Single-family room neonatal intensive care unit design: do patient outcomes actually change?

OBJECTIVE: This study examined outcomes in a single-family room neonatal intensive care unit (NICU) compared to an open bay within a public safety net hospital. STUDY DESIGN: We included 9995 NICU encounters over 5 years pre and post move for a predominantly low SES population. Outcomes were length of stay (LOS), growth, time to first oral feeding, and incidence of sepsis. Analysis included regression models, interrupted time series, and growth models. RESULTS: LOS decreased over time in preterm infants both pre and post move, but increased post move for term/post-term infants (p < 0.001). First oral feeding decreased over time in both periods. A higher incidence of sepsis was found in the post period for term/post-term infants (p = 0.01). CONCLUSION: Our analysis appropriately accounted for time trends. Few differences were observed. Changes in LOS for term/post-term infants should be further explored as well as the impact of NICU care patterns.

Nurse-Led Interventions for Hypertension: A Scoping Review With Implications for Evidence-Based Practice.

BACKGROUND: Hypertension is the leading preventable contributor to cardiovascular morbidity and mortality, affecting 1 billion people globally. Low- and middle-income countries have increasing rates of hypertension, much of it undiagnosed. AIMS: The purpose of the project is to review studies of nurse-led hypertension interventions that have been implemented in East Africa and to inform hypertension interventions in low-resource settings. METHODS: A scoping review was conducted following Arksey and O'Malley's (2005) format. An electronic search in six databases for citations was conducted by the medical librarian author. The parameters for this scoping review were nurse interventions related to hypertension in East Africa. RESULTS: Fourteen full-text articles were identified that met inclusion criteria. Nurse-led interventions for hypertension were found to increase access to care and be cost- effective. Medication Adherence Clubs were an innovative intervention that increased the retention of patients in care. LINKING EVIDENCE TO ACTION: This scoping review provides evidence from studies of nurse-led hypertension interventions in East Africa relevant to implementing or improving hypertension screening, diagnosis, and treatment. Nurses provide 80% of health care in East Africa, and nurse-led hypertension interventions are critically needed to ameliorate the significant hypertension-related increases in morbidity and mortality globally.

Stigma in HIV-infected health care workers in Kenya: a mixed-method approach.

HIV-related stigma decreases access to HIV testing, prevention, and treatment services. Our mixed methods study explored stigma as perceived, experienced, and managed in a sample of 76 HIV-infected health care workers in Kisumu, Kenya. Stigma was quantitatively measured using the HIV/AIDS Stigma Instrument for People Living with AIDS (HASI-P). Overall, subjects experienced low stigma levels (mean = 7.88, SD = 12.90; range = 0-61), and none of the sociodemographic variables were predictive of stigma. Transcript analysis of 20 qualitative interviews revealed two negative themes (blame, lack of knowledge) and five positive themes (living positively, optimism, empathy, support, changes over time). Three themes emerged on reducing stigma (normalizing, empowerment, leading by example). Disclosure, access to treatment, stigma reduction training, workplace support groups, and awareness of an HIV workplace policy may have contributed to low stigma scores. Qualitative findings corroborated quantitative findings and corresponded to the six domains of the HASI-P.

Meeting tomorrow's health care needs through local and global involvement.

Strengthened efforts to achieve the United Nations Millennium Development Goals by 2015 are urgently needed. A fundamental step toward achieving these goals is strengthening global partnerships for development. This article describes critical challenges and opportunities in global health and the social responsibility of the nursing profession in this area. Examples and suggestions for nursing action are provided for consideration by those interested in influencing global health. Engaging in global health activities such as study abroad programs, interprofessional exchanges, continuing education workshops, and seminars with a global health focus can have significant implications for nursing education, research, policy, and practice. Equipping nurses with the leadership skills, knowledge, and attitudes needed to advance global health is integral in the delivery of effective, culturally relevant health care.