No abstract

Background: Nurses in collaboration with fire rescuers, emergency medical technicians (EMTs), and doctors are often called to be first responders to worldwide disasters ranging from terrorist attacks to catastrophic weather events. The American Association of Colleges of Nursing has established the need for disaster-preparedness education in baccalaureate nursing programs. Limited research has been conducted about the impact of utilizing simulation as an educational tool to prepare nursing students for disaster response. This paper presents the results of a simulation of a mass casualty incident utilizing low-fidelity and static manikins, as well as actors to play the role of victims, family members and news personnel. Methods: One hundred and seven students from traditional and accelerated second-degree programs participated in a simulation in the roles of victims as well as providers. A quasi-experimental pre-and post-test design was used to assess students' selfperceptions. Results: Statistically significant improvement in self-perceived knowledge, attitudes and skills was seen. Students who participated as victims or providers reported similar improvements. Conclusions: Well-designed and concise mass casualty incident simulation is a valuable educational tool that can be easily incorporated into nursing curricula, with students undertaking the role of either a victim or a provider.

A descriptive study design was used to describe the decision of women having a cesarean surgery. The Cesarean Birth Decision Survey was used to collect data from 101 postpartum women who underwent a cesarean.Most of the surgeries were to primipara women who reported doctor recommendation and increased safety for the baby as the main reasons for the cesarean. Those women who had repeat cesarean surgery all cited their previous cesarean as the main reason for the current surgery. Women's knowledge of cesarean surgery needs to be assessed early in pregnancy so that appropriate education may be provided. Accurate and ongoing information may decrease the number of women choosing a cesarean surgery.

It is important for healthcare professionals to realize women experience similar physical and emotional difficulties irrespective of whether the cesarean was emergent or planned. The overarching themes of (a) in your hands and (b) scared to death reveal the importance of assessing the woman's level of knowledge about cesarean birth throughout the pregnancy so misconceptions can be rectified and correct information can be provided. Healthcare professionals need to be aware of the differences in perspectives about the care provided.

A quantitative descriptive secondary data analysis design was used to describe older Black adult communication of osteoarthritis pain and the communication strategies used to convey the pain information. Pain content from 74 older Black adults with persistent osteoarthritis pain was analyzed with criteria from the American Pain Society arthritis pain management guidelines that included type of pain (nociceptive/neuropathic), quality of pain, source, location, intensity, duration/time course, pain affect, effect on personal lifestyle, functional status, current pain treatments, use of recommended glucosamine sulfate, effectiveness of prescribed treatments, prescription analgesic side effects, weight management to ideal body weight, exercise regimen or physical therapy and/or occupational therapy, and indications for surgery. Communication strategies were analyzed with criteria derived from Communication Accommodation Theory that included being clear, using medical syntax, using ethnic specific syntax, being explicit, and staying on topic when discussing pain. The majority of communicated pain content included pain location, intensity, and timing. Regarding communication strategies, most of the older Black adults used specific descriptions of pain and remained on topic. Fewer used explicit descriptions of pain that produced a vivid mental image, and few used medical terminology. Use of medical syntax and more explicit descriptions might improve communication about pain between healthcare practitioners and patients. Practitioners might assist older Black adults with persistent osteoarthritis pain to communicate important clinical pain information by helping them to use relevant medical terminology and more explicit pain descriptions when discussing pain management.