RESUMO
AIM: The purpose of this article is to inform nurse educators of an innovative and transformative approach to advancing nursing education through the creation of the Minnesota Alliance for Nursing Education (MANE). BACKGROUND: MANE was formed to answer national appeals to transform nursing education and demands by health care organizations for a more highly educated nursing workforce. METHOD: An action plan was developed with the Minnesota Action Coalition to create a dual admission community college and university eight-semester baccalaureate curriculum that students could complete seamlessly in four years. RESULTS: Admissions to the program have been robust, matriculation rates to upper division course work have exceeded initial goals, and diversity of students is increasing. CONCLUSION: Measures to date show that MANE is a viable and successful program that is surpassing its initial goals.
Assuntos
Bacharelado em Enfermagem , Pesquisa em Educação em Enfermagem , Currículo , Educação em Enfermagem , Humanos , Minnesota , Estudantes de EnfermagemRESUMO
BACKGROUND: Health-related quality of life (HRQOL) is a major clinical outcome for heart failure (HF) patients. We aimed to determine the frequency, durability, and prognostic significance of improved HRQOL after hospitalization for decompensated HF. METHODS AND RESULTS: We analyzed HRQOL, measured serially using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), for 425 patients who survived to discharge in a multicenter randomized clinical trial of pulmonary artery catheter versus clinical assessment to guide therapy for patients with advanced HF. All patients enrolled had 1 or more prior HF hospitalizations or chronic high diuretic doses and 1 or more symptom and 1 sign of fluid overload at admission. Improvement, defined as a decrease of more than 5 points in MLHFQ total score, occurred in 68% of patients by 1 month and stabilized. The degree of 1-month improvement differed (P < .0001 group x time interaction) between 6-month survivors and non-survivors. In a Cox regression model, after adjustment for traditional risk factors for HF morbidity and mortality, improvement in HRQOL by 1 month compared to worsening at 1 month or no change predicted time to subsequent event-free survival (P=.013). CONCLUSIONS: In patients hospitalized with severe HF decompensation, HRQOL is seriously impaired but improves substantially within 1 month for most patients and remains improved for 6 months. Patients for whom HRQOL does not improve by 1 month after hospital admission merit specific attention both to improve HRQOL and to address high risk for poor event-free survival.
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Nível de Saúde , Insuficiência Cardíaca/terapia , Hospitalização/tendências , Qualidade de Vida , Adulto , Idoso , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Seguimentos , Insuficiência Cardíaca/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Taxa de Sobrevida/tendênciasRESUMO
A systematic literature review of studies published between 1990 and 2008 was conducted to evaluate the impact of isolated telephone interventions on glycemic control in adults with type 2 diabetes. Eight randomized controlled trials met the inclusion criteria. Overall, the interventions had mixed effects on glycemic control, suggesting further research is needed in this area. Current evidence does not support isolated telephone interventions to improve glycemic control in type 2 diabetes mellitus; well-designed studies to establish the effectiveness of this potentially cost-effective modality can be an important step in addressing the diabetes epidemic.
Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Educação de Pacientes como Assunto/organização & administração , Telefone , Adulto , Assistência Ambulatorial , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/metabolismo , Gerenciamento Clínico , Hemoglobinas Glicadas/metabolismo , Necessidades e Demandas de Serviços de Saúde , Humanos , Pesquisa em Avaliação de Enfermagem , Cooperação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Autocuidado , Telefone/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
A randomized controlled trial was conducted to evaluate the impact of an automated telephone intervention on glycemic control in patients with type 2 diabetes. One hundred twenty participants were randomly assigned to a treatment group that received a daily, automated telephone message regarding diabetes or to a control group that received usual care. The treatment group demonstrated a significant improvement in the frequency of self-monitoring of blood glucose levels compared with the control group (P < .001). A favorable trend in positive attitudes toward diabetes and a reduction in perceived monitoring and exercise barriers were seen in the intervention group compared with the control group.