based on the NANDA-I, NOC, NIC and ICNP® . Faced with problems related to learning of the nursing process and classifications, there is an urgent need to develop innovative teaching resources that modify the relationship between students and teachers. The methodology was based on the steps inception, development, construction and transition, and the software development process Rational Process Unifield. The team involved in the development of this environment was composed by researchers and students of The Care and Epidemiological Practice in Health and Nursing and Group of the Software Engineering curse of the Federal University Rio Grande do Norte, with the participation of the Lisbon and Porto Schools of Nursing, in Portugal. In the inception stage the inter research communication was in order to define the functions, features and tools for the construction process. In the preparation, step the planning and modeling occurred, which resulted in the creation of a diagram and a architectural drawings that specify the features and functionality of the software. The development, unit testing and integrated in interfaces of the modules and areas (administrator, teacher, student, and construction of the NP). Then the transition step was performed, which showed complete and functioning system, as well as the training and use by researchers with its use in practice. In conclusion, this study allowed for the planning and the construction of an educational technology, and it is expected that its implementation will trigger a substantial change in the learning of the nursing process and classifications, with the student being active agent of the learning process. Later, an assessment will be made of functional performance, which will enable the software development, with a feedback, correction of defects and necessary changes. It is believed that the software increment after the reviews, this tool grow further and help insert this methodology and every language under the educational and health institutions, promoting paradigmatic desired change by nursing.

Estudo do domínio segurança/proteção da NANDA internacional em pacientes de unidade de terapia intensiva

The study aimed to analyze the field of nursing diagnoses safety / protection of NANDA International present in patients in the Intensive Care Unit. This is a crosssectional study in intensive care complex of a university hospital in northeastern Brazil. The research took place in two stages. The first step was to collect data through an interview form and physical examination, with 86 patients admitted to the unit, during the months of December 2013 to May 2014. Spreadsheets were built in Microsoft Office Excel 2010 Software in which were marked by the researcher of this study, the presence or absence of defining characteristics, related factors and risk factors of the 31 studied diagnoses. In the second stage, held between July and August 2014, the sheets were sent to three diagnosticians, previously trained to perform the diagnostic inference. Data were analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%, using IBM SPSS version 20.0 for Statistic Windows.O project was approved by the 440/414 and Presentation Certificate for Ethics Assessment number 22955113 .2.0000.5292. The results indicated the presence of 29 field of nursing diagnoses safety / protection in hospital clientele in the Intensive Care Unit, of which five were present in 100% of patients, namely: Risk of contamination, injury risk, falls risk,risk of allergic response and risk of trauma. Diagnoses that presented more frequently than 50% were: Risk of infection, dry eye risk, poisoning risk, vascular trauma risk, impaired skin integrity, impaired dentition, bleeding risk, risk imbalance in body temperature, Risk perioperative positioning injury, impaired tissue integrity, peripheral neurovascular dysfunction Risk, Risk adverse response to contrast media with iodine, shock Hazard and Risk of aspiration. For these analyzes, we identified 35 risk factors, 11 defining characteristics and three related factors showed statistically significant association with the studied diagnoses. For diagnostics: Risk of contamination, injury risk, falls risk, allergic response risk, trauma Risk, Risk of infection, dry eye risk and risk poisoning there was no association with any of their risk factors. We conclude that most of the area of nursing diagnoses safety / protection feature is prevalent in critically ill patients, with special attention to the risk diagnoses. There was a significant association between these diagnoses and its components. It is noteworthy, therefore, that the lifting of this profile contributes relevant clues to the inference of the priority nursing diagnoses domain safety / protection in the study population, supporting the practice of nursing and stimulating knowledge on the subject.

Adherence to latent tuberculosis treatment among immigrants in low endemic settings : a scoping review

Contexte : En dépit du fait que la tuberculose est un problème de santé publique important dans les pays en voie de développement, les pays occidentaux doivent faire face à des taux d'infection important chez certaines populations immigrantes. Le risque de développer la TB active est 10% plus élevé chez les personnes atteintes de TB latente si elles ne reçoivent pas de traitement adéquat. La détection et le traitement opportun de la TB latente sont non seulement nécessaires pour préserver la santé de l'individu atteint mais aussi pour réduire le fardeau socio- économique et sanitaire du pays hôte. Les taux d'observance des traitements préventifs de TB latente sont faibles et une solution efficace à ce problème est requise pour contrôler la prévalence de l'infection. L'objectif de ce mémoire est d'identifier les facteurs qui contribuent à l'observance thérapeutique des traitements de TB latente auprès de nouveaux arrivants dans les pays occidentaux où les taux endémiques sont faibles. Méthodologie : Une revue systématique a été effectuée à partir de bases de données et répertoires scientifiques reconnus tels Medline, Medline in Process, Embase, Global Health, Cumulative Index to Nursing, le CINAHL et la librairie Cochrane pour en citer quelques un. Les études recensées ont été publiées après 1997 en français, en anglais, conduites auprès de populations immigrantes de l'occident (Canada, Etats-Unis, Europe, Royaume-Uni, Australie et la Nouvelle Zélande) dont le statut socio-économique est homogène. Résultats : Au total, neuf (9) études réalisées aux Etats-Unis sur des immigrants originaires de différents pays où la TB est endémique ont été analysées: deux (2) études qualitatives ethnographiques, six (6) quantitatives observationnelles et une (1) quantitative interventionnelle. Les facteurs sociodémographiques, les caractéristiques individuelles, familiales, ainsi que des déterminants liés à l'accès et à la prestation des services et soins de santé, ont été analysés pour identifier des facteurs d'observance thérapeutique. L'âge, le nombre d'années passées dans le pays hôte, le sexe, le statut civil, l'emploi, le pays d'origine, le soutien familiale et les effets secondaires et indésirables du traitement de la TB ne sont pas des facteurs ii déterminants de l'adhésion au traitement préventif. Toutefois, l’accès à l'information et de l'éducation adaptées aux langues et cultures des populations immigrantes, sur la TB et des objectifs de traitement explicites, l'offre de plan de traitement plus court et mieux tolérés, un environnement stable, un encadrement et l'adhésion au suivi médical par des prestataires motivés ont émergés comme des déterminants d'observance thérapeutique. Conclusion et recommandation : Le manque d'observance thérapeutique du traitement de la TB latente (LTBI) par des populations immigrantes, qui sont déjà aux prises avec des difficultés d'intégration, de communication et économique, est un facteur de risque pour les pays occidentaux où les taux endémiques de TB sont faibles. Les résultats de notre étude suggèrent que des interventions adaptées, un suivi individuel, un encadrement clinique et des plans de traitement plus courts, peuvent grandement améliorer les taux d'observance et d'adhésion aux traitements préventifs, devenant ainsi un investissement pertinent pour les pays hôtes.