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Purpose. The experience at a medium-sized regional medical center participating in the ASHP MENTORED QUALITY IMPROVEMENT IMPACT PROGRAMSM (MQIIP) on Insulin Pen Safety in Hospitals is described. Summary. With the support of top hospital leaders, Munson Medical Center (MMC) applied in June 2014 to participate in the MQIIP to complement its ongoing risk assessment related to the use of pen devices for insulin administration. Nurse knowledge deficits, problems with insulin pen storage and labeling, and improper insulin injection practices identified in baseline assessments for the MQIIP were the basis for process improvements, including new policies and procedures, an electronic alert and education for nurses, and individualized communication with pharmacy and nursing personnel about insulin pen safety. The experiences of other hospitals helped us identify solutions to safety issues and formulate communication strategies for improving insulin pen safety in our hospital. Awareness of the importance of insulin pen safety increased in all staff. Implementing these process improvements during the five-month intervention period resulted in increases in nurse knowledge and improvements in insulin pen storage, labeling, and injection practices, although problems persisted. Additional plans have been made to further enhance the safety of insulin use at MMC. Conclusion. The ASHP MQIIP on Insulin Pen Safety in Hospitals provided a structured and supportive approach to identifying and addressing insulin pen safety issues at MMC. The insight gained through participation enabled us to devise strategies to communicate with staff about safety issues and improve the safety of insulin pen use in the institution. [ABSTRACT FROM AUTHOR]

Purpose. UF Health's participation in a mentored quality-improvement impact program for health professionals as part of an ASHP initiative--"Strategies for Ensuring the Safe Use of Insulin Pens in the Hospital"--is described. Summary. ASHP invited hospitals to participate in its initiative at a time when UF Health was evaluating the risks and benefits of insulin pen use due to external reports of safety concerns and making a commitment to continue insulin pen use and optimize safeguards. Improvement opportunities in insulin pen best practices and staff education on insulin pen preparation and injection technique were identified and implemented. The storage of insulin pens for patients with contact isolation precautions was identified as a problem in certain patient care areas, and a practical solution was devised. Other process improvements included implementation of barcode medication administration, with scanning of insulin pens designated for specific patients to avoid inadvertent and intentional sharing of pens among multiple patients. Mentored calls with teams at other hospitals conducted as part of the program provided the opportunity to share experiences and solutions to improve insulin pen use. Conclusion. Participating with a knowledgeable mentor and other hospital teams struggling with the same issues and concerns related to safe insulin pen use facilitated problem solving. Discussing challenges and sharing ideas for solutions to safety concerns with other hospitals identified new process enhancements, which have the potential to improve the safety of insulin pen use at UF Health. [ABSTRACT FROM AUTHOR]

Purpose. Results of the MENTORED QUALITY IMPROVEMENT IMPACT PROGRAMSM (MQIIP) on Ensuring Insulin Pen Safety in Hospitals, which was part of an ASHP educational initiative aimed at ensuring the safe use of insulin pens in hospitals, are described. Methods. During this ASHP initiative, which also included continuing-education activities and Web-based resources, distance mentoring by pharmacists with expertise in the safe use of insulin pens was provided to interprofessional teams at 14 hospitals between September 2014 and May 2015. The results of baseline assessments of nursing staff knowledge of insulin pen use, insulin pen storage and labeling audits, and insulin pen injection observations conducted in September and October 2014 were the basis for insulin pen quality-improvement plans. Postintervention data were collected in April and May 2015. Results. Compared with the baseline period, significant improvements in nurses' knowledge of insulin pen use, insulin pen labeling and storage, and insulin pen administration were observed in the postintervention period despite the relatively short time frame for implementation of quality-improvement plans. Program participants are committed to sustaining and building on improvements achieved during the program. The outcome measures described in this report could be adapted by other health systems to identify opportunities to improve the safety of insulin pen use. Conclusion. Focused attention on insulin pen safety through an interprofessional team approach during the MQIIP enabled participating sites to detect potential safety issues based on collected data, develop targeted process changes, document improvements, and identify areas requiring further intervention. A sustained organizational commitment is required to ensure the safe use of insulin pen devices in hospitals. [ABSTRACT FROM AUTHOR]

The article discusses the study that determined the effectiveness of the Rural Trauma Team Development Course (RTTDC) for the education of nurses and other health care providers at nine rural community hospitals from 2011-2013. Findings discussed include positive perception of RTTDC by health care providers, improvement in 13 of 19 knowledge items for nurses, and education intervention as independent predictor in emergency department (ED) time (EDT) and ED length of stay (LOS) reduction.

This is the fourth and final article in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. Dementia training in hospitals is often inadequate and staff do not always have sufficient knowledge of dementia to provide appropriate care. It can also be difficult for them to identify when patients with dementia are in pain, especially when their communication skills deteriorate. The case studies presented illustrate how two NHS trusts have worked to ensure that their staff are fully equipped to care for people with dementia in hospital. Basildon and Thurrock University Hospitals NHS Foundation Trust in Essex made dementia training a priority by including dementia awareness in staff induction across a range of roles and providing additional training activities tailored to meet staff needs. Nottingham University Hospitals NHS Trust focused on pain assessment, aiming to standardise its approach for patients with dementia. The pain assessment in advanced dementia tool was chosen and piloted, and is being implemented across the trust after a positive response. [ABSTRACT FROM AUTHOR]

Objectives To describe the prevalence of screening for complicated grief ( CG) and depression in hospice and access to bereavement therapy and to examine whether screening and access to therapy varied according to hospice organizational characteristics or staff training and involvement. Design Cross-sectional national survey conducted from 2008 to 2009. Setting United States. Participants Hospices (N = 591). Measurements Whether hospices screened for depression or CG at the time of death or provided access to bereavement therapy (individual or group). Organizational characteristics included region, chain status, ownership, and patient volume. Staffing-related variables included training length and meeting attendance requirements. Results Fifty-five percent of hospices provided screening for CG and depression and access to bereavement therapy, 13% provided screening but not access to bereavement therapy, 24% provided access to bereavement therapy but not screening, and 8% neither screened nor provided access to bereavement therapy. Hospices with 100 patients per day or more were significantly more likely to provide screening and access to bereavement therapy. Conclusion Hospices appear to have high capacity to provide screening for CG and depression and to deliver group and individual therapy, but data are needed on whether screeners are evidence based and whether therapy addresses CG or depression specifically. Future work could build upon existing infrastructure to ensure use of well-validated screeners and evidence-based therapies. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6-93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79-0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73-0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54-0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance. [ABSTRACT FROM AUTHOR]

Frequently misdiagnosed as obesity, lipoedema is chronic condition involving an abnormal build-up of fat cells in the legs, thighs and buttocks that cannot be shifted by exercise or dieting. Estimated to affect up to 11% of the female population, the condition is widely unknown by health professionals. This means women typically wait for many years before diagnosis. This allows the condition to progress unchecked, resulting in unnecessary deterioration and the development of associated comorbidities, as well as significant pain and mental anguish. A free, 30-minute Royal College of General Practitioners (RCGP) e-learning course created in partnership with Lipoedema UK aims to rectify this situation by educating nurses, GPs and other health professionals on how to diagnose and manage lipoedema in primary care. This article aims to describe the condition of lipoedema, how to recognise/diagnose it, current treatment options and the findings of a 240-patient survey carried out by Lipoedema UK in 2013 that included documenting the difficulties for patients in obtaining a diagnosis as well as the mental and physical effects of the condition. [ABSTRACT FROM AUTHOR]

Objective To describe the effect of interventions designed to improve patient identification ( PI) during pathology collection in the ED. Methods A prospective before-and-after intervention study was conducted between June 2009 and June 2010 in a regional ED in Queensland, Australia. Interventions aimed to improve PI and specimen labelling, and consisted of: (i) education alone; and (ii) education plus an armband scanner that voice-prompted collector behaviour. Main outcomes measured included: frequency of correct key behaviours (KBs) during specimen collection, pathology integrity errors and cost of interventions. Results Data from 282 ED pathology collections were analysed (before: n = 115, after with education: n = 95, after with education plus armband scanner: n = 72). KBs for PI and labelling improved significantly following education plus armband scanner use. Application of armbands before sample collection increased (36% vs 90%, P < 0.001), as did asking the patient to state their name (25% vs 93%, P < 0.001) and date of birth (22% vs 93%, P < 0.001). These results were similar, albeit less pronounced, when the effect of education only was assessed. No primary patient misidentification was detected in this small study. The annual costs for a hospital to adopt the education programme with and without the armband scanner were $104 045 and $5330 respectively. Conclusion ED staff had poor behaviours for identifying patients and labelling pathology specimens before intervention. These safety behaviours were considered an assumed skill. Education alone improved critical KBs markedly that was further augmented by the armband scanner. The cost to adopt education alone is relatively low compared to the addition of armband scanner technology. [ABSTRACT FROM AUTHOR]

Testicular cancer (TC) is the most common malignancy among men aged 15–35 years. Testicular self-examination (TSE) is an important tool for preventing late-stage TC diagnoses. This study aimed to assess health beliefs and knowledge related to TC and TSE and the effectiveness of TC and TSE training for patient care staff in a hospital. This was a prospective, randomized, controlled intervention study. The study included 96 patient care staff divided into two groups of 48 participants each: Group I, the interactive education group, and Group II, the pamphlet education group. The results demonstrated that TSE practice and TC knowledge significantly increased in both Group I and Group II. Significant differences were observed between the groups pre and post education. TSE and TC knowledge levels were higher for participants in Group I than those in Group II. There was a significant difference in the performance of TSEs between groups: the rates were 83.3% in Group I and 54.2% in Group II. Perceived confidence and perceived barriers increased significantly for both groups. Interactive education sessions should be used to train men at risk for TC to perform TSEs. [ABSTRACT FROM PUBLISHER]

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. [ABSTRACT FROM AUTHOR]

Hand hygiene adherence needs to be increased and sustained in order to prevent and reduce healthcare associated infections. We implemented an educational intervention and observed the adherence of healthcare workers, patients and visitors over 24 hour periods at four observation points. For healthcare workers a total of 2,294 opportunities were observed and for patients and visitors, a total of 597 opportunities were observed. Healthcare worker adherence increased following the introduction of the educational intervention, with 53.0% (282/532) adherence at baseline (observation point 1), and was sustained varying between 67.7% and 70.8% in the post-intervention points (p=0.0007). The greatest increase in adherence was observed between baseline and the observation point 2. Adherence varied according to type of opportunity (p< 0.0001) with the lowest level of adherence observed after contact with patient surroundings, however there was no obvious trend across the observation points. There was an interaction between point of study and ward (p=0.0001). For patients and visitors, adherence did differ according to the point of study (p=0.0074) with adherence prior to the intervention being 49.1% and then ranging from 43.5-61.8%. We suggest that future educational interventions should be implemented as this study implies that there is potential for increased and sustained adherence to hand hygiene protocols. [ABSTRACT FROM AUTHOR]

Needlestick injuries (NSIs) involving hollowbore needles are the most commonly reported occupational exposure within the healthcare sector in the United Kingdom (HPA, 2012). It is estimated that at least 100,000 NSIs occur each year but due to under-reporting the figure may be much higher (RCN, 2008).Many strategies aimed at preventing NSIs have been implemented in the healthcare environment, including administrative controls, safer work practices and engineering controls, but despite these measures NSIs remain a serious health and safety threat (EU, 2010).New legislation has now been introduced as part of EU Directive 2010/32/EU, which requires UK and all EU member states to bring into force regulations, laws and administrative provisions to further protect healthcare workers from sustaining NSIs (EU Directive, 2010). The aim of this study was to determine the degree of responsibility that NHS ward/department managers felt they have in relation to the prevention and management of NSIs and if this was reflected in the way that they carry out relevant practices in their clinical environment. The study also aimed to identify factors which might impact on the ward/department managers’ ability to manage sharps effectively.The study found that although ward/department managers did acknowledge a high degree of responsibility overall for the prevention and management of NSIs, there were some concerns highlighted in relation to certain practices. These included not ensuring that all staff had received up to date training on the safe use and disposal of sharps and not disseminating information on NSI incidences and outcomes to staff in their clinical areas.The findings of this study have the potential to inform and enhance future training and education schedules that relate to NSI prevention and management and to improve the corporate strategic commitment to reducing NSIs across healthcare organisations. [ABSTRACT FROM PUBLISHER]

Objective:The aims of the study were to report on the development and evaluation of a staff training intervention in dementia care designed for use in the general hospital setting: the ‘Getting to Know Me’ training programme. The study also aimed to undertake initial psychometric analysis on two new outcome scales designed to measure knowledge and confidence in dementia care.Methods:The study comprised two phases. The first phase comprised the design of two questionnaires which are shared within this paper: Confidence in Dementia (CODE) Scale and Knowledge in Dementia (KIDE) Scale. In phase two, staff undertook the ‘Getting to Know Me’ training programme (n= 71). The impact of the programme was evaluated using a pre–post design which explored: (1) changes in confidence in dementia; (2) changes in knowledge in dementia; and (3) changes in beliefs about challenging behaviour.Results:The psychometric properties of the CODE and KIDE scales are reported. Statistically significant change was identified pre–post training on all outcome measures. Clinically meaningful change was demonstrated on the CODE scale.Conclusions:The ‘Getting to Know Me’ programme was well received and had a significant impact on staff knowledge and confidence. Our findings add to a growing evidence base which will be strengthened by further robust studies, the exploration of the impact of staff training on direct patient outcomes, and further identification of ways in which to transfer principles of care from specialist dementia environments into general hospital settings. [ABSTRACT FROM PUBLISHER]

Violence in hospitals complicates patient care. Emergency department settings (ED) pose significant risk for caregivers. Nonviolent crisis intervention (NCI) training was initiated to reduce the incidence of violence in an acute care hospital ED with more than 75,000 annual visitors. Training intended to build skills to defuse potentially violent situations and significantly decrease incidents in the ED requiring emergency security team involvement (manifested as code purples). A quantitative quality improvement study evaluated the training investment. The study collected ED code purple and staff training data from November 2012 to October 2013. Correlations were derived using Pearson's r. A regression model determined incremental training impact. There was a negative correlation between violence and NCI training in the previous 90-150 days; regression determined a 23% decrease in code purples, pursuant to training. Risk mitigation justified the facility's investment to continue NCI training. Training reinforcement at 6-month intervals shall be implemented for continued benefit. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages This is the first study assessing hospital-wide knowledge and the impact of a Child Protection Week as a method of training., We have identified the effective elements of a Child Protection Week. The newsletter and Intranet articles proved the most recalled media., Self-declaration of child protection knowledge is an effective method to evidence training. Staff were significantly more likely to have positive knowledge, skills and attitudes to safeguard children. [ABSTRACT FROM AUTHOR]

The article focuses on a workplace assessment field guide and an accompanying worksheet which are worksheet are invaluable tools for recognizing hazards in the hospital environment. It mentions that these tools ensure that both front line workers as well as health, safety, and infection control professionals can systematically evaluate hazards and formulate recommendations. It suggests that innovative training for occupational health can help in controlling workplace assessment in health care.

BISTARAKI A., WADDINGTON K. & GALANIS P. (2011) The effectiveness of a disaster training programme for healthcare workers in Greece. International Nursing Review 58, 341-346 Background: Recent natural disasters have made disaster training a public priority. Multiple methods of disaster preparedness training have been established in hospitals worldwide. Nevertheless, researchers have not yet discovered the most effective method for training hospital personnel in the area of disaster preparedness. Aim: The aim of this study is to test the hypothesis that a brief educational intervention would improve hospital staff knowledge about the hospital disaster plan and procedures. Methods: A quasi-experimental design was used. The intervention group included 56 professionals and the comparison group included 35 professionals in Greece. The intervention group attended a 5-h course that addressed the basic principles of hospital disaster management. A structured questionnaire was used to estimate the participants' changes in knowledge. Repeated measures analysis of variance (ANOVA), t-test, one-way ANOVA and chi-square test were used to analyse the data. Results: The intervention resulted in a significant improvement in knowledge. The mean score was significantly higher immediately after the intervention programme [86; standard error (SE): 2] than before (44.5; SE: 1.7) ( P < 0.001). The mean score 1 month later was significantly lower (77.2; SE: 2.3) than that immediately after the intervention programme ( P < 0.001), but significantly higher than the mean score before the intervention programme ( P < 0.001). Participants in the control group achieved a score of 40 (SE: 2.4), which was significantly lower than the scores of the intervention group after the course ( P < 0.001). Conclusion: The disaster training course had a great benefit for the participants. This study suggests that a brief educational intervention is beneficial, but more must be done. [ABSTRACT FROM AUTHOR]

PURPOSE: The Joint Commission established a new safety goal mandating staff education in evidence-based infection prevention due to multidrug-resistant organisms (MDROs). This pilot study assessed the effectiveness of the MDRO educational module in our behavioral health hospital. DESIGN AND METHODS: An online survey was administered to a convenience sample (N = 44) consisting of employees hired within the previous 8 months. FINDINGS: Results identified knowledge gaps between and among disciplines that guided subsequent improvements to our MDRO educational module. PRACTICE IMPLICATIONS: Online surveys are an effective way to evaluate knowledge gaps and may be useful in other educational activities within nursing. [ABSTRACT FROM AUTHOR]

Background: Well before the H1N1 influenza, health care organizations worldwide prepared for a pandemic of unpredictable impact. Planners anticipated the possibility of a pandemic involving high mortality, high health care demands, rates of absenteeism rising up to 20–30% among health care workers, rationing of health care, and extraordinary psychological stress. Method: The intervention we describe emerged from the recognition that an expected influenza pandemic indicated a need to build resilience to maintain the health of individuals within the organization and to protect the capacity of the organization to respond to extraordinary demands. Training sessions were one component of a multifaceted approach to reducing stress through effective preparation and served as an evidence based platform for our hospital’s response to the H1N1 pandemic. Results: The training was delivered to more than 1250 hospital staff representing more than 22 departments within the hospital. The proportion of participants who felt better able to cope after the session (76%) was significantly higher than the proportion who felt prepared to deal confidently with the pandemic before the session (35%). Ten key themes emerged from our qualitative analysis of written comments, including family-work balance, antiviral prophylaxis, and mistrust or fear towards health care workers. Conclusions: Drawing on what we learned from the impact of SARS on our hospital, we had the opportunity to improve our organization’s preparedness for the pandemic. Our results suggest that an evidence-based approach to interventions that target known mediators of distress and meet standards of continuing professional development is not only possible and relevant, but readily supportable by senior hospital administration. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate clinical and electrophysiological findings of post-injection sciatic neuropathy. Methods: Age, gender, clinical and electrophysiological features of 30 cases (19 male), who were sent to our laboratory between 1992-2004, were evaluated by conventional nerve conduction study and needle electromyography. Results: The study included patients aged between 1-83 years and 37% of the cases were ≤10 years. All electrophysiological examinations were done between 3 weeks and 5.5 months after injection, except for one case. Seventeen cases had both medial and lateral truncal deficits, 4 of them showed equal deficit, whereas the lateral truncus was affected more severely in 13 patients. In eight cases, only lateral truncal deficit was detected, while two subjects had only medial truncal deficit. Two cases showed impaired sensory fibers only. One patient showed normal electrophysiological findings. Patients with severe injury had very limited clinical improvement at control examinations and their quality of life was negatively affected. Conclusion: Our findings indicate that sciatic injection neuropathy is a common health problem in children. Severity of neuropathy has a wide range according to the clinical and electrophysiological findings. The severely affected cases should be treated surgically. Special attention should be paid to educating the medical personnel on the safe injection techniques. (Archives of Neuropsychiatry 2010; 47: 207-12) [ABSTRACT FROM AUTHOR]

The article discusses an Interdisciplinary, Comprehensive, Education program implemented to reduce the Central Line-Associated Bloodstream Infections (ICE-CLABSI) and aimed at zero Healthcare-Associated infections (HAIs). It states that the hospital-wide incidence rates of CLABSI dropped by following the ICE-CLABSI program. It mentions that the goal of "Aimed for Zero" HAIs was achieved in the second year of the ICE-CLABSI program.

An introduction is presented where the editor discusses various reports in the issue on topics including specific recommendations to improve safe use of insulin pen devices in hospitals, methods used to collect safety data on insulin pen use and the tools, approaches and recommended practices to improve insulin pen safety.

The article focuses on the strategies used by the teams nominated for the 2016 education award to improve learning. Topics covered include the development by consultant physician Simon Maxwell of the online tool Prescribing Safety Assessment (PSA), the introduction by consultant Laura McGregor of a course that provides simulation based training in emergency medicine and the creation by clinical lecturer Rakesh Patel of a method for assessing doctors at the start of their rotation.

Topic: If an agency desires changes in practice and a consistent approach to services, psychiatric rehabilitation staff development requires more than a single session of training. Purpose: This column describes one agency's approach to a comprehensive staff training and development program, designed to enhance the 3 Cs of capacity, commitment, and culture. Sources used: The program described has been in place, with frequent adjustments, for over 20 years, and the experiences of the authors and their colleagues form the primary source for the paper. Conclusions and implications for practice: Staff development requires an ongoing investment--competency-based training, supervision congruent with the service vision and mission, accountability through performance evaluation, and opportunities for growth. We have a firm belief that our employees learn to treat others, in part, from how they are treated by our agency leadership. [ABSTRACT FROM AUTHOR]

The article offers a presentation regarding the case report "Remote monitoring using Spectrum Medical, Live Vue allows improved response time and improved quality of care for patients on cardiopulmonary support" during the 34th Annual Seminar of the American Academy of Cardiovascular Perfusion. According to James Beck, the intensive care unit employees could refer to the perfusion team if they would see a compliance alarm. Deborah Adams says that there ventricular assist program has improved.

The article looks at economic aspects of health care staff education, with particular focus on the attitudes of administrators about the cost effectiveness of staff education. The author argues that strategic business outcomes of education programs should be evaluated prior to formulating learning or productivity objectives.

The article presents several recommendations for improving employee hand hygiene compliance in outpatient surgery practices, including providing hand sanitizers, instructing staff to disinfect hands after removing gloves, and including physicians in the compliance program.

The article offers information on a hospital leadership development program in 2008 with 40 participants, which was based on the Magnet Model. It mentions the program recruited nursing staff with an interest or a potential in leadership roles, and selected the hospital's leadership team as program faculty. The cost, curriculum, and the outcome of the program are also discussed. The article reports that the hospital repeated the program in 2011 with an updated curriculum and 23 additional candidates. It highlights the program helped the faculty and participants understand the benefit of planned succession planning under the Magnet structure.

The article presents updates on nursing-related research as of November 2016 including the end of life care needs of patients with drug and alcohol addiction, the effect of education on environmental cleaning and the psychological effects of head and neck cancer.

The article reports that the National Institute for Health and Care Excellence (NICE) has issued guidance to standardize trauma care in England covering the most important areas of trauma care including fractures, complex fractures and spinal injury assessment. It cites recommendations to promote better communication which include a designated point of contact in each trauma team for patients, their family members and carers.

The article discusses a project called Time to Heal, which aims to help homeless patients find a home upon discharge from hospital in Great Britain. Consultant physician Pippa Medcalf of Gloucestershire Royal Infirmary collaborated with a local homeless project and they won a government grant to launch a six-month pilot. Medcalf is recommending a three tier level of support for homeless patients. Also mentioned are the standards of care for homeless patients set by the charity Pathway.

The author reflects on the results of the national dementia care audit in acute hospitals in Ireland which revealed the need for all hospitals to train its staff about basic dementia care and offer advanced training to selected ward staff.

A letter to the editor is presented in response to the article "Can An Education Program Reduce CLABSIs," by Glenn H. Raup, Joyce Putman, and Kathy Cantu in the May 2013 issue.

The article offers information on the TeamSTEPPS® Ltd. English Proficiency Module, novel tool to help improve patient safety for those with limited English proficiency, which was developed by the Agency for Healthcare Research and Quality, and U.S. Department of Defense.

This section offers news briefs related to community health in Great Britain as of May 2013 including the free training to qualify support staff at National Health Service London, publication of child mental health literature by the Royal College of Psychiatrists and registration for the Nightrider Challenge of the charity Lullaby Trust.

The article reports on the inconsistency on training on how hospital staff should apply the Deprivation of Liberty Safeguards in 2010-2011 based on the reports of inspections analysed by the Care Quality Commission (CQC) in Great Britain.