Self-Esteem, Study Habits, and Academic Performance of Business College Students

Individual’s academic success may be affected by personal and social dimensions of life. Self-esteem and study habits are that dimensions in life that have influential effects on academic achievement.  Thus, this study was conducted to determine if there is a significant relationship between self-esteem, study habits and the academic performance of 151 students from the College of Business.  This study utilized the descriptive and correlational designs.   Using stratified sampling, the questionnaires were administered to a sample of 151 business students.  The descriptive results revealed that the business students have high self-esteem, good study habits, and average academic performance (GPA=3.31).  Using Pearson’s correlation, a significant relationship was found between self-esteem and academic performance and between study habits and academic performance in terms of reading textbooks, taking notes and using resources. It was recommended that educators should encourage and cheer up students, raise their spirits when they are down, and congratulate them when they are doing well. Educators should find activities that will motivate students to study harder to improve their academic performance

A systematic review of the impact of nurse-initiated medications in the emergency department

Nurse-initiated medications are one of the most important strategies used to facilitate timely care for people who present to Emergency Departments (EDs). The purpose of this paper was to systematically review the evidence of nurse-initiated medications to guide future practice and research.A systematic review of the literature was conducted to locate published studies and Grey literature. All studies were assessed independently by two independent reviewers for relevance using titles and abstracts, eligibility dictated by the inclusion criteria, and methodological quality.Five experimental studies were included in this review: one randomised controlled trial and four quasi-experimental studies conducted in paediatric and adult EDs. The nurse-initiated medications were salbutamol for respiratory conditions and analgesia for painful conditions, which enabled patients to receive the medications quicker by half-an-hour compared to those who did not have nurse-initiated medications. The intervention had no effect on adverse events, doctor wait time and length of stay. Nurse-initiated analgesia was associated with increased likelihood of receiving analgesia, achieving clinically-relevant pain reduction, and better patient satisfaction.Nurse-initiated medications are safe and beneficial for ED patients. However, randomised controlled studies are required to strengthen the validity of results

Experiences of and support for nurses as second victims of adverse nursing errors: a qualitative systematic review

Second victims are clinicians who have made adverse errors and feel traumatized by the experience. The current published literature on second victims is mainly representative of doctors, hence nurses' experiences are not fully depicted. This systematic review was necessary to understand the second victim experience for nurses, explore the support provided, and recommend appropriate support systems for nurses.To synthesize the best available evidence on nurses' experiences as second victims, and explore their experiences of the support they receive and the support they need.Participants were registered nurses who made adverse errors.The review included studies that described nurses' experiences as second victims and/or the support they received after making adverse errors.All studies conducted in any health care settings worldwide.The qualitative studies included were grounded theory, discourse analysis and phenomenology.A structured search strategy was used to locate all unpublished and published qualitative studies, but was limited to the English language, and published between 1980 and February 2017. The references of studies selected for eligibility screening were hand-searched for additional literature.Eligible studies were assessed by two independent reviewers for methodological quality using a standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI QARI).Themes and narrative statements were extracted from papers included in the review using the standardized data extraction tool from JBI QARI.Data synthesis was conducted using the Joanna Briggs Institute meta-aggregation approach.There were nine qualitative studies included in the review. The narratives of 284 nurses generated a total of 43 findings, which formed 15 categories based on similarity of meaning. Four synthesized findings were generated from the categories: (i) The error brings a considerable emotional burden to the nurse that can last for a long time. In some cases, the error can alter nurses' perspectives and disrupt workplace relations; (ii) The type of support received influences how the nurse will feel about the error. Often nurses choose to speak with colleagues who have had similar experiences. Strategies need to focus on helping them to overcome the negative emotions associated with being a second victim; (iii) After the error, nurses are confronted with the dilemma of disclosure. Disclosure is determined by the following factors: how nurses feel about the error, harm to the patient, the support available to the nurse, and how errors are dealt with in the past; and (iv) Reconciliation is every nurse's endeavor. Predominantly, this is achieved by accepting fallibility, followed by acts of restitution, such as making positive changes in practice and disclosure to attain closure (see "Summary of findings").Adverse errors were distressing for nurses, but they did not always receive the support they needed from colleagues. The lack of support had a significant impact on nurses' decisions on whether to disclose the error and his/her recovery process. Therefore, a good support system is imperative in alleviating the emotional burden, promoting the disclosure process, and assisting nurses with reconciliation. This review also highlighted research gaps that encompass the characteristics of the support system preferred by nurses, and the scarcity of studies worldwide

The impact of prehabilitation on postoperative functional status, healthcare utilization, pain, and quality of life: a systematic review

BACKGROUND: "Preoperative rehabilitation" or prehabilitation has been increasingly studied alongside the deleterious effects of surgery and functional decline. Prehabilitation is the preoperative optimization of physical functionality to enable the individual to maintain a normal level of function during and after surgery. This systematic review evaluates the effectiveness of prehabilitation on functional status, healthcare utilization, quality of life, and pain postoperatively.METHODS: Trials registries and databases of published and unpublished literature were extensively searched. All studies were assessed independently for relevance, eligibility, and quality. Seventeen studies were included in the review: 13 in orthopaedics (mainly knee or hip arthroplasty for osteoarthritis), 2 in abdominal surgery, and 2 in cardiac surgery.FINDINGS: There is no evidence to show that prehabilitation has significant benefits in function, quality of life, and pain; however, it may reduce admission to rehabilitation after knee or hip arthroplasty for osteoarthritis. There is insufficient evidence to make inferences in other surgical populations, notwithstanding initial evidence does not demonstrate advantages

Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: a scoping review

Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn-over and burn-out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre-empt incidences of OV during ED episodes of care. A five-stage methodological framework for scoping reviews was used to identify, summarise and synthesise OV risk factors from five key databases. A validated tool was used to appraise the quality of included studies. Independent evaluation by the reviewers was used throughout. Patient factors were extracted and described from 24 methodologically and geographically diverse papers. Methodological quality for these studies varied from moderate to high. A total of 34 OV risk factors were identified. Although there was variation in, and differences between, staff-perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage

The use of a contextual, modal and psychological classification of medication errors in the emergency department: A retrospective descriptive study

Aims and objectives: To describe the contextual, modal and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors. Background: The causes of medication errors are unique in every clinical setting; hence, error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. Design: Retrospective analysis of reported medication errors in the emergency department. Methods: All voluntarily staff-reported medication-related incidents from 2010–2015 from the hospital's electronic incident management system were retrieved for analysis. Contextual classification involved the time, place and the type of medications involved. Modal classification pertained to the stage and issue (e.g. wrong medication, wrong patient). Psychological classification categorised the errors in planning (knowledge-based and rule-based errors) and skill (slips and lapses). Results: There were 405 errors reported. Most errors occurred in the acute care area, short-stay unit and resuscitation area, during the busiest shifts (0800–1559, 1600–2259). Half of the errors involved high-alert medications. Many of the errors occurred during administration (62·7%), prescribing (28·6%) and commonly during both stages (18·5%). Wrong dose, wrong medication and omission were the issues that dominated. Knowledge-based errors characterised the errors that occurred in prescribing and administration. The highest proportion of slips (79·5%) and lapses (76·1%) occurred during medication administration. It is likely that some of the errors occurred due to the lack of adherence to safety protocols. Conclusion: Technology such as computerised prescribing, barcode medication administration and reminder systems could potentially decrease the medication errors in the emergency department. There was a possibility that some of the errors could be prevented if safety protocols were adhered to, which highlights the need to also address clinicians’ attitudes towards safety. Relevance to clinical practice: Technology can be implemented to help minimise errors in the ED, but this must be coupled with efforts to enhance the culture of safety.</p

Effect of the 4-h target on time-to-analgesia in an Australian emergency department: A pilot retrospective observational study

Objectives The aim of the present study was to assess the relationship between and the effect of the 4-h target or National Emergency Access Target (NEAT) on the time-to-analgesia (TTA), as well as the provision of analgesia in an adult emergency department (ED). Methods The present study was a pilot descriptive explorative retrospective cohort study conducted in a public metropolitan ED. Eligible presentations for analysis were adults presenting with a documented pain score of ≥4 out of 10 between 1 and 14 September 2014. Triage Category 1, pregnant, chest pain and major trauma cases were excluded from the study. As a result, data for 260 patients were analysed. Results Of 260 patients, 176 had analgesia with a median TTA of 49min. Increased NEAT compliance did not significantly decrease TTA. However, when the factors that affected the provision of analgesia were analysed, an association was demonstrated between Admitted and Short Stay NEAT performance and the provision of analgesia. The likelihood of receiving analgesia at all increased as Admitted and Short Stay NEAT compliance improved. Conclusion NEAT is a significant health policy initiative with little clinical evidence supporting its implementation. However, as the Admitted NEAT compliance increases, the probability of receiving analgesia increases, demonstrating a possible link between hospital function and clinical care provision that needs to be explored further. What is known about the topic? The 4-h target or NEAT is a widely used initiative in EDs to allay crowding and access block. However, little is known of its impact on clinical endpoints, such as TTA. What does this paper add? TTA was not significantly reduced as NEAT compliance increased. However, when the focus was on the probability of receiving analgesia, the results demonstrated that an improvement in Admitted and Short Stay NEAT compliance was associated with an increase in the likelihood of patients receiving analgesia. What are the implications for practitioners? NEAT is a relatively recent initiative, hence evidence of its effect on clinically orientated outcomes is limited. Nevertheless, evidence of safety and effectiveness is emerging. The results of the present pilot study provide preliminary data on the timeliness of patient-centred care as demonstrated by TTA and administration of analgesia when required. Further, the results would seem to suggest that the provision of analgesia is affected by how timely patients are moved out of the ED to the in-patient setting. As for future investigations on TTA as a result of NEAT, a wider time period should be considered so that the accurate effect of compliance thresholds (e.g. ≥90%, 81-89%, ≤80%) of NEAT can be explored

Engaging with nurses to develop an occupational violence risk assessment tool for use in emergency departments: a participatory action research inquiry

Background: Early detection of occupational violence (OV) risk factors could facilitate timely and appropriate management of patients in the emergency department. For this purpose, an OV risk assessment could be useful and best initiated at triage. Aims: To understand the need for and determine potential utility and desirable components of an OV risk assessment tool; and to determine specific challenges to its implementation if appropriate. Methods: A participatory action research was conducted. Data were collected through focus groups and semi-structured interviews. Thematic analysis was done inductively and collaboratively using Braun and Clarke's technique. Findings: Six themes were identified from triage nurses (N = 15) pertaining to: i) OV risk assessment; ii) communication of OV risk; iii) clinical implications of risk assessment; iv) tool attributes; v) future implementation challenges; vi) unintended consequences. Conclusion: The development of an OV risk assessment tool is supported, but with very specific attributes. Findings herein also have implications on the implementation and evaluation of this tool in emergency settings

Effect of the 4-h target on 'time-to-ECG' in patients presenting with chest pain to an emergency department: A pilot retrospective observational study

Objectives The aim of this study was to assess the relationship between compliance with time-based Emergency Department (ED) targets (known as NEAT) and the time taken to collect an electrocardiogram (TTE) in patients presenting with chest pain. Methods This was a pilot descriptive retrospective cohort study completed in a large inner city tertiary ED. Patients who presented with active or recent chest pain between July 2014 and June 2015 were eligible for inclusion. Pregnant patients, inter-hospital transfers, and traumatic chest pain were excluded. A random selection of 300 patients from the eligible cohort comprised the final sample. The differences of TTE between categories of NEAT compliance were compared using Kruskal-Wallis test. Also, the factors affecting with the acquisition of ECG within ten minutes of arrival were explored using proportional hazards regression. Results There was a significant inverse association between the percentage of admitted patients leaving the ED within four hours (admitted NEAT) and TTE. As admitted NEAT compliance increased TTE decreased (p = 0.004). A number of variables including triage score, arrival time, total NEAT, first location, doctor wait time, and cardiac diagnosis were all significant predictors of TTE. After adjusting for other variables Admitted NEAT remained as an independent predictor of TTE. Conclusion There is likely to be a relationship between NEAT and TTE that is reflective of overall hospital and not just ED functioning; however the exact relationship remains uncertain. Further study in a multisite study is warranted to further explore the relationship between NEAT, TTE and other important clinical metrics of ED performance. What is known about the topic? The 4-h time target or National Emergency Access Target (NEAT) is implemented in Australia to ease crowding and access block. However, little is known of its effect on important clinical endpoints, particularly 'time-to-ECG' (TTE). What does this paper add? This paper demonstrates a complex relationship between measures of time-based targets, such as time to ECG. It is likely that increasing compliance with admitted NEAT shortens TTE, demonstrating the effect of hospital functioning on the ability to deliver quality care in the emergency department. What are the implications for practitioners? Emergency department flow has an effect on the ability of the department to deliver key assessment. There is a relationship between NEAT compliance and TTE, but the exact relationship requires further exploration in larger multicentre studies