Medication errors are common in health care settings. Safety motivation, such as willingness to report error, is needed to contain medication errors. Limited evidence exists about measures to enforce nurses’ safety motivation. The purpose of this study was to test a proposed model explaining the mechanism by which organizational and social factors influence nurses’ safety motivation. Survey for this cross-sectional study was mailed to a random sample of 500 acute care nurses. Data collection started in January 2014 and lasted 6 months. Path analysis results showed a good fitting final model with 15% of explained variance on nurses’ safety motivation. Safety climate dimensions of error feedback (β = .38, p ⩽ .00) and nonpunitive response to errors (β = .22, p = .01) significantly predicted the outcome. There is a need for both organizational and social factors to motivate nurses to report errors. Leadership practices emphasizing safety as a priority is needed to enhance nurses’ safety motivation.
In primary and urgent care, headache and facial pain are common and challenging to diagnose and manage, especially with using opioids appropriately. We therefore developed the Decision Support Tool for Responsible Pain Management (DS-RPM) to assist healthcare providers in diagnosis (including multiple simultaneous diagnoses), workup (including triage), and opioid-risk-informed treatment. A primary goal was to supply sufficient explanations of DS-RPM’s functions allowing critique. We describe the process of iteratively designing DS-RPM adding clinical content and testing/defect discovery. We tested DS-RPM remotely with 21 clinician-participants using three vignettes—cluster headache, migraine, and temporal arteritis—after first training to use DS-RPM with a trigeminal-neuralgia vignette. Their evaluation was both quantitative (usability/acceptability) and qualitative using semi-structured interviews. The quantitative evaluation used 12 Likert-type questions on a 1–5 scale, where 5 represented the highest rating. The mean ratings ranged from 4.48 to 4.95 (SDs ranging 0.22–1.03). Participants initially found structured data entry intimidating but adapted and appreciated its comprehensiveness and speed of data capture. They perceived DS-RPM as useful for teaching and clinical practice, making several enhancement suggestions. The DS-RPM was designed, created, and tested to facilitate best practice in management of patients with headaches and facial pain. Testing the DS-RPM with vignettes showed strong functionality and high usability/acceptability ratings from healthcare providers. Risk stratifying for opioid use disorder to develop a treatment plan for headache and facial pain is possible using vignettes. During testing, we considered the need to adapt usability/acceptability evaluation tools for clinical decision support, and future directions.
T he novel coronavirus (COVID-19) pandemic required a rapid shift to virtual learning. With that comes the need for innovative ways to maintain student attention, engage students in learning, and provide opportunities for collaboration with their peers during synchronous online class time. Clinical practicum courses in our nursing program have 1 of 3 semester hours allocated for didactic learning where faculty prompt students to reflect on clinical experiences, participate in small group activities, and build connections between theory and clinical practice. Nurse practitioner students in a clinical practicum course were divided into small groups and placed into breakout rooms on the virtual platform. They were instructed to build an infographic using a free web-based site in which they each explored a cardiovascular risk calculator. Students included the strengths and weaknesses of the calculator, appropriate populations for use, information necessary to complete a calculation, sensitivity, specificity, what to do with positive screens, and how they can apply the cardiovascular risk calculator to practice. The infographic needed to be both visually appealing and informative with succinct but pertinent information. Students then presented their infographics to the entire class to disseminate their findings. Having each group present allowed everyone in the course to learn about each selected risk calculator, while highlighting key information. Use of student-driven learning activities that require knowledge dissemination and active participation can promote student engagement while still conforming to the restrictions of virtual learning.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.