Creating a career ladder for nursing assistants in long-term care

This article describes the development, implementation, and evaluation of a career ladder for certified nursing assistants in long-term care. A career ladder is an effective way to maximize the use of unlicensed workers without changing the skill mix (eg, no loss of licensed nursing positions) and allow the licensed nurse more time to perform higher-level clinical tasks, such as assessments, patient education, and documentation. Implementation of an unlicensed worker career ladder also can improve nursing assistant retention.     

Pediatric Obsessive‐Compulsive Disorder: An Update for Advanced Practice Psychiatric Nurses

Obsessive‐compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence‐based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence‐based treatment options.     

A new scale to measure family members' perception of community health care services for persons with Huntington disease

Rationale, aims, and objectives Huntington disease (HD) is a progressive genetic brain disease leading to disruptive cognitive, behavioural and physical impairments. Persons with the condition and their caregivers need appropriate and accessible health care services to help them manage the disease adequately. The purpose of this study was to evaluate the psychometric properties of a new scale that measures family members' perception of community health care services (CHCS) for persons with HD. Methods A methodological design was used to examine the initial reliability and dimensionality of the CHCS scale among 245 family members of persons with a diagnosis of HD. Data analysis consisted of computing Cronbach's α coefficients, calculating the 95% confidence interval for α and performing item‐analysis and exploratory factor analysis. Results Reliability of the scale based on Cronbach's α was 0.83. Factor analysis using principal component analysis and varimax rotation suggested that three interpretable factors underlie the scale. Factor 1, HD knowledge, had α = 0.82, eigenvalue of 4.67 and explained 33.42% of the variance; factor 2, HD community resources, had α = 0.62, eigenvalue of 1.68 and explained 12.02% of the variance; factor 3, individualized HD management, had α = 0.77, eigenvalue of 1.45 and explained 10.39% of the variance. Conclusions Findings from this study provide evidence of both construct validity and internal consistency reliability of the CHCS scale. Further psychometric testing of the scale in other samples of family caregivers of persons with HD is warranted.