Total small bowel resection in a patient who refused surgery: why did the surgeon do it?

Gastric surgery may result in internal herniation of bowel, weeks to years after the initial surgery and can result in rapid onset of death if not promptly treated. We present a case in which a patient with this complication underwent surgery despite his clear refusal of surgery. The patient had a remote history of gastrectomy for malignancy.

Evidence informed generalist palliative care content for undergraduate nursing curriculum: An integrative review.

Background: Clinicians delivering palliative care require the specific knowledge, skill and understanding to meet the needs of the dying. Research shows that undergraduate nursing students report feeling inadequately prepared to provide safe and effective palliative care.

Objectives: To identify existing empirical evidence on generalist palliative care content within international undergraduate nursing curricula and to synthesize existing generalist palliative care topics.

Exploring the formal assessment discussions in clinical nursing education: An observational study.

Introduction: According to EU standards, 50% of the bachelor education program in nursing should take place in clinical learning environments. Consequently, this calls for high quality supervision, where appropriate assessment strategies are vital to optimize students' learning, growth, and professional development. Despite this, little is known about the formal assessment discussions taking place in clinical nursing education.

Should isolated morbid obesity influence the decision to operate in hip and knee arthroplasty?

Aims: We studied the outcomes of hip and knee arthroplasties in a high-volume arthroplasty centre to determine if patients with morbid obesity (BMI ≥ 40 kg/m) had unacceptably worse outcomes as compared to those with BMI < 40 kg/m.

Methods: In a two-year period, 4,711 patients had either total hip arthroplasty (THA; n = 2,370), total knee arthroplasty (TKA; n = 2,109), or unicompartmental knee arthroplasty (UKA; n = 232). Of these patients, 392 (8.

Outcomes of Combined Antegrade-Retrograde Dilations for Radiation-Induced Esophageal Strictures in Head and Neck Cancer Patients.

The purpose of this study is to analyze outcomes of combined antegrade-retrograde dilations (CARD). This retrospective study was conducted on 14 patients with a history of head and neck cancer, treated with radiation therapy that was complicated by either complete or near-complete esophageal stenosis. All patients had minimal oral intake and depended on a gastrostomy tube for nutrition.

Informed consent: a shared decision-making process that creates a new professional obligation for care.

This statement on informed consent, developed by the SAGES Ethics Committee, has been reviewed and approved by the Board of Governors of SAGES. This statement is provided to offer guidance about the purpose and process of obtaining informed consent, and it is intended for practicing surgeons as well as patients seeking surgical intervention. It is an expression of well-established principles and extensive literature.

Effect of bolus enteral tube feeding on body weight in ambulatory adults with obesity and type 2 diabetes: a feasibility pilot randomized trial.

Background/objectives: To ascertain the effect on body weight of 14 days of bolus enteral feeding with mixed meal (MM) and electrolyte solution (ES) in ambulatory adults with type 2 diabetes and obesity, and also the safety and feasibility of using a modified, intraorally anchored enteral feeding tube for this purpose.

Subjects/methods: We conducted a randomized, crossover pilot trial with 16 participants. A 140 cm, 8-French feeding tube was placed in the jejunum under electromagnetic guidance and anchored intraorally.

COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education.

• COVID 19. • Education. • Transformation.

Current issues with the identification of threshold concepts in nursing.

While there has been some growth in the body of literature on threshold concepts in health science disciplines, the nature of this discourse and which approaches have proved successful remains unclear. This paper illustrates one of the primary issues facing the development of threshold concepts in nursing education literature specifically - a lack of transparent and rigorous processes for their identification. The paper briefly examines the methods that have been utilised to identify threshold concepts in the nursing education literature, and what issues using these approaches raise.

Signature pedagogies: An integrative review of an emerging concept in nursing education.

Objectives: The aim of this paper is to provide an integrative review of the literature associated with signature pedagogies and to discover what lessons have been learned about unearthing, articulating and applying signature pedagogies across a variety of disciplines, but particularly with respect to nursing.

Design: A systematic search of databases using key terms was utilised with a particular focus to papers emerging from nursing disciplines.

Data Sources: The databases MEDLINE, CINAHL, ERIC, Web of Science and Google Scholar were searched for literature from 2005 to 2018 inclusive.

Clinical Significance of Esophageal Outflow Resistance Imposed by a Nissen Fundoplication.

Background: Attention has been focused on the amplitude of esophageal body contraction to avoid persistent dysphagia after a Nissen fundoplication. The current recommended level is a contraction amplitude in the distal third of esophagus above the fifth percentile. We hypothesized that a more physiologic approach is to measure outflow resistance imposed by a fundoplication, which needs to be overcome by the esophageal contraction amplitude.

Preoperative Pneumoperitoneum: Low-Risk Surgical Adjunct to the Surgical Management of Dense Abdominal Adhesions.

Surgical lysis of intra-abdominal adhesions is associated with a high rate of complications. This brief report presents 24 patients with dense intra-abdominal adhesions who underwent preoperative progressive pneumoperitoneum (PPP) prior to surgical lysis of adhesions. PPP was successfully performed in 23 patients, with few adverse events, resulting in subjectively improved ease of intraoperative tissue dissection.

Measuring the outcomes of nursing practice: A Delphi study.

Aims And Objective: To develop nursing-sensitive patient indicators to measure the outcomes of nursing practice.

Background: Nurses play an important role in the healthcare system, yet there is no consensus on how the impact of nursing work should be evaluated. Limited research has previously examined the views of clinical nurses on the important concepts for measuring nursing practice.

Post-Nissen Dysphagia and Bloating Syndrome: Outcomes After Conversion to Toupet Fundoplication.

Introduction: Protracted dysphagia and bloating are potential troublesome side effects following Nissen fundoplication. The aim of this study was to evaluate the effects of conversion from Nissen to Toupet on dysphagia and bloating.

Methods: The study used a retrospective chart review of all patients who had undergone conversion from Nissen to Toupet between 2001 and 2014.

What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study.

Background: Individuals who have recently completed accredited courses and are eligible to register as a nurse in Australia are often referred to as not being 'work-ready' by clinically based colleagues. This project identified the level of competence that can be reasonably expected of a newly registered nurse (RN) graduating in Australia. The research was undertaken using the necessary skills identified by Crookes and Brown in 2010.

Clinical leadership and pre-registration nursing programmes: A model for clinical leadership and a prospective curriculum implementation and evaluation research strategy.

Aim: To present for wider debate a conceptual model for clinical leadership development in pre-registration nursing programmes and a proposed implementation plan.

Background: Globally, leadership in nursing has become a significant issue. Whilst there is continued support for leadership preparation in pre-registration nursing programmes, there have been very few published accounts of curriculum content and/or pedagogical approaches that foster clinical leadership development in pre-registration nursing.

What are the 'necessary' skills for a newly graduating RN? Results of an Australian survey.

Background: There appears to be a sense of disappointment with the product of contemporary nursing programs in Australia in that new graduate RNs are often referred to as not possessing appropriate skills by clinical colleagues. This work identifies the skills that the profession believes that newly graduating RN's should possess at the point of registration.

Methods: A qualitative consensus methodology was used in the form of a modified Delphi survey.

An audit of skills taught in registered nursing preparation programmes in Australia.

Background: A competitive Carrick Institute Competitive Grant (CG7-523) was obtained to explore what skills were taught and what assessment of practice approaches were used in nursing programmes in Australia. The intention was twofold; firstly to identify what skills were being taught which would contribute to the development of an assessment of practice toolkit for eligibility to practice programmes in Australia. This paper specifically reports on the skills taught in nursing programmes in Australia.

Clinical leadership as an integral curriculum thread in pre-registration nursing programmes.

Background: In recent years there has been a growth in leadership development frameworks in health for the existing workforce. There has also been a related abundance of leadership programmes developed specifically for qualified nurses. There is a groundswell of opinion that clinical leadership preparation needs to extend to preparatory programmes leading to registration as a nurse.

History as reflective practice: A model for integrating historical studies into nurse education.

The role of history in developing professional identity in nursing is well known, and the discipline of nursing history research continues to flourish. Yet this work often struggles to find its way into undergraduate university nurse education courses. We put forward a model for "history as reflective practice" in which we suggest that historical studies can be used as a form of evidence to develop critical thinking and clinical reasoning, as well as situate nursing practice within its social and political context.

Clinical leadership in pre-registration nursing programmes--an international literature review.

Background: Clinical leadership and the safety, quality and efficiency of patient/client care are inextricably linked in government reports, major inquiries and the professional literature.

Objectives: This review explores the literature on clinical leadership development within pre-registration nursing programmes.

Method: The literature retrieved from a scoping review was evaluated to identify what is already published on the development of clinical leadership within pre-registration nursing programmes.

Clinical leadership development in a pre-registration nursing curriculum: What the profession has to say about it.

Background: In the last decade literature, inquiries and reports into the short comings in health services have highlighted the vital role of leadership in clinical practice and the impact on patient care and effective workplace culture. Whilst there is an abundance of literature on leadership and the registered nursing workforce, an international literature review revealed there is very little known on leadership development in pre-registration nursing programmes.

Objective: To identify what the profession's views are on proposed indicative curriculum content suggested for clinical leadership development in a pre-registration nursing degree in Australia.