RESUMEN
Sleep-wake disturbances are common in patients with cancer. Despite the high prevalence of altered sleep patterns in oncology settings, there remains a gap in consistent assessment of sleep, leading to an underrecognized and undertreated condition. Provider failure in addressing sleep-wake disturbances can result in chronic issues with insomnia and has a negative impact on quality of life and cancer survivorship. Often sleep-wake disturbances present in symptom "clusters" including, anxiety, depression, and fatigue, which adds to the complexity of managing sleep disorders in oncology. Aggressive management strategies for managing underlying symptom burden from disease or medications effects is a priority.
Asunto(s)
Trastornos del Sueño-Vigilia/enfermería , Fatiga/etiología , Fatiga/psicología , Humanos , Neoplasias/complicaciones , Neoplasias/psicología , Enfermería Oncológica/métodos , Enfermería Oncológica/tendencias , Cuidados Paliativos/métodos , Cuidados Paliativos/psicología , Cuidados Paliativos/normas , PrevalenciaRESUMEN
INTRODUCTION: Vital signs measurements aid in the early identification of patients at risk of clinical deterioration and determining the severity of illness. Health care providers rely on registered nurses to document vital signs and communicate abnormalities. The purpose of this project was to improve the provider notification process regarding abnormal vital signs in a pediatric emergency department. METHOD: A best practice advisory (BPA) was piloted by the advanced practice providers in the pediatric emergency department. To evaluate the effects of the BPA, a mixed-methods study was employed. RESULTS: Implementation of the BPA improved the provider notification process and enhanced clinical decision making. The percentage of patients discharged home with abnormal respiratory rates (10.9% vs. 5.9%, p = .31), abnormal temperatures (15.6% vs. 7.5%, p = .14), and abnormal heart rates (25% vs. 11.9%, p = .11) improved. DISCUSSION: Creation and implementation of the BPA improved the abnormal vital sign communication process to providers at this single institution.
Asunto(s)
Servicio de Urgencia en Hospital , Pediatría , Signos Vitales , Niño , Toma de Decisiones Clínicas , Servicio de Urgencia en Hospital/organización & administración , Humanos , Alta del Paciente , Pediatría/organización & administración , Proyectos Piloto , Guías de Práctica Clínica como Asunto , Estudios Retrospectivos , Medición de RiesgoRESUMEN
Many, especially newer, nurses lack the experience for nuanced skillful communication at end of life. This study incorporated the End-of-Life Nursing Education Consortium (ELNEC) Core Curriculum Communication module into a nurse residency program and tested for change in attitudes toward end-of-life (EOL) care. Researchers found significant differences in attitudes toward care of the dying before and after the ELNEC training, and between nurses with greater than and less than 5 years experience. Findings support that ELNEC education can significantly impact nurse attitudes about EOL care.