An Integrative Review of the Use and Outcomes of HESI Testing in Baccalaureate Nursing Programs.

AIM: To evaluate the current utilization of the Health Education Systems, Inc. (HESI) examinations in nursing education. BACKGROUND: HESI exam results are frequently predictive of NCLEX-RN results in nursing education. METHOD: The integrative review method of Whittemore and Knafl was used to search and evaluate the existing evidence to answer the following research questions: a) What is the current utilization of the HESI examinations in baccalaureate nursing education? b) What is the evidence supporting or contraindicating their use in nursing education? c) What is known regarding outcomes related to their use? RESULTS: There is a wide variation in the use and outcomes of HESI exams in baccalaureate nursing education. CONCLUSION: Despite validity and reliability, there are many gaps in evidence regarding use of these exams in nursing education.

Factors associated with delay in seeking care for acute decompensated heart failure.

BACKGROUND: Despite reports that persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment, few studies have prospectively explored specific factors influencing treatment-seeking delay in this population. OBJECTIVE: The purpose of this study was to explore how factors related to the symptom experience, such as perception (number and intensity), evaluation (attribution and understanding), and response (behaviors of patients and others) influence delay in seeking treatment for symptoms of acute decompensated HF. METHODS: Patients hospitalized for acute HF were enrolled into an exploratory, descriptive study. Only those who had HF for 3 months or longer and a previous HF admission were eligible. Data on factors related to the symptom experience, response to symptoms, and delay time were collected by interview during hospitalization. Delay time measured in hours was analyzed using generalized linear modeling. RESULTS: The sample of 131 adults was predominately older (77 ± 11.3 years) men (55.7%). The median delay time was 60 hours (2.5 days), with a range of 1 to 336 hours (14 days). Only 34 (25.9%) sought care in less than 12 hours. Three variables were statistically significant determinants of long delay time-waiting to see if the symptoms would abate, receiving a passive response to symptoms from others, and living in a rural environment. These variables explained 13.9% of the variance in delay time. Clinical characteristics were not significant predictors of delay. CONCLUSIONS: The response of patients (wait-and-see) and others (eg, don't worry) contributed to delay, as did living in a rural environment. Evaluative characteristics of attribution and understanding were not significant determinants of delay, suggesting that patient education alone will not effectively decrease delay. Instead, interventions directed toward decision making in response to symptoms and inclusion of family members in such discussions may be more effective.

The N-CODES project moves to user testing.

For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders who will use it in practice. This article reports on the user testing of the Nurse Computer Decision Support working prototype. Ten acute care nurses with varying levels of education and experience participated in the testing. The study's protocol consisted of a series of tasks requiring the participants to use the system while solving patient problems. Both quantitative and qualitative data on usability, ease of navigation, and nurse satisfaction were collected. The nurses ranked usability and ease of navigation highly. Nurses were excited about the system's clinical potential and felt that it would be useful to all practitioners regardless of experience. Testing the system in an actual clinical setting is the next step, but it is clear that the system has extraordinary potential to improve clinical decision making and patient outcomes.