Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease: Development of a Situation-Specific Theory for African American Emerging Adults.

BACKGROUND: Emerging adulthood (18-25 years old) is a distinct developmental period in which multiple life transitions pose barriers to engaging in healthy lifestyle behaviors that reduce cardiovascular disease risk. There is limited theory-based research on African American emerging adults. OBJECTIVE: This article introduces a synthesized empirically testable situation-specific theory for cardiovascular disease prevention in African American emerging adults. METHODOLOGY: Im and Meleis' integrative approach was used to develop the situation-specific theory. RESULTS: Unlocking Population-Specific Treatments to Render Equitable Approach and Management in Cardiovascular Disease is a situation-specific theory developed based on theoretical and empirical evidence and theorists' research and clinical practice experiences. DISCUSSION: African American emerging adults have multifaceted factors that influence health behaviors and healthcare needs. Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease has the potential to inform theory-guided clinical practice and nursing research. Recommendations for integration in nursing practice, research, and policy advocacy are presented. Further critique and testing of the theory are required.

Authentic Teaching to Promote Active Learning: Redesign of an Online RN to BSN Evidence-Based Practice Nursing Course.

BACKGROUND: Although an evidence-based practice course (EBP) is taught in most undergraduate nursing programs, timeworn teaching strategies of lecture, discussions, and narrative written assignments are typically used. PROBLEM: The current online EBP course in an RN-BSN program was initially developed with low level objectives and included busywork that did not provide students with an opportunity to apply the seven steps of the EBP process. APPROACH: Revision of the EBP course incorporated authentic teaching/learning methods, in which active learning was required since students actually worked through the seven steps of the EBP process; first through small group online discussions and then through individually crafted assignments. The project was not implemented since it was based on a realistic but fictitious clinical scenario that was used throughout the various steps. Each step began with all students working from the same information or data, which helped to focus on learning the EBP process itself. CONCLUSIONS: Students reported decreased stress by first working collaboratively in groups where they received support from faculty and classmates, then completing individual assignments. Faculty were in turn given support when giving feedback and grading assignments by using completed templates and reference lists that were provided for them. Students also demonstrated better preparation to develop and implement their own EBP projects in their capstone course.

Discharge planning for the patient with chronic pancreatitis.

For patients with chronic pancreatitis, there are many ramifications of failing to plan for the patient's discharge appropriately. The chronicity of the disease often makes discharge planning more complex. In addition, patient needs may include complicated home regimens, psychosocial interventions, or both. Patients with chronic pancreatitis have disease-specific needs and issues that should be assessed to implement an appropriate plan. Resources need to be identified, implemented, and evaluated to ensure positive outcomes, adequate patient satisfaction, and lower readmission rates. This article presents the impact of chronic pancreatitis on the healthcare system, recommendations for appropriate discharge planning for this population, and a case study demonstrating the discharge planning process for a patient with chronic pancreatitis.

Nursing perception of patient transitions from hospitals to home with home health.

PURPOSE OF THE STUDY: The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. PRIMARY PRACTICE SETTING: The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. METHODOLOGY AND SAMPLE: The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. RESULTS: Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.