Building a Culturally Responsive Workforce: Faculty of Color in Nursing Education

The representation of nursing faculty of color is disproportionate to that in the general population, despite recruitment and retention strategies. Boosting the presence of nursing faculty of color requires an understanding of factors that undermine diversity initiatives and calls for the adoption of innovative practices. This article addresses the importance of racial and ethnic diversity within nursing education. Furthermore, it examines the factors that prevent the recruitment and retention of a racially and ethnically diverse nursing faculty workforce and provides evidence-based recommendations for increasing diversity among nursing faculty and nursing organizations.     

Healthcare professionals’ knowledge,skills, and role in offering and facilitating memory making during end-of-life care in the adult intensive care unit

BackgroundAn activity to provide a tangible keepsake following the death of a loved one is termed ‘memory making’. However, limited evidence is available related to professionals' education and support to provide memory making opportunities in the adult intensive care unit (ICU). Having a greater understanding of healthcare professionals’ experiences can inform future patient/family care and support for professionals in end-of-life care.ObjectiveThe objective of this study was to describe what participants perceive memory making to be, if they have facilitated memory making activities as part of their practice, if they perceive it as part of their role, and if they have the necessary skills to do so.MethodsSeventy-five registered nurses (75% response rate), 19 medical doctors (76% response rate), and two social workers (66.7% response rate) completed a survey at a single tertiary referral centre in an adult ICU.ResultsParticipants reported memory making to include the creation of tangible keepsakes as well as nontangible activities. Overall, participants reported high agreement scores that the responsibility for initiating memory making predominately belonged to the nurse. Participants reported skills most needed involved the ability to interact with the family, being open to the concept, and integrating memory making into their standard of care. Having developed a rapport with families was considered an enabler, whereas lack of knowledge and clinical workload were reported as inhibitors to offering memory making.ConclusionsOverall, participants in this study reported positive experiences with offering memory making to families during end-of-life care in the adult ICU. Nurses are more likely to perceive professional responsibility for offering memory making, likely due to their increased time at the bedside and higher prominence and leadership in other end-of-life practices. To support professionals, education should include conceptual knowledge, procedural knowledge of keepsake creations, communication techniques using reflective practices, and organisational support to facilitate time requirements.     

NICE’s recent guidelines on “the size of your waist” unfairly penalizes shorter people

The National Institute for Clinical Excellence (NICE) has just released its latest guidelines to assess and predict health risk, such as type 2 diabetes, hypertension or cardiovascular disease. Their latest advice is “Keep the size of your waist to less than half of your height”. We believe this advice is flawed and will seriously and unfairly penalize shorter people and lull taller people into a false sense of security. In this short communication, we provide this evidence. We consider this a serious oversight by NICE and feel strongly that this evidence needs to be made available in the public domain.     

Comparison of Foaming Properties Between the Shirasu Porous Glass Membrane Device and Tessari’s Three-way Stopcock Technique for Polidocanol and Ethanolamine Oleate Foam Production: A Benchtop Study

PurposeTo compare the characteristics of polidocanol (POL) and ethanolamine oleate (EO) sclerosing foams produced by a Shirasu porous glass membrane (SPGM) device with those made using a 3-way stopcock (3WSC).Materials and MethodsFoam half-life times were measured in an ex-vivo benchtop study. Computed tomography (CT) images of each foam were obtained over the time course, and a CT texture analysis was conducted. The bubble size in each foam was measured by an optical microscope.ResultsMedian foam half-life times were longer in the SPGM group than in the 3WSC group (POL: 198 vs 166 s, P = .02; EO: 640 vs 391 s, P < .01). In the CT texture analysis, median standard deviation (SD) and entropy (randomness) were lower, and median energy (uniformity) and gray-level cooccurrence matrix (GLCM) homogeneity were higher in the SPGM group than in the 3WSC group (POL SD: at 30 s and 50–300 s; POL entropy: at 0–60 s; EO SD: at 0–600 s; EO entropy: at 0–460 s; POL energy: at 0–40 s; POL GLCM homogeneity: at 0–250 s; EO energy: at 0–360 s; EO GLCM homogeneity: at 0–480 s; all P < .05). Median bubble diameters in the SPGM group and in the 3WSC group were 69 and 83 μm (P < .01), respectively, in the POL foam; and 36 and 36 μm (P = .45), respectively, in the EO foam.ConclusionsPOL and EO foams had greater uniformity and longer foam half-life time when prepared with an SPGM device than with a 3WSC.     

435例原发性高血压患者脉图参数与心血管危险分层的相关性分析

目的 本研究旨在探讨原发性高血压患者脉图参数与心血管危险分层的相关性，为原发性高血压患者心血管风险事件预警提供中医特色的依据。方法 采集435例原发性高血压患者的症状体征、脉象信息、生化指标等，分为低中危组、高危组、很高危组，采用单因素方差分析、秩和检验、有序logistic回归分析等方法，探讨原发性高血压患者脉图参数与心血管危险分层的相关性。结果 ①高血压低中危组→高危组→很高危组患者病程逐渐延长，两两组间比较有统计学差异；②高血压低中危组→高危组→很高危组患者的脉图参数H3/H1、H4/H1逐渐上升；高血压患者很高危组H5/H1、T1/T低于低中危组；③有序logistic回归分析结果显示，脉图参数T1、T4、T5、T为影响因素。结论 病程、血脂、肾功能是高血压患者心血管危险分层的影响因素之一。心血管危险分层等级的升高与脉图参数H3/H1、H4/H1、T5、T的升高及H5/H1、T4、T1的降低相关，说明脉图能一定程度上反映原发性高血压患者血管壁增厚、血管内壁受损、血管硬化及左心室收缩功能的减退程度。     

Performance of risk prediction models for post-operative mortality in patients undergoing liver resection

BackgroundLiver resection is commonly performed for hepatic tumors, however preoperative risk stratification remains challenging. We evaluated the performance of contemporary prediction models for short-term mortality after liver resection in patients with and without cirrhosis.MethodsThis retrospective cohort study examined National Surgical Quality Improvement Program data. We included patients who underwent liver resections from 2014 to 2019. VOCAL-Penn, MELD, MELD-Na, ALBI, and Mayo risk scores were evaluated in terms of model discrimination and calibration for 30-day post-operative mortality.ResultsA total 15,198 patients underwent liver resection, of whom 249 (1.6%) experienced 30-day post-operative mortality. The VOCAL-Penn score had the highest discrimination (area under the ROC curve [AUC] 0.74) compared to all other models. The VOCAL-Penn score similarly outperformed other models in patients with (AUC 0.70) and without (AUC 0.74) cirrhosis.ConclusionThe VOCAL-Penn score demonstrated superior predictive performance for 30-day post-operative mortality after liver resection as compared to existing clinical standards.     

基于罗森塔尔效应的护理干预对脑出血后遗症病人的心理状况和生活质量的影响

目的:探讨基于罗森塔尔效应的护理干预对脑出血后遗症病人的心理状况和生活质量的影响。方法:按照随机数字表法将2019年1月—2021年1月收治的98例脑出血后遗症病人分为对照组和观察组各49例,对照组实施常规护理,观察组在常规护理基础上给予基于罗森塔尔效应的护理干预。干预前后采用卒中量表(NIHSS)、功能独立性评定量表(FIM)、生活活动功能测量量表Barthel指数(BADL)评定两组病人康复情况,采用非精神病性焦虑量表(HADS-A)、非精神病性抑郁量表(HADS-D)、自我效能量表(GSES)评定两组病人心理状态,采用生活质量简明调查表(SF-36)评定两组病人生活质量。结果:观察组病人干预后NIHSS评分低于对照组,FIM和BADL评分高于对照组(P<0.05);观察组病人干预后HADS-A和HADS-D评分低于对照组,GSES评分高于对照组(P<0.05);观察组病人干预后生活质量各维度(躯体功能、躯体角色、肌体疼痛、总体健康、活力、社会功能、情绪角色、心理卫生)评分均明显高于对照组(P<0.05)。结论:基于罗森塔尔效应的护理干预应用于脑出血后遗症病人能有效促进病人康复,改善病人心理状态,提高病人生活质量。