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Gloria McKee-Lopez Leslie Robbins Elias Provencio-Vasquez Hector Olvera 《Journal of Professional Nursing》2019,35(2):112-119
Background
Research evidence strongly suggests that Adverse Childhood Experiences (ACEs) predispose individuals to development of an increased sensitivity to stress and negative physical and mental health outcomes in adulthood.Purpose
To determine if there was a relationship between the number of ACEs reported by first semester BSN students and their reported level of Burnout and Depression.Methods
211 students enrolled in the first semester of upper division courses of their BSN program completed self-report questionnaires which measured the number of ACEs, the level of Depression and the level of Burnout.Results
The number of reported ACEs by participants had a significant relationship on the levels of burnout and severity of depressive symptoms. Female students with a higher number of ACEs were more likely to report higher levels of Burnout A (Emotional Exhaustion) and Burnout B (Depersonalization), and higher depression severity scores compared to males.Conclusion
Nursing programs should educate faculty concerning the frequency and range of adverse experiences that students may have had prior to admission to the nursing program, and the possible relationship with Burnout and Depression. Faculty can provide early information on counseling and support services. 相似文献3.
Mary Jo Krivanek Mary A. Dolansky Aniko Kukla Meghan Ramic James Guliano Pamela Waite Deborah Small 《Journal of Professional Nursing》2019,35(2):75-80
Background
Medication reconciliation is a complex process that occurs during hospitalization at admission, transfer and discharge and at each outpatient clinic visit. Despite numerous quality improvement initiatives implemented by healthcare facilities nationwide to refine the process, medication errors still occur. Medication reconciliation processes are institution specific and undergo constant refinement. Few reports are available on the nursing student's role in this contemporary safety process.Purpose
The purpose of this study was to assess the nursing student's education and role in the medication reconciliation process from the perspective of academic faculty and hospital nursing leadership.Methods
Electronic surveys were sent to 90 nurse academic and 160 nurse practice leaders in Ohio during the first quarter of 2015. Surveys were completed by 47% of the academic leaders (42/90) and 23% of the practice leaders (42/160). Survey questions focused on the nursing curriculum regarding medication reconciliation and the student nurse's role in the process during clinical experiences.Results
Faculty from 75% of the schools of nursing reported that the medication reconciliation curriculum was mostly taught in the classroom. Only 24.4% of the schools taught medication reconciliation in an interdisciplinary context with pharmacy students. During clinical time, 33% of faculty reported that students had direct involvement and 33% had the opportunity to observe the process of medication reconciliation. The majority (80%) of practice nurse leaders reported that their facility does not permit nursing students to perform medication reconciliation. Although medication reconciliation processes are specific to each organization, only 52.8% of the practice leaders reported that they provide faculty or nursing students’ formal training on their hospital's medication reconciliation policy or site-specific process.Conclusion
Students are not receiving adequate education or opportunity to practice medication reconciliation during clinicals. Future alignment of academia, and practice efforts on medication reconciliation are needed. 相似文献4.
Adrienne P. Hudson Amy J. Spooner Natasha Booth Robyn A. Penny Louisa G. Gordon Tai-Rae Downer Patsy Yates Robyn Henderson Natalie Bradford Aaron Conway Christopher O’Donnell Alanna Geary Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):110-117
Background
Nurse navigator roles aim to assist patients and their carers with navigating the healthcare system and accessing services to enable them to take a more active role in their own health care.Aim
The aim of this study was to explore patients’ and carers’ experiences of receiving care from a nurse navigator.Methods
This was a qualitative study involving semi-structured interviews with 12 patients (adults and children) and 13 carers receiving care from a nurse navigator in Queensland, Australia. Thematic analysis was conducted.Findings
The nurse navigator was a central contact person for patients and carers within the complex healthcare system. They were described as approachable, available and knowledgeable about the medical condition and the healthcare system, enabling patients to take a more active role in their own healthcare. The navigators played a pivotal role in navigating the seemingly insurmountable obstacles of accessing advice, services, equipment and appointments in a seamless way. However, further work is required to ensure that patients and carers are connected with a nurse navigator earlier in their healthcare journey.Discussion
The nurse navigators’ understanding of the complex healthcare system coupled with their global overview of patients and carers provided the participants with a sense of direction, options and more control over their own healthcare trajectory.Conclusions
The nurse navigator role has the ability to improve the care experience of patients and carers of varying ages and with varying medical conditions as explored in this study. 相似文献5.
Abraham Aizer Brody Ashley Leak Bryant G. Adriana Perez Donald E. Bailey 《Nursing outlook》2019,67(2):133-139
Background
Nurse scientists are highly sought after and find satisfaction in serving as members of interdisciplinary research teams. These teams also tend to be highly productive. However, nurse scientists in academia also have to reach certain productivity milestones to be promoted and receive tenure that may be incongruent with team science principles.Purpose
This study therefore sought to examine whether APT documents in research intensive nursing schools incorporate team science principles.Methods
Qualitatively analyzed the appointment, promotion and tenure documents of 18 U.S. based research intensive schools of nursing with over $2 million in NIH funding in fiscal year 2014.Findings
The study found that only 8 of 18 documents included any reference to team science principles and even these mentions were largely negligible. There were few best practices to recommend across documents. By not recognizing team science within these documents, nursing risks marginalization within the larger scientific community by limiting mentorship and learning opportunities for early career nurse scientists.Discussion
Schools of nursing should revisit their promotion and tenure criteria and include a greater commitment to encouragement of team science. 相似文献6.
Amy J. Spooner Natasha Booth Tai-Rae Downer Louisa Gordon Adrienne P. Hudson Natalie K. Bradford Chris O’Donnell Alanna Geary Robyn Henderson Cherie Franks Aaron Conway Patsy Yates Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):103-109
Background
Effective coordination and integration of care between health care providers is critical to manage complex, chronic medical conditions.Aim
Describe the advanced practice profile and activities of nurse navigators who provide a service for patients with chronic health conditions.Design
An observational study was conducted in four health services, in Queensland, Australia.Methods
In part one, nurse navigators completed a survey incorporating the Advanced Practice Role Delineation tool. In part two, nurse navigators completed a work activity diary, capturing the time spent performing daily activities, modes of communication and referral sources.Findings
Twenty-three and 18 nurse navigators participated in the survey and diary, respectively. Participants were experienced nurses, working full-time. Participants reported spending a great extent of time performing direct comprehensive care, support of systems and education in surveys. The diaries captured a mean of 20 working days per participant, a total of 5,748 work activities. including care of 615 patients. The majority of nurse navigator activities were performed within the direct comprehensive care domain. Communication predominantly occurred with patients, families, hospital health professionals either in person, at a healthcare facility or via phone.Discussion
Our research identified three focus areas of nurse navigator activities: direct comprehensive care, support of systems and education. Further work is required to extend the nurse navigators’ unique contribution to research and publication and professional leadership.Conclusions
This study established baseline knowledge regarding advanced practice profiles and work activities of nurse navigators, which can be utilised to improve current processes and future enhancement of the role. 相似文献7.
Nicholas Ralph Coralie Graham Lisa Beccaria Cath Rogers 《Collegian (Royal College of Nursing, Australia)》2019,26(1):140-145
Background
Entrance requirements for undergraduate nursing programs have been under government scrutiny in recent times. To date, no Australia studies have reported nurse academics’ perspectives of entry requirements for Bachelor of Nursing programs.Study aim
The aim of this study is to examine nursing academics’ perceptions of entry requirements for Australian Bachelor of Nursing Programs.Methods
A total of 223 nurse academics responded to questions in an online national survey on pre-requisite subject areas, minimum tertiary entrance scores, English proficiency, and inherent requirements for clinical practice.Findings
English, Maths and Science were seen as important pre-requisite subject areas for students commencing a Bachelor of Nursing Program. Nurse academics believed that increasing the tertiary entrance score and English proficiency, was necessary to increase entrance standards and that a minimum score be consistently applied across universities. There were mixed views as to the disclosure of inherent requirements by students.Conclusion
Nationally, dialogue needs to occur about how universities can apply a consistent approach to ensure that the necessary foundation skills, knowledge and abilities are in place prior to admission into programs. 相似文献8.
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Background
Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described.Purpose
Provide an exploration of pediatric oncology nurses’ experiences with prognosis-related communication (PRC).Method
Mixed-methods, multiphase design. This paper highlights the qualitative portion of the study.Findings
Three themes were identified: Importance of collaboration, impact of PRC, and delivery of prognostic information.Discussion
Collaboration is a critical element of PRC. Nurses are often not included in the disclosure process, which limits the ability of nurses to fully function in their roles, compromising patient, family, and nurse outcomes. A paradigm shift is required to empower nurses to be more active participants. More education of physicians and nurses is necessary to consistently engage nurses in PRC and prepare nurses for critical conversations. 相似文献10.
Kimberly D. Shea Barbara B. Brewer Jane M. Carrington Mary Davis Sheila Gephart Anne Rosenfeld 《Nursing outlook》2019,67(1):39-48
Background
Building on the efforts of the American Association of Colleges of Nursing, we developed a model to infuse data science constructs into doctor of philosophy (PhD) curriculum. Using this model, developing nurse scientists can learn data science and be at the forefront of data driven healthcare.Purpose
Here we present the Data Science Curriculum Organizing Model (DSCOM) to guide comprehensive doctoral education about data science.Methods
Our team transformed the terminology and applicability of multidisciplinary data science models into the DSCOM.Findings
The DSCOM represents concepts and constructs, and their relationships, which are essential to a comprehensive understanding of data science. Application of the DSCOM identified areas for threading as well as gaps that require content in core coursework.Discussion
The DSCOM is an effective tool to guide curriculum development and evaluation towards the preparation of nurse scientists with knowledge of data science. 相似文献11.
Jessica M. Jarvis Karen Choong Mary A. Khetani 《Archives of physical medicine and rehabilitation》2019,100(4):703-710
Objective(s)
Determine the associations between having participation-focused strategies and receiving rehabilitation services in the pediatric intensive care unit (PICU) with caregiver stress over 6 months post-PICU discharge.Design
Substudy of a data from Wee-Cover, a prospective cohort study.Setting
Two PICU sites.Participants
Caregivers (N=168) of children 1-17 years old admitted into a PICU for ≥48 hours.Main Outcome Measures
Data were collected from caregivers at enrollment and 3 and 6 months post-PICU discharge. Caregiver stress was assessed using the Pediatric Inventory for Parents. Having strategies to support their child’s participation in home-based activities was assessed using the Participation and Environment Measure (PEM). In PEM, caregivers report on strategies used to support their child’s participation in home-based activities. Data were dichotomized (yes, no) to denote having participation-focused strategies and if their child received PICU rehabilitation services. Additional covariates were history of a preexisting condition, child age, length of PICU stay, and change in functional capacities at PICU discharge.Results
History of a preexisting condition, time, and change in functional capacities significantly predicted caregiver stress frequency and difficulty. The interaction of having strategies-by-rehabilitation-by-time significantly predicted caregiver stress frequency and difficulty.Conclusion(s)
Results highlight the role of early rehabilitation and the importance of working with caregivers to develop participation-focused strategies to support their child’s functioning post-PICU. Families of children with a preexisting condition or those who experience a decrease in function during a PICU stay are susceptible to higher levels of stress and may be a priority population to target for rehabilitation services. 相似文献12.
Ge Bai Gabor D. Kelen Kevin D. Frick Gerard F. Anderson 《The American journal of emergency medicine》2019,37(5):928-932
Objective
As nurse practitioners (NPs) and physician assistants (PAs) become an integral part of delivering emergency medical services, we examined the involvement of NPs and PAs who billed independently in emergency departments (EDs).Methods
We used Medicare provider utilization and payment data from 2012 to 2016 to conduct a retrospective analysis. We examined the changes in the number of each clinician type who billed independently for four common emergency services (CPT codes: 99282-5), the change in their service volume, and the change in their average number of services billed.Results
Between 2012 and 2016, the proportion of NPs and PAs billing independently increased from 18% to 22% for ED visits of low severity (99282), 23% to 29% for visits with moderate severity (99283), 21% to 27% for visits with high severity (99284), 18% to 24% for visit with the highest severity (99285), and 23% to 29% across all four services. The proportion of services provided by emergency physicians decreased from 66% to 63% across all four services, and from 11% to 9% for internists and family physicians. The number of NPs, PAs billing independently, and emergency physicians increased by 65%, 35% and 12% respectively.Conclusions
NPs and PAs are increasingly billing emergency services of all levels of severity, independent of physicians. This trend is driven by a growing number of NPs and PAs independently billing services, despite a relatively stable number of emergency physicians (excepting the decline in rural areas), and diminished involvement of family physicians and internists in EDs. 相似文献13.
Itay Zmora Yonit Wiener-Well Evan Avraham Alpert 《The American journal of emergency medicine》2019,37(5):1006.e5-1006.e7
Background
Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.Case report
An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.Why should an emergency physician be aware of this?
Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage. 相似文献14.
Introduction
Transgender and gender non-conforming (TGNC) people in the United States face disproportionate rates of mental health disorders, including suicidality, depression, anxiety, and substance use disorders than the general population. Patients' experiences utilizing mental healthcare is a determinant in their care-seeking behaviors and treatment success.Aim/question
The purpose of this integrative review is to better understand the firsthand mental healthcare experiences of TGNC persons.Method
The authors sought to locate recent English-language articles that described the mental healthcare experiences of TGNC persons. To do so, only articles that conducted data collection with a TGNC sample were considered for review.Results
Seven articles met criteria for review. Four themes emerged that depicted experiences of health promotion (welcoming environments, staff knowledge and response) and health prevention (enacted stigma, racial disparities and intersectional insensitivity).Discussion
Themes indicated that TGNC persons have mixed experiences (excellent to harmful/damaging) when receiving mental healthcare. There is room for healthcare provider growth in skills to increase TGNC cultural competency.Implications for practice
Mental healthcare providers and nurses would benefit from interventions to promote TGNC culturally competent care, including in-service training or continuing education for the current work force as well as incorporating TGNC content into pre-licensure educational curricula. 相似文献15.
Tener Goodwin Veenema Roberta Proffit Lavin Annah Bender Clifton P. Thornton Sarah Schneider-Firestone 《Nursing outlook》2019,67(1):54-88
Background
Little is known regarding the capacity of U.S. nurses to respond following a large-scale radiation release, despite its relevance to our National Security Strategy.Purpose
To conduct a systematic review of the literature to assess nurse readiness for radiation emergencies and nuclear events.Methods
A systematic review of publications identified through a comprehensive search of four relevant databases (Embase, PubMed/Medline, Scopus, and Web of Science) was conducted (n?=?62).Findings
Limited evidence exists to support that nurses are prepared or willing to respond to a large-scale emergency resulting from a radiation release or nuclear-level event.Discussion
History suggests nurses will be expected to perform triage, minimize radiation exposure, decontaminate, manage trauma, treat burns, and coordinate care for patients. Research is needed to identify the specific roles and responsibilities of nurses in radiation emergencies and nuclear response and to ascertain quantitative measurement of the level of national nurse readiness for these large-scale radiation emergency and nuclear events. 相似文献16.
M. González-Rincón P. Díaz de Herrera-Marchal M.L. Martínez-Martín 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2019,30(2):78-91
Objective
Analyze the role of the nurse at the end of the life of a critically ill patient.Method
Bibliographic review from a search of the health science databases such as PubMed, CINAHL, Cuiden, Scopus, Cochrane, as well as specialized platforms, general and thematic browsers. The limits were language (English or Spanish) and publication date (2005-2015).Results
180 articles met the inclusion criteria, and 16 of them were selected for analysis. The main results were grouped into three categories of analysis: direct patient care, family-focussed care and the nurse's role within the team.Conclusions
the described roles place the nurse as a key element in humanising death in the ICU and so nurses can and must lead change, playing an active role in creating strategies that really promote the integration of a palliative care approach in ICU. 相似文献17.
Background
Within nursing education research, protection of students as human subjects must be the highest priority. This protection can be provided via student anonymity. A subject-generated identification code, comprised of responses to a series of questions, can link data across time points while protecting student anonymity.Method
Two studies, focused on palliative care education, used a subject-generated identification code to link student data across multiple time points. Refinements to the code were made between studies to further enhance anonymity and response consistency.Results
The subject-generated identification code fostered linking of student responses across three time points in study one and two time points in study two.Conclusion
There are many benefits to utilizing a subject-generated identification code in nursing education studies. Researchers must consider the need for a data management expert and balancing transposition errors and the power to differentiate between responses. 相似文献18.
R. Jouffroy A. Saade P. Alexandre P. Philippe P. Carli B. Vivien 《The American journal of emergency medicine》2019,37(3):387-390
Background
Epinephrine is recommended for the treatment of non-shockable out of hospital cardiac arrest (OHCA) to obtain return of spontaneous circulation (ROSC). Epinephrine efficiency and safety remain under debate.Objective
We propose to describe the association between the cumulative dose of epinephrine and the failure of ROSC during the first 30?min of advanced life support (ALS).Methodology
A retrospective observational cohort study using the Paris SAMU 75 registry including all non-traumatic OHCA. All OHCA receiving epinephrine during the first 30?min of ALS were enrolled. Cumulative epinephrine dose given during ALS to ROSC was retrieved from medical reports.Results
Among 1532 patients with OHCA, 776 (51%) had initial non-shockable rhythm. Fifty-four patients were excluded for missing data.The mean value of cumulative dose of epinephrine was 10?±?4?mg in patients who failed to achieve ROSC (ROSC?) and 4?±?3?mg (p?=?0.04) for those who achieved ROSC.ROC curve analysis indicated a cut-off point of 7?mg total cumulative epinephrine associated with ROSC? (AUC?=?0.89 [0.86–0.92]).Using propensity score analysis including age, sex and no-flow duration, association with ROSC? only remained significant for epinephrine?>?7?mg (p?≤10–3, OR [CI95]?=?1.53 [1.42–1.65]).Conclusion
An association between total cumulative epinephrine dose administered during OHCA resuscitation and ROSC? was reported with a threshold of 7?mg, best identifying patients with refractory OHCA. We suggest using this threshold in this context to guide the termination of ALS and early decide on the implementation of extracorporeal life support or organ harvesting in the first 30?min of ALS. 相似文献19.
Background
Online medical information has transformed the way patients obtain information.Purpose
The present study examined patients' informational needs and the patient- Healthcare Provider (HCP) relationship from the perceptions of both patients and HCP.Methods
The study was a cross-sectional study; data were collected in Israel from100 HCPs (nurses and physicians) and 184 e-patients.Findings
E-patients were comfortable sharing e-information with their HCP and expected them to consider the e-information in treatment decision-making. Physicians thought they provided more information than the patients considered that they received from them, while both nurses and patients were in agreement about their interactions. Patients thought that there was a higher concordance between the e-information and the information they received from the physician/nurse as compared to what physicians and nurses reported.Discussion and Conclusions
E-health information does not disrupt the patient-nurse/physician relationship. To promote compliance to treatment, it is important that HCPs consider information presented by patients when preparing the treatment plan. 相似文献20.