Predictive Modeling for One-Year Lower Extremity Endovascular Revascularization Failure in Black Persons.

Introduction: Black persons bear a disproportionate burden of peripheral artery disease (PAD) and experience higher rates of endovascular revascularization failure (ERF) when compared with non-Hispanic White persons. We aimed to identify predictors of ERF in Black persons using predictive modeling.

Methods: This retrospective study included all persons identifying as Black who underwent an initial endovascular revascularization procedure for PAD between 2011 and 2018 at a midwestern tertiary care center.

Social Determinants of Health Factors and Loss-To-Follow-Up in the Field of Vascular Surgery.

Background: It is estimated that 22-57% of vascular patients are lost to follow-up (LTF) which is of concern as the Society of Vascular Surgery recommends annual patient follow-up. The purpose of this report was to identify social determinants of health factors (SDoH) and their relationship to LTF in vascular patients.

Methods: The methods employed were a systematic literature review of 29 empirical articles and a retrospective quality improvement report with 27 endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) patients at the University of Chicago.

Hypotensive Events in Pediatric Patients Receiving Dexmedetomidine for MRI.

Purpose: Dexmedetomidine, the preferred pediatric sedating agent for magnetic resonance imaging (MRI), has the side effect of hypotension. Newer recommendations for reporting adverse events in pediatric procedural sedation include using a two-pronged definition. Our aim was to describe the incidence of hypotension in patients undergoing sedated MRI and to identify demographic and clinical factors associated with hypotension, applying a two-pronged definition, where a numerical threshold/clinical criterion must be met as well as at least one clinical intervention performed.

Inpatient pediatric nursing staff experiences treating psychiatric patients: A mixed methods study.

Problem: A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff.

Methods: A mixed-method research study was conducted among full- and part-time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale.

Using a Cascading Approach to Improve Multisite Study Procedures.

Background: Multisite studies offer larger, more diverse samples to successfully capture populations and clinical practices of interest at the point of care. However, investigators face challenges with site recruitment and sampling, differences in clinical practices across sites, and data integrity. Addressing these issues a priori can improve the rigor and reproducibility of the research.

Transitioning to Independent Nursing Practice during COVID-19: A Mixed Methods Study.

The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs.

Quantifying Compassion Fatigue in Ancillary and Clinical Staff in an Adult Emergency Department.

Introduction: Emergency department (ED) staff are at a high risk for compassion fatigue (CF) due to a work environment that combines high patient acuity, violence, and other workplace stressors. This multifaceted syndrome has wide-ranging impacts which, if left untreated, can lead to adverse mental health conditions including depression, anxiety, and substance use disorders. However, the majority of studies examining CF look solely at clinicians; as a result, there is little information on the impact of CF across other roles involved in supporting patient care.

Nurse-Driven Assessment, Prevention, and Management of Delirium on an Acute Inpatient Neurology Unit.

Background: Delirium commonly affects hospitalized patients and is associated with increased hospital length of stay, discharge to skilled care, cost, morbidity, and mortality.

Local Problem: At our organization, there was no formal delirium assessment performed by the nursing staff outside of the intensive care unit.

Methods: Assessment of nurses' knowledge about delirium, a nurse-driven delirium screening protocol, and patient education were implemented on an adult inpatient neurology unit.

Palliative Care Utilization Following Out-of-Hospital Cardiac Arrest in Pediatrics.

Objectives: Pediatric out-of-hospital cardiac arrest (OHCA) is associated with significant morbidity and mortality. Pediatric palliative care (PPC) services could provide an integral component of the comprehensive care necessary for these patients and their families. The main objectives of this study are to examine the utilization of PPC following OHCA and compare the differences in characteristics between children who received PPC with those who did not.

Racial and Ethnic Differences in Inpatient Palliative Care for Pediatric Stem Cell Transplant Patients.

Objectives: Racial/ethnic disparities in utilizing inpatient palliative care services are well documented in the adult literature. However, the impact of racial/ethnic disparities in the context of pediatric palliative care is less well understood even in high-acuity patient populations such as stem cell transplant patients. We investigated racial/ethnic differences in the utilization of inpatient palliative care consultations (IPCCs) for pediatric stem cell transplant patients.

Predicting Who Receives Nonpharmacologic Pain Interventions in the Pediatric Intensive Care Unit.

Aims: The majority of patients in the pediatric intensive care unit (PICU) experience pain daily, while nonpharmacologic interventions are indicated for pain management in children, there is limited information on which nonpharmacologic interventions are provided in the PICU and which patients receive those interventions. The aim of this descriptive correlational secondary data analysis was to determine what nonpharmacologic interventions were recorded in the electronic health record of PICU patients and patterns in use by patient demographics.

Setting/subjects: All patients hospitalized in 15 participating PICUs are located within 12 unique children's hospitals across the United States were eligible for participation.

Novel Trauma Composite Score is superior to Injury Severity Score in predicting mortality across all ages.

Background: Injury Severity Score (ISS) is a widely used metric for trauma research and center verification; however, it does not account for age-related physiologic parameters. We hypothesized that a novel age-based injury severity metric would better predict mortality.

Methods: Adult patients (≥18 years) sustaining blunt trauma (BT) or penetrating trauma (PT) were abstracted from the 2010 to 2016 National Trauma Data Bank.

Testing a Resilience Training Program in Police Recruits: A Pilot Study.

Background: Stress from multiple sources is inherent in law enforcement. However, it is possible to modify responses to stress with resilience training that includes teaching techniques to modify emotional and physical responses to stress, interface with mental health professionals, and practice sessions to improve self-regulation of responses to stress including coherence, a measure of heart rate variability. A gap exists in the research, however, regarding evaluation of the duration of effects after the initial resilience training.

Quality of Transition From Hospital to Home: The Influence of Nurse- and Patient-Reported Readiness.

Identifying those at risk of poor outcomes after hospital discharge is a central focus of health care systems. Our purpose was to better understand whether and how patient- and nurse-assessed readiness for discharge (Pt- and RN-RHDS) is related to patient experiences after discharge. We conducted a prospective survey of 70 Veterans and their assigned nurses on the day of, and again with Veterans 2 weeks after, hospital discharge.

Pain sensitivity profiles in patients with advanced knee osteoarthritis.

The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population.

Readiness for Hospital Discharge, Health Literacy, and Social Living Status.

Patient characteristics and lack of preparedness are associated with poor outcomes after hospital discharge. Our purpose was to explore the association between patient characteristics and patient- and nurse-completed Readiness for Hospital Discharge Scale (RHDS). We conducted a prospective study of 70 Veterans being discharged from medical and surgical units.