Nursing最新文献_第2页

Caring for a patient with Fournier gangrene. 照顾一个福涅尔坏疽病人。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000492

引用次数: 0

A Thanksgiving tribute. 感恩节献礼。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000502

Linda Laskowski-Jones

引用次数: 0

The quiet power of encouragement: How mentorship shaped my nursing journey. 鼓励的无声力量：导师如何塑造了我的护理之旅。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000472

Brauna Selby

引用次数: 0

Demystifying credentialing and privileging for clinical nurse specialists. 揭开临床护理专家资格认证和特权的神秘面纱。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000464

Molly Archer

{"title":"Demystifying credentialing and privileging for clinical nurse specialists.","authors":"Molly Archer","doi":"10.1097/NSG.0000000000000464","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000464","url":null,"abstract":"Abstract: A clinical nurse specialist (CNS) is an advanced practice registered nurse who holds a graduate degree and specializes in managing specific patient populations or disease types, bringing advanced clinical expertise to diagnose, treat, and oversee care for individuals and improve population health conditions. CNSs serve as clinical leaders, educators, and practitioners of evidence-based care, driving improvements in patient outcomes and instigating transformational organizational change within health care systems. Their scope of practice is broad, encompassing assessment, care coordination, consultation, and, where permitted, prescribing and procedural privileges, all founded upon rigorous academic and clinical standards. The process of credentialing ensures that CNSs meet established educational, training, licensure, and competency criteria before providing care, while privileging authorizes them to perform specialized clinical activities within health care facilities. Unfortunately, CNSs often face regulatory and institutional barriers, such as misclassification, restrictive state laws, and inconsistent privileging criteria, which undermine their ability to fully utilize their advanced skills and impede the recognition of their contributions. Such obstacles can limit professional growth and restrict independent practice and reimbursement opportunities. This article discusses credentialing, privileging, mapping, patient encounters, and workload for CNSs, who are often overlooked and underutilized in advanced practice conversations despite providing safe, high-quality, and cost-effective care for specialty populations.","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 11","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical improv as a strategy for creative problem-solving and positive change. 医疗即兴表演作为创造性解决问题和积极改变的策略。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000487

Beth Boynton

{"title":"Medical improv as a strategy for creative problem-solving and positive change.","authors":"Beth Boynton","doi":"10.1097/NSG.0000000000000487","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000487","url":null,"abstract":"Abstract: Unsafe staffing, bullying and incivility, and burnout and compassion fatigue are examples of three chronic and pervasive problems that nurses face. At their roots, they involve issues associated with emotional intelligence and communication-related skills, also known as \"soft\" skills. For nurses to be effective and positive change agents in addressing these and other challenging problems, they must be proficient in such skills and competencies. This article examines the importance of soft skills in addressing key professional and practice-related challenges, and discusses strategies for developing these competencies through experiential learning, particularly medical improv. This approach can help nurses strengthen essential communication, collaboration, adaptability, empathy, and leadership skills. The \"YES AND\" philosophy of medical improv is described and specifically examined through learning associated with emotional intelligence, communication, teamwork, and leading and following. Discussions about nuances and questions that arise in medical improv sessions and implications for practice are included to further demonstrate the relevance and complexity of this modality and its potential to support nurses as positive change agents individually and collectively.","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 11","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric abusive head trauma: A nursing call to action. 儿童虐待性头部创伤：护理行动呼吁。

Nursing Pub Date : 2026-11-01 Epub Date: 2026-10-19 DOI: 10.1097/NSG.0000000000000491

引用次数: 0

Achalasia: A nursing perspective. 失弛缓症：护理的视角。

Nursing Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1097/NSG.0000000000000483

引用次数: 0

Controlled substance medication safety rounds: A 3-year journey. 管制药物用药安全回合：3年旅程。

Nursing Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1097/NSG.0000000000000474

Summera Zaheer, Sharron Coffie

{"title":"Controlled substance medication safety rounds: A 3-year journey.","authors":"Summera Zaheer, Sharron Coffie","doi":"10.1097/NSG.0000000000000474","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000474","url":null,"abstract":"Background: Controlled substance diversion amid the opioid epidemic threatens patients, health care workers, organizations, and communities, underscoring the need for effective prevention and response strategies within health systems.Purpose: A 3-year performance improvement initiative at a large academic medical center was undertaken to enhance awareness of medication safety related to controlled substance (CS) chain of custody. This article describes the implementation of CS medication safety rounds (CSMSRs) across three phases, with a primary focus on Phase III (2023-2024).Method: Using a Plan-Do-Study-Act (PDSA) framework, a seven-member interdisciplinary team implemented CSMSRs in ambulatory clinics, pharmacies, inpatient nursing units, and procedural areas. Proactive on-site evaluations engaged nurses and provided real-time feedback, improving adherence to best practices and strengthening CS safety and accountability.Results: Nurses reported appreciation for the in-person CSMSRs and the opportunity to engage in dialogue regarding their adherence to institutional policies, equipment management, education options, and meaningful staff support resources.Conclusion: CSMSRs provided a platform for open dialogue, anonymous feedback, psychological safety, and accountability in CS management. Continued rounds are expected to engage nurses in sustaining safe practices, advancing opioid stewardship, and strengthening a culture of patient and employee safety.","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 10","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accidental overdoses and adverse effects from compounded GLP-1 agonists. 复合GLP-1激动剂的意外过量和不良反应。

Nursing Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1097/NSG.0000000000000471

Jana O'hara, Shannon Bertagnoli

引用次数: 0

Passive leg raise as a noninvasive nursing intervention to predetermine fluid responsiveness in patients with sepsis in the emergency department: A comparative cohort study. 被动抬腿作为一种无创护理干预，预先确定急诊科脓毒症患者的液体反应性：一项比较队列研究

Nursing Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1097/NSG.0000000000000468

Janet Gregory, Catherine Restua, Marie Baumann, Mary Ann Esquela, Laura Gobeli, Vicki Harbeck, Lowine Sarbacker, Gregg Shoemaker, Tu Sibert, Charles Wellington, Shameya Ceasar, Jessica Peterson, Tajudaullah Bhaloo

{"title":"Passive leg raise as a noninvasive nursing intervention to predetermine fluid responsiveness in patients with sepsis in the emergency department: A comparative cohort study.","authors":"Janet Gregory, Catherine Restua, Marie Baumann, Mary Ann Esquela, Laura Gobeli, Vicki Harbeck, Lowine Sarbacker, Gregg Shoemaker, Tu Sibert, Charles Wellington, Shameya Ceasar, Jessica Peterson, Tajudaullah Bhaloo","doi":"10.1097/NSG.0000000000000468","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000468","url":null,"abstract":"Background: Sepsis-related hypotension is treated by administration of intravenous fluids. Excess fluid volume can result in pulmonary edema and respiratory failure. Monitoring increases in patients' end-tidal carbon dioxide (ETCO2) in response to a passive leg raise (PLR) is a noninvasive method to evaluate fluid responsiveness.Objective: To determine the effectiveness of PLR and ETCO2 monitoring after initial fluid resuscitation among spontaneously breathing or intubated patients with sepsis.Methods: Using a quantitative comparative design, the study compared the total amount of fluid administered and outcomes between two cohorts of patients with sepsis in the emergency department (ED): the preintervention retrospective cohort (n = 259) who did not receive PLR, and the intervention prospective sample (n = 77) who received the PLR intervention. Supplementary analyses divided the intervention group into those who did (n = 28) and did not (n = 49) meet criteria for fluid responsiveness, comparing fluid administration totals.Results: Patients who received PLR had a higher total fluid volume administered than the preintervention group (P < .001). Tachycardia was more common in the preintervention group than in the intervention group (P < .001). Of the patients who received PLR, 64% were identified as negative fluid responders. These patients had lower mean total fluid administration, although the difference was not statistically significant (P = .06).Conclusion: This study demonstrates that PLR can be instrumental in assessing fluid responsiveness among ED patients with sepsis who are spontaneously breathing or intubated.","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 10","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0