Coincidence Analysis: A Novel Approach to Modeling Nurses' Workplace Experience.

Objectives: The purpose of this study is to identify combinations of workplace conditions that uniquely differentiate high, medium, and low registered nurse (RN) ratings of appropriateness of patient assignment during daytime intensive care unit (ICU) work shifts.

Methods: A collective case study design and coincidence analysis were employed to identify combinations of workplace conditions that link directly to high, medium, and low RN perception of appropriateness of patient assignment at a mid-shift time point. RN members of the study team hypothesized a set of 55 workplace conditions as potential difference makers through the application of theoretical and empirical knowledge.

Evaluation of Electronic Health Record-Generated Work Intensity Scores and Nurse Perceptions of Workload Appropriateness.

Electronic health record-generated work intensity scores represent state-of-the art functionality for dynamic nursing workload estimation in the hospital setting. In contrast to traditional stand-alone patient classification and acuity tools, electronic health record-based tools eliminate the need for dedicated data entry, and scores are automatically updated as new information is entered into patient records. This paper summarizes the method and results of evaluation of electronic health record-generated work intensity scores on six hospital patient care units in a single academic medical center.

Registered Nurse Strain Detection Using Ambient Data: An Exploratory Study of Underutilized Operational Data Streams in the Hospital Workplace.

Background: Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. Dynamic monitoring of RN strain could identify when intervention is needed, but comprehensive views of RN work demands are not readily available. Electronic care delivery tools such as nurse call systems produce ambient data that illuminate workplace activity, but little is known about the ability of these data to predict RN strain.

Subtle cues: Qualitative elicitation of signs of capacity strain in the hospital workplace.

Through everyday care experiences, nurses develop expertise in recognition of capacity strain in hospital workplaces. Through qualitative interview, experienced nurses identify common activity changes and adaptive work strategies that may signal an imbalance between patient demand and service supply at the bedside. Activity change examples include nurse helping behaviors across patient assignments, increased volume of nurse calls from patient rooms, and decreased presence of staff at the nurses' station.

Immigration Brings New Pathology with No Standardized Treatment Protocol .

Madura foot is an uncommon invasive soft-tissue infection that foot and ankle specialists encounter. We present two rare cases of Phialemonium and Phaeoacremonium fungi infections of the foot diagnosed in northern California to inform physicians on the presentation and current treatment options for this unique pathology. The two cases presented outline the clinical presentations, diagnostic data, and surgical and antimicrobial interventions.

Informal caregiving in Hematopoietic Blood and Marrow Transplant patients.

Purpose: Hematopoietic cell transplant patients are among the most vulnerable and acutely ill cancer populations (Bevans et al., 2008). The responsibility of caring for the daily physical and psychosocial needs of these patients after transplant is placed mostly on family caregivers (Williams, 2007).

Effect of functional foot orthoses on first metatarsophalangeal joint dorsiflexion in stance and gait.

Reduction in first metatarsophalangeal joint maximum degree of dorsiflexion with dorsiflexion of the first ray has been proposed to be the predominant cause of hallux abducto valgus and hallux rigidus. We sought to determine whether orthoses made from a cast with the first ray plantarflexed and a 4-mm medial skive could increase the maximum degree of dorsiflexion in patients with functional hallux limitus in stance and gait. Forty-eight feet of 27 subjects were casted for orthoses with the first ray plantarflexed and in the customary neutral rearfoot position with locked midtarsal joint.

Explaining family caregiver role strain following autologous blood and marrow transplantation.

This research project explores family caregiving processes during the first 100 days following autologous blood and marrow transplantation (ABMT). In this paper, we (1) explore patterns in caregiving, and ABMT recipient function early recovery from ABMT; (2) examine the relationships among caregiver demographics, relationship quality, preparedness, ABMT recipient function, predictability of caregiving, caregiver role strain and rewards of caregiving; and (3) examine the relative contribution of caregiver age, preparedness, relationship quality, and ABMT recipient function on caregiver role strain, and rewards of caregiving. Fifty-two family caregivers of ABMT recipients completed questionnaires about caregiving at hospital discharge, and again 2, 6, and 12 weeks following discharge.

Variables predicting trauma patient survival following massive transfusion.

Introduction: The literature contains little information regarding demographic or transfusion-related factors associated with survival following massive blood transfusion in trauma patients. The objective of this study was to describe patient, transfusion, and laboratory variables contributing to survival in this population during the first and second days after arrival at the hospital. A secondary objective was to identify costs associated with massive blood transfusion.

Hormonal responses to the 6-minute walk test in women and men with coronary heart disease: a pilot study.

Background: Women with coronary heart disease (CHD) are more likely than men to develop congestive heart failure (CHF). Dysregulation of sympathetic and volume-regulatory hormones may contribute to the onset of symptomatic CHF. We hypothesized that this hormonal dysregulation develops at an earlier stage of CHD in women than in men.

Helping at the bedside: spouses' preferences for helping critically ill patients.

Spouses of patients in intensive care units (ICU) need to be close and helpful to ill partners. According to adult attachment theory, emotional responses may be related to preferences for closeness and helpfulness, and according to control theory optimism also may influence spouses' emotional responses. Spouses' goals and helping behaviors were assessed in 88 spouses of ICU patients.

Perception of risk for coronary heart disease in women undergoing coronary angiography.

Background: Even though coronary heart disease (CHD) is the leading cause of death among women in the United States, most women underestimate their risk of developing CHD.

Design: Survey to examine the relationship between women's recollection of being told they were at risk for CHD and the presence of risk factors.

Setting/participants: A convenience sample of 450 women undergoing coronary angiography at 1 university hospital.

Associations between attachment representations and health behaviors in late adolescence.

In this study, we tested the associations among attachment ratings and health behaviors by relationship status. For individuals in relationships, attachment security was associated positively with health promotion and quality sleep and negatively with risk behaviors; fearfulness was associated positively with risk behaviors. With the exception of sleep behaviors, associations with security and fearfulness were reversed for single participants.

Reasons for use of hormone replacement therapy in women undergoing coronary angiography.

The recommendation has been made that all women be counseled about the risks and benefits of hormone replacement therapy (HRT). Use of HRT among women undergoing coronary angiography was explored to assess whether patterns of use were similar to data drawn from community samples. Using a descriptive design, a convenience sample of 414 postmenopausal women was interviewed.

Association between nurse-physician collaboration and patient outcomes in three intensive care units.

Objective: To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome.

Design: Prospective, descriptive, correlational study using self-report instruments.

Settings: A community teaching hospital medical ICU, a university teaching hospital surgical ICU, and a community non-teaching hospital mixed ICU, all in upstate New York.

Sex differences in exercise motivation and body-image satisfaction among college students.

The current study was an expansion of one by Cash, Novy, and Grant in 1994, in which responses of 101 female nursing students were examined for associations between reasons for exercise, frequency of exercise, and body-image satisfaction. In the current study, 78 male and 100 female undergraduates between the ages of 18 and 25 years (M = 21.2, SD = 1.

Nurse-physician collaboration and satisfaction with the decision-making process in three critical care units.

Objective: To assess and compare levels of nurse-physician collaboration and satisfaction with the decision-making process as reported by critical care nurses, resident physicians (residents), and attending physicians (attendings) in making decisions to transfer individual patients out of the critical care unit, and to assess if satisfaction predicts nurse retention.

Design: Longitudinal descriptive correlational study using self-reporting instruments.

Settings: A university hospital's surgical ICU, a community teaching hospital's medical ICU, and a community hospital's mixed ICU.