Using the peer review process to educate and empower emerging nurse scholars.

Peer review, in various forms, is fundamental to research-based fields and scholarly publication. The integrity of the publication process is necessary to advance nursing science and support clinical nursing practice. The peer review process undergirds publication and grant funding. In theory, peer review should occur in a process that is unbiased with results providing a fair assessment of the scientific merit and credibility of the work being reviewed. The purpose of peer review is lost if reviewer comments are unprofessional. Budding nurse scholars may be demoralized and discouraged to revise and resubmit their work after receiving review feedback they perceive unprofessional and lacking constructive recommendations on how to improve their work. This "incivility" in the peer review process may discourage nursing authors from revising and resubmitting their work, thus robbing nursing of potentially meaningful contributions to nursing science. Often beginning doctorate nursing students have little or no experience in having their scholarly works evaluated and receiving feedback via the peer review process. Peer review provides an opportunity to educate emerging nurse scholars on ways to improve their writing skills and ways to receive and respond to constructive, meaningful feedback. This article aims to discuss: 1) peer review process, 2) challenges with peer review, 3) impact of unprofessional peer review comments and incivility in nursing peer review process can have on a budding scientists and nurse scholars, 4) ways the peer review process can be used to educate and empower emerging nurse scholars, 5) implications for nursing scholarship, 6) recommendations to address bias and how to provide supportive and constructive feedback and 7) finally provide readers with available resources where they can learn more about how to conduct a peer review.

Utilization of Advanced Practice Providers in Advanced Practice Provider-Led Stroke Clinic to Expand Outpatient Stroke Follow-up Care.

Stroke follow-up care with neurology specialty advanced practice providers is critical to focus on stroke prevention. The need for which is underscored by results of a recent study noting that many stroke survivors of first-ever strokes were not receiving stroke standard-of-care prevention measures including consistent antiplatelet therapies and regular exercise. Study findings further note the rates of usage for stroke prevention interventions (daily anti-platelet therapy, smoking cessation, regular exercise, hypertension control) were between 50% and 70%. Clinical nurse specialists along with nurse practitioner and physician assistant advanced practice providers are uniquely suited to manage outpatient ischemic stroke care to reduce the recurrence of stroke and improve patient outcomes.

Preoperative Nutritional Status and Risk for Subsyndromal Delirium in Older Adults Following Joint Replacement Surgery.

BACKGROUND: Subsyndromal delirium following surgery in older adults is related to increased lengths of hospital stay and increased admissions to long-term care. Impaired nutrition increases risk for delirium, but its relationship to subsyndromal delirium remains unclear. PURPOSE: This correlational study examined the relationship between nutritional status and subsyndromal delirium in older adults. METHODS: Assessments for subsyndromal delirium in 53 adults 65 years or older were completed for three consecutive days following joint replacement surgery. Relationships between nutritional status and subsyndromal delirium were analyzed. Level of significance for all tests was set at p ≤ .05. RESULTS: Participants' scores from the Mini Nutritional Assessment screen were significantly related (p = .05) to subsyndromal delirium severity after accounting for variability posed by age and cognition status. CONCLUSION: When preoperative risk assessment of older adults indicates nutritional risk, preoperative optimization may improve effectiveness of delirium prevention efforts.

Reliability and Validity of the Patient Health Questionnaire-9 as a Screening Tool for Poststroke Depression.

BACKGROUND: Screening for poststroke depression (PSD) using a valid and reliable tool is recommended for all stroke survivors. This literature review identifies the specificity, sensitivity, and appropriateness of the 9-item Patient Health Questionnaire (PHQ-9) to screen stroke patients for PSD. METHODS: Relevant databases were searched using the following selection criteria: (1) peer-reviewed primary research, (2) published from 2012 to 2018 (to evaluate the most recent research using this tool), and (3) examined the specificity and sensitivity of the PHQ-9 for screening stroke survivors for PSD. RESULTS: Six studies, with an overall level of evidence grade of "B," representing an overall total sample size of 930 participants (851 given a diagnosis of stroke and 49 given a diagnosis of transient ischemic attacks) met criteria for inclusion in the review. Only 2 studies reported data on all of the components necessary to determine the robustness of this tool to screen for depression in stroke survivors. CONCLUSION: Evidence regarding the sensitivity and specificity of the PHQ-9 to screen stroke patients for PSD is inconclusive. Additional research is needed to address the appropriateness of the PHQ-9 as a depression screening tool in this population. Clinicians should validate the results of PHQ-9 screening of ischemic stroke patients for PSD with the Structured Clinical Interview for DSM-5, the standard for diagnosing depression, before initiating treatment of PSD.

Avoiding failure to rescue situations: a simulation exercise for oncology nurses

This project aimed to improve RNs' recognition of and appropriate responses to failure to rescue situations on a surgical oncology unit. Simulation exercises played a key role in identifying areas of strength, opportunities for improvement, and development of a personalized education plan. In addition, the exercises improved RNs' clinical confidence.