Credentialed and Privileged Clinical Nurse Specialists.

PURPOSE/OBJECTIVES: The purpose of this article is to illustrate, using exemplars, the practice of clinical nurse specialists (CNSs) in Michigan who are credentialed and privileged as providers by hospital/healthcare agencies to practice in acute inpatient and ambulatory settings. DESCRIPTION: The CNS provides expert specialty direct patient care to improve patient outcomes. They hold a graduate degree as a CNS, are professionally certified as a CNS in a specialty practice population, and are licensed or otherwise recognized to practice as an advanced practice nurse by the state nursing practice regulatory agency. OUTCOME: The exemplars illustrate CNS practice as an independent provider within a health system. CONCLUSION: Hospital-based credentialing and privileging facilitates CNS practice within the full scope of practice authority that consists of education, certification, and licensure and is a valuable contribution to cost-effective, high-quality clinical care for specialty populations.

The Immediate Physiological Effects of E-Cigarette Use and Exposure to Secondhand E-Cigarette Vapor.

BACKGROUND: Vaping continues to grow as an alternative to smoking and as a recreational activity for people of all ages, including minors. The billion-dollar industry offers users a plethora of flavors, nicotine concentrations, e-juice combinations, and devices. While some studies suggest vaping is beneficial for certain ailments and as a smoking cessation tool, many studies report concerning health outcomes associated with vape use. Recent FDA regulations have banned certain vaping products following an increase of vaping-related lung injuries reported in 2019. Health care providers need to better understand the physiological effects of vaping-specific products and the impact of secondhand vapor. The specific aims of the present study were to understand the immediate effects on heart rate, breathing frequency, blood pressure, blood sugar, [Formula: see text], pulmonary function, and oral temperature following e-cigarette use and secondhand vapor exposure. METHODS: A total of 149 volunteers participated in this study; 76 subjects vaped mint-flavored e-cigarettes with 5% nicotine for 20 min while seated next to 73 nonvaping subjects who agreed to be exposed to the vapor. Health variables including heart rate, blood pressure, breathing frequency, blood glucose, FVC, [Formula: see text], and oral temperature were obtained prior to vaping or exposure to vapor and again after 20 min. RESULTS: Subjects who vaped had significantly higher heart rate, breathing frequency, and oral temperature, and significantly lower blood oxygenation levels (ie, [Formula: see text]) after vaping for 20 min. Nonvaping subjects exposed to vapor had significantly higher oral temperature after 20 min of exposure. Blood sugar and FVC were not significantly affected by vaping or exposure to vapor. CONCLUSIONS: Vaping with mint-flavored e-cigarettes with 5% nicotine for 20 min resulted in significant immediate physiological changes. Exposure to e-cigarette vapor significantly increased oral temperature within the same amount of time.

Effects on vital signs after twenty minutes of vaping compared to people exposed to second-hand vapor.

INTRODUCTION: Very little is known about the immediate physiological implications of vaping or inhaling second-hand vapor. This study used a quantitative approach to understand the short-term physiological implications of vape use and exposure to sec-ond-hand vapor for people who do not vape. MATERIAL AND METHODS: One hundred and forty-eight people participated in the study, 75 self-identified as non-vapers and 73 self-identified as people who vape. All participants were over the age of 18. Participants used or were exposed to non-flavored e-juice without nicotine in Sorin® vape devices. Heart rate, blood pressure, respiratory rate, blood oxygenation, blood glucose and pulmonary function tests were assessed. Physiological parameters were assessed prior to vape use or exposure to vapor and again after 20 minutes of vaping. RESULTS: Findings indicated there were no significant changes in most health parameters except blood pressure which was reduced in both groups. Heart rate was also significantly reduced for vaping participants. CONCLUSION: Vaping without flavorings or nicotine do not appear to have an immediate negative health impact on vital signs. The physiological effects of long-term exposure and/or vape use requires additional investigation. Information was established regarding the physiological effects of non-flavored, non-nicotine vaping so future studies can compare the effects of vaping with assorted flavors and nicotine concentrations to the effects of vaping only the base ingredients (vegetable glycerin and propylene glycol). New knowledge was gleaned relating to exposure to vapor, a phenomenon not previously examined but common espe-cially among non-vaping people who attend social events where people are vaping.

Readiness of newly licensed associated degree registered nurses to screen for domestic violence.

Lack of education and training have been identified as common barriers nurses experience in implementing domestic violence screening. The reasons for the barriers are poorly understood. Participants were interviewed to determine if and how they screen for domestic violence, which patients are screened, and how pre-licensure education and current workplace training has influenced this practice. An exploratory qualitative design guided by Constructivist Grounded Theory was used. Eligible participants were contacted via a social media and sixteen agreed to participate in the study. Individual interviews were conducted utilizing an open-ended interview guide. Data collection and analysis were done concurrently exploring factors influencing screening behaviors. Six themes emerged from the interview data: Preparedness, Discomfort, Taboo, Disenchantment, Presumptuous, and Evolving Realizations. These findings suggest nurses are not being taught about screening for domestic violence., Findings also suggested work environment and peers influenced if and how diligently nurses screened. The findings point to an interpersonal or intimate nature to screening for domestic violence that is unique and may require highly interactive training throughout pre-licensure education and work orientation.

Perception of Obesity in African-American and Arab-American Minority Groups.

BACKGROUND: Effectiveness of health education programs and interventions, designed to improve obesity rates, may vary according to perceptions of health within cultural groups. METHOD: A qualitative approach was used. Two minority cultural groups (Arab-American and African-American) living in the same county were studied to compare perceptions of health, nutrition, and obesity and subsequent health behaviors. RESULTS: Control, expectations, bias, acceptance, and access were the five themes identified. Arab-Americans that had lower weights, lower prevalence of chronic diseases, expected healthy weights, reported age and gender bias related to being overweight were not as accepting of being overweight and did not report difficulties in accessing healthy food choices compared to their African-American counterparts. CONCLUSIONS: Health interventions aimed at reducing obesity rates and related chronic diseases should be culturally specific and aimed at changing expected and accepted cultural norms. Cultural group's void of certain disease states should be studied and used as models to ameliorate the problem in other cultures. Changing health behaviors within a certain cultural group may produce better outcomes when initiated from a member of that same group. The impact of economic and environmental factors on health behaviors must also be considered.