The Role of the Nurse Practitioner in Adult Day Care

During the past 25 years, nurse practitioners (NPs) have become health care providers in a variety of settings. Adult day care is one of the settings in which it is increasingly clear that there is a role for the NP. Nurse practitioners have the potential to provide increased comprehensive primary health care to clients participating in these programs.     

Maximizing Team Performance: The Critical Role of the Nurse Leader

Facilitating team development is challenging, yet critical for ongoing improvement across healthcare settings. The purpose of this exemplary case study is to examine the role of nurse leaders in facilitating the development of a high‐performing Change Team in implementing a patient safety initiative (TeamSTEPPs) using the Tuckman Model of Group Development as a guiding framework. The case study is the synthesis of 2.5 years of critical access hospital key informant interviews (n = 50). Critical juncture points related to team development and key nurse leader actions are analyzed, suggesting that nurse leaders are essential to maximize clinical teams' performance.     

Multiple Myeloma: The Role of the Primary Care Nurse Practitioner

Multiple myeloma is a hematologic disease characterized by an excessive number of abnormal plasma cells that infiltrate the bone marrow and overproduction of monoclonal immunoglobulins. It is the third most prevalent hematologic disease and makes up just over 15% of all hematologic malignancies. Patients may present with 1 or more nonspecific symptoms of hypercalcemia, renal insufficiency, anemia, or new-onset bone pain. Early recognition, referral, and monitoring may improve the quality of life and extend the survival of patients.     

The Evolving Role of Nurse Leadership in the Fight for Health Equity

Devastating disparities in COVID-19 infection and outcomes among socioeconomically marginalized groups have resulted in a public outcry to address longstanding societal inequities that have contributed to the present situation. Nurse leaders have an opportunity and an obligation in this moment to lend their skills as scientists, innovators, advocates, and educators to lead in these efforts, advancing health equity for all.     

Circumstances of Falls During Sit-to-Stand Transfers in Older People: A Cohort Study of Video-Captured Falls in Long-Term Care

ObjectiveTo characterize the circumstances of falls during sit-to-stand transfers in long-term care (LTC), including the frequency, direction, stepping and grasping responses, and injury risk, based on video analysis of real-life falls.DesignCohort study.SettingLTC.ParticipantsWe analyzed video footage of 306 real-life falls by 183 LTC residents that occurred during sit-to-stand transfers, collected from 2007 to 2020. The mean age was 83.7 years (SD=9.0 years), and 93 were female (50.8%).InterventionNot applicable.Main Outcome MeasuresWe used Generalized Estimating Equations to test for differences in the odds that a resident would fall at least once during the rising vs stabilization phases of sit-to-stand and to test the association between the phase of the transfer when the fall occurred (rising vs stabilization) and the following outcomes: (1) the initial fall direction; (2) the occurrence, number, and direction of stepping responses; (3) grasping of environmental supports; and (4) documented injury.ResultsFalls occurred twice as often in the rising phase than in the stabilization phase of the transfer (64.0% and 36.0%, respectively). Falls during rising were more often directed backward, while falls during stabilization were more likely to be sideways (odds ratio [OR]=1.95; 95% confidence interval [CI]=1.07-3.55). Falls during rising were more often accompanied by grasping responses, while falls during stabilization were more likely to elicit stepping responses (grasping: OR=0.30; 95% CI=0.14-0.64; stepping: OR=8.29; 95% CI=4.54-15.11). Injuries were more likely for falls during the stabilization phase than the rising phase of the transfer (OR=1.73; 95% CI=1.04-2.87).ConclusionMost falls during sit-to-stand transfers occurred from imbalance during the rising phase of the transfer. However, falls during the subsequent stabilization phase were more likely to cause injury.     

拓展护士知识 推进整体护理

随着整形外科学科发展及护理模式的转变,要求护士具有多学科、多领域的知识体系。通过定期进行业务学习,提高理论水平;进行术前宣教,制定切实可行的护理措施;结合具体病例,学习相关知识及宣传竞争意识,激发学习热情等途径,拓展知识,强化了整形外科护士职业心态,促进心理护理的实施,并能正确认识患者的需求,尊重患者的隐私;运用交流技术进行身心整体护理;制定多元化心理护理,从而提高护理质量。