Nerve agents: A guide for emergency nurses. Part 1

Recent incidents in the UK and the alleged chemical attacks in Syria by the Bashar al-Assad regime have brought the subject of chemical weapons back into the public domain. To date these types of event have been relatively rare because terrorist plans to harm large numbers of people have mostly been thwarted. This is the first part of a two-part article on nerve agents. Part one gives an overview of these agents, their historical background and manufacture, and how the agents affect physiology. Part two, which will appear in the next issue, considers the pre-hospital response to the use of nerve agents, including effective triage and decontamination, and in-hospital treatment

Evidence-based instruction strategies to improve Drug Calculation Skills

Introduction: Medication errors and insecure practices harm healthcare systems worldwide. Each year, around 7,000 to 9,000 people in the United States die due to medication errors. (Tariq et al., 2023). There is no standardized method of educating healthcare providers on medication calculations. Objectives: Identify evidence-based instruction strategies for drug calculation skills development and describe the strategies based on the research-based principles for smart teaching. Methods: Through an evidence-based systematic review, we followed Whittemore and Knalf (2005) steps to assess the level and quality of evidence. The research process involved five steps: (1) defining the research question, (2) conducting a literature review, (3) gathering data from primary sources, (4) analyzing data, and (5) presenting findings. An electronic search of CINAHL, PubMed, and PsycINFO was conducted using the search terms “students,” “nursing,” “education,” “drug dosage calculations,” and “mathematics.” To qualify for inclusion in the review, the studies had to include nursing students or nurses, be written in English, and not restricted in regards of the country. Articles were not restricted to any one country because medication calculation errors related to patient safety remain a significant global issue. From 2014 to 2020, a total of 1793 articles were retrieved. Results: For this review, we found 51 studies that met the eligibility criteria. Most of these studies reported results based on evidence levels III (23.5%) and V (41.2%). The majority of the information quality was from Level B (82.4%). Table 1 summarizes the level of evidence, quality of evidence, role of evidence in learning and teaching, and the research-based principles addressed in the studies reviewed. The major teaching strategies were early diagnostic assessments of students' knowledge, anxiety, and self-confidence; stimulate self-directed learning, and working on knowledge organization by scaffolding complex tasks, and being explicit about objectives and expectations. The use of e-learning has become increasingly popular since 2018. Discussion: Utilizing technology can greatly benefit education by complementing in-class practice and providing students with opportunities for creative, autonomous, collaborative, and interactive learning. In recent years, there has been an increase in publications utilizing e-learning, smartphone apps, and web pages to improve drug calculation skills (for example: https://www.safemedicate.net/ and https://testandcalc.com/index.html). However, due to the low levels and quality of evidence, we recommend that future studies use research designs that produce higher levels of evidence. For instance, randomizing teaching methods per semester allows for a standardized approach to data gathering in nursing programs, which enhances consistency in monitoring student progress and evaluating teaching effectiveness. Implementing web-based software can also support effective research-based approaches. We recommend that teaching approaches address cognitive, motivational, and developmental goals to ensure student success. Future trends are adaptive web-based technology aiming at improving the learning of medication calculation skills (Ravik & Andresen, 2023).<p/

Translating the power of Coverdell fellows to address global nursing challenges

Academic opportunities to enter undergraduate nursing should include access for mature, experienced professionals who are prepared to care for an ever more diverse patient population and who can provide nursing expertise in the global arena. The Coverdell Fellowships in nursing are designed to actively support Returned Peace Corps Volunteers (RPCV) in developing nursing skills in such a way that supports the local community. Coverdell Fellows already have the skills and abilities enabling them to communicate with sensitivity and to develop therapeutic relationships with diverse global populations. Many Colleges of Nursing are currently faced with the challenge of providing students with opportunities which will allow them to become more globally aware and culturally competent. Thus, working with the Peace Corps, a highly respected organization with longstanding international experience, is an obvious step not only to bolster the nursing workforce, but also to develop a more globally sensitive and competent nursing workforce in the U.S. and abroad

Editorial control: Part 2--Fostering collegial relationships.

Typically the association president and the editor of the association's publication find themselves in discussions over who is ultimately responsible for the publication's style and content. The first article in this set of two focused on the problem, this article describes strategies to use to prevent conflicts between the editor and association leaders

Preparing senior nursing students through optional clinical experiences

Exposure to the realities of critical care nursing before graduation eases the transition afterward. © Williams & Wilkins 1983. All Rights Reserved

Problems in interpreting abnormal auditory brainstem responses in comatose patients.

Auditory brainstem responses (ABRs) provide a way to evaluate central nervous system function in young, confused, uncooperative or comatose patients. Auditory brainstem responses represent activity in or around the vestibulocochlear (VIII) cranial nerve, cochlear nucleus, superior olivary complex, lateral lemniscus, and inferior colliculus. Many factors affect recording of the auditory brainstem response. These factors include technical factors, chronic alcoholism, demyelinating diseases, ototoxic drugs, barbiturates, hearing loss, otitis media, and hypothermia