Strategies for promoting a healthy dietary intake.

Strategies for promotion of a healthy dietary intake must emphasize sound, up-to-date nutritional knowledge that supports broad dietary guidelines for healthy eating. Effective dietary intervention does not rely on a "good food, bad food" approach. The plethora of nutritional studies reported in the popular press must be critically examined at their sources, and information from the studies incorporated into wellness programs only after they have been substantiated to be applicable to the groups of people to whom the wellness programs are addressed. This article briefly describes the 10th revision of the RDAs that was recently released by the National Academy of Sciences in the United States. The US RDA labeling information is also described, and its difference from the RDAs is identified. In addition, the article discusses the recent US Dietary Guidelines and modified four-food-groups daily diet plan which are based on the most recent RDA. Pender's health promotion model is presented as a workable model on which to base healthy dietary intake programs, and three programs that have used elements similar to this model are presented, one in detail. Cost effectiveness as an outcome and tracking technique is highlighted for one of the programs. Nutrition is an important part of nursing care for well clients. Nurses must maintain interdisciplinary contacts with nutritionists and continually update information in this rapidly growing body of knowledge in order to respond to clients' needs and to promote health in this important area.

Predictors of hospital readmission. A meta-analysis.

Summarizing the results of research related to identifying potential predictors of hospital readmissions has been difficult because of conflicting results across studies. Using the techniques of meta-analysis, the results from 44 studies were examined in the present study. Overall, the mean readmission rate was 27%, with significant differences based on patient diagnosis. Although diagnosis, age, initial length of hospital stay, and prior use of hospital resources were related to readmission, the strength of the relationship is trivial. Combining data from 12 intervention studies designed to reduce readmission indicated that the overall treatment effect was not significant. Further research is needed to determine demographic, clinical, and social predictors of readmission if strategies are to be developed to reduce readmission and the resulting health care costs.

Emergency department nursing management of patients with orthopedic fractures resulting from motor vehicle accidents.

Nursing management of patients with orthopedic fractures resulting from motor vehicle accidents is a frequent challenge for nurses in an emergency department setting. The nurse must have knowledge of the mechanics of injury, the classification of the resulting fracture types, and the usual medical interventions. In addition, emergency department nurses should follow plans of care that are based on nursing diagnoses so that appropriate nursing interventions can be determined and consistently provided. Initiation of these care plans must not be delayed until the patient is admitted to an inpatient nursing unit, but should be begun in the emergency unit setting. This article presents information that the emergency room nurse needs in order to make plans for nursing care, and discusses seven nursing diagnoses that are almost always appropriate for patients seen in the emergency department who are experiencing orthopedic fractures resulting from motor vehicle accidents.

Secondary data analysis: research method for the clinical nurse specialist.

This article presents a description of secondary data analysis and suggests that this type of research methodology may be helpful in facilitating research by the clinical nurse specialist (CNS). The article discusses the advantages and disadvantages of the use of this method specifically in relation to the CNS and offers suggestions for sources of data.