H [ 。 j i セ L compared with 27 calls in the precedingseve nキ エG ・ォ セ I N It seems reaconable III assume thai therecogmuon.w l.! treatme nt of patients with physioluglcal derangemcrus rhar meet .\\lET ca ll-o ur cruena would improve then(lutCOIIIl.' . However, at A ィ ゥ セ nme, thereh no direct .. videnceto suppnr t thrc r j i セ ュ セ nurvmg N Q w j イ c ョ ・ ウ セ o f thc call-our criteria to r the MET i セ fundamen\\;1.1 to It S success.T he modnied nursl1lg oh -er vation ( h.H t corunbures 10i lus and I' therefore J useful ir movatiun.

The medical emergency team.

A systematic review of critical thinking in nursing education.

Aims and objectives
To identify barriers and facilitators to nurses' decisions regarding activation of rapid response teams (RRTs) in hospitals.

Background
Hospitalised patients in the United States who experience cardiopulmonary arrest seldom recover. Most of these patients show signs of clinical deterioration prior to cardiopulmonary arrest. RRTs have been shown to decrease the incidence of cardiopulmonary arrest by bringing needed resources to unstable patients. Despite the evidence in support of the activation of RRTs, nurses do not always use this resource. Nurses' decisions to activate or not to activate the RRT are not clearly understood.

Design
We used a qualitative design for this study.

Methods
A purposive sample of 15 medical/surgical nurses was recruited from a small medical centre in the Midwest. Researchers used semistructured, open-ended questions to elicit subject responses regarding facilitators and barriers to activating RRTs.

Results
Themes emerged and were categorised as facilitators and barriers to calling the RRT. Facilitators and barriers were then subdivided into distinct subthemes: RRT characteristics and unit culture. The expertise of the RRT members and support and encouragement from nursing unit colleagues and leaders emerged as two potential facilitators. Communication of the RRT members and calling the physician first emerged as two potential barriers. We also identified educational factors that were not clearly facilitators or barriers to calling the RRT.

Conclusions
Further study is needed using quantitative designs with larger sample sizes.

Relevance to clinical practice
Nurses can build upon knowledge of facilitators and barriers related to RRT characteristics and nursing unit culture.

Qualitative exploration of nurses' decisions to activate rapid response teams.

Aim
The aim of this study was to examine the impact of a novel educational intervention on student nurses' clinical judgment regarding the management of patients experiencing rapid clinical deterioration

Method
A randomized sample of baccalaureate nursing students enrolled in the final semester of their program at a midwestern public university participated All students (N = 79) were pretested; the control group (n = 39) was posttested after receiving traditional code blue and rapid response education The intervention group (n = 40) was posttested after receiving a novel education intervention

Results
An independent t-test revealed that nursing students who received the innovative education intervention had significantly higher posttest scores (M = 9091, standard deviation [SD] = 873) than did the nursing students who had not received the intervention (M = 6480, SD = 1969), t(77) = 765, p <001)

Conclusions
The findings demonstrate that clinical simulation is effective in improving students' knowledge and clinical judgment, specifically concerning rapid response systems

Nursing students' clinical judgment regarding rapid response: the influence of a clinical simulation education intervention.

Practice patterns and perceived impact of clinical nurse specialist roles in Canada: Results of a national survey

Purpose
Academic dishonesty is growing among nursing students. Reasons for this growth can be categorized into student, faculty, and system factors. Nursing faculty designed a study to explore this problem.

Conclusions
We identified three themes: characteristics of students with academic integrity, patient safety, and professional outcomes. Exploring student perceptions of academic integrity can help faculty design measures to prevent dishonesty in these three areas.

Practice Implications
We recommend fostering culture change through strategies that target students, faculty, and systems. These strategies include peer mentoring, role modeling integrity, enhancing awareness of what constitutes cheating, and developing policies that promote honesty.

Perceptions of academic integrity among nursing students.

Aim. The purpose of this exploratory, mixed-methods study was to test an intervention to build social capital and civility among nursing students. Background. Incivility impacts nurses and nursing students, and can negatively influence patient care and the quality of nursing education. The Institute of Medicine and the Joint Commission recommended implementation of strategies to manage incivility and build social capital. Method. Twenty-five student nurses completed the Ways of Coping Questionnaire and participated in interviews; 10 participated in the intervention, a journal club focused on civility in nursing. This study provided insight into student nurses' perceptions of civility. Results. Participation in the intervention changed students' attitudes and behavior regarding civility. Specifically, students refused to participate in uncivil behavior, helped peers, were supportive, and tried to prevent or avoid incivility. Conclusion. Expansion of this study to further test the impact of civilit...

An Intervention to Promote Civility Among Nursing Students

The purpose of this cross-cultural study was to explore critical thinking among nurse scholars in Thailand and the United States. The study used qualitative methodology to examine how nurse scholars describe critical thinking in nursing. Nurse educators in Thailand and the United States were questioned concerning the following aspects of critical thinking: essential components; teaching and evaluation techniques; characteristics of critical thinkers; and the importance of a consensus definition for critical thinking in nursing. Their statements, which revealed both common and specific cultural aspects of critical thinking, were subjected to content analysis. Certain themes emerged that have not been widely discussed in the literature, including the link between staying calm and thinking critically, the assertion that happiness is an essential component of critical thinking, and the participants' nearly unanimous support for coming to a consensus definition of critical thinking for nursing.

Cross-cultural perspectives on critical thinking.

The purposes of this article were to provide background information about rapid response teams (RRTs), to describe the actual and potential outcomes of RRTs, to define the potential role of the clinical nurse specialist in leading RRTs, and to provide recommendations for implementation of RRTs. Rapid response teams provide the opportunity for early intervention for patients demonstrating clinical decline before they reach a point of no return. The long-standing practice of waiting for intensive intervention (code blue) until the patient experiences cardiopulmonary arrest has shown poor outcomes, bringing this practice into question. Although research results are mixed, there is evidence to suggest that the successful use of RRTs results in clinically significant patient outcomes as evidenced by decreased cardiopulmonary arrests and decreased rates in mortality. Other positive patient, nursing, and organizational outcomes can result from RRTs and are discussed. Clinical nurse specialists are uniquely qualified to provide leadership in the development and implementation of RRTs and the monitoring of outcomes. As RRTs become a more common standard practice, further research is needed to examine their benefits and to further refine effective early intervention for high-risk patients.

Clinical nurse specialists as leaders in rapid response.

Little has been written to help researchers prepare for the unique challenges of conducting transcultural research The purpose of this article is to discuss issues that arose during the planning and execution of a transcultural study designed to compare critical thinking in Thailand and the United States The challenges of identifying a research site, selecting participants, incorporating Thai research into the literature review, traveling and living in a foreign culture, overcoming cultural barriers to research, and strengthening internal validity and reliability are addressed

Sheryl D. Jenkins

Papers

Perceptions of academic integrity among nursing students.

An Intervention to Promote Civility Among Nursing Students

Cross-cultural perspectives on critical thinking.

Clinical nurse specialists as leaders in rapid response.

Conducting transcultural research: critical thinking in Thailand.