The relationship of aptitude, course grades, and program length, to performance on a standards based test (NCLEX -RN)

The purpose of this study was threefold: first, to investigate variables associated with learning, and performance as measured by the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The second purpose was to validate the predictive value of the Assessment Technologies Institute (ATI) achievement exit exam, and lastly, to provide a model that could be used to predict performance on the NCLEX-RN, with implications for admission and curriculum development. The study was based on school learning theory, which implies that acquisition in school learning is a function of aptitude (pre-admission measures), opportunity to learn, and quality of instruction (program measures). Data utilized were from 298 graduates of an associate degree nursing program in the Southeastern United States. Of the 298 graduates, 142 were Hispanic, 87 were Black, non-Hispanic, 54 White, non-Hispanic, and 15 reported as Others. The graduates took the NCLEX-RN for the first time during the years 2003���2005. This study was a predictive, correlational design that relied upon retrospective data. Point biserial correlations, and chi-square analyses were used to investigate relationships between 19 selected predictor variables and the dichotomous criterion variable, NCLEX-RN. The correlation and chi square findings indicated that men did better on the NCLEX-RN than women; Blacks had the highest failure rates, followed by Hispanics; older students were more likely to pass the exam than younger students; and students who passed the exam started and completed the nursing program with a higher grade point average, than those who failed the exam. Using logistic regression, five statistical models that used variables associated with learning and student performance on the NCLEX-RN were tested with a model adapted from Bloom's (1976) and Carroll's (1963) school learning theories. The derived model included: NCLEX-RNsuccess = f (Nurse Entrance Test and advanced medical-surgical nursing course grade achieved). The model demonstrates that student performance on the NCLEX-RN can be predicted by one pre-admission measure, and a program measure. The Assessment Technologies Institute achievement exit exam (an outcome measure) had no predictive value for student performance on the NCLEX-RN. The model developed accurately predicted 94% of the student's successful performance on the NCLEX-RN.

Gerodontology teaching amongst European dental schools ��� A European College of Gerodontology survey.

Introduction: In 2009, the European College of Gerodontology (ECG) published the Gerodontology undergraduate teaching guidelines. Seven years later it conducted a survey to explore the current status of Gerodontology teaching amongst the European dental schools.<br/>Methods: The ECG Education Committee developed an electronic questionnaire that was emailed to the Deans or other contact persons in 185 dental schools in 40 European countries. The questionnaire recorded the prevalence, contents and methodology of Gerodontology education. Two weeks later a reminder was sent to non-respondents. <br/>Results: The first wave of responses included 70 dental schools from 28 European countries. Gerodontology was included in the undergraduate curricula of 77% of the respondents and was compulsory in 61% of them. The course was usually offered in senior students and was interdisciplinary; the educators included dentists, physicians, nurses and other care providers. Lecturing was the most common educational technique (75%), and the most common topics included medical problems in old age, pharmacology and polypharmacy, the association between general and oral health, nutritional and chewing problems, xerostomia and prosthodontic management. Clinical training was usually offered within the dental school clinics (50%) and less often in remote locations (nursing homes, geriatric hospitals, day centers). <br/>Key Conclusions: An increasing number of European dental schools teach Gerodontology at the undergraduate curriculum. The study is still ongoing, but a "worst case scenario" has to be born in mind, where dental schools, who failed to participate in the survey, may not be teaching in Gerodontology. <br/>

Ultrasound in undergraduate medical education: A systematic and critical review

Introduction: Point-of-care ultrasound (POCUS) use in clinical care is growing rapidly, and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. In this study, we conducted a critical and systematic review framed by the rationales enumerated by advocates of ultrasound in UME in academic publications.<br/><br/>Methods: This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified using techniques from Foucauldian critical discourse analysis (CDA) from an archive of 403 academic publications. We then sought empirical evidence in support of theses rationales, using a critical synthesis methodology also adapted from CDA.<br/><br/>Results: We identified four dominant discursive rationales, with different levels of evidentiary support. Ultrasound was not demonstrated to improve students��� understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent,and rests on minimal evidence. With POCUS, students��� diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve quality of patient care was difficult to evaluate.<br/><br/>Discussion: Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimizes them and may preclude further primary research. Since the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required.

Sjuksk��terskans st��d till personer med psykiska funktionsneds��ttningar i ut��vandet av fysisk aktivitet och dess h��lsoeffekter Litteraturstudie

Det har forskats mycket om fysisk aktivitets positiva effekter p�� m��nniskokroppen rent fysiskt. Tidigare har det inte varit en naturlig del av behandlingen inom psykiatrin vilket gjorde f��rfattarna nyfikna p�� hur det kan lyftas fram i v��rden av personer med psykiska funktionsneds��ttningar. Syfte: Syftet med litteraturstudien var att beskriva h��lsoeffekterna av fysisk aktivitet f��r personer med psykiska funktionsneds��ttningar och sjuksk��terskans st��d genom handledning. Metod: Litteraturstudie. Resultat: Under sammanst��llningen av resultatet framkom att sjuksk��terskor kan ge st��d genom Motiverande samtal (MI) som var av central betydelse. D�� patienten sj��lv h��rsammas och bygger upp sina m��l som ska vara m��tbara tillsammans med utbildad v��rdpersonal, men ��ven genom st��d i patienternas egen utbildning och kunskap av den fysiska aktivitetens positiva inverkan p�� psykisk oh��lsa. Slutsats: Sjuksk��terskans metod att st��dja och motivera personer med psykiska funktionsneds��ttningar till att ut��va fysisk aktivitet visade sig vara flera. D�� det var viktigt med personcentrarad metod, var viktigt att de beh��rskade och k��nde till olika v��gar att kunna motivera personer med psykiska funktionsneds��ttningar. Andra betydelsefulla tillv��gag��ngss��tt var god v��rdrelation, individualiserade tr��ningsprogram, samt st��d och utbildning i de positiva h��lsoeffekterna som fysisk aktivitet gav.

Sjuksk��terskans upplevelse av humorns betydelse i psykiatrisk omv��rdnad - En intervjustudie

Bakgrund: Sjuksk��terskan f��rv��ntas arbeta med patientens b��sta i fokus och hon m��ter m��nga allvarliga situationer d��r sj��lva existensen st��r p�� spel och d��r sjuksk��terskan beh��ver h��rb��rgera starka k��nslor hos patienter och deras n��rst��ende, men ocks�� uppr��tth��lla sin egen integritet och k��nslom��ssiga balans. Humor har visats vara ett kraftfullt men tveeggat verktyg i kommunikation och relationsbyggande. Inom psykiatrin kan detta verktyg f��rmodas beh��va hanteras med s��rskilt kunskap och omsorg. Syfte: Att beskriva hur sjuksk��terskan i psykiatrisk omv��rdnad ser p�� humor som f��reteelse och hennes upplevelse av positiva respektive negativa effekter av att anv��nda humor. Metod: Unders��kningen utf��rdes med en kvalitativ inneh��llsanalys av halvstrukturerade intervjuer med fem sjuksk��terskor verksamma inom psykiatrisk omv��rdnad. Resultat: Humor s��gs som ett viktigt verktyg inom psykiatrisk omv��rdnad som det kr��vdes lyh��rdhet, respekt, fingertoppsk��nsla och timing f��r att kunna anv��nda. Den huvudsakliga strategin f��r att anv��nda humor var ��ppenhet f��r spontant humor i m��tet men det gavs ��ven exempel p�� medvetna interventioner. Humor ��ppnade m��jligheter att f�� se verkligheten fr��n nya perspektiv vilket var verksamt f��r att f��r��ndra negativa tankar samt l��tta p�� ��ngest och negativa k��nslor. Humor underl��ttade kommunikation och kunde anv��ndas f��r att j��mna ut maktbalanser. Det fanns risk f��r negativa effekter om humor anv��ndes f��r att trycka ner andra eller som verklighetsflykt. Psykiatriska patienter uppfattades som mer s��rbara och medvetenhet om hur sv��ra psykiska sjukdomar p��verkar f��rm��gan att uppfatta och uppskatta humor var viktig ��ven om ett allm��nt bra bem��tande ans��gs vara grundl��ggande. Slutsats: Positiva former av humor som anv��nds p�� ett respektfullt och ink��nnande s��tt kan vara ��r ett viktigt verktyg i omv��rdnaden f��r att m��jligg��ra nya perspektiv p�� tillvaron, ge l��ttnad i ��ngest, minska negativa k��nslor och tankar samt h��ja livskvaliteten f��r b��de patienter och personal i en verksamhet med mycket allvar.

Person-Centered Care Training, May 16, 2014

A FREE training event that will offer valuable and timely information about: ��� *LifeLong Links Network Statewide Expansion ��� *Preadmission Screening and Resident Review (PASRR) in Iowa ��� *Magellan Health Services���SeniorConnect and Integrated Health Homes (IHH) ��� *The role of the Long Term Care Ombudsman

Proposta de processo de enfermagem em unidade de interna����o obst��trica: hist��ricos, diagn��sticos e cuidados de enfermagem �� luz de horta fundamentada em nanda

O presente estudo teve como objetivo geral elaborar uma proposta de processo de enfermagem contemplando hist��ricos de enfermagem, diagn��sticos de enfermagem, prescri����o de cuidados de enfermagem para gestantes e pu��rperas em Unidade de Interna����o Obst��trica �� luz de Horta, fundamentada em NANDA e, como objetivos espec��ficos: identificar os dados cl��nico-obst��tricos mais frequentes das gestantes em Unidade de Interna����o Obst��trica; identificar os dados cl��nico-obst��tricos mais frequentes das pu��rperas em Unidade de Interna����o Obst��trica; identificar os diagn��sticos de enfermagem a partir dos dados cl��nico-obst��tricos mais frequentes das gestantes em Unidade de Interna����o Obst��trica; identificar os diagn��sticos de enfermagem a partir dos dados cl��nico-obst��tricos mais frequentes das pu��rperas em Unidade de Interna����o Obst��trica; elaborar modelos de hist��rico de enfermagem e de prescri����o de cuidados de enfermagem para os diagn��sticos de enfermagem identificados; e obter o consenso dos enfermeiros assistenciais da Unidade de Interna����o Obst��trica sobre a proposta constru��da. Trata-se de pesquisa qualitativa, descritiva e explorat��ria, realizada em uma Unidade de Interna����o Obst��trica de um hospital universit��rio do Sul do Brasil. Realizou-se uma consulta documental em 148 prontu��rios, com vistas �� identifica����o dos diagn��sticos e cuidados de enfermagem, baseados, respectivamente, na taxonomia II da North American Diagnosis Association 2009-2011 e da Nursing Intervention Classification. Desenvolveu-se um modelo de hist��rico de enfermagem para gestante/pu��rpera e outro para o rec��m-nascido. No total, identificaram-se 26 diagn��sticos de enfermagem, assim distribu��dos: nove direcionados ��s gestantes; nove, ��s pu��rperas; dois, ao bin��mio m��e/filho; seis, ao rec��m-nascido. A an��lise foi realizada por meio da apresenta����o da proposta constru��da e discuss��o com base em autores da ��rea. Com isso, almeja-se contribuir para direcionar o cuidado de enfermagem ��s necessidades das gestantes, pu��rperas, bin��mios m��e/filho e rec��m-nascidos nesse microcen��rio, favorecendo a educa����o em sa��de, a identifica����o precoce e a preven����o de complica����es. Permanecem lacunas quanto ��s necessidades psicoespirituais, visto que elas n��o foram abordadas nos resultados. Assim, essa proposta de Processo de Enfermagem em Unidade Obst��trica contemplando hist��ricos, diagn��sticos e cuidados de enfermagem mant��m em aberto o aperfei��oamento do modelo, visando �� inclus��o de outros diagn��sticos de enfermagem, de forma a aproximar-se de um cuidado mais hol��stico.

Perce����o dos enfermeiros sobre as compet��ncias de supervis��o cl��nica

Introdu����o: A evolu����o da ci��ncia e tecnologia, as mudan��as no seio das organiza����es de sa��de, as novas e emergentes filosofias de cuidados, exigem dos profissionais de sa��de uma participa����o ativa na forma����o dos seus pares, tendo o processo de supervis��o cl��nica uma import��ncia relevante. Objetivos: Identificar a perce����o dos enfermeiros tutores especialistas sobre as compet��ncias do supervisor cl��nico na ��rea de sa��de infantil e pediatria. M��todos: Estudo qualitativo explorat��rio descritivo, fenomenol��gico, numa amostra de dez enfermeiros tutores dos servi��os da ��rea de pediatria do Hospital Dr. N��lio Mendon��a, SESARAM. Recorremos �� entrevista semiestruturada e ��udio gravada. Efetu��mos an��lise de conte��do ao ���corpus��� de todas as entrevistas, com defini����o de subcategorias e indicadores. Resultados:. Emergiu a categoria compet��ncias do supervisor cl��nico e as subcategorias mais referenciadas foram as carater��sticas pessoais com 38% de unidade de registo e as compet��ncias profissionais (25,7%). Nos aspetos relevantes em sa��de infantil e pediatria destacaram-se tamb��m as compet��ncias pessoais e profissionais com 40,4% cada. O principal fator facilitador da supervis��o foi o ser um processo estruturado (21,6%), e o dificultador foi o deficit no relacionamento interpessoal (21,7%). No global houve mais unidades de registo relacionadas com os aspetos dificultadores. Conclus��o: Conscientes das perce����es dos supervisores numa ��rea t��o espec��fica como �� a ��rea de sa��de infantil e pediatria, pensamos que este estudo poder�� contribuir para melhorar a qualidade do processo supervisivo na enfermagem. �� necess��rio o esfor��o conjunto entre o supervisor e supervisionado, melhorando os processos mediados entre as institui����es e os atores, onde proliferam a partilha de saberes, experi��ncias e objetivos profissionais. Palavras-chave: Supervisor, Mentor, Supervisor cl��nico, Enfermagem, Supervis��o.

Psychosocial Risk Factors, Interventions, and Comorbidity in Patients with Non-Specific Low Back Pain in Primary Care: Need for Comprehensive and Patient-Centered Care

International audience

Burnout nos docentes de enfermagem

Disserta����o de mest. em Ci��ncias da Educa����o na Especialidade de Observa����o e An��lise da Rela����o Educativa, Faculdade de Ci��ncias Humanas e Sociais, Universidade do Algarve, 2003

Do health care providers use online patient ratings to improve the quality of care?

Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.

The impact of ethics education in medical laboratory science.

Teachers and students were asked what ethics education is offered in their program. The survey of the teachers regarding ethics education revealed some differences between english and french schools. It was found that franch schools favoured ethics courses taught by philosophers while english schools favoured ethics courses taught by health care providers. Furthermore, case studies were reported to be used more often in english schools and more often in assignments. However, regarless of the differences, 87 % of teachers agreed that ethics training is a high priority and most teachers thought that ethics training in their programs was adequate. At same time, students were asked to answer some questions that involved ethical dilemmas wherein some moral decisions would have to be made. Their responses revealed their level of moral development, based on Kohlberg's theory of moral development. The impact of ethics courses in the curriculum on moral development was correlated taking into account what ethics education students actually received with what year-of-study they were in (1st year, end of program or two years post graduation). Students were presented scenarios about falsifying records, communication, student dishonesty and preanalytical impact on patient care. These are authentic issues that technologists face on a daily basis. In reply to multiple-choice questions, respondents chose, in order of personal preference, the three best answers out of six offered to complete a statement regarding ethics. Statistical analysis was performed using SPSS (Statistical Package for Social Studies), employing crosstabulations and Oneway Anova. Factors including respondents age range, mother tongue, gendre, and years of schooling were considered.

Medici��n de la cultura de seguridad del paciente en un hospital p��blico de primer nivel en el municipio de Villeta

Esta investigaci��n midi�� la percepci��n del personal asistencial sobre la cultura de seguridad de los pacientes en un hospital de primer nivel de complejidad por medio de un estudio descriptivo de corte transversal. Se utiliz�� como herramienta de medici��n la encuesta ���Hospital Survey on Patient Safety Cultura��� (HSOPSC) de la Agency of Healthcare Research and Quality (AHRQ) versi��n en espa��ol, la cual eval��a doce dimensiones. Los resultados mostraron fortalezas como el aprendizaje organizacional, las mejoras continuas y el apoyo de los administradores para la seguridad del paciente. Las dimensiones clasificadas como oportunidades de mejora fueron la cultura no punitiva, el personal, las transferencias y transiciones y el grado en que la comunicaci��n es abierta. Se concluy�� que aunque el personal percib��a como positivo el proceso de mejoramiento y apoyo de la administraci��n tambi��n sent��a que era juzgado si reportaba alg��n evento adverso.