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991.
992.

Background

Factors that contribute to student success in accelerated degree nursing programs are poorly understood and may vary by gender.

Purpose

Examine associations between satisfaction with peer and mentor support, gender, and academic outcomes among students in accelerated degree nursing programs.

Methods

We used data (demographic variables, satisfaction with peer and mentor support, graduation, and attempts of National Council Licensure Examination for Registered Nurses) from the American Association of Colleges of Nursing and Robert Wood Johnson Foundation's New Career in Nursing Program. Multivariable mixed effects regression models were used to examine associations among gender, satisfaction with support, and academic outcomes.

Findings

Males had an increased probability of reporting high satisfaction with peer support. Both males and females who were very dissatisfied with peer support were less likely to graduate than students who were very satisfied with peer support. Gender did not moderate the relationships between satisfaction with peer and mentor support and academic outcomes.

Conclusion

Peer support is an important aspect of graduation among students in accelerated degree nursing programs. Continuous quality improvement strategies to improve student peer support may be warranted.  相似文献   
993.

Background

Advanced Practice Registered Nurses (APRNs) provide access to cost-effective, high quality care. APRNs are underutilized in states that restrict their practice. Removing restrictions could expand access to quality health care, cost-effectively relieve the physician shortage, and contribute economically.

Purpose

This study forecasts the health system and economic impacts of reducing practice restrictions for Florida APRNs.

Methods

The analysis utilized a number of data sources and IMPLAN software and estimated changes in APRN supply given less restrictive practice laws, and consequential health system and economic benefits.

Findings

Between 2013 and 2025 APRN full time equivalents could increase an additional 11% with less restrictive practice regulations. This could eliminate or reduce the shortage of different types of physicians. Health care cost-savings could be $50 to $493 per resident. There would be a number of general economic benefits.

Discussion

A number of health system and economic benefits would ensue from less restrictive APRN regulation.  相似文献   
994.

Background

Further efforts are warranted to identify innovative approaches to best implement competencies in nursing education. To bridge the gap between competency-based education, practice, and implementation of knowledge, skills, and attitudes, one emerging approach is entrustable professional activities (EPAs).

Purpose

The objective of this study was to introduce the concept of EPAs as a framework for curriculum and assessment in graduate nursing education and training.

Methods

Seven steps are provided to develop EPAs for nurses through the example of a quality and safety EPA. The example incorporates the Quality and Safety Education for Nurses (QSEN) patient safety competencies and evidence-based literature.

Findings

EPAs provide a practical approach to integrating competencies in nursing as quality and safety are the cornerstones of nursing practice, education, and research.

Discussion

Introducing the EPA concept in nursing is timely as we look to identify opportunities to enhance nurse practitioner (NP) training models and implement nurse residency programs.  相似文献   
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While cognitive-behavioral therapy for hoarding disorder (HD) has resulted in significant reductions in symptoms, most individuals continue to have significant hoarding symptoms following treatment. This investigation sought to extend the literature on the behavioral treatments for hoarding by examining (1) group cognitive rehabilitation and exposure/sorting therapy (CREST) and (2) group exposure therapy (ET) for hoarding. Participants in both studies reported significant decreases in hoarding symptom severity from baseline to post-treatment on all primary outcome measures using mixed-effects linear regression models with the intent to treat sample. Participants who received group CREST reported statistically significant reductions in anxiety, depression, and overall severity at post-treatment, while participants who received group ET did not. Results provide preliminary evidence for both group CREST and group ET as effective treatments for hoarding disorder.  相似文献   
999.

Problem

Active shooter incidents are becoming more common, and although they are still rare compared with other shooting sites, incidents have increased in health care facilities. Agencies such as the Federal Bureau of Investigation, The Joint Commission, and the Emergency Nurses Association have emphasized that an action plan and training are essential for hospital preparedness.

Methods

Planning an active shooter simulation for the emergency department was a complex project and involved collaboration between the hospital’s Emergency Management team, simulation staff, security, and ED leadership, which included the educators and clinical nurse specialist. Decisions were made related to appropriate location, equipment, and needs for the functional exercises. Scenarios also were developed with roles for the ED population and actors.

Results

A total of 204 staff members participated in the simulations between August and December of 2016. A survey was distributed to staff who attended the simulation. Ninety-two percent of staff felt more prepared to respond to an active shooter event and reported a 70% improvement in knowledge and preparation. Attendees reported their first response would be to flee the scene (66%), protect patients (15%), hide (7%), fight (6%), and call 911 (4%).

Implications for Practice

The active shooter education included a didactic portion, a pre- and postsurvey, and the simulation event. The presentation focused on statistics of active shooters, possible threats, and the concepts of RUN, HIDE, and FIGHT. A Critical Incident Stress Management team member was present to ensure the emotional and psychological health of the participants. The debriefing was a crucial part of the simulation experience so staff could talk about their experience and express their concerns.  相似文献   
1000.
Objective An individual’s birth month has a significant impact on the diseases they develop during their lifetime. Previous studies reveal relationships between birth month and several diseases including atherothrombosis, asthma, attention deficit hyperactivity disorder, and myopia, leaving most diseases completely unexplored. This retrospective population study systematically explores the relationship between seasonal affects at birth and lifetime disease risk for 1688 conditions.Methods We developed a hypothesis-free method that minimizes publication and disease selection biases by systematically investigating disease-birth month patterns across all conditions. Our dataset includes 1 749 400 individuals with records at New York-Presbyterian/Columbia University Medical Center born between 1900 and 2000 inclusive. We modeled associations between birth month and 1688 diseases using logistic regression. Significance was tested using a chi-squared test with multiplicity correction.Results We found 55 diseases that were significantly dependent on birth month. Of these 19 were previously reported in the literature (P < .001), 20 were for conditions with close relationships to those reported, and 16 were previously unreported. We found distinct incidence patterns across disease categories.Conclusions Lifetime disease risk is affected by birth month. Seasonally dependent early developmental mechanisms may play a role in increasing lifetime risk of disease.  相似文献   
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