From Blank Canvas to Masterwork: Creating a Professional Practice Model at a Magnet Hospital.

Objective. The purpose of this study was to engage registered nurses (RNs) in the creation of a Professional Practice Model (PPM). Background. PPMs are essential as the philosophical underpinnings for nursing practice. The study institution created a new PPM utilizing the voice of their RNs. Methods. Qualitative inquiry with focus groups was conducted to explore RNs values and beliefs about their professional practice. Constant-comparative analysis was used to code data and identify domains. Results. The 92 RN participants represented diverse roles and practice settings. The four domains identified were caring, knowing, navigating, and leading. Conclusions. Nurse leaders face the challenge of assisting nurses in articulating their practice using a common voice. In this study, nurses described their identity, their roles, and how they envisioned nursing should be practiced. The results align with the ANCC Magnet® Model, ANA standards, and important foundational and organization specific documents.

Viral gastroenteritis in the adult population: the GI peril.

Viral gastroenteritis is extremely common, causing millions of cases of diarrhea in all age groups worldwide. Norovirus has been identified as the leading cause of viral gastroenteritis in the adult population. The combination of a low infectious dose, viral shedding before and for weeks after illness, and resistance to temperatures from freezing to 60°C and to many common household cleaners makes norovirus a winter peril. Mild disease requires symptomatic treatment alone. Complicated cases develop severe dehydration and hypovolemia, requiring the skills of critical care nurses to meet the challenges of care. This article addresses diagnosis and prevention strategies.

Postoperative care for the robotic surgery bowel resection patient.

A new surgical method is available for colon and rectal surgery. Robotic surgery, using the daVinci Si HD Surgical System, offers surgical advances compared with the traditional open or laparoscopic surgical methods. The potential advantages of robotic technology continue to be explored and its most appropriate functions are yet to be determined. In clinical experience, the use of this surgical method has resulted in changes to postoperative nursing care management. This article describes changes in the management of postoperative patient care including fluid and electrolyte balance, and patient and staff education. Modifications were instituted in the clinical pathway to facilitate an accelerated standard of care. New discharge strategies were implemented to ensure ongoing fluid and electrolyte balance by the patient. A true team effort from a multitude of disciplines was required for the changes in patient care routine to be effective. Outcomes including length of stay and patient satisfaction are presented.

Using complementary and alternative therapies to promote comfort at end of life.

Dying is a journey for all involved. We have been fortunate to work in a hospital with both an ICU and a palliative care/hospice unit. We have transferred patients for whom care was withdrawn and who were still alive on the next day to the palliative care unit and have found the transfer to work to maximize comfort in dying. For many patients and families who have developed relationships with the staff in their ICU, the combination of established relationships, traditional therapies, and CAT maximizes the comfort during the dying process.