Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department

Background

Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient‐initiated violence.

Methods

A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient‐initiated violence estimates were calculated comparing genders. Semi‐structured interviews and a focus group were conducted with injured EMS responders.

Results

Paramedics had significantly higher odds for patient‐initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2–22.2, P < 0.001). Females reported increased odds of patient‐initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8–10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94–2.85). Qualitative data illuminated the impact of patient‐initiated violence and highlighted important organizational opportunities for intervention.

Conclusions

Mixed methods greatly enhanced the assessment of EMS responder patient‐initiated violence prevention. Am. J. Ind. Med. 59:150–163, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.     

Use of electronic nicotine delivery systems (ENDS) in lesbian,gay, bisexual,transgender and queer persons: Implications for public health nursing

Smoking and rates of tobacco abuse remain higher in lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons. There has been very little scholarly inquiry about the emerging trend of use of electronic nicotine delivery systems (ENDS; e.g., vaping and eCigarettes [eCigs]) in LGBTQ populations. The purpose of this article is to: (a) explore the most recent prevalence data regarding smoking and tobacco abuse in LGBTQ persons, (b) reveal strategies the tobacco industry has historically used in marketing their products to the LGBTQ community, (c) review data from the few studies evaluating use of ENDS in LGBTQ persons, (d) provide evidence-based methods public health nurses can employ to discourage use of ENDS in LGBTQ persons by addressing two identified causes of ENDS use in LGBTQ populations (harassment/discrimination in LGBTQ youth and binge drinking in LGBTQ adults), and (5) encourage cessation among those already using ENDS.     

Nurse delivered medication safety screening program for home care visits

Home care clients have safety barriers related to medication storage, disposal, and safe use of opioids. Limited research is available regarding medication safety initiatives in the home care setting. This study evaluates a medication safety initiative, linked with opioid misuse and overdose prevention screening, for home care clients with different levels of service. Training and screening tools designed for community pharmacies by the Opioid & Naloxone Education (ONE) Program were modified for use by home health nurses. All new admits to the home health services were screened for medication storage, medication disposal, and use of pain medications. Patients taking opioids were screened for opioid-specific risks. Interventions based on screening results included education, provision of medication lock boxes, drug disposal packets, and/or naloxone. Most home care clients (85%) are properly storing their medication and 38% were not properly disposing unused medications. Higher levels of care had greater pain medication needs, including the provision of naloxone. This study demonstrates the opportunity to incorporate medication safety screening into nursing home health visits.     

Results of a Statewide Survey of Adolescent Substance Use Screening Rates and Practices in Primary Care

ABSTRACT

Professional guidelines recommend annual screening, brief intervention, and referral to treatment (SBIRT) as part of health maintenance for all adolescents, but reported screening rates have been low and no report has documented the techniques being used. The objective of this study was to describe the results of a statewide questionnaire regarding adolescent substance use screening rates and techniques used by primary care physicians practicing in Massachusetts. A questionnaire was mailed to every licensed physician registered as practicing pediatrics (N = 2176), family medicine (N = 1335), or both (N = 8) in the Massachusetts Board of Medicine database. After eliminating physicians who did not provide care for adolescents, the survey response rate was 28% and the final analyzable sample consisted of 743 surveys. Less than half of respondents reported using a validated adolescent screening tool. The majority of respondents used ineffective screening practices for adolescent substance use. Further physician training is recommended to encourage the use of developmentally appropriate screening tools and interventions for adolescents.     

Advanced Ethics for Addiction Professionals,by Michael J. Taleff

This article discusses what a social worker or health practitioner should know about the family and its influence on health care among various ethnic groups, focusing first on basic information on family organization and interrelationships and then on the family's role during health care. The material is presented in a format designed to be useful to the practitioner in the field, discussing what important aspects of various topics the worker might investigate, why the information is important, and how to gather it.     

Increasing the pipeline and diversity of doctorally prepared nurses: Description and preliminary evaluation of a health disparities summer research program

Despite calls to increase the number and diversity of doctorally prepared nurses, recent data indicate a severe shortage of PhD‐prepared nurses, especially those of racial/ethnic minority backgrounds. This is concerning, given that evidence indicates that racial/ethnic minority PhD‐prepared nurses are well‐positioned to address health disparities, by attending to the needs/concerns of medically underrepresented groups. The purpose of this article is to describe and provide a preliminary evaluation of a summer research program for minority nursing students. Online surveys were administered to assess for student satisfaction, knowledge gains, attitudes toward research, and intentions to pursue a PhD among minority undergraduate nursing students (N = 6) participating in the 10‐week program. Favorable trends were observed related to satisfaction, knowledge gains, and attitudes toward research. Fifty percent of the sample intended to pursue a PhD immediately after the program, compared to none before the program, and this result was maintained at 1‐year post‐program. The summer research program appears to be a promising strategy for increasing the number/diversity of PhD‐prepared nurses. More research on the implementation of programs exposing minority nursing students to health disparities research is needed to strengthen evidence that similar programs can serve to increase the pipeline of diverse doctorally prepared nurses.