Measuring Nursing Student Development Through Computer-Based Simulation Activities.

BACKGROUND: New nurse attrition jeopardizes patient safety, devastates career plans, and negatively impacts costs to hospitals and patients. Employers and educators recognize the widening transition-to-practice gap in meeting expectations for practice-ready, resilient nurses. PURPOSE: The purpose of this study was to test the use of computer-based simulation activities (CBSAs) to measure processes in Aller's Development of Decision-Making and Self-Efficacy Model (ADD-SEM). METHODS: BSN students (N = 50) in a multisite, cross-sectional study used CBSAs to provide data on decision making (Virtual Patient Lasater's Clinical Judgment Rubric), psychological capital (Nursing Anxiety and Self-Confidence in Decision-Making Scale©), and reflection. RESULTS: Repeated-measures analysis of variance and reflexive thematic analysis revealed that decision-making (DM) scores were highest in noticing and lowest in interpreting with significant differences in cohorts (DM) (juniors: P < .001; seniors: P = .013) and self-confidence/anxiety ( P < .001). CONCLUSION: The CBSAs are an effective means of measuring student development of DM and psychological capital needed to retain resilient nurses.

Biomechanical and Mechanobiological Drivers of the Transition From PostCapillary Pulmonary Hypertension to Combined Pre-/PostCapillary Pulmonary Hypertension.

Combined pre-/postcapillary pulmonary hypertension (Cpc-PH), a complication of left heart failure, is associated with higher mortality rates than isolated postcapillary pulmonary hypertension alone. Currently, knowledge gaps persist on the mechanisms responsible for the progression of isolated postcapillary pulmonary hypertension (Ipc-PH) to Cpc-PH. Here, we review the biomechanical and mechanobiological impact of left heart failure on pulmonary circulation, including mechanotransduction of these pathological forces, which lead to altered biological signaling and detrimental remodeling, driving the progression to Cpc-PH. We focus on pathologically increased cyclic stretch and decreased wall shear stress; mechanotransduction by endothelial cells, smooth muscle cells, and pulmonary arterial fibroblasts; and signaling-stimulated remodeling of the pulmonary veins, capillaries, and arteries that propel the transition from Ipc-PH to Cpc-PH. Identifying biomechanical and mechanobiological mechanisms of Cpc-PH progression may highlight potential pharmacologic avenues to prevent right heart failure and subsequent mortality.

The Effect of Aromatherapy on Insomnia and Other Common Symptoms Among Patients With Acute Leukemia

Purpose/Objectives: To determine if the use of aromatherapy improves insomnia and other common symptoms in hospitalized patients with newly diagnosed acute leukemia. Design: A randomized, crossover, washout trial. Setting: An inpatient acute leukemia unit at the Arthur G. James Cancer Hospital and Richard L. Solove Research Institute of the Wexner Medical Center at Ohio State University in Columbus. Sample: 50 patients who were newly diagnosed with acute leukemia and hospitalized to receive their initial four weeks of intensive induction chemotherapy. Methods: Patients were offered a choice of three scents to be used during the trial: lavender, peppermint, or chamomile. Each patient was randomized to receive either the chosen aromatherapy intervention or a placebo intervention during alternate weeks, with a washout period in between. Sleep quality and other common symptoms were measured. Main Research Variables: Aromatherapy, sleep, insomnia, pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and well-being. Findings: Most patients reported poor quality sleep at baseline, but aromatherapy had a statistically significant positive impact. Improvements were noted in tiredness, drowsiness, lack of appetite, depression, anxiety, and well-being because of aromatherapy. Conclusions: Aromatherapy is a viable intervention for improving insomnia and other symptoms commonly experienced by patients with acute leukemia. Implications for Nursing: Oncology nurses can employ aromatherapy safely and inexpensively, and with minimal training, as an effective tool in decreasing many symptoms that plague patients with leukemia. Patients can exercise a greater sense of control over their treatment environments through the use of aromatherapy.