ABSTRACT
Emerging infectious diseases (EID) and reemerging infectious diseases are increasing globally. Zoonotic diseases are transmitted from animals to humans through direct contact or through food, water, and the environment. Vector-borne diseases are major sources of mortality and morbidity globally. Three mosquito-borne viruses are yellow fever, chikungunya virus, and dengue virus. Recent EIDs include Candida auris, Elizabethkingia anopheles, The Lone Star tick, and avian influenza H7N2. In addition, mcr-1 may contribute to the dissemination of drug resistance to gram-negative bacteria. Nurses play a major role in the identification and prevention of EID within health care settings.
Subject(s)
Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/nursing , Communicable Diseases/epidemiology , Communicable Diseases/nursing , Zoonoses/epidemiology , Zoonoses/nursing , Adult , Animals , Communicable Diseases/diagnosis , Female , Humans , Male , Middle Aged , Nurse's Role , Zoonoses/diagnosisABSTRACT
Our objective was to better understand the experience and impact of pain on ALS patients in the U.S., and to survey ALS physicians on their pain assessment and management practices. Individuals with ALS were invited to complete an online survey of pain in ALS. ALS specialist physicians were sent an e-mail survey about their experiences in evaluating and managing patients' pain. Nearly 75% of patients with ALS reported significant pain, and most thought that ALS was the source of at least some of this pain. Pain intensity scores (mean 3.9/10) and pain interference scores (mean 4.3/10) were moderate on average, but nearly 80% of participants were using pain medication, including 22% using opioids. Nearly 25% of patients thought they needed stronger pain medication than they were receiving. Physicians generally assess and manage pain in ALS patients, but few use standardized assessment tools. Nearly two-thirds felt that there is a need for better pain management practices and more than one-third felt better training was needed. In conclusion, pain in patients with ALS is not always well controlled. Improvement in care may be facilitated by a more standardized approach to evaluation, and by additional education and training of ALS health care professionals.
Subject(s)
Amyotrophic Lateral Sclerosis/epidemiology , Attitude of Health Personnel , Pain Management/statistics & numerical data , Pain Measurement/statistics & numerical data , Pain/epidemiology , Patient Satisfaction/statistics & numerical data , Activities of Daily Living , Adolescent , Adult , Aged , Aged, 80 and over , Comorbidity , Female , Health Care Surveys , Humans , Male , Middle Aged , Pain Management/methods , Pain Measurement/methods , Practice Patterns, Physicians'/statistics & numerical data , Prevalence , Quality of Life , Risk Factors , Treatment Outcome , United States/epidemiology , Young AdultABSTRACT
The addition of the DNP created challenges that resulted in a re-evaluation of the leveling of informatics competencies across the nursing curriculum. The knowledge and skills needed by informatics nurse specialists was differentiated from those needed by three levels of nurses (entry level practitioner, advanced practice nurse, and nurse scholar (both PhD and DNP)). After a thorough review of the literature and examination of various competencies and definition for nursing informatics, a new model was proposed and guided the creation and implementation of a core course in informatics for DNP students.
Subject(s)
Education, Nursing , Nursing Informatics/education , Nursing Process , Curriculum , Humans , Information Storage and RetrievalABSTRACT
PURPOSE: The purpose of this article is to explore the phenomenon of saying "no" to secondary prevention recommended by healthcare providers. DATA SOURCES: Extracted findings from two qualitative studies in which participants have said "no" to provider recommendations for secondary prevention, specifically screening mammograms or treatment for latent tuberculosis infection, are discussed. CONCLUSIONS: Although these two studies focus on different aspects of secondary prevention, both studies emphasize how client values and beliefs impact health decisions. In evidence-based practice (EBP), both scientific evidence and client values and beliefs must be considered. Nurse practitioners (NPs) have the skill set and are in a position to assist clients to mediate between their values and beliefs and current scientific evidence. IMPLICATIONS FOR PRACTICE: Several findings from the two qualitative studies are relevant for practice: qualitative studies provide information about values and beliefs for EBP, and findings from these particular qualitative studies demonstrated that women were protective about their health even though their values and beliefs did not align with current scientific evidence. Through client narratives, NPs can facilitate clients aligning personal values and beliefs with current scientific evidence in relationship to caring for self.
Subject(s)
Evidence-Based Practice , Nurse Practitioners , Patient Compliance/psychology , Secondary Prevention , Treatment Refusal/psychology , Decision Making , Health Knowledge, Attitudes, Practice , Health Planning Guidelines , Humans , Informed Consent , Mammography/psychology , Mass Screening/psychology , Models, Psychological , Nurse Practitioners/organization & administration , Nurse's Role , Nursing Methodology Research , Patient Compliance/ethnology , Patient Education as Topic , Patient Selection , Primary Health Care/methods , Qualitative Research , Self Care/psychology , Treatment Refusal/ethnology , Tuberculosis/ethnologyABSTRACT
UNLABELLED: Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. MAJOR FINDINGS: Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. CONCLUSIONS: Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.
Subject(s)
Hormone Replacement Therapy , Menopause , Aged , Estrogen Replacement Therapy , Female , Humans , Middle AgedSubject(s)
Leadership , Nurse Practitioners , Nurse's Role/psychology , Attitude of Health Personnel , Goals , Humans , Interprofessional Relations , Models, Nursing , Nurse Administrators/organization & administration , Nurse Administrators/psychology , Nurse Practitioners/organization & administration , Nurse Practitioners/psychology , Nursing Theory , Organizational Innovation , Organizational Objectives , Social Support , Societies, Nursing/organization & administration , United StatesABSTRACT
UNLABELLED: Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. MAJOR FINDINGS: Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. CONCLUSIONS: Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.
Subject(s)
Estrogen Replacement Therapy , Menopause , Estrogen Replacement Therapy/adverse effects , Female , HumansABSTRACT
The purpose of this study was to examine selected health and cost outcomes of clients who used an academic nursing clinic (ANC) located in a high-rise public housing facility for low-income citizens. Service use, health promotion and screening, quality of care, satisfaction and costs were examined. Health outcomes were improved. Estimated cost savings were about $36,000 during the first year with reduced paramedic and police calls, hospitalizations, and emergency room visits. Findings show that advanced practice nurses can positively influence health outcomes by providing cost-effective quality health care.
