The effect of forearm position on elbow flexion strength in nursing, occupational, and physical therapy students

BACKGROUND: Novice nurses, occupational and physical therapist’s injury rates are alarming. OBJECTIVE: To test for differences in peak elbow flexion forces (PEFF) by profession using different forearm positions. METHODS: Entry-level RN, OT, and PT students performed 3-repetitions of standing PEFF in forearm supination, pronation, and neutral. A one-way repeated measures ANOVA determined the forearm position with the greatest PEFF. A one-way ANOVA assessed differences in PEFF between professions. The alpha level was set at p≤0.05 for all analyses. RESULTS: Thirty 30 RN, 25 OT, and 30 PT students (x = 23.27 + /–3.29 yrs.) were studied. A one-way repeated measures ANOVA revealed a significant difference in PEFF between positions (F(2,168) = 144.3, p < 0.0001). A significant (p < 0.0001) pairwise comparison revealed neutral produced the greatest (28.15 + /–12.64 kg) and pronation the least PEFF (17.27 + /–7.40). PEFF was significantly different between position by profession (supination: F(2,82) = 10.14, p < 0.0001; pronation: F(2,82) = 10.33, p < 0.0001; neutral: F(2,82) = 13.39, p < 0.0001). PTs were significantly stronger than OTs and RN students in all forearm positions (p < 0.01). CONCLUSIONS: Neutral PEFF was greatest and PT students demonstrated greater PEFF than OT and RN students.

Alcohol Hand Rub Significantly Reduces Overall Bacterial Bioburden on Stethoscopes in a Real-World Clinical Setting

Background: Stethoscopes are a known vector for microbial transmission; however, common strategies used to clean stethoscopes pose certain barriers that prevent routine cleaning after every use. We aimed to determine whether using readily available alcohol-based hand rub (ABHR) would effectively reduce bacterial bioburden on stethoscopes in a real-world setting. Methods: We performed a randomized study on inpatient wards of an academic medical center to assess the impact of using ABHR (AlcareExtra; ethyl alcohol, 80%) on the bacterial bioburden of stethoscopes. Stethoscopes were obtained from healthcare providers after routine use during an inpatient examination and were randomized to control (no intervention) or ABHR disinfection (2 pumps applied to tubing and bell or diaphragm by study personnel, then allowed to dry). Cultures of the tubing and bell or diaphragm were obtained with premoistened cellulose sponges. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but ~5 mL of the supernatant was discarded. Samples were plated on sheep’s blood agar and selective media for clinically important pathogens (CIPs) including S. aureus, Enterococcus spp, and gram-negative bacteria (GNB). CFU count was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. Results: In total, 80 stethoscopes (40 disinfection, 40 control) were sampled from 46 physicians (MDs) and MD students (57.5%), 13 advanced practice providers (16.3%), and 21 nurses (RNs) and RN students (26.3%). The median CFU count was ~30-fold lower in the disinfection arm compared to control (106 [IQR, 50–381] vs 3,320 [986–4,834]; P < .0001). The effect was consistent across provider type, frequency of recent usual stethoscope cleaning, age, and status of pet ownership (Fig. 1). Overall, 26 of 80 (33%) of stethoscopes harbored CIP. The presence of CIP was lower but not significantly different for stethoscopes that underwent disinfection versus controls: S. aureus (25% vs 32.5%), Enterococcus (2.5% vs 10%), and GNB (2.5% vs 5%). Conclusions: Stethoscopes may serve as vectors for clean hands to become recontaminated immediately prior to performing patient care activities. Using ABHR to clean stethoscopes after every use is a practical and effective strategy to reduce overall bacterial contamination that can be easily incorporated into clinical workflow. Larger studies are needed to determine the efficacy of ABHR at removing CIP from stethoscopes as stethoscopes in both arms were frequently contaminated with CIP. Prior cleaning of stethoscopes on the study day did not seem to impact contamination rates, suggesting the impact of alcohol foam disinfection is short-lived and may need to be repeated frequently (ie, after each use).Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

Circadian Typology and Personality Dimensions of Croatian Students of Health-Related University Majors

The aim of this study was to determine the relationship between circadian preferences and personality dimensions among 712 students of three different majors from the Faculty of Medicine, Osijek: medical students (MD), nursing students (RN) and medical laboratory diagnostics students (MLD). For the measurement of personality dimensions, the IPIP50 Big-Five questionnaire was used. The circadian preference of students was assessed using the reduced morningness-eveningness questionnaire (rMEQ). Several significant results were observed and there was a significant difference in circadian preference among the three tested groups, with RN students scoring highest on the morningness scale and MLD students scoring the lowest. RN students scored significantly higher on agreeableness and conscientiousness than the other two groups. On the other hand, MD students scored higher on intellect than the MLD students. MLD students scored the lowest on emotional stability scales. Morning type students had higher conscientiousness and emotional stability scores. These results imply that circadian preference and personality traits are crucial elements of medical professionals’ wellbeing. With this paper, we would like to raise awareness about common personality traits and adherence to certain circadian orientations in medical professionals as a motivation to introduce a more flexible view towards strict time and task divisions in everyday practice.

The effect of a mindfulness based stress reduction intervention on the perceived stress and burnout of RN students completing a doctor of nursing practice degree

Background and objective: There is a vast amount of literature documenting the epidemic of stress and burnout within the nursing profession. It is well established that chronic stress contributes to burnout among nursing staff and students. Research suggests that organizational change, curriculum adjustment, and mindfulness interventions can contribute to decreased stress and better outcomes for nurses. The objective of this study was to investigate the effect of a Mindfulness Based Stress Reduction (MBSR) intervention on the perceived stress and burnout of students in a cohort of Registered Nurses (RNs) completing a Doctor of Nursing Practice (DNP) Degree.Methods: This study utilized pre and post data collection to explore the effect of a MBSR intervention on self-reported perceived stress and burnout using the Perceived Stress Scale (PSS) and Copenhagen Burnout Inventory (CBI). Study participants (n = 24) received a general orientation to the study followed by a brief intervention using the body scan meditation, a component of the MBSR-model. Students registered with the Remind mobile app to supplement the live instruction and to encourage the students to engage in daily mindfulness practice.Results: The repeated measures ANOVAs for all three CBI factors showed that personal, work, and client burnout means were statistically lower at four weeks post-intervention than they were at baseline. Perceived stress measures four weeks post-intervention were also statistically lower than baseline. There were no demographic interactions, and only one main effect for gender, in that males reported lower perceived stress. Conclusions: The MBSR intervention was successful in reducing the self-reported perceived stress and burnout of RN students completing their DNP Degree.