ACCCN Workforce Standards for Intensive Care Nursing: Systematic and evidence review, development, and appraisal

Background: The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses’ ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing. There was a need for a stronger more evidence based document to support the intensive nursing workforce. Objectives: To undertake a systematic and evidence review of the evidence related to intensive care nurse staffing and quality of care, and determine evidence-based professional standards for the intensive care nursing workforce in Australia. Methods: The National Health and Medical Research Council standard for clinical practice guidelines methodology was employed. The English language literature, for the years 2000-2015 was searched. Draft standards were developed and then peer- and consumer-reviewed. Results: A total of 553 articles was retrieved from the initial searches. Following evaluation, 231 articles met the inclusion criteria and were assessed for quality using established criteria. This evidence was used as the basis for the development of ten workforce standards, and to establish the overall level of evidence in support of each standard. All draft standards and their subsections were supported multi-professionally (median score >6) and by consumers (85–100% agreement). Following minor revisions, independent appraisal using the AGREE II tool indicated that the standards were developed with a high degree of rigour. Conclusion: The ACCCN intensive care nursing nurse workforce standards are the first to be developed using a robust, evidence-based process. The standards represent the optimal nurse workforce to achieve the best patient outcomes and to maintain a sustainable intensive care nursing workforce for Australia

Turn that Frown Upside-down! The Effectiveness of Opposite Action in Changing Emotion

While research demonstrates that opposite action (OA) impacts emotion (Rizvi & Linehan, 2005), we lack an understanding of the mechanisms by which it produces opposite emotions. The current study dismantled emotion regulation skill components by comparing tasks with different combinations of cognitive, emotive and behavioral components. I predicted that the OA condition would be the most effective in altering negative emotion. University students (n = 194) completed a sadness induction and were randomly assigned to either a (1) control, (2) low arousal positive imagery (3) high arousal positive imagery, or (4) OA plus high arousal positive imagery condition. The control condition experienced the smallest changes in emotion in the predicted directions across most emotion outcomes, followed by the low arousal positive imagery condition and last, the OA and high arousal positive imagery conditions, which did not tend to differ from each other. Using opposite emotion (valence and arousal) was effective in changing sadness; however, the behavioral component did not change emotion above and beyond the cognitive and emotive components tested. Study conditions were not different in the time they spent persisting on a distressing task. The behavioral component of OA might not be important for emotion change; however, it seems likely that self-reported levels of discomfort and vividness in mental imagery experienced by the OA condition hindered the effectiveness of the behavioral component. This finding could shed light on the importance of building therapeutic rapport to increase comfortability engaging in OA prior to introducing it in psychotherapy

Electrical Safety on the Farm

Over the years, electrically powered farm equipment has become an indispensable element of modern farming. With the widespread use of electricity on the farm, more emphasis needs to be placed on using electricity and electrical equipment safely. Nationaly, approximately 30 to 40 people a year are electrocuted on farms. This factsheet covers electric shock, Basics of electrical systems, common precautions, safety hazards and first aid

Lightning Protection for farms

Lightning, one of natures most powerful forces, can cause a great deal of damage, particularly in a farm environment. A lightning strike can start fires in buildings, damage electrical equipment, and electrocute humans and livestock. Losses from lightning can be very costly. Replacing buildings, equipment or livestock disrupts farm operations and incurs considerable expense, and of course a human life can not be replaced. This factsheet covers characteristics of lightning, principles of lightning protection, lightning hazards and protection systems as well as personal safety

Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study

This is an open access article under the terms of the Creative Commons Attribution license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities. Aim This paper investigates the predictors of resilience, including dispositional mindfulness and employment status of third year nursing students from three Australian universities. Design Participants were 240 undergraduate, third year, nursing students. Participants completed a resilience measure (Connor–Davidson Resilience Scale, CD-RISC), measures of dispositional mindfulness (Cognitive and Affective Mindfulness Scale Revised, CAMS-R) and professional quality of life (The Professional Quality of Life Scale version 5, PROQOL5), such as compassion satisfaction, compassion fatigue and burnout. Method An observational quantitative successive independent samples survey design was employed. A stepwise linear regression was used to evaluate the extent to which predictive variables were related each to resilience. Results The predictive model explained 57% of the variance in resilience. Dispositional mindfulness subset acceptance made the strongest contribution, followed by the expectation of a graduate nurse transition programme acceptance, with dispositional mindfulness total score and employment greater than 20 hours per week making the smallest contribution. This was a resilient group of nursing students who rated high with dispositional mindfulness and exhibited hopeful and positive aspirations for obtaining a position in a competitive graduate nurse transition programme after graduation

Understanding boys (dis)engagement with reading for pleasure: Project findings

Why do boys from low-income families appear to read for pleasure far less than other groups of young people? This research project provides new evidence that how reading is taught in schools influences different boys’ orientations to and engagement with reading for pleasure. It offers evidence that boys’ (dis)engagement is not simply a gender issue and that it also involves teacher perceptions of other aspects of boys’ social and learner identities, including ‘ability’, ethnicity and social class. The research was funded by the British Academy and the Leverhulme Foundation

Identification of the severe sepsis patient at triage: a prospective analysis of the Australasian Triage Scale

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objective This study aims to investigate the accuracy and validity of the Australasian Triage Scale (ATS) as a tool to identify and manage in a timely manner the deteriorating patient with severe sepsis. Methods This was a prospective observational study conducted in five sites of adult patients. Keywords and physiological vital signs data from triage documentation were analysed for the ‘identified’ status compared with confirmed diagnosis of severe sepsis after admission to the intensive care unit. The primary outcome is the accuracy and validity of the ATS Triage scale categories to identify a prespecified severe sepsis population at triage. Secondary outcome measures included time compliance, antimicrobial administration and mortality prediction. Statistical analysis included parameters of diagnostic performance. Adjusted multivariate logistic regression analysis was applied to mortality prediction. Results Of 1022 patients meeting the criteria for severe sepsis, 995 were triaged through the emergency department, 164 with shock. Only 53% (n=534) were identified at triage. The overall sensitivity of the ATS to identify severe sepsis was 71%. ATS 3 was the most accurate (likelihood ratio positive, 2.45, positive predictive value 0.73) and ATS 2 the most valid (area under the curve 0.567) category. Identified cases were more likely to survive (OR 0.81, 95% CI 0.697 to 0.94, p4 (OR 1.63, 95% CI 1.10 to 2.89, p<0.001) and ATS 1 category (OR 1.55, 95% CI 1.09 to 2.35, p<0.005). Conclusions The ATS and its categories is a sensitive and moderately accurate and valid tool for identifying severe sepsis in a predetermined group, but lacks clinical efficacy and safety without further education or quality improvement strategies targeted to the identification of severe sepsis

Dispositional mindfulness and employment status as predictors of resilience in third year nursing students : A quantitative study

Background Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities. Aim This paper investigates the predictors of resilience, including dispositional mindfulness and employment status of third year nursing students from three Australian universities. Design Participants were 240 undergraduate, third year, nursing students. Participants completed a resilience measure (Connor–Davidson Resilience Scale, CD-RISC), measures of dispositional mindfulness (Cognitive and Affective Mindfulness Scale Revised, CAMS-R) and professional quality of life (The Professional Quality of Life Scale version 5, PROQOL5), such as compassion satisfaction, compassion fatigue and burnout. Method An observational quantitative successive independent samples survey design was employed. A stepwise linear regression was used to evaluate the extent to which predictive variables were related each to resilience. Results The predictive model explained 57% of the variance in resilience. Dispositional mindfulness subset acceptance made the strongest contribution, followed by the expectation of a graduate nurse transition programme acceptance, with dispositional mindfulness total score and employment greater than 20 hours per week making the smallest contribution. This was a resilient group of nursing students who rated high with dispositional mindfulness and exhibited hopeful and positive aspirations for obtaining a position in a competitive graduate nurse transition programme after graduation

A Review of the Pikes Peak Batholith, Front Range, Central Colorado: A Type Example of A-Type Granitic Magmatism

The N 1.08-Ga Pikes Peak composite batholith of central Colorado is a type example of an Atype granitic system. From the 1970s through the 1990s, details of the field relations, mineralogy, major and trace element compositions, and isotopic geochemistry of Pikes Peak rocks were documented, and they reveal the existence of two chemical groups, a potassic and a sodic series. The potassic series (~64-78 wt % SiO2) includes the Pikes Peak Granite, which is mostly coarse-grained biotite f hornblende syenogranite and minor monzogranite that dominates the batholith. The potassic series also includes fine- to medium-grained biotite granite found in numerous, small, late-stage plutons throughout the batholith. The sodic series is found in seven plutons comprised of a wide range of rock types ( N 44-78 wt % SiO2), including gabbro, diabase, syenite/quartz syenite, and fayalite and sodic amphibole granite. Differences in petrologic and geochemical characteristics between the sodic and potassic series indicate different petrogenetic histories. Major and trace element and strontium and oxygen isotopic data were used by some workers to hypothesize that mantle-derived alkali basalt underwent crystal fractionation and reaction with lower crustal rocks to generate syenitic magmas of the sodic series, which subsequently underwent further fractionation to produce sodic granites. Recent studies involving estimates of oxygen fugacities, along with additional trace element and neodymium isotopic data, also support a basalt fractionation model for the sodic series, but suggest only minor crustal involvement. Gabbros and diabase dikes associated with the sodic series appear to have been derived from mantle sources that previously had been affected by a subduction event, based on neodymium isotopic and trace element data. Some workers propose that the potassic series also formed by fractionation of syenitic and/ or basaltic magmas coupled with reaction with intermediate rather than lower crust. Other workers propose a model in which genesis of the potassic series was dominated by partial melting involving tonalitic sources, with fractionation and-perhaps magma mixing playing subordinate roles in generating compositional diversity among the potassic granitoids. The Pikes Peak batholith thus formed by emplacement of at least two petrogenetically different granite types, which were emplaced close together in space and time and which exhibit geochemical characteristics typical of A-type granites