Laura Fernández-Puerta, Germán Prados, María Dolores Quiñoz-Gallardo, Dolores Vellido-González, María Leticia González-Guerrero, Antonio Rivas-Campos, Eladio Jiménez-Mejías
{"title":"Hospital Environmental Disruptors and Caregiver Sleep During Hospitalization.","authors":"Laura Fernández-Puerta, Germán Prados, María Dolores Quiñoz-Gallardo, Dolores Vellido-González, María Leticia González-Guerrero, Antonio Rivas-Campos, Eladio Jiménez-Mejías","doi":"10.1097/NUR.0000000000000778","DOIUrl":"10.1097/NUR.0000000000000778","url":null,"abstract":"<p><strong>Purpose: </strong>Caregivers must cope with a poor sleep environment when caring for someone admitted to the hospital. The aim was to study the environmental factors associated with a sleep disruption pattern in caregivers during hospitalization and to test their association with caregivers' insomnia symptoms.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Methods: </strong>One hundred twenty-three caregivers completed the study. The effect of environmental stimuli on sleep disruption was measured on a scale from 1 to 10 (1 = no disruption, 10 = significant disruption). Type of room (single vs shared), insomnia symptoms, anxiety and depression, and patients' dependence (Barthel Index) were assessed as well. Caregiver and patient characteristics as well as identified hospital disruptors were compared with Student t test, χ2 test, and Fisher exact test according to the caregivers' type of room. A linear regression model using main caregiver and patient sociodemographic variables, questionnaires, and the sum of all hospital disruptors determined the factors associated with caregivers' insomnia symptoms.</p><p><strong>Results: </strong>Of the caregivers and their care recipients, 51.2% shared a room with 1 to 2 other patients. Higher self-reported levels of sleep disruption due to environmental stimuli were found in shared rooms when compared with single rooms (eg, nursing care, noise, and light) (P < .05). Hospital sleep disruptors (adjusted regression coefficient, 0.15; 95% confidence interval, 0.06-0.24) and caregiver anxiety (adjusted regression coefficient, 0.57; 95% confidence interval, 0.33-0.81) were predictors for insomnia (P < .01). However, caregivers' type of room was not associated with insomnia severity symptoms (P > .05).</p><p><strong>Conclusions: </strong>Interventions are urgent to implement, such as relieving caregivers from patient needs during the night, providing them with single rooms, and conducting multiple nursing tasks in 1 visit to minimize night hospital noise.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 6","pages":"272-280"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694184","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":"Medicare Overall Hospital Star Rating and Value Based Purchasing: What You Need to Know.","authors":"Laurie E Lisk, Elizabeth Ann Scruth","doi":"10.1097/NUR.0000000000000776","DOIUrl":"10.1097/NUR.0000000000000776","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 6","pages":"256-258"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694186","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}
Jessica L Nelson, Stephanie P Chambers, Holly E Brakke, Jessica H Hus
{"title":"Decreasing the Frequency of Nursing Assessment for Medically Stable Hospitalized Patients.","authors":"Jessica L Nelson, Stephanie P Chambers, Holly E Brakke, Jessica H Hus","doi":"10.1097/NUR.0000000000000768","DOIUrl":"10.1097/NUR.0000000000000768","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>During the COVID-19 pandemic, a large Midwest tertiary care medical center had prolonged hospitalizations due to strained staffing and few options for post-acute care recovery. Patients deemed medically ready for discharge were receiving the same care interventions as all other hospitalized medical-surgical patients. The study objective was to appropriately match care assessment frequency for these patients with their individual needs by reducing the frequency of routine nursing assessments.</p><p><strong>Description of the project/program: </strong>This quality improvement initiative reduced the frequency of nursing assessments, including routine monitoring of vital signs, to once daily for medically stable patients whose discharge was delayed.</p><p><strong>Outcome: </strong>During the 4-week pilot, 40 hospitalized patients were enrolled; 960 assessments were eliminated, and nurses were able to reallocate approximately 500 hours to other nursing tasks. No adverse outcomes were observed among patients who received once-daily assessment.</p><p><strong>Conclusion: </strong>By decreasing nursing assessment frequency for hospitalized patients with discharge delays, nurses appropriately matched care interventions with the patient's needs.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"223-227"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028510","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":"ChatGPT: Implications for Faculty, Students, and Patients: May 19, 2023.","authors":"Amy Shay","doi":"10.1097/NUR.0000000000000770","DOIUrl":"10.1097/NUR.0000000000000770","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"245-246"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016580","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":"Defining Nurse Work: The Groundbreaking Research of the 1950s.","authors":"Janet S Fulton","doi":"10.1097/NUR.0000000000000773","DOIUrl":"10.1097/NUR.0000000000000773","url":null,"abstract":"","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"208-210"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028507","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}
Jackeline Iseler, Taylor Long, Melissa Barach, Molly L McClelland, Mitzi M Saunders
{"title":"Credentialed and Privileged Clinical Nurse Specialists.","authors":"Jackeline Iseler, Taylor Long, Melissa Barach, Molly L McClelland, Mitzi M Saunders","doi":"10.1097/NUR.0000000000000767","DOIUrl":"10.1097/NUR.0000000000000767","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>The purpose of this article is to illustrate, using exemplars, the practice of clinical nurse specialists (CNSs) in Michigan who are credentialed and privileged as providers by hospital/healthcare agencies to practice in acute inpatient and ambulatory settings.</p><p><strong>Description: </strong>The CNS provides expert specialty direct patient care to improve patient outcomes. They hold a graduate degree as a CNS, are professionally certified as a CNS in a specialty practice population, and are licensed or otherwise recognized to practice as an advanced practice nurse by the state nursing practice regulatory agency.</p><p><strong>Outcome: </strong>The exemplars illustrate CNS practice as an independent provider within a health system.</p><p><strong>Conclusion: </strong>Hospital-based credentialing and privileging facilitates CNS practice within the full scope of practice authority that consists of education, certification, and licensure and is a valuable contribution to cost-effective, high-quality clinical care for specialty populations.</p>","PeriodicalId":55249,"journal":{"name":"Clinical Nurse Specialist","volume":"37 5","pages":"218-222"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10023060","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}