bluuebunny/crossref_metadata_2025 huggingface dataset:
Arthroscopic Lysis of Adhesions for Stiff Total Knee Arthroplasty
Authors: Schwarzkopf Ran , William Arsani , Deering Rachel M. , Fitz Wolfgang
Published: February 2014

The goal of this study was to evaluate the efficacy of arthroscopic lysis of adhesions after total knee arthroplasty (TKA) in improving range of motion (ROM) and providing an improvement in knee function. The authors retrospectively examined 19 patients who underwent arthroscopic lysis of adhesions following TKA due to poor ROM. The criterion for lysis was the inability to flex to 90° at 3 months. All patients were followed for at least 2 years after lysis. Patient demographics, postoperative and follow-up ROM, number of prior surgeries, Knee Society Scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) functional scores were collected. Average ROM increased from 75.37° preoperatively to 98.95° postoperatively. The authors found an association between preoperative knee score and change in ROM between pre-arthroscopic lysis and ROM at final follow-up (
P
=.0188). When the authors examined the relationship between patient body mass index (BMI) and change in ROM, they found that patients with a BMI higher than 30 kg/m
2
had a change of 26.44° compared with patients with a BMI lower than 30 kg/m
2
, who had a change of only 8.75°. A strong association was found between patient height and change in ROM and final ROM achieved (
P
=.0062 and .0032, respectively). The authors report a successful outcome among study patients. Furthermore, they found an association between patient height, BMI, and preoperative knee score and the improvement achieved after arthroscopic lysis of adhesions following TKA. The currrent study’s results are comparable with those of published results. The authors recommend arthroscopic lysis of adhesions as a treatment option for stiff knees after TKA that fails after at least 3 months of nonoperative treatment.
Posttraumatic Arthritis From Gunshot Injuries to the Hip Requiring a Primary THA
Authors: Naziri Qais , Issa Kimona , Rizkala Amir , Rasquinha Vijay J. , Pivec Robert , Harwin Steven F. , Mont Michael A.
Published: February 2014

Gunshot injuries to the hip can be devastating, leading to posttraumatic arthritis and presenting a surgical challenge at the time of total hip arthroplasty (THA) due to the presence of metallic fragments and damaged soft tissues. However, there are few reports of gunshot-related posttraumatic arthritis. The purpose of this study was to describe the features and report the early outcomes of THA in 4 patients who developed posttraumatic arthritis from gunshot injuries to their hips 2, 10, 18, and 26 years after their initial injury, respectively. All 4 patients underwent successful THA without complications. None of the patients had undergone a revision procedure at a mean 26-month (range, 12–48 months) follow-up. The authors believe that primary THA is a safe and effective procedure to reduce pain and improve function for gunshot-related posttraumatic arthritis in patients in whom nonoperative management failed.
Drain Technique in Elective Total Joint Arthroplasty
Authors: Jaafar Sami , Vigdorchik Jonathan , Markel David C.
Published: February 2014

The authors report a simple technique for effective management of surgical drains and their reliable removal in elective hip and knee arthroplasty. Many surgeons use surgical drains for elective total hip and knee arthroplasties and instruct residents in their use despite limited evidence to support routine use of surgical drains in noninfected cases. There are many different types of drains and equally varied methods for implantation, monitoring, and removal. Technical issues regarding use of closed suction surgical drainage postoperatively deal primarily with the questions of when to remove the surgical drain and how to manage difficulties with drain removal or breakage. [
Orthopedics.
2014; 37(1):37–39.]
Self-designed Femoral Neck Guide Pin Locator for Femoral Neck Fractures
Authors: Xia Shengli , Wang Ziping , Wang Minghui , Wu Zuming , Wang Xiuhui
Published: February 2014

Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (
P
<.05). Anteroposterior and lateral radiographs showed that the screws were more parallel in the self-designed positioning group and general positioning group compared with the freehand positioning group (
P
<.05). The screw reset rate in the self-designed positioning group was significantly lower than that in the general positioning group and the freehand positioning group (
P
<.05). Maximum bearing load among the 3 groups was equivalent, showing no statistically significant difference (
P
>.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.
Computer Navigation and Total Knee Arthroplasty
Authors: Shi Jingsheng , Wei Yibing , Wang Siqun , Chen Feiyan , Wu Jianguo , Huang Gangyong , Chen Jie , Wei Licheng , Xia Jun
Published: February 2014

Research has added evidence in favor of computer-navigated techniques over conventional surgery for total knee arthroplasty (TKA). The goal of the current meta-analysis was to compare the outcome of outliers in mechanical axis and postoperative complications in patients undergoing conventional vs computer-navigated techniques for TKA. English literature searches were performed in PubMed, EMBASE, Web of Science, and the Cochrane Library for studies published between January 2002 and August 2012. Randomized, controlled trials comparing computer navigation with conventional surgery for the measurement of mechanical axes in patients with primary osteoarthritis were considered eligible. Fifteen trials were eligible for inclusion. The baseline demographics of 2089 patients (computer-navigated=1111; conventional=978) were well matched. Publication bias was eliminated using the funnel plot. A mechanical axis of more than 30° was considered to be malalignment and an outlier in limb alignment. A significant increase of 16.9 minutes in mean operative time for computer-navigated TKA was observed (
P
=.046). Although patients undergoing computer-navigated TKA had fewer outliers in mechanical axis (13.4%) compared with the conventional technique (27.4%), the results did not achieve statistical significance (I
2
=0.0%;
P
=1.000). Fewer complications were observed in patients undergoing computer-navigated TKA (4%) compared with conventional TKA (6.5%).

The use of computer-navigated TKA reduced the number of outliers in mechanical axis compared with conventional TKA; however, it did not achieve statistical significance. Additional research with longer follow-up is recommended.
Allograft Cortical Strut for Reconstruction of Space-occupying Bone Lesions
Authors: Tank Jason C. , Vignos Michael F. , Wetzel Robert J. , Weiner Scott D.
Published: February 2014

Space-occupying bone lesions present orthopedic surgeons with clinical and operative challenges. Multiple reconstructive procedures have proven successful for small bone lesions but lack the structural support necessary for reconstruction of larger lesions. This study reports the clinical outcomes of patients undergoing excision and reconstruction of large bone lesions with allograft cortical struts without additional internal fixation.

This retrospective outcomes study reviewed patients who underwent surgical curettage and cortical strut allograft reconstruction of any space-occupying bone lesion. Clinical, surgical, and imaging data were collected. The primary outcome measures were lesion healing, graft incorporation, long-term pain, return to activity, and presence of complications/recurrences.

Seventeen patients met the inclusion criteria. At least partial lesion healing and allograft incorporation was identified in 15 of 17 lesions. Of the 15 patients who did not sustain a recurrence, only 1 did not return to full activities. Mean lesion volume was 107 cc. Average follow-up was 19.6 months. Two recurrences were identified, and no other major complications were identified.
Small Bone Islands: Unusual Clinical Symptomatology
Authors: Diab Michel Gerges , Glard Yann , Launay Franck , Jouve Jean-Luc , Bollini Gérard , Cottalorda Jérôme
Published: February 2014

Bone islands are usually considered benign, stable, nonprogressive lesions, radiographically characterized by an ovoid, round, or oblong homogeneously dense and sclerotic focus in the spongiosa, with a preference for the long bones and the pelvis. Benign solitary bone islands are usually believed to be asymptomatic, with no necessity for treatment. Symptomatic bone islands reported in the literature are characterized by a diameter greater than 2 cm, belonging to the category of giant bone islands.

The authors report a rare case starting from a painful symptomatology and involving dense sclerotic bone lesions of less than 2 cm, thus falling into the category of small bone islands. The patient underwent a surgical resection to achieve complete recovery. Normally, small bone islands do not explain the pain in patients who present with symptomatology when they are detected during radiographic studies. Based on this case, the authors believe that even small bone islands can be the cause of symptomatology and justify a surgical procedure if all medical investigations suggest no other possible causes of the pain.
Avulsive Axillary Artery Injury in Reverse Total Shoulder Arthroplasty
Authors: Wingert Nathaniel C. , Beck John D. , Harter G. Dean
Published: February 2014

In addition to neurologic injuries such as peripheral nerve palsy, axillary vessel injury should be recognized as a possible complication of reverse total shoulder arthroplasty. Limb lengthening associated with Grammont-type reverse total shoulder arthroplasty places tension across the brachial plexus and axillary vessels and may contribute to observed injuries. The Grammont-type reverse total shoulder arthroplasty prosthesis reverses the shoulder ball and socket, shifts the shoulder center of rotation distal and medial, and lengthens the arm. This alteration of native anatomy converts shearing to compressive glenohumeral joint forces while augmenting and tensioning the deltoid lever arm. Joint stability is enhanced; shoulder elevation is enabled in the rotator cuff–deficient shoulder. Arm lengthening associated with reverse total shoulder arthroplasty places a longitudinal strain on the brachial plexus and axillary vessels. Peripheral nerve palsies and other neurologic complications of reverse total shoulder arthroplasty have been documented.

The authors describe a patient with rotator cuff tear arthropathy and a history of radioulnar synostosis who underwent reverse total shoulder arthroplasty complicated by intra-operative injury to the axillary artery and postoperative radial, ulnar, and musculocutaneous nerve palsies. Following a seemingly unremarkable placement of reverse shoulder components, brisk arterial bleeding was encountered while approximating the incised subscapularis tendon in preparation for wound closure. Further exploration revealed an avulsive-type injury of the axillary artery. After an unsuccessful attempt at primary repair, a synthetic arterial bypass graft was placed. Reperfusion of the right upper extremity was achieved and has been maintained to date. Postoperative clinical examination and electromyographic studies confirmed ongoing radial, ulnar, and musculocutaneous neuropathies.
Neuralgic Amyotrophy (Parsonage Turner Syndrome)
Authors: Gupta Amit , Winalski Carl S. , Sundaram Murali
Published: February 2014

A 41-year-old man presented with moderate right shoulder pain on abduction. He had a history of sudden-onset right shoulder pain (10/10 in intensity) at rest and profound weakness on right shoulder abduction 1.5 years earlier. The pain and weakness remained at the same level for approximately 2 weeks and then gradually improved. At presentation, the patient had pain rated 7/10 in intensity and muscle strength rated 4 out of 5 (5=normal) on right arm abduction, but no pain at rest. Significant atrophy of the deltoid muscle and mild atrophy of the right pectoral muscle were noted, in addition to numbness along the lateral aspect of the right shoulder.
Limb-length Discrepancy After Total Hip Arthroplasty: Novel Treatment and Proposed Algorithm for Care
Authors: Thakral Rishi , Johnson Aaron J. , Specht Stacy C. , Conway Janet D. , Issa Kimona , Mont Michael A. , Herzenberg John E.
Published: February 2014

Limb-length discrepancy after total hip arthroplasty (THA) leads to patient dissatisfaction and can be a cause of orthopedic surgery malpractice cases. Nonsurgical and surgical techniques exist to correct limb-length discrepancies. Two limb-lengthening methods were used to correct greater than 2-cm limb-length discrepancies after THA: lengthening over a femoral nail with an external fixator and lengthening with an intramedullary kinetic skeletal distractor. These techniques achieved equal length in less than 4 weeks, with both resulting in a healed distraction gap within 4 months. No patient had loss of proximal or distal joint motion, and mean Harris Hip Score was 90 points at final follow-up. No surgical complications were reported with the intramedullary skeletal kinetic distractor. Limb lengthening using an intramedullary skeletal kinetic distractor is a viable treatment option resulting in reliable lengthening, healing of the distraction gap, and progression to full weight bearing. [
Orthopedics.
2014; 37(2):101–106.]
Ensuring Correct Placement of Proximal Fixation in Reconstruction Intramedullary Nailing for Subtrochanteric Femur Fractures
Authors: Waryasz Gregory R. , Bariteau Jason T. , Born Christopher T.
Published: February 2014

Subtrochanteric femur fractures present a challenge to orthopedic surgeons. Anatomic reduction and stabilization can be technically difficult. A variety of intramedullary and extramedullary devices have been used to stabilize these fractures. The authors describe a novel technique for easier proximal interlock fixation for reconstruction intramedullary nailing to ensure proper placement into the nail. This will likely save time in a patient population that may be either frail and elderly or young with high-energy polytrauma, and it may reduce radiation exposure for both patients and surgeons. [
Orthopedics.
2014; 37(2):107–110.]
Return to Sport After ACL Reconstruction
Authors: Harris Joshua D. , Abrams Geoffrey D. , Bach Bernard R. , Williams Donna , Heidloff Dave , Bush-Joseph Charles A. , Verma Nikhil N. , Forsythe Brian , Cole Brian J.
Published: February 2014

Objective guidelines permitting safe return to sport following anterior cruciate ligament (ACL) reconstruction are infrequently used. The purpose of this study was to determine the published return to sport guidelines following ACL reconstruction in Level I randomized controlled trials. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Level I randomized controlled trials were included if they reported a minimum 2-year follow-up after ACL reconstruction and return to sport criteria. Outcomes analyzed were the timing of initiation of return to sport, follow-up duration, and use of quantitative/qualitative criteria to determine return to sport. Forty-nine studies were included (N=4178; 68% male; mean patient age, 27.5±3.2 years; mean follow-up, 3.0±1.9 years; mean time from injury to reconstruction, 379±321 days). Ninety-six percent of reconstructions used autograft and 87% were single-bundle reconstructions. Lysholm score, single-leg hop, isokinetic strength, and KT-1000 or KT-2000 arthrometer (MEDmetric, San Diego, California) testing were performed in 67%, 31%, 31%, and 82% of studies, respectively. Only 5 studies reported whether patients were able to successfully return to sport. Ninety percent and 65% of studies failed to use objective criteria or any criteria, respectively, to permit return to sport. Description of permission/allowance to return to sport was highly variable and poor. Twenty-four percent of studies failed to report when patients were allowed return to sport without restrictions. Overall, 39%, 45%, and 51% of studies permitted running at 3 months, return to cutting/pivoting sports at 6 months, and return to sport without restrictions at 6 months, respectively. Further research into validated return to sport guidelines is necessary to fill the existing void in contemporary literature and to guide clinical practice.
Osteoinductive Activity of ErhBMP-2 After Anterior Cervical Diskectomy and Fusion With a ß-TCP Interbody Cage in a Goat Model
Authors: Wang Hongli , Zhang Fan , Lv Feizhou , Jiang Jianyuan , Liu Dayong , Xia Xinlei
Published: February 2014

Bone morphogenetic protein (BMP)-2 induces bone and cartilage tissue formation. Large amounts of BMP-2 are difficult to purify or to produce in vitro using eukaryotic cells. The goal of the present study was to assess the clinical use of
Escherichia coli
–derived recombinant human BMP-2 (ErhBMP-2) on bone fusion after cervical and lumbar spine surgery in a goat model, compared with the standard autogenous iliac bone grafting. Thirty-six goats were randomized to 3 groups: (A) autogenous iliac bone grafting, (B) cervical interbody fusion cage containing ß-tricalcium phosphate (ß-TCP), or (C) cervical interbody fusion cage containing ß-TCP+ErhBMP-2 (2.5 mg). Cervical bone repair was evaluated using radiographs and computed tomography scans at 0, 3, and 6 months. Histological analyses were performed on cervical samples. Two goats died from infection. The differences in intervertebral height among the groups were not significant 3 months postoperatively but became significant after 6 months between groups A vs B and C (
P
=.04); there was no difference between groups B and C at 6 months. Adding ErhBMP-2 significantly increased cervical fusion at 6 months (
P
=.04). Histological examinations showed that ß-TCP+ErhBMP-2 increased new bone area, material degradation rate, and depth of tissue penetration and decreased residual material area, all in a time-dependent manner.
Escherichia coli
–derived rhBMP-2 combined with an enhanced fusion cage containing ß-TCP induced bone formation in a goat model. Furthermore, its ability to promote bone fusion was similar to autogenous iliac bone grafting.
Assessment of Mortality Risk in Elderly Patients After Proximal Femoral Fracture
Authors: Meessen Jennifer M.T.A. , Pisani Salvatore , Gambino Maria L. , Bonarrigo Domenico , van Schoor Natasja M. , Fozzato Stefania , Cherubino Paolo , Surace Michele F.
Published: February 2014

Mortality after hip fracture is a major problem in the Western world, but its mechanisms remain uncertain. This study assessed the 2-year mortality rate after hip fracture in elderly patients by including hospital factors (eg, intervention type, surgical delay), underlying health conditions, and, for a subset, lifestyle factors (eg, body mass index, smoking, alcohol). A total of 828 patients (183 men) 70 to 99 years old experiencing a hip fracture in 2009 in the province of Varese were included in the study. The risk factors for death were assessed through Kaplan-Meier analysis and Cox proportional hazards analysis. Hip fracture incidence per 1000 persons was higher in women (8.4 vs 3.7 in men) and in elderly patients (12.4 for 85–99 years vs 4.4 for 70–84 years). The mortality rate after 1, 6, 12, and 24 months was 4.7%, 16%, 20.7%, and 30.4%, respectively. For the province of Varese, sex (hazard ratio, 0.39 for women), age group (hazard ratio, 2.2 for 85–99 years), and Charlson Comorbidity Index score (hazard ratio, 2.06 for score greater than 1) were found to be statistically significant. The 2-year mortality rate in hip fractures is associated with sex, age, and comorbidities. Male sex, age older than 85 years, and Charlson Comorbidity Index score greater than 1 are associated with a higher risk. Surgical delay was significant in the Kaplan-Meier survival time analysis but not in the Cox hazard analysis, suggesting that early surgery reduces risk in patients with numerous comorbidities.
Treatment of Humeral Shaft Aseptic Nonunions in Elderly Patients With Opposite Structural Allograft, BMP-7, and Mesenchymal Stem Cells
Authors: Murena Luigi , Canton Gianluca , Vulcano Ettore , Surace Michele Francesco , Cherubino Paolo
Published: February 2014

Humeral shaft aseptic nonunions occur in 2% to 10% of patients managed conservatively and 10% to 15% of patients treated surgically. The complex muscular and neurovascular anatomy of the upper limb makes the surgical approach to the fracture site demanding and risky, especially when previous surgeries have been attempted. The clinical consequence of atrophic humeral shaft nonunions is a severe functional limitation that may significantly affect activities of daily living, especially in the elderly. The surgical treatment of humeral shaft nonunions is challenging for orthopedic surgeons. Patients with atrophic nonunions require both a stable fixation and enhancement of the biologic response because of the weak biologic reaction observed at the fracture site. The gold standard of treatment in elderly patients has not been described. Nonetheless, older age and comorbidities are associated with potentially malignant nonunions. This study reports the authors’ experience using opposite cortical allograft combined with bone morphogenetic protein 7 and mesenchymal stem cells to treat humeral shaft atrophic nonunions in 2 elderly patients. The nonunion site healed at 4 months (patient 1) and 8 months (patient 2) postoperatively, with full return to activities of daily living and no pain. Neither patient reported complications of the radial nerve, which is at high risk of injury during this type of surgery. The only reported complication (patient 2) was an intraoperative longitudinal partial distal humeral fracture, probably caused by compression screw overtightening. The use of a locking plate and opposite cortical allograft, combined with BMP-7 and mesenchymal stem cells, represents a safe and effective treatment for malignant nonunions in older patients.
Effectiveness of Classroom Response Systems Within an Active Learning Environment
Authors: Welch Susan
Published: February 2014

In nursing education, the inclusion of pedagogical tools is necessary to transform Millennial classrooms. One such pedagogical tool currently offered is classroom response systems (CRS). The purpose of this study was to evaluate the effectiveness of CRS as a pedagogical tool in improving nursing students' examination performance within an active learning environment. A pretest–posttest design was used to determine whether there was a relationship between the use of CRS (independent variable) and nursing students' examination performance in a first-year Professional Practice course (dependent variable). Paired
t
tests revealed no greater improvement in posttest scores. Therefore, the use of CRS technology was not effective in increasing nursing students' examination scores in the Professional Practice course. Additional research is needed to provide adequate understanding of the effectiveness of CRS within the nursing education classroom. [
J Nurs Educ.
2013;52(11):653–656.]
Principles and Practices of Social Entrepreneurship for Nursing
Authors: Gilmartin Mattia J.
Published: February 2014

Although social justice and action for change are among the nursing profession's core values, curricular content on social entrepreneurship for nurses is not as well developed as it is in the educational programs for students in business, engineering, or public policy. This article describes an undergraduate honors elective course in social entrepreneurship offered at New York University College of Nursing. The course uses a seminar format and incorporates content from the humanities, business, and service–learning, with the goal of promoting participants' understanding of the sources of inequality in the United States and providing the requisite skills to promote effective nursing action for social change. [
J Nurs Educ.
2013;52(11):641–644.]
Service–Learning in Baccalaureate Nursing Education: A Literature Review
Authors: Murray Billie S.
Published: February 2014

Service–learning is an educational pedagogy that provides students with an opportunity to apply classroom learning to real-world situations, while meeting a specific community need. The purpose of this literature review is to identify what type of baccalaureate nursing courses utilize service–learning, to determine the level at which baccalaureate nursing students are being engaged in service–learning, and to evaluate the efficacy of service–learning to meet curricular objectives. Suggestions are made for instructors who are considering integrating service–learning into their curriculum. [
J Nurs Educ.
2013;52(11)621–626.]
Perceived Benefits of Study Abroad Programs for Nursing Students: An Integrative Review
Authors: Kelleher Seán
Published: February 2014

Study abroad programs that offer health care experiences in another country have become an important method in nursing education to increase students' understanding of cultural competence and intercultural sensitivity and to present them with new ideas and opportunities for personal and career development. Despite the many alleged positive attributes associated with such programs, a gap exists in the overall understanding of the benefits obtained by undergraduate nursing students who study abroad. Using Cooper's framework, 13 studies that explored the benefits of study abroad programs for undergraduate nursing students were reviewed. Findings suggest that participation in a study abroad experience is associated with many benefits for nursing students, including various forms of personal and professional growth, cultural sensitivity and competence, and cognitive development. Although research outcomes are encouraging, the nursing literature regarding this topic is limited, and more rigorous research studies are needed to support this educational practice. [
J Nurs Educ.
2013;52(12):690–695.]
Implementation of the Court Visitor Program in a Clinical Nursing Curriculum
Authors: Stowell Jane M. , Pihlak Mary Rose , Matzke Amanda , O'Keefe Mary
Published: February 2014

The State of Texas has more than 19,000 individuals who lack the physical or mental ability to provide for their need for shelter, financial management, or physical care. These individuals have been designated as wards of the court and placed under guardianship. Texas probate courts appoint individuals known as court visitors to make annual visits to wards of the court to assess their well-being under guardianship. Although the 10 statutory probate courts have court visitor programs, many county courts do not. This article describes the details of a service–learning experience using an online distance educational program to train undergraduate nursing students in a mental health course to become court visitors. This information may be useful to others looking for nontraditional clinical experiences and service–learning opportunities for undergraduate nursing students. [J Nurs Educ.2013;52(12):709–712.]
Use of the 5E Learning Cycle Model Combined With Problem-Based Learning for a Fundamentals of Nursing Course
Authors: Jun Won Hee , Lee Eun Ju , Park Han Jong , Chang Ae Kyung , Kim Mi Ja
Published: February 2014

The 5E learning cycle model has shown a positive effect on student learning in science education, particularly in courses with theory and practice components. Combining problem-based learning (PBL) with the 5E learning cycle was suggested as a better option for students’ learning of theory and practice. The purpose of this study was to compare the effects of the traditional learning method with the 5E learning cycle model with PBL. The control group (
n
= 78) was subjected to a learning method that consisted of lecture and practice. The experimental group (
n
= 83) learned by using the 5E learning cycle model with PBL. The results showed that the experimental group had significantly improved self-efficacy, critical thinking, learning attitude, and learning satisfaction. Such an approach could be used in other countries to enhance students’ learning of fundamental nursing. [
J Nurs Educ.
2013;52(12):681–689.]
What Do Nursing Students Learn About Patient Safety? An Integrative Literature Review
Authors: Tella Susanna , Liukka Mari , Jamookeeah David , Smith Nancy-Jane , Partanen Pirjo , Turunen Hannele
Published: February 2014

Preventing adverse events and enhancing patient safety in health care are key objectives of nursing education. This integrative literature review critically appraises the content of patient safety in prelicensure nursing education, the teaching and learning methods used, and subsequent nursing student learning. The studies (
N
= 20) reviewed reveal that patient safety in nursing curricula was not necessarily obvious. However, patient safety was taught within both academic settings and clinical environments. The identified content of patient safety was learning from errors, responsible individual and interprofessional team working, anticipatory action in complex environments, and patient safety–centered nursing. The teaching and learning methods used included combining multiple methods. Patient safety curricula included continuing improvement in patient safety competency, sensitivity to nursing students’ role, and having a supportive learning environment. Patient safety in the nursing curriculum requires broad, comprehensive attention and development as a specific theme with an interprofessional approach. [
J Nurs Educ
. 2014;53(1):7–13.]
Teaching Undergraduate Nursing Students About Environmental Health: Addressing Public Health Issues Through Simulation
Authors: Stanley Mary Jo , Rojas Deb
Published: February 2014

Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study’s simulation scenario was created to enhance nursing students’ understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client’s and family’s health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice. [
J Nurs Educ
. 2014;53(1):48–51.]
Insight Into Error Hiding: Exploration of Nursing Students’ Achievement Goal Orientations
Authors: Dunn Karee E.
Published: February 2014

An estimated 50% of medication errors go unreported, and error hiding is costly to hospitals and patients. This study explored one issue that may facilitate error hiding. Descriptive statistics were used to examine nursing students’ achievement goal orientations in a high-fidelity simulation course. Results indicated that although this sample of nursing students held high mastery goal orientations, they also held moderate levels of performance-approach and performance-avoidance goal orientations. These goal orientations indicate that this sample is at high risk for error hiding, which places the benefits that are typically gleaned from a strong mastery orientation at risk. Understanding variables, such as goal orientation, that can be addressed in nursing education to reduce error hiding is an area of research that needs to be further explored. This article discusses the study results and evidence-based instructional practices for this sample’s achievement goal orientation profile. [
J Nurs Educ
. 2014;53(2):93–96.]
Academic Dishonesty Among Nursing Students
Authors: Krueger Linda
Published: February 2014

This quantitative study identified sociodemographic and situational conditions that affected 336 nursing students’ engagement in academic dishonesty, their attitudes regarding various forms of academic dishonesty, and the prevalence of academic dishonesty in which they engaged and witnessed. More than half of the participants reported cheating in the classroom and in the clinical settings. A positive relationship was found between the frequency of cheating in classroom and clinical settings. Results revealed differences in frequency of engagement in and attitudes toward academic dishonesty by gender, semester in the program, and ethnicity. Relationships were also found among peer behavior, personal beliefs and values, and frequency of engaging in academic dishonesty. [
J Nurs Educ.
2014;53(2):77–87.]
Using Simulations to Identify Nursing Student Behaviors: A Longitudinal Study of Medication Administration
Authors: Schneidereith Tonya A.
Published: February 2014

The Centers for Disease Control and Prevention recognizes adverse drug events as a serious public health problem. Nurses routinely administer patient medications and must be safe when delivering care. Typically, students are taught the traditional rights method (RM) of safe medication administration in the skills laboratory and through the use of high-fidelity simulation scenarios. The RM includes measures of ensuring the right patient, right medication, right dose, right time, and right route. This pilot study demonstrates changes in verification of the rights among junior and senior nursing students in four simulation scenarios over the course of one academic year. The findings suggest that students become more neglectful in verification of the rights prior to medication administration as they progress through the curriculum. This study should help educators identify significant focus areas for clinical supervisors, including the importance of increased verification of the rights of safe medication administration in the clinical setting. [
J Nurs Educ
. 2014;53(2):89–92.]
Nursing Student Medication Errors: A Snapshot View From a School of Nursing’s Quality and Safety Officer
Authors: Cooper Elizabeth
Published: February 2014

Medication errors are one of the most common types of errors in the health care arena. For more than a decade, health care providers have been challenged to improve patient safety outcomes, including medication administration issues. Nurse educators are challenged to provide didactic content and clinical experiences that will ensure students gain the knowledge necessary to administer medications in a safe manner. The aim of this article is to discuss nursing student medication errors identified at a university school of nursing, looking to categorize the errors into three areas: administration rights, system issues, and knowledge and understanding. Introducing nursing students to a reporting system early in their educational process can lead to increased transparency in error reporting and increased patient safety. [
J Nurs Educ
. 2014;53(3, Suppl.):S51–S54.]
Baccalaureate Nursing Students’ Accounts of Medical Mistakes Occurring in the Clinical Setting: Implications for Curricula
Authors: Noland Carey M.
Published: February 2014

Since the Institute of Medicine’s landmark report on medical mistakes,
To Err Is Human
, was published, considerable attention has been given to training medical professionals about medical mistakes. However, little research has been conducted to explore the experiences of nursing students with mistakes made during their clinical rotations. If nurse educators are to teach nursing students how to deal with mistakes appropriately, it is necessary to have a more complete understanding of the types of mistakes nursing students make during their training, how and if they communicate about their mistakes, and students’ perceptions of how prepared they were to address the mistakes. Greater knowledge in this area will help nurse educators better prepare nursing students to intercept and report mistakes. This article presents research results from three components of a larger qualitative research study that explored the socialization processes of nursing students in regard to medical mistakes. [
J Nurs Educ
. 2014;53(3, Suppl.):S34–S37.]
Microethical Decision Making Among Baccalaureate Nursing Students: A Qualitative Investigation
Authors: Krautscheid Lorretta , Brown Molly
Published: February 2014

Nursing students frequently encounter microethical nursing practice problems during their clinical experience. The purpose of this study was to understand the lived experiences of senior-level baccalaureate students faced with making microethical clinical decisions in practice settings. A descriptive qualitative design was used, and five central themes emerged. A dominant finding was the experience of unapplied and forgotten ethics education revealing a mismatch between what faculty perceived was taught and students’ experiences of that education. When faced with microethical decisions, participants trusted and deferred to staff nurse recommendations, even if the advice contradicted best-practice standards. Contextual naivete was brought out of concealment, contributing to the experience of moral disequilibrium (i.e., students felt conflicted about what they learned in school as best practice and what they observed being role modeled in the clinical environment). This study resulted in theory-guided implications for nursing education and recommendations for future study. [
J Nurs Educ
. 2014;53(3, Suppl.):S19–S25.]
Use of Prebriefing in Nursing Simulation: A Literature Review
Authors: Page-Cutrara Karin
Published: February 2014

Simulation has gained much attention in the literature for its contributions to nursing education; however, the simulation process itself and how each of the components—prebriefing, scenario, and debriefing—are effective for learning are understudied. Specifically, how prebriefing may enrich simulation for learners without adequate prior clinical experience or how it may develop complex thinking skills and clinical judgment is not well understood. This article comprehensively reviews the available nursing simulation literature about the phenomenon of prebriefing and critically evaluates its current role as a component of nursing simulation. Gaps in the reviewed literature regarding the definition and purpose of prebriefing, alternate learning structures used in prebriefing, and use in relation to learner outcomes were identified. Implications for undergraduate nursing education and recommendations for further research are discussed. [J Nurs Educ.2014;53(3):136–141.]
An Interprofessional Approach to Undergraduate Critical Care Education
Authors: Hinderer Katherine A. , Joyner Robert L.
Published: February 2014

Published research suggests that the best outcomes in critical care clinical practice require an interprofessional (IP) collaborative approach to patient care. The Institute of Medicine has called for increased IP education. This article describes the development of an elective undergraduate IP critical care course. The course was developed to educate nursing and respiratory care students on the importance of IP practice, current evidence, and essentials of critical care. Several challenges were met in the development and implementation of the course. Various IP teaching strategies were used, including simulation, clinical observations, and student patient case presentations. An IP course provides a unique learning environment in which fundamental principles of critical care clinical practice and IP practice can be learned in an IP educational environment. There is a critical need to increase IP education and to conduct research related to IP education and its outcomes in preprofessional educational programs. [
J Nurs Educ
. 2014;53(3, Suppl.):S46–S50.]
Social Media in Nursing Education: Responsible Integration for Meaningful Use
Authors: Peck Jessica L.
Published: February 2014

The astonishing popularity of social media and its emergence into the academic arena has shown tremendous potential for innovations in teaching. The appeal of using social media in the learning environment is enhanced by accessibility and affordability. However, it has also broadened the scope of consideration for protecting student privacy. This article explores the legal impact of privacy concerns when social media is used as a teaching tool. Institutions of higher learning must formulate guidelines that will govern appropriate social media use so that novel teaching modalities can be safely explored. Students must be educated by faculty regarding the standards of conduct and privacy considerations related to social media. The National Council of State Boards of Nursing has issued the
White Paper: A Nurse’s Guide to the Use of Social Media
, a must-read for nursing faculty in the current academic arena. [
J Nurs Educ.
2014;53(3):164–169.]
Calcified Scleral Choristoma in Organoid Nevus Syndrome Simulating Retinoblastoma
Authors: Shields Charlotte Nelle , Shields Carol L. , Lin Chris J. , Menacker Sheryl J. , Shields Jerry A.
Published: February 2014

A child referred for management of retinoblastoma who alternatively had a calcified scleral choristoma as part of previously undiagnosed organoid nevus syndrome is described. A 31-month-old male infant with scalp alopecia was referred for retinoblastoma management after a calcified mass in his left eye was found. Ophthalmic examination revealed the mass was of choroidal or scleral origin, underlying the retina. The amelanotic circumpapillary mass extended superonasally in a geographic configuration and measured 14 × 12 mm. There was no subretinal fluid, hemorrhage, feeder vessels, or tumor seeding. Ocular ultrasonography confirmed a homogeneous calcified intraocular mass 3.1 mm in thickness. Enhanced depth imaging optical coherence tomography revealed that the lesion was located within the sclera compressing the overlying choroidal tissue. Further evaluation disclosed cutaneous aplasia cutis congenita with nevus sebaceous of Jadassohn. Magnetic resonance imaging disclosed an arachnoid cyst of the brain. Later, optical coherence tomography revealed the mass to be in the deep choroid or within the sclera. This constellation of ocular, cutaneous, and neurological features were suggestive of organoid nevus syndrome. At the 2-year follow-up, the findings were stable. The calcified choristoma of organoid nevus syndrome, located within the sclera in this case, has distinctive clinical features that differentiate this benign tumor from retinoblastoma.
[J Pediatr Ophthalmol Strabismus 2014;51:e1–e3.]
Visual Functions in Amblyopia as Determinants of Response to Treatment
Authors: Singh Vinita , Agrawal Siddharth
Published: February 2014

Purpose:

To describe the visual functions in amblyopia as determinants of response to treatment.

Methods:

Sixty-nine patients with unilateral and bilateral amblyopia (114 amblyopic eyes) 3 to 15 years old (mean age: 8.80 ± 2.9 years), 40 males (58%) and 29 females (42%), were included in this study. All patients were treated by conventional occlusion 6 hours per day for mild to moderate amblyopia (visual acuity 0.70 or better) and full-time for 4 weeks followed by 6 hours per day for severe amblyopia (visual acuity 0.8 or worse). During occlusion, near activities requiring hand–eye coordination were advised. The follow-up examination was done at 3 and 6 months. Improvement in visual acuity was evaluated on the logMAR chart and correlated with the visual functions. Statistical analysis was done using Wilcoxon rank sum test (Mann–Whitney
U
test) and Kruskal–Wallis analysis.

Results:

There was a statistically significant association of poor contrast sensitivity with the grade of amblyopia (
P
< .001). The grade of amblyopia (
P
< .01), accommodation (
P
< .01), stereopsis (
P
= .01), and mesopic visual acuity (
P
< .03) were found to have a correlation with response to amblyopia therapy.

Conclusions:

The grade of amblyopia (initial visual acuity) and accommodation are strong determinants of response to amblyopia therapy, whereas stereopsis and mesopic visual acuity have some value as determinants.

[J Pediatr Ophthalmol Strabismus 2013;50(6):348–354.]
Exotropia-Hypotropia Complex in High Myopia
Authors: Monga Sumit , Kekunnaya Ramesh , Sachdeva Virender
Published: February 2014

Purpose:

To highlight the association of exotropia-hypotropia complex in cases of high myopia and its surgical outcome.

Methods:

A retrospective study of 15 consecutive patients, diagnosed as having high myopia and exotropia-hypotropia, observed between January 2002 and May 2012 was performed. The main outcome measures were clinical presentation, orbital imaging features, and the surgical outcome of cases.

Results:

Of the 15 patients, 9 were female. The median age was 23.5 years (range: 10 to 35 years). Thirteen cases had unilateral high myopia in the deviated eye. The mean axial length of the deviated eye was 29.43 ± 1.51 mm. Eight patients (53%) had a history of progressive eye deviation in adulthood. All patients had amblyopia of the deviating eye. The mean preoperative exotropia was 37.2 ± 8.72 prism diopters (PD) (range: 18 to 50 PD). The mean preoperative hypotropia was 12.73 ± 5.58 PD (range: 5 to 20 PD). An elevation deficit was noted in 6 patients (40%). On orbital imaging, high myopic eyes with deviation did not show significant displacement of rectus muscles in comparison to fellow eyes (
P
> .05, all rectus muscles). Eight cases (53%) were surgically managed with a median follow-up of 7 months. Intraoperatively, one case was found to have misplaced muscle insertion. Successful alignment was achieved by surgery on either horizontal rectus muscles alone (37%), or in combination with vertical muscles (62%).

Conclusions:

Exotropia-hypotropia complex can occur in association with high myopia. No specific etiologic factors, clinical or radiological, were identified in this study. Successful alignment may be achieved in these cases using tailor-made strabismus procedures.

[J Pediatr Ophthalmol Strabismus 2013;50(6):340–346.]