Aim-This paper is a report of a study to identify critical thinking learning needs of new and experienced nurses.Background-Concern for patient safety has grown worldwide as high rates of error and injury continue to be reported. In order to improve patient safety, nurses must be able to recognize changes in patient condition, perform independent nursing interventions, anticipate orders and prioritize.

The results, together with the updates of the ONS Research Agenda, can guide ONS and ONS Foundation research and evidence-based practice initiatives.

In 2015, 232,670 women will be diagnosed with breast cancer and most will undergo surgery. Postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV) continue to be common and disturbing complications experienced after surgery, particularly in women and especially in women undergoing breast cancer surgery. The purpose of this study was to assess the incidence and risk factors associated with PONV and PDNV from pre-operative through 48 hours postoperatively in 97 women scheduled for breast cancer surgery. Twenty-nine (29.8%) women experienced nausea and nine (9%) experienced nausea and vomiting while in the PACU despite close attention to the need for prophylactic antiemetic medications. Women who experienced PONV had higher levels of pain and received more opioids than those women who did not experienced PONV. Women who received IV acetaminophen did not experience less PONV in this study. PDNV occurred more frequently than PONV, with 34 women (35%) reporting occurrence after discharge. 13 women who did not experience PONV while in the PACU subsequently experienced PDNV after leaving the hospital, evidence for the importance of patient discharge teaching regarding these symptoms. While clinical guidelines are necessary, our observation is that nurses in the PACU setting continuously challenge themselves to individualize the combination of medications and activities for each patient to reduce PONV following surgery.

he Oncology Nursing Society (ONS) promotes excellence in oncology nursing and quality cancer care. In keeping with this mission, since 2001, ONS has developed and disseminated a Research Agenda identifying priority areas where new knowledge is urgently needed. The purpose of the Research Agenda is two-fold: it includes both the development and dissemination of contemporary research priorities needed to advance cancer care and delineates critical areas to be considered by research funders.A multimethod approach was used to develop the Research Agenda. ONS identified content experts to serve on the project team. This team was broken into smaller work groups to address various tasks that needed to be accomplished to update the Research Agenda. The first work group was convened to review the previous process used to formulate the prior ONS Research Agenda and discuss the best way to update the process in a scientifically rigorous yet time-and resource-efficient manner (Knobf et al., 2015). The previous process spanned multiple years and involved surveying ONS members, publishing survey results, and then convening an expert panel to update the Research Agenda based on survey responses. Given the low response rates (11%) and the lack of a clear set of focused research priorities that emerged from analysis of the survey results, an alternative approach was discussed to actively engage ONS members with expertise in research together with other key stakeholders to yield a focused set of research priorities (LoBiondo-Wood et al., 2014).A condensed process was recommended by the work group to identify a focused set of contemporary

Background Postoperative nausea and vomiting (PONV) are two of the most frequent and distressing complications following surgical procedures, with as many as 80% of patients considered to be at risk. Despite recognition of well-established risk factors and the subsequent use of clinical guidelines, 20–30% of women do not respond to antiemetic protocols, indicating that there may be a genetic risk. Objective The purpose of this pilot study was to describe the incidence and explore the risk factors associated with PONV after surgery in women diagnosed with early stage breast cancer. Methods A prospective cohort design was employed to measure PONV in women recruited prior to surgery. DNA was extracted from saliva samples collected prior to discharge. Polymorphisms for seven candidate genes with a known role in one of the neural pathways associated with PONV were included in this study; serotonin receptor (HTR3A), serotonin transport (SLC6A4), tryptophan (TPH), dopamine receptors (DRD2/ANKK and DRD3), catechol-O-methyltransferase (COMT) and histamine (H1). Results Twenty-nine (29.8%) women experienced nausea and 10 (11%) experienced nausea and vomiting while in the PACU despite administration of multiple antiemetic medications. Women who experienced PONV had higher levels of pain and received more opioids than those women who did not experienced PONV. Odds ratios demonstrated that alleles for the COMT, DRD3, and TPH genes were associated with decreased PONV. Conclusion The understanding of the multifactorial nature of PONV and the recognition of genetic risk will ultimately lead to the development of personalized interventions to manage these frequent and often debilitating symptoms.