Negative CPOE Attitudes Correlate with Diminished Power in the Workplace

Power changes have been identified as a frequent and unintended consequence of the implementation of computerized physician order entry (CPOE). However, no previous study has described the degree or direction of power change, or even confirmed that such a relationship exists. Using a validated, standardized instrument for measuring personal power we collected data from 276 healthcare workers in two different hospitals before and after implementation of CPOE. We identified a significant correlation between power perceptions and attitudes toward CPOE. Examining the direction of change by healthcare position, we found that the power perception values decreased for all positions and that attitudes toward CPOE varied based on use of the system. Understanding the relationship between power and CPOE is the first step in enabling systems developers to change the direction of power changes from negative to positive

Population Health for Nurses: Improving Community Outcomes

Fairfield University faculty members Jessica Alicea-Planas, Susan Bartos, Cynthia Bautista, Jaclyn Conelius, Laura Conklin, Vanessa Daou, Christa Palancia Esposito, Rose Iannino-Renz, Alison E. Kris, Jenna A. LoGiudice, Kathleen Lovanio, Diana R. Mager, Eileen R. O’Shea, and Kelly Sullivan contributed chapters to this book. This practical text is distinguished by its in-depth coverage of populations, ranging from opioidaddicted veterans to young children suffering from obesity. Focused on the educational needs of students in undergraduate and bridge programs, this book is grounded in evidence-based practice, in-depth content, and clinical case studies. Five sections address population health in the following settings: community-based care, home and rural health, school-based and primary care, medical home and palliative care, and acute and long-term care. Each section begins with an overview chapter addressing fundamental concepts, characteristic trends, expenditures, and critical considerations. Subsequent chapters provide descriptions of varied patient populations, relevant care settings, and examples of the RN’s role within each setting. Chapters conclude with a case study that illustrates a day in the life of a typical nurse, which includes assessment and evaluation of present symptoms, demographic information, social and environmental determinants, and medical background. Chapters also encompass advocacy and policy roles, care access, emergency preparedness, and community resiliency.https://digitalcommons.fairfield.edu/nursing-books/1092/thumbnail.jp

Space experiment “Cellular Responses to Radiation in Space (CellRad)”: Hardware and biological system tests

One factor contributing to the high uncertainty in radiation risk assessment for long-term space missions is the insufficient knowledge about possible interactions of radiation with other spaceflight environmental factors. Such factors, e.g. microgravity, have to be considered as possibly additive or even synergistic factors in cancerogenesis. Regarding the effects of microgravity on signal transduction, it cannot be excluded that microgravity alters the cellular response to cosmic radiation, which comprises a complex network of signaling pathways. The purpose of the experiment “Cellular Responses to Radiation in Space” (CellRad, formerly CERASP) is to study the effects of combined exposure to microgravity, radiation and general space flight conditions on mammalian cells, in particular Human Embryonic Kidney (HEK) cells that are stably transfected with different plasmids allowing monitoring of proliferation and the Nuclear Factor κB (NF-κB) pathway by means of fluorescent proteins. The cells will be seeded on ground in multiwell plate units (MPUs), transported to the ISS, and irradiated by an artificial radiation source after an adaptation period at 0×g0×g and 1×g1×g. After different incubation periods, the cells will be fixed by pumping a formaldehyde solution into the MPUs. Ground control samples will be treated in the same way. For implementation of CellRad in the Biolab on the International Space Station (ISS), tests of the hardware and the biological systems were performed. The sequence of different steps in MPU fabrication (cutting, drilling, cleaning, growth surface coating, and sterilization) was optimized in order to reach full biocompatibility. Different coatings of the foil used as growth surface revealed that coating with 0.1 mg/ml poly-D-lysine supports cell attachment better than collagen type I. The tests of prototype hardware (Science Model) proved its full functionality for automated medium change, irradiation and fixation of cells. Exposure of HEK cells to the β-rays emitted by the radiation source dose-dependently decreased cell growth and increased NF-κB activation. The signal of the fluorescent proteins after formaldehyde fixation was stable for at least six months after fixation, allowing storage of the MPUs after fixation for several months before the transport back to Earth and evaluation of the fluorescence intensity. In conclusion, these tests show the feasibility of CellRad on the ISS with the currently available transport mechanisms

Development of an instrument for measuring clinicians' power perceptions in the workplace

We report on the development of an instrument to measure clinicians' perceptions of their personal power in the workplace in relation to resistance to computerized physician order entry (CPOE). The instrument is based on French and Raven's six bases of social power and uses a semantic differential methodology. A measurement study was conducted to determine the reliability and validity of the survey. The survey was administered online and distributed via a URL by email to 19 physicians, nurses, and health unit coordinators from a university hospital. Acceptable reliability was achieved by removing or moving some semantic differential word pairs used to represent the six power bases (alpha range from 0.76 to 0.89). The Semantic Differential Power Perception (SDPP) survey validity was tested against an already validated instrument and found to be acceptable (correlation range from 0.51 to 0.81). The SDPP survey instrument was determined to be both reliable and valid. © 2008 Elsevier Inc. All rights reserved