Sternal Wound Management in Pediatric Cardiac Surgical Patients: A Novel Strategic Interprofessional Approach.

Objective: Information on sternal wound management in children after cardiac surgery is limited. The authors formulated a pediatric sternal wound care schematic incorporating concepts of interprofessional wound care and the wound bed preparation paradigm including negative-pressure wound therapy and surgical techniques to expedite and streamline wound care in children.

Methods: Authors assessed knowledge about sternal wound care among nurses, surgeons, intensivists, and physicians in a pediatric cardiac surgical unit regarding the latest concepts such as wound bed preparation, NERDS and STONEES criteria for wound infection, and early use of negative-pressure wound therapy or surgery.

Assessing the Impact of Weighted Blankets on Anxiety Among Patients With Anorexia Nervosa and Avoidant- Restrictive Food Intake Disorder: A Randomized Controlled Trial.

Importance: Interventions to reduce anxiety are needed for patients with anorexia nervosa (AN) and avoidant- restrictive food intake disorder (ARFID). Weighted blankets are one such intervention.

Objective: To evaluate the impact of weighted blankets on anxiety for patients with AN and ARFID.

Practice Integration as an Effective Educational Strategy.

Bundles are composed of individually established practices supported by research that, when combined, structure patient care. Implementing bundles improves patient outcomes. The ABCDEF initiative is an example of a bundled approach that improves outcomes of critically ill patients that are related to the likelihood of hospital death within 7 days, delirium and coma days, physical restraint use, intensive care unit readmission, and discharge disposition, with outcomes being proportional to the number of appropriate components performed.

Program Evaluation of an Early Nurse Intervention Team.

Background: Many hospitals have implemented early rapid response teams to improve detection of patients at risk for decline. However, formal evaluation of these programs is rare.

Objective: To evaluate the Early Nurse Intervention Team program at a large community hospital in the southeastern United States.

Interprofessional Simulation to Improve the Understanding of Obstetric Sepsis.

Sepsis parameters are not well defined for the obstetric population, which can result in delayed recognition. The escape room-based simulation sought to improve obstetric providers' and nurses' understanding, identification, and timely treatment of maternal sepsis. Participants expressed interest and enthusiasm in using this learning style to improve care of the sepsis patient.

Development and Testing of an Electronic Multidisciplinary Rounding Tool.

Patients hospitalized with neurologic and medical issues in the neuroscience critical care unit have widely varying and complex disease states that can change rapidly. The large amount of data that must be reviewed regularly by medical staff members presents a challenge to the provision of high-quality care to these patients. In an effort to lessen the burden, the authors' team implemented an electronic multidisciplinary rounding tool, which facilitates team communication by allowing accurate and concise review of patient information.

Simulation for Clinical Preparedness in Pediatric Emergencies: A Pilot Study.

Positive outcomes for pediatric in-hospital cardiopulmonary arrest remain low with little change in mortality rates. Infrequently used clinical knowledge and skills decline quickly, contributing to poor quality of resuscitation. The aim of this pilot study exploring the outcomes of repeated pediatric mock code simulations with structured debriefing demonstrated statistically significant differences in participants' knowledge of pediatric emergencies, with no significant decline in resuscitation skills.

Creating a Culture of Mobility: Using Real-Time Assessment to Drive Outcomes.

Background: Recent studies have demonstrated the safety and feasibility of early mobilization of patients in the hospital setting. Promoting early mobility improves patients' ability to perform daily activities and attend to basic needs. It also preserves patients' dignity and independence.

Can You Escape? Creating an Escape Room to Facilitate Active Learning.

Nursing professional development practitioners have the responsibility to find creative and innovative ways to teach and provide learners with the education needed to practice safely in the hospital setting. This article describes an interactive game-based learning experience as a way to engage and empower both nurse residents and experienced nurses.

Empowering Bedside Nurses to Lead Discussion Groups.

This article focuses on an approach three clinical nurse educators used to empower their Telemetry Education Nurse Team to grow professionally. The clinical nurse educators mentored the Telemetry Education Nurse Team, who were then able to facilitate successful discussion groups for their organization.

Emergency Airway Response Team Simulation Training: A Nursing Perspective.

Background: Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants.

Effect of Peer-to-Peer Nurse-Physician Collaboration on Attitudes Toward the Nurse-Physician Relationship.

The goal of this study was to pilot a novel peer-to-peer nurse-physician collaboration program and assess for changes in attitudes toward collaboration among a group of newly licensed nurses and resident physicians (n = 39). The program included large group meetings, with discussion of key concepts related to interprofessional collaboration. In unit-based teams, the registered nurses and physicians developed a quality improvement project to meet a need on their unit.

External Ventricular Catheters: Is It Appropriate to Use an Open/Monitor Position to Adequately Trend Intracranial Pressure in a Neuroscience Critical Care Environment?

Intracranial pressure (ICP) monitoring can be an important assessment tool in critically and acutely ill patients. An external ventricular drain offers a comprehensive way to monitor ICP and drain cerebrospinal fluid. The Monro-Kellie hypothesis, Pascal's principle, and fluid dynamics were used to formulate an assumption that an open/monitor position on the stopcock is an adequate trending measure for ICP monitoring while concurrently draining cerebrospinal fluid.

CJD: Understanding Creutzfeldt-Jakob disease.

Rare, transmissible, and rapidly progressive, Creutzfeldt-Jakob disease (CJD) is an ultimately fatal central nervous system infection caused by accumulation of abnormally shaped prion proteins in neurons (see Understanding prion proteins). Although categorized as an infection, CJD doesn't lead to the immune system or inflammatory response typical of most infectious diseases. This article discusses the pathophysiology and diagnosis of this terminal illness and nursing care for patients with suspected or confirmed CJD.

Simulation Improves Nurses' Adherence With Stroke Quality Measures.

Simulation engages nurses in learning within a safe environment. This teaching method evaluates both skill and knowledge attainment, but evaluating the impact on patient outcomes after a simulation training event is limited. This article reviews the impact simulation training had on nurses' adherence to stroke quality measures.

Educating certified nursing assistants educational offerings on the run and more.

Certified nursing assistants (CNAs) are important partners in the delivery of quality care to patients. Nurse educators are challenged with providing "just-in-time" education to CNAs within the constraints of a fast-paced clinical environment. This article will discuss a successful CNA training program and lessons learned for improving just-in-time education to assistive personnel.

Improving the culture of evidence-based practice at a Magnet® hospital.

Evidence-based practice (EBP) is the foundation of quality care, but EBP is not widely adopted. This study evaluated the impact of a hospital-wide EBP nursing project on the organizational culture of a Magnet hospital. Results of pre- and postintervention surveys suggest the intervention increased the nurses' confidence in the hospital's EBP environment.