Investigating the association between asthma and opioid use disorder with interactions of anxiety and depression among a national sample of the US population.

Introduction: Previous studies have not examined the association between asthma and opioid use disorder (OUD) in a comprehensive national sample of the U.S. population.

Exploring the Association Between Opioid Use Disorder and Alzheimer's Disease and Dementia Among a National Sample of the U.S. Population.

Background: Past research suggests associations between heavy alcohol use and later life dementia. However, little is known about whether opioid use disorder (OUD) and dementia share this association, especially among age groups younger than 65 years old.

Objective: Examine the association between OUD and Alzheimer's disease (AD) and dementia.

Externally validated deep learning model to identify prodromal Parkinson's disease from electrocardiogram.

Little is known about electrocardiogram (ECG) markers of Parkinson's disease (PD) during the prodromal stage. The aim of the study was to build a generalizable ECG-based fully automatic artificial intelligence (AI) model to predict PD risk during the prodromal stage, up to 5 years before disease diagnosis. This case-control study included samples from Loyola University Chicago (LUC) and University of Tennessee-Methodist Le Bonheur Healthcare (MLH).

Can Prehospital Data Improve Early Identification of Sepsis in Emergency Department? An Integrative Review of Machine Learning Approaches.

Background: Sepsis is associated with high mortality, especially during the novel coronavirus disease 2019 (COVID-19) pandemic. Along with high monetary health care costs for sepsis treatment, there is a lasting impact on lives of sepsis survivors and their caregivers. Early identification is necessary to reduce the negative impact of sepsis and to improve patient outcomes.

Impact of a Procalcitonin-Based Protocol on Antibiotic Exposure and Costs in Critically Ill Patients.

Unlabelled: To examine the impact before and after adoption of a procalcitonin-based protocol to guide sepsis management has on antibiotic use, care costs, and outcomes of critically ill patients.

Design: Before-after study.

Setting: ICU of an academic tertiary care center.

Cross-Cultural Adaptation and Psychometrics Evaluation of the Arabic Version of the Patient-Readiness for Hospital Discharge Scale.

Background And Purpose: The Patient Readiness for Hospital Discharge Scale (PT-RHDS) is an outcome measure of discharge care processes. The purpose of the study was to test a cross-cultural adaptation from English into Arabic.

Methods: The Rand Corporation cross-cultural adaptation method and psychometric analysis of data from 1844 adult surgical inpatients in two Saudi Arabia hospitals.

Using Concept Unique Identifiers to Filter Electronic Health Records for Delirium Cases.

Delirium, an acute mental status change associated with inattention, confusion, hypervigilance, or somnolence due to a medical cause, is considered a medical emergency. Unfortunately, screening and diagnosis of delirium in acute care are often inadequate. It is estimated that 60% of delirium cases are not identified, and in claims data, they are underreported.

Nonlinear association of nurse staffing and readmissions uncovered in machine learning analysis.

Objective: Several studies of nurse staffing and patient outcomes found a curvilinear or U-shaped relationship, with benefits from additional nurse staffing diminishing or reversing at high staffing levels. This study examined potential diminishing returns to nurse staffing and the existence of a "tipping point" or the level of staffing after which higher nurse staffing no longer improves and may worsen readmissions.

Data Sources/study Setting: The Readiness Evaluation And Discharge Interventions (READI) study database of over 130,000 adult (18+) inpatient discharges from 62 medical, surgical, and medical-surgical (noncritical care) units from 31 United States (US) hospitals during October 2014-March 2017.

Effectiveness of home health care in reducing return to hospital: Evidence from a multi-hospital study in the US.

Background: Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed.

Objective: To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization.

Effectiveness of using a simulation combined with online learning approach to develop discharge teaching skills.

Background: Despite evidence of the impact of discharge teaching on patient outcomes, nursing students are poorly prepared in the pedagogical skills necessary for their role as patient and family educators in clinical practice. This study evaluated the effectiveness of simulation combined with online learning to improve nursing students' discharge teaching skills.

Methods: The module included simulations before and after an online module on patient/family teaching for hospital discharge.

Reducing Cardiac Telemetry Nuisance Alarms Through Evidence-Based Interventions.

Background: Cardiac telemetry nuisance alarms due to leads off and poor signal increase staff workflow interruptions, decrease staff trust in technology, and can compromise patient safety.

Local Problem: Interventions were directed at reducing nuisance alarms on a 32-bed, non-intensive care - a cardiac telemetry unit.

Methods: A nursing staff education module with evidence-based practices for reducing nuisance alarms, a daily care protocol for patients on cardiac telemetry monitoring, and daily audits of protocol adherence were implemented.

Clinical nurses' perspectives on discharge practice changes from participating in a translational research study.

Aim: To describe clinical nurses' experiences with practice change associated with participation in a multi-site nursing translational research study implementing new protocols for hospital discharge readiness assessment.

Background: Nurses' participation in translational research studies provides an opportunity to evaluate how implementation of new nursing interventions affects care processes within a local context. These insights can provide information that leads to successful adoption and sustainability of the intervention.

Using the consolidated framework for implementation research to evaluate clinical trials: An example from multisite nursing research.

Background: The Consolidated Framework for Implementation Research (CFIR) is a comprehensive guide for determining the factors that affect successful implementation of complex interventions embedded in real-time clinical practice.

Purpose: The study aim was to understand implementation constructs in a multi-site translational research study on readiness for hospital discharge that distinguished study sites with low versus high implementation fidelity.

Methods: In this descriptive study, site Principal Investigator interviews (from 8 highest and 8 lowest fidelity sites) were framed with questions from 20 relevant CFIR constructs.

Nurse Continuity at Discharge and Return to Hospital.

Background: Promoting continuity of nurse assignment during discharge care has the potential to increase patient readiness for discharge-which has been associated with fewer readmissions and emergency department visits. The few studies that examined nurse continuity during acute care hospitalizations did not focus on discharge or postdischarge outcomes.

Objectives: The aim of this research was to examine the association of continuity in nurse assignment to patients prior to hospital discharge with return to hospital (readmission and emergency department or observation visits), including exploration of the mediating pathway through patient readiness for discharge and moderating effects of unit environment and unit nurse characteristics.

Individual Nurse Productivity in Preparing Patients for Discharge Is Associated With Patient Likelihood of 30-Day Return to Hospital.

Objective: Applied to value-based health care, the economic term "individual productivity" refers to the quality of an outcome attributable through a care process to an individual clinician. This study aimed to (1) estimate and describe the discharge preparation productivities of individual acute care nurses and (2) examine the association between the discharge preparation productivity of the discharging nurse and the patient's likelihood of a 30-day return to hospital [readmission and emergency department (ED) visits].

Research Design: Secondary analysis of patient-nurse data from a cluster-randomized multisite study of patient discharge readiness and readmission.

Variability in catheter-associated asymptomatic bacteriuria rates among individual nurses in intensive care units: An observational cross-sectional study.

Catheter-associated asymptomatic bacteriuria (CAABU) is frequent in intensive care units (ICUs) and contributes to the routine use of antibiotics and to antibiotic-resistant infections. While nurses are responsible for the implementation of CAABU-prevention guidelines, variability in how individual nurses contribute to CAABU-free rates in ICUs has not been previously explored. This study's objective was to examine the variability in CAABU-free outcomes of individual ICU nurses.

Effect of Implementing Discharge Readiness Assessment in Adult Medical-Surgical Units on 30-Day Return to Hospital: The READI Randomized Clinical Trial.

Importance: The downward trend in readmissions has recently slowed. New enhancements to hospital readmission reduction efforts are needed. Structured assessment of patient readiness for discharge has been recommended as an addition to discharge preparation standards of care to assist with tailoring of risk-mitigating actions.

Aligning Evidence-Based Practice With Translational Research: Opportunities for Clinical Practice Research.

Magnet® and other organizations investing resources in evidence-based practice (EBP) are ideal laboratories for translational nursing research. Translational research, the study of implementation of evidence into practice, provides a unique opportunity to leverage local EBP work for maximum impact. Aligning EBP projects with rigorous translational research can efficiently meet both EBP and research requirements for Magnet designation or redesignation, inform clinical practice, and place organizations at the leading edge of practice-based knowledge development for the nursing discipline.

Validation of the Registered Nurse Assessment of Readiness for Hospital Discharge Scale.

Background: Statistical models for predicting readmissions have been published for high-risk patient populations but typically focus on patient characteristics; nurse judgment is rarely considered in a formalized way to supplement prediction models.

Objectives: The purpose of this study was to determine psychometric properties of long and short forms of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS), including reliability, factor structure, and predictive validity.

Methods: Data were aggregated from two studies conducted at four hospitals in the Midwestern United States.

Interprofessional Health Team Communication About Hospital Discharge: An Implementation Science Evaluation Study.

The Consolidated Framework for Implementation Research guided formative evaluation of the implementation of a redesigned interprofessional team rounding process. The purpose of the redesigned process was to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation.

A Model for Hospital Discharge Preparation: From Case Management to Care Transition.

There has been a proliferation of initiatives to improve discharge processes and outcomes for the transition from hospital to home and community-based care. Operationalization of these processes has varied widely as hospitals have customized discharge care into innovative roles and functions. This article presents a model for conceptualizing the components of hospital discharge preparation to ensure attention to the full range of processes needed for a comprehensive strategy for hospital discharge.

Models of Discharge Care in Magnet® Hospitals.

Objective: The aim of this article is to describe how the discharge preparation process is operationalized in Magnet® hospitals.

Background: Nationally, there are intensive efforts toward improving discharge transitions and reducing readmissions. Discharge preparation is a core hospital function, yet there are few reports of operational models.

Quality Improvement Project: analysis of efficiency of current order set for the diagnostic workup used to evaluate neurogenic stress myocardium in aneurysmal subarachnoid hemorrhage.

Purpose: To evaluate patterns of utilization of the aneurysmal subarachnoid hemorrhage (aSAH) protocol order set for neurogenic stress myocardium (NSM).

Data Sources: Retrospective chart review.

Conclusions: The results of this study demonstrate that protocol order sets can be prone to omissions, variations in practice, and delays.

Comparison of nurse staffing based on changes in unit-level workload associated with patient churn.

Aim: This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers.

Background: Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit.

Validation of patient and nurse short forms of the Readiness for Hospital Discharge Scale and their relationship to return to the hospital.

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits.

Data Sources/study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011.

Study Design: Prospective longitudinal design, multinomial logistic regression analysis.