Clinical Nurse Specialist最新文献

{"title":"To Bless the Space Between Us: Erratum.","authors":"","doi":"10.1097/NUR.0000000000000851","DOIUrl":"10.1097/NUR.0000000000000851","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 5","pages":"253"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned From a Clinical Nurse Specialist \"Elder\".","authors":"Deborah A Boyle","doi":"10.1097/NUR.0000000000000835","DOIUrl":"10.1097/NUR.0000000000000835","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 5","pages":"199-201"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Identification, Intervention, and Prevention of Hospital-Acquired Pressure Injuries Using a Nurse-Driven Pressure Injury Prevention Program.","authors":"Sharee McCray, Amy Donaldson","doi":"10.1097/NUR.0000000000000840","DOIUrl":"10.1097/NUR.0000000000000840","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>The purpose of this quality improvement project was to reduce the hospital-acquired pressure injury (HAPI) rate to less than 1.177 per 1000 patient-days, increase staff competency and care in pressure injury prevention best practices through implementation of a nurse-driven pressure injury prevention program, to engage patients in pressure injury prevention through implementation of skin rounds, and improve staff adherence to documentation requirements for pressure injury interventions on an amputee/stroke unit.</p><p><strong>Description of the project/program: </strong>HAPIs can lead to negative patient outcomes including pain, infection, extended hospitalization, and morbidity. Using an evidence-based education strategy, the Agency for Healthcare Research and Quality pressure ulcer prevention clinical pathway and skin rounds were implemented. Focused education for nursing, staff competency, daily audits, HAPI rates, and documentation compliance were evaluated pre and post intervention.</p><p><strong>Outcomes: </strong>The HAPI rate reduced from 1.177 to 0.272 per 1000 patient-days. After completion, the unit maintained zero pressure injuries, daily patient care for pressure injuries improved, documentation compliance increased, and staffs' knowledge and skill set in early identification, intervention, and prevention of pressure injuries heightened.</p><p><strong>Conclusion: </strong>A nurse-driven pressure injury prevention program was successful in the reduction of the HAPI rate.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 5","pages":"210-220"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Laughter Yoga Applied to Intensive Care Nurses on Their Perceived Stress, Job Motivation, and Mental Well-being: Randomized Controlled Study.","authors":"Ramazan Yılmaz, Kıvan Çevik Kaya","doi":"10.1097/NUR.0000000000000839","DOIUrl":"10.1097/NUR.0000000000000839","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine the effect of laughter yoga applied to intensive care nurses on perceived stress, job motivation, and mental well-being.</p><p><strong>Design: </strong>This study was a randomized controlled trial.</p><p><strong>Methods: </strong>The study was conducted with nurses working at the university hospital's surgical intensive care and anesthesia intensive care units of the third-level intensive care unit in Turkey. Data obtained from 30 participants in the intervention group and 33 participants in the control group were analyzed. The Nurse Introduction Form, Nurse Job Motivation Scale, Perceived Stress Scale, and Warwick-Edinburgh Mental Well-being Scale were used to collect data. Data obtained from the study were evaluated using the SPSS 22.0 package.</p><p><strong>Results: </strong>It was determined that there was no statistically significant difference in the average scores of the pretest/posttest 1/posttest 2 of the Perceived Stress Scale (13.70 ± 3.33 to 14.57 ± 4.57, P > .05; 13.50 ± 3.15 to 13.48 ± 4.59, P > .05; and 13.56 ± 3.15 to 13.15 ± 3.49, P > .05, respectively) and Work Motivation Scale (59.70 ± 7.58 to 59.69 ± 7.98, P > .05; 60.30 ± 8.07 to 58.48 ± 8.94, P > .05; and 60.56 ± 7.86 to 57.93 ± 9.54, P > .05, respectively) for both the intervention and control groups of nurses. A statistically significant difference was found in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the intervention group of nurses (50.90 ± 7.60, 51.50 ± 7.80, and 53.70 ± 7.08, respectively; F = 3.330, P = .043). However, the difference was found to be insignificant in pairwise comparisons in the further analysis (a = b = c). It was determined that there was no statistically significant difference in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the control group of nurses (52.21 ± 9.89, 51.93 ± 10.45, and 51.03 ± 9.63, respectively; P > .05).</p><p><strong>Conclusions: </strong>The application of laughter yoga on intensive care nurses did not result in a significant change in perceived stress levels and work motivation. However, statistically significant differences were observed in the average mental well-being scores among the intervention group.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 5","pages":"229-236"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Shortages After 10 Years-Sorry, Nothing Has Changed.","authors":"Patricia Anne O'Malley","doi":"10.1097/NUR.0000000000000836","DOIUrl":"10.1097/NUR.0000000000000836","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 5","pages":"208-209"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing a New Evidence-Based Thought Paradigm of Sepsis.","authors":"Lindsay Richardson, Julie-Kathryn Graham","doi":"10.1097/NUR.0000000000000828","DOIUrl":"10.1097/NUR.0000000000000828","url":null,"abstract":"<p><strong>Abstract: </strong>In 1991, sepsis was first defined by the Society of Critical Care Medicine as the systemic inflammatory response syndrome, in the presence of infection. Systemic inflammatory response syndrome is an adaptive host response to infection, as well as to other insults like trauma and stress. Research pertaining to sepsis was guided by this adaptive definition for 25 years. After established guidelines for sepsis management were challenged in 2014, sepsis was redefined in 2016 as a dysregulated host response to infection. However, there still remains no consensus on which immunologic or metabolic mechanisms have become dysregulated. We sought to examine sepsis literature published after the 2016 consensus definition and compare it to the original systemic inflammatory response syndrome paradigm proposed in 1991. The purpose of this intensive analysis was to recommend a new sepsis archetype, with consideration to dysregulated immunologic and metabolic mechanisms that have recently been identified in sepsis. Nurses and other clinicians must shift their thought paradigm toward an evidence-based dysregulated model, in order to improve on sepsis recognition and management.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 4","pages":"171-174"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Predictive Validity of Norton and Braden Scales in Determining the Risk of Pressure Injury in Elderly Patients.","authors":"Ibrahim Kiyat, Ayfer Ozbas","doi":"10.1097/NUR.0000000000000815","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000815","url":null,"abstract":"<p><strong>Aim: </strong>To compare the reliability and predictive validity of Norton and Braden scales in determining the risk of pressure injury in elderly patients.</p><p><strong>Design: </strong>This research used a comparative design. One hundred thirty elderly patients participated in the study.</p><p><strong>Methods: </strong>The daily pressure injury risk of participants was evaluated by a researcher using both the Norton and Braden scales in a consecutive manner.</p><p><strong>Results: </strong>The mean age of patients was 75.1 ± 8.5 years, and that for those without and with pressure injury development was 75.0 ± 8.3 years and 76.1 ± 9.7 years (P < .001), respectively. The reliability coefficients of the Norton and Braden scales were .82 and .89, respectively. The sensitivity, specificity, and positive and negative predictive values of the Norton Scale were 100%, 40.7%, 20.2%, and 100%, and those of the Braden Scale were 100%, 32.7%, 18.3%, and 100%, respectively.</p><p><strong>Conclusions: </strong>The reliability of both scales for elderly patients was found to be high, and their ability to differentiate patients at risk was comparable. However, both scales had low specificity. Further research is needed to develop scales that have higher predictive validity for the elderly population, taking into account other risk factors that influence total scale scores.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 3","pages":"141-146"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alignment of an Etracorporeal Membrane Oxygenation Therapy Program across Two Facilities.","authors":"Rachael Alexis Jividen","doi":"10.1097/NUR.0000000000000824","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000824","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 3","pages":"150-152"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Antibiotic Overuse in Primary Care: A Multimodal Quality Improvement Project.","authors":"Anestasia Wharton, Bonnie Jerome-D'Emilia, Margaret Avallone","doi":"10.1097/NUR.0000000000000817","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000817","url":null,"abstract":"<p><strong>Purpose: </strong>Antibiotic overuse has increased over time related to provider knowledge gaps about best practices, provider perception of patient expectations on receiving an antibiotic, possible pressure to see patients in a timely fashion, and concerns about decreased patient satisfaction when an antibiotic is not prescribed. The Centers for Disease Control and Prevention estimates that up to 30% of antibiotics are inappropriately prescribed in the outpatient setting.</p><p><strong>Approach: </strong>This quality improvement project consisted of a multimodal approach to decrease inappropriate antibiotic prescribing for viral upper respiratory infections (URIs) by using provider education, passive patient education, and clinical decision support tools based on Centers for Disease Control and Prevention recommendations and the Be Antibiotic Aware tool.</p><p><strong>Outcomes: </strong>Following implementation, there was an 11% decrease in viral URI antibiotic prescribing, from a rate of 29.33% to 18.33% following the multimodal implementation.</p><p><strong>Conclusion: </strong>The use of evidence-based education and treatment guidelines was found to decrease inappropriate antibiotic prescribing for patients diagnosed with viral URIs.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 3","pages":"136-140"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Cancer Patients' Perceptions of Factors That Influence Hospital Admissions.","authors":"Patricia I Geddie, Victoria W Loerzel","doi":"10.1097/NUR.0000000000000816","DOIUrl":"https://doi.org/10.1097/NUR.0000000000000816","url":null,"abstract":"<p><strong>Purpose/aims: </strong>To explore cancer patients' perceptions of factors that influence hospital readmissions.</p><p><strong>Design: </strong>A cross-sectional, prospective design was employed utilizing a 1-time survey and brief interviews to measure patients' perceptions and unplanned hospital admissions.</p><p><strong>Methods and variables: </strong>The principal investigator collected data from medical record review, the Hospital Admission Survey, and interviews to measure patient characteristics and perceptions of influencing factors that contributed to an unplanned hospital admission upon admission. Data were analyzed using descriptive statistics to categorize patient perceptions of influencing factors of unplanned hospital admissions.</p><p><strong>Results: </strong>The top reasons for admission were symptoms of uncontrolled gastrointestinal, pain, fever, and respiratory problems. The majority perceived the admission was unavoidable and wanted to avoid an admission. Perceived influencing factors were related to survey categories of 1) communication (ie, cannot reach physician anytime, cannot get a next-day appointment, medical problems are out of control, advised to go to the emergency department) and 2) home environment (ie, unable to adequately manage symptoms at home and hospital admission is the best place for care). Other survey categories of patient education and palliative care were not perceived as influencing or contributing factors.</p><p><strong>Conclusions: </strong>These findings highlight opportunities for clinical nurse specialists to target these vulnerable patients and provide expert consultation to address potential barriers and gaps in utilization of appropriate supportive services that may reduce unplanned hospital admissions.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"38 3","pages":"122-130"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}