The value of comprehensive evaluation DNP projects.

Inconsistencies in DNP project identification and scope, and the demands of the DNP project on faculty remain a source of ongoing challenges and discussion in DNP education. Additionally, the demands on organizational resources generated by student DNP projects strain the already stressed post-pandemic healthcare system. At the same time, the need for more student project sites is growing along with the increasing number of DNP programs.

Development and validation of a sepsis risk index supporting early identification of ICU-acquired sepsis: an observational study.

Background: Sepsis is a threat to global health, and domestically is the major cause of in-hospital mortality. Due to increases in inpatient morbidity and mortality resulting from sepsis, healthcare providers (HCPs) would accrue significant benefits from identifying the syndrome early and treating it promptly and effectively. Prompt and effective detection, diagnosis, and treatment of sepsis requires frequent monitoring and assessment of patient vital signs and other relevant data present in the electronic health record.

Concurrent Nephrotoxicity and Neurotoxicity Induced by Oral Valacyclovir in a Patient With Previously Normal Kidney Function.

Drug-induced nephrotoxicity and neurotoxicity are commonly encountered problems in clinical practice. We describe a case of concurrent valacyclovir-induced nephrotoxicity and neurotoxicity in a 64-year-old man with no history of renal disease who developed acute renal injury and neurological symptoms after he received two weeks of the standard dose of oral valacyclovir for herpes zoster meningitis. His clinical condition improved significantly after the initiation of hemodialysis.

Academic-Practice Partnerships: Building a sustainable model for Doctor of Nursing Practice (DNP) projects.

Background: DNP programs should follow the Academic-Practice Partnership guiding principles developed by the AACN-AONE Task Force of Academic Practice Partnerships (2012) to support students educational and practice experiences. This paper outlines the collaboration between a college of nursing (CON) and academic medical center in establishing a formal process for identification and vetting of student DNP projects.

Methods: A collaborative committee called DNP Project Oversight Committee (DNPPOC) was formed.

Implementing a Heart Failure Transition Program to Reduce 30-Day Readmissions.

Background: Thirty-day readmissions for heart failure (HF) patients are often considered avoidable and linked to inadequate treatment and poor coordination of services and discharge plans.

Problem: Lack of coordinated transitional care services and high 30-day readmissions prompted the interdisciplinary team to develop an HF Transition Program (HFTP).

Methods: This quality improvement initiative used monthly trend data before and after HFTP implementation.

Exploring the Doctor of Nursing Practice project facilitator/mentor role.

Background: The Doctor of Nursing Practice (DNP) facilitator/mentor is a collaborative member of the project team, yet little has been reported about this role. This qualitative study explored the experiences of DNP project facilitators.

Methods: Focus groups were conducted using a purposeful sample of project facilitators.

Evaluation and enhancement of medical knowledge competency by monthly tests: a single institution experience.

Background: In-training examination (ITE) has been used as a predictor of performance at the American Board of Internal Medicine (ABIM) certifying examination. ITE however may not be an ideal modality as it is held once a year and represents snapshots of performance as compared with a trend. We instituted monthly tests (MTs) to continually assess the performance of trainees throughout their residency.

Vibrational lifetimes and friction in adsorbate motion determined from quasi-elastic scattering.

The vibrational excitation of molecules adsorbed on a surface is typically probed by spectroscopic techniques such as infrared or Raman spectroscopy. In the present article we demonstrate an alternative method to determine vibrational lifetimes of adsorbate molecules using quasi-elastic helium atom scattering (QHAS). As a probe of diffusive motion of molecules on surfaces QHAS is well established.

Acyclovir-Induced Neurotoxicity: A Case Report and Review of Literature.

Neurotoxicity can develop as a side effect of intravenous acyclovir use in patients with renal impairment. It is underreported in clinical practice and often confused with worsening herpes encephalitis. We present a 69-year-old woman with end-stage renal disease on hemodialysis with acyclovir neurotoxicity treated with daily extended hemodialysis sessions.

Fecal Transplant for Treatment of Toxic Megacolon Associated With Clostridium Difficile Colitis in a Patient With Duchenne Muscular Dystrophy.

Clostridium difficile (C diff) colitis infection is the most common cause of nosocomial infectious diarrhea and the prevalence is increasing worldwide. Toxic megacolon is a severe complication of C diff colitis associated with high mortality. Gastrointestinal (GI) comorbidity and impaired smooth muscle contraction are risk factors for the development of C diff-associated toxic megacolon.

Integrating gerontological content across advanced practice registered nurse programs.

Purpose: Faculty members across the country are faced with integrating gerontological content and competencies across advanced practice registered nurse (APRN) programs that focus on the adult-gerontology population. The purpose of this initiative was to effectively and efficiently integrate gerontological content into the adult management courses for several APRN programs in acute and primary care at one university's college of nursing.

Data Sources: Current literature, resources for integrating adult-gerontology content, course evaluations, and end of program surveys were used in this project.

Jumping, Rotating, and Flapping: The Atomic-Scale Motion of Thiophene on Cu(111).

Self-assembled monolayers of sulfur-containing heterocycles and linear oligomers containing thiophene groups have been widely employed in organic electronic applications. Here, we investigate the dynamics of isolated thiophene molecules on Cu(111) by combining helium spin-echo (HeSE) spectroscopy with density functional theory calculations. We show that the thiophene/Cu(111) system displays a rich array of aperiodic dynamical phenomena that include jump diffusion between adjacent atop sites over a 59-62 meV barrier and activated rotation around a sulfur-copper anchor, two processes that have been observed previously for related systems.

Atomic scale friction of molecular adsorbates during diffusion.

Experimental observations suggest that molecular adsorbates exhibit a larger friction coefficient than atomic species of comparable mass, yet the origin of this increased friction is not well understood. We present a study of the microscopic origins of friction experienced by molecular adsorbates during surface diffusion. Helium spin-echo measurements of a range of five-membered aromatic molecules, cyclopentadienyl, pyrrole, and thiophene, on a copper(111) surface are compared with molecular dynamics simulations of the respective systems.

Recurring competitive reactions: desorption of methane and molecular hydrogen from Cu(001).

Methane and molecular hydrogen desorption from a methyl and hydrogen exposed Cu(001) surface is investigated. Both gaseous products are observed nearly simultaneously within two temperature regimes separated by more than 100 K. The lower temperature desorption, at ∼325 K, is believed to result from two processes which compete for adsorbed atomic hydrogen: methyl reduction and associative hydrogen desorption.

Trajectory compensation in an autoresonant trap mass spectrometer.

The auto-resonant trap mass spectrometer, ART-MS, utilizes electrostatic ion trapping within an anharmonic potential well. Ions are detected after mass selective trap ejection with auto-resonant driving employing only low-power rf electronics. We identify the major limiting factor in the mass resolution of these instruments.

Weak intermolecular interactions in an ionically bound molecular adsorbate: cyclopentadienyl/Cu(111).

The dissociative adsorption of cyclopentadiene (C(5)H(6)) on Cu(111) yields a cyclopentadienyl (Cp) species with strongly anionic characteristics. The Cp potential energy surface and frictional coupling to the substrate are determined from measurements of dynamics of the molecule together with density functional calculations. The molecule is shown to occupy degenerate threefold adsorption sites and molecular motion is characterized by a low diffusional energy barrier of 40±3 meV with strong frictional dissipation.

Promoting professional nursing practice: linking a professional practice model to performance expectations.

Professional practice models (PPMs) provide the conceptual framework for establishing professional nursing practice. Integrating a PPM requires complex organizational change. One strategy for integrating a PPM is to directly link the PPM with performance expectations to ensure that underlying beliefs are integrated into everyday practice.

Implementation of new TPD analysis techniques in the evaluation of second order desorption kinetics of cyanogen from Cu(001).

The interactions of cyanide species with a copper (001) surface were studied with temperature programmed desorption (TPD) and X-ray photoelectron spectroscopy (XPS). Adsorbed cyanide species (CN(a)) undergo recombinative desorption evolving molecular cyanogen (C(2)N(2)). As the adsorbed CN species charge upon adsorption, mutually repulsive dipolar interactions lead to a marked desorption energy reduction with increasing CN(a) coverages.

A surface work function measurement technique utilizing constant deflected grazing electron trajectories: oxygen uptake on Cu(001).

We report on the application of a novel nondestructive in-vacuum technique for relative work function measurements, employing a grazing incidence electron deflection above a sample with a planar surface. Two deflected electron beam detectors are used as a position sensitive detector to control feedback to the sample potential as the sample work function changes. With feedback the sample potential exactly follows the surface sample-size averaged work function variation, so that the deflected beam trajectory remains stable.

An electrostatic autoresonant ion trap mass spectrometer.

A new method for ion extraction from an anharmonic electrostatic trap is introduced. Anharmonicity is a common feature of electrostatic traps which can be used for small scale spatial confinement of ions, and this feature is also necessary for autoresonant ion extraction. With the aid of ion trajectory simulations, novel autoresonant trap mass spectrometers (ART-MSs) have been designed based on these very simple principles.

Developing an advanced practice nursing credentialing model for acute care facilities.

Credentialing of advanced practice registered nurses (APRNs) in acute care settings is an essential practice, but care must be taken to ensure that full utilization of the scope of practice and capacity of APRNs is attained. The process of credentialing and privileging involves the verification of required education, licensure, and certification to practice as an APRN along with the recognition of the scope of the individual APRN's practice based on training, education, and practice setting. Nursing administrators are challenged with ensuring that APRNs are credentialed and privileged and that appropriate mechanisms exist within the institution for promoting recognition of the scope of practice of APRNs.