Preparing New Graduate Nurses for Patient Rescue: An Experimental Quantitative Study.

A patient deterioration educational program was offered to new graduate nurses. Pre and post self-confidence scores were compared, and competency performance was evaluated during a simulation. The results indicate that most of the participants successfully demonstrated simulation competencies, and there was a statistically significant improvement in self-confidence scores. Based on these findings, education on identifying and managing patient deterioration that includes a simulation experience may be beneficial.

Meeting our students' educational needs during a global pandemic: Creating online clinical learning experiences.

The purpose of this paper is to describe the conversion of in-person simulations into online evolving case study activities in an undergraduate nursing curriculum as a result of COVID-19 precautions. The School of Nursing at Eastern Kentucky University utilized technological resources to provide meaningful online learning activities to meet student learning outcomes. The key teaching strategies to maintain were application and synthesis of knowledge through guided reflective activities and discussion. Interactive evolving case studies were selected with critical thinking questions and video clips to promote student engagement. The curricular concepts were medication administration, prioritization of patient care, communication, patient safety, and clinical judgment. Student and faculty evaluations were overwhelmingly positive, resulting in sustained use of these teaching strategies within the curriculum.

Building Resilience Through Sport in Young People With Adverse Childhood Experiences.

Interventions focused on young people at risk of anti-social and criminal behaviour frequently involve physical exercise and/or participation in sporting activities as a primary vehicle to bring about behavioural change in both the short to medium term. Anecdotal evidence suggests that sporting activities positively influence individual well-being alongside a sense of purpose and belonging centred around sporting clubs and activities. Empirically, participation in sport has been identified as a key resilience factor for young people with numerous Adverse Childhood Experiences (ACEs) and investment and policy initiatives target investment in these opportunities. However, the psychological mechanisms which underpin these improvements in well-being and building of resilience are less clearly articulated. This article will review current and developing research in this field to synthesise future applications of sport-related interventions with young people, with a particular emphasis on furthering understanding of the pathways to capacity building at individual and community level which sport and exercise can generate.

Patient Deterioration Simulation Education and New Graduate Nurses' Self-Confidence and Competence: A Pilot Study.

A rural community hospital provided a pilot patient deterioration simulation education for new graduate nurses in an attempt to advance the utilization of an existing rapid response team. Pre- and post-intervention self-confidence scores demonstrated a large effect size and a clinically significant eta squared value (.48). The participants successfully completed most of the simulation competencies. This pilot project supports further studies exploring new graduate nurses' self-confidence levels and competency performance with patient deterioration simulation education.

Participants' experiences of care during a randomized controlled trial comparing a lay-facilitated angina management programme with usual care: a qualitative study using focus groups.

AIM: This paper is a report of a qualitative study conducted as part of a randomized controlled trial comparing a lay-facilitated angina management programme with usual care. Its aim was to explore participants' beliefs, experiences, and attitudes to the care they had received during the trial, particularly those who had received the angina management intervention. BACKGROUND: Angina affects over 50 million people worldwide. Over half of these people have symptoms that restrict their daily life and would benefit from knowing how to manage their condition. DESIGN: A nested qualitative study within a randomized controlled trial of lay-facilitated angina management. METHOD: We conducted four participant focus groups during 2008; three were with people randomized to the intervention and one with those randomized to control. We recruited a total of 14 participants to the focus groups, 10 intervention, and 4 control. FINDINGS: Although recruitment to the focus groups was relatively low by comparison to conventional standards, each generated lively discussions and a rich data set. Data analysis demonstrated both similarities and differences between control and intervention groups. Similarities included low levels of prior knowledge about angina, whereas differences included a perception among intervention participants that lifestyle changes were more easily facilitated with the help and support of a lay-worker. CONCLUSION: Lay facilitation with the Angina Plan is perceived by the participants to be beneficial in supporting self-management. However, clinical expertise is still required to meet the more complex information and care needs of people with stable angina.

Randomized controlled trial of a lay-facilitated angina management programme.

AIMS: This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP). BACKGROUND: Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes. DESIGN: A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist. METHODS: Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6 months; secondary outcomes at 3 and 6 months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation. RESULTS: There was no important difference in angina frequency at 6 months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3 months for: Anxiety, angina misconceptions and for exercise report; and at 6 months for: anxiety; depression; and angina misconceptions. The intervention was considered cost-effective. CONCLUSION: The angina management programme produced some superior benefits when compared to advice from a specialist nurse.

Vascular complications of prosthetic inter-vertebral discs.

Five consecutive cases of prosthetic inter-vertebral disc displacement with severe vascular complications on revisional surgery are described. The objective of this case report is to warn spinal surgeons that major vascular complications are likely with anterior displacement of inter-vertebral discs. We have not been able to find a previous report on vascular complications associated with anterior displacement of prosthetic inter-vertebral discs. In all five patients the prosthetic disc had eroded into the bifurcation of the inferior vena cava and the left common iliac vein. In three cases the aortic bifurcation was also involved. The fibrosis was so severe that dissecting out the arteries and veins to provide access to the relevant disc proved impossible. Formal division of the left common iliac vein and artery with subsequent repair was our solution. Anterior inter-vertebral disc displacement was associated with severe vascular injury. Preventing anterior disc displacement is essential in disc design. In the event of anterior displacement, disc removal should be planned with a Vascular Surgeon.