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.

Implementing the Brøset Violence Checklist in the ED.

The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the second in a series on applying IS, describes how a nurse-led IS team at a multisite health system implemented the Brøset Violence Checklist-a validated, evidence-based tool to predict a patient's potential to become violent-in the system's adult EDs, with the aim of decreasing the rate of violence against staff. The authors discuss how they leveraged IS concepts, methods, and tools to achieve this goal.

Receptive Music Therapy for Patients Receiving Mechanical Ventilation in the Intensive Care Unit.

Background: Live music therapy provided by a board-certified music therapist reduces anxiety, decreases pain, and improves the physiological response of patients in the intensive care unit (ICU).

Objectives: To examine the effect of live music therapy on the physiological parameters and pain and agitation levels of adult ICU patients receiving mechanical ventilation.

Methods: A total of 118 patients were randomly assigned to live music therapy or standard care.

A Retrospective Analysis Comparing Post-Operative Bleeding with Various Doses of Aspirin after Lower Extremity Joint Arthroplasty or Revision.

Study Objective: Previous studies have shown that aspirin is noninferior to other anticoagulation therapies in preventing postoperative venous thromboembolism following lower extremity arthroplasty or revision; however, its optimal dosing for this indication is less clear. This study aims to compare the odds of bleeding between different aspirin dosages following lower extremity joint arthroplasty or revision.

Design: This is a 3-year retrospective multi-center cohort study across the United States and its territories.

A retrospective analysis of bleeding risk with rivaroxaban, enoxaparin, and aspirin following total joint arthroplasty or revision.

Study Objective: Rivaroxaban, enoxaparin, and aspirin are commonly used medications for thromboprophylaxis following lower extremity joint arthroplasty or revision. Previous research has demonstrated efficacy in preventing venous thromboembolism with each medication, however, the comparative risk of bleeding between them remains poorly understood. The aim of this study was to compare the odds of bleeding between rivaroxaban, enoxaparin, and aspirin following lower extremity joint arthroplasty or revision.

Development of the Perception of Opioid Use Survey Instrument.

Background And Purpose: A new instrument was designed specifically to evaluate nurses' knowledge, attitude, and practice toward patients who use opioids. This study team developed and tested the psychometric properties of the Perception of Opioid Use Survey (POUS) instrument.

Methods: The instrument was tested among 306 nurses at a 183 bed acute care community hospital, with psychometric evaluation for validity, reliability, and exploratory factor analysis.

Improvement in SRS-22R Self-Image Correlate Most with Patient Satisfaction after 3-Column Osteotomy.

Study Design: Longitudinal cohort.

Objectives: The aim of this study was to examine the relationship between patient satisfaction, patient-reported outcome measures (PROMs) and radiographic parameters in adult spine deformity (ASD) patients undergoing three-column osteotomies (3CO).

Summary Of Background Data: Identifying factors that influence patient satisfaction in ASD is important.

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.

Combined Albendazole and Praziquantel Therapy in an Adult Female with Neurocysticercosis and Generalized Tonic-clonic Seizures.

The use of albendazole monotherapy has been favored as the treatment option for neurocysticercosis. This case reports an incidence of neurocysticercosis in a 32-year-old woman who presented to the emergency department with a generalized tonic-clonic seizure. Neurocysticercosis was confirmed by magnetic resonance imaging (MRI) of the brain and a positive Taenia solium serologic test.

Survivability of Existing Peripheral Intravenous Access Following Blood Sampling in a Pediatric Population.

Purpose: Although pediatric patients report venipuncture as their most feared experience during hospitalization, blood sampling from peripheral intravenous accesses (PIVs) is not standard of care. Blood sampling from PIVs has long been considered by healthcare personnel to harm the access. In an effort to minimize painful procedures, pediatric nursing staff conducted a prospective, observational study to determine if blood sampling using existing PIVs resulted in the loss of the access.

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.

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.

The effect of obesity on outcomes in mechanically ventilated patients in a medical intensive care unit.

Background: The effect of obesity on outcomes in critically ill patients requiring invasive mechanical ventilation in a medical intensive care unit (ICU) is uncertain.

Objectives: This study was intended to further explore the relationship between outcomes and obesity in patients admitted to a medical ICU who required invasive mechanical ventilation.

Methods: All adult patients admitted to the medical ICU at Washington Hospital Center requiring intubation and invasive mechanical ventilation for at least 24 h between January 1 and December 31, 2009, were retrospectively studied.

Helping nurses care for self, family, and patients through the nurses living fit intervention.

Background: More than half of United States nurses are estimated to be overweight or obese. Interventions are needed that help nurses live healthier lifestyles. With most registered nurses being female and with an average age of 45.

Can you help me?: knowledge sharing within the nursing profession.

In the business world, knowledge sharing has been credited with advantages in productivity. When applied to health care, a comprehensive knowledge-sharing program can help nurses compete in today's globalized and highly competitive health care market while improving patient outcomes.

Posterior reversible encephalopathy syndrome: a case study.

Posterior reversible encephalopathy syndrome (PRES) is a rare neurologic disorder characterized by an acute increase in blood pressure, and by headaches, altered mental status, seizures, and visual loss. It is usually seen on computed tomographic scans as white-matter vasogenic edema predominantly affecting the posterior occipital and parietal lobes of the brain. Risk factors include malignant hypertension, eclampsia, medications such as immunosuppressants (including tacrolimus and cyclosporine), chemotherapy, biotherapy, and renal failure.

Adjusting eptifibatide doses for renal impairment: a model of dosing agreement among various methods of estimating creatinine clearance.

Background: Because of the renal elimination and increased risk for bleeding events at supratherapeutic doses of eptifibatide, the manufacturer recommends dosing adjustment in patients with renal dysfunction. Methods commonly used to estimate renal dysfunction in hospital settings may be inconsistent with those studied and recommended by the manufacturer.

Objective: To compare hypothetical renal dosing adjustments of eptifibatide using both the recommended method and several other commonly used formulas for estimating kidney function.

Effect of Nurses Living Fit™ exercise and nutrition intervention on body mass index in nurses.

Objective: The hospital-based Nurses Living Fit (NLF) intervention was implemented by nurses to determine its effect on decreasing body mass index (BMI) in nurse participants.

Background: Although there are limited data on obesity rates of nurses working in the United States, more than half are estimated to be overweight or obese.

Methods: The NLF intervention included exercise (12 weekly sessions), yoga and nutrition (4 monthly sessions), and diary completion (exercise/yoga, food/water consumption, and sleep), addressing healthy lifestyle principles.

Jamaican adolescent girls with older male sexual partners.

Purpose: The purpose of this study was to describe the relationships between adolescent girls and older male sexual partners in urban Kingston, Jamaica, and identify the human immunodeficiency virus (HIV)-related sexual risks that occur within these relationships.

Design: The study employed a descriptive qualitative design.

Methods: Data were collected through focus groups and individual interviews conducted with 43 late adolescent girls (18-21 years old).

Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates.

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation.

HIV-related sexual risk behaviours among late-adolescent Jamaican girls with older male partners.

Objective: To describe HIV-related sexual risk behaviours among late-adolescent Jamaican girls and examine whether having an age-discordant male sexual partner (> or = 2 years older) was associated with a decrease in condom use at last coitus.

Methods: Utilizing an expanded Theory of Planned Behaviour a survey was designed to capture HIV-related sexual risk behaviours. Descriptive and inferential statistics were used to analyse the final sample of one hundred and eighty-four late-adolescent girls (18-21 years) in Kingston, Jamaica.