Eccentric rehabilitation induces white matter plasticity and sensorimotor recovery in chronic spinal cord injury.

Experience-dependent white matter plasticity offers new potential for rehabilitation-induced recovery after neurotrauma. This first-in-human translational experiment combined myelin water imaging in humans and genetic fate-mapping of oligodendrocyte lineage cells in mice to investigate whether downhill locomotor rehabilitation that emphasizes eccentric muscle actions promotes white matter plasticity and recovery in chronic, incomplete spinal cord injury (SCI). In humans, of 20 individuals with SCI that enrolled, four passed the imaging screen and had myelin water imaging before and after a 12-week (3 times/week) downhill locomotor treadmill training program (SCI + DH).

A multifactorial action plan improves hand hygiene adherence and significantly reduces central line-associated bloodstream infections.

Background: Although hand hygiene (HH) is key to reducing health care-associated infections, it is well documented that health care worker (HCW) adherence to appropriate HH protocols is relatively low.

Methods: This was a collaborative quality improvement project with multiple interventions conducted in a 570-bed academic hospital in Columbia, MO between April 2006 and September 2012. A multimodal action plan to improve HH adherence among all HCWs was developed, addressing 4 key areas: staff education, staff accountability, hand sanitizer product selection and accessibility, and organizational culture.

Transradial vascular access: a growing trend.

The transradial route for coronary angiography is a growing trend in the United States. Nurse practitioners (NPs) are an essential part of the preprocedural assessment and management of patients. This article will outline the benefits and risks of transradial access as well as methods for NPs to assess arterial hand circulation.

Pain management for pediatric tonsillectomy: an integrative review through the perioperative and home experience.

Purpose: This integrative review aims to increase our understanding of current pain management care practices for children undergoing tonsillectomy.

Conclusions: Synthesis of the literature resulted in four main opportunities for care providers to manage pain: preoperative education and preparation, intraoperative surgical interventions, and postoperative pharmacologic and nonpharmacologic interventions in the post anesthesia care unit and home settings.

Practice Implications: Nurses have many opportunities to understand pain management practices and intervene to minimize pain experienced in pediatric outpatients undergoing tonsillectomy.

Pain management of children aged 5 to 10 years after adenotonsillectomy.

Purpose: The undertreatment of pediatric pain has been widely researched and continues to be a concern for health care professionals. Adenotonsillectomy is a common pediatric surgery associated with a moderate-to-high level of postoperative pain. The purpose of this study was to increase understanding of the current pain management practices provided to children aged 5 to 10 years undergoing adenotonsillectomy and identify areas for improvement.

Caring for our own: deploying a systemwide second victim rapid response team.

A unique rapid response system was designed to provide social, psychological, emotional, and professional support for health care providers who are "second victims"--traumatized as a result of their involvement in an unanticipated adverse event, medical error, or patient-related injury.