Use of a Digital Air Leak Detection Device to Decrease Chest Tube Duration.

Background: The aim of this evidence-based practice project was to determine if a digital air leak detection device could speed the identification of chest tube air leak cessation in patients after pulmonary lobectomy. Staff members assessing air leaks have varying levels of expertise, and the digital device is a limited resource in the study institution. A chest tube management algorithm is necessary to standardize care and determine which patients are most likely to benefit.

Remote patient triage: Shifting toward safer telehealth practice.

Telehealth is a tool used to diagnose and treat patients at a distance. Telehealth quickly became essential during the COVID-19 pandemic as a result of stay-at-home orders. Regulatory waivers encouraged the use of telehealth as an alternative to the in-person encounter to limit the spread of disease.

The value of faculty during student on-site evaluations.

The American Academy of Nurse Practitioners Certification Board recognizes the value of nurse practitioner faculty in evaluating students at the clinical site. The Board of Commissioners recently approved the awarding of clinical hours to nurse practitioner faculty for clinical site visits. This article outlines the rationale and procedure for conducting and documenting student visits that can be applied to recertification.

Fostering promotion and protection of the professional nurse practitioner role: A call to action.

The professional obligations to protect and promote nursing professional roles stem from the American Nurses Association Code of Ethics. Nurturing new generations of NPs to assume leadership role is foundational to succession planning and is critical to assuring NPs' continued contributions to health care. Making professional role development a priority at various points in educational programs, modeling ways to contribute to the profession, and encouraging professional organization membership are a few of the suggestions presented for the academic environment.

Foot care behaviors among adults with type 2 diabetes.

Aim: The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes.

Methods: A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014.

Results: Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet.

Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes.

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010.

Pharyngitis: soothing the sore throat.

Sore throat is a common presentation in primary care. Accurate identification of cause is important for appropriate treatment. Clinical scoring systems and diagnostic tests are recommended to identify group A beta-hemolytic streptococcus, which warrants guideline-driven therapy.

Tinnitus evaluation in primary care.

Tinnitus is a common, yet poorly understood problem. This symptom has many causes, both benign as well as serious. Patients can experience significant changes in quality-of-life related to symptom severity and duration.

Acute chest syndrome of sickle cell disease.

As patients with sickle cell anemia (SCA) are living longer, health care practitioners increasingly manage the chronic effects of the disease. Although significant strides in management of children with SCA over the past decade resulted in decreased mortality, less research exists to guide the care of the adult with complications from the disease. This case study reviews the care of a young woman with SCA admitted to the hospital for vaso-occlusive crisis with subsequent acute chest syndrome and acute respiratory distress syndrome.

Pneumonia and encephalopathy in a patient with progressing Parkinson's disease and dementia.

The aging of the US population poses complex management issues for the health care provider in the acute and subacute setting. Although management guidelines exist to guide the treatment of individual disease processes, addressing goals of care in an aging patient with multiple comorbidities requires conversations unique to each patient and family. This case study examines the care of a patient with Parkinson's disease, dementia, and pneumonia admitted to the intensive care unit for altered mental status and metabolic encephalopathy.

Stent thrombosis in a clopidogrel nonresponder.

Stent thrombosis is a known complication of percutaneous coronary intervention (PCI) following coronary stent deployment. Dual antiplatelet therapy is standard of care following PCI, however, recent studies demonstrate marked variability in platelet response to clopidogrel. This case study explores the management of a clopidogrel nonresponder who presented with recurrent stent thrombosis despite traditional pharmacologic management.

Management of a patient with severe sepsis.

Severe sepsis and septic shock affect more than 700,000 people annually and represent approximately $17 billion annually in health care costs. Mortality in patients with 3 or more failed organs is up to 70%. Early identification and prevention of severe sepsis and septic shock are key factors in impacting mortality rates.

Ischemic middle cerebral artery stroke: a case study.

Stroke is the third leading cause of death, ranking lower only to cardiac disease and cancer. Patients with stroke involving large vessels, including the middle cerebral artery, account for almost half of all patients with ischemic strokes and have an increased risk for poor outcomes and mortality at 6 months. Despite the availability and use of published guidelines for the early management of ischemic stroke, evidence to support treatment modalities for cerebral edema is still lacking.

Acute respiratory distress syndrome--a case study.

This case study explores the management of an unusually complicated case of acute respiratory distress syndrome (ARDS) extending over 52 days of hospitalization. Despite the utilization of conventional medical treatments and optimum respiratory support modalities, the patient's condition worsened and death was imminent without salvage therapy. After cardiovascular surgery consultation and spousal affirmation, extracorporeal membrane oxygenation (ECMO) therapy was initiated for 6 days.

Ischemic colitis--a case study.

Mesenteric ischemia is a well-documented complication associated with the repair of abdominal aortic aneurysm, especially when it is accomplished on an emergent basis. This case study outlines the roles of the nurse practitioner, working collaboratively with the intensivist, in the management of a complicated case. Medical and surgical care, along with rationale, will be presented and discussed as they relate to the patient subject in this case study.

Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia.

Purpose: To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia.

Method: Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions.