Impact of vitamin C on the reduction of opioid consumption for acute musculoskeletal pain: A double-blind randomized control pilot study.

Introduction: Recent evidence has shown that vitamin C has analgesic and opioid sparing properties in immediate postoperative context. However, this has never been studied for acute musculoskeletal (MSK) emergency department (ED) injuries. The aim of this pilot study is to evaluate the feasibility of conducting a randomized placebo-controlled study to determine the opioid sparing and analgesic effect of vitamin C compared to placebo, in acute MSK injured ED patients.

Advance Directives for Adolescents and Young Adults Living With Neuromuscular Disease: A Nurse Practitioner-Driven Intervention.

The literature shows that adolescents and young adults (AYAs) living with neuromuscular disease want to have discussions about goals of care and want them sooner. Conversations about goals of care and advance directives are not common practice in the neuromuscular clinic setting. This nurse practitioner-led project used a conversation tool as a 1-time intervention to guide conversations about participants' goals and wishes, comparing the number of participants with advance directives before and after the use of the intervention, and their satisfaction with having had a conversation about goals of care using this tool was measured.

Tabletop Simulations in Medical Emergencies: A Scoping Review.

Tabletop simulations (TTS) are a novel educational modality used in health care education. The objective of this scoping review was to describe the use of TTS in medical emergencies, specifically settings, specialties, participants, formats, and outcomes.We included 70 studies (33 descriptive studies [47%], 33 cohort studies [47%], and 2 randomized controlled trials [3%]), of which 65 reported positive results regarding reaction and learning educational outcomes (reaction: n = 37, 53%; learning: n = 25, 36%; behavior: n = 7, 10%; result: n = 1, 1%).

Fostering Oral Chemotherapy Understanding and Safety (FOCUS) Project: Interventions for Improving Knowledge and Compliance With National Safety Standards.

Background: Oral chemotherapy drug development and use has increased, and evidence in the literature suggests variability in practices nationally. Thus, there is a need for continuous review of the process of oral chemotherapy administration that focuses on improving adherence to national standards.

Objectives: This quality improvement project evaluated provider and staff general knowledge on oral chemotherapy and national safety standards and the implementation and ease of use of an electronic medical record (EMR)-integrated chemotherapy documentation template geared toward improving compliance with national chemotherapy administration standards.

State Full Practice Authority Regulations and Nurse Practitioner Practice Autonomy: Evidence From the 2018 National Sample Survey of Registered Nurses.

State full practice authority (FPA) laws are designed to permit NPs to practice autonomously from physicians. Little is known regarding how FPA laws affect NPs' practice autonomy in daily practice. This study used nationwide survey data from 20,830 NPs to estimate how NPs' practice autonomy differs between NPs in FPA and non-FPA states.

Opioid prescribing requirements to minimize unused medications after an emergency department visit for acute pain: a prospective cohort study.

Background: Unused opioid prescriptions can be a driver of opioid misuse. Our objective was to determine the optimal quantity of opioids to prescribe to patients with acute pain at emergency department discharge, in order to meet their analgesic needs while limiting the amount of unused opioids.

Methods: In a prospective, multicentre cohort study, we included consecutive patients aged 18 years and older with an acute pain condition present for less than 2 weeks who were discharged from emergency department with an opioid prescription.

Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence.

Background: The care of patients undergoing low-volume, high-risk emergency procedures such as bedside laparotomy (BSL) remains a challenge for surgical trauma critical care nurses.

Objectives: This study evaluates simulation and microlearning on trauma nurse role ambiguity, knowledge, and confidence in caring for patients during emergency BSL.

Methods: The study is a single-center, prospective pretest-posttest design conducted from September to November 2022 at a Level I trauma center in the Mid-Atlantic United States using simulation and microlearning to evaluate role clarity, knowledge, and confidence among surgical trauma intensive care unit (STICU) nurses.

Cultivating Self-Compassion to Protect Nurses From Burnout and Secondary Traumatic Stress.

Nursing burnout, a result of prolonged occupational stress, has always been a challenge in health care, but recently the COVID-19 pandemic made this issue into a national priority. In fact, burnout among health care workers is one of the four priorities of the U.S.

PRIME-nurse practitioner competency model validation and criterion based OSCE rubric interrater reliability.

The PRIME-NP (Professional-Reporter-Interpreter-Manager-Educator/Evaluation-Nurse Practitioner) Model is adapted from the RIME (Reporter-Interpreter-Manager-Educator) model used in medical education to guide medical student and resident education. The Delphi technique was used to validate the PRIME-NP Model. After two rounds of review by a group of experts in NP curriculum, the model was determined to be valid based on expert consensus.

Factors associated with frequent buprenorphine / naloxone initiation in a national survey of Canadian emergency physicians.

Objective: To identify individual and site-related factors associated with frequent emergency department (ED) buprenorphine/naloxone (BUP) initiation. BUP initiation, an effective opioid use disorder (OUD) intervention, varies widely across Canadian EDs.

Methods: We surveyed emergency physicians in 6 Canadian provinces from 2018 to 2019 using bilingual paper and web-based questionnaires.

Implementing an evidence-based guideline to decrease opioids after cardiac surgery.

Background: Deaths related to overdoses continue growing in the United States. The overprescription of opioids after surgical procedures may contribute to this problem.

Local Problem: There is inconsistency in the prescription of opioids in cardiovascular surgery patients.

Resilience and Ethics in Nursing Education and Practice: Needs and Opportunities.

Background: Nursing faculty and clinicians are leaving the profession due to increased workload and burnout. Evidence-based interventions to build skills in resilience and well-being are encouraged; however, strategies to implement them in nursing curricula and nurse residency programs (NRPs) are not well known.

Purpose: To understand the current state of resilience, well-being, and ethics content in the curriculum in schools of nursing and NRPs in the state of Maryland as part of a statewide initiative for Renewal, Resilience and Retention of Maryland Nurses (R 3 ).

Efficacy of prescribed opioids for acute pain after being discharged from the emergency department: A systematic review and meta-analysis.

Background: Opioids are often prescribed for acute pain to patients discharged from the emergency department (ED), but there is a paucity of data on their short-term use. The purpose of this study was to synthesize the evidence regarding the efficacy of prescribed opioids compared to nonopioid analgesics for acute pain relief in ED-discharged patients.

Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL, and gray literature databases were searched from inception to January 2023.

Patient opinion and acceptance of emergency department buprenorphine/naloxone to-go home initiation packs.

Objectives: Many emergency department (ED) patients with opioid use disorder are candidates for home buprenorphine/naloxone initiation with to-go packs. We studied patient opinions and acceptance of buprenorphine/naloxone to-go packs, and factors associated with their acceptance.

Methods: We identified patients at two urban EDs in British Columbia who met opioid use disorder criteria, were not presently on opioid agonist therapy and not in active withdrawal.

The impact of full practice authority on nurse practitioner compensation, collaboration, and billing.

Background: Although there is a substantial body of evidence regarding full practice authority's (FPA) effects on health care access and quality, very little research has examined how nurse practitioner (NP) licensure laws affect the status of NPs as clinicians, employees, and leaders in health care organizations.

Purpose: This study examined whether states' implementation of FPA leads to higher pay, business ownership, assigned patient panel, and billing transparency for NPs' and whether NPs' gains from FPA increase over time in states where FPA has been in effect longer.

Methodology: Data from a nationwide survey of licensed NPs ( N = 5,770) were used to compare NPs' employment conditions between FPA and non-FPA states.

Impacts of Remote Physical Exercises on Functional Status and Mobility among Community-Dwelling Pre-Disabled Seniors during the Covid-19 Lockdown.

Objectives: To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown.

Design: This is an interventional study conducted from May 2020 to May 2021.

Setting: Community-dwelling older adults in 2 Canadian cities.

Intubation practices and outcomes for patients with suspected or confirmed COVID-19: a national observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN).

Objective: Intubation practices changed during the COVID-19 pandemic to protect healthcare workers from transmission of disease. Our objectives were to describe intubation characteristics and outcomes for patients tested for SARS CoV-2 infection. We compared outcomes between patients testing SARS COV-2 positive with those testing negative.

High-'n'-dry? A comparison of cannabis and alcohol use in drivers presenting to hospital after a vehicular collision.

Design: This was a prospective observational study.

Background And Aims: The characteristics of cannabis-involved motor vehicle collisions are poorly understood. This study of injured drivers identifies demographic and collision characteristics associated with high tetrahydrocannabinol (THC) concentrations.

Advanced practice physiotherapy care in emergency departments for patients with musculoskeletal disorders: a pragmatic cluster randomized controlled trial and cost analysis.

Background: Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians' burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD).

Objectives: To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs.

Methods: This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis.