Comparison of Nurse Staffing Based on Changes in Unit-level Workload Associated with Patient Churn

Aim This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers. Background Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes. Method(s) Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical. Result Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts. Conclusion Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn. Implications for nursing management Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements

Orientation dependence of the elastic instability on strained SiGe films

At low strain, SiGe films on Si substrates undergo a continuous nucleationless morphological evolution known as the Asaro-Tiller-Grinfeld instability. We demonstrate experimentally that this instability develops on Si(001) but not on Si(111) even after long annealing. Using a continuum description of this instability, we determine the origin of this difference. When modeling surface diffusion in presence of wetting, elasticity and surface energy anisotropy, we find a retardation of the instability on Si(111) due to a strong dependence of the instability onset as function of the surface stiffness. This retardation is at the origin of the inhibition of the instability on experimental time scales even after long annealing.Comment: 3 pages, 4 figure

SiGe nanostructures: new insights into growth processes

International audienceDuring the last decade, Si/Si 1−x Ge x heterostructures have emerged as a viable system for use in CMOS technology with the recent industrial production of heterojunction bipolar transistor-based integrated circuits. However, many key problems have to be solved to further expand the capabilities of this system to other more attractive devices. This paper gives a comprehensive review of the progress achieved during the last few years in the understanding of some fundamental growth mechanisms. The discrepancies between classical theories (in the framework of continuum elasticity) and experimental results are also specially addressed. In particular, the major role played by kinetics in the morphological evolution of layers is particularly emphasized. Starting from the unexpected differences in Si 1−x Ge x morphological evolution when deposited on (001) and on (111), our review then focuses on: (1) the strain control and adjustment (from fully strained to fully relaxed 2D and 3D nanostructures)-in particular, some original examples of local CBED stress measurements are presented; (2) the nucleation, growth, and self-assembly processes, using self-patterned template layers and surfactant-mediated growth; (3) the doping processes (using B for type p and Sb for type n) and the limitations induced by dopant redistribution during and after growth due to diffusion, segregation, and desorption. The final section will briefly address some relevant optical properties of Si 1−x Ge x strained layers using special growth processes

Sb-surfactant mediated growth of Ge nanostructures

International audienceThis paper reports the AFM and HREM study of the Sb surfactant mediated growth of Ge on Si(0 0 1). We show that very dense self-organised Ge dots of small lateral dimensions can be grown by using a sub-monolayer coverage of Sb on Si(0 0 1) in the transient growth regime between 2D nucleation and step flow. The dramatic Ge growth change induced by Sb is attributed to both kinetic and thermodynamic effects. Indeed, HREM observations evidence mainly two phenomena: the close-packing of ultra-small Ge islands indicating a lower surface diffusion in presence of Sb and a mono-modal island shape and size that strongly differs from the bimodal islands 'huts' and 'domes' commonly observed without Sb. Morphological and microstructural features of Ge islands formed with and without Sb are studied and the differences between facets and aspect ratio are exhibited. Moreover, at lower growth temperature (in the 2D nucleation regime, T g 0 350°C), a delay to 3D island nucleation is observed and defect free 2D flat layers can be grown up to thicknesses of 18 A ,. At higher growth temperature, (in pure step flow at T g 750°C) large, well separated 'dome' islands partially relaxed by dislocation nucleation on their edges are obtained. Such islands are very similar to those obtained without Sb coverage. The complete desorption of Sb on Ge rich surface at T\ 720°C explains this result. This study which improves the understanding on the formation of ultra-small dense islands is very promising for the fabrication of quantum devices that require highly homogeneous islands of small lateral sizes and of MOSFET heterostructures with strained SiGe n-channel which require flat Ge rich layers with abrupt interfaces

New Graduate Nurses’ Perceptions and Applications of Participating in a Multipatient Simulation

Students can benefit from simulation in-that sometimes during clinicals they don\u27t get to provide care where they are solely responsible for the patient. Students need to learn to prioritize and provide care for their patients. Learn students’ perceptions and their practical application of their simulated learning experience

Blog Postings: Reputable or Risky?

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Initial stage of the 2D-3D transition of a strained SiGe layer on a pit-patterned Si(001) template

We investigate the initial stage of the 2D-3D transition of strained Ge layers deposited on pit-patterned Si(001) templates. Within the pits, which assume the shape of inverted, truncated pyramids after optimized growth of a Si buffer layer, the Ge wetting layer develops a complex morphology consisting exclusively of {105} and (001) facets. These results are attributed to a strain-driven step-meandering instability on the facetted side-walls of the pits, and a step-bunching instability at the sharp concave intersections of these facets. Although both instabilities are strain-driven, their coexistence becomes mainly possible by the geometrical restrictions in the pits. It is shown that the morphological transformation of the pit surface into low-energy facets has strong influence on the preferential nucleation of Ge islands at the flat bottom of the pits.Comment: 19 pages, 7 figure

Категорія двоїни і становлення морфологічної норми української мови

У статті простежено вплив граматичної категорії двоїни на становлення морфологічної норми сучасної української літературної мови.The research presents an analysis of grammatical category of plural number with pair meaning. The main trends of morphological norm in literary Ukrainian have been generalised

Databases for Researching Athletic Training Literature

Searching the athletic training literature can be confusing and overwhelming with many possible databases for locating relevant peer-reviewed scholarship. Finding evidence-based literature from respected publications is helpful in clinical decision-making for athletic training practitioners. This column details recommended databases and search tips to help students, staff, clinicians, and faculty in the field of athletic training find the literature they need to help make evidence-based decisions and to stay current with the published literature. Databases discussed include Cochrane, PubMed, SPORTDiscus, CINAHL, PEDro, Sports Medicine, and Education Index (formerly Physical Education Index), and Google Scholar

Academic Libraries and Athletic Training: Research Preferences of Athletic Training Students

To ensure academic standards are met for athletic training curriculums, it is essential that librarians and faculty understand student research habits and information literacy instruction preferences. This article provides results from a survey of undergraduate athletic training students conducted at two universities. Athletic training students prefer information literacy instruction at the beginning of the semester. When seeking research assistance, students ask their classmates first, followed by friends and Google. Most students spend up to 60 minutes researching online before seeking assistance and prefer in-person communication for assistance from the library followed by email