A quality improvement project to improve diabetes self-management and patient satisfaction in a low-resourced central Kenyan hospital.

Background: There is limited evidence about effective strategies for promoting culturally congruent diabetes education in low-resourced primary-care settings.

Objectives: This project, conducted in Central Kenya, examined the effect of an intervention on provider practices and patients' knowledge of diabetes self-care management.

Methods: The intervention consisted of short (30-minute) sessions that offered providers evidenced-based, culturally congruent diabetes education and teaching materials to use with patients.

An Ethnohistory of the Transcultural Nursing Scholars and Their Contributions to the Field.

The Transcultural Nursing Society (TCNS) recognizes transcultural nursing (TCN) scholars for creative leadership and advancing education, practice, research, and administration. The purpose of this study was to discover the historical context of scholars' professional growth and development and their contributions to and future vision for transcultural nursing. Leininger's Ethnonursing Research Method was used to develop an ethnohistorical qualitative approach that included a semistructured, open-ended interview guide and data analysis plan.

A Quality Improvement Project Using Verbal De-Escalation to Reduce Seclusion and Patient Aggression in an Inpatient Psychiatric Unit.

The use of seclusion is controversial and has been deemed an encroachment on human rights and dignity which can cause psychological trauma and physical injury to patients in the psychiatric setting. This quality improvement project used a quasi-experimental design to implement the TeamSTEPPS educational program, an evidenced-based program to inform nurses about verbal de-escalation to reduce patient aggressive behavior that can lead to patient seclusion. The targeted patient population included all patients admitted 2 months prior to initiation of Team STEPPS (n = 388) and 2 months following completion of the education modules (n = 342).

Leininger's Ethnonursing Research Method: Historical Retrospective and Overview.

A historical overview and evolution of Leininger's ethnonursing research method (ERM) is presented along with descriptions of the method's purpose, goal, terminology, and enablers. A succinct guide to using ERM is provided to assist novice and seasoned researchers, as well as mentors and educators, in teaching, mentoring, advising, and/or conducting ethnonursing research studies. Criteria for evaluation of qualitative research studies, such as the ERM, are highlighted.

Increasing influenza vaccination acceptance in the homeless: A quality improvement project.

The US homeless population is predisposed to serious complications of influenza with increased likelihood of hospitalization and death. This quality improvement project sought to increase influenza vaccination in the homeless population of a rural area in the Midwest and improve provider knowledge of risks and preventive care responsibilities.

Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review.

Introduction: For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes.

Method: The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity.

Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future.

An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

Implementing a Clinical Practice Guideline on Opioid-Induced Advancing Sedation and Respiratory Depression.

Background: Opioid-induced respiratory depression (OIRD) is a serious adverse reaction associated with opioid administration.

Local Problem: The purpose of this quality improvement study was to evaluate the impact of implementing a clinical practice guideline for OIRD in a medical-surgical setting lacking standardized monitoring techniques and reporting criteria for patients receiving opioid analgesia.

Methods: An American Society for Pain Management Nursing protocol was implemented in 4 medical/surgical units.

Educating Nurses to Use a Brief Tobacco Cessation Intervention With Patients on a Mood Disorder Unit in a Midwestern U.S. Hospital.

Background: Evidence shows that smoking cessation interventions are effective in reducing individual's smoking behavior. Despite tobacco cessation efforts, individuals with mental illness smoke more than do members of the general population.

Objective: This study's objective was to determine whether educating nurses to use an evidence-based brief tobacco intervention would improve educating patients on smoking cessation and lead to more patients accepting nicotine replacement therapy (NRT).

Using a Veterans Affairs Posttraumatic Stress Disorder Group Therapy Program With Refugees.

The PTSD Recovery Program, an intervention based on guidelines for the treatment of combat Veterans diagnosed with posttraumatic stress disorder (PTSD) that includes group therapy as adjunctive treatment to medication and individual therapy, was used for the treatment of PTSD in refugees at a clinic in central Texas. Eighteen clients diagnosed with PTSD completed 10 weekly group therapy sessions in addition to individual therapy and medication use. An in-service presentation educated providers on the PTSD Recovery Program and the group therapy intervention.

Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study.

Background: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea.

Purpose: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness.

Methods: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States.

An Intervention to Improve Cultural Competence in Graduate Nursing Education.

Noting the small number of studies on the influence of an entire curriculum on graduate nursing students' cultural competence, the researchers examined the effect of a curricular intervention using a pretest-posttest design. The study, conducted from 2012 to 2014, focused solely on the Doctor of Nursing Practice program at a midwestern university. Results from a pre- and postintervention faculty curriculum survey indicated that the percentage of courses including a cultural competence objective increased from 65 percent to 81 percent.

Healthcare provider compliance with the 2013 ACC/AHA Adult Cholesterol Guideline recommendation for high-intensity dose statins for patients with coronary artery disease.

Background: Atherosclerotic cardiovascular disease is the foremost cause of death for U.S. adults.

Can follow-up phone calls improve patients self-monitoring of blood glucose?

Aims And Objectives: To evaluate the effectiveness of follow-up phone calls in improving frequency of glucose monitoring over a three month period in two groups of patients with type 2 diabetes with the goal to lower haemoglobin A1C.

Background: Telephone intervention has been successfully used in improving adherence to diabetes self-management and other chronic disease conditions.

Design: A quality improvement study.

Somali Immigrant Perceptions of Mental Health and Illness: An Ethnonursing Study.

Purpose: Knowledge of Somali immigrants' mental health care beliefs and practices is needed so that nurses can promote culturally congruent care. The purpose of this study was to explore, discover, and understand mental health meanings, beliefs, and practices from the perspective of immigrant Somalis.

Method: Leininger's qualitative ethnonursing research method was used.

Exploring faculty health and wellbeing: creating a caring scholarly community.

Background: Nursing educators worldwide are challenged to integrate the care of culturally diverse people into coursework to prepare a nursing workforce to deliver culturally congruent care (CCC). Care that recipients consider safe, satisfying, and beneficial is the essence of CCC. To effectively teach and role model such care for students, it is important for faculty to experience it at work.

Nurse practitioner management of chronic musculoskeletal pain: a chart review.

This study explored NPs' management of chronic musculoskeletal pain via a record review of 50 uninsured patients. The findings include a summary of the utilization of services and treatments along with demographic data. Recommendations for education, practice, and further research are discussed.

Mortality, mauling, and maiming by vicious dogs.

Objective: Maiming and death due to dog bites are uncommon but preventable tragedies. We postulated that patients admitted to a level I trauma center with dog bites would have severe injuries and that the gravest injuries would be those caused by pit bulls.

Design: We reviewed the medical records of patients admitted to our level I trauma center with dog bites during a 15-year period.

Caring: some reflections on the impact of the culture care theory by McFarland & Andrews and a conversation with Leininger.

This column is the first of two with a special focus on the construct of caring. In this dialogue, two Leininger scholars together address the questions related to the global impact on practice and the contribution of the model to scientific development in nursing. Then, in a special conversation, nurse theorist Madeleine Leininger offers her view of the impact of her work as well as some of her early experiences.

Visual literacy in the online environment.

Visual literacy combines words and graphics to enhance learning. Students are immersed in digital literacy and multimodal learning; therefore, it is important for educators to embrace visual literacy and strike out beyond printed text, PowerPoint slides, and discussion boards. This article describes the use of visual literacy as a tool to enhance student learning.

Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings.

Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.

A crisis in the delivery of care to patients with brain injuries in South Texas.

Background: To determine the opinions of neurosurgeons regarding the care of the injured and to assess the impact of these attitudes on the care of the patients with brain injuries.

Methods: A survey was sent to the 2,465 active members of the American Association of Neurologic Surgeons. A manpower assessment of neurosurgical coverage of South Texas was also performed.