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The number of students with special healthcare needs (SHCN) and severe disabilities in public schools in the United States has steadily increased in recent years, largely due to the changing landscape of public health relative to advances in medicine and medical technology. The specialized care required for these students often necessitates complex coordination amonga large number of medical and educational service providers. While collaboration is critical in promoting appropriate academic progress for these students, school nurse reductions coupled with minimal teacher training in healthcare procedures leads to role confusion as school personnel attempt to meet the increasing demands of students with SHCN. Thus, this study examined the collaboration between the two most critical members of the team: the school nurse and the special education teacher. A 45-item survey on this collaborative partnership was completed by 76 school nurses working in public school settings. Results were consistent with existing literature, suggesting there are noteworthy aspects of the partnership between school nurses and special education teachers that are described as positive by school nurses; however, there are also many barriers that persist, resulting in fractured care for students with severe disabilities and SHCN. Recommendations for future collaboration and research are provided. C 2015 Wiley Periodicals, Inc.

Open-ended questions are a common component in surveys and questionnaires that are used in the social sciences. Such items can provide researchers with insights into respondents' attitudes and opinions that cannot be easily gleaned from closed-response items based on a traditional Likert-type response format. However, the use of openended items can also be associated with a set of analytic problems, particularly in terms of identifying coherent themes that are supported by the data. Topic models present the researcher with a statistically based tool for identifying underlying topics within text, based on how words group together, much in the way that factor analysis uses correlations among observed variables to identify potential latent variables. The current study demonstrates the use of topic models with open-ended response items in order to illustrate how the resulting topics can both provide insights into respondents' attitudes and create variables that can be used in data analyses with closed-ended item responses. A full illustration of topic modeling in this context is given and discussion of the utility of these models is provided. What is the significance of this article for the general public?This study focused on the use of topic modeling to gain insights into open-ended survey responses. The article reports the results of these analyses, highlighting the utility of topic modeling for identifying themes underlying free-form responses provided by respondents to survey items. These topics can yield insights into respondents' thoughts and also provide researchers with additional variables (in the form of topics) that can be used in other statistical analyses.

Objective: The purpose of this pilot study was to understand nursing students' perception of the relationship between sleep deprivation and learning, and personal and patient safety when in a clinical or work setting. Methods: Design: The researchers used a cross-sectional correlational design. Setting: The study was conducted in a Midwestern state university school of nursing with an average of 400 undergraduate pre-licensure nursing students. Sample: All 328 undergraduate pre-licensure nursing students were invited to participate in the study. The convenience sample of 179 (response rate of 55%) pre-licensure, nursing students completed the study. Methodology: The Sleep Deprivation of Nursing Students, a 4-point Likert scale questionnaire, consisted of demographic questions and forty-five questions on personal sleep habits, caffeine/stimulant use, and sleep inducing aids, motor vehicle safety, spare time activities, and safety during work and clinical experiences. Results: One hundred and fifty-five (n = 155) students needed seven or more hours of sleep daily to feel rested, but received less than 5 hours/day. All participants reported (n = 179) feeling sleep deprived. Sleep inducing aids were used by (n = 56) participants, and (n = 35) took stimulants to stay awake. Students (n = 166) worked 8 or more hours at a job, and (n = 158) had at some 12 hour school clinical rotations, and (n = 64) reported a combined clinical and work of five to greater than 12 consecutive days. Students (n = 172) believed they provided safe practice at work and (n = 174) and safe practice in a clinical setting. Some students reported being awake 17-19 hours. The majority of students (n = 144) believed 12-hour-clinicals were too long, yet more than half of the students preferred 12-hour work and clinical experiences. Conclusions: Nursing students may lack the knowledge that chronic sleep deprivation may result in personal and patient safety issues when in a clinical or work setting. Students are potentially exposing themselves to acute and chronic health problems as a result of sleep deprivation and the use of substances to remain awake or obtain sleep. Nurse educators and nurse managers must collaborate to reduce the number of consecutive clinical and work shifts, limit overtime hours, and better educate students on the negative impact of sleep deprivation.

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