An Intergenerational Comparison of Civility: Nursing Students and Nurse Educators.

PURPOSE: Intergenerational differences in perceptions related to civility among nursing students and nurse educators were explored. METHOD: A convenience sample of 13 students and 10 educators were interviewed in this descriptive qualitative study. RESULTS: Both groups defined civility as kindness, collaboration, and respect. Educators described civil students as being open to learning, polite, appreciative, and gracious. Students described civil educators as listening without judgment and being supportive and respectful. Educators described uncivil students as being disrespectful and entitled, and improperly using social media. Students described uncivil educators as belittling and impatient, and failing to listening. CONCLUSION: Respect was the strongest theme for both students and educators. In describing civil acts, students focused on cooperation to accomplish classroom and clinical tasks, whereas educators focused on productive classroom behaviors. More research on intergenerational differences is needed to help nurse educators develop interventions that allow faculty to view civility from a student perspective. [J Nurs Educ. 2024;63(2):86-92.].

Effects of Medicare wellness visits on health promotion outcomes.

BACKGROUND: The American older adult population has the highest historical prevalence of chronic disease and underuses wellness visit benefits. Little is known about how Medicare wellness visits (MWVs) affect health outcomes. PURPOSE: The aim of this retrospective case-control study was to examine how MWVs affect health outcomes by measuring two kinds of data for case and control groups at baseline versus 15 months: (1) the differences in blood pressure, fasting lipids, and glucose levels and (2) the completion frequencies for seven screenings and vaccinations. METHODOLOGY: Informed by Pender's Health Promotion Model, this design used purposively matched samples from a large American Midwestern Medicare population active between January 2013 and January 2016, with a total sample size of 252, consisting of the case group ( N = 120) and control group ( N = 132). The case and control group samples were matched according to gender, age, marital status, Charlson index scores, smoking status, and pharmaceutical classes. The two groups, case (MWV recipients) and matched control (MWV nonrecipients), were compared at different time points using a doubly multivariate repeated-measures analysis procedure. Descriptive statistics were computed to compare completion frequencies between groups. RESULTS: A doubly repeated multivariate analysis of variance (MANOVA) and descriptive statistics revealed significant differences between the case and control group for three of the four health outcomes. The case group had increased completion frequencies in pneumococcal vaccination. CONCLUSIONS: Additional research controlling for more variables is warranted to better understand MWV efficacy on health outcomes. IMPLICATIONS: Primary care providers need to study how MWVs affect longitudinal health outcomes.

Navigating the Institutional Review Board Process.

Participating in a research project can be a very rewarding activity. Yet prior to undertaking any aspect of a research project that involves human participants, the principal investigator must submit their project to and gain approval from an Institutional Review Board (IRB). This article in the "Exploring the Evidence: Focusing on the Fundamentals" series provides nephrology nurses with basic information related to the IRB process, as well as steps to follow in the preparation and submission of a research project for IRB approval.

Retrospective Analysis of Factors Associated With a Revised Fall Prevention Bundle in Hospitalized Patients.

OBJECTIVE: The study aims to describe factors associated and injuries sustained with inpatients who fell while hospitalized and identify the impact of a revised fall-prevention bundle. BACKGROUND: Approximately 1 million falls occur in hospitals annually, accounting for approximately 70% of inpatient accidents. Inpatient falls can result in physical injury, increased patient mortality and morbidity, decreased quality of life, and increased length of stay and cost. METHODS: We used a retrospective review of patient fall data for adult inpatients who fell while hospitalized. RESULTS: After reeducation and implementation of all elements of a revised fall-prevention bundle, there were fewer falls per patient day. We identified additional characteristics indicating when patients were more likely to be injured in a fall. CONCLUSIONS: A fall-prevention bundle is effective in decreasing inpatient falls and falls with injury. Raising awareness of additional factors may decrease risk of injuries during an inpatient fall.

Are Medicare wellness visits improving outcomes?

BACKGROUND: As the largest and unhealthiest population in American history enrolls as Medicare beneficiaries, it is vital for primary care providers to understand how to maximize Medicare wellness provisions. The Baby Boomer population has been documented to have the highest chronic disease prevalence related to preventable lifestyle behaviors. Perpetual unhealthy lifestyle behaviors associated with chronic disease prevalence are detrimental to life quality and the American Medicare resource structure. Since 2011, the Affordable Care Act provisions have included free wellness visits designed to prevent disease for Medicare beneficiaries, who continue to grossly underuse these services. OBJECTIVES: This systematic review was conducted to evaluate the quality, level, and strength of evidence regarding Medicare wellness service efficacy on related health outcomes. DATA SOURCES: The methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for selection of 21 research-based articles included in the analysis. Results from the 21 eligible studies revealed low research quality and vigor; therefore, lacking causality and generalizability of medicare wellness visit (MWV) efficacy on health promotion outcomes. CONCLUSIONS: The evidence is focused on how MWVs are affecting preventive care utilization instead of patient health outcomes. In the interest of reducing chronic disease prevalence and the economic burden on our health care system, it is important to understand how these services affect health promotion outcomes. IMPLICATIONS FOR PRACTICE: The results of this systematic literature review substantiate the need for primary care providers to study MWV efficacy on health promotion outcomes for the Medicare population.

Nurses Need to Publish Scholarly Articles: Overcoming Reticence to Sharing Valuable Experience.

This article is part of the "Exploring the Evidence: Focusing on the Fundamentals" series. It provides nephrology nurses with basic principles related to writing for publication, information regarding different types of professional articles that may be used for the dissemination of nursing knowledge, as well as steps to follow and issues to consider in the planning and preparation of a manuscript.

Disseminating Scholarly Work through Nursing Presentations.

This article in the "Exploring the Evidence: Focusing on the Fundamentals" series provides nephrology nurses with basic principles related to the dissemination of knowledge in a professional conference setting. This article provides steps to follow in the preparation and submission of an abstract, as well as the subsequent development of a poster or podium presentation.

Methodological Issues of Research with African-American Women: Influences on Long-Term Physical Activity in Physically Active African-American Women.

This paper reports the methodological challenges encountered while performing a descriptive, qualitative study examining the perspectives of African-American women who successfully maintained long-term physical activity. The socioecological model was used to expand on the dynamics pertaining to the long-term physical activity of 14 African-American women between 35 and 65 years of age. These women were recruited in 2 Midwestern American states and had been physically active for more than 6 months at the time of the study. Content analysis of themes revealed factors influencing physical activity at the individual, social, environmental, and political levels. Methodological challenges the student researcher encountered were choosing the appropriate framework to guide the study, recruiting participants who met the inclusion criteria, and proficiently transcribing and organizing the responses for data analysis using qualitative analysis software. The reflections described in this paper may provide insight to challenges and possible solutions for new researchers to consider when developing a research project.

Gastrointestinal Microbiota in Patients with Chronic Kidney Disease: A Systematic Review.

Emerging evidence suggests that gastrointestinal (GI) microbiota dysbiosis is associated with chronic kidney disease (CKD) and metabolite concentrations. The purpose of this systematic review was to evaluate and contextualize the research characterizing GI microbiota in patients with CKD. We searched for full-text, peer-reviewed, English studies in PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Google Scholar using a combination of MeSH terms and keywords. Eleven of the 20 studies examined GI microbiota in patients with CKD, and 9 studies focused on the effect of interventions on GI microbiota or metabolites. Available data characterizing GI microbiota in patients with CKD suggest a decline in saccharolytic bacteria and an increase in fermenters of nitrogen-containing compounds, serving as a source for circulating uremic toxins. However, studies examined limited sets of predetermined microbes, which do not reflect the entire GI microbial community and its influence on host physiology. We recommend further studies examining the entire microbial community and the potential role in regulating host physiology in CKD.

A comparative study of social capital and hospital readmission in older adults.

Numerous factors contribute to hospital readmissions of older adults. The role social capital may play in preventing hospital readmissions is unknown. The aim of this descriptive, cross-sectional study was to determine if levels of personal social capital differ in two groups of patients aged 65 and older, those readmitted to the hospital within 30 days of discharge and those not readmitted. Participants in this study (N = 106) were community-dwelling older adults discharged from 11 hospitals in the Midwestern United States. The Personal Social Capital Scale and a demographic questionnaire were mailed to eligible participants for completion. Multivariate Analysis of Variance (MANOVA) was computed to examine the differences in the dependent variables of bonding and bridging social capital between those patients readmitted within 30 days and those not readmitted within 30 days. No significant differences between the two groups' mean levels of bonding or bridging social capital were identified.

Focusing on the Fundamentals: Reading Quantitative Research with a Critical Eye.

Nephrology nurses must be able to critically analyze research to improve their practice. This article defines the components of a quantitative research article, reviews principles that nephrology nurses can use when reading and interpreting a quantitative research article, and provides a methodical way of approaching a quantitative research article to determine its merits and limitations.

A qualitative exploration of nursing students' perceptions of the homeless and their care experiences.

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students' perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students' knowledge of homelessness.

Social capital, health, health behavior, and utilization of healthcare services among older adults: A conceptual framework.

Meeting the health needs of Americans must change as the population continues to live longer. A strategy that considers social well-being is necessary. One way to improve social well-being is through increased social capital, which includes networks among individuals and norms of reciprocity and trust between them. Supporting attainment of bonding social capital from close-knit groups, such as family, and bridging or linking social capital from those who are dissimilar are vital. Research shows there is a relationship among social capital and self-reported mental and physical health, health behaviors, healthcare utilization, and mortality. Because older adults are often dependent on others for their healthcare needs, it is posited that social capital plays a key role. Nurses can be instrumental in investigating levels of social capital for individuals and determining what type of social support is needed and who in the individual's network will provide that support. When support is absent, the nurse serves as the link between patients and available resources. The purpose of this article is to introduce a conceptual framework that can assist nurses and other healthcare providers to consider social capital in older adults in the context of relationships and the social environments to which they belong.

Improving the Patient Experience in the Urology Office: An Evidence-Based Tool Kit to Impact Staff Perception Of Patient Satisfaction.

Researchers evaluated the effectiveness of an educational intervention, which included use of an evidence-based tool kit for healthcare providers to improve patient satisfaction. Findings demonstrated improved staff perceptions of their actions influencing patient experiences, use of standardized patient care processes, and increased patient experience scores.

The Impact of Disordered Gambling Among Older Adults.

The current study is a secondary analysis that describes the mental, social, and economic health impacts of disordered gambling in older adults recovering from pathological gambling. The study sought to answer the following research questions: (a) What are the problem behaviors in the mental, social, and economic health dimensions?; and (b) What is the association between mental, social, and economic health impact dimensions and the South Oaks Gambling Screen score? The study population comprised a convenience sample of 40 older adults recovering from pathological gambling in the Midwestern United States. Participants were originally recruited from Gamblers Anonymous(®) meetings and gambling treatment centers. Significant findings for the current study population were: gambling causing depression, being fired from a job due to gambling, and still paying off gambling debt. Nurses should evaluate effects of disordered gambling, assess for disordered gambling, and include a financial assessment in routine care of this patient population.

Behind Bars: Experiences Conducting Behavioral Addictions Research in a County Jail.

Individuals who are incarcerated experience disparities in mental health, warranting study by nurse researchers. However, nurse researchers' unfamiliarity with the jail environment may pose a barrier to conducting research with this vulnerable population. The current article presents an account of the planning and implementation needed to study perceived health and gambling behavior in county jail inmates. The challenges and rewards of research that aim to better understand the mental health issues affecting this population are also identified. Developing relationships with jail personnel and understanding the incarcerated population and their surroundings are key to conducting research in this environment.

Non-Critical-Care Nurses' Perceptions of Facilitators and Barriers to Rapid Response Team Activation.

Rapid response teams can save lives but are only effective when activated. We surveyed 50 nurses for their perceptions of facilitators and barriers to activation. Findings showed that participants need more education on their role and when to activate the rapid response team. Nurses who comprise the team need help building their communication skills. We recommend nursing professional development specialists increase the frequency of offerings and expand the focus on roles, activation criteria, and communication skills.

Changing measures to evaluate changing bone.

Osteoporosis is a silent, progressive disease affecting millions of Americans, costing $23.5 billion annually (). Fragility fractures, painful and costly sequelae of osteoporosis, are frequently underdiagnosed and undertreated partially because of limited assessment measures. Currently, bone mineral density measured by dual-energy x-ray absorptiometry is the surrogate marker of bone health () but has shortcomings predicting fragility fractures. Bone turnover markers and magnetic resonance spectroscopy are promising techniques for earlier, more accurate assessment of bone physiology and structure. Bone turnover markers reflect the dynamic nature of living bone (), thus providing a more comprehensive picture of bone health. Magnetic resonance spectroscopy may hold predictive power in determining fast and slow bone mineral density losers (). The use of these tools may assist with diagnosis of osteoporosis, allowing earlier determination of the effectiveness of prescribed therapies to improve bone health.

Lessons learned from conducting qualitative research in a hospital.

AIM: To examine unexpected barriers to the conduct of hospital research during a study of nurses' activation of rapid response teams. BACKGROUND: We interviewed hospital nurses regarding their decisions to activate rapid response teams and encountered unexpected barriers to the conduct of this study in the hospital setting. DATA SOURCES: Experience of conducting qualitative research with bedside nurses in a community hospital. REVIEW METHODS: Review of the reports of others who have conducted hospital research. DISCUSSION: Barriers related to administrative support, environmental distractors, constraints on nurses' time, apparent lack of investment in research by staff and a cumbersome recruitment process are identified. Recommendations on study site selection, timing of research, gaining access to nurses, scheduling and conducting interviews, and transcribing recorded data are made. CONCLUSION: As evidence is necessary to deliver safe, quality care, it is important that nurses understand and participate in research. This participation involves not only conducting research, but also serving as subjects. Given the importance of bedside nurses' willingness to engage in research, it is crucial to understand factors that impede or assist their participation. IMPLICATIONS FOR RESEARCH/PRACTICE: We offer several recommendations to nurses conducting research in hospitals, including: ■ Seek hospitals that are supportive of research, yet not over-invested in the process. ■ Build extra time into data collection schedules to maximize flexibility and accommodate work-place demands. ■ Emphasise the relevance and benefits of the research to nurses.