Nurse Leaders Advocate for Nurses Across a Health Care System: COVID-19.

The COVID-19 pandemic emphasizes the importance of nursing care globally. Nurses are the frontline staff in the care of individuals stricken with this highly infectious and deadly illness. Nurse leaders must advocate for nursing staff when staff are immersed in often overwhelming conditions. Through a case study, this article outlines how one healthcare system's Chief Nursing Officer council worked collaboratively, jointly and with the Emergency Incident Command Structure, to operationalize CDC guidelines and support, protect, educate, and empower staff. These initiatives resulted in creative solutions, technological advances for the system, and nursing staff and leaders rising to the challenge.

"Going the Extra Mile": Disclosure, Accommodation, and Stigma Management among Working Women with Disabilities.

Although research has quantitatively evaluated the impacts of stigma on working women with disabilities (WWD), nuanced, qualitative accounts voiced by these women are rare. To address this literature gap, we conducted seven focus groups with forty-two WWD. We asked: "What are women's experiences of disability disclosure and accommodation in the workplace?" Findings reveal that WWD face intentional and unintentional structural discrimination and must weigh the pros and cons of disclosure and navigate devaluation threats in pursuing workplace accommodations. "Going the extra mile" emerged as a stigma management technique that was prevalent among women of higher social capital.

Haitian, Chinese, Somali, Ethiopian, and Asian/Pacific Islander perspectives on research.

Researchers often approach community-based organizations as an access point to engage underserved populations in studies. In this article, 5 representatives of community organizations present their perspectives on the complexity of researcher-community partnerships and the nuances of engaging Haitian, Ethiopian, Somali, Chinese, and Asian/Pacific Islander populations in research. Each representative presents recommendations for gaining trust and understanding within their communities and challenge researchers to move beyond seeking knowledge and into social action that improves the lives of their constituents.

Returning nurses to the workforce: developing a fast track back program.

TOPIC: Fast Track Back: Re-entry into Nursing Practice program. PURPOSE AND SOURCES OF INFORMATION: Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. CONCLUSIONS: The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Building a foundation for an evidence-based approach to practice: teaching basic concepts to undergraduate freshman students.

The University of Pittsburgh School of Nursing introduced evidence-based practice (EBP) into the freshman-level curriculum this year. This article describes the reasons behind this decision, the development of the curriculum, the specific EBP content, and the student assignments. The introduction of EBP into the first-level nursing curriculum has proven to be successful; consideration is even being given to expanding the EBP content.

Update on risk factors for atherosclerosis: the role of inflammation and apolipoprotein E.

Over 1 million adults will have a new or recurrent myocardial infarction this year. Traditional risk factor assessment predicts less than one-half of all future cardiovascular events, and many patients develop atherosclerosis in the absence of these factors. Alternative risk factors, including genotype and the inflammatory response, are presented, along with intervention considerations for the medical-surgical nurse.

Factors associated with attrition of African Americans during the recruitment phase of a clinical trial examining adherence among individuals with rheumatoid arthritis.

OBJECTIVE: To examine factors contributing to the loss of potential minority participants in a study of medication adherence among rheumatoid arthritis patients. METHODS: Chi-square statistics were used to test for differences in refusal/ineligibility by race and site at 4 screening points (initial eligibility review, initial patient contact, adherence screening, and informed consent). Differences in criteria-specific risks for exclusion at initial eligibility review were examined across 4 sites by race. Odds ratios (95% confidence intervals) were estimated if differences were significant. Multivariate logistic regression was used to examine sociodemographic factors associated with the probability for ineligibility at the initial eligibility review. Stated reasons for refusal were qualitatively quantified. RESULTS: A greater percentage of African Americans were lost at every screening point when compared with whites, but only the difference at the initial eligibility review was statistically significant. CONCLUSION: Factors associated with attrition included selection of area medical sites, research design issues, comorbid conditions, alcohol abuse, and being younger, unmarried, African American, and male.

Adherence to oral therapies in pelvic inflammatory disease.

PURPOSE: To assess adherence to oral therapies in pelvic inflammatory disease (PID). METHODS: Medication adherence to oral doxycycline therapy (100 mg) was measured using electronic event monitoring (EEM) among adult women with PID. Subjects (n = 91), who were predominantly black and with a high school or lower educational attainment, were randomly selected from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Study, a trial in which subjects were randomized to either (1). initial inpatient then outpatient or (2). fully outpatient treatment with doxycycline and cefoxitin. Summary statistics calculated within treatment groups and in the cohort as a whole included the percentage of administrations taken, percentage of days with correct dosage, percentage of days with no drug taken, time elapsed until the first drug holiday, and percentage of optimal dosing intervals. RESULTS: Study subjects took an average of 70% of prescribed doses, took the prescribed two daily doses for less than half of their outpatient days, took an unscheduled drug holiday for almost 25% of their outpatient days, and took only 16.9% of their doses within the optimal timing interval. In general, working, not bleeding with sex, and not drinking hard liquor were positively associated with measures of adherence. Adherence estimates were similar among women in the inpatient and outpatient groups after hospital discharge. CONCLUSIONS: The disturbing rates of time interval adherence, even after hospitalization, suggest the need to determine the effectiveness of antibiotic regimens involving shorter courses and longer dosing intervals.

Medication adherence in persons with cardiovascular disease.

The purpose of this investigation was to determine medication adherence rates among 3 groups of elderly individuals 62 years of age or older, experiencing comorbid conditions including at least 1 cardiovascular disorder. Data, taken from a 3-week period, were combined across the groups to calculate the percentage of prescribed doses taken, percentage of days with correct number of doses, and percentage of expected doses with the correct timing of administration. Multiple linear regression also was performed on several sociodemographic variables to determine their ability to predict adherence. Risks for poor adherence and suggestions to increase adherence are presented.

Cruise ships and kayaks: welfare and rehabilitation approaches for women with disabilities in poverty.

Women with disabilities have low employment rates and about one-third live in poverty. They represent half of the population using either services of the vocational rehabilitation (VR) system or the welfare system, and many use both. Although both systems have made gains in improving their employment status, neither comprehensively addresses the needs of this population. Welfare policy has encouraged state level innovation and moved large numbers of people into employment in as little as five years. State welfare agencies offer a range of services specifically addressing the needs of families with children. VR agencies have decades of specific experience assisting people with disabilities gain employment. Welfare reform has been the cruise ship moving large numbers of people across an ocean. VR agencies have been the kayak builders designing specialized small craft to move specific people along tributaries. What can they learn from each other?