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Background: Nursing education influences medication administration practices, which involve clinical decision making and risk perceptions. Method: This mixed-methods concurrent nested study explored the relationship among knowledge, personality traits, and self-efficacy related to medication administration error in fourth-year, prelicen-sure nursing students ( n = 60) who were recruited from three campuses of a large university. Results: Results indicated low mean knowledge (70.75) and neuroticism (2.44) scores, and high mean self-efficacy and confidence (5.78) and conscientiousness (4.51) scores. Conscientiousness was correlated with both knowledge ( r = .271, p = .036) and neuroticism (r = −.313, p = .015). Thematic analysis yielded four themes: nature of risk perceptions, more opportunities to learn, experiences with medication administration error, and intrinsic characteristics influence errors. Convergence was evident in both knowledge and personality data; self-efficacy/confidence and risk perceptions data diverged. Conclusion: Knowledge, personality traits, and self-efficacy appear to influence nursing students' risk perceptions of medication administration error, indicating an area for future research. [ J Nurs Educ . 2022;61(7):367–374.]

Nursing homes (NHs) are challenged to consistently deliver person-centered care (PCC), or care based on residents' values and preferences. NH staff associate certain resident preferences with risk. However, there are limited evidence-based person-centered risk management strategies to assist NH staff with risky resident preferences. The purpose of the current study was to explore NH staff perceptions of health and safety outcomes associated with honoring NH residents' risky preferences to inform intervention development. This descriptive, qualitative study used sequential focus groups and content analysis, revealing that nursing staff perceive negative and positive outcomes for staff and residents when seeking to honor residents' risky preferences. This finding is supported by three themes: Potential Harms to Staff , Potential Harms to Residents , and Positive Shared Outcomes . These results contribute a set of nurse-driven quality of life and quality of care outcomes for NH staff and residents associated with PCC delivery in NHs. [ Research in Gerontological Nursing, 15 (6), 271–281.]

Background Moderate to severe pain has been frequently reported in hospitalized older adults. Pain in hospitalized persons with dementia within the context of other common symptoms, functional decline, delirium, and behavioral and psychological symptoms of dementia (BPSD), has received little attention. Aims Describe the incidence of pain, the pharmacologic management of pain, and the association of pain with physical function, delirium, and BPSD in hospitalized persons with dementia. Design Descriptive, cross-sectional study. Setting Six medical units in three hospitals. Participants Baseline data from 299 hospitalized persons with dementia enrolled in the Family-centered Function-focused Care (Fam-FFC) cluster randomized trial. Methods Descriptive analyses of pain used the Pain Assessment in Advanced Dementia (PAINAD) scale and the use of medication for pain management. Linear regression analyses tested relationships between pain and:1) physical function (Barthel Index), 2) delirium severity (Confusion Assessment Method Severity Short Form) and 3) BPSD severity (Neuropsychiatric Inventory- Questionnaire). Results The majority of the sample was female (61.9%), non-Hispanic (98%), and Black (53.2%), with a mean age of 81.58 (SD=8.54).Of the 299 patients, 166 (56%) received pain medication. Of the 108 individuals who demonstrated pain, 40% (n=43) did not receive pain medication. When controlling for age, gender, cognition, and comorbidities, pain was significantly associated with function, delirium severity, and BPSD severity. Conclusions Results suggest that pain may be undertreated in hospitalized persons with dementia, and should be considered upon admission to optimize function, decrease delirium, and prevent or decrease BPSD.

Objectives: This study examined differences in physical function, delirium, depressive symptoms, and behavioral and psychological symptoms of dementia (BPSD) in hospitalized African American and white older adults with dementia. Methods: This secondary data analysis using baseline data from an ongoing trial testing family-centered function-focused care included African American ( n = 159) and white persons ( n =135) with dementia. Results: A multivariate analysis of covariance showed that controlling for relevant demographic and health characteristics, African Americans with dementia had lower physical function, more delirium, and more depressive symptoms upon admission than white participants. There were no significant differences in BPSD between African American and white persons. Discussion: To our knowledge, this is the first study to examine racial differences in admission symptoms of hospitalized persons with dementia. While the findings are preliminary, they can be used to inform the design of future research, including identifying the causes of disparities.

Hospitalized persons with dementia are at higher risk for functional decline and cognitive loss related to delirium. Family-centered, function-focused care (Fam-FFC) engages the family care partner in education and active participation in function-focused goal setting, implementation, and evaluation to support delirium prevention and abatement and return to baseline physical function. The purpose of the current study was to examine the association of function-focused goal attainment with two discharge outcomes, return to baseline physical function and delirium severity at discharge, in hospitalized persons with dementia. In the ongoing Fam-FFC clinical trial, the majority of goals ( N = 433) developed by 134 care partner/patient dyads and nurses address mobility, cognitive stimulation, and self-care. Regression techniques demonstrated that goal attainment was significantly associated with return to baseline function ( B = 0.826, Wald = 4.17 [1], p = 0.041) and lower delirium severity at discharge ( B = 0.175, t = 2.239, p = 0.027). Results support the contribution of family engagement in promoting functional recovery of hospitalized persons with dementia. [ Journal of Gerontological Nursing, 47 (9), 13–20.]

AIM: The purpose of this study was to explore and describe pre-licensure nursing students’ perceptions of risk for medication administration errors in fourth-year baccalaureate student nurses from three campuses at a large X university. BACKGROUND: Medication administration errors continue to be a significant safety concern in healthcare settings. Pre-licensure nursing education is a critical time period during which to have an impact on future medication administration practices. Perception of risk influences decision making and behavior, including nursing clinical decision making. DESIGN: This descriptive, exploratory study involved a qualitative design. METHODS: A thematic analysis of the qualitative data resulting from 60 individual, in-depth semi-structured interviews was conducted. RESULTS: The participants offered rich, detailed narratives which revealed the following themes: 1) the nature of risk perceptions, 2) more opportunities to learn, 3) experiences with medication administration error and 4) intrinsic characteristics influence errors. CONCLUSIONS: The findings provide a broad description of the nature of student nurse risk perceptions for future medication administration errors. Recommendations for nursing education practice and pedagogy include additional clinical experiences, modified pharmacology curricula and instruction and expanded simulations involving medication administration error.

Partnering with families to develop function-focused plans for hospitalized persons with dementia (PWD) improves both the hospital experience and patient outcomes. This secondary analysis included patients enrolled in the intervention arm of the on-going Family-centered Function-focused Care (Fam-FFC).study. This study examined the goals co-established by family caregivers, PWD, and nurses to prevent hospital-acquired complications and promote functional and cognitive recovery. The influence of goal attainment upon delirium and physical function at discharge was also examined. The majority of patients (N=162) were female (65%), black (53%) with a mean age of 82.7 (SD= 8.2). Goal attainment ranged from -2 to 2; mean = -0.24 (SD= 0.75). The goals (N=432) represent three main areas: mobility, self-care, and cognitive stimulation. Controlling for age and admission function, goal attainment was associated with less discharge delirium (F=3.2, p = .022) but not discharge function. Results support the contribution of function-focused care to improving delirium outcomes.