Long-Term Outcomes of a Collaborative Regional Evidence-Based Practice Fellowship.

Academic-practice partnerships provide a model for sharing resources, increasing professional knowledge and skills, improving patient outcomes, and strengthening organizational cultures of quality and safety. This article describes the long-term outcomes of a regional collaborative evidence-based practice fellowship. Results reveal the fellowship had a measurable positive impact on fellows' evidence-based practice knowledge and practice, project outcomes, professional growth, and the culture of excellence within partner organizations.

Pharmacological Options for Treating Delirium in Critically Ill Adults.

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.

The use of dexmedetomidine as an adjuvant to benzodiazepine-based therapy to decrease the severity of delirium in alcohol withdrawal in adult intensive care unit patients: a systematic review.

Background: Chronic alcohol consumption is a prevalent issue. Healthcare professionals often discover their patient has an alcohol consumption issue when they are admitted to the hospital and no longer have access to alcohol. The global standard for treating alcohol withdrawal syndrome (AWS) symptoms are benzodiazepines; however this therapy is often inadequate to control symptoms of delirium in adult intensive care unit (ICU) patients due to an imbalance of inhibitory and excitatory neurotransmitters.

An overview of systematic review.

Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review.

Evidence in mental health.

Health practitioners wishing to positively improve health outcomes for their clients have access to a unique set of collated tools to guide their practice. Systematic reviews provide guidance in the form of synthesized evidence that can form the basis of decision making as they provide care for their clients. This article describes systematic reviews as a basis for informed decision making by mental health practitioners.

Evidence-based clinical audit criteria for the prevention and management of delirium in the postoperative patient with a hip fracture.

Delirium is a frequent, yet often unrecognized, occurrence in elderly hospitalized patients. In patients with hip fracture, the incidence of delirium is reported to be as high as 62% and even greater if over 65 years of age. One approach to the prevention and management of postoperative delirium in elderly patients with hip fracture is the clinical audit.

Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

Aim: To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level.

Background: Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment.

The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey.

Aim: To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment.

Background: Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care.

The impact of pre-injury anticoagulation therapy in the older adult patient experiencing a traumatic brain injury: A systematic review.

Review Question/objective: The objective of this systematic review is to synthesize the best available evidence on the impact of pre-injury anticoagulation therapy in the older adult patient who experiences a traumatic brain injury.

Background: Trauma in the elderly remains one of the most challenging problems for healthcare providers in the 21 century. The most recent United States (U.

A regional evidence-based practice fellowship: collaborating competitors.

The authors describe the development of an effort by 21 hospitals and 2 academic institutions in a metropolitan area to strengthen the diffusion of evidence-based practice in their organizations. This has been accomplished by providing collaborative training, mentoring, and support for direct-care RNs through an evidence-based fellowship. The participating direct-care nurses are prepared to take the new knowledge, skills, and abilities they have gained back to the bedside care environment.

Climate for innovation: problems in patient flow.

Problems in patient flow persist in practice and seem to defy traditional approaches to resolution. Using concepts from complex adapted systems and diffusion of innovation principles, problems in patient flow are analyzed and possible routes for innovation are identified. Emphasis is on creating a climate receptive to change as the norm, one that values relationships and communication.

Development of an evidence-based practice and research collaborative among urban hospitals.

This article describes the development of an evidence-based practice and research collaborative among urban hospitals. The collaborative began as a mechanism to support the incorporation of evidence-based practice and research in the acute care practice setting. This article discusses the development of the collaborative, as well as the challenges, success, and future goals from both the academic and practice perspectives.

Sonographic evaluation of venous obstruction in liver transplants.

Objective: The purpose of our study was to identify specific Doppler criteria for portal vein and outflow vein (hepatic veins and inferior vena cava) obstruction in liver transplants.

Materials And Methods: A retrospective review was performed of Doppler sonographic studies and angiograms in 94 liver transplant cases (72 whole liver, 22 lobar) with suspected vascular obstruction. The angiograms were classified as normal, occluded, or stenosed on the basis of appearance and elevated pressure gradient.

Mobilization of a nursing community after a disaster.

Topic: This article is a personal account of the author's experience of coordinating American Red Cross Disaster Health Services in her home community (Fort Worth, TX) following Hurricane Katrina. Although the community was 550 miles away from the impacted area, thousands of evacuees arrived in this community in need of immediate attention.

Purpose: The purpose of this article is to share significant lessons that were learned from the experience to help other communities prepare for future disasters.

Comparison of simultaneous and sequential two-view registration for 3D/2D registration of vascular images.

Accurate 3D/2D vessel registration is complicated by issues of image quality, occlusion, and other problems. This study performs a quantitative comparison of 3D/2D vessel registration in which vessels segmented from preoperative CT or MR are registered with biplane x-ray angiograms by either a) simultaneous two-view registration with advance calculation of the relative pose of the two views, or b) sequential registration with each view. We conclude on the basis of phantom studies that, even in the absence of image errors, simultaneous two-view registration is more accurate than sequential registration.

3D stereo interactive medical visualization.

Transjugular intrahepatic portosystemic shunt formation (TIPS) is an effective treatment for portal hypertension [LaBerge 1995]. The procedure requires the insertion of a needle through the liver to connect the hepatic and portal veins. This operation is traditionally guided by fluoroscopic images that do not show the location of the target veins during needle insertion.

Local therapeutic treatments for focal liver disease.

Patients diagnosed with primary hepatic malignancies or metastases to the liver remain a difficult population to treat. A small percentage of these people can undergo surgical resection or transplantation. The remaining nonsurgical aggregate does not often benefit from conventional radiation and chemotherapy; minimally invasive means either to cure or palliate these patients are a requirement for complete cancer care.

Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis.

Purpose: The purpose of this study was to evaluate the utility of transcatheter thrombolytic therapy in 20 patients with acute or subacute (symptoms <40 days) portal and/or mesenteric vein thrombosis with severe symptoms, deteriorating clinical condition, and/or persistent symptoms despite anticoagulation.

Materials And Methods: This retrospective study examined 12 male patients and eight female patients seen over a period of 11 years. The average age was 37.