Implementation of a Walking School Bus: Lessons Learned*

Background: Obesity is rapidly becoming the most common chronic medical condition affecting children. To address this crisis, an Albuquerque, New Mexico, elementary school partnered with University of New Mexico researchers and conducted a Walking School Bus (WSB). The purpose of this article is to examine the feasibility of implementing a WSB. Methods: This pilot study featured 2 WSBs conducted for 10 weeks with kindergarten through fifth‐grade students from a predominantly Hispanic elementary school. Qualitative and quantitative data, including coordinator field notes, attendance records, surveys of student and parent satisfaction, and a focus group, were used to evaluate feasibility. Results: Student and adult participants expressed a high degree of enthusiasm regarding their involvement in the WSB. Participants uniformly indicated that the WSB provided a supportive and safe environment to promote social interaction and physical activity. Conducting a WSB in an urban, underserved school district is feasible but requires attention to ensure participants’ involvement and safety. In particular, it is recommended to begin the planning process early to enhance investment from key stakeholders. Conclusion: Effective, low‐cost interventions are increasingly desired as solutions to the problem of obesity. The WSB has emerged as a promising strategy to address obesity and encourage partnerships across different social levels. Further research is necessary to assess the logistical challenges associated with conducting a large‐scale WSB trial and whether such efforts lead to reductions in obesity risk factors.     

Academic leadership in nursing: legitimating the discipline in contested spaces

Aim  To investigate the potential of recent conceptual developments in the sociology of education for conceptualising academic leadership in nursing.
Background  During an investigation into the current status and future trajectory of academic nursing in Ireland, academic leadership emerged as a major concern for respondents.
Method  The languages of legitimation of academic leaders were elicited in in-depth interviews and analysed as expressions of underlying legitimation principles.
Results  The concept of legitimation principles provides a way of thinking about how academic nursing is positioned in the health and higher education sectors, how its leaders construct its identity, practices and purposes, and clarifies the proper focus and goals of academic leadership in nursing.
Conclusions  Academic leadership is concerned with legitimating the discipline of nursing as an autonomous, coherent and distinctive professional and academic endeavour. This legitimacy must be secured in academic, clinical and wider contexts in which academic nursing is viewed with ambivalence; leaders must take account of the impact of nursing history on the current status and future trajectory of the discipline.
Implications for nursing leadership  The analytic tools facilitate a better understanding of the internal and external conditions under which academic nursing will flourish, or wither, in contemporary higher education.     

Reducing nosocomial infection in neonatal intensive care: An intervention study

Nosocomial infection is a common cause of morbidity and mortality for hospitalized neonates. This report describes measures taken to reduce the prevalence of nosocomial infection within a 34‐bed neonatal intensive care unit in Malaysia. Interventions included a one‐to‐one education programme for nursing staff (n = 30); the education of cleaners and health‐care assistants allocated to work in the unit; and the introduction of routine (weekly) screening procedure for all infants with feedback given to staff. The education programme for nurses focused on the application of standard precautions to three common clinical procedures: hand washing, tracheobronchial suctioning and nasogastric tube feeding. These were evaluated using competency checklists. The prevalence of nosocomial blood and respiratory tract infections declined over the 7‐month study period. This study highlights the importance of education in contributing to the control of nosocomial infection in the neonatal intensive care unit.     

Adverse events in health care: a literature review

Aim  This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the healthcare system.
Background  Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes.
Evaluation  A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue.
Key issues  Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences.
Conclusion  Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations.
Implication for Nursing Management  Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care.     

Tenants of Trust: Building Collaborative Work Relationships

Relationships are built and sustained because of trust-building behaviors demonstrated by the leader and the work team. Likewise, many work relationships have been destroyed by trust-eroding behaviors. One of the most important roles of the leader is to build collaborative partnerships in the workplace. Collaborative activities help to engage employees in the decision-making activities that affect how they get their work done as well as build trust between employees and management. By sharing ideas and designing solutions to workplace challenges, employees feel appreciated, respected, and valued. Collaboration—working synergistically together to achieve a common goal—is one of the most essential factors needed to build and sustain business results. At the core of collaboration is trust.     

Evaluation of health promotion activities in community nursing practice

The purpose of this research was to study the extent to which community nurses (CNs) were involved in health promotion activities and to investigate whether these activities were meeting the needs of their clients A cross-sectional survey by multiple methods was designed and carried out in four district health authorities (DHAs) in one regional health authority in England Two hundred and fifty-one (83 67%) completed questionnaires were returned by CNs working in primary health care (PHC) Sixty sessions with CNs were observed and 249 interviews were conducted with clients Additionally, as part of the observation 155 clinical records were examined CNs reported involvement in a wide range of opportunistic and organized health promotion activities Lifestyle advice and ill-health prevention were most frequently used by all groups Health visitors (HVs) were involved significantly more in group and community wide activities District nurses (DNs) were mainly involved in opportunistic health promotion Practice nurses (PNs) were found to be involved significantly more in health promotion activities organized on an individual basis Observation revealed that opportunistic health promotion was carried out in almost half of the consultations observed, of which lifestyle advice was the most frequent Records however showed that this information was rarely recorded The clients of PNs were mostly aware of other health promotion activities available within the general practice, while almost half of the HVs 'clients knew what other health promotion activities were available to them and few DNs' clients were aware of any