Zentangle® Pilot Study: A Mindfulness Exercise for Oncology Nurses.

BACKGROUND: This study introduced Zentangle®, which involves drawing simple, repetitive lines and shapes to create patterns, as a tool to promote wellness for oncology nurses in a clinical practice setting. OBJECTIVES: The purpose of this study was to determine whether Zentangle used as a meditative activity in an acute time frame decreased stress, fatigue, and burnout while increasing professional quality of life and well-being in oncology nurses. METHODS: Twenty-six oncology nurses participated in a two-hour Zentangle class and received materials to complete art over four weeks. The Perceived Stress Scale, the Warwick-Edinburgh Mental Wellbeing Scale, the Patient-Reported Outcomes Measurement Information System-29, and the Professional Quality of Life measure were administered at selected periods. Twenty-four participants completed the study. FINDINGS: Nurses' well-being, socialization, anxiety, fatigue, secondary traumatic stress levels, and stress levels improved significantly. Most participants noted they would continue using Zentangle after the study. Zentangle is another tool to advance nurses' wellness by encouraging self-care.

Feasibility and Impact of Physical Activity on Compassion Fatigue and Burnout Among Ambulatory Care Oncology Nurses.

BACKGROUND: Compassion fatigue (CF) and burnout are well described phenomena among oncology nurses. Physical activity (PA) has been shown to reduce CF and burnout. OBJECTIVES: The purpose of this pilot study was to determine the feasibility of promoting PA and assessing its impact on CF and burnout among RNs across three ambulatory care cancer clinics. METHODS: A convenience sample of nurses with varying roles were invited to participate. Feasibility was assessed by participant accrual and retention rates. CF and burnout were assessed at weeks 0, 6, and 12. The Yale Physical Activity Survey was used to obtain self-reported PA, and daily steps were tracked using participants' personal devices. FINDINGS: Stress scores decreased. Burnout scores demonstrated levels of low emotional exhaustion, moderate depersonalization, and moderate to high personal achievement. Leisurely walking increased significantly, and average daily step counts increased by 37% for weekdays, 10% for weekend days, and 29% for the total week.

Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines.

Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.

Massage Chair Sessions: Favorable Effects on Ambulatory Cancer Center Nurses' Perceived Level of Stress, Blood Pressure, and Heart Rate.

BACKGROUND: High stress levels over time can contribute to compassion fatigue and burnout and negatively affect individual health and well-being. OBJECTIVES: A pre-/post-test initiative was implemented to determine the effects of massage chair sessions on ambulatory cancer center nurses (RNs and advanced practice providers) based on their perceived stress, blood pressure (BP), and heart rate (HR). METHODS: A mechanical massage chair was available for 20-minute sessions in a secure room, and nurses self-recorded perceived stress using a visual analog scale, as well as BP and HR using a wrist cuff device. Descriptive statistics and paired t tests were used to assess nurse characteristics and differences before and after massage chair sessions. FINDINGS: Nurses participated in 200 massage chair sessions during a six-month period. Significant reductions were noted in perceived stress, systolic and diastolic BP, and HR. These data indicate that providing a relaxing room with chair massage has favorable effects on nurses' perceived stress, BP, and HR.

Symptom presentation of women with acute coronary syndromes: myth vs reality.

BACKGROUND: Optimal diagnosis and timely treatment of patients with an acute coronary syndrome (ACS) depends on distinguishing differences between popular "myths" about ischemic symptoms in women and men. Chest pain or discomfort is regarded as the hallmark symptom of ACS, and its absence is regarded as "atypical" presentation. This review describes the presenting symptoms of ACS in women compared with men and ascertains whether women should have a symptom message that is separate or different from that for men. METHODS: MEDLINE (1970-2005), bibliographies of articles, and pertinent abstracts were reviewed, focusing on studies of ACS presentation, especially those reporting differences in symptoms by sex. This analysis included 69 of 361 possible studies. Data regarding symptom presentation were recorded. RESULTS: The published literature lacks standardization in characterizing ACS presentation, data collection, and reporting of symptoms. Approximately one-third of patients in the large cohort studies and one-quarter of patients in the smaller reports and direct patient interviews presented without chest pain or discomfort. The absence of chest pain or discomfort with ACS was noted more commonly in women than in men in both the cumulative summary from large cohort studies (37% vs 27%) and the single-center and small reports or interviews (30% vs 17%). CONCLUSIONS: Women are significantly less likely to report chest pain or discomfort compared with men. These differences, however, are not likely large enough to warrant sex-specific public health messages regarding the symptoms of ACS at the present time. Further research must systematically investigate sex differences in the clinical presentation of ACS symptoms and must include standardized data collection efforts.

Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council.

Patient delay in seeking treatment for acute coronary syndrome and stroke symptoms is the major factor limiting delivery of definitive treatment in these conditions. Despite decades of research and public education campaigns aimed at decreasing patient delay times, most patients still do not seek treatment in a timely manner. In this scientific statement, we summarize the evidence that (1) demonstrates the benefits of early treatment, (2) describes the extent of the problem of patient delay, (3) identifies the factors related to patient delay in seeking timely treatment, and (4) reveals the inadequacies of our current approaches to decreasing patient delay. Finally, we offer suggestions for clinical practice and future research.

Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council.

Patient delay in seeking treatment for acute coronary syndrome and stroke symptoms is the major factor limiting delivery of definitive treatment in these conditions. Despite decades of research and public education campaigns aimed at decreasing patient delay times, most patients still do not seek treatment in a timely manner. In this scientific statement, we summarize the evidence that (1) demonstrates the benefits of early treatment, (2) describes the extent of the problem of patient delay, (3) identifies the factors related to patient delay in seeking timely treatment, and (4) reveals the inadequacies of our current approaches to decreasing patient delay. Finally, we offer suggestions for clinical practice and future research.

Pre-hospital 12-lead electrocardiography programs: a call for implementation by emergency medical services systems providing advanced life support--National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health.

Emergency medical services (EMS) providers who administer advanced life support should include diagnostic 12-lead electrocardiography programs as one of their services. Evidence demonstrates that this technology can be readily used by EMS providers to identify patients with ST-segment elevation myocardial infarction (STEMI) before a patient's arrival at a hospital emergency department. Earlier identification of STEMI patients leads to faster artery-opening treatment with fibrinolytic agents, either in the pre-hospital setting or at the hospital. Alternatively, a reperfusion strategy using percutaneous coronary intervention can be facilitated by use of pre-hospital 12-lead electrocardiography (P12ECG). Analysis of the cost of providing this service to the community must include consideration of the demonstrated benefits of more rapid treatment of patients with STEMI and the resulting time savings advantage shown to accompany the use of P12ECG programs.