Qualifications of Executive Nurses for Service on Hospital Boards.

OBJECTIVE: The purpose of this qualitative survey was to document executive nurse leaders' perception of their own leadership qualities in the context of the American Hospital Association (AHA) recommended membership requirements for executive hospital board appointment. BACKGROUND: Hospital boards of trustees are increasingly responsible for the quality of care and its impact on financial performance. High-performing boards are focused on the accountability of chief executive officer for quality metrics. Nurse leaders have valuable insight into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. METHODS: Fifty senior-level nurse executive members polled from the American Organization of Nurse Leaders, the Texas Organization of Nurse Leaders, and the Texas Nurse Practitioners Association completed an online quantitative survey using The Center for Healthcare Governance (CHG) Assessment Tool© of the AHA, which details a list of skills, experience, and personal qualities for executive hospital board placement. Respondents ranked their individual knowledge and skills on a 4-point Likert scale. RESULTS: Participant responses indicated that senior-level nurse executives have significant expertise in the key areas of quality, patient safety and performance, healthcare administration and policy, and business management. Areas ranking lower are those associated with organizational specialties: legal, construction project management, and finance. CONCLUSION: This information can be used to educate executive hospital boards regarding the qualifications of nurse leaders members. Nursing leaders, professional organizations, and academia can use this information to assess the skills of senior nursing leaders as it relates to potential board appointments.

The Case for Bringing the Licensed Practical Nurse Back to the Hospital.

The expansion of the aging population, residential care facilities, and projected registered nurse shortages pose significant challenges to nurse staffing ratios. The licensed practical/vocational nursing role is now being reexamined, as acute care and long-term care facilities look at staffing models and patient safety. There is now a demand for an increase in the numbers of practical nurse education programs, which have been overlooked as a pipeline for professional nursing. Recruiting and educating practical nurses open a pathway for greater diversity in the nursing profession as well as improving patient health outcomes.

Transformational partnerships in nursing education.

Although the nursing care environment has changed significantly over the past 30 years, little has changed in the educational methods used to prepare new nurses. Since the 1930s, most clinical education in nursing has been structured with a faculty member supervising a small group of students on one or more inpatient units. Students usually move to new settings for each clinical rotation. This traditional model is heavily dependent on nursing faculty and often requires students to wait for direct faculty supervision. Students often are "strangers" to the registered nurses providing patient care in these settings. This arrangement can compromise the cohesiveness of the nursing team and limit opportunities for building professional relationships between students, registered nurses, and other members of the health care team. Developing a more structured and cohesive partnership between the registered nurse and the student, both of whom are providing care to the same patients, has the potential to revitalize clinical education in nursing.

Analysis of faecal volatile organic compounds in preterm infants who develop necrotising enterocolitis: a pilot study.

OBJECTIVE: : To determine differences in the profiles of volatile organic compounds (VOCs) in faecal samples from preterm infants who develop necrotising enterocolitis (NEC) compared with non-NEC controls. MATERIALS AND METHODS: : Daily faecal samples from preterm infants were collected prospectively during an 8-month period from a level 3 regional neonatal intensive care unit. Six infants subsequently developed NEC and were matched with 7 non-NEC infants. Solid-phase microextraction and gas chromatography and mass spectrometry were used to extract and identify the VOCs from the headspace above the faecal samples taken before the onset of NEC and after the disease was diagnosed. Faecal samples at similar ages were also studied from the control infants. RESULTS: : Two hundred twenty-four different VOCs were extracted from 65 samples. Volatile organic compounds increased in number with age for non-NEC infants. In the days before and after the diagnosis of NEC a reduction in the number of VOCs extracted was observed. In addition, 4 specific esters present in controls-2-ethylhexyl acetic ester, decanoic acid ethyl ester, dodecanoic acid ethyl ester, and hexadecanoic acid ethyl ester-were consistently absent from all faecal samples in those infants who developed NEC in the 4 days before the onset of the disease. CONCLUSION: : This pilot study shows that VOC extraction from faeces may be used to identify infants that are at risk of developing NEC.

Identification of Campylobacter infection in chickens from volatile faecal emissions.

Volatile organic compounds from chicken faeces were investigated as biomarkers for Campylobacter infection. Campylobacter are major poultry-borne zoonotic pathogens, colonizing the avian intestinal tract. Chicken faeces are the principal source of contamination of carcasses. Fresh faeces were collected on farm sites, and Campylobacter status established microbiologically. Volatile organic compounds were pre-concentrated from the headspace above 71 separate faecal samples using solid-phase microextraction and separated and identified by gas chromatography/mass spectrometry. A Campylobacter-specific profile was identified using six of the extracted volatile organic compounds. The model developed reliably identified the presence or absence of Campylobacter in >95% of chickens. The volatile biomarker identification approach for assessing avian infection is a novel approach to enhancing biosecurity in the poultry industry and should reduce the risk of disease transmission to humans.

Volatile organic compounds from feces and their potential for diagnosis of gastrointestinal disease.

Little is known about the volatile organic compounds (VOCs) in feces and their potential health consequences. Patients and healthcare professionals have observed that feces often smell abnormal during gastrointestinal disease. The aim of this work was to define the volatiles emitted from the feces of healthy donors and patients with gastrointestinal disease. Our hypotheses were that i) VOCs would be shared in health; ii) VOCs would be constant in individuals; and iii) specific changes in VOCs would occur in disease. Volatile emissions in health were defined in a cohort and a longitudinal study. Subsequently, the pattern of volatiles found in the cohort study were compared to that found from patients with ulcerative colitis, Campylobacter jejuni, and Clostridium difficile. Volatiles from feces were collected by solid-phase microextraction and analyzed by gas chromatography/mass spectrometry. In the cohort study, 297 volatiles were identified. In all samples, ethanoic, butanoic, pentanoic acids, benzaldehyde, ethanal, carbon disulfide, dimethyldisulfide, acetone, 2-butanone, 2,3-butanedione, 6-methyl-5-hepten-2-one, indole, and 4-methylphenol were found. Forty-four compounds were shared by 80% of subjects. In the longitudinal study, 292 volatiles were identified, with some inter and intra subject variations in VOC concentrations with time. When compared to healthy donors, volatile patterns from feces of patients with ulcerative colitis, C. difficile, and C. jejuni were each significantly different. These findings could lead the way to the development of a rapid diagnostic device based on VOC detection.