Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project.

Purpose: The purpose of this quality improvement project was to develop guidance for safe patient handling and mobility efforts to prevent pressure injuries (PIs) within the Veterans Health Administration (VHA) when slings and other transfer devices are left under patients.

Participants And Setting: Health care staff (n = 112) in patient safety and nursing at 77 unique VHA facilities responded to surveys between November and December 2019. Interviews (n = 24) were conducted using purposive sampling with VHA staff at facilities with highest and lowest PI rates (n = 9) between January and March 2021.

Original Research: What Health Care Staff Who Experienced Assisted Patient Falls Can Teach Us: Implications for Fall and Fall Injury Risk.

Purpose: This quality improvement project had three aims: to identify common assisted falls scenarios, describe staff members' experiences with and risk perceptions of such falls, and explore factors that influenced their perceptions. The overarching goal was to gain useful insight for the development of assisted fall-related strategies and policies.

Methods: In the fall of 2020, 16 staff members from 13 health care facilities were purposively recruited and interviewed.

Assessing Nurse Competency in the Veterans Health Administration Registered Nurse Transition-to-Practice Residency Program: Item Pool Content Validation.

Background: New graduate registered nurse (RN) competencies are complex and difficult to measure. Psychometrically sound tools are needed to evaluate competencies for nurses participating in nurse residencies.

Purpose: Project aims were to develop an item pool for a tool to measure new graduate RN competencies for the Veterans Health Administration RN Transition-to-Practice Residency Program; validate item pool content; and use consensus methods to improve item pool content validity.

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data.

Aims: To investigate factors affecting non-completion by registered nurses (RNs) participating in degree programs supported by the scholarship program of the National Nursing Education Initiative of the United States Veterans Health Administration. Secondarily, to assess overall retention in the scholarship program over time.

Design: Retrospective longitudinal design using administrative data.

Staff Low Back Injury Risk During Assisted Falls Virtual Reality Simulations.

Background: Assisted falls occur when staff try to minimize the impact of falls by slowing a patient's descent. Assisting a patient fall may decrease patient injury risk, but biomechanical risk of injury to staff has not been evaluated. Assisted falls virtual reality (VR) simulations were conducted to examine staff low back injury risk during common assisted falls scenarios.

Reliability and validity of the Veterans Administration Mobility Screening and Solutions Tool.

Objectives: The Veterans Administration (VA) Mobility Screening and Solutions Tool (VA MSST) was developed to screen a patient's safe mobility level 'in the moment' and provide clinical decision support related to the use of safe patient handling and mobility (SPHM) equipment. This evidence-based flowchart tool is a common language tool that enables any healthcare worker at any time to accurately measure and communicate patient mobility and transfer equipment needs across disciplines and settings.

Methods: The VA MSST has four levels and differentiates between the need for powered and non-powered equipment depending on the patient's independence.

Evaluation of a new assistive technology: the StandBar.

Purpose: Evaluate the potential of a wheelchair assistive technology (StandBar) to promote power wheelchair users' ability to safely stand independently from their power wheelchair and determine the impact of the device use on psychological well-being for both power wheelchair users and their caregivers.

Materials And Methods: A convenience sample of 11 power wheelchair users and caregiver dyads provided study data. Participants included power wheelchair users who were existing StandBar users or currently in training with the StandBar as part of their rehabilitation.

Evaluation of Protective Properties of Commercially Available Medical Helmets: Are Medical Helmets Protective?

Objectives: The aims of the study were to evaluate and to compare protective properties of commercially available medical helmets for a set of standardized head injury risk measures.

Methods: Eleven helmet types were evaluated to represent the variety of commercially available medical helmet designs and manufacturers. A test mannequin and sensor apparatus were used to simulate a backward-standing fall.

A preliminary evaluation of full practice authority of advance practice registered nurses in the Veterans Health Administration.

Background: Responding to National Academy of Medicine and National Council of State Boards of Nursing recommendations, the Department of Veterans Health Affairs (VHA) implemented full practice authority (FPA) for Advanced Practice Registered Nurses in VHA medical centers (VAMCs) in 2017.

Purpose: To evaluate FPA policy implementation's impact on quality indicators including access to care as measured by new patient appointments in primary, specialty and mental health services.

Methods: Linear growth models compared early (n = 85) vs.

Risk Factors for Hospital-Acquired Pressure Injury in Surgical Critical Care Patients.

Background: Hospital-acquired pressure injuries disproportionately affect critical care patients. Although risk factors such as moisture, illness severity, and inadequate perfusion have been recognized, nursing skin assessment data remain unexamined in relation to the risk for hospital-acquired pressure injuries.

Objective: To identify factors associated with hospital-acquired pressure injuries among surgical critical care patients.

Pressure Injury Prevention Considerations for Older Adults.

There are well-documented physiologic changes that occur in the human body during the aging process, such as decreased body fat, decreased muscle mass, cellular senescence, changes in skin pH, decreased metabolism, decreased immune function, vascular changes, altered tissue perfusion, nutritional status changes, and poor hydration. These changes affect skin integrity and wound healing, and raise the risk of pressure-related skin injury. This article discusses aging as a risk factor for pressure injury (PrI).

Best Practice in Pressure Injury Prevention Among Critical Care Patients.

Pressure injuries are areas of damage to the skin and underlying tissue caused by pressure or pressure in combination with shear. Pressure injury prevention in the critical care population necessitates risk assessment, selection of appropriate preventive interventions, and ongoing assessment to determine the adequacy of the preventive interventions. Best practices in preventive interventions among critical care patients, including skin and tissue assessment, skin care, repositioning, nutrition, support surfaces, and early mobilization, are described.

Doctoral-prepared nurses in the Veterans Health Administration: A cross-sectional survey.

Background: Doctoral-prepared nurses with diverse skillsets are required to meet nursing care needs in a complex and changing healthcare environment. A better understanding of the roles of doctoral-prepared nurses in Veterans Health Administration (VHA) workforce will help leverage their expertise to meet the needs of Veterans.

Purpose: Assess the current roles of doctoral-prepared nurses within the VHA.

Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients.

It is estimated that up to 50% of hospitalized patients are malnourished. Malnutrition can lead to longer hospital stays, altered immune function, and impaired skin integrity and wound healing. Malnutrition has been found to be a significant factor influencing pressure injury (PI) risk and wound healing.

Mortality and Associated Risk Factors in Community-Dwelling Persons With Early Dementia.

Objective: Examine mortality and associations with baseline characteristics among Veterans with early dementia.

Methods: Participants included dyads of community-based Veterans with early dementia and their caregivers (N=143) enrolled in a previous longitudinal study. Department of Veterans Health Affairs' electronic records were used to retrospectively collect Veteran mortality outcomes, over a 6-year period.

Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me?

Over the past decade, leading health care organizations have recommended doubling the number of doctorally prepared nurses to meet the future demands of health care. In 2018, the National Organization of Nurse Practitioner Faculties committed to move all nurse practitioner degree programs to the Doctor of Nursing Practice degree by 2025. As more and more doctorally prepared nurses enter the workforce, other nurses are considering returning to school for a terminal degree.

Pressure ulcer summit 2018: An interdisciplinary approach to improve our understanding of the risk of pressure-induced tissue damage.

Pressure ulcers (PrUs) affect approximately 2.5 million patients and account for 60,000 deaths annually. They are associated with an additional annual cost of $43,000 per related hospital stay and a total cost to the US health care system as high as $25 billion.

The impact of imperfect screening tools on measuring the prevalence of epilepsy and headaches in Burkina Faso.

Background: Epilepsy and progressively worsening severe chronic headaches (WSCH) are the two most common clinical manifestations of neurocysticercosis, a form of cysticercosis. Most community-based studies in sub-Saharan Africa (SSA) use a two-step approach (questionnaire and confirmation) to estimate the prevalence of these neurological disorders and neurocysticercosis. Few validate the questionnaire in the field or account for the imperfect nature of the screening questionnaire and the fact that only those who screen positive have the opportunity to be confirmed.

Pressure Injury Documentation Practices in the Department of Veteran Affairs: A Quality Improvement Project.

Evidence suggests that inaccurate and incomplete pressure injury (PI) documentation threatens the validity of treatment and undermines policy and quality improvement. This quality improvement project sought to identify barriers and facilitators when conducting and documenting the daily comprehensive skin assessment in 31 Department of Veterans Affairs (VA) facilities. Evaluators in this 1-year, cross-sectional quality improvement project, using a qualitative approach, interviewed nurses of medical-surgical and critical care units.

A model of successful DNP and PhD collaboration.

Background And Purpose: Within nursing education, the existence of two graduate-level programs has created some challenges. Role confusion between the practice-focused Doctor of Nursing Practice (DNP) and the research-focused Doctor of Philosophy (PhD) is compounded by competition for similar positions. Collaboration between DNP and PhD nurses, however, benefits the health care system and patients.

Pressure Injury Education in the Department of Veterans Affairs: Results of a National Wound Provider Cross-sectional Survey.

Purpose: The aim of this study was to describe experience, training, educational needs and preferences, and perceptions of pressure injury (PI) prevention education of wound care providers in the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) as an indicator of effectiveness of the mandated VHA PI Prevention Program.

Subjects And Setting: A convenience sample of national VHA wound care providers practicing in VHA facilities was compiled from members of special interest groups and committees and by referrals from known wound care specialists and clinicians (N = 1726). The response rate was 24% (n = 410).

Improving Cardiac Surgery Outcomes by Using an Interdisciplinary Clinical Pathway.

A cardiothoracic intensive care unit (CTICU) team evaluated preoperative and postoperative processes to improve outcomes for cardiac surgery patients. The primary aim of this project was to streamline and improve care in the CTICU by implementing a new clinical pathway for patients undergoing coronary artery bypass graft or valve replacement procedures. We analyzed processes, communication, ventilator days, respiratory complications, patient mobility, presence of invasive catheters and lines, CTICU length of stay, and hospital-adjusted length of stay before and after we implemented the clinical pathway.

Research productivity following nursing research initiative grants.

Background: In 1995, VA's Office of Research and Development launched the Nursing Research Initiative (NRI), to encourage nurses to apply for research funding and to increase the role of nurse investigators in the VA's research mission. This program provides novice nurse researchers the opportunity to further develop their research skills with the guidance of a mentor.

Purpose: Since the NRI's inception, its impact on the research career trajectory of budding nurse researchers had never been fully explored.

Effectiveness of a community-based educational programme in reducing the cumulative incidence and prevalence of human Taenia solium cysticercosis in Burkina Faso in 2011-14 (EFECAB): a cluster-randomised controlled trial.

Background: The effectiveness of drug-free interventions in controlling human cysticercosis is not well known. We aimed to estimate the effectiveness of a community-based educational intervention in reducing the frequency of human cysticercosis in Burkina Faso.

Methods: We did a cluster-randomised controlled trial between 2011 and 2014.