Are Nurse Leaders Prepared to Lead Across the Continuum of Care in the New Paradigm?

The movement toward linking reimbursement with outcomes necessitates providing care across a continuum of settings, leading to the need for a new healthcare paradigm. Issues related to shifting to this new paradigm include disagreement about what this paradigm encompasses, the fragmentation of the healthcare system, and overreliance on the medical model as a framework for driving health policy decisions. We advocate for nurse leaders to guide the development of this new paradigm.

Development of a Self-Management Theory-Guided Discharge Intervention for Parents of Hospitalized Children.

Background: Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self-management of their child's care at home after discharge.

Problem: No theory-based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge.

Purpose: To develop a theory-based conversation guide to optimize nurses' preparation of parents for discharge and self-management of their child at home following hospitalization.

Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children.

Purpose: This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods: In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits).

Reinventing the home visit for undergraduate nursing students.

The Family Outreach Project was designed to teach senior-level undergraduate nursing students how to assess, care for, and develop care plans for children with chronic health conditions and their families. Nursing students (n=24) could attend one focus group conducted at the end of the semester as part of the evaluation of the America's Promise School Project. Responses were audiotaped and transcribed verbatim.

Under pressure: preventing pressure ulcers in critically ill infants.

Purpose: To determine whether a pressure ulcer prevention bundle was associated with a significant reduction in pressure ulcer development in infants in the pediatric intensive care unit.

Design And Methods: Quasi-experimental design involving 399 infants 0 to 3 months of age at a large tertiary care medical center.

Results: The implementation of the care bundle was associated with a significant drop in pressure ulcer incidence from 18.

Barriers to pediatric pain management: a nursing perspective.

This study describes strategies used by the Joint Clinical Practice Council of Children's Hospital of Wisconsin to identify barriers perceived as interfering with nurses' (RNs) ability to provide optimal pain management. A survey was used to ascertain how nurses described optimal pain management and how much nurses perceived potential barriers as interfering with their ability to provide that level of care. The survey, "Barriers to Optimal Pain management" (adapted from Van Hulle Vincent & Denyes, 2004), was distributed to all RNs working in all patient care settings.

Evidence-based practice: perceptions, skills, and activities of pediatric health care professionals.

The purposes of this descriptive study were to evaluate pediatric professional staffs' perceptions of evidence-based practice (EBP), to identify individual and organizational barriers experienced when applying EBP into practice, and to determine differences in perceptions by those attending and not attending an EBP education series. A total of 486 pediatric health care professionals, 56 of whom attended all of the sessions, completed an anonymous online survey. Professional staff participated in and valued EBP activities but identified barriers to full implementation.

Nurse researchers in children's hospitals.

Little is known about the role of nurse researchers (NRs) and the structure of nursing research programs in children's hospitals in the United States. This descriptive study obtained survey data from 33 NRs. Data suggest that the NR role is emerging and has both commonalities and unique components when compared with the previous studies of NRs in adult hospitals.

Readiness for discharge in parents of hospitalized children.

Parental preparation for a child's discharge from the hospital sets the stage for successful transitioning to care and recovery at home. In this study of 135 parents of hospitalized children, the quality of discharge teaching, particularly the nurses' skills in "delivery" of parent teaching, was associated with increased parental readiness for discharge, which was associated with less coping difficulty during the first 3 weeks postdischarge. Parental coping difficulty was predictive of greater utilization of posthospitalization health services.

Engaging students through collaboration: how Project FUN works.

Students from three disciplines designed, developed, and implemented exercise and nutrition interventions, online modules and videos, to benefit low-income middle school students. The process used to incorporate the scholarship of teaching ito a collaborative college-level application of learning is described.

Determinants of physical activity and low-fat diet among low income African American and Hispanic middle school students.

African Americans, Hispanics, and those with low income experience disproportionate health problems that can be prevented by physical activity and a lower fat diet. In this descriptive cross-sectional study, antecedents of diet and exercise within the Health Promotion/Transtheoretical Model were examined among low-income African American and Hispanic seventh-grade students (n = 127). Total support was associated with higher physical activity for girls.

Changing the tide: an Internet/video exercise and low-fat diet intervention with middle-school students.

The rising tide of obesity erodes the health of youths and many times results in adult obesity. The purpose of this investigation was to examine the effectiveness of an eight-session health promotion/transtheoretical model Internet/video-delivered intervention to increase physical activity and reduce dietary fat among low-income, culturally diverse, seventh-grade students. Those who completed more than half the sessions increased exercise, t (103) = -1.

Diet and exercise in low-income culturally diverse middle school students.

It is important to understand constructs essential to low-fat-diet and physical-activity behaviors of low-income culturally diverse middle-school-age students, because ethnicity and socioeconomic status influence body weight status, and these groups are most at risk for obesity later in life. In this descriptive study, constructs important in low-fat diet and physical activity in low- to middle-income, culturally diverse middle school students were examined. Revised for cultural/developmental appropriateness and reading level, instruments incorporating constructs from the Health Promotion and Transtheoretical Models were tested with 221 youth.

Stage-based interventions for low-fat diet with middle school students.

Preventing obesity and cardiovascular disease at early ages is important; however, few effective interventions for early adolescents have been reported. In this study, low-income, culturally diverse students from an urban middle school (n = 60) received four classroom interventions with the use of a combined Health Promotion/Transtheoretical Model to control fat in diet and increase physical activity. A control group (n = 57) received the usual classroom education.

Addressing health disparities in middle school students' nutrition and exercise.

Those with low income, especially women of African American and Hispanic heritage have the greatest risk of inactivity and obesity. A 4-session (Internet and video) intervention with healthy snack and gym labs was tested in 2 (gym lab in 1) urban low-middle-income middle schools to improve low fat diet and moderate and vigorous physical activity.1 The gym lab was particularly beneficial (p =.