Pearls for surviving unprecedented healthcare challenges: Qualitative research responses from nurses.

Purpose: Before the COVID-19 pandemic, nurses had little experience providing care during a pandemic. This project aimed to identify Pearls (suggestions) to survive a pandemic as a nurse.

Methods: A phenomenologic design was implemented.

Perceptions of providing nursing care during the COVID-19 pandemic.

Purpose: To characterize the experience of providing nursing care amid the COVID-19 pandemic.

Methods: A qualitative, phenomenology method was used. Data were collected via a confidential electronic survey.

A comparison of nurse attitudes before implementation and 6 and 18 months after implementation of an electronic health record.

The implementation of an electronic health record is a dramatic change in a healthcare organization; however, little is known about how nurse attitudes toward the electronic health record change over time. The purpose of this research project was to compare nurses' attitudes before and at 6 and 18 months after implementation of a comprehensive electronic health record. A presurvey-postsurvey design using a modified Nurses' Attitudes Toward Computerization Questionnaire was implemented with a population of nurses employed at an academic medical center.

Learning from within to ensure a successful implementation of an electronic health record.

Implementation of an electronic health record has multiple facility-wide challenges affecting all direct care providers. Because the dialysis unit and emergency department had already undergone transition with differing electronic systems several years before, could anything be learned from these past experiences to inform the future institution-wide implementation? Utilizing focus groups and surveys, recurring themes emerged: "It will take one hundred charts"; allowing for "self-discovery" of individual learning progression; establishing and communicating "clear processes" for use of the electronic record; and ensuring adequate support to facilitate a "customer-focused" approach in learning how to utilize electronic documentation. Although training related to the electronic health record was discussed in all focus groups, training was not described as a main concern, which challenged our initial presumptions that education was the key resource for a successful change.

Health literacy and the patient with heart failure--implications for patient care and research: a consensus statement of the Heart Failure Society of America.

Background: Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality.

Methods: The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, impact on health outcomes (cardiovascular disease and heart failure), and interventions.

What works in chronic care management: the case of heart failure.

The evidence base of what works in chronic care management programs is underdeveloped. To fill the gap, we pooled and reanalyzed data from ten randomized clinical trials of heart failure care management programs to discern how program delivery methods contribute to patient outcomes. We found that patients enrolled in programs using multi-disciplinary teams and in programs using in-person communication had significantly fewer hospital readmissions and readmission days than routine care patients had.

Relationship of literacy and heart failure in adults with diabetes.

Background: Although reading ability may impact educational strategies and management of heart failure (HF), the prevalence of limited literacy in patients with HF is unknown.

Methods: Subjects were drawn from the Vermont Diabetes Information System Field Survey, a cross-sectional study of adults with diabetes in primary care. Participants' self-reported characteristics were subjected to logistic regression to estimate the association of heart failure and literacy while controlling for social and economic factors.

Case management in a heterogeneous congestive heart failure population: a randomized controlled trial.

Background: Both randomized and nonrandomized controlled studies have linked congestive heart failure (CHF) case management (CM) to decreased readmissions and improved outcomes in mostly homogeneous settings. The objective of this randomized controlled trial was to test the effect of CHF CM on the 90-day readmission rate in a more heterogeneous setting.

Methods: A total of 287 patients admitted to the hospital with the primary or secondary diagnosis of CHF, left ventricular dysfunction of less than 40%, or radiologic evidence of pulmonary edema for which they underwent diuresis were randomized.