Assessing Patient Readiness for Hospital Discharge, Discharge Communication, and Transitional Care Management.

Background: Discharge communication between hospitalists and primary care clinicians is essential to improve care coordination, minimize adverse events, and decrease unplanned health services use. Health-related social needs are key drivers of health, and hospitalists and primary care clinicians value communicating social needs at discharge.

Objective: To 1) characterize the current state of discharge communications between an academic medical center hospital and primary care clinicians at associated clinics; 2) seek feedback about the potential usefulness of discharge readiness information to primary care clinicians.

Palliating Serious Illness During Disasters and Public Health Emergencies.

The increase in disasters and public health emergencies in recent years is a serious public health concern. The needs of suffering victims can be multifaceted, particularly the needs of those who are from systematically marginalized populations. Palliative care nurses play a vital role in mitigating the suffering of those affected by these events.

Impact of COVID-19 visitation policies and hospital capacity on discharge readiness in medicine patients.

Background: COVID-19 impacted the experience of being hospitalized with the widespread adoption of strict visitation policies to ensure healthcare worker safety. One result was decreased time of caregivers at the bedside of hospitalized patients.

Objective: To understand the impact of pandemic-related system effects on patient-reported discharge preparation.

Coming Full Circle: A Transplant Nurse on Why Tissue Donation Matters.

A son's loss and the healing power of giving.

The Pathways to Prevention program: nutrition as prevention for improved cancer outcomes.

Adequate nutrition is central to well-being and health and can enhance recovery during illness. Although it is well known that malnutrition, both undernutrition and overnutrition, poses an added challenge for patients with cancer diagnoses, it remains unclear when and how to intervene and if such nutritional interventions improve clinical outcomes. In July 2022, the National Institutes of Health convened a workshop to examine key questions, identify related knowledge gaps, and provide recommendations to advance understanding about the effects of nutritional interventions.

Posttraumatic growth and life course stress predict dyadic wellbeing among sexual and gender minority (SGM) and non-SGM couples facing cancer.

Objective: This study examined: (1) Differences among sexual and gender minority (SGM) and non-SGM couples' life course stress, posttraumatic growth (PTG), individual, and dyadic wellbeing while facing cancer, (2) The predictive ability of PTG and life course stress on wellbeing for each dyad member, and (3) The predictive ability of dyad-level PTG and dyad-level life course stress on dyadic wellbeing.

Methods: Thirty SGM and 30 non-SGM dyads (N = 60) completed measures assessing demographics, life course stress, PTG, individual, and dyadic wellbeing. Regression and multilevel models tested predictive hypotheses.

"It Just Depends on Their Stability": A Qualitative Examination of Patient Factors Influencing Providers' Contraceptive Counseling Approaches for Persons With Substance Use Disorders.

Objectives: This qualitative study examined how patient-related factors influence providers' contraceptive counseling for persons with substance use disorders (SUDs). Specifically, we explored individual behavior and social factors that contribute to providers modifying their contraceptive counseling approaches and described how providers alter their counseling recommendations and communication strategies in the presence of such factors.

Methods: In 2019, we purposively recruited a national sample of contraceptive providers (N = 24) and conducted semistructured phone interviews to inquire about their contraceptive counseling practices for women with SUDs.

Assessing EHR Data for Use in Clinical Improvement and Research.

Data from electronic health records (EHRs) are becoming accessible for use in clinical improvement projects and nursing research. But the data quality may not meet clinicians' and researchers' needs. EHR data, which are primarily collected to document clinical care, invariably contain errors and omissions.

A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings.

Background: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.

Methods: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia.

Leveraging Partnerships to Reduce Insulin Needlestick Injuries: Nurse-Led System-Wide Quality Improvement Project.

Background: Percutaneous injuries from needlesticks are a major occupational hazard for nurses.

Local Problem: Reducing subcutaneous insulin-related needlestick injuries was part of a nurse-led comprehensive sharps injury-reduction program at an integrated, not-for-profit health system.

Methods: The incident rate of needlestick injuries was compared between 1 year before and 1 year after introducing this quality improvement project.

Oral Care in Critically Ill Patients Requiring Noninvasive Ventilation: An Evidence-Based Review.

Topic: Hospital-acquired pneumonia commonly develops after 48 hours of hospitalization and can be divided into non-ventilator-acquired and ventilator-acquired pneumonia. Prevention of non-ventilator-acquired pneumonia requires a multimodal approach. Implementation of oral care bundles can reduce the incidence of ventilator-acquired pneumonia, but the literature on oral care in other populations is limited.

Comparison of levonorgestrel level and creamatocrit in milk following immediate versus delayed postpartum placement of the levonorgestrel IUD.

Background: Breastfeeding and postpartum contraception critically influence infant and maternal health outcomes. In this pilot study, we explore the effects of timing and duration of postpartum levonorgestrel exposure on milk lipid and levonorgestrel content to establish baseline data for future research.

Methods: This sub-study recruited a balanced convenience sample from 259 participants enrolled in a parent randomized controlled trial comparing immediate to delayed (4-8 weeks) postpartum levonorgestrel IUD placement.

Original Research: Understanding Nursing Home Staff Attitudes Toward Death and Dying: A Survey.

Background: Nearly 70% of nursing home residents are eligible for palliative care, yet few receive formal palliative care outside of hospice. Little is known about nursing home staff attitudes, knowledge, skills, and behaviors related to palliative care.

Methods: We administered a modified survey measuring attitudes toward death to 146 nursing home staff members, including both clinical and nonclinical staff, from 14 nursing homes.

Risk factors for falls in homebound community-dwelling older adults.

Objective: To examine risk factors associated with falls among homebound community-dwelling older adults, a vulnerable population often possessing functional disabilities and chronic conditions.

Design And Sample: The study was a cross-sectional study utilizing round 6 data of the National Health and Aging Trend Study (NHATS). Descriptive statistics and multiple logistic regression analyses were conducted.

Outcomes Associated With Stage 2 Pressure Injuries Among Surgical Critical Care Patients: A Retrospective Cohort Study.

Background: Hospital-acquired pressure injuries are a serious problem among critical care patients. Although most hospital-acquired pressure injuries are stage 2 (partial-thickness skin loss with exposed dermis), no studies have examined outcomes of stage 2 pressure injuries among critical care patients.

Objectives: To examine outcomes of stage 2 hospital-acquired pressure injuries among critical care patients and identify factors associated with nonhealing stage 2 hospital-acquired pressure injuries.

Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge: The Going Home Toolkit.

Purpose Of Study: Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge.

Primary Practice Setting(s): Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based.

A Statewide Survey Report of Roles and Responsibilities in Current Utah Care Management Processes.

Purpose Of The Study: Measure current roles and responsibilities of care managers in the state of Utah.

Primary Practice Setting: All settings of health care including inpatient, outpatient, community, payer, post-acute, and transitional care settings.

Methods And Sample: A quantitative descriptive survey design was used to assess and describe current care management roles and responsibilities of 191 care managers within the state of Utah.

Genitourinary syndrome of menopause: A new name for an old condition.

Genitourinary syndrome of menopause (GSM) is the new name for the conditions that formerly included vulvovaginal atrophy and atrophic vaginitis. GSM better describes the range of conditions associated with low estrogen levels in menopause and invites patient discussion without the use of words that might be uncomfortable to say. This article discusses the physiology of GSM and reviews both hormonal and nonhormonal treatment options.

Evaluation of an intervention designed to improve the management of difficult IUD insertions by advanced practice clinicians.

Objectives: To assess whether clinical skills training in cervical dilation and paracervical anesthesia, as well as the introduction of a clinical protocol for difficult insertions, increased intrauterine device (IUD) insertion success rates among advanced practice clinicians (APCs) including women's health and family practice nurse practitioners, physician assistants and certified nurse midwives.

Study Design: This prospective study assessed an intervention to improve IUD insertions among APCs at six family planning clinics in Utah. We collected data on IUD insertions performed by participating clinicians during two observation phases: preintervention (Phase 1) and postintervention (Phase 2).

Length of hospital stay and discharge disposition in older trauma patients.

As the number of older adults increases and life expectancies are increasing, more incidences of traumatic injury are expected in this population. In this study, the relationships between demographic variables, pain, days from admission to therapy evaluation, length of stay and discharge disposition were examined in 132 older adults who had experienced a traumatic event. Results showed that significant relationships existed between pain, age, comorbidities, injury severity and days from admission to therapy evaluation and length of stay; those with less pain, greater age and had more days between admission and when the first therapy evaluation occurred had longer lengths of stay.

Enabling nurses to lead change: the orientation experiences of nurses to boards.

Objectives: Nurses need to be full partners in shaping health care and health care policy. One way to do this is to be present and active on boards at all levels. The purpose of this study is to examine the orientation experiences of nurses to boards and their preparation to influence health care and health care policy.