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Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

Aim: This paper will present a study, which tested a theoretical Critical Care Nurse Retention model and mechanisms that may influence intent to stay in the organization, unit and nursing profession. Background: The current international nursing shortage is worsening and is particularly acute in critical care settings. There is a rapidly aging nursing workforce and at the same time a significant shortfall in the number of new graduates to replace the large numbers of retiring nurses. Intensive care units have been shown to have the highest turnover rates and there is limited scientific evidence on how to retain critical care nurses. One of the most commonly listed incentives for nurses is organizational support in the form of access to educational opportunities and career development. Design: A quasi-experimental longitudinal design was used in a random sample of 363 critical care nurses from multiple hospital sites in Ontario. Method: The 374-hour intervention included an online component, high-fidelity simulation, and a preceptored clinical component. Data Analysis: ANCOVA and hierarchical regression were used to analyze the hypothesized model. Results: Findings showed the professional development intervention had a direct effect on intent to stay in the unit and intent to stay in the profession. Final analysis revealed that the model explained 23% of the variance in intent to stay in the profession. Conclusion: This research provides new evidence supporting the relevance and importance of investing in professional development opportunities and its subsequent impact on intent to stay. [ABSTRACT FROM AUTHOR]

Background: Due to changes in critical care worldwide, the World Federation of Critical Care Nurses Board of Directors commissioned a review of its 2005 Declaration of Buenos Aires: Position Statement on the Provision of a Critical Care Nursing Workforce. Aim: To provide international recommendations to inform and assist critical care nursing associations, health services, governments, and other interested stakeholders in the development and provision of an appropriate critical care nursing workforce. Methods: An international review group was established, comprised of critical care nurse clinicians, leaders, and researchers. A literature search was undertaken, which informed the revision of the 2005 Declaration, which is contained in the 2019 Position Statement. Position: The position is supported by six central principles, and is comprised of eight key statements: A critical care unit should have a dedicated nurse leader; Each shift should have at least one registered nurse (RN) designated as the team leader; The majority of RNs providing patient care should hold a recognized post-registration qualification or certification in critical care; Critical care RN staffing should be assessed on a shift-by-shift basis according to patient acuity, the staffing profile, and unit need; An additional critical care RN, not counted in RN-to-patient ratios or allocated a patient load, may provide additional hands-on assistance in patient care, and coordinate other patient-related activities; Support staff (such as nursing and allied health assistants, nursing aides, and care assistants) should work only under the direct supervision of a critical care RN, and never in place of a critical care RN; Where institutionally supported, and in accordance with local legislation, a critical care RN may provide expert critical care consultancy; A critical care unit should be staffed to provide at least one senior nurse, who holds a recognized post-registration critical care qualification or certification, and ideally further qualifications in education. [ABSTRACT FROM AUTHOR]

This experimental study examined whether the use of clinical simulation in nursing education could help reduce medication errors. Fifty-four student volunteers were randomly assigned to an experimental (treatment) group (24 students) or a clinical control group (30 students). The treatment replaced some early-term clinical placement hours with a simulated clinical experience. The control group had all normally scheduled clinical hours. Treatment occurred prior to opportunities for medication administration. [ABSTRACT FROM AUTHOR]

This longitudinal study, conducted within a laptop-based BScN program examines the relationship of goal orientation profiles to comfort with technology and academic success. In phase 1 of this study, 101 first year nursing students completed an on line survey. The measurement tools used were Goal Orientation Assessment, Multiple Intelligences Learning Inventory and a locally developed Technology Comfort survey. Results showed that students were predominately high in the mastery goal orientation profile. Males had a higher comfort level with technology. Age was inversely related to comfort with technology. An unexpected finding was that grade point average was inversely related to comfort with use of technology. The data did not support the commonly held belief that today's students are uniformly well-skilled and comfortable with new technologies. This study will continue over the next three years and will allow comparison of variables overtime. Specific teaching interventions may be developed to accommodate varying learning and motivational styles in relation to comfort with technology. [ABSTRACT FROM PUBLISHER]

Purpose/goals: The purpose of this presentation is to describe the current research in relation to critical care nurse work environments and to provide an opportunity for participants to rate their own work environment. Strategies for promotion of healthy work environment will be discussed. Outcome 1: Identify key elements of a healthy work environment. Outcome 2: Rate your own work environment. Outcome 3: Discuss implications and potential strategies to improve your critical care work environment. Session description: The urgency of examining nurse work environment factors has accelerated in recent years due to the nursing shortage and concerns with retaining and stabilizing the critical care nursing workforce. With cutbacks, nursing shortages, increasing nurse/patient ratios, and changing patient care delivery models, healthy workplaces have gained traction as a variable that influences whether a nurse stays or leaves the unit, the organization, or even the nursing profession. In this presentation, results of Canadian and U.K. critical care nurse work environment recent studies will provide the backdrop for participants to actively participate and ‘have their say', as they rate their own ICU work environments and discuss potential strategies to promote healthy work environments for Canadian critical care nurses. [ABSTRACT FROM AUTHOR]

Purpose/goals: The aim of this session is to explore the theoretical perspectives related to medication errors, why they might occur and strategies to prevent errors in the ICU. Session description: Adverse events associated with clinical error have been observed in 9-11% of hospital admissions (Sari et al., 2007), which, in turn, can result in increased clinical expenditure, length of hospital stay and potential patient mortality and morbidity (Fortune et al., 2013). Furthermore, clinical errors have been noted to occur more frequently in critical care settings, due to patient complexity and acuity (Garrouste-Orgeas et al., 2012). This session aims to explore some of the theoretical perspectives associated with such clinical errors and why mistakes might occur within a critical care setting. In addition, discussion will highlight a selection of evidence-based strategies and interventions that have been effectively used to mitigate the risk of clinical errors occurring within the critical care setting; these will include the use of safety check-lists, communication tools and educational approaches to support their integration, such as simulation and role-play. Lastly, the presenters will share personal reflections on how error reduction interventions have been implemented within their own clinical experience. Learning outcomes: 1. Describe potential causes and factors that contribute to medication errors. 2. Describe evidence-based strategies to reduce the incidence of medication errors. 3. Reflect on his/her own practices in relation to medication errors. [ABSTRACT FROM AUTHOR]

Purpose/goals: The aim of this presentation is to provide interactive ACLS case studies to enhance competency according to the most current ACLS guidelines. Outcome 1: Identify the key ACLS algorithms. Outcome 2: Apply the ACLS competencies in a case study format. Outcome 3: Identify key strategies for successful ACLS certification. Session description: Competency in managing a cardiac arrest is a foundational skill for critical care nurses. To ensure optimal patient outcomes, application of the most current evidence-based guidelines during a cardiac arrest is crucial. In this presentation, key Advanced Cardiac Life Support (ACLS) algorithms will be reviewed and a case-based approach will allow participants to apply the most current guidelines. The presentation is aimed at building confidence in approaching cardiac arrest scenarios. Pre-requisites: It is beneficial to understand basic arrhythmias prior to this presentation. CSI Calgary: Hemodynamic profile analysis: Making sense of the numbers Sandra Goldsworthy PhD, RN, CNCC(C), CMSN(C), Calgary AB Educational stream: Clinical Practice Learning level: Applicable to all Key words: confidence, competency, hemodynamic, critically ill patients Purpose/goals: The purpose of this session is to build confidence and competence in analyzing hemodynamic profiles of critically ill patients. Outcome 1: Identify the components of the ‘grid' method of analyzing hemodynamic profiles. Outcome 2: Apply the grid method in case study examples. Session description: Hemodynamic monitoring is a foundational competency for all critical care nurses. Management of pulmonary artery catheters, arterial lines and recognition of decreased cardiac output are essential to optimizing patient outcomes in the intensive care unit. This presentation will provide a review of factors that impact preload, afterload, contractility, and perfusion. The grid' method will be discussed and an opportunity to apply this approach through case studies will be used to interpret hemodynamic profiles of critically ill patients. [ABSTRACT FROM AUTHOR]

Purpose/goals: The aim of this presentation will be to follow up an initial presentation at Dynamics 2016. Results of the work environment study conducted among critical care nurses in Canada and the United Kingdom will be presented. Session description: Canadian nurse mean turnover rates have been shown to be 19.9%, with supportive work environments playing a key role in curtailing turnover (O’Brien-Pallas et al., 2010). Healthy work environments have been linked to nurse retention (Heinen et al., 2013). In this presentation results of a work environment study conducted among Canadian and United Kingdom critical care nurses will be described. The intent of this study was to establish a baseline in the Canadian and United Kingdom context to begin planning strategies to improve ICU nurse work environments and positively impact nurse retention. The study was a cross-sectional survey design. The practice environment scale of the nurse work index (PES-NWI) was the primary measure used in this study. The PES-NWI is the most widely reported measure that has been used to examine various aspects of a nurse’s work environment. Two additional reliable and valid measures that were used in this study included: the moral distress-revised instrument (Corley, 2005) and the intent to stay measure (adapted from Facteau et al, 1995). Research Questions: 1. How do nurses in Canada and the U.K. rate their current work environment? 2. Is there a relationship? Learning outcomes: 1. Describe the results of a work environment study conducted among critical care nurses in Canada and the United Kingdom. 2. Reflect on the context of their own work environment. 3. Describe potential strategies to take back to their own Intensive Care Unit for work environment improvement. [ABSTRACT FROM AUTHOR]

The intensive care unit has the highest turnover rates among nurses in the country. Factors affecting nurse turnover include nurse manager leadership ability, work environment, the availability of professional development opportunities, nurse-physician collaboration, feeling valued and recognized and workload. Results of a doctoral study that examined the influence of professional development opportunities on intent to stay among critical care nurses will be presented, along with their implications for nurses, managers, educators and policy. [ABSTRACT FROM AUTHOR]

How healthy is your work environment? This interactive presentation is aimed at discussing the current state of critical care nursing work environm ents in Canada and globally. Current literature will be explored and results from a doctoral study am ong Canadian nurses will be presented. Challenges and opportunities in changing the environm ent we work in will be discussed. Improving work environm ent conditions will help stabilize the critical care nurse workforce across Canada. Global innovations will be shared along with potential solutions for future consideration. [ABSTRACT FROM AUTHOR]

The guidelines for A dvanced Cardiac Life Support (ACLS) have recently been updated based on the current state of resuscitation science. This presentation is aim ed at outlining the new changes in the guidelines, the rationale for these changes and how they will im pact practice for critical care nurses. New and em erging research in the area of adult resuscitation will be discussed. In addition, tips and resources for instructors will be included in the presentation. [ABSTRACT FROM AUTHOR]

The article presents the abstract of a study of the skills required to manage the pulmonary artery lines in a critical care unit, to be presented at the Dynamics of Critical Care conference scheduled in St. John's, Newfoundland on September 24-26, 2006.

Introduction: A good working climate increases the chances of adequate care. The employees of Emergency in Hospitals are particularly exposed to work-related stress. Support from management is very important in order to avoid stressful situations and conflicts that are not conducive to good work organization. The aim of the study was to assess the work climate of Emergency Health Services during COVID-19 Pandemic using the Abridged Version of the Work Climate Scale in Emergency Health Services., Design: A prospective descriptive international study was conducted., Methods: The 24-item Abridged Version of the Work Climate Scale in Emergency Health Services was used for the study. The questionnaire was posted on the internet portal of scientific societies. In the study participated 217 women (74.5%) and 74 men (25.4%). The age of the respondents ranged from 23 to 60 years (SD = 8.62). Among the re-spondents, the largest group were Emergency technicians (85.57%), followed by nurses (9.62%), doctors (2.75%) and Service assistants (2.06%). The study was conducted in 14 countries., Results: The study of the climate at work shows that countries have different priorities at work, but not all of them. By answering the research questions one by one, we can say that the average climate score at work was 33.41 min 27.0 and max 36.0 (SD = 1.52)., Conclusion: The working climate depends on many factors such as interpersonal relationships, remuneration or the will to achieve the same selector. In the absence of any of the elements, a proper working climate is not possible., Competing Interests: Author BO was employed by European Specialist Nurses Organization. Authors KV was employed by Advancing Nursing LLC and MR was employed by Critical Care Nurses Association of the Philippines, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kosydar-Bochenek, Krupa, Religa, Friganovic, Oomen, Williams, Vollman, Rogado, Goldsworthy, Lopez, Brioni and Medrzycka-Dabrowska.)

This study examined the relationships between the use of personal digital assistants and self-efficacy and the preparation for medication administration among second-year Bachelor of Science in Nursing students in a medical-surgical clinical environment. By using a controlled experimental method, the study attempted to support claims about the educational benefits of personal digital assistants which have generally been reported in more descriptive and anecdotal formats. The sample consisted of 36 students, of which two groups had personal digital assistants and two groups served as a control. The control groups were provided with paper resources equivalent to the software provided by the personal digital assistants. Findings showed a significant increase in self-efficacy in the groups with personal digital assistants.