Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems.

Objective: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

Methods: QII activities occurred at sites over several years, all concluding by December 2020.

Implementation and outcome evaluations of a multi-site improvement program in cancer genetics.

Program evaluation can identify the successes and challenges of implementing clinical programs, which can inform future dissemination efforts. A cancer genetics improvement program, disseminated from the Lead Team's institution to five health systems (Participating Sites), was genetic counselor led, using virtual implementation facilitation to support Participating Sites' performance of quality improvement (QI) activities over several years. Program implementation and outcome evaluations were performed and included evaluation of program delivery and initial effects of the program on Participating Sites.

Immune reconstitution inflammatory syndrome in HIV-infected patients: what a critical-care nurse needs to know.

Immune reconstitution inflammatory syndrome is a constellation of clinical manifestations seen in patients with HIV/AIDS who are taking highly active antiretroviral therapy. The revitalization of their immune systems by these medications leads to the emergence of opportunistic infections that had been treated previously and those never treated. Some of these diseases have serious ramifications if undetected.

Care of the AIDS patient with Pneumocystis pneumonia.

Pneumocystis pneumonia and AIDS have been linked together for many years. In the 1980s and 1990s, these diseases often resulted in admission to the critical care unit for many patients. Since the discovery of antiretroviral therapy and Pneumocystis prophylaxis, this has been a less frequent occurrence.

The challenges of managing and treating Guillain-Barré syndrome during the acute phase.

Guillain-Barré syndrome (GBS) is a randomly acquired inflammatory disease that affects approximately 2 persons in 100,000 annually. There have been no discriminating risk factors identified including age, sex, or race. The syndrome results in the demyelination of peripheral nerves, which leads to progressive motor weakness and paralysis.

Stigma: a health barrier for women with HIV/AIDS.

The stigma experienced by women with HIV/AIDS is much like that of Hester Prynne in The Scarlet Letter. At the time of diagnosis with HIV/AIDS, women already are aware of the stigma associated with the disease. They immediately see themselves differently and believe others do also.

Lifelines: a life history methodology.

Background: Life histories are data collection strategies that detail an individual's life Lifelines are a visual depiction of a life history, displaying events in chronological order and noting the importance, or meaning, of events.

Approach: A sample lifeline from a study of young women's developmental transitions used to demonstrate the application of this technique to nursing research. A review life histories as well as lifeline techniques, analysis, and applications is included.