Best Practice for Delivering Small-Volume Intermittent Intravenous Infusions.

This study investigated the delivery of small-volume intermittent intravenous (IV) infusions. Laboratory protocol evaluated potential medication loss among 6 administration methods using 50- and 100-mL solutions. Significant variations existed in calculated medication loss depending on administration method and volume. Up to 35% of medication may not be administered due to residual volume, with the greatest percentage associated with 50-mL solutions. Results suggest that intermittent IV infusions should only be delivered as a secondary infusion through a primary infusion administration set with a continuous infusion or an infusion that can flush the administration set at the completion of the secondary infusion.

Alcohol Use and Activity Limitations in Gout Patients.

BACKGROUND: Few studies have evaluated whether patients with a diagnosis of gout adhere to alcohol use recommendations and the relationship between adherence and activity limitations. PURPOSE: The purpose of this study was to determine adherence to American College of Rheumatology (ACR) alcohol use recommendations and evaluate the relationship between alcohol use and activity limitations in persons with gout. METHOD: A secondary analysis was performed with a sample of 298 persons with gout from the 2008 National Health Interview Survey. RESULTS: In all, 22.8% of persons with gout were nonadherent to alcohol use recommendations. Males, those aged 41-60 years, and those not receiving healthcare for joint symptoms were most likely to be nonadherent. In all, 39.9% reported that joint symptoms interfered with activity in the preceding 30 days. Those who were adherent were more likely to report limitations (χ = 6.788, p = .03). CONCLUSIONS: To promote optimal patient outcomes, more attention needs to be devoted to individualized patient education and self-management interventions that follow ACR recommendations.

An update on gout for primary care providers.

This article discusses the current beliefs regarding the pathogenesis of gout and reviews the 2012 guidelines from the American College of Rheumatology regarding diagnostic testing, optimal treatments, and lifestyle modifications. Implementing these guidelines will assist clinicians in resolving acute episodes and managing gout long term, improving outcomes and quality of life.

Effect of nurse navigation on patient care satisfaction and distress associated with breast biopsy.

BACKGROUND: Navigation during the biopsy period is a superior approach to delivering care, with those patients receiving services experiencing less distress. Critical nurse navigator roles include providing information and facilitating access to the healthcare system, both of which are influential on distress. The information in this article supports the expansion of navigation programs to include women undergoing biopsy and aids in promoting a higher standard of care. OBJECTIVES: To evaluate the effect of navigation on care satisfaction and distress in women undergoing breast biopsy. METHODS: A descriptive, cross-sectional survey design from two outpatient radiology clinics in Appalachia was used. FINDINGS: Navigated women had lower scores on every distress measure and were less likely to seek information from an outside source. Women who were more satisfied with their care reported decreased distress; the factors influencing distress varied depending on whether they were the recipient of navigation services. In the non-navigated population, general satisfaction with care and accessibility were more likely to influence distress.

Incidence of distress and associated factors in women undergoing breast diagnostic evaluation.

The purpose of this study was to identify the incidence of distress and factors associated with distress in women undergoing breast diagnostic evaluations. A total of 128 women undergoing a breast biopsy at three hospitals completed a set of nine standardized instruments. The presence of distress was identified with 14% having symptoms above the cutoff point for clinical anxiety. In multiple regression analyses, trait anxiety alone explained 71% of the State-Trait Anxiety Inventory State score. A model with trait anxiety, satisfaction with health care, meaning in life, and friend support accounted for 66% of the Hospital Anxiety and Depression Scale score for depression. It appears that when faced with a potential cancer diagnosis, distress levels are based on personality and self-evaluation of whether one has the resources to adapt to life with cancer. Distress screening protocols need to be routinely included in diagnostic radiology appointments. Nurses should implement interventions focusing on providing information, facilitating communication, and offering psychosocial support.

Experiences of non-navigated women undergoing breast diagnostic evaluation.

During the diagnostic period, women need appropriate, timely information regarding tests and procedures. Nurse navigator programs were developed to combat the negative effects on survival that are caused by delays in the diagnosis of breast cancer and lack of support from the healthcare team. Nurse navigators decreased barriers to care, increased patient satisfaction, and lowered anxiety in women undergoing diagnostic evaluation. However, although patient navigation programs have become a presence in oncology centers, those programs and the accompanying support are not offered at every facility that provides components of diagnostic evaluation. Therefore, the purpose of the current study was to explore the experiences of women who underwent a breast diagnostic evaluation without any accompanying navigation services.

Health-promotion behaviors and psychological distress in cancer survivors.

PURPOSE/OBJECTIVES: To determine whether cancer survivors engage in health-promotion behaviors, to evaluate the extent of their experience of psychological distress, and to investigate the relationship between the practice of health-promotion behaviors and psychological distress. DESIGN: Cross-sectional secondary data analysis. SETTING: A national, face-to-face interview conducted by personnel of the U.S. Census Bureau using a random sampling of American adults. SAMPLE: 1,784 survey respondents who reported a previous cancer diagnosis. METHODS: Data from the 2009 National Health Interview Survey were used to examine the prevalence of smoking, physical inactivity, alcohol use, and reports of psychosocial distress. Interviews pertained to the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive. MAIN RESEARCH VARIABLES: Age, current smoking prevalence, alcohol consumption, physical activity, and the experience of feeling hopelessness, sadness, and anxiety. FINDINGS: Cancer survivors continue to smoke at a rate similar to the national average. Overall, most respondents reported no symptoms of psychological distress. However, age appears to play a major role, showing significant differences in the prevalence of current smoking, participation in physical activity, alcohol use, and reported level of distress. CONCLUSIONS: This study provides estimates of the prevalence of health-promotion behaviors and experience of psychological distress among American cancer survivors. The results reveal opportunities for interventions among cancer survivors. IMPLICATIONS FOR NURSING: Nurses should be proactive in providing guidance to survivors regarding the adoption of healthy lifestyle behaviors. Those who encounter younger cancer survivors need to be alert to the higher potential for distress in that population, perform appropriate screenings, and be prepared to offer guidance, supportive care, and referrals for psychological care if needed.

Efficacy of a midcurricular examination for predicting nursing student academic success.

The purpose of this study was to investigate the usefulness of the HESI midcurricular examination in identifying at-risk students earlier in their nursing career. This study used quantitative measures to examine the relationship between the HESI midcurricular examination and the student's success in the nursing program and their performance on the HESI-E2 and the NCLEX-RN. In logistic regression models, the score attained on the HESI midcurricular examination was a significant predictor of academic and NCLEX-RN success, with significant differences in scores between those who were and were not successful. Statistically significant correlations were found between the HESI midcurricular examination score and the score on the HESI-E2 and their performance in the capstone nursing courses. An analysis of the data supported the belief that the HESI midcurricular examination was a useful predictive tool that can identify students at risk for nonsuccess prior to the senior year of nursing so that measures to ensure success can be implemented.

Predictability associated with exit examinations: a literature review.

The aims of this review are to study the accuracy of commercial examinations for predicting NCLEX-RN® success to determine whether there are significant differences in scores for graduates who pass the NCLEX-RN on their first attempt compared with those who do not and to discuss the implications of the findings in relation to progression policies. The most widely reported relationships between standardized test scores and NCLEX-RN success are associated with the Health Education Systems, Inc. (HESI) Exit Examination. In studies conducted over 4 consecutive years with a total of 17,432 students, HESI was found to be 96.4% to 98.3% accurate in predicting NCLEX-RN success for the highest scoring students. When HESI Exit Examination scores are used in logistic regression models, they are useful only in predicting NCLEX-RN success, not failure. These findings are consistent with reports regarding other computerized examinations. There is mixed evidence that these progression policies result in increased NCLEX-RN pass rates.

Usefulness of a midcurricular examination for identifying at-risk nursing students.

The purpose of this study was to investigate the usefulness of the Health Education Systems, Inc, midcurricular examination in identifying at-risk students earlier in their nursing career. This study used quantitative measures to examine the relationship between the Health Education Systems, Inc, midcurricular examination and the students' success in the nursing program and their performance on the HESI exit examination and the NCLEX-RN. Statistically significant correlations were found between the score attained on the Health Education Systems, Inc, midcurricular examination and the students' admission grade point average and the grade point average at the time of the Health Education Systems, Inc, midcurricular examination, the students' score on the HESI exit examination, and their performance in the capstone nursing courses. An analysis of the data supported the belief that the Health Education Systems, Inc, midcurricular examination was a useful predictive tool that can identify students at risk for nonsuccess prior to the senior year of nursing so thatmeasures to ensure success can be implemented.