Impact of a pilot community pharmacy system redesign on reducing over-the-counter medication misuse in older adults.

Background: No interventions have attempted to decrease misuse of over-the-counter (OTC) medications for adults aged 65 years or older (older adults) by addressing system barriers. An innovative structural pharmacy redesign (the Senior Section) was conceptualized to increase awareness of higher-risk OTC medications. The Senior Section contains a curated selection of OTC medications and is close to the prescription department to facilitate pharmacy staff-patient engagement to reduce misuse.

Utilizing an Evidence-Based Practice Approach to Examining Infusion Therapy Practices in Non-hospital Outpatient Ambulatory Clinic Settings.

The types of infusion therapy services provided in ambulatory care settings are expanding. The Infusion Therapy Standards of Practice can be applied across service locations/care settings; however, no specific literature was found to indicate how these recommendations have been applied in ambulatory care settings. This article demonstrates how an Ambulatory Care Shared Governance Practice Council led a systemwide evidence-based practice (EBP) initiative to improve infusion therapy over an 18-month period (May 2017 to December 2018).

The U-ARE Protocol: A Pragmatic Approach to Decisional Capacity Assessment for Clinical Research.

With increased longevity and growth in the number of older adults comes rising rates of individuals with cognitive impairment and dementia. The expansion of this population has important implications for research on aging and dementia syndromes, namely increased enrollment of older individuals in clinical research. Ethical prerogatives, as well as historical underrepresentation of persons with dementia in research studies due to the perceived burden of traditional decisional capacity evaluations, necessitates the development of pragmatic approaches to ascertain decisional abilities in research settings.

A pilot study of decision factors influencing over-the-counter medication selection and use by older adults.

Background And Objectives: Despite their availability without prescription, OTC medications pose a risk for significant harm for older adults due to higher likelihood of polypharmacy, drug interactions, and age-related physiological changes. The purpose of this study is to identify the individual decision factors that influence how older adults select and use over-the-counter medications.

Methods: A pilot study was conducted with 20 community-dwelling older adults.

Applying participatory design to a pharmacy system intervention.

Background: Stakeholder engagement is an important component of the research process for improving the use and uptake of patient-centered health care innovations. Participatory design (PD), a method that utilizes the involvement of patients and other stakeholders, is well-suited for the design of multifaceted interventions in complex work systems, such as community pharmacies, that have diverse and dynamic end-users.

Objective: The objective is to describe a blueprint for how to use PD when designing a community pharmacy intervention.

A Narrative Review of How Sleep-Related Breathing Disorders and Cardiovascular Diseases Are Linked: An Update for Advanced Practice Registered Nurses.

Purpose/objectives: Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea and central sleep apnea, are common among patients with cardiovascular disease (CVD), but clinicians often do not pay enough attention to SRBDs. The purpose of this narrative review is to update advanced practice registered nurses on the literature focusing on the relationship between SRBDs and CVD (eg, hypertension, heart failure, coronary artery disease, arrhythmias, and stroke) and on treatments that can improve SRBDs in patients with CVD.

Description Of The Project: We conducted an electronic search of the literature published between 1980 and 2016 from PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Academic Search Premier, and related health resource Web sites to address the aims of this study.

A preliminary examination of over-the-counter medication misuse rates in older adults.

Background: Older adults are the largest consumers of over the counter (OTC) medications. Of the older adults who are at risk of a major adverse drug event, more than 50% of these events involve an OTC medication.

Objective: To explore how older adults select and hypothetically use OTC medications and if the selected medications would be considered safe for use.

Building capacity for the conduct of nursing research at a Veterans Administration hospital.

Evidence is the bedrock of nursing practice, and nursing research is the key source for this evidence. In this article, we draw distinctions between the use and the conduct of nursing research and provide a perspective for how the conduct of nursing research in a Veterans Administration hospital can build an organization's capacity for nursing research.

Is sleep quality related to cognition in individuals with heart failure?

Objective: To examine how self-reported sleep quality and daytime symptoms are associated with selected domains of cognitive function among individuals with heart failure (HF).

Background: HF patients suffer from poor sleep quality and cognitive decline. The relationship between sleep and cognition has not been well documented among individuals with HF.

Psychosocial predictors of changing sleep patterns in aging women: a multiple pathway approach.

The authors of this investigation sought to examine changes in the sleep quality of older women over time and to determine whether dimensions of psychological well-being, health (subjective health and number of illnesses), and psychological distress (depression and anxiety) predict these changes. A secondary analysis was conducted with a longitudinal sample of aging women (Kwan, Love, Ryff, & Essex, 2003). Of 518 community-dwelling older women in the parent study, 115 women (baseline M age = 67 years, SD = 7.

Older breast cancer survivors' symptom beliefs.

Purpose/objectives: To use Leventhal's Common Sense Model (CSM) to describe older breast cancer survivors' symptom representations, symptom management strategies, and perceived barriers to symptom management.

Design: A secondary analysis was conducted using data from three pilot studies that tested a theory-based intervention to improve symptom management in older breast cancer survivors.

Setting: Advanced practice nurses conducted open-ended interviews with older breast cancer survivors either in their homes or via telephone.

An individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors: three pilot studies.

Purpose/objectives: To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress.

Design: Two small randomized clinical trials and one pre-experimental study.

Setting: Oncology clinic and community.

Patterns of pain and well-being in older women: a 10-year longitudinal study.

The relationships among pain, health, and psychological well-being were examined in a secondary analysis of a ten-year study of community-dwelling older women. Over time, there was an increase in the percentage of women reporting pain and a significant increase in the mean level of pain, although 24% of the women never reported pain. Subjective health declined as pain increased.