Nursing Students’ Perception of Safety in Clinical Settings: From the Quality and Safety Officer

Teaching methods to improve the safety of care for patients has been a priority for nurse educators. This article discusses the student nurses’ use of error reporting tools in the clinical setting, revealing study results completed by the Quality and Safety Officer in a School of Nursing and Health Professions. The aim was to report on the use of safety tools and the perception of safety issues in clinical settings identified by 121 prelicensure baccalaureate nursing students. Responses suggest that it is challenging for nursing students to report errors and near miss events. Barriers exist for the nursing student. The survey reveals difficulty in reporting but discloses that safety for the patient continues to be a primary concern for the nursing student

Use of Root Cause Analysis in Nursing Education: Best Practice from the Quality and Safety Officer

Teaching nursing students to be safe in practice is a key element to any nursing curriculum. This article will discuss the use of a Root Cause Analysis (RCO) framework with prelicensure nursing students, by the Quality and Safety Officer (QSO) in a School of Nursing and Health Professions, as a method to enhance transparency and improve patient safety. The aim is to provide a rationale for using this strategy, to identify the steps of a root cause analysis, to disclose barriers to its successful use, and to explore dissemination to the partnering healthcare environments

Addressing Gaps in Quality and Safety Education during Pre-Licensure Clinical Rotations

United States national reports have called for improvement in healthcare professions education to better address patient care outcomes. In response, an initiative titled “Quality and Safety Education for Nurses (QSEN)” has been adopted by nursing programs across the nation, which describes the six main competencies to be included in nursing curricula. As early adopters of the QSEN competencies, the University of San Francisco nursing faculty promptly threaded the material throughout the 4-year Bachelor’s of Science in Nursing (BSN) curriculum. Confident that the topics were well covered in the classroom, we then sought to learn how often our students practiced these skills during their assigned clinical rotations. After completing an IRB-approved observational study of junior-level BSN students, we tallied the actual number of minutes spent in each competency area while assigned to the patient care unit. Using a time-on-task author developed QSEN-based tool, we found that our students spent little to no time engaged in quality improvement, evidence based practice, or informatics. This is a very important finding, as it indicates that our students may not be sufficiently developing these particular skills during assigned clinical hours. Weaving the six QSEN competencies throughout the curriculum is a good start, but as we saw in our observational study, all of the competencies are not equally demonstrated in the clinical setting. Continuing to provide QSEN enriched didactic courses, adding targeted simulation experiences, and nourishing academic/practice partnerships may help bridge the gaps

Menstrual Dignity and the Bar Exam

This Article examines the issue of menstruation and the administration of the bar exam. Although such problems are not new, over the summer and fall of 2020, test takers and commentators took to social media to critique state board of law examiners’ (“BOLE”) policies regarding menstruation. These problems persist. Menstruators worry that if they unexpectedly bleed during the exam, they may not have access to appropriately sized and constructed menstrual products or may be prohibited from accessing the bathroom. Personal products that are permitted often must be carried in a clear, plastic bag. Some express privacy concerns that the see-through bag outs test takers’ menstruation as well as their birth-assigned sex — an especially difficult problem for transgender, genderqueer/nonbinary, and intersex individuals who do not wish to share that information. The authors conducted a study documenting experiences with menstruation and the bar exam and examined BOLE policies and practices relevant to menstruation. The Article uses the data from these studies to delineate the contours and substance of the problem. To guide this analysis, the Article also analyzes BOLE policies under the Equal Protection Clause and local human rights laws, determining that current policies are likely unconstitutional and discriminatory. Finally, the Article proposes a comprehensive Model Policy that appropriately balances BOLE concerns against the important principles of privacy and respect, fairness and non-discrimination, promoting health, providing accommodations, and transparency. If adopted, the Model Policy would bring BOLE policies closer to the goals of the critical intersectional movements urging diversification of the legal profession, bar exam reform, and menstrual justice

Characterization of a putative mutant for iron homeostasis

Abstract only availableLittle is known about the genetics of iron homeostasis in plants. A novel genetic screen was used to identify mutants with alterations in iron homeostasis. Because Ferritin (Fer1) mRNA expression is upregulated by intracellular iron concentration in leaves, this gene can be used to predict intercellular iron concentrations in leaves. To identify mutants that over- or under-accumulate leaf iron, Arabidopsis was transformed with the reporter gene Green Fluorescent Protein (GFP) driven by the Fer1 promoter. Seed from this transgenic plant were mutagenized with EMS. The resulting M2 seed were screened for high or low GFP fluorescence relative to transgenic controls grown on iron-sufficient medium. A putative Over-Accumulator of Fe, pOAF40, was identified that expressed high levels of GFP fluorescence. Our objective was to characterize this mutant for alterations in iron homeostasis. Seed of pOAF40 and the non-mutagenized transgenic control were germinated and plants grown on iron-sufficient medium for 14 days before transferring to iron-sufficient or -deficient media for four days. Fer1 mRNA levels, chlorophyll content, and ferric-chelate reductase activity (an enzyme whose activity increases during iron deficiency) were determined at the point of transfer and again four days after transfer. Fer1 mRNA expression was the same at the time of transfer, but greater relative to transgenic controls regardless of iron concentration 4 days later. The average concentration of chlorophyll in pOAF40 was less than the control regardless of sampling time or iron concentration. pOAF40 exhibited lower reductase activity than control on the day of transfer, however this difference in activity was not detected four days after transfer within iron-sufficient or -deficient treatments. Furthermore, ferric-chelatate reductase activity was greater in iron-deficient than -sufficient media for both mutant and control suggesting normal response to iron-deficiency by pOAF40. Further characterization of this mutant is being performed to determine whether the mutation deregulates ferritin expression or leads to over-accumulation of iron in leaves.MU Monsanto Undergraduate Research Fellowshi

Menstrual Dignity and the Bar Exam

This Article examines the issue of menstruation and the administration of the bar exam. Although such problems are not new, over the summer and fall of 2020, test takers and commentators took to social media to critique state board of law examiners’ (“BOLE”) policies regarding menstruation. These problems persist. Menstruators worry that if they unexpectedly bleed during the exam, they may not have access to appropriately sized and constructed menstrual products or may be prohibited from accessing the bathroom. Personal products that are permitted often must be carried in a clear, plastic bag. Some express privacy concerns that the see-through bag outs test takers’ menstruation as well as their birth-assigned sex — an especially difficult problem for transgender, genderqueer/nonbinary, and intersex individuals who do not wish to share that information.The authors conducted a study documenting experiences with menstruation and the bar exam and examined BOLE policies and practices relevant to menstruation. The Article uses the data from these studies to delineate the contours and substance of the problem. To guide this analysis, the Article also analyzes BOLE policies under the Equal Protection Clause and local human rights laws, determining that current policies are likely unconstitutional and discriminatory. Finally, the Article proposes a comprehensive Model Policy that appropriately balances BOLE concerns against the important principles of privacy and respect, fairness and non-discrimination, promoting health, providing accommodations, and transparency. If adopted, the Model Policy would bring BOLE policies closer to the goals of the critical intersectional movements urging diversification of the legal profession, bar exam reform, and menstrual justice

Scaling Up Psychological Treatments: A Countrywide Test of the Online Training of Therapists.

BACKGROUND: A major barrier to the widespread dissemination of psychological treatments is the way that therapists are trained. The current method is not scalable. OBJECTIVE: Our objective was to conduct a proof-of-concept study of Web-centered training, a scalable online method for training therapists. METHODS: The Irish Health Service Executive identified mental health professionals across the country whom it wanted to be trained in a specific psychological treatment for eating disorders. These therapists were given access to a Web-centered training program in transdiagnostic cognitive behavior therapy for eating disorders. The training was accompanied by a scalable form of support consisting of brief encouraging telephone calls from a nonspecialist. The trainee therapists completed a validated measure of therapist competence before and after the training. RESULTS: Of 102 therapists who embarked upon the training program, 86 (84.3%) completed it. There was a substantial increase in their competence scores following the training (mean difference 5.84, 95% Cl -6.62 to -5.05; P<.001) with 42.5% (34/80) scoring above a predetermined cut-point indicative of a good level of competence. CONCLUSIONS: Web-centered training proved feasible and acceptable and resulted in a marked increase in therapist competence scores. If these findings are replicated, Web-centered training would provide a means of simultaneously training large numbers of geographically dispersed trainees at low cost, thereby overcoming a major obstacle to the widespread dissemination of psychological treatments

No difference found in time to publication by statistical significance of trial results: a methodological review

Objective: Time-lag from study completion to publication is a potential source of publication bias in randomised controlled trials. This study sought to update the evidence base by identifying the effect of the statistical significance of research findings on time to publication of trial results.Design: Literature searches were carried out in four general medical journals from June 2013 to June 2014 inclusive (BMJ, JAMA, the Lancet and the New England Journal of Medicine). Setting: Methodological review of four general medical journals. Participants: Original research articles presenting the primary analyses from phase 2, 3 and 4 parallel-group randomised controlled trials were included. Main outcome measures: Time from trial completion to publication.Results: The median time from trial completion to publication was 431 days (n ¼ 208, interquartile range 278–618). A multivariable adjusted Cox model found no statistically significant difference in time to publication for trials reporting positive or negative results (hazard ratio: 0.86, 95% CI 0.64 to 1.16, p ¼ 0.32). Conclusion: In contrast to previous studies, this review did not demonstrate the presence of time-lag bias in time to publication. This may be a result of these articles being published in four high-impact general medical journals that may be more inclined to publish rapidly, whatever the findings. Further research is needed to explore the presence of time-lag bias in lower quality studies and lower impact journals