Long-Term Care Nurse Residency Program: Evaluation of New Nurse Experiences and Lessons Learned.

Transitioning to long-term care environments presents a significant challenge for new nurses and their directors of nursing. The complexity of this environment, instability of the workforce, and the lack of support structures frequently affect a new nurse's decision not to apply to long-term care, but to look for positions in acute care hospitals. To address these issues, a long-term care new nurse residency program was developed, implemented, and evaluated in New Jersey through the work of the New Jersey Action Coalition.

Care Bundles: Increasing Consistency of Care.

Care bundling is a strategy for reliably delivering quality, evidence-based care for patients undergoing treatments known to be accompanied by potential risks. This article reviews the purpose, types, and components of care bundles, as well as the process for development and implementation.

Healthcare Transformation and Changing Roles for Nursing.

Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern.

Creating a Long-Term Care New Nurse Residency Model.

As the impact of health care reform continues to evolve, the movement of patients from acute to post-acute settings will continue to expand. Currently, the turnover and retention of RNs nationally in long-term care is at an all-time high, with a median turnover rate of 50% for RNs. Workforce instability is a prime contributor to poor patient outcomes, increased costs, and a dissatisfied nursing workforce.

Using systematic reviews to guide decision making about family-witnessed resuscitation.

Family-witnessed resuscitation (FWR) allows family members to be present while emergency cardiac life support measures are applied. This article describes the use of systematic reviews to inform best clinical policy on FWR. The authors searched Medline and CINAHL for relevant systematic reviews and retrieved four.

Finding and using best evidence for rehabilitation.

With the demands for improved experiences of care, improved outcomes, and greater efficiency/lower costs, the need for an evidence-based approach to care in rehabilitation settings has never been more urgent. This article guides practitioners in how to find the best available evidence for rehabilitation settings. It then discusses the use of evidence from systematic reviews through a high-impact case study: delirium in patients with postoperative hip fracture.

Finding the evidence to support evidence-based practice.

Practicing from an evidence-based paradigm requires the practitioner to integrate best available evidence with the patient's preference and values, the clinical context, and the practitioner's clinical expertise. However, the clinician is often at a loss for where to access best evidence. The 6S Model of evidence acquisition can guide the busy practitioner in efficient searching for best available evidence.

A Systematic Review of Family Witnessed Resuscitation and Family Witnessed Invasive Procedures in Adults in Hospital Settings Internationally - Part II: Perspectives of Healthcare Providers.

Background: Medicalization of care has removed family members from loved ones during critical events. Family Witnessed Resuscitation and Family Witnessed Invasive Procedures represent patient / family centered care options that can assist with having the family at the bedside during this perilous time.

Objectives: The objective was to examine the evidence on FWR and FWIP in adults from the perspective of healthcare providers.

A Systematic Review of Family Witnessed Resuscitation and Family Witnessed Invasive Procedures in Adults in Hospital Settings Internationally - Part I: Perspectives of Patients and Families.

Background: Medicalization of care has removed family members from loved ones during critical events. Family Witnessed Resuscitation and Family Witnessed Invasive Procedures represent patient / family centered care options that can assist with having the family at the bedside during this perilous time.

Objectives: The objective was to examine the evidence on FWR and FWIP in adults from the perspective of patients and relatives.

A systematic review of relocation stress following in-house transfer out of critical/intensive care units.

Objective The objective was to conduct a mixed methods systematic review to determine the occurrence and meaningfulness of relocation stress and the effectiveness of strategies for decreasing transfer anxiety in patients and their families upon transfer from an intensive care unit to a non-intensive care unit and to offer evidence-based recommendations for best practice.Inclusion criteria The review included quantitative and qualitative studies where the participants were adult intensive care patients, family members of adult intensive care patients, intensive care nurses caring for the adult critically ill patient, and ward/unit nurses receiving transfer patients from the ICU (intensive care unit). Studies examining the transfer experience for infants, children or psychiatric patients were excluded from this review.

When the family member is a nurse: the role and needs of nurse family members during critical illness of a loved one.

Objectives: The aim of this study was to explore the experience of being a nurse family member of a relative hospitalised for a critical illness. This paper will describe how nurse family members viewed the challenges of the illness experience and the strategies used to manage the challenges and cope with their loved one's critical illness.

Methods: A qualitative approach using open-ended, focused exploratory interviews was used.

A comprehensive systematic review of evidence on determining the impact of Magnet designation on nursing and patient outcomes: is the investment worth it?

Objective: The overall objective is to examine the current evidence of the impact of Magnet designation on patient and nurse outcomes.

Inclusion Criteria: This review considered any quantitative or qualitative study comparing organizational, nurse, patient or economic outcomes in Magnet designated hospitals with a comparison to a non-Magnet facility. Studies which used case-controlled, descriptive comparative, descriptive correlational and qualitative designs were considered due to the nature of the question.

Advancing evidence-based practice: a primer.

Evidence-based practice (EBP) requires a shift from the traditional paradigm of clinical practice grounded in intuition, clinical experience, and pathophysiological rationale. In the EBP paradigm, clinical expertise is combined with integration of best scientific evidence, patient values and preferences, and the clinical circumstances. This primer article provides a summary of driving forces mandating EBP, barriers to EBP, and an overview of the EBP process highlighting critical resources and practices.

Attitudes toward advance directives and advance directive completion rates.

Background: The Patient Self-Determination Act (PSDA) (part of the ) requires that all healthcare institutions receiving Medicare and Medicaid funds inform patients about their right to participate in healthcare decisions, including their right to have an advance directive. Advance directives (ADs) allow an individual to participate indirectly in future medical care decisions if he or she becomes decisionally incapacitated. Despite passage of this bill and mechanisms within most healthcare institutions to provide this information, the AD completion rate remains low.

Workplace violence. A focus on verbal abuse and intent to leave the organization.

Purpose: To describe the experience of verbal abuse in a large multihospital system and determine the relationship of verbal abuse with intent to leave the organization.

Design: Descriptive correlational design using mailed questionnaires.

Sample: Randomized sample of 1000 nurses received questionnaire; 46% response rate, with a final useable sample of 461 surveys.