Implementing a Hospital-Acquired Pressure Injury Prevention Bundle in Critical Care.

The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the third in a series on applying IS, describes how a nurse-led team at a multisite health system used IS concepts, methods, and tools to implement a hospital-acquired pressure injury (HAPI) prevention bundle on six critical care units, with the aim of decreasing HAPI incidence.

Guidance for Healthcare Providers on Newest Guidelines for Over-the-Counter Drug Treatment of Mild Symptoms of COVID-19.

On January 18, 2024, the US Centers for Disease Control and Prevention issued their most recent guidelines for over-the-counter drugs for coronavirus disease 2019 (COVID-19). Specifically, the organization stated that "Most people with COVID-19 have mild illness and can recover at home. You can treat symptoms with over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), to help you feel better.

Further refinement of the differentially methylated distant lung-specific FOXF1 enhancer in a neonate with alveolar capillary dysplasia.

Heterozygous SNVs or CNV deletions involving the FOXF1 gene, or its distant enhancer, are causative for 80-90% of cases of alveolar capillary dysplasia with misalignment of pulmonary veins. Recently, we proposed bimodal structure and parental functional dimorphism of the lung-specific FOXF1 enhancer, with Unit 1 having higher activity on the paternal chr16 and Unit 2 on the maternal chr16. Here, we describe a novel unusually sized pathogenic de novo copy-number variant deletion involving a portion of the FOXF1 enhancer on maternal chr16 that implies narrowing Unit 2 to an essential ~ 9-kb segment.

Severity of post-Roux-en-Y gastric bypass dumping syndrome and weight loss outcomes: is there any correlation?

Purpose: The present research was conducted to evaluate the effect of the severity of dumping syndrome (DS) on weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in patients with class III obesity.

Methods: The present retrospective cohort study used the dumping symptom rating scale (DSRS) to evaluate the severity of DS and its correlation with weight loss outcomes in 207 patients 1 year after their RYGB. The patients were assigned to group A with mild-to-moderate DS or group B with severe DS.

Association of Hypercholesterolemia With Gastric Intestinal Metaplasia, Findings After Sleeve Gastrectomy Pathology Review.

Background: We evaluated the relationship between comorbidities associated with obesity, body mass index (BMI), and development of intestinal metaplasia (IM) after vertical sleeve gastrectomy (VSG).

Materials And Methods: All VSG specimens performed at an academic center between 2011 and 2018 were reviewed. All specimens underwent histopathologic assessment, while those with findings suspicious for IM underwent additional immunohistochemical work up.

Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus.

Background: Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS.

Spatial Learning Is Impaired in Male Pubertal Rats Following Neonatal Daily but Not Randomly Spaced Maternal Deprivation.

Severe early life stress has long been associated with neuropsychological disorders in adulthood, including depression, schizophrenia, post-traumatic stress disorder, and memory dysfunction. To some extent, all of these conditions involve dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and reduced negative feedback inhibition of cortisol release in adulthood. However, the time course for mental health and hormonal outcomes across life stages and the attributes of early life stress that direct the behavioral and biological alterations is not fully understood.

Reducing the Incidence of Medical Device-Related Pressure Injuries From Use of CPAP/BiPAP Masks: A Quality Improvement Project.

Purpose: The purpose of this work was to reduce the number of hospital-acquired pressure injuries on the nasal bridge resulting from the use of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) therapy.

Participants And Setting: Patients with medical device-related pressure injuries (MDRPI) receiving continuous/intermittent CPAP/BiPAP in a 12-bed critical care unit in a Magnet-designated, 182-bed community hospital in the mid-Atlantic region of the United States.

Approach: An interprofessional team collaborated to assess factors contributing to an increase in MDRPI development in critical care unit patients using CPAP/BiPAP.

Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis.

Morbid obesity is a global chronic disease, and bariatric procedures have been approved as the best method to control obesity. Roux-en-Y gastric bypass is one of the most common bariatric surgeries in the world and has become the gold standard procedure for many years. However, some patients experience weight regain or weight loss failure after the initial bypass surgery and require revisional or conversional interventions.

The Effect of Healing Touch on Critical Care Patients' Vital Signs: A Pilot Study.

To determine the impact of Healing Touch on vital signs, adult intensive care unit patients were recruited from multiple hospital sites. Both pain and agitation improved and there was a significant change in hemodynamics that reflected a calming effect. Healing Touch may be considered a respected addition to symptom management.

Pancreas Solid Tumors.

Solid tumors of the pancreas encompass a variety of diagnoses with treatments ranging from observation to major abdominal surgery. Pancreatic ductal adenocarcinoma remains one of the most common and most lethal of these differential of diagnoses and requires a multimodality approach through a multidisciplinary team of specialists. This article reviews the classification, clinical presentation, and workup in differentiating solid tumors of the pancreas and serves as an additional tool for general surgeons faced with such a clinical finding, from a surgical oncology perspective.

Bedside Technologies to Enhance the Early Detection of Pressure Injuries: A Systematic Review.

Background: Hospital-acquired pressure injuries strain organizational resources and negatively impact the quality of life of affected patients. However, early detection of pressure injuries is limited due to challenges with visual assessment, particularly in individuals with dark skin.

Purpose: The purpose of this systematic review was to determine whether sufficient research evidence exists to support the use of bedside technologies for early detection of pressure injures, which is inclusive of pressure-related blanchable erythema (PrBE), pressure-related nonblanchable erythema (PrNBE), and deep tissue pressure injury (DTPI).

Effects of Aromatherapy on Pain and Anxiety Scores in Adult Patients Admitted to a Community Hospital on the Medical Unit or Telemetry Unit: A Pilot Study.

The purpose of the study was to determine the impact of aromatherapy intervention on pain and anxiety. The hypothesis was that the use of aromatherapy will improve pain and anxiety scores when assessed within 30 to 60 minutes of administration. The study design was a prospective comparison of aromatherapy using a pre-/postdesign study.

Duodenal Gangliocytic Paraganglioma Requiring a Pancreaticoduodenectomy: A Case Report and Review of the Literature.

Introduction: Duodenal gangliocytic paragangliomas (GPs) are a subclass of duodenal neuroendocrine neoplasms and are exceedingly rare. They have been associated with an indolent behavior; however, they can rarely metastasize. Radical resection like a pancreaticoduodenectomy is sometimes indicated.

Intrahepatic Reactive Lymphoid Hyperplasia: A Case Report and Review of the Literature.

Introduction: Reactive lymphoid hyperplasia (RLH) is a rare and benign lesion found in organs of the gastrointestinal tract, skin, lung, orbit, and more rarely in the liver. Due to its similar appearance on imaging, it is hard to differentiate from primary liver malignancies. The following is a case report of a patient presenting with a suspicious liver lesion found to be RLH associated with primary biliary cirrhosis (PBC), after surgical resection.

The effects of healing touch on pain, nausea, and anxiety following bariatric surgery: a pilot study.

Context: Given the growth in the number of bariatric surgeries, it is important for healthcare practitioners to maximize symptom management for these patients, including the option of complementary therapies such as Healing Touch.

Objective: A quasi-experimental study was conducted to determine the feasibility of a Healing Touch intervention for reducing pain, nausea, and anxiety in patients undergoing laparoscopic bariatric surgery.

Design: Following surgery, a nurse administered the Healing Touch intervention once daily.

What causes near-misses and how are they mitigated?

Objectives: The objectives of this study were to determine the reasons hospital RNs attribute to near-misses and the techniques they used to mitigate these near-misses to prevent serious reportable events.

Background: Our health system developed this definition for the study: A near-miss is a variation in a normal process that, if continued, could have a negative impact on patients.

Methods: Study participants were RNs who completed a survey about a self-reported near-miss or another RN's near-miss they'd witnessed.

BSN completion barriers, challenges, incentives, and strategies.

Objective: The objectives of this study were to explore RN perceptions regarding barriers/challenges and incentives/supports for BSN completion and identify recommendations to increase RN BSN completion.

Background: The Institute of Medicine's 2011 The Future of Nursing report recommended the proportion of RNs with a BSN increase to 80% by 2020.

Method: This qualitative study included 41 RNs who participated in 1 of 6 focus groups based on their BSN completion status.