The Hidden Morbidity of Cancer: Burden in Caregivers of Patients with Brain Metastases.

Caregiving is a highly individualized experience. Although numerous articles have been published on caregiver burden from a variety of diagnoses and conditions, this article presents the unique features of caregiving in patients with brain metastases. Improved long-term survival, concerns about disease recurrence or progression, the cancer experience (initial diagnosis, treatment, survivorship, recurrence, progression, and end of life), and the increasing complexity of cancer treatments add to the demands placed on the caregivers of patients with brain metastases.

Reports From RNs on Safe Patient Handling and Mobility Programs in Acute Care Hospital Units.

Objective: The aim of this study was to investigate the perceptions of RNs on the implementation of safe patient handling and mobility (SPHM) programs in states with and without SPHM legislation.

Background: Despite numerous strategies developed to reduce caregiver injuries, nurses are still experiencing work-related musculoskeletal injuries. A comprehensive SPHM program has been found to be effective in reducing patient handling injuries among nurses.

A novel method for expediting the development of patient-reported outcome measures and an evaluation across several populations.

Item response theory (IRT) models provide an appropriate alternative to the classical ordinal confirmatory factor analysis (CFA) during the development of patient-reported outcome measures (PROMs). Current literature has identified the assessment of IRT model fit as both challenging and underdeveloped (Sinharay & Johnson, 2003; Sinharay, Johnson, & Stern, 2006). This study evaluates the performance of Ordinal Bayesian Instrument Development (OBID), a Bayesian IRT model with a probit link function approach, through applications in two breast cancer-related instrument development studies.

Differences in Pediatric Pain Management by Unit Types.

Purpose: The purpose of this study was to determine differences in pediatric pain management by unit type in hospitals across the United States. The aims were to (a) compare unit-type rates of assessment, intervention, and reassessment (AIR), and (b) describe differences in assessment tools and intervention use by unit type.

Design: The study used a cross-sectional design.

Communication with Residents and Families in Nursing Homes at the End of Life.

Communication with residents and their families is important to ensure that the end-of-life experience is in accordance with resident's wishes. A secondary analysis was conducted to determine: (a) who should communicate with the resident/family about death and dying; (b) when communication should occur around death and dying, obtaining a "DNR" order, and obtaining a hospice referral; and (c) what differences exist in communication about death and dying between Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. Greater than 90% of staff (=2,191) reported that the physician or social worker should communicate about death and dying with residents/families, but only 53% thought that direct care staff should talk with them.

Coaching Model + Clinical Playbook = Transformative Learning.

Health care employers demand that workers be skilled in clinical reasoning, able to work within complex interprofessional teams to provide safe, quality patient-centered care in a complex evolving system. To this end, there have been calls for radical transformation of nursing education including the development of a baccalaureate generalist nurse. Based on recommendations from the American Association of Colleges of Nursing, faculty concluded that clinical education must change moving beyond direct patient care by applying the concepts associated with designer, manager, and coordinator of care and being a member of a profession.

The Ongoing Controversy: Crystalloids Versus Colloids.

There is still much debate over the optimal fluid to use for resuscitation. Different studies have indicated either crystalloid or colloid is the ideal intravenous solution to administer, based on mortality or various physiological parameters. Older studies found differences between crystalloids and colloids.

Emerging roles for telemedicine and smart technologies in dementia care.

Demographic aging of the world population contributes to an increase in the number of persons diagnosed with dementia (PWD), with corresponding increases in health care expenditures. In addition, fewer family members are available to care for these individuals. Most care for PWD occurs in the home, and family members caring for PWD frequently suffer negative outcomes related to the stress and burden of observing their loved one's progressive memory and functional decline.

The Preparation of Community/Public Health Nurses: Amplifying the Impact.

In summary, improved population health, population focused care, and community-based networks are the objectives of health care delivery systems. Community/public health nursing education, practice, and research must be re-examined, re-focused, and re-designed to address the challenges of an expanding 21st century health care delivery to populations and communities. Common standards are in place to be utilized by academia, practice and research.

Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers.

Purpose: To identify how organizational nursing factors at different structural levels (i.e., unit-level work environment and hospital Magnet status) are associated with hospital-acquired pressure ulcers (HAPUs) in U.

A novel method for expediting the development of patient-reported outcome measures and an evaluation of its performance via simulation.

Background: Developing valid and reliable patient-reported outcome measures (PROMs) is a critical step in promoting patient-centered health care, a national priority in the U.S. Small populations or rare diseases often pose difficulties in developing PROMs using traditional methods due to small samples.

A Collaborative Step-Wise Process to Implementing an Innovative Clinic for Adult Survivors of Childhood Cancer.

With a 5 year survival rate of approximately 80%, there is an increasing number of childhood cancer survivors in the United States. Childhood cancer survivors are at an increased risk for physical and psychosocial health problems many years after treatment. Long-term follow-up care should include education, development of individualized follow up plans and screening for health problems in accordance with the Children's Oncology Group survivor guidelines.

Nurse work environment and quality of care by unit types: A cross-sectional study.

Background: Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment.

The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family: Achieving Normalcy in Life.

Home parenteral nutrition (HPN) is a technologically complex, life-sustaining therapy for individuals who have intestinal failure. Accepting an invasive lifelong therapy like HPN is challenging for patients and their family caregivers. There is a desire to maintain a sense of normalcy in life and to carry on as usual.

Evaluation of Elements of the Nursing Worklife Model Using Unit-Level Data.

The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and Leiter posited causal relationships by development and testing of the Nursing Worklife Model (NWLM). Using a secondary analysis of unit-level data (N = 3,203; medical, surgical, medical-surgical, critical-care, and step-down units) from the 2011 National Database for Nursing Quality Indicators®, hypothesized pathways of the NWLM were tested using structural equation modeling.

Exploring leadership roles, goals, and barriers among Kansas registered nurses: a descriptive cross-sectional study.

Objectives: The Institute of Medicine's Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs).

Methods: Data were collected through an online survey and analyzed using quantitative and qualitative methods.

Response to Sijtsma and van der Ark (2015): "Conceptions of reliability revisited and practical recommendations".

Sijtsma and van der Ark present a broad set of models and methods for reliability estimation, and their discussion of similarities and differences provides clear information for nurse researchers to move forward in their instrument development projects. In particular, we applaud the authors' clear exposition of the factor analytic model and its utility for providing a framework for unifying reliability and validity. However, we do not want to be constrained only to the point estimates.

Pioneering through chaos.

The 2014 International Nursing Administration Research Conference, "Pioneering Through Chaos: Leadership for a Changing World," was held at the Texas Woman's University in Dallas, Texas, in the fall of 2014. The program drew more than 100 attendees from 4 countries. The conference informed attendees from both academe and practice about the role of nursing administration in navigating the dynamic healthcare climate.

Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta-Analysis.

Objective: Rheumatoid arthritis (RA) fatigue is not being well-managed currently, and evidence of effective interventions is limited. Aerobic exercise may provide benefit to treat fatigue in RA. Therefore, the purpose of this meta-analysis is to analyze the effect of aerobic land-based exercise on fatigue in RA.

Head-of-bed elevation and early outcomes of gastric reflux, aspiration and pressure ulcers: a feasibility study.

Background: Guidelines recommending head of bed (HOB) elevation greater than 30º to prevent ventilator-associated pneumonia conflict with guidelines to prevent pressure ulcers, which recommend HOB elevation less than 30º.

Objectives: To examine the feasibility of 45º HOB elevation and describe and compare the occurrence of reflux, aspiration, and pressure ulcer development at 30º and 45º HOB elevation.

Methods: A randomized 2-day crossover trial was conducted.

Organization of Hospital Nursing and 30-Day Readmissions in Medicare Patients Undergoing Surgery.

Background: Growing scrutiny of readmissions has placed hospitals at the center of readmission prevention. Little is known, however, about hospital nursing—a critical organizational component of hospital service system—in relation to readmissions.

Objectives: To determine the relationships between hospital nursing factors—nurse work environment, nurse staffing, and nurse education—and 30-day readmissions among Medicare patients undergoing general, orthopedic, and vascular surgery.

Costs of multidisciplinary parenteral nutrition care provided at a distance via mobile tablets.

Background: Determining the costs of healthcare delivery is a key step for providing efficient nutrition-based care. This analysis tabulates the costs of delivering home parenteral nutrition (HPN) interventions and clinical assessments through encrypted mobile technologies to increase patients' access to healthcare providers, reduce their travel expenses, and allow early detection of infection and other complications.

Methods: A traditional cost-accounting method was used to tabulate all expenses related to mobile distance HPN clinic appointments, including (1) personnel time of multidisciplinary healthcare professionals, (2) supply of HPN intervention materials, and (3) equipment, connection, and delivery expenses.

Infected Lives: Lived Experiences of Young African American HIV-Positive Women.

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. One pattern, Infected Lives, and three themes--Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal--emerged.

Higher numbers of nurses and consultants improve survival rates for critically ill patients.

Implications for practice and research: The number of nurses, as well as doctors, working in intensive care units (ICUs) is associated with patient mortality. Patients at high risk of death are more vulnerable if they are admitted to ICUs with lower nurse staffing, while higher unit workload in ICUs is associated with higher patient mortality. Future research would be aided by the establishment of standardised national electronic databases.

A secondary data analysis of Internet use in caregivers of persons with dementia.

Aim: This paper is a secondary data analysis to investigate relationships among caregiver stress appraisal, self-rated health and health-related Internet use.

Design: Cross-sectional correlation design.

Methods: National Alliance for Caregiving telephone survey conducted in the USA was a primary data source collected in 2009 from 258 caregivers of persons with dementia, who used the Internet to perform care-giving tasks.