Successful collaboration within an integrative practice model.

The purpose of this article is to illustrate how collaboration is a key aspect in successful use of an integrative practice model. The integrative practice model depicts the clinical nurse manager, staff development specialist, and clinical nurse specialist roles as having a primary focus with shared secondary dimensions. Critical components of successful collaboration are described as: the establishment of a trusting relationship, ability to develop mutually satisfying goals, and effective communication. An example of the authors' successful implementation of the integrative practice model is given. Positive, measurable outcomes validated the effectiveness of this model when combined with effective collaboration. Striving for successful collaboration within an integrative practice model is recommended to other advanced practitioners who wish to increase individual effectiveness, enhance professional growth, and improve patient outcomes.

Emergence of gram-negative bacilli in the mouths of bone marrow transplant recipients using chlorhexidine mouthrinse.

PURPOSE/OBJECTIVES: To examine whether use of chlorhexidine (CHX) in stomatitis-prevention regimens following bone marrow transplantation (BMT) enhances the emergence of gram-negative bacilli (GNB) to a degree that exceeds its benefits. DATA SOURCES: Articles, book chapters, and case studies. DATA SYNTHESIS: Despite rigorous topical and systemic antimicrobial therapy, oral opportunistic GNB infections occur following BMT. This is most likely because of low susceptibility of GNB to CHX and not that CHX predisposes patients to these infections or the development of CHX resistant strains. CONCLUSIONS: The benefits of CHX use (e.g. preservation of oral mucosa and broad-spectrum antibacterial and antifungal effects) outweight the risks of GNB infection. IMPLICATIONS FOR NURSING PRACTICE: Routine clinical and microbiologic monitoring of the oral cavity are essential with use of CHX. Stomatitis care standards and patient instructions following discharge are included.

A systematic evaluation of a poster presentation.

The purpose of this study was to describe an alternative approach to educating nurses and comparing attendance rates between traditional and alternative programs. In these times of scarce nursing resources, traditional methods of staff development have been found to be ineffective. Frequently, nurses are unwilling to leave their patient care responsibilities to attend even short presentations at a given place and time. A poster presentation designed for oncology nurses attracted 65% of all possible participants.