Caregiver knowledge and self-confidence of stress dosing of hydrocortisone in children with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) is a rare disorder characterized by cortisol deficiency, with/without aldosterone deficiency, and androgen excess. The purposes of this descriptive, exploratory study were to assess caregiver knowledge of CAH, adrenal crisis, and stress dosing of hydrocortisone during times of acute illness and to assess caregivers' self-efficacy in managing adrenal crisis and stress dosing of children with CAH. A survey was distributed that collected information about child and family demographics and about caregiver knowledge of the disorder and stress dosing instruction history and evaluated their self-efficacy.

Implementation of an evidence-based order set to impact initial antibiotic time intervals in adult febrile neutropenia.

Purpose/objectives: To evaluate the impact of the implementation of a standardized order set on the time interval in initiation of antibiotic therapy for adult patients with cancer and febrile neutropenia.

Design: Practice change.

Setting: The oncology unit of an urban hospital in the south-eastern United States.

Delegation in Long-term Care: Scope of practice or job description?

This study is a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutionalized long-term care settings delegate care, including their strategies and processes for delegating care, and their perceptions of barriers to effective delegation and potential benefits of delegation. Findings indicate two key approaches to delegation, including the "follow the job description" approach, emphasizing adherence to facility-level roles and job descriptions, and the "consider the scope of practice" approach, emphasizing consideration of multiple aspects of scope of practice and licensure, and the context of care. While the former resulted in more clarity and certainty for the RN, the latter facilitated a focus on quality of resident care outcomes as linked to the delegation process.

Use of a handheld computer observational tool to improve communication for care planning and psychosocial well-being.

Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study describes the outcomes of a program where UAP recorded behavioral problems of residents to inform care. Findings suggest that staff development nurses who aim to improve UAP reporting without simultaneously targeting licensed nursing staff behaviors may worsen nursing staff relationships.

A rubric for improving the quality of online courses.

All of the graduate students in the School of Nursing take some of their Master of Science courses online. A group of six School of Nursing faculty members and a graduate student received funding to determine best practices in online courses. The group developed an evaluation rubric to measure quality in the graduate online curriculum.

Content Validation of the Organizational Climate for Research Integrity (OCRI) Survey.

THE PURPOSE OF THIS STUDY WAS TO develop and establish content validity of an instrument designed to measure the organizational climate for research integrity in academic health centers. Twenty-seven research integrity scholars and administrators evaluated 64 survey items for relevance and clarity, as well as overall comprehensiveness of the constructs that are measured (organizational inputs, structures, processes and outcomes). Both quantitative and qualitative methods were used, particularly content validity indices (CVI) and analyses of respondents' comments.

Difficulties experienced by the ostomate after hospital discharge.

Purpose: This descriptive study used a mailed survey to identify difficulties related to the stoma that ostomates experience after discharge from the hospital, who they sought help from, and if the advice was perceived as helpful.

Subjects And Setting: Ostomates who are 18 years or older and have undergone a urinary or fecal diversion at a North Carolina hospital between January 1, 2003 and June 30, 2005, were asked to respond to a survey about the difficulties related to their ostomy.

Instrument: The survey gathered demographic and anthropometric data, information regarding stomal complications, self-evaluation of emotional state, and contact with clinicians and support groups.

Care of individuals with Alzheimer's disease in the new millennium.

The incidence of Alzheimer's disease (AD), the leading form of dementia, is expected to increase exponentially in the next 50 years. The nursing and medical care of individuals diagnosed with AD, including the health-related challenges faced by all aging individuals, are discussed.

Identifying factors critical to implementation of integrated mental health services in rural VA community-based outpatient clinics.

The purpose of this study was to gain a better understanding of the critical components associated with implementing integrated mental health care services in rural VA community-based outpatient clinics (CBOCs). In-person semi-structured interviews were conducted with 20 health care providers and staff within a year after placing a trained advanced practice nurse (APN) to provide mental health/substance abuse (MH/SA) care at 2 rural CBOCs in the southeastern United States. Four raters independently evaluated interview transcripts and conducted content analysis to summarize the interview results.