The efficacy of gum chewing in reducing postoperative ileus: a multisite randomized controlled trial.

Purpose: The purpose of this prospective, attention-controlled, randomized study was to determine whether postoperative gum chewing reduces the duration of postoperative ileus symptoms following elective open or laparoscopic sigmoid colectomy when compared with standard care or an attention-control intervention.

Subjects And Settings: Forty-seven subjects scheduled for either an open or laparoscopic colon resection participated in the study. Subjects were recruited preoperatively at the preadmission learning centers of the 2 acute care medical centers that comprised the study settings.

When the usual symptoms become an unusual diagnosis: a case report of trifunctional protein complex.

Disorders of mitochondrial fatty acid b-oxidation should be considered in any infant who presents with unexplained hypoglycemia and/or myopathy. Although disorders of trifunctional protein (TFP) complex including long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) and mitochondrial TFP deficiencies are extremely rare, the combined incidence of mitochondrial fatty acid disorders is quite frequent. With the expansion of newborn screening, what were once considered uncommon disorders are being identified with increasing frequency in asymptomatic infants.

A systematic review on the transfer of information during nurse transitions in care.

Aims And Objectives: To examine the qualitative evidence on dynamics of knowledge transfer during transitions in care in acute care hospitals.

Background: The most common transition between nurse care providers is the intershift handoff. As these handoffs tend to be time-consuming and costly, it is important to understand the dynamics of the transfer of information at this time and, by extension, improve quality and safety.

Interpreting and using meta-analysis in clinical practice.

Systematic reviews, which can include a meta-analysis, are considered the gold standard for determination of best practice. Meta-analysis combines the results from many primary studies to identify patterns among the individual study results and then assesses the overall effectiveness of a specific healthcare intervention. The purpose of this article was to describe the process of performing a meta-analysis, discuss advantages and disadvantages of meta-analyses, and interpret the results of a meta-analysis from current research relevant to orthopaedic nursing practice.

Acute delirium: differentiation and care.

The health care costs for patients with delirium were estimated to be more than double the costs for patients without delirium and potentially exceeded the costs for falls, diabetes mellitus, and hip fractures; yet the fluctuating nature of the condition makes it a difficult condition for health professionals to recognize and treat. The key, then, is in recognition and prevention.

A two-round Delphi study examining consensus of recommended clinical practices for patients with ventricular assist devices as destination therapy.

Objective: To identify the current clinical practices of Medicare-certified facilities offering ventricular assist devices as destination therapy and to attain a consensus of recommended clinical practices across the United States for the management of adults with ventricular assist devices as destination therapy.

Method: Sixty ventricular assist device coordinators from Medicare-certified centers were invited to participate in an online, 2-round Delphi survey. The surveys asked whether recommended practices are current practices and whether respondents always/agreed or never/disagreed with performing the recommended practice guidelines.

Effectiveness of patient-caregiver dyad discharge interventions on hospital readmissions of elderly patients with community acquired pneumonia: a systematic review.

Background: The aim of discharge planning is to reduce unplanned readmission to the hospital and improve coordination of care. As the global population ages, including family caregivers in discharge planning maybe an effective strategy to improve patient outcomes and quality of care. In the United States, hospital readmission following discharge for community acquired pneumonia is a process measure utilized to evaluate discharge planning outcomes.

The effectiveness of group medical visits on diabetes mellitus type 2 (dm2) specific outcomes in adults: a systematic review.

Background: The prevalence of diabetes mellitus is ubiquitous. Complications and costs of diabetes are rising and are depleting limited resources. It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions.

Telehealth in adult patients with congestive heart failure in long term home health care: a systematic review.

Background: Congestive heart failure results in clinical signs of edema, shortness of breath, and decreased quality of life. The effective management of patients with congestive heart failure in long term home care settings is important in reducing rehospitalization, emergency department visits and improving quality of life. Telehealth interventions following hospital discharge in various settings have been reported in the published literature as having an impact on decreasing emergency department visits, rehospitalization and quality of life.

Interactive immersive learning in higher education.

An expanded definition of simulation encompasses patient simulators, avatars, and virtual learning environments. This article explains the elements and advantages of each of these education modalities.

Sexually speaking: The whole truth about IUDs.

Nurses are perfectly positioned to offer women accurate information about an often-neglected contraceptive method.

Nurse-directed care model in a psychiatric hospital: a model for clinical accountability.

Purpose: The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care delivery model in a state psychiatric hospital.

Description Of The Project: The quality improvement project team instituted a new model to promote the hospital's vision of wellness and recovery through utilization of the therapeutic relationship and greater clinical accountability.

Visits coded as intimate partner violence in emergency departments: characteristics of the individuals and the system as reported in a national survey of emergency departments.

Introduction: This study was conducted to explore the characteristics of intimate partner violence (IPV) victims whose visit was coded as IPV and the health care delivery system in emergency departments (ED).

Methods: This study utilized a secondary data analysis of a national probability sample that comprised the National Hospital Ambulatory Medical Care Survey for 1997 to 2001.

Results: There were 111 coded ED visits of IPV victims 16 years or older (equivalent of 482,979 out of 4 million national visits for the 5-year study period).

Implementing the clinical nurse specialist role in a regional state psychiatric hospital.

Clinical nurse specialists (CNSs) are essential to enhancing psychiatric-mental health nursing within state psychiatric hospital settings. This article presents a project focused on the CNSs in a state psychiatric hospital to expand their clinical role to increase the quality of care to individuals with serious mental illness and their numbers in other state psychiatric hospitals. As the patient population served in these settings becomes more complex, it is critical that advanced practice nurses are provided with appropriate updated state-of-the-art advanced knowledge and skills to collaborate within the interdisciplinary team.

Sleep disorders, glucose regulation, and type 2 diabetes.

Recent epidemiological, biological, and behavioral evidence suggests that sleep disorders may contribute to the development of diabetes; conversely, diabetes itself may contribute to sleep disorders. Sleep appears to moderate the neurohormones that regulate blood glucose. Sleep deprivation and sleep disorders contribute to pathophysiological changes associated with the development of type 2 diabetes.

Legacy of diabetes and self-care behavior.

The effect of multigenerational legacies of diabetes on health beliefs and behaviors was explored. Diabetic participants (N = 123) with family histories of diabetes responded to survey questions about their own diabetes self-care behavior, illness representation (including consequences and controllability of diabetes), recollection of a family member's illness representation and complications, and perceived social consequences of diabetes. Recollections about family members' disease controllability (r = .