Obtaining the patient's perspective on frailty: a mini-review of qualitative studies.

There is a small, but growing, evidence base on obtaining the patient's perspective on frailty, which can help guide future research and clinical management strategies. This mini-review provides a brief summary of some qualitative studies on the patient's perspective on frailty with a focus on the study design and emerging findings to date. We reviewed seven studies in total, examining how they approached the research question and their main findings.

Nursing Process Approach to Pain Management for Women with Polysubstance Use.

Delving into the complexities of pain management in women with polysubstance use, the focus of this article is on the intersection of chronic pain and mental health. One in 5 adults in the United States experience chronic pain, with women being particularly susceptible. To address these challenges, a careful and patient-centered is crucial.

Influences of a Remote Monitoring Program of Home Nasogastric Tube Feeds on Transition from NICU to Home.

Objective:  The transition from the neonatal intensive care unit (NICU) to the home is complex and multifaceted for families and infants, particularly those with ongoing medical needs. Our hospital utilizes a remote monitoring program called Growing @ Home (G@H) to support discharge from the NICU with continued nasogastric tube (NGT) feeds. We aim to describe the experience of the transition from NICU to home for families enrolled in G@H.

Interfacility Referral Communication for PICU Transfer.

Objectives: For patients requiring transfer to a higher level of care, excellent interfacility communication is essential. Our objective was to characterize verbal handoffs for urgent interfacility transfers of children to the PICU and compare these characteristics with known elements of high-quality intrahospital shift-to-shift handoffs.

Design: Mixed methods retrospective study of audio-recorded referral calls between referring clinicians and receiving PICU physicians for urgent interfacility PICU transfers.

Validity of Patient-Reported Outcomes Measurement Information System Physical, Mental, and Social Health Measures After Left Ventricular Assist Device Implantation and Implications for Patient Care.

Background: A better understanding is needed of the burdens and benefits of left ventricular assist device (LVAD) implantation on patients' physical, mental, and social well-being. The purpose of this report was to evaluate the validity of Patient-Reported Outcomes Measurement Information System (PROMIS) measures for LVAD patients and to estimate clinically important score differences likely to have implications for patient treatment or care.

Methods: Adults from 12 sites across all US geographic regions completed PROMIS measures ≥3 months post-LVAD implantation.

A primer on incorporating sex as a biological variable into the conduct and reporting of basic and clinical research studies.

The recent move to require sex as a biological variable (SABV), which includes gender, into the reporting of research published by the follows a growing, and much-needed, trend by journals. Understandably, there is concern over how to do this without adding considerable work, especially if one's primary research focus is not on elucidating sex/gender differences. The purpose of this article is to provide additional guidance and examples on how to incorporate SABV into the conduct and reporting of basic and clinical research.

Frailty and the risk of all-cause mortality and hospitalization in chronic heart failure: a meta-analysis.

To estimate the risk of all-cause mortality and hospitalization in frail patients with chronic heart failure (HF), a systematic search and meta-analysis was carried out to identify all prospective cohort studies conducted among adults with HF where frailty was quantified and related to the primary endpoints of all-cause mortality and/or hospitalization. Twenty-nine studies reporting the link between frailty and all-cause mortality in 18 757 patients were available for the meta-analysis, along with 11 studies, with 13 525 patients, reporting the association between frailty and hospitalization. Frailty was a predictor of all-cause mortality and hospitalization with summary hazard ratios (HRs) of 1.

The impact of a service-learning foot soak experience on nursing students' attitudes towards the homeless.

Background: Opportunities for meaningful engagement with the homeless can alter negative attitudes. The purpose of this study was to assess changes in attitudes towards the homeless among undergraduate nursing students participating in a service-learning foot soak experience.

Methods: This was a prospective, pretest and posttest interventional study.

Development of an Instrument for Measuring Self-Care Behaviors After Left Ventricular Assist Device Implantation.

Background: Successful long-term left ventricular assist device (LVAD) therapy necessitates a high degree of self-care. We aimed to develop an instrument that measures self-care behaviors in adult patients living with an LVAD.

Methods: We used the method to develop patient-reported outcomes recommended by the US Food and Drug Administration.

Factors influencing nurses' willingness to lead.

Aim: To identify factors influencing nurses' willingness to lead.

Background: Given the ageing workforce and the projected retirement of nurse leaders, there is a concern about nursing leadership shortages in the next decade. Several studies have shown that nurses are not interested in pursuing leadership positions, but studies investigating nurses' willingness to lead and related predictors remain limited.

Feasibility and Acceptability of Nurse-Led Primary Palliative Care for Older Adults with Chronic Conditions: A Pilot Study.

Background: Many older adults live with serious illness for years before their death. Nurse-led primary palliative care could improve their quality of life and ability to stay in their community.

Objectives: To assess feasibility and acceptability of a nurse-led Transitional Palliative Care (TPC) program for older adults with serious illness.

Care in Nursing Facilities after Palliative Consult.

Despite hospital palliative care consultations during which goals of care are discussed in the context of poor prognoses, older adults are admitted to nursing homes for post-acute care where the focus is on rehabilitation. The purpose of this qualitative descriptive study was to describe factors that influence discontinuity between a palliative care consult and nursing home care and explore the potential consequences of this discontinuity. Twelve adults (mean age of 80 years) were enrolled from one community hospital and nursing home in the mid-Atlantic United States.

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy.

Background: Although current guidelines emphasize the importance of social support to the success of left ventricular assist device (LVAD) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life (QOL) and caregiver strain in response to LVAD therapy.

Methods And Results: Data on patients receiving LVAD therapy and their caregivers (n=50 dyads) were prospectively collected pre-implantation and 1, 3, and 6 months post-implantation.

From Start-up to Sustainability: A Decade of Collaboration to Shape the Future of Nursing.

Aim: This article describes progress the Oregon Consortium for Nursing Education has made toward addressing the academic progression goals provided by the 2011 Institute of Medicine's Future of Nursing: Leading Change, Advancing Health report.

Background: The history of the consortium's development is described, emphasizing the creation of an efficient and sustainable organization infrastructure that supports a shared curriculum provided through a community college/university partnership.

Method: Data and analysis describing progress and challenges related to supporting a shared curriculum and increasing access and affordability for nursing education across the state are presented.

Advance Care Planning: The Nurse's Role.

: This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org).

Nursing students' experiences of mentorship in their final placement.

Aim: The aim of this study was to explore final-year students' experiences of the mentorship role in their final placement and, in particular, to establish their expectations of the mentorship role, as well as their support and supervision needs.

Method: Seven final-placement students were recruited from one Scottish university, using purposive sampling. Heideggerian phenomenology was chosen as the underpinning philosophical approach because of its emphasis on the 'lived experience'.

Frequency of and Significance of Physical Frailty in Patients With Heart Failure.

Physical frailty is an important prognostic indicator in heart failure (HF); however, few studies have examined the relation between physical frailty and invasive hemodynamics among adults with HF. The purpose of this study was to characterize physical frailty in HF in relation to invasive hemodynamics. We enrolled 49 patients with New York Heart Association class II to IV HF when participants were scheduled for a right-sided cardiac heart catheterization procedure.

Determinants of frequent Internet use in an urban kidney transplant population in the United States: characterizing the digital divide.

Context: The Internet is a staple of electronic communication and is essential to the emerging telemonitoring and health information technology interventions for adults with chronic diseases.

Objective: To identify determinants of frequent Internet use in an urban kidney transplant population in the United States.

Design: A single center, cross-sectional survey study.

Living through the end: The phenomenon of dying at home.

Objectives: To explore the unique lived experiences of one patient who died at home and her family members, and to interpret how dying at home influenced patterns of bereavement for this patient's family.

Methods: Benner's (1985) interpretive phenomenological approach was employed to get at the embedded nature of the social phenomenon of dying at home, uncovering what may be taken for granted by participants - in this case, during and after the patient's home hospice course. The participants were a 78-year-old female diagnosed with amyotrophic lateral sclerosis six months prior to death, her husband, and three of her four children.

Adapting cognitive interviewing for nursing research.

Cognitive interviewing (CI) has been used by instrument developers to examine how well an instrument generates the intended data when tested with prospective respondents. In using CI to test a new instrument to measure patients' perceptions of the quality of nursing care, the authors found challenges in applying a theory-based traditional CI approach derived from experimental psychology to more clinically oriented nursing research. The purposes of this article are to describe these challenges and the modifications of CI to capture the nursing care perspectives of hospitalized participants, and to present interpretive phenomenology as a theoretical orientation for clinically situated CI.

Developing the Oregon Consortium for Nursing Education: the back story.

The Oregon Consortium for Nursing Education (OCNE) is a collaborative partnership between community colleges and a multicampus university in Oregon that developed in response to an emerging nursing shortage and changing health needs in the population. OCNE has created a redesigned curriculum with shared agreements for academic standards, admission, and seamless transition from associate to baccalaureate programs. Although the schools share pedagogical resources, curriculum, and standards, each partner school retains autonomy and accountability for its degree program.

Preparing nursing students for the future: an innovative approach to clinical education.

A clinical education model was developed and implemented by nursing faculty in the Oregon Consortium for Nursing Education undergraduate curriculum to improve clinical learning for preparation of nurses to practice in the 21st century. This clinical education model, developed though collaborative work by nursing practice and education representatives throughout the state, moves away from a "random access opportunity" model of clinical education reliant on "total patient care" experiences to an intentional design of clinical learning activities based on course competencies appropriate to student level. Five elements of the model were proposed: case-based, concept-based, intervention skill-based, focused direct client care and integrative experiences.