The results of this study can be helpful to nurse administrators who are responsible for developing highly collaborative healthcare teams and for nurse educators who are focused on developing professional values in future nurses.

Vicarious trauma (VT), the phenomenon of changes in cognition and worldview that result from empathic response and repeated exposure to narratives of trauma, is a risk for helping professionals. This descriptive, correlational study sought to examine levels of VT among sexual assault nurse examiners (SANEs) as compared with other women's health nurses. It also explored whether levels of VT are different for nurses who have experienced primary trauma alone, VT alone, or both personal trauma and VT. VT was assessed through an anonymous online survey using the nurses' total scores on the Trauma and Attachment Belief Scale. Trauma and Attachment Belief Scale scores were significantly higher for SANEs (M = 178.5, SD = 42.6) than for women's health nurses (M = 168.1, SD = 41.4; p = 0.025), indicating higher levels of trauma-related cognitive disruption in the SANE group. Scores were also significantly higher for both groups with personal trauma histories at the p < 0.05 level compared with the women's health nurses with no personal history. SANEs who had no personal history of trauma did not differ significantly from either group of nurses who did, suggesting that VT from working as an SANE is associated with levels of cognitive disruption similar to oneself having experienced trauma. Nurses should be aware of this phenomenon and its sequelae when choosing to pursue the specialty of sexual assault nursing. Hospitals and other organizations employing SANEs should also be aware of VT and provide a support system with resources in place to mitigate these effects. Future research should further explore effects of primary trauma versus VT, clinical manifestations and significance of varying levels of VT, and interventions and strategies for dealing with VT.

This work has practical recommendations for the individual faculty member. Promoting higher-level cognition, asking questions that probe the learner's understanding and linking discussions to the clinical context are some of the approaches that can be incorporated immediately.

Improvements in health care are slow, in part because doctors and nurses lack skills in quality improvement, patient safety, and interprofessional teamwork. This article reports on the Retooling for Quality and Safety initiative of the Josiah Macy Jr. Foundation and the Institute for Healthcare Improvement, which sought to integrate improvement and patient safety into medical and nursing school curricula. In one academic year, 2009-10, the initiative supported new learning activities (87 percent of which were interprofessional, involving both medical and nursing students) in classrooms, simulation centers, and clinical care settings that involved 1,374 student encounters at six universities. The work generated insights-described in this article-into which learning goals require interprofessional education; how to create clinically based improvement learning for all students; and how to demonstrate the effects on students' behavior, organizational practice, and benefits to patients. A commonly encountered limiting factor for the programs was the lack of a critical mass of clinically based faculty members who were ready to teach about the improvement of care. What's more, the paucity of robust evaluation strategies for such programs suggests a future research agenda that deserves to be funded.

In China, nurses have limited presence in schools, thus, adolescent girls often lack accurate information about menstrual health, which may lead to incorrect and unhealthy menstrual-related behavior. This study investigated the effects of a culturally and developmentally tailored nursing intervention on the menstrual health of adolescent girls in China. Following institutional review board approval, adolescent girls aged 12-15 were recruited from two schools. A quasi-experimental, pretest-posttest design examined the effects of five interactive education sessions on menstrual health. The final sample included 116 adolescent girls. Significant improvement was observed in the intervention group regarding menstrual knowledge, confidence in performing menstrual healthcare behavior, and dysmenorrhea related self-care behavior. A nurse-managed education program improved adolescent girls' menstrual knowledge, promoted a more positive attitude, encouraged confidence, and improved pain relief practice. We recommend that professional nurses globally advocate for school nursing and routine menstrual health education for adolescent girls.Key words adolescent health promotion, menstrual attitude, menstrual behavior, menstrual health, menstrual knowledge, school health education.

Today’s health care delivery system relies heavily on interhospital transfer of patients who require higher levels of care. Although numerous tools and algorithms have been used for the prehospital determination of mode of transport, no tool for the transfer of patients between hospitals has been widely accepted. Typically, the interfacility transport decision is left to the discretion of the referring provider, who may or may not be aware of the level of care provided or the means of transport available. A need exists to determine the appropriate level of care required to meet the needs of patients during transport. The American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care is a patient-centered model that focuses on optimizing patient care by matching the characteristics of the patient with the competencies of the nurse. This model shows significant promise in providing the theoretical backing to guide the decision on the level of care necessary to complete interfacility transfers safely and effectively. This article describes a new tool inspired by the AACN Synergy Model for Patient Care to determine the appropriate level of care required for interfacility transport.

A growing body of evidence supports the fact that optimal health-related quality of life is largely dependent on patient competence in symptom perception. However, many studies have reported poor symptom perception in patients with heart failure. In China, there has been no previous research on assessing the symptom perception ability of patients with heart failure. This study aimed to describe how Chinese patients with heart failure perceive their symptoms, as well as to explore their influencing factors. A theory-based, descriptive, correlational cross-sectional design was used in this study. Data on symptom perception and factors related to symptom perception were collected via structured interviews and medical records. A convenience sample of 208 hospitalized patients was enrolled. The degree of symptom perception in this study was at a high level. The results showed that the level of depression, the New York Heart Association functional class, the left ventricular ejection fraction, and educational background were identified as independent factors of symptom perception in Chinese patients with heart failure. The degree of symptom perception of patients with heart failure was affected by personal, psychological, and physiological factors. Health policy and healthcare providers should pay more attention and deepen the understanding to Chinese patients with heart failure to provide better healthcare.

This study examined the supports, barriers, and strategies to successful progression in a DNP program using a nationwide online survey of DNP students and graduates. Subjects (n = 172) had a mean age of 46.2 years; 83% worked full time. Major barriers were competing demands of work, family, and school. Perseverance was a key element in overcoming barriers; most students reported being overwhelmed, and 37% considered quitting. Mechanisms for programs to consider in addressing this stress are discussed.