"Live your life cuz everybody's terminal": Describing emotions and coping behaviors of rural advanced cancer patients.

Purpose: Culturally competent health care has led to increasing interest in how patients' identities influence the management of their health. The ways rural patients with advanced cancer process emotions and cope with their disease may be influenced by their rural context. The aims for this study were to (1) describe the emotions rural cancer patients experience, (2) describe how rural cancer patients manage their emotions within their rural context, and (3) interlace the themes related to coping with emotions.

Evaluating a symptom-triggered gastric residual volume policy in a surgical trauma intensive care unit: Simple and safe.

Background: Routine checking of gastric residual volumes (GRVs) during enteral feeding within surgical trauma intensive care units (STICUs) is a common practice. However, data on the necessity of this practice and its impact on nutrient delivery are limited. We aim to study the association between the replacement of a routine GRV (rGRV) policy with a triggered GRV (tGRV) policy and the safe achievement of daily nutrition goals.

Implementation of an accelerated discharge process following percutaneous coronary intervention for patients with non-ST elevation acute coronary syndromes.

Aims: Historically, patients with non-ST elevation acute coronary syndrome (NSTE-ACS) are monitored as inpatients following successful percutaneous coronary intervention (PCI), but accumulating evidence demonstrates that accelerated discharge is safe, reduces cost, and enhances patient satisfaction. This quality improvement project examined the impact of implementing a post-PCI streamlined discharge process for NSTE-ACS patients on length of stay (LOS), major adverse cardiovascular events, and provider utilization at a university-affiliated hospital system.

Methods And Results: Clinical characteristics, the timing of admission, PCI, and discharge data were collected prospectively from patients presenting to the catheterization laboratory for intervention for NSTE-ACS during 90-day historical control and implementation periods.

Preparing Advanced Practice Registered Nursing Students to Provide Primary Palliative Care.

Background: Advanced practice registered nursing students need primary palliative care education to care for the growing number of patients with serious illness and their families and to fill the serious resource gaps in specialty palliative care.

Problem: There has been a lack of primary palliative care education in most graduate nursing programs and little direction as to competencies and essential content.

Approach: In an effort to support faculty to teach palliative care content, the End-of-Life Nursing Education Consortium (ELNEC) has created an online curriculum that meets the new American Association of Colleges of Nursing Graduate-Competencies and Recommendations for Educating Nursing Students in primary palliative care for master's degree and doctor of nursing practice students.

Body temperature instability and respiratory morbidity in the very low birth weight infant: a multiple case, intensive longitudinal study.

Background: Very low birth weight (VLBW) infant thermal instability upon neonatal intensive care unit admission has been associated with respiratory morbidity; however, the association between ongoing thermal instability and respiratory morbidity remains unclear.

Methods: A longitudinal data analysis was conducted on 12 VLBW infants. Chronic respiratory morbidity risk was defined as supplemental oxygen requirement (FiO) or scheduled diuretic dosing at 36 weeks post-menstrual age.

Clinical nurses' perspectives on discharge practice changes from participating in a translational research study.

Aim: To describe clinical nurses' experiences with practice change associated with participation in a multi-site nursing translational research study implementing new protocols for hospital discharge readiness assessment.

Background: Nurses' participation in translational research studies provides an opportunity to evaluate how implementation of new nursing interventions affects care processes within a local context. These insights can provide information that leads to successful adoption and sustainability of the intervention.

Using Combined Tabletop and Simulation Activities to Improve Nursing Students' Attitudes About Quality Improvement: A Feasibility Study.

Nursing students' attitudes about quality improvement (QI) reflect poor understanding of its importance. In a mixed-method interventional feasibility study, students received instruction about QI processes, plus information about factors contributing to central line-associated bloodstream infection (CLABSI) rates at a hypothetical hospital. Experimental group students observed a high-fidelity simulation bedside report for a CLABSI-affected patient.

The Role of Helplessness in the Appraisal of Illness Uncertainty in Women With Fibromyalgia.

Fibromyalgia is a chronic pain disorder characterized by uncertainty in etiology, symptomatology, diagnosis, treatment, and outcome. The high level of illness uncertainty that results from fibromyalgia is a risk factor for maladjustment to illness. A cross-sectional survey design was used to examine the relationships among illness uncertainty, helplessness, and subjective well-being in 138 women with fibromyalgia.

Using the consolidated framework for implementation research to evaluate clinical trials: An example from multisite nursing research.

Background: The Consolidated Framework for Implementation Research (CFIR) is a comprehensive guide for determining the factors that affect successful implementation of complex interventions embedded in real-time clinical practice.

Purpose: The study aim was to understand implementation constructs in a multi-site translational research study on readiness for hospital discharge that distinguished study sites with low versus high implementation fidelity.

Methods: In this descriptive study, site Principal Investigator interviews (from 8 highest and 8 lowest fidelity sites) were framed with questions from 20 relevant CFIR constructs.

Investing in Nursing's Future.

Nursing leaders continue to struggle with capacity issues in both clinical and academic settings-particularly those related to aging patient and nurse populations and the increasing complexity of health care in general. Programs and resources for formal mentoring have primarily focused on mid- and advanced-career RNs, but there is an imperative to develop methods of expertly mentoring "professionally younger" RNs across all settings and roles. In 2017, the American Nurses Association (ANA) conducted an extensive member needs assessment with more than 15,000 respondents.

Reducing Blood Culture Contamination in the Emergency Department.

Background: Blood culture contamination results in delayed or unnecessary treatments, increased morbidity risk, extended lengths of hospital stay, and increased health care costs. Collecting 2 sets of blood cultures from separate sites helps differentiate bloodstream infections (BSIs) from contamination.

Local Problem: Blood culture contamination rates trailed the national threshold of less than 3% in one southeastern US emergency department (ED).

Developing a Workforce for Health in North Carolina: Planning for the Future.

Among the many trends influencing health and health care delivery over the next decade, three are particularly important: the transition to value-based care and increased focus on population health; the shift of care from acute to community-based settings; and addressing the vulnerability of rural health care systems in North Carolina.

Peer support during in vivo exposure homework to reverse attrition from prolonged exposure therapy for posttraumatic stress disorder (PTSD): description of a randomized controlled trial.

Background: Effective treatments for posttraumatic stress disorder (PTSD) (e.g., prolonged exposure (PE); cognitive processing therapy (CPT)) exist and are widely adopted by the Departments of Veterans Affairs (VA) and Defense (DoD).

Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents.

Purpose: There are growing concerns about patients' adherence to oral anticancer agents (OAAs), and the need for patients to engage in self-management of OAA-related side effects. We assessed associations among adherence, severity of side effects, and effectiveness of self-management of side effects in patients taking capecitabine.

Methods: Adherence to capecitabine at 6 weeks was measured by the Medication Event Monitoring System among 50 patients with gastrointestinal cancers.

CE: An Evidence-Based Update on Contraception.

Contraception is widely used in the United States, and nurses in all settings may encounter patients who are using or want to use contraceptives. Nurses may be called on to anticipate how family planning intersects with other health care services and provide patients with information based on the most current evidence. This article describes key characteristics of nonpermanent contraceptive methods, including mechanism of action, correct use, failure rates with perfect and typical use, contraindications, benefits, side effects, discontinuation procedures, and innovations in the field.

Mass Casualty Incident Simulation for a Small Space With Limited Resources.

To be able to respond appropriately and safely, nursing students must learn about the principles of triage and managing disasters. An accelerated bachelor of science in nursing program with limited resources (space and time) determined there was a need for education on these principles beyond the classroom and developed a mass casualty incident simulation for a small space and budget. Based on faculty and student evaluation, this activity was found to be effective in presenting and enhancing understanding of the principles for triage and disaster management as they relate to nursing.

Impact of a community-based approach to patient engagement in rural, low-income adults with type 2 diabetes.

Objective: This secondary analysis examined the relationships between Patient Activation Measure (PAM) scores, use of health services, and HgA1C.

Design: A feasibility study was conducted for a community-based intervention for high-risk adults with uncontrolled diabetes. Data were collected at baseline and monthly, including PAM and modified Diabetes Self-Management Assessment Report Tool.

Building Scholarship for Evidence-Based Practice in Undergraduate Nursing Students.

Journal clubs were utilized in an undergraduate nursing research course to achieve scholarship for evidence-based practice. Journal club members learned to critically appraise an assigned nursing research article by identifying the clinical problem, practicing literature search skills, and determining the research design and level of evidence. They also critically appraised the data collection methods, the sample size, and study outcomes and translated findings to practice.

Nonacademic Factors That Influence Nontraditional Nursing Student Retention.

The purpose of this study is to identify the most supportive and restrictive factors contributing to students' ability to persist through nursing program course completion as perceived by 59 nontraditional students enrolled in a nursing associate degree program. The Student Perception Appraisal-Revised tool was used. Results include that encouragement by friends within school is the top supportive factor, while financial status was found to be the most restrictive factor.

A Volume-Based Feeding Protocol Improves Nutrient Delivery and Glycemic Control in a Surgical Trauma Intensive Care Unit.

Background: Inadequate delivery of nutrition in critically ill patients has been shown to have adverse outcomes. A surgical trauma intensive care unit provides unique challenges to enteral feeds. Although volume-based feeding protocols, like Enhanced Protein-Energy Provision via the Enteral Route Feeding Protocol (PEP uP), have been successfully used in medical intensive care patients, data are sparse on its safety and efficacy in a surgical intensive care unit population.

Schizophrenia Spectrum Disorder Disparity Among African-Americans.

Worldwide, Schizophrenia Spectrum Disorder (SSD) affects a low percentage of individuals, but a severe health disparity exists for African-Americans, especially men. Several factors are contributing to this inequality. These factors occur at the individual, social, and organizational levels.

Development and Evaluation of a Theory-Based Approach to Reducing Carbon Monoxide (CO) Morbidity and Mortality: The CO Blitz Model.

Carbon monoxide (CO) poisoning is preventable yet remains the most common cause of U.S. non-drug poisoning.