Pediatric emergence delirium is a postoperative phenomenon characterized by aberrant cognitive and psychomotor behavior, which can place the patient and health care personnel at risk for injury. A common tool for identifying emergence delirium is the Level of Consciousness-Richmond Agitation and Sedation Scale (LOC-RASS), although it has not been validated for use in the pediatric population. The Pediatric Anesthesia Emergence Delirium Scale (PAED) is a newly validated tool to measure emergence delirium in children. We chose to implement and evaluate the effectiveness and fidelity of using the PAED Scale to identify pediatric emergence delirium in one eight-bed postanesthesia care unit in comparison with the traditional LOC-RASS. The overall incidence of pediatric emergence delirium found by using the LOC-RASS with a retrospective chart review (3%) was significantly lower than the incidence found by using the LOC-RASS (7.5%) and PAED Scale (11.5%) during the implementation period. Our findings suggest that the PAED Scale may be a more sensitive measure of pediatric emergence delirium, and, in the future, we recommend that health care personnel at our facility use the PAED Scale rather than the LOC-RASS.

The purpose of this article is to describe the outcomes of a systematic review of educational programs and strategies for developing the writing skills of nursing students and nurses. Of 728 screened citations, 80 articles were included in the review. Writing assignments in nursing courses were the most common, followed by strategies for writing across the curriculum and specific courses to improve the writing skills of nursing students. To improve nurses' writing skills, workshops were used most frequently. Only 28 (35%) of the articles were data based, and most articles described the writing program, strategy, or assignment but did not evaluate its effectiveness.

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Workshops have been described in the literature as a strategy for preparing nurses to publish their work and develop their writing skills. Articles about the use of workshops for these purposes have not been integrated systematically. Seventeen articles were included in the current review. The workshop method has been found to be effective for preparing nurses to write for publication and for improving nurses' and nursing students' writing skills. However, workshops must be combined with one-to-one mentoring and feedback on writing to be successful.

Strategies, assignments, and courses intended to promote writing skills of nursing students were documented in this literature review; however, further evaluation is needed to determine which are most effective. Hawks Turner Derouin Hueckel Leonardelli Oermann.