Reducing New-Onset Atrial Fibrillation After Coronary Artery Bypass Graft Surgery.

Postoperative atrial fibrillation is the most common dysrhythmia to occur after coronary artery bypass graft surgery. It develops in 10% to 40% of patients and can lead to complications such as hemodynamic instability, heart failure, and stroke. Risk factors include hypertension, diabetes, chronic kidney disease, and obesity. Patients who experience postoperative atrial fibrillation often have longer hospital stays, are at higher risk for readmission, and have increased mortality. Protocols designed to reduce the incidence of the condition can decrease hospital costs, improve patient outcomes, and increase overall quality of care. This quality improvement project took place in a tertiary care center located in southeastern Michigan and focused on the development and implementation of an evidence-based postoperative atrial fibrillation prophylaxis protocol using amiodarone. The outcomes of this project suggest that amiodarone prophylaxis can reduce the incidence of postoperative atrial fibrillation in patients with no previous history of atrial fibrillation undergoing coronary artery bypass graft surgery.

Transforming graduate nursing education in the context of complex adaptive systems: implications for master's and DNP curricula.

The purpose of this article is to describe the evolution and implementation of a graduate nursing program's curricular framework. A number of factors contributed to the realization that the curricular framework needed revision. These factors included the rapid changes occurring in the U.S. health care system, the publication of the 2011 edition of the Essentials of Master's Education in Nursing, and the publication of the Institute of Medicine's report entitled The Future of Nursing: Leading Change, Advancing Health (2010). A careful analysis of key guiding documents resulted in the development of three central, interrelated concepts to guide this revision, namely, relationship-based care, creative inquiry, and leadership.

Engaging the learner by bridging the gap between theory and clinical competence: the impact of concept mapping and simulation as innovative strategies for nurse-sensitive outcome indicators.

Concept mapping and simulation provide professional nurses in the academic and practice environment with an opportunity for experiential learning. This integral combination allows for learning to be congruent with the national clinical practice guidelines that support and promote nurse-sensitive indicators. Implications for practice are forthcoming as data are collected on the impact on health outcomes when using concept mapping and simulation.