A conceptual model for growing evidence-based practice.

Nursing administration at a small medical center is developing and implementing an evidence-based practice (EBP) model of care to support a culture of quality care, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth. The purpose of this article is to describe a conceptual model for EBP that addresses how to overcome barriers to implementation. Clinician expertise and values, experience, patient preference and expectation, and caring become grounded in a practice environment that must strive to become rooted in clinical research to evolve into a practice that is evidence-based.

Retrograde intussusception following Roux-en-Y gastric bypass.

A case of retrograde intussusception is presented occurring >1 year following a Roux-en-Y gastric bypass (RYGBP). Presentation may be confusing and lead to a serious delay in diagnosis. Review of the literature shows most intussusceptions following RYGBP are retrograde, and most, if not all, appear to originate in the proximal common channel, as ours clearly did.

Early weightbearing after first metatarsophalangeal joint arthrodesis: a retrospective observational case analysis.

A retrospective observational study was performed to determine if early ambulation compromised healing in patients who underwent primary first metatarsophalangeal joint arthrodesis. The records of 42 patients undergoing 47 fusions were evaluated to determine time to radiographic union, time to clinical union, and return to regular shoes. Results showed that patients achieved clinical healing at an average of 5.

Use of the Z osteotomy for Tailor bunionectomy.

The authors present a unique use of the Z osteotomy in the fifth metatarsal for correction of Tailor bunion. The rotational capabilities of the Z osteotomy are exploited to provide correction of fifth metatarsal lateral bowing and to decrease intermetatarsal angles. The osteotomy is inherently stable, and the design facilitates internal fixation.