The Effect of a Comprehensive Provider and Patient Intervention to Improve Blood Pressure Control.

To examine the comprehensive provider and patient intervention (CPPI) compared to usual care (UC) on blood pressure control among newly diagnosed hypertensive patients treated in a nurse practitioner practice. CPPI included provider and patient education, electronic health record messages about the guidelines of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, Treatment of High Blood Pressure (JNC-7), and patient counseling. Blood pressure control (intervention group; CPPI) was assessed and compared to levels of newly diagnosed patients prior to the intervention (usual care group; UC).

Teen Mothers' Mental Health.

Psychological distress is common in teen mothers. High rates of distress are attributed to teen mothers' childhood adversities and the challenges of parenting in the context of chronic stress, cumulative disadvantage, and limited social support. We describe the prevalence of psychological distress in teen mothers; what is known about its origins and impact on mothers and children; factors that promote teen mothers' mental health and resilience; and the many barriers that make it difficult to obtain traditional mental healthcare.

The pH of Feeding Tube Aspirates From Critically Ill Infants.

Background: The extent to which gastric acid inhibitors and feedings affect gastric pH in infants is unclear.

Objectives: To compare pH values of gastric aspirates from infants according to use or no use of gastric acid inhibitors and feedings.

Methods: Colorimetric pH tests were used to measure the pH of aspirates from feeding tubes in 54 critically ill infants; 29 of the gastric aspirates were from infants who did not receive acid inhibitors or feedings, 13 were from infants who received acid inhibitors but no feedings, 3 were from infants who received feedings but no acid inhibitors, and 5 were from infants who received both acid inhibitors and feedings.

Gender differences in use of prescription narcotic medications among living kidney donors.

Prescription narcotic use among living kidney donors is not well described. Using a unique database that integrates national registry identifiers for living kidney donors (1987-2007) in the United States with billing claims from a private health insurer (2000-2007), we identified pharmacy fills for prescription narcotic medications in periods 1-4 and >4 yr post-donation and estimated relative likelihoods of post-donation narcotic use by Cox regression. We also compared narcotic fill rates and medication possession ratios (MPRs, defined as (days of medication supplied)/(days observed)), between donors and age- and sex-matched non-donors.

Secondary health conditions in individuals with multiple sclerosis: a cross-sectional web-based survey analysis.

Purpose: The purpose of this study was to compare the rates of secondary health conditions in individuals with multiple sclerosis (MS) with age-matched U.S. general population norms.

Clinical Management of Antipsychotic-Induced Hyperprolactinemia.

Purpose: This article describes the physiology and mechanisms of prolactin and the assessment and clinical management strategies of antipsychotic-induced hyperprolactinemia.

Conclusions: Hyperprolactinemia is a disorder of the hypothalamic-pituitary axis which can be caused by several mechanisms. Typical antipsychotic agents are more likely to cause hyperprolactinemia than atypical antipsychotic agents, with the exception of amisulpride, paliperidone, and risperidone.

Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor.

When a child's prognosis is poor, physicians and nurses (MDs/RNs) often struggle with initiating discussions about palliative and end-of-life care (PC/EOL) early in the course of illness trajectory. We describe evaluation of training procedures used to prepare MD/RN dyads to deliver an intervention entitled: Communication Plan: Early Through End of Life (COMPLETE) intervention. Our training was delivered to 5 pediatric neuro-oncologists and 8 pediatric nurses by a team of expert consultants (i.

Internal medicine resident training and provision of diabetes quality of care indicators.

Objective: Existing research is inconsistent on whether clinical experience is associated with improved management of type 2 diabetes mellitus. We sought to determine whether meeting diabetes quality indicators improves as general internal medicine physicians progress from first to last year of residency.

Methods: We performed a chart abstraction of electronic health records data covering the period from September 2008 to August 2011.

The relationship between sleep and physical function in community-dwelling adults: a pilot study.

More than 50% of community-dwelling adults have sleep complaints. Because aging is associated with decline in physical function, coexistent sleep difficulties may exacerbate functional decline. This pilot study explored the relationships between sleep, age, chronic disease burden, and physical function among 50 community-dwelling older adults.

Effectiveness of an electromagnetic feeding tube placement device in detecting inadvertent respiratory placement.

Background: Use of technology capable of electromagnetically tracking advancement of a feeding tube on a monitoring screen during insertion may enable detection of deviation of the tube from the midline as it advances through the chest, possibly indicating entry of the tube into the right or left main bronchus.

Purposes: To describe (1) published peer-reviewed studies that report on the detection of malpositioned tubes inserted by an electromagnetic tube placement device, and (2) events reported to the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database regarding use of such a device.

Methods: An Ovid MEDLINE search was conducted to locate peer-reviewed studies published between 2007 and 2012 that referred to use of an electromagnetic tube placement device to detect inadvertent respiratory placements of feeding tubes.

Promoting cultures of thinking: transforming nursing education to transform nursing practice.

Contemporary nursing education is highly invested in the development of the academic, critical, and empirical aspects of education that represent the science of nursing, and concomitantly less attentive to the development of the creative, interpersonal aspects of education typically associated with the art of nursing. This represents a reversal of historic patterns in nursing education, but the pendulum may have swung so far that there could be costs to nursing practice unless the creative, interpersonal aspects of education can be reclaimed and balanced. Ideas and suggestions regarding how nurse educators might foster the creation of cultures of thinking, which represent whole-brain, integrated teaching approaches that are based on emerging neurocognitive evidence, are discussed.

Aging muscles and joints: mobilization.

Critical illness can impose immobility in older patients, resulting in loss of strength and functional ability. Many factors contribute to immobility, including patients' medical conditions, medical devices and equipment, nutrition, use of restraint, and staff priorities. Early mobilization reduces the impact of immobility and improves outcomes for older patients.

Pioneering the psychiatric nurse role in foster care.

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program.

Influence of motivation on the efficacy of natural family planning.

Purpose: To determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy.

Study Design And Methods: Using an online taught NFP method, 358 women and (their male partners) indicated "how much" and "how hard" they wished to avoid pregnancy on a scale of 0 to 10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation.

Evaluation of child and parent outcomes after a pediatric cardiac camp experience.

Purpose: This study evaluated the effects of a cardiac camp experience on children with heart disease and their parents.

Design And Methods: A repeated measures design was used with 49 parent-child dyads. Repeated measures evaluated the effects of camp on anxiety, attitude toward illness, and psychosocial functioning of the children.

A review of published case reports of inadvertent pulmonary placement of nasogastric tubes in children.

Problem: Little is known about the incidence of inadvertent pulmonary placement of nasogastric tubes during blind insertions in children.

Purpose: The purpose of this paper was to conduct a review of published case reports over the past two decades.

Methods: An OVID Medline search was conducted of articles published from 1993 through 2012.

Development of an online orientation course for preceptors in a dedicated education unit program.

The dedicated education unit (DEU) is an emerging model of nursing education. Instead of an instructor-led clinical group, students are partnered with a unit staff nurse for precepted learning. These experiences in learning typically begin with early clinical courses.

Head-of-bed elevation in critically ill patients: a review.

Clinicians are confused by conflicting guidelines about the use of head-of-bed elevation to prevent aspiration and pressure ulcers in critically ill patients. Research-based information in support of guidelines for head-of-bed elevation to prevent either condition is limited. However, positioning of the head of the bed has been studied more extensively for the prevention of aspiration than for the prevention of pressure ulcers, especially in critically ill patients.

Preserving personhood of individuals with advanced dementia: lessons from family caregivers.

This article reports on a phenomenological study of 15 family caregivers who admitted their spouse or parent with probable Alzheimer's disease to long-term care. The caregivers were attuned to the needs, desires, moods and concerns of their family members with dementia; thus, they were attuned to personhood. Caregivers also reported observations of care by nurses and nursing staff.

HPV & age-appropriate cervical cancer prevention for adolescents.

Over the last decade, new information about human papillomavirus infection has increased the healthcare community's understanding of the natural history of the disease and cervical cancer. Advances in screening, management, and diagnosis continue to refine clinicians' efforts to prevent cervical cancer in adolescent females.

Monitoring for intolerance to gastric tube feedings: a national survey.

Background: Confusion about how to assess for intolerance to feedings often results in unnecessary feeding interruptions.

Objectives: To report findings from a national survey of methods used by critical care nurses to assess tolerance to gastric tube feedings and to discuss the findings in light of current enteral nutrition guidelines.

Methods: A paper-and-pencil survey was mailed to 1909 members of the American Association of Critical-Care Nurses.

Listening to and learning from older adult Hurricane Katrina survivors.

Objective: The objective of this pilot study was to explore how Hurricane Katrina affected older adult disaster survivors.

Design And Sample: Participants for this descriptive exploratory pilot study were recruited from churches and senior centers on the Gulf Coast of Mississippi. Of the 224 participants, one hundred provided additional comments at the end of a forced-response questionnaire.

Caregivers' desired patterns of communication with nursing home staff- just TALKKK!

Individuals with cognitive impairment often represent a significant percentage of the residents in a nursing home nurse's care. With years of experience caring for their placed family members, caregivers of these residents are often experts in knowing the resident's needs, habits, behaviors, and moods. Caregivers often wish to convey this insider knowledge to nursing home staff.