Pediatrician perspectives on barriers and facilitators to discharge instruction comprehension and adherence for parents of children with medical complexity.

Background: High rates of posthospitalization errors are observed in children with medical complexity (CMC). Poor parent comprehension of and adherence to complex discharge instructions can contribute to errors. Pediatrician views on common barriers and facilitators to parent comprehension and adherence are understudied.

The Standardization of Home Blood Pressure Monitoring in Primary Care: A Quality Improvement Project.

Current guidelines recommend the use of home blood pressure monitoring (HBPM) to screen for and manage hypertension. In this study, a quality improvement project was designed to standardize the use of HBPM in a primary care setting and demonstrate improved blood pressure outcomes. Initial systolic and diastolic values were compared to averages from patient logs.

An observational pilot study of sleep disruption and delirium in critically ill children.

Background: Sleep disruption is frequently observed in children with delirium in the pediatric intensive care unit (PICU).

Objectives: This observational pilot study explores relationships among modifiable characteristics of the PICU environment (i.e.

Documented Penicillin Allergies on Antibiotic Selection at Pediatric Emergency Department Visits.

Background: Penicillin or amoxicillin are the recommended treatments for the most common pediatric bacterial illnesses. Allergies to penicillin are commonly reported among children but rarely true. We evaluated the impact of reported penicillin allergies on broad-spectrum antibiotic use overall and for the treatment of common respiratory infections among treat-and-release pediatric emergency department (ED) visits.

Perceived usefulness of a mnemonic to improve nurses' evaluation of reported penicillin allergies.

We surveyed clinicians to evaluate the perceived usefulness of a mnemonic, STORY, to improve penicillin allergy evaluation. Survey responses indicated that the perceived usefulness of STORY was high, and support for nurses' involvement in penicillin allergy assessment was high. Future research may evaluate the feasibility of STORY implementation in clinical care.

Clinical course and outcomes in adults with co-occurring hypertrophic cardiomyopathy and hypertension: a scoping review protocol.

Introduction: Hypertension affects 40%-60% of adults with hypertrophic cardiomyopathy (HCM), the most common inherited cardiac condition. It can be a diagnostic confounder for HCM, contributing to delayed diagnosis. Clinically, treatment of co-occurring hypertension and HCM poses challenges as first-line and second-line antihypertensive medications are often contraindicated in HCM.

Early emergence of racial and ethnic differences in sleep health among toddlers living in low-income families.

Objectives: Emerging evidence suggests racial and ethnic and socioeconomic differences in children's sleep health, yet few have examined these differences among very young children. The purpose of this study is to identify potential racial, ethnic, and sociodeomographic factors associated with multiple dimensions of sleep health in toddlers living in very low-income families.

Participants: Sample included 110 racially and ethnically diverse dyads with toddlers aged 12-15 months living in low-income families.

Validation of Electronic Health Record-Based Algorithms to Identify Specialist Palliative Care Within the Department of Veterans Affairs.

Background: The measurement of specialist palliative care (SPC) across Department of Veterans Affairs (VA) facilities relies on algorithms applied to administrative databases. However, the validity of these algorithms has not been systematically assessed.

Measures: In a cohort of people with heart failure identified by ICD 9/10 codes, we validated the performance of algorithms to identify SPC consultation in administrative data and differentiate outpatient from inpatient encounters.

Pain self-management plus activity tracking and nurse-led support in adults with chronic low back pain: feasibility and acceptability of the problem-solving pain to enhance living well (PROPEL) intervention.

Background: Chronic low back pain can lead to individual suffering, high medical expenditures, and impaired social well-being. Although the role of physical activity in pain management is well established, the underlying mechanisms of biological and clinical outcomes are unknown. This study aimed to assess the feasibility and acceptability of a pain self-management intervention, Problem-Solving Pain to Enhance Living Well, which employs wearable activity tracking technology and nurse consultations for people with chronic low back pain.

Rest-activity rhythms predict time to hospitalizations and emergency department visits among participants in a randomized control of adults with heart failure and insomnia.

Background: We examined the effects of insomnia and diurnal rest-activity rhythms (RARs) on time to hospitalizations and emergency department (ED) visits in a randomized controlled trial of cognitive behavioral therapy for insomnia among people with chronic heart failure (HF) and insomnia.

Methods: Among 168 HF patients, we measured insomnia, CPAP use, sleep, symptoms, and 24-h wrist actigraphy and computed the circadian quotient (strength of the RAR) from wrist actigraphy and computed cox-proportional hazard and frailty models.

Results: Eighty-five (50.

An Evolutionary Concept Analysis in People With Heart Failure-Symptom Clusters or Symptom Cluster Profiles?

The concept of symptom clusters in heart failure (HF) has been defined and measured inconsistently. We used Rodgers' evolutionary method to review related concepts in the HF literature. Symptom clusters and symptom cluster profiles are characterized by multiple symptoms, a synergistic relationship, and result in a myriad of poor outcomes.

The Feasibility and Acceptability of a Diabetes Survival Skills Intervention for Persons Transitioning from Prison to the Community.

Community evidenced-based diabetes self-management education (DSME) models have not been examined for feasibility, acceptability, or effectiveness among persons transitioning from prison to the community to independent diabetes self-management (DSM). In a non-equivalent control group design with repeated measures, we examined the feasibility, acceptability, and preliminary effect of a 6-week, 1-h per week Diabetes Survival Skills (DSS) intervention on diabetes knowledge, distress, self-efficacy, and outcome expectancy for transitioning incarcerated males. Of the 92 participants (84% T2D, 83% using insulin, 40% Black, 20% White, 30% Latino, 66% high school or less, mean age 47.

Targeted Approaches, Universalism, and Targeted Universalism: Opportunities for the U.S. Correctional Health Care System.

Social policy has traditionally been implemented in two ways: using targeted or universal approaches. Each of these mechanisms has advantages and disadvantages to the populations to whom the policies are applied and to the system applying the policies. A third approach to social policy implementation has emerged: targeted universalism.

Participation in an Attachment-Based Home Visiting Program Is Associated with Lower Child Salivary C-Reactive Protein Levels at Follow-Up.

Objective: Exposure to early childhood adversity is associated with an increased risk for physiological disruption, including increased inflammation. Early interventions that support the mother-child relationship have been shown to potentially buffer negative psychosocial outcomes related to early adversity, but it is unclear whether these interventions have long-term biological effects. We evaluated whether prior participation in Minding the Baby® (MTB), an attachment-based home visiting intervention for young mother-infant dyads living in underserved communities, is associated with lower child salivary inflammatory biomarkers compared with controls at follow-up.

Screening for Social Determinants of Health in the Pediatric Intensive Care Unit: Recommendations for Clinicians.

Social determinants of health (SDoH) play a significant role in the health and well-being of children in the United States. Disparities in the risk and outcomes of critical illness have been extensively documented but are yet to be fully explored through the lens of SDoH. In this review, we provide justification for routine SDoH screening as a critical first step toward understanding the causes of, and effectively addressing health disparities affecting critically ill children.

Contemporary adult gerontology acute care nurse practitioner (AGACNP) practice: Findings from the 2020 American Association of Critical Care Nurses AGACNP practice analysis survey.

Background: National standards for nurse practitioner licensure require certification programs to conduct practice analyses to ensure that certified nurse practitioners possess the necessary knowledge for entry-level practice. The practice analysis for the American Association of Critical Care Nurses Certification Corporation (AACN Cert Corp) adult-gerontology acute care nurse practitioner (AGACNP) credential is performed every five years by the AACN Certification Corporation.

Purpose: The AACN Cert Corp conducted a practice analysis to confirm that current AGACNP practice is reflected in the ACNPC-AG test plan, and the examination is congruent with 2008 consensus model guidelines.

Sleep-related predictors of cognition among adults with chronic insomnia and heart failure enrolled in a randomized controlled trial of cognitive behavioral therapy for insomnia.

Study Objectives: Cognitive impairment and insomnia are common in chronic heart failure (HF). We examined the effects of cognitive behavioral therapy for insomnia (CBT-I) and the extent to which demographic, clinical, symptom, and functional characteristics predicted cognition among people with chronic HF and insomnia who participated in a randomized controlled trial of CBT-I.

Methods: Participants with HF were randomized to group-based CBT-I or an attention control (HF self-management education).

Barriers and Facilitators of Pain Self-Management Among Patients with Cancer: An Integrative Review.

Background: Defining the main barriers and facilitators of cancer pain self-management are essential to improve patients' overall quality of life.

Aim: The main purpose of this review was to identify the main barriers and facilitators for cancer pain self-management.

Method: An integrative review guided by the five-stages framework that was identified by Souza et al.

Storytelling: Manifesting Integral Interconnectedness in Holistic Nursing Education.

This paper presents a middle-range theory of storytelling in nursing education. Both explanatory and predictive, the theory further develops the existing conceptual work on the topic of storytelling. It places storytelling as a pedagogical technique within the realm of holistic nursing theory and philosophy.

Dr. Saba's innovative contributions to nursing informatics.

Dr. Virginia Saba, Ed.D.