Background Smart infusion pumps with dose error reduction software can be used to prevent harmful medication errors. The aim of this study was to develop a method for defining and assessing optimal dosing limits in a neonatal intensive care unit's smart infusion pump drug library by using simulation-type test cases developed based on medication error reports. Methods This mixed-methods study applied both qualitative and quantitative methods. First, wrong infusion rate-related medication errors reported in the neonatal intensive care unit during 2018-2019 were explored by quantitative descriptive analysis and qualitative content analysis to identify the error mechanisms. The researchers developed simulation-type test cases with potential errors, and a literature-based calculation formula was used to set upper soft limits to the drug library. The limits were evaluated by conducting programming of pumps without errors and with potential errors for two imaginary test patients (1 kg and 3.5 kg). Results Of all medication errors reported in the neonatal intensive care unit, 3.5% (n = 21/601) involved an error or near-miss related to wrong infusion rate. Based on the identified error mechanisms, 2-, 5-, and 10-fold infusion rates, as well as mix-ups between infusion rates of different drugs, were established as test cases. When conducting the pump programming for the test cases (n = 226), no alerts were triggered with infusion rates responding to the usual dosages (n = 32). 73% (n = 70/96) of the erroneous 2-, 5-, and 10-fold infusion rates caused an alert. Mix-ups between infusion rates triggered an alert only in 24% (n = 24/98) of the test cases. Conclusions Simulation-type test cases can be applied to assess the appropriateness of dosing limits within the neonatal intensive care unit's drug library. In developing the test cases, combining hospital's medication error data to other prospective data collection methods is recommended to gain a comprehensive understanding on mechanisms of wrong infusion rate errors. After drug library implementation, the alert log data and drug library compliance should be studied to verify suitability of dosing limits.

Universities invest in teaching academies to reward outstanding teachers. Few studies have been published about the impact of teaching academies on teaching communities. The aim of this study was to see who excellent academic teachers spoke to when they discussed teaching and learning, and what kind of community a Teachers' Academy established in 2013 offered to its Fellows. We analysed the answers to two open-ended questions from two surveys. The first survey (2013) was addressed to first-round applicants to the Academy in 2013 (N = 46, 32%) and the second (2018) to its Fellows (N = 56, 65%). In both surveys, most teachers had meaningful discussions with their close colleagues. In the second survey, the conversations with pedagogical experts merged with the discussions at the Academy. The 2018 survey also examined how well the Academy's key objectives of providing teachers with an interdisciplinary community and peer support had been achieved in five years. The Academy had become an important community for teachers, in which teachers shared mutual appreciation for teaching and collaborated across disciplinary boundaries and campuses. A challenge for a teaching academy is to support its fellows in implementing the principles of scholarship of teaching and learning, that is, carrying out scholarly educational projects and sharing the results locally, nationally and internationally.

Purpose - The purpose of this study was to investigate how a workshop can enhance first-year university students' understanding of their study strategies and self-regulated learning. Design/methodology/approach - Aqualitative content analysis was done of 190 reflective journals written by first-year university students. Findings - The main findings confirmed that starting studies in higher education is challenging for many students. New insights were provided on how these challenges can be addressed, especially regarding selfregulated learning. Students perceived that they gained several insights from the workshop that they believed could benefit their studying and thereby enhance motivation. Practical implications - This study showed that even small measures promote both good study habits and specifically self-regulated learning skills. Interventions like the workshop described in this study ease first-year students' transition to the university and foster successful studies for all students. Originality/value - This study contributes to research on supporting students' transition to higher education by investigating how students perceive early study skill interventions. It adds to a holistic perspective of students' challenges and coping strategies during their first semester in higher education.

Positive education is the teaching of both traditional school skills and skills for enhancingwell-being. This study examines teachers' (N = 72) experiences with training in positive education.Qualitative content analysis was used to provide an in-depth understanding of theexperiences, and quantitative measures investigated teachers' well-being. Results show thatteachers experienced both personal and professional growth. They also saw positive changesin their students. Teachers used methods of positive education e.g. when communicating withstudents and co-workers, and when supporting the students' socioemotional development.Challenges with implementing positive education practices mostly consisted of lack of timeor support from colleagues. The authors argue that positive education is an effective tool forenhanced well-being both for participating teachers and their students and could therefore be utilised on alarger scale. Future studies could focus on whether teachers continue systematicimplementing of positive education methods long-term, and the reasons behind continued ordiscontinued.

Purpose: This paper aims to explore the acceptability of Dynamic Appraisal of Situational Aggression (DASA) from the perspective of patients, its actual use by mental health nurses, and the predictive validity of the DASA instrument. Methods: A feasibility study design incorporating quantitative and qualitative components was used. The study was conducted in three mental health inpatient units at three hospitals in southern Finland. Quantitative data were used to explore demand (nurses' actual use of the DASA), limited efficacy (predictive validity), and acceptability (measured through patients' participation in the project). Qualitative data were collected to enhance the understanding of acceptability by describing patients' perceptions of the strengths and weaknesses of the DASA. Results: Nurses used the DASA for most patient assessments. The predictive validity of the DASA was outstanding or excellent, depending on the type of aggression predicted, although the patient recruitment ratio was low. Patients reported both strengths and weaknesses of the DASA, providing complementary information regarding the instrument's acceptability and clinical application. Conclusion: The DASA accurately predicts inpatient aggression. The patients' preferences and concerns regarding risk assessment have been noted. More patient involvement in risk assessment research and violence prevention efforts is required.

Background: Patient violence against nurses in their work environments is a widespread global concern, particularly in the field of mental health care. A high prevalence of violent events impacts the well-being of nurses and may also impair overall ward climate. However, it has been proposed that nurses' use limited techniques to prevent patient violence, and, therefore, more comprehensive methods for dealing with patient violence are needed. There is still restricted understanding of the ward climate during the occurrence of a violent event as well as how these incidents could be more effectively prevented. This study aimed to explore nurses' experiences of violent events in psychiatric wards, give insight into ward climates and examine suggestions for violence prevention. Methods: This study employed a descriptive, exploratory design including focus groups (n = 5) and open-ended questions. The participants were registered and enrolled nurses (n = 22) working on three closed psychiatric inpatient wards in one Finnish hospital district. Focus groups were tape-recorded, transcribed and analyzed with inductive content analysis. Results: Nurses' experiences of violent events included a variety of warning signs and high-risk situations which helped them to predict forthcoming violence. Patient-instigated violent events were described as complicated situations involving both nurses and patients. When the wards were overloaded with work or emotions, or if nurses had become cynical from dealing with such events, well-being of nurses was impaired and nursing care was complicated. Suggestions for violence prevention were identified, and included, for example, more skilled interaction between nurses and patients and an increase in contact between nurses and patients on the ward. Conclusions: This study revealed the complexity of violent events on psychiatric wards as well as the implications of these events on clinical practice development and training, administration and policy. A routine process is needed through which nurses' experiences and ideas concerning prevention of violent events are acknowledged.