Transitioning Nurse Handoff to the Bedside: Engaging Staff and Patients.

The emergency department is a complex environment in which reliable communication is vital for safe patient care. Communication during nurse shift report can be risky without an effective report process in practice. Reliability improves with the use of a standardized, patient-centered nurse handoff process.

Implementing a Protocol to Improve Self-Care Behaviors in Adult Patients With Heart Failure.

Background: Heart failure (HF) is a condition that affects millions of Americans and costs $30 billion to treat annually. HF is the cause for frequent hospitalizations. Self-care practices have been found to improve quality of life, decrease hospitalizations, and reduce treatment costs.

CE: Venous Thromboembolism: Updated Management Guidelines.

: Venous thromboembolism (VTE) is a leading cause of death and disability worldwide. Each year, more than 10 million cases of VTE are diagnosed; studies suggest there are as many as 900,000 cases per year in the United States. The condition is estimated to cost the U.

Implementing an Alcohol Withdrawal Protocol: A Quality Improvement Project.

This quality improvement project evaluates the effectiveness of implementing an evidence-based alcohol withdrawal protocol in an acute care setting. Patient outcomes, length of stay, and nurses' knowledge and satisfaction with care are compared pre- and postimplementation. Implementation resulted in significant reduction of restraint use, transfers to critical care, 1:1 observation, and length of stay, whereas no reduction was seen in rapid response calls.

Nurse-Driven Catheter-Associated Urinary Tract Infection Reduction Process and Protocol: Development Through an Academic-Practice Partnership.

Translating evidence-based practices to the bedside can be facilitated by an active academic-practice partnership between nursing faculty and frontline nursing staff. A collaborative effort between the university's academic nurses and the medical center's clinical nurses explored, created, implemented, and evaluated an evidence-based nurse-driven protocol for decreasing the rate of catheter-associated urinary tract infections. The nurse-driven protocol was piloted in 4 intensive care units and included nurse-driven orders for catheter discontinuation, utilization of smaller bore urinary catheters, addition of silver-based cleansing products for urinary catheter care, and education of staff on routine catheter care and maintenance.

Providing Breast Cancer Survivorship: Lessons Learned From a Pilot Project Implementation.

Background: Many cancer survivors have gaps in knowledge of their disease and treatments received.

Objective: The goal of this project was to evaluate the development and implementation of a pilot breast cancer survivorship program aimed at decreasing the gap in patient knowledge of disease and treatment, from both the staff and patient perspectives.

Methods: A mixed methods approach used data from multiple sources: (1) historical data, (2) medical record review, (3) a mailed patient questionnaire, (4) 1:1 semistructured telephone interviews with patients, and (5) 1:1 semistructured interviews with staff members.

Relationships Among Perceived Stress, Bullying, Cortisol, and Depressive Symptoms in Ninth-Grade Adolescents: A Pilot Study.

Adolescence is considered a critical period for risk of depressive symptoms, with prevalence ranging from 13% to 34%. Few studies have examined the relationships among perceived stress, bullying, and depressive symptoms accompanied by a biological marker of stress (cortisol). The purpose of this pilot study was to determine the feasibility of collecting biological specimens in a high school setting, including a morning and afternoon sample of salivary cortisol as well as computer-based survey data in order to examine the relationships among these variables in ninth-grade adolescents.

Improving transition of care for veterans after total joint replacement.

Background: Patients transitioning from hospital to home are at risk for readmission to the hospital. Readmissions are costly and occur too often. Standardized discharge education processes have shown to decrease readmissions.

Deployment of lean six sigma in care coordination: an improved discharge process.

Purpose/objectives: This article presents a quality improvement project to reduce readmissions in the Medicare population related to heart failure, acute myocardial infarction, and pneumonia. The article describes a systematic approach to the discharge process aimed at improving transitions of care from hospital to post-acute care, utilizing Lean Six Sigma methodology.

Primary Practice Setting: Inpatient acute care hospital.

Safe and effective pain management in elders.

The elderly are often either untreated or undertreated for pain. The consequences of undertreatment for pain can have a devastating impact on health and quality of life, resulting in depression, anxiety, social isolation, cognitive impairment, immobility, and sleep disturbances. Reasons cited by healthcare professionals for inadequate pain control include lack of training, inappropriate pain assessment, and reluctance to prescribe opioids, however, the undertreatment of pain can be legally considered to constitute neglect, abuse, or negligence.

Concept mapping a baccalaureate nursing program: a method for success.

The understanding of curricular design and development is paramount for faculty. For novice faculty, learning teaching methods commonly takes precedence over understanding curriculum development. Professional accrediting bodies of nursing programs require curriculum course content to be pertinent and flow logically.

The relationships among adaptive behaviors of children with autism, family support, parenting stress, and coping.

Background: As the number of children diagnosed with autism continues to rise, resources must be available to support parents of children with autism and their families. Parents need help as they assess their unique situations, reach out for help in their communities, and work to decrease their stress levels by using appropriate coping strategies that will benefit their entire family.

Methods: A descriptive, correlational, cross-sectional study was conducted with 75 parents/primary caregivers of children with autism.

Antidepressants and sleep: a review.

Purpose: Insomnia is one of the most common symptoms seen in both primary and psychiatric care. Sleep hypnotics and benzodiazepines are the drugs of choice for insomnia but are not appropriate for all patients.

Conclusion: The sedating tricyclics, the serotonin-2A receptor antagonist/serotonin-reuptake inhibitor antidepressants, and the atypical antidepressants can improve sleep and return sleep architecture to its restorative function.

A CRASH course in cultural competence for nurses.

Nurses are at the forefront of providing health care and need to be sensitive to the unique needs of all populations. Because urologic nurses care for individuals with sometimes embarrassing health care needs, we encourage urologic nurses to take a CRASH course in cultural competence, combining knowledge of Culture, Respect and Assessment of others' worldviews, Sensitivity to cultural differences, and providing care with Humility that can be integrated into urology. Resources for increasing cultural competence are also suggested.

Native Americans: traditional healing.

There are an estimated 4.1 million people who are classified as American Indian and Alaska Native alone or in combination with one or more other races. This racial group composes 1.

Problem behaviors of children adopted from the former Soviet Union.

Introduction: Although current meta-analyses of problem behavior of internationally adopted children exist, few children adopted from the former Soviet Union have been included in these reports. A significant concern is that 13 children adopted from the former Soviet Union have died at the hands of their American adoptive parents since 1996.

Method: A cohort of 105 children adopted from the former Soviet Union has been assessed at two points in time by telephone and postal surveys to measure the impact of risk and protective factors on problem behavior.

Women and health care.

Women have specific health risks not only because of their race, ethnicity, and lifestyle, but they also have unique risks related to gender. Women in industrialized countries such as the United States have multiple indicators of morbidity but lower rates of mortality than men. Among women from different racial and ethnic groups, there are clear differences in morbidity and mortality.