Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors.

Introduction: Workplace violence against nurses is a serious problem. Nurses from a US urban/community hospital system employing more than 5,000 nurses researched the incidence of workplace violence against nurses perpetrated by patients or visitors in their hospital system.

Methods: Survey research and retrospective database review methods were used.

Continuously rethinking the definition of influenza for surveillance systems: a Dependent Bayesian Expert System.

Objective: In the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), influenza was originally defined by a list of 29 and later by a list of 12 diagnosis codes. This article describes a dependent Bayesian procedure designed to improve the ESSENCE system and exploit multiple sources of information without being biased by redundancy.

Methods: We obtained 13,096 cases within the Armed Forces Health Longitudinal Technological Application electronic medical records that included an influenza laboratory test.

Effect of Nurses Living Fit™ exercise and nutrition intervention on body mass index in nurses.

Objective: The hospital-based Nurses Living Fit (NLF) intervention was implemented by nurses to determine its effect on decreasing body mass index (BMI) in nurse participants.

Background: Although there are limited data on obesity rates of nurses working in the United States, more than half are estimated to be overweight or obese.

Methods: The NLF intervention included exercise (12 weekly sessions), yoga and nutrition (4 monthly sessions), and diary completion (exercise/yoga, food/water consumption, and sleep), addressing healthy lifestyle principles.

Bayesian processing of context-dependent text: reasons for appointments can improve detection of influenza.

Objective: This article aims to examine whether words listed in reasons for appointments could effectively predict laboratory-verified influenza cases in syndromic surveillance systems.

Methods: Data were collected from the Armed Forces Health Longitudinal Technological Application medical record system. We used 2 algorithms to combine the impact of words within reasons for appointments: Dependent (DBSt) and Independent (IBSt) Bayesian System.

A randomized double-blind study comparing intradermal anesthetic tolerability, efficacy, and cost-effectiveness of lidocaine, buffered lidocaine, and bacteriostatic normal saline for peripheral intravenous insertion.

In this double-blind study, 256 surgical patients meeting eligibility criteria were randomized in a 1:1:1 ratio to 1 of the 3 intradermal injection groups prior to intravenous (IV) line insertion (Group 1=1% lidocaine, Group 2=1% buffered lidocaine, and Group 3=bacteriostatic normal saline with a benzyl alcohol preservative). The most tolerable solution, as measured by the average level of pain from an intradermal insertion, was buffered lidocaine (Group 2). The most efficacious, as measured by average level of pain at IV cannulation, were Groups 1 and 2.

Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates.

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation.

Electronic influenza monitoring: evaluation of body temperature to classify influenza-like illness in a syndromic surveillance system.

The Centers for Disease Control and Prevention (CDC) defines influenza-like illness (ILI) for its sentinel providers as fever (temperature > or =100.5 degrees F or 37.8 degrees C) and a cough and/or a sore throat in the absence of a known cause other than influenza.

Evaluation of a pilot hospital-based community program implementing fitness and nutrition education for overweight children.

Purpose: Evaluate the effect of the Kids Living Fit hospital-based intervention on body mass index (BMI) percentile, adjusted for age (months) and gender in children ages 8-12 years with BMI percentiles > or = 85.

Design And Methods: Twelve weekly exercise sessions and three nutrition presentations were held. Nurses recorded BMI and waist circumference at baseline, week 12, and week 24.

Comparison of occlusion rates by flushing solutions for peripherally inserted central catheters with positive pressure Luer-activated devices.

In this prospective, randomized study of 102 subjects with single-lumen peripherally inserted central catheters with positive pressure Luer-activated devices, 2 flushing solution groups were compared for their effect on occlusion rates. Of the 50 subjects randomly assigned to the normal saline group, 3 (6%) experienced occlusions, all of whom were elderly women. There were no occlusions in the 52 subjects randomly assigned to the heparinized saline group.

Evaluating the effectiveness of the Kids Living Fit program: a comparative study.

After-school programs can be implemented by school nurses to facilitate healthy lifestyle choices in children with the goal of decreasing obesity. Kids Living Fit (KLF), an after-school program designed by community hospital nurses, was implemented in elementary schools and focused on best lifestyle choices regarding foods consumed and activities chosen for children in grades 2 through 5. Study measures included comparison of body mass index (BMI) percentiles for age and gender and waist circumference between two self-selected groups composing a total sample size of 185 participants: the KLF intervention group (n = 80) and the no-intervention/ contrast group (n = 105).

Evaluating use of flash sterilization in the OR with regard to postoperative infections.

This article describes a quality improvement project that examined postoperative infection rates for 100 surgical procedures in which a total of 121 flash sterilizations were performed and determined the costs of treating the postoperative infections compared to the cost of purchasing additional instruments. The post operative infection rate on physical examination was 3%, and the overall cost of diagnosing and treating the postoperative infections was found to be lower than the cost of purchasing additional instruments. To minimize use of flash sterilization, the hospital has added additional surgical instrument inventory and expanded flash sterilization education requirements for staff members.

Evaluation of demographic, behavioral, and procedural factors on pain perception by patients undergoing colonoscopy and moderate sedation.

This prospective study collected demographic, behavioral, and procedural factors data on the pain perception of 100 patients as they were undergoing colonoscopy and moderate sedation. Patients were asked to rate pain on a 4-point categorical scale (no, slight, moderate, or severe pain) before the colonoscopy, every 5 minutes during, and after the colonoscopy. Before discharge, patients recorded overall pain control satisfaction on a 100-mm visual analog scale (0=not satisfied and 100=satisfied).

Influenza vaccination: incidence of symptoms and resulting absenteeism in hospital employees.

A convenience sample of hospital workers, those receiving influenza vaccine and those not receiving vaccine, were asked to complete questionnaires delineating the occurrence of symptoms (e.g., fever, headache, extreme tiredness, dry cough, sore throat, runny nose, stuffy nose, muscle aches) and absenteeism in the 7-day period post-vaccination if vaccinated.

Construct validity and reliability of scores on scales to measure the impairment of health-related quality of life in persons with asthma.

The purpose of this study was to test the reliability, validity, and effectiveness of a health-related quality of life (HRQOL) instrument--the MiniAQLQ--among persons with asthma who were using a web-based intervention for guided self-management (www.MyAsthma.com).

Race, ethnicity, and insurance as determinants of epidural use: analysis of a national sample survey.

Despite widespread availability of pain interventions in childbirth, for most women, childbirth is associated with labor pain that exceeds expectations. Although epidural is superior to other medical interventions, the choice to use epidural still remains a matter of patient and doctor preference. Whether racial or ethnic characteristics influence preference of physician use or interact with insurance coverage is still unknown.