Equipping Nurses to Lead Evidence-Based Practice: An Opportunity for Professional Nursing Associations.

Objective: The aim of this study was to describe the evidence-based practice (EBP) attributes among California nurse leaders who are members of a professional nursing organization.

Background: Nurse leaders are pivotal for successful EBP implementation. The Association of California Nurse Leaders' (ACNL) mission to equip nurses to lead self, others, and systems propelled them to conduct a study of members' EBP beliefs, knowledge, competencies, and implementation.

Unexpectedly high prevalence of primary immune deficiency in fibromyalgia: serologic features and clinical correlates.

Objectives: We sought laboratory evidence of primary immune deficiency (PID), a condition known to be associated with recurrent infections and autoimmunity, in fibromyalgia (FM). We correlated laboratory findings with a clinical history of recurrent infections and reduced epidermal nerve fiber density (ENFD).

Methods: We prospectively measured serum total and subclass concentrations for IgA, IgG, IgM, IgE, and mannose-binding lectin in 72 adult FM subjects (31 "FM only;" 41 "FM+RA") and compared those results against historical controls.

Parental attitudes towards choosing between operative and nonoperative management of pediatric acute appendicitis.

Introduction: Making healthcare decisions for children can be challenging for parents or guardians. We aimed to characterize the decision-making preferences and stress of parents or guardians who were offered both appendectomy or nonoperative management (NOM) for children with acute appendicitis.

Methods: Criteria was developed for offering operative or NOM for patients.

Nurse Listening as Perceived by Patients: How to Improve the Patient Experience, Keep Patients Safe, and Raise HCAHPS Scores.

Objective: The purpose of this qualitative research study was to ascertain which nurse behaviors a subsection of adults 50 years and older who had had a recent inpatient admission believed conveyed nurse listening.

Background: Listening by nurses has been identified as one of the factors with the greatest impact on patients' overall rating of their hospital experience. The behaviors of nurses that lead to patients' perceptions that listening has occurred have been unexamined, thus hampering attempts at improvement.

Tools and tactics for postdischarge medication management interventions.

Purpose: To identify interventions for organizational pharmacist-leaders and frontline pharmacy staff to optimize peri- and postdischarge medication management.

Summary: An evidence-based toolkit was systematically constructed on the basis of findings of 3 systematic overviews of systematic reviews. The interventions were reviewed by a technical expert panel and categorized as either tools or tactics.

Do Errorless Methods Improve Discharge Medication Instruction and Adherence?

Purpose And Design: Postdischarge adverse drug events are a national issue, and effective inpatient instruction may help. Therefore, this intervention study examined whether using errorless teaching/learning methods including pictorial medication cards (ETL + card) improved RN teaching and patient medication adherence among persons with cognitive challenges (PWCCs).

Methods: Convenience samples of RNs and PWCCs from a 24-bed rehabilitation unit provided baseline data.

Electric Scooter Injury in Southern California Trauma Centers.

Background: Electric scooters are popular in Southern California due to their ease of use, affordability, and availability. The objective of this study was to characterize how hospital admissions and outcomes varied due to electric scooter injury among Southern California trauma centers.

Study Design: Trauma registry data from 9 urban trauma centers were queried for patients sustaining injury while operating an electric scooter from January to December 2018.

Unique Case of Disseminated Plague With Multifocal Osteomyelitis.

Plague is a disease caused by Yersinia pestis. Septicemic and pneumonic plague have a high mortality rate if untreated. Here we describe the challenges of accurately diagnosing a nonfatal pediatric case of septicemic plague with involvement of multiple organs; to our knowledge, the first documented case of multifocal plague osteomyelitis.

RN Evaluation of Errorless Methods in Teaching Discharge Medications to Cognitively Challenged Patients.

Purpose: To identify (1) effectiveness of current registered nurse (RN) strategies in teaching discharge medications to cognitively challenged patients and (2) whether errorless teaching/learning (ETL) with pictorial medication cards improves such instruction.

Design: Cross-sectional, qualitative, pretest/posttest.

Methods: Open-ended interviews and a class on ETL were conducted with a purposive sample of 10 expert staff RNs from rehabilitation and neurological telemetry units in a 377-bed, not-for-profit hospital.

Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists.

Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.

Academic-community partnerships improve outcomes in pediatric trauma care.

Background: To address the specialized needs of injured children, pediatric trauma centers (PTCs) were established at many large, academic hospitals. This study explores clinical outcomes observed for injured children treated at an academic-sponsored community facility.

Methods: In partnership with an academic medical center in a major metropolitan area, a not-for-profit community hospital became a designated Level II PTC in October 2010.

Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.

Objective: A subset of patients with fibromyalgia (FM) exhibit a large fiber demyelinating peripheral polyneuropathy akin to that seen in chronic inflammatory demyelinating polyneuropathy (CIDP). It has been suggested that this demyelinating process is likely to be immune mediated. Because it is known that similar large fiber neuropathic lesions may be associated with a cutaneous small fiber neuropathy, we sought to determine the prevalence of small fiber neuropathy, as measured by epidermal nerve fiber density (ENFD), in a series of patients with FM and clinically healthy control subjects.

Natalizumab-associated progressive multifocal leukoencephalopathy in a patient with multiple sclerosis: a postmortem study.

Natalizumab, a monoclonal antibody directed against α4 integrins, has, to date, been associated with 399 cases of progressive multifocal leukoencephalopathy (PML) worldwide in patients receiving treatment for multiple sclerosis (MS). Because of the limited number of histologic studies, the possible interplay between MS and PML lesions has not been investigated. We report the clinical, radiologic, and histologic findings of an MS patient who developed PML after 32 months of natalizumab monotherapy.

Importance of antiresorptive therapies for patients with bone metastases from solid tumors.

Patients with bone metastases are at risk of skeletal-related events such as pathologic fractures, spinal cord compression, the need for orthopedic surgery to bone, and palliative radiotherapy for severe bone pain. Antiresorptive therapies have demonstrated efficacy for reducing the risk of skeletal-related events and ameliorating bone pain. Despite the well documented clinical benefits of antiresorptive therapies, patient benefits can be limited or compromised by nonadherence with scheduled therapy.

"Here comes Santa Claus": what is the evidence?

The purpose of this article is to examine the strength of evidence regarding our holiday Santa Claus (SC) practices and the opportunities for new descriptive, correlation, or experimental research on SC. Although existing evidence generally supports SC, in the end we may conclude, "the most real things in the world are those that neither children nor men can see" (Church, as cited in Newseum, n.d.

Premenstrual exacerbation of Meniere's disease revisited.

Some women with Meniere disease demonstrate exacerbation of symptoms during the premenstrual period. It is believed that the hormonal stress of the premenstrual period acts on the volatile inner ear with Meniere disease to result in dysfunction. Migraine, Meniere disease, and the premenstrual period may be a complex interaction leading to exacerbation of symptoms.

A review of delusions of parasitosis, part 2: treatment options.

Delusions of parasitosis (DOP), a psychiatric disorder in which patients erroneously insist that they are infested with parasites, remains a treatment problem for dermatologists. Generally, these patients are resistant to psychiatric referral and treatment with psychotropic medications. We discuss treatment options and management recommendations.

A review of delusions of parasitosis, part 1: presentation and diagnosis.

Delusions of parasitosis (DOP), a psychiatric disorder in which patients erroneously insist that they are infested with parasites, remains a fascinating entity with elusive origins. Typically, these patients are resistant to psychiatric referral and treatment with psychotropic medications. We discuss the classification, epidemiology, clinical presentation, etiology, associated features, and differential diagnosis of this disorder.