ABSTRACT
ABSTRACT: Research has demonstrated the ability of evidence-based practice (EBP) to enhance quality and reliability of health care, improve health outcomes, and reduce cost and health disparities. Nursing curricula often lack best practices for teaching EBP, as well as actual EBP course content, objectives, and activities, to advance student understanding of EBP. The unfortunate results are nurse graduates who do not value or perceive that they can use EBP. This study implemented an EBP assignment assessing clinical practice guidelines as a means of improving EBP beliefs in senior-level nursing students.
Subject(s)
Students, Nursing , Curriculum , Delivery of Health Care , Evidence-Based Nursing , Evidence-Based Practice/education , Humans , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
In the last decade, critical-care nurses have seen a surge in acute opioid overdose admissions to intensive care units; there have also been significant increases in intensive care unit admissions due to opioid-related illness such as dependence, tolerance, and hyperalgesia. Despite these issues, opioids continue to be the criterion standard of pain management, and the search for opioid alternatives has not produced a clear replacement. A contributor to this problem has been the prevailing opinion that once bound to a receptor, all opioids engaged in the same types of intracellular signaling, which resulted in the same types of responses, only differing in the magnitude of those responses. Contemporary research with G-protein-coupled receptor models (eg, opioids) has demonstrated that this oversimplification is incorrect or incomplete. Understanding the complexity of opioid pharmacodynamics and pharmacokinetics helps us to grasp the intricacies of opioid-related adverse effects. Although there are many potential adverse effects related to opioids, this review focuses on the major adverse effects commonly seen in critical care, namely, respiratory depression, tolerance, hyperalgesia, and central sensitization. In addition, a case study has been incorporated to aid in understanding of strategies nurses can incorporate into their practices: that help mitigate the development of these effects.
Subject(s)
Analgesics, Opioid , Drug Overdose , Analgesics, Opioid/adverse effects , Drug Overdose/drug therapy , Humans , Pain ManagementABSTRACT
Most nurse residency literature published on nurse residency evaluation comes from programs based in academic medical centers. Fewer studies exist on evaluation of nurse residencies in community hospitals. Secondary data analysis was used to evaluate a 12-month program based in a community hospital setting. Participants reported improvements in confidence, nursing skills, abilities, professional satisfaction, feeling supported, and decreased stress. Turnover decreased from 37% to <4% within 3 years.