ABSTRACT
BACKGROUND: Bedside handoffs, the teach-back method, and discharge bundles have been shown to contribute to empowering patients to actively engage in their treatment. OBJECTIVES: The objectives were to identify patient activation scores, patient readmission rates, and nursing staff satisfaction before and after implementing bedside handoffs, the teach-back method, and discharge bundles on an inpatient oncology unit at a large military treatment facility. METHODS: A series of three cycles using the Plan-Do-Study-Act framework guided implementation of the multifaceted approach. Patient activation scores, readmission rates, staff satisfaction, and anecdotal feedback from patients and nursing staff were collected prior to and following implementation. FINDINGS: The sample of patients with cancer had high patient activation scores. After implementation of the multifaceted approach, readmission rates decreased from 32% to 25%, and staff satisfaction improved.
Subject(s)
Oncology Nursing/education , Oncology Nursing/standards , Patient Discharge/standards , Patient Handoff/standards , Patient Participation , Patient Satisfaction , Practice Guidelines as Topic , Adult , Aged , Aged, 80 and over , Education, Nursing, Continuing , Female , Humans , Male , Middle AgedSubject(s)
Cytokines/blood , Stress, Psychological/physiopathology , Students/psychology , Female , Humans , MaleABSTRACT
Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine production or decreases glucocorticoid sensitivity (GCS) of peripheral blood leukocytes from healthy college students. A convenience sample of Reserve Officer Training Corps (ROTC) students completed the Perceived Stress Scale (PSS). Whole blood was incubated in the presence of influenza vaccine and dexamethasone to evaluate production of interleukin-6 (IL-6), interleukin-1-beta (IL-1ß), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ). Multiple regression models controlling for age, gender, and grade point average revealed a negative relationship between PSS and GCS for vaccine-stimulated production of IL-1ß, IL-6, and TNF-α. These data increase our understanding of the complex relationship between chronic stress and immune function.
