Utilisation of goals of care discussions and palliative care prior to image-guided procedures near the end of life.

AIM: To characterise image-guided procedures performed near the end of life and the use of goals of care discussions (GOC) and palliative care consultation (PCC) prior to these procedures. MATERIALS AND METHODS: Retrospective chart review of 3,714 consecutive inpatient procedures performed for 2,351 patients and 8,206 outpatient procedures performed for 5,225 patients within a suburban medical system. Data were collected on demographics, procedures performed, mortality, and use of GOC or PCC prior to the procedures. Procedures near the end of life were classified as emergent, elective, or palliative. Logistic regression was used to assess for demographic disparities in care. RESULTS: Nine percent of inpatients died within 30 days of their procedure, 57% of which were within the same hospitalisation. Of these patients, 59% had a documented GOC and 35% had a PCC. Similarly, 7% of outpatients died within 6 months of their procedure. A minority of these patients had a documented GOC (37%) or PCC (13%). There were few statistically significant demographic disparities in this care and the associated odds ratios were small. CONCLUSION: A wide array of image-guided procedures is performed near the end of life. GOC and PCC are underutilised prior to these procedures. Few demographic disparities exist in this care.

The effect of writing after reading on college nursing students' factual knowledge and synthesis of knowledge.

The purpose of this experimental study was to investigate the effect of writing after reading on factual knowledge and synthesis of knowledge. College sophomore nursing students (N = 118) were randomly assigned to one of three groups: a control group which read, reviewed, but did no writing; a notetaking group; or an essay writing group. A 10-item multiple-choice test of factual knowledge was given to all subjects immediately after completing each reading and writing task and again 7 days later. At the later time, each student also wrote an essay to demonstrate synthesis of knowledge. Seven days later, students repeated the same reading and writing activities with a second text. Results of ANOVA showed that notetaking was significantly better than essay writing or no writing for recall of facts. Essay writing, on the other hand, helped students synthesize better than notetaking. However, there was no difference between essay writing and no writing on synthesis of knowledge.

Predicting success for baccalaureate graduates on the NCLEX-RN.

The purpose of this retrospective study was to identify predictors of success for baccalaureate nursing graduates on the National Council Licensure Examination-Registered Nurse (NCLEX-RN). Subjects (505) were graduates of a baccalaureate nursing program in the southeastern United States from 1993 to 1998. The outcome variable was pass/fail on the NCLEX-RN on the first attempt. Predictor variables included type of student (freshman admission, transfer, second degree), age at the time of licensing examination, gender, performance on selected prenursing courses, performance in all junior and senior nursing courses, cumulative grade point average (GPA) at graduation and the Mosby AssessTest score. Results showed a significant relationship between number of Cs, Ds, and Fs in nursing courses and NCLEX-RN results. Students who passed the NCLEX-RN had significantly higher average GPAs, made fewer grades of C or below, and scored higher on the Mosby AssessTest than students who failed. Nontraditional college-age students tended to have a higher passing rate than did traditional age students. A logistic regression model was developed that correctly predicted 76 per cent of the students who failed based on the information available by the end of the end of the first semester of the senior year. J Prof Nurs 17:121-127, 2001.