Patient-Centered Education in Wound Management: Improving Outcomes and Adherence.

GENERAL PURPOSE: To educate wound care practitioners about methods of communication that can help promote patient adherence to wound healing recommendations. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Distinguish the use of theoretical frameworks to promote patient adherence to prescribed wound healing recommendations.2. Synthesize the principles of motivational interviewing to best encourage patients to adhere to prescribed wound healing recommendations.3. Select the appropriate self-care strategies for patients who have nonhealing wounds.

Patients with chronic wounds make daily decisions that affect healing and treatment outcomes. Patient-centered education for effective self-management decreases episodes of care and reduces health expenditures while promoting independence. Theoretical frameworks, including the Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory, and Transtheoretical Model of Behavior Change, can assist healthcare providers in identifying strategies that enhance adherence. These strategies include the use of motivational interviewing, a communication technique designed to elicit patients' perspectives regarding treatment goals, outcome expectations, anticipated barriers, and intentions to follow provider recommendations.

Coordinating Clinical Rotations During the Novel Corona Virus 2 Pandemic.

BACKGROUND: The outbreak of COVID-19 cases and deaths caused havoc in the medical, social, and education arenas, turning the normal routine into a new normal. Health care facilities across the state of Florida closed clinical training sites. Nursing students who were in scheduled clinical rotations suddenly were removed from assigned clinical sites. When students were no longer able to attend their clinical rotations due to COVID-19, panic ensued for students and educators. METHOD: After clinical rotations came to a halt due to COVID-19, family nurse practitioner faculty promptly began discussions on clinical placement resolutions including creative and innovative strategies to provide clinical alternatives to face-to-face clinical hours. RESULTS: Graduation has been delayed for 69% of the students due to COVID-19 and the inability to complete the required number of direct face-to-face clinical hours. CONCLUSION: Innovation, dedication, and perseverance allowed faculty to sustain student engagement and retention through quality clinical alternatives. [J Nurs Educ. 2021;60(7):394-396.].

Sleep deprivation and error in nurses who work the night shift.

OBJECTIVE: The aim of this study was to investigate the relationship between sleep deprivation and occupational and patient care errors among staff nurses who work the night shift. BACKGROUND: Whereas the aviation and trucking industries report that sleep deprivation increases errors, few studies have examined sleep deprivation association with occupational and patient care errors among nurses. METHODS: A cross-sectional correlational design was used to evaluate relationships between sleep deprivation and occupational and patient care errors in 289 hospital night shift nurses. RESULTS: More than half (56%) of the sample reported being sleep deprived. Sleep-deprived nurses made more patient care errors. Testing for associations with occupational errors was not feasible because of the low number of occupational errors reported. CONCLUSION: Interventions to increase the quality and quantity of sleep among hospital night shift nurses are needed. Improved sleep among night shift nurses will reduce the impact of sleep deprivation on patient care errors.

What do we know about educating Asian ESL nursing students? A literature review.

Because of cultural differences and language barriers, some Asian nursing students who speak English as a second language (ESL) have not realized their full potential and career goals. Based on an exhaustive search through existing electronic databases in health sciences, this article synthesizes the published literature between 1980 and 2010 on this subgroup of nursing students in four domains: conceptual frameworks, language and communication, support and infrastructure, and instructional strategies. However, some of the classic works were published before 1980. Findings indicate that a body of literature on ESL nursing students has emerged in the last decades, with several limitations. Based on this review, implications for future educational practice and research are elaborated, with an emphasis on an evidence-based approach.

Consequences of the "back to sleep" program in infants.

Sudden infant death syndrome (SIDS) is the third leading cause of infant mortality in the United States and the leading cause of death among infants 28-364 days of age. The "Back to Sleep" program was implemented in 1992 to promote supine sleeping in efforts to prevent SIDS. Along with this implementation came several consequences that are avoidable in infants. The purposes of this article are to describe the Back to Sleep program and its intended purpose, to identify the adverse consequences, and to develop a teaching program for nurse practitioners to use with parents that will both promote safe sleeping and reduce the untoward consequences of the back to sleep program while maintaining the integrity of the SIDS prevention advice.

Nurse practitioner role in preparing families for pediatric outpatient surgery.

Due to medical advances in surgery and anesthesia and cost of hospital stays, more elective pediatric surgical procedures are being performed in outpatient settings. One proposed advantage of outpatient surgery is decreased anxiety or a shorter period of anxiety for pediatric patients and their families because they are able to go home shortly after the surgery. A literature review was conducted to describe anxiety experienced by pediatric patients and their families in the outpatient surgery setting and to explore ways to decrease that anxiety. Both children and parents reported not feeling emotionally and educationally prepared for outpatient surgery. Developmentally appropriate pre-surgical educational programs and parental involvement in the surgical experience can help alleviate the anxiety of both children and parents during the pediatric surgical experience. Nurse practitioners (NPs) are currently being used in pre-operative outpatient settings to conduct physical examinations and provide pre-op education. Pre-op education programs provided by NPs are beneficial in decreasing the anxiety state among children and parents prior to surgery.

Sleep deprivation and psychomotor performance among night-shift nurses.

This study examined how sleep deprivation influenced psychomotor performance of nurses who worked the night shift. Psychomotor performance was measured with the d2 Test of Attention, which quantifies attention, concentration, processing speed, and quality of performance. A sample of 289 licensed nurses was tested with the instrument. Fifty-six percent of the sample was sleep deprived. Mean psychomotor performance scores (26.6 for men and 11.4 for women) were above the normative means (44.4 for men and 41.03 for women). A significant (p<.001) inverse relationship was found between psychomotor performance and hours of sleep. Nurses reported more hours of sleep on a general self-report sleep item than in a sleep diary.

Decreasing psychological distress during the diagnosis and treatment of pediatric leukemia.

A literature review was performed to explore the experiences of parents during their child's diagnosis of leukemia. The findings revealed that anxiety is a major reaction to the diagnosis. Because of the parents' reactions, communication barriers and parental role changes are established between the parent and child. The lack of communication between the parent and child during diagnosis and treatment and parental role changes produce negative outcomes. Negative outcomes place the parent and child at risk for experiencing anxiety years after the illness is treated. This literature review describes positive outcomes that can be accomplished by decreasing the anxiety of parents, which leads to a decrease in communication barriers and parental role changes during the new diagnosis of leukemia. Interventions are provided to increase the support and resources of parents during this phase of the disease. Future research may focus on interventions to decrease anxiety, which will increase communication, produce positive outcomes for treatment, and decrease stress years after the disease is treated.

A nursing faculty's transition to teaching online.

The introduction of web-based instruction into nursing education has resulted in a significant change in the responsibilities of nurse educators. This phenomenological research study explored the experiences of a graduate nursing faculty who had recently made the transition from traditional face-to-face instruction to web-based teaching. Through guided interviews, the faculty participants provided a rich description of their transition to web-based teaching and their perceptions of what faculty members need in order to make such a change successfully. Faculty members described how their role as nurse educators was reconceptualized as they learned to teach in a different environment. The participants' accounts of their experiences revealed a true paradigm shift in their perception of the nurse educator role and, for many, a comparable shift in their philosophy of teaching.

Parental presence during pediatric invasive procedures.

Parental presence during pediatric invasive procedures is becoming more common, yet it remains a controversial issue related to providing family-centered care. A literature review related to this important issue was performed. Credible arguments supporting parental presence during invasive procedures as well as opposing arguments were discussed. One must consider both views in order to create a nonbiased analysis of the issue. Parental presence during invasive procedures raises critical debates related to maintaining or altering the continuum of holistic patient care. Additional research would provide an objective approach to the problem. Development of an evidence-based protocol would provide a framework for this issue.

The anxiolytic effect of the novel antipsychotic ziprasidone compared with diazepam in subjects anxious before dental surgery.

The novel atypical antipsychotic ziprasidone has a pharmacologic profile notable for potent agonism of serotonin (5-HT)1A receptors, antagonism at 5-HT1D receptors, and reuptake inhibition of norepinephrine. 5-HT1A receptor agonism, in particular, suggests anxiolytic activity, and ziprasidone has shown preliminary efficacy in treating the symptoms of anxiety associated with psychotic disorders. In this study, the anxiolytic efficacy of ziprasidone was evaluated in nonpsychotic subjects who were anxious before undergoing minor dental surgery. We compared a single oral dose of 20 mg ziprasidone (N = 30) with that of 10 mg diazepam (N = 30) and placebo (N = 30) in a randomized, parallel-group, double-blind study. The peak anxiolytic effect of ziprasidone compared with that of placebo was similar to that of diazepam but had a later onset. At 3 hours postdose, the anxiolytic effect of ziprasidone was significantly greater than that of placebo (p < 0.05) and somewhat greater than that of diazepam. Diazepam showed a significantly greater anxiolytic effect than placebo at 1 hour (p < 0.05) but not at 3 hours. The sedative effect of ziprasidone was never greater than that of placebo, whereas that of diazepam was significantly greater than that of placebo 1 to 1.5 hours postdose. Ziprasidone was generally well tolerated. Only one patient reported treatment-related adverse events (nausea and vomiting) and, unlike diazepam, ziprasidone did not cause reductions in blood pressure. Dystonia, extrapyramidal syndrome, akathisia, and postural hypotension were not seen with ziprasidone. Thus, ziprasidone may possess anxiolytic effects in addition to its antipsychotic properties.