In defense of clinical conferences in clinical nursing education.

Clinical conferencing has been a consistent feature of clinical education, but the current clinical education environment poses many challenges to its continuance. The paper raises concern regarding the current state of clinical conferencing as part of clinical practice education in nursing. This topic is of great concern, but has there is little direction for clinical educators. The paper reviews the literature on conferencing and recommends avenues for future research.

A practical approach to implementing new CDC GBS guidelines.

Group beta streptococcus (GBS) is a well-documented pathogen causing serious maternal and fetal morbidity and mortality. The CDC guidelines for managing clients who test positive for GBS in pregnancy were revised and published in 2010. However, CDC and extant literature provide limited guidance on implementation strategies for these new recommendations. Although several algorithms are included in the CDC (2010) document, none combine the maternal risk factors for practical and consistent implementation from pregnancy to newborn. In response to confusion upon initial education of these guidelines, we developed an algorithm for maternal intrapartum management. In addition, we clarified the CDC (2010) newborn algorithm in response to provider request. Without altering the recommendations, both algorithms provide clarification of the CDC (2010) guidelines. The nursing process provides an organizational structure for the discussion of our efforts to translate the complex guidelines into practice. This article could provide other facilities with tools for dealing with specific aspects of the complex clinical management of perinatal GBS.

Health disparities of coal miners and coal mining communities: the role of occupational health nurses.

This article investigates how the health disparities of Appalachian coal miners and coal mining communities could be decreased through a partnership with occupational health nurses. On-site health clinics managed by occupational health nurses working in the coal mining industry are proposed as a means to improve health care outcomes. Health effects, economic considerations, environmental impacts, and U.S. coal mining legislation and regulation are examined. An epidemiological approach is presented to the unique health effects experienced by Appalachian coal miners and coal mining communities within the context of existent socioeconomic disparities. The long-standing health crisis in Appalachian coal mining communities requires a multidisciplinary approach led by occupational health nurses.

The use of music intervention in healthcare research: a narrative review of the literature.

BACKGROUND: Although music has been widely used in healthcare, there has been scant review of literature analyzing the use of music as an intervention in healthcare research. PURPOSE: The purpose of this article was to provide a narrative review of the literature to explore how "music therapy" has been used in healthcare research to promote healing in adult populations. The following five questions were addressed: (a) In what populations and under what conditions has music intervention been studied? (b) What specific kinds of music have been used for study intervention? (c) How has the music intervention been operationalized? (d) What metrics have been used as outcome measures? (e) Have music interventions been effective? METHODS: Articles were retrieved from several scientific databases (PubMed, CINAHL, and PsycINFO) using the following search parameters: MeSH search terms "music therapy" in the title field with the search limit to "adults 19 years and older," "humans," "clinical randomized controlled studies," and "English." A total of 33 clinical randomized controlled studies that met the search criteria were reviewed. RESULTS: (a) In the reviewed studies (studied articles), subjects with dementia were the most commonly studied population group, and the predominant aim of the study was to alleviate anxiety. (b) Employed music interventions may be categorized as one of two types: passive (receptive) and active. The passive (receptive) music intervention commonly involved subjects in a resting position listening to music, whereas the active music intervention is usually carried out in a group format in which subjects are actively involved in the music intervention. (c) Intervention frequency, dosing, and duration were highly variable across the reviewed studies. Very few studies described the intervention setting, which made evaluation of these studies difficult. Direct supervision seemed to be an influential factor for adherence. (d) Outcome measures in retrieved articles involved two types: psychological and physiological or biological. (e) The effectiveness of music intervention was reported as successful in most of the retrieved studies. CONCLUSION: Much work has been done on the use of music interventions in the clinical setting. Future research should consider participant music selection preferences, and the selection of active versus passive intervention approach should be based on a clear conceptual framework. Combining both physiological and psychological measures in the study design is a recommended approach to increase measurement validity.

Effects of audio relaxation programs for blood pressure reduction in older adults.

BACKGROUND: Stress management is one element of the lifestyle modification that is recommended for blood pressure control. Reduction in sympathetic arousal may be achieved through a series of audio relaxation training. AIMS: The purpose of this study was to evaluate the short-term and long-term effects of two audio relaxation programs for blood pressure reduction in older adults. METHODS: This clinical randomized study consists of 12-sessions of intervention, with one-month and three-month follow up measures. 41 older adults were randomly assigned to either listening to a 12-minute audio relaxation program or a 12-minute Mozart andante. At each session, blood pressures were recorded. RESULTS: For both groups, the reduction in systolic and diastolic blood pressures after the 12-session intervention training was statistically and clinically significant. The reduction in systolic blood pressure was greater in the audio relaxation group than the Mozart group. The adherence to the program at one-month and three-month was 54% and 66% respectively. The blood pressure at one-month and three-month were not significantly different than the initial measurement. CONCLUSIONS: Significant blood pressure reduction can be achieved through a brief 12-minute audio relaxation program with older adults. Guided relaxation may be more effective in lowering blood pressure than plain music.

Hospitals going green: a holistic view of the issue and the critical role of the nurse leader.

The healthcare industry produces millions of tons of waste each year and is one of the largest consumers of energy in the United States. This article focuses on how nurses can facilitate "green" hospitals and work toward environmental sustainability. The authors critically approach the topic from the perspectives of nursing, environmental health, psychology, politics, international health, economics, and ethics. Specifically, the article addresses the critical role of the professional nurse as a leader in the creation of environmentally friendly and holistic clinical practice.

Comparison of body composition, handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants.

Immigration to a foreign country has a significant impact on a person's health status and health management behavior. The purpose of this pilot study was to examine body composition (body mass index and muscle area of the mid-upper arm and mid-calf), handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants. In this cross-sectional study, a convenience sample of 87 elderly Korean immigrants and 294 elderly Koreans were recruited from senior centers and senior apartments in the United States and Korea. Compared with elderly Koreans, elderly Korean immigrants had higher mid-calf muscle area (p = 0.06), handgrip strength (p = 0.01), and functional capacity (p = 0.01) and less physical activity (p < 0.01). Older men were more physically active and had more muscle areas, greater handgrip strength, and better functional capacity than older women, whereas older women had higher BMI scores than older men. This study provides motives for the development of health promotion intervention studies (e.g., culturally relevant exercise programs incorporating strength training). Future studies could identify culturally relevant strategies to promote physical activity in elderly Korean immigrants and especially elderly Korean women in both groups.

An audio relaxation tool for blood pressure reduction in older adults.

The purpose of this pilot study was to evaluate the effectiveness of an audio relaxation tool for lowering blood pressure and augmenting heart rate variability (HRV) in older adults. Fourteen older adults (83 +/- 8 years) participated in the study. The intervention consisted of 12 sessions of a guided relaxation program. Blood pressure was taken before and after each intervention. HRV was assessed once before training and at the conclusion of the final session. Paired sample t tests were used for data analysis. Comparing pre and post parameters for all sessions, the intervention resulted in a statistically significant reduction in systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and heart rate (P < .005). HRV was unaffected. This study provides support for the use of guided relaxation to reduce high blood pressure in older adults. This 12-minute relaxation audio program can be used for high blood pressure prevention or in conjunction with antihypertensive medications for blood pressure management. Further research is recommended.

Teaching professional values in a BSN program.

Values are core to the practice of nursing, determining priorities in healthcare and forming the foundation of relationships with clients. Specific values have been recognized as essential to professional nursing practice and are considered central content within a baccalaureate nursing program. While these professional values are identified and defined, there is little guidance in nursing pedagogical literature as to teaching approaches, range and depth of content, and evaluative methods in this area. Clear discussion of an effective educational approach to professional values would be a significant contribution to the discipline of nursing. The paper expands on the brief summary of the five professional values identified by AACN as essential to professional nursing practice. It is easy to understand these values on a superficial level, but these values have many layers and are very difficult to live out in nursing practice. The discussion moves beyond definition and gives specific examples to lend clarity and depth to the topic. The discussion includes common areas in which students have difficulty, noting the inherent challenges for each of the values.

Timing of the newborn first bath: a replication.

PURPOSE: To evaluate the effects on thermoregulation of bathing a healthy newborn within the first hour of life compared to bathing four to six hours after birth. DESIGN: Quasi-experimental. SETTING: Newborn nursery of a 30-bed obstetric unit in an urban university hospital. SAMPLE: Fifty-one healthy term newborns with a minimum axillary temperature of 36.5 degrees C (97.7 degrees F). INTERVENTION: Newborns in an experimental group were bathed within the first hour of birth; those in a control group were bathed at the standard four to six hours of age. MAIN OUTCOME VARIABLE: Axillary temperatures were measured before the bath, immediately after the bath, one hour later, and two hours later. RESULTS: Axillary temperatures as measured at four different times did not differ significantly between infants bathed within one hour of birth and those bathed four to six hours after birth. CONCLUSIONS: A flexible bathing time is recommended according to the characteristics and stability of the newborn and to family desires.

Caring: from philosophical concerns to practice.

I read Hilde L. Nelson's article with great interest. To be "against caring" is tantamount to being against apple pie and motherhood. Caring as philosophy, theory, behavior, and ontology is pervasive in the literature of almost all socially interactive professions. Nelson's article raises common concerns about caring.... My difficulties with Nelson's argument against caring center around three issues: misunderstanding of caring in nursing practice, discomfort with ambiguity, and heroism as a replacement for the ethics of care....