Glycemic Variability in Patients With Stage II-III Colon Cancer Treated With Surgery and Adjuvant Chemotherapy.

OBJECTIVES: To examine glycemic variability within one month and one year following surgery and throughout adjuvant chemotherapy among patients with stage II-III colon cancer, with and without type 2 diabetes (T2D). SAMPLE & SETTING: 58 patients with stage II-III colon cancer treated with surgery and chemotherapy. METHODS & VARIABLES: A retrospective analysis of electronic health record data over one year showed glycemic variability, measured as standard deviation and coefficient of variation. Chi-square, Fisher's exact, and Mann-Whitney U tests and Spearman's correlation coefficient were calculated. RESULTS: Patients with T2D had higher glycemic variability throughout chemotherapy and within one year following surgery. A significant increase in glycemic variability throughout chemotherapy was observed in patients without T2D. Significant associations between glycemic variability and demographic and clinical characteristics differed by T2D status, standard deviation, and coefficient of variation. IMPLICATIONS FOR NURSING: Nurses need to assess serial blood glucose levels in patients with and without T2D. Teaching patients how to maintain glycemic control during treatment is a priority. Research should include predictive models to identify risk factors for higher glycemic variability and cancer-related symptoms and outcomes.

Comparison of Recertification Methods on CPR Quality.

BACKGROUND: High-quality cardiopulmonary resuscitation (CPR) is vital to improving survival from cardiac arrest. This study compared participant performance of CPR with three American Heart Association (AHA)-approved CPR recertification programs because current literature does not show which method is superior. Our goal is to investigate the best training methods to deliver high-quality CPR. METHOD: Participants were within 90 days of recertification in face-to-face, Heart Code, or Resuscitation Quality Improvement (RQI). RESULTS: No statistically significant differences were found among training modalities or demographic characteristics. The only significant difference was among those who had performed CPR on a human. CONCLUSION: Mean scores for the three modalities did not reach the passing requirement for AHA, suggesting that one method of CPR training is not better than the others. Recommendations for translating these findings into clinical practice include mock codes with the ability to measure CPR metrics and simulations of cardiac responses to provide vicarious CPR experience. [J Contin Educ Nurs. 2022;53(1):43-48.].

Changes in Patient Activation in a Self-Management Intervention.

The purpose of this study was to compare results using individual change in level of patient activation measure (PAM) scores, individual point change scores, and group means in an outcome analysis. We evaluated changes in PAM scores (increase in level or increase of ≥5 points) to mean group PAM scores on patients who completed a self-management intervention compared with usual care on health care utilization and health-related quality of life. The sample was a subset of 91 multimorbid patients with complete data at completion of a self-management intervention. Results indicated that using a change in points allowed for more refined analysis of change compared with level changes; however, both individual measures were more reflective of actual change than group means. When tailoring interventions, we should consider using individual change scores. Further research is needed to evaluate how best to use PAM scores to measure the impact on clinical and health care outcomes.

Correlates of Student Performance during Low Stakes Simulation.

BACKGROUND: Simulation plays a vital role in nursing education, however, modifiable factors influencing students' simulation performance have not been sufficiently examined. The purpose of this study was examine relationships among anxiety, self-efficacy, nursing knowledge, and performance during simulation. METHODS: The study used a mixed-methods design. Anxiety, self-efficacy, academic achievement, and performance during simulation were measured quantitatively; correlations between key variables were calculated. Qualitative data were collected during post-simulation debriefing and triangulated to inform quantitative findings. RESULTS: Significant relationships were identified between knowledge of nursing care and simulation performance. Student qualitative reports of heightened anxiety and lack of confidence and uncertainty contrasted from quantitative measures. Potential reasons for this finding were explored. CONCLUSIONS: The relationship between knowledge of nursing care and simulation performance supports the effectiveness of simulation as a means to evaluate the application of knowledge in a clinical laboratory setting. Further research is needed to explain the complex relationships between anxiety, self-efficacy, and performance during simulation.