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Abstract: This paper reports a discourse analysis of the language doctors used as they talked about and engaged in patient handoffs between the emergency department (ED) and various inpatient services at one highly specialized academic tertiary teaching and referral hospital in the Midwest United States. Although interest in handoff improvement has grown considerably in recent years, progress has been hampered, perhaps in part, because of a widely used but limiting conceptual model of handoff as an information transmission. The purpose of the study reported here is to analyze the way doctors make sense of handoff interactions, including uncovering the interpretive frames they use, in order to provide empirical findings to expand conceptual models of handoff. All data reported were drawn from a two-year ethnographic study (2009–2011) and include semi-structured interviews (n = 48), non-participant observations (349 h), and recorded telephone handoff conversations (n = 48). A total of eighty-six individuals participated, including resident and attending doctors from the ED, internal medicine and surgical services, as well as hospital administrators. Findings are organized around four metaphors doctors used: sales, sports and games, packaging, and teamwork. Each metaphor, in turn, reveals an underlying interpretive frame that appears to be influenced by organizational and social structures and to shape the possibilities for action that doctors perceive. The four underlying interpretive frames are: handoff as persuasion, handoff as competition, handoff as expectation matching, and handoff as collaboration. Taken together, these interpretive frames highlight the complex, socially interactive nature of handoff and provide an empirical basis for grounding and enriching the conceptual model of handoff that guides research and practice improvement efforts. [Copyright &y& Elsevier]

Abstract: The release of the Institute of Medicine () report “To Err is Human”, brought attention to the problem of medical errors, which led to a concerted effort to study and design medical error reporting systems for the purpose of capturing and analyzing error data so that safety interventions could be designed. However, to make real gains in the efficacy of medical error or event reporting systems, it is necessary to begin developing a theory of reporting systems adoption and use and to understand how existing theories may play a role in explaining adoption and use. This paper presents the results of a 9-month study exploring the barriers and facilitators for the design of a statewide medical error reporting system and discusses how several existing theories of technology acceptance, adoption and implementation fit with many of the results. In addition we present an integrated theoretical model of medical error reporting system design and implementation. [Copyright &y& Elsevier]

Prominent nursing organizations globally have called for a concerted effort to increase diversity in nursing education. While the number of men in the nursing workforce in the United States has increased slowly over the past five decades, the proportion of men in the profession remains low in comparison to the U.S. population. In response to research indicating a less-than-optimal experience for male nursing students, faculty and students embarked on a collaborative effort to improve the experience of this student population. This paper explores the reasons that men choose to enter nursing as well as the lived experience of men in a baccalaureate prelicensure nursing program in the United States. The purpose of the study was to determine if progress had been made toward a shared goal of an improved experience for male students. Of the 19 male students who met the inclusion criteria, 13 students agreed to participate in the descriptive phenomenological study. Findings of this study indicate that previous interventions aimed at creating a more welcoming environment for male nursing students at the research site have been moderately successful. Clinically, it is evident that there is still more work left to be done, specifically regarding the maternal-newborn clinical experience. • Male nursing students experience gender bias in didactic and clinical education. • Men choose nursing for the caring aspect of the profession, similar to women. • Men also choose nursing for the perceived job security and financial rewards. • Mentorship and male role models would benefit male nursing students. • Faculty must ensure gender equity in didactic and clinical learning opportunities. [ABSTRACT FROM AUTHOR]

• Kinship care giving has been on the rise. • Grandparents provide majority of the kinship placements. • Kinship grandparents experience unique challenges to raising their grandchildren. • Child welfare systems should ensure kinship grandparent voices are heard. • Supports and service delivery should meet kinship families' needs and ensure empowerment. This paper presents the perspectives of a small sample of eight kinship caregivers, who are grandparents raising their grandchildren in a mid-Western state. The study explored the grandparents' experiences of family empowerment in public child welfare, using semi-structured qualitative interviews. The grandparents identify the services that they find useful, including both tangible resources and relational supports. They also highlight service gaps and unfulfilled needs, as well as aspects of their experience with public child welfare that they find concerning. The authors discuss the salience of including kinship grandparents' voices in shaping the services provided for them and offer recommendations for strategies that could empower the growing population, and improve the public child welfare system so that it is more responsive to its changing environment. [ABSTRACT FROM AUTHOR]