Anemia and its impact on function in nursing home residents: What do we know?

Purpose: To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes.
Data Sources: Literature review of current peer-reviewed research articles.
Conclusions: In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community-dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes.
Implications for Practice: Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence-based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence.     

Academic performance of nursing students: do prerequisite grades and tutoring make a difference?

The purpose of this study was to evaluate the relationship of prerequisite science course performance and tutoring services with academic performance of first semester nursing students. Quantitative data were gathered from student records after a semester in which tutoring services were offered. The convenience sample consisted of 37 students enrolled in first semester nursing courses. Influence on academic performance was determined by comparing the academic performance of two groups, students who attended four or fewer tutorial sessions and students who attended five or more tutorial sessions. Previous academic performance was shown to have a statistically significant relationship with first semester nursing school performance. Recommendations for nursing faculty are offered.     

Academic and clinical performance among nursing students: What's grit go to do with it?

BackgroundNursing is both a science and an art and requires students to develop sound scientific foundations for artful application. The at times binary nature of how the way in which the knowledge and skills of nursing are delivered in higher education can be difficult for students to comprehend initially and synchronise for practice and can lead to feelings of being overwhelmed, withdrawal or failure. Understanding what influences student performance in bachelor level nursing studies is imperative so educators can develop programs that straddle the art and science conundrum and lead to graduate success. Grit is a non-cognitive trait, a drive that keeps an individual on task through difficult circumstances for sustained periods of time. Grit might well represent a key factor in our understanding of why one student succeeds while another withdraws.ObjectivesTo examine measures of grit in the context of demographic characteristics of nursing students and their impact on student self-perceived academic and clinical performance.DesignA cross-sectional design.SettingA single School of Nursing at a multi-campus, regional, peri-urban Australian University.ParticipantsAll nursing students (n = 2349) studying a three-year bachelor of nursing degree were invited to participate.MethodsData were collected using a questionnaire that included several demographic items, questions relating to the student's perceived level of academic and clinical performance, and the eight-item Short Grit Scale (Grit-S) used to measure trait-level perseverance and passion for long-term goals.ResultsStudents, regardless of their year of study or any other demographic factor, showed grit was the only significant predictor of clinical and academic performance.ConclusionsThe strength between grit and perceived performance both academically and clinically, makes grit a valuable factor for development in students as a vehicle for success in nursing programs of study. This paper culminates in suggestions for creative approaches to grit development.     

Nursing educators’ and undergraduate nursing students’ beliefs and perceptions on evidence-based practice,evidence implementation,organizational readiness and culture: An exploratory cross-sectional study

AimsTo describe the undergraduate nursing students’ and nursing educators' evidence-based practice beliefs, their extent of evidence-based practice implementation and their perspectives regarding organizational culture for evidence-based practice. To identify any relationship between the mentioned variables.BackgroundThe integration of evidence-based practice in nursing curricula is crucial to educate nursing students to incorporate evidence-based practice in their future clinical practice. Therefore, to promote its integration within nursing education, it is important to deeply understand how prepared academic institutions are for teaching about and supporting evidence-based practice integration.DesignCross-sectional study.MethodsNursing educators and undergraduate nursing students from nine Portuguese nursing schools were invited to participate in this study through an electronic survey comprising socio-demographic questions and the scales.ResultsSixty-eight nursing educators replied to the survey. Most were female, have PhD and have evidence-based practice training. They showed mean scores of 88.92 ± 8.18 for evidence-based practice beliefs, 40.20 ± 18.93 for evidence-based practice implementation and 80.59 ± 17.52 for evidence-based practice organizational culture and readiness. Concerning nursing educator sample, there were moderate and statistically significant relationship between: evidence-based practice beliefs and implementation; and evidence-based practice beliefs and organizational culture and readiness for school-wide integration of evidence-based practice. Between evidence-based practice implementation and organizational culture and readiness for school-wide integration of evidence-based practice, there was a small relationship.One hundred and sixty-seven undergraduate nursing students answered the survey. Mostly, they were female and were in third or fourth year of their nursing degree. Similarly, to educators, students showed mean scores of 58.69 ± 6.92 for evidence-based practice beliefs, 32.37 ± 16.97 for evidence-based practice implementation and 84.20 ± 23.48 for evidence-based practice organizational culture and readiness. Regarding undergraduate nursing student sample, there were moderate and statistically significant relationship between the different variables.ConclusionsBoth nursing educators and undergraduate nursing students had strong evidence-based practice beliefs, but low levels of evidence-based practice implementation. In nursing educators’ and undergraduate nursing students’ perspectives, there were opportunities in their schools for the development of an evidence-based practice culture. Based on results, support for development and testing of interventions, specifically tailored for promoting evidence-based practice implementation in nursing educational contexts, is recommended.     

What is the impact of advanced primary care nursing roles on patients, nurses and their colleagues? A literature review

OBJECTIVES: To review and draw together the existing research evidence to assess the impact of advanced primary care nursing roles, particularly first contact nursing roles, for patients, nurses themselves and their colleagues in order to highlight salient issues for policy, practice and research. BACKGROUND: Internationally, nurses' roles continue to expand in response to doctor shortages and policy drives to provide effective and efficient health services. A body of research exists from which to evaluate the impact of advanced nursing roles on various dimensions of healthcare delivery and organisation. DESIGN AND DATA SOURCES: Medline, CINAHL, Applied Social Sciences Index and Abstracts, British Nursing Index, Cochrane Library, EMBASE, National Research Register, and PsycINFO databases were searched, including relevant websites. Studies were included if published in English and relevant to the primary/community care setting. Of a total of 211 papers identified, 88 were of relevance and included in the review. RESULTS: Nurses working in many advanced primary care roles such as acute/minor illness, minor injury and long-term conditions provide safe and effective care, and patient satisfaction is generally high. Many factors influence patient satisfaction with, and access to, such services but are little understood. Evidence on cost-effectiveness, efficiency and impact on other health care professionals is inconclusive though research suggests the introduction of extended roles can create uncertainty and intra-/inter-professional tensions. CONCLUSIONS: Evidence is of variable quality, often ignoring potentially important effect mediators such as the experience and educational level of advanced nurses, the effect of service 'maturation', organisational characteristics and differing patient preferences. The complex range of factors that influence patient satisfaction, access and outcomes of care need further investigation. Recent UK developments in nurse prescribing and the introduction of a national post-registration competency framework may improve working relations and patient understanding and experience of advanced nursing roles in primary care.     

Islet Transplantation for Type 1 Diabetes, 2015: What Have We Learned From Alloislet and Autoislet Successes?

The therapeutic potential of pancreatic islet allotransplantation, in which human donor islets are used, as a treatment for type 1 diabetes (T1D) has fascinated diabetes researchers and clinicians for decades. At the same time, the therapeutic potential of total pancreatectomy and islet autotransplantation (TPIAT) (in which one’s own islets are used) as a preventive treatment for diabetes in patients who undergo total pancreatectomy for chronic, painful pancreatitis has received relatively less attention. This is ironic, since the latter has been much more effective than the former in terms of successful glucose management and duration of efficacy. The reasons for this disparity can be partially identified. TPIAT receives very little attention in textbooks of internal medicine and general surgery and surprisingly little print in textbooks of endocrinology and transplantation. T1D is much more predominant than TPIAT as a clinical entity. Provision of insulin or replacement of islets is mandatory and a primary goal in T1D. Provision of pain relief from chronic pancreatitis is the primary goal of total pancreatectomy in TPIAT, whereas treatment of diabetes, and certainly prevention of diabetes, has been more of a secondary consideration. Nonetheless, research developments in both fields have contributed to success in one another. In this Perspective, I will provide a brief history of islet transplantation and contrast and compare the procedures of allo- and autoislet transplantation from three major points of view 1) the procedures of islet procurement, isolation, and transplantation; 2) the role and complications of immunosuppressive drugs; and 3) the posttransplant consequences on β- as well as α-cell function.     

Health and Safety Needs in Early Care and Education Programs: What do Directors,Child Health Records,and National Standards Tell Us?

ABSTRACT Objective: To identify the overlapping and unique health and safety needs and concerns identified by early care and education (ECE) directors, health records, and observed compliance with national health and safety (NHS) standards. Design and Sample: Cross‐sectional study. 127 ECE programs from 5 California counties participated in the study, including 118 directors and 2,498 children's health records. Measures: Qualitative data were collected using standardized ECE directors' interviews to identify their health and safety concerns; and objective, quantitative data were collected using child health record reviews to assess regular health care, immunizations, health insurance, special health care needs, and screening tests and an observation Checklist of 66 key NHS standards collected by research assistants. Results: The overlapping health and safety needs and concerns identified by the directors and through observations were hygiene and handwashing, sanitation and disinfection, supervision, and the safety of indoor and outdoor equipment. Some of the health and safety needs identified by only one assessment method were health and safety staff training, medical plans for children with special health care needs and follow‐up on positive screening tests. Conclusions: Comprehensive, multimethod assessments are useful to identify health and safety needs and develop public health nursing interventions for ECE programs.