Evaluation of Nurse-Driven Management of Hypoglycemia In Critically Ill Patients.

Background: Intensive care unit (ICU) patients experience hypoglycemia at nearly 4 times the rate seen in non-ICU counterparts. Although inpatient hypoglycemia management relies on nurse-driven protocols, protocol adherence varies between institutions and units.

Objective: To compare hypoglycemia management between ICU and non-ICU patients in an institution with high adherence to a hypoglycemia protocol.

Capturing Original Preanesthetic Comprehensive History and Physical Assessments with the use of Video Telehealth: A Quality Improvement Project for Student Nurse Anesthetists.

Purpose: Beginning January 1, 2022, the Council on Accreditation is requiring student registered nurse anesthetists (SRNAs) matriculating into nurse anesthesia programs to track preanesthetic comprehensive history and physical (H&P) assessment completion numbers. This quality improvement (QI) project aimed to create a new clinical rotation for SRNAs to practice their preanesthetic H&P assessment skills through video telehealth.

Design: A quality improvement project.

Symptoms in Patients Receiving Noninvasive Ventilation in the Intensive Care Unit.

Background: Although a multitude of studies have demonstrated the effectiveness of noninvasive ventilation (NIV) for treatment of respiratory insufficiency, there have been few investigations of patients' experiences while receiving this common treatment. Identification of the presence, intensity, and distress of symptoms during NIV will inform the development and testing of interventions to best manage them and improve patients' intensive care unit (ICU) experiences.

Objective: The objectives of this study were (a) to identify the presence, intensity, and distress of symptoms in patients receiving NIV in the ICU using a modified version of the Edmonton Symptom Assessment Scale (MESAS) and (b) to describe the most common and distressing symptoms experienced by patients.

Emotional, mental health and physical symptom experience of patients hospitalized with COVID-19 up to 3 months post-hospitalization: A longitudinal study.

Aims And Objectives: To explore emotional, mental health and physical symptoms up to 3 months after discharge for adults hospitalized with COVID-19.

Background: 10%-30% of adults with COVID-19 experience physical and psychological symptoms 3 months or more following infection. Knowing symptoms can help direct early intervention.

The impact of the COVID-19 pandemic on ICU clinical trials: a description of one research team's experience.

Background: Disruptions to clinical trials conducted in the intensive care unit (ICU) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2; coronavirus disease 2019 [COVID-19]) pandemic included fewer new trials activated and more trials stopped. While a number of ongoing, non-COVID-19 clinical trials remained open to enrollment, the direct impact of the pandemic on ICUs instilled chaos in this already challenging environment. The numerous challenges need to be reported so investigators can proactively plan and manage these myriad challenges.

Nurses' use of the clinically aligned pain assessment tool: A mixed methods study.

Background: Assessment of pain in the hospital has often relied on intensity rating alone. To address the gap in meeting patients' pain management expectations, a Midwestern medical center implemented the CAPA (Clinical Aligned Pain Assessment) tool for more comprehensive nursing pain assessments.

Aims: This research described nurses' experience using CAPA on an adult general medicine unit and their documentation of the tool in the electronic health record (EHR) more than 5 years after CAPA implementation.

Study protocol to test the efficacy of self-administration of dexmedetomidine sedative therapy on anxiety, delirium, and ventilator days in critically ill mechanically ventilated patients: an open-label randomized clinical trial.

Background: Administration of sedative and opioid medications to patients receiving mechanical ventilatory support in the intensive care unit is a common clinical practice.

Methods: A two-site randomized open-label clinical trial will test the efficacy of self-management of sedative therapy with dexmedetomidine compared to usual care on anxiety, delirium, and duration of ventilatory support after randomization. Secondary objectives are to compare self-management of sedative therapy to usual care on level of alertness, total aggregate sedative and opioid medication exposure, and ventilator-free days up to day 28 after study enrolment.

Survey of Nurses' Use of the Clinically Aligned Pain Assessment (CAPA) Tool.

Background: Limited research is available on tools for assessing pain and its effect on function in the acute care setting.

Aim: This research's purpose is to describe nurses' use of the Clinically Aligned Pain Assessment (CAPA) tool and their beliefs about its utility for assessing pain compared to the numeric rating scale (NRS) in a hospital where CAPA had been used for 6 years.

Design: A cross-sectional self-report survey.

A scoping review of outcomes of operational success for nurse scientists in clinical practice settings.

Background: The nurse scientist in the clinical setting is a role that has evolved over recent decades to encompass the concomitant development of personal research programs and the facilitation of staff and advanced practice nurse research in health care settings. However, the definition, operationalization, and measures of success are extremely variable.

Purpose: To identify the defining features and characteristics of the nurse scientist role in clinical practice settings as represented in the existing literature.

Recovery Model Implementation for a Medical/Geriatric Psychiatric Unit to Decrease Restraint and Seclusion Episodes: A Quality Improvement Project.

Introduction: In inpatient behavioral health units, a long-standing behavioral management controversy has been whether to physically restrain or seclude patients. The rate of restraint use at the institution underperformed compared with the national average, which led to the project implementation.

Aims: This quality improvement project's objective was to decrease restraint and seclusion use, improve quality of care, and decrease cost through implementation of recovery model principles.

Who Advances Nursing Science in Practice Settings and How?

Nurse scientist (NS) roles in clinical practice settings are key components of The Future of Nursing and ANCC Magnet® recognition. Despite increased opportunities for NS roles, leveraging these roles to advance nursing science remains at an early stage. We describe opportunities and challenges for NSs in clinical practice settings, highlighting the value of a strong partnership with chief nurse officers as critical for the success of NSs and outcomes associated with these roles.

Pediatric Critical Care Nurses' Practices Related to Sedation and Analgesia.

Background: Pediatric intensive care unit (PICU) nurses may consider additional factors beyond validated tools when managing pain and sedation of children. However, these other factors and related beliefs, practices, and decision-making for analgesia and sedation have not been well described.

Objectives: This study describes nurses' beliefs, practices, and decision-making related to sedation and analgesia for mechanically ventilated children on a PICU and a pediatric cardiovascular ICU at a tertiary academic children's medical center in the United States.

Assessing Student Performance in a Dedicated Education Unit: Validity of the Creighton Competency Evaluation Instrument.

In dedicated education units (DEUs), nurses serving as clinical teaching partners (CTPs) provide formative feedback about student performance. The Creighton Competency Evaluation Instrument (C-CEI) has demonstrated validity and reliability by faculty in both the simulated and clinical environments. The purpose of this pilot study was to determine the content validity of the C-CEI in the direct patient care environment when used by staff nurses functioning as CTPs in the DEU setting.

Hypoglycemia: Comparison of Health Status Outcomes Between Patients After Allogeneic Hematopoietic Cell Transplantation.

Background: Patients who have undergone hematopoietic cell transplantation (HCT) often face lengthy hospital stays. Hospitalized patients' compromised health status puts them at risk for complications to recovery when glucose is not controlled.

Objectives: This study aimed to investigate differences in outcomes in patients who experienced hypoglycemia compared to patients who did not experience hypoglycemia post-allogeneic HCT.

Adherence to a Hypoglycemia Protocol in Hospitalized Patients: A Retrospective Analysis.

Background: Hypoglycemia can be a common occurrence in hospitalized patients, both those with and without diabetes. Hypoglycemia poses significant risks to hospitalized patients, including increased mortality.

Objectives: This was a retrospective pre-post study of hypoglycemic patients in an academic medical center of an intervention to improve timely staff nurse adherence to a hypoglycemia protocol.

Improving the care and health of populations through optimal use of clinical nurse specialists.

Patients with complex and chronic illnesses and those who have significant needs related to care coordination and transitions of care are dependent on access to healthcare providers who are skilled at meeting the distinct needs of these populations and are current in the latest evidence-based practices and guidelines. Clinical nurse specialists (CNSs) are uniquely qualified to care for patients with complex illnesses as well as having the skills to optimize care for entire populations with complex needs. The absence of consistent legislative advanced practice registered nurse recognition of CNSs prevents health care systems from optimal use of this advanced practice registered nurse role to improve and provide safe and quality care for these patients.

Challenges and Lessons Learned Tailoring a Behavioral Intervention for Stroke Survivor-Care Partner Dyads.

Introduction: Research is increasingly exploring interventions for patient-care-partner dyads, but little has been reported regarding challenges of implementing dyad-focused interventions. This article reports the lessons learned in a pilot feasibility study of problem-solving therapy versus stroke education in stroke survivor-care partner dyads.

Challenges And Lessons Learned: Challenges arose in numerous aspects of intervention delivery.