Improving Blood Pressure and Weight in Patients with Diabetes.

The purpose of this study was to improve healthcare outcomes by reducing blood pressure and weight in adult patients with diabetes at afederally qualified health center. NextGen electronic health record was used to review aggregate data of blood pressures and weight pre-intervention and post-intervention for women and men (N = 304) between 20 and 87 years of age with type 2 diabetes and a BMI : 30. Findings from this study showed that blood pressure and weight did not improve as anticipated using a variety of educational approaches and strategies within the study population.

Appointment Reminders to Decrease 30-Day Readmission Rates to Inpatient Psychiatric Hospitals.

Purpose Of Project: The purpose of this quality improvement project was to reduce 30-day readmission rates to inpatient psychiatric hospitals by standardizing discharge processes by including scheduling outpatient psychiatric appointments for all patients at discharge and also to include the mailing postal reminders to prompt patients to attend their first outpatient mental health appointment following treatment.

Primary Practice Setting: Inpatient psychiatric hospital.

Methodology And Sample: The project design was an analysis of readmission data obtained both 3 months before and after implementation of the postal reminder letters.

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

Aims And Objectives: Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr.

Streamlining Appointment, Promotion, and Tenure Procedures to Promote Early-Career Faculty Success.

A critical component of the progression of a successful academic career is being promoted in rank. Early-career faculty are required to have an understanding of appointment, promotion, and tenure (APT) guidelines, but many factors often impede this understanding, thwarting a smooth and planned promotion pathway for professional advancement. This article outlines the steps taken by an APT committee to improve the promotion process from instructor to assistant professor.

Implementing a Pediatric Fall Prevention Policy and Program.

Preventing patient falls begins with an accurate assessment of a patient's risk of falling followed by the initiation and continued evaluation of a fall prevention program based on patient-specific identified risks. Children have a normal tendency to fall based on developmental growth, and each child is different in physical and cognitive abilities. Falls may occur both in and out of the hospital setting.

Scaffolding behavioral health concepts from more simple to complex builds NP students' competence.

Background: Behavioral health disorders (psychiatric illness and substance abuse disorders) represent a significant burden across the nation's health care system. About one half of the problems that present in primary health care settings are behavioral in nature. There is urgent need to improve the integration of behavioral health care services into primary care.

Improving Follow-Up for Failed Newborn Hearing Screening in Emirati Infants.

This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.

Depression Screening in Chronic Disease Management: A Worksite Health Promotion Initiative.

This pilot project aimed to improve depression symptoms and quality-of-life measures for individuals in a worksite disease management program. Two hundred forty-three individuals were invited to participate, out of which 69 enrolled. The participants had a history of diabetes, hypertension, or hyperlipidemia, and demonstrated depression using the Patient Health Questionnaire-9 (PHQ-9).

Recognizing depression in late life.

Depression presents differently in older adults than in younger adults and frequently occurs with many chronic illnesses in later life, though it is not a normal part of aging. The astute practitioner will screen for depression in this population and appropriately treat to improve chronic illness management and quality of life in older adults.

Preventing ventilator-associated events: complying with evidence-based practice.

The leading cause of death due to health care-associated infections is ventilator-associated pneumonia (VAP). The lack of clarity in the definition of VAP has made it difficult to execute and evaluate the effectiveness of prevention strategies. Beginning in 2013, hospitals were expected to implement a new surveillance definition algorithm to identify ventilator-associated events (VAEs).

Use of nonsteroidal anti-inflammatory drugs in the older adult.

Purpose: Annually, approximately 90 million prescriptions are filled for nonsteroidal anti-inflammatory drugs (NSAIDs) with the number prescribed for older adults approximately three times higher than for younger adults. This article examines the benefits and risk of NSAID use in older adults.

Data Sources: Electronic data collection of research studies, evidence-based reviews, consensus statements, and guidelines related to the purpose of this article were analyzed if published between 2000 and 2013 in English from Ovid, MEDLINE, and PubMed databases.

Outcomes of a quality improvement project implementing stroke discharge advocacy to reduce 30-day readmission rates.

The purpose of this quality improvement project was to determine whether use of aspects of a transitional care model by nurse navigators would affect 30-day readmission rates in hospitalized ischemic stroke patients discharged home with self-care. Thirty-day readmission rates and emergency department (ED) visits were compared before, during, and after the implementation of the revised discharge process. Comparative analysis demonstrated reductions in readmissions and in ED visits.

An evidence-based parenting intervention with inner-city teen mothers.

The consequences of teen pregnancy have a substantial negative impact on both the teen mother and her child. Recent evidence clearly supports parenting education as the most effective means for improving adolescent parenting skills. This study evaluated the effectiveness of a school-based program using an evidence-based educational intervention to improve parenting style in high school teen mothers.

Exploring factors associated with nurses' adoption of an evidence-based practice to reduce duration of catheterization.

Hospitalized adult patients are at increased risk for adverse outcomes, particularly when undergoing invasive procedures that include indwelling urinary catheterization. This study identified factors associated with nurses' adoption of an evidence-based practice to reduce the duration of catheterization and potential for catheter-associated urinary tract infections in hospitalized adults.

Statin drugs: reducing cardiovascular risk in older adults.

Dyslipidemia is one of the most modifiable risk factors in preventing heart disease. Evidence demonstrates that the process of atherosclerosis, a result of dyslipidemia, begins in young adults. Initiating statin therapy has been shown to reduce the risk of cardiovascular events and mortality.

Recommended routine vaccinations for older adults.

A goal of primary prevention is to avoid the development of disease. Immunizations are one of several strategies used by clinicians in primary prevention. Influenza and pneumococcal disease--both preventable--cause significant morbidity and mortality in older adults who have an altered immune system, often have several chronic health problems, and are at higher risk for complications.

Pharmacological management of chronic constipation in older adults.

Chronic constipation in older adults has multiple etiologies, and many of these factors are interrelated. An initial medical history and physical examination can provide relevant clues to the causes of the problem. The Rome III classification system of functional constipation is useful in clinical practice to help clinicians identify symptoms and confirm a diagnosis.

Crushing or splitting medications: unrecognized hazards.

Given the high use and the cost of medications in the current economy, one way older adults may save money on prescription costs is to split some of their medications in half. However, not all oral medications can be split. Splitting inappropriate medications such as extended-release tablets can be harmful and in some instances very dangerous.

Anticoagulation therapy in older adults newly diagnosed with atrial fibrillation.

Atrial fibrillation (AF) is the most common chronic arrhythmia and the most serious heart rhythm irregularity in individuals older than 70. It is usually not life threatening in and of itself, but it can lead to serious medical problems, including stroke, additional heart rhythm problems, and heart failure. Symptoms of AF vary considerably.

Introducing insulin into diabetes management: transition strategies for older adults.

Many older adults with type 2 diabetes require insulin to supplement or replace oral hypoglycemic control. Overtime, the addition of this more intensive therapy is needed to preserve beta cell function or prevent macrovascular sequelae. This is the result of the natural progression of diabetes and not a failure on the part of the patient.