Neurohospitalists reduce length of stay for patients with ischemic stroke.

BACKGROUND: Neurohospitalists may improve the efficiency and quality of care delivered to hospitalized patients with neurological disease. However, there is limited systematic data to support this hypothesis. The primary purpose of this study was to compare length of stay (LOS) for patients with ischemic stroke cared for by either neurohospitalists or community-based neurologists at a single institution. METHODS: A retrospective chart review was performed for all patients with ischemic stroke discharged from St. Luke's Hospital in Jacksonville, Florida, between January 2006 and December 2007. The LOS for patients cared for by neurohospitalists was compared to the LOS for patients cared for by community neurologists. Compliance with Joint Commission inpatient stroke quality metrics was also compared. RESULTS: A total of 533 patients were discharged with a principal diagnosis of ischemic stroke over the 24-month study period. Neurohospitalists cared for 313 patients with mean (± SD) LOS of 4.9 (5.2) days (95% CI: 4.3-5.5 days), and community-based neurologists cared for 220 patients with a mean LOS of 6.5 (8.2) days (95% CI: 5.4-7.6 days). The mean LOS was significantly less for the neurohospitalists compared to the community-based neurologists (P = .005). Neurohospitalists achieved a higher compliance rate in 10 of 11 inpatient stroke quality metrics and achieved significantly higher compliance rate of smoking cessation education (P = .019). CONCLUSIONS: Neurohospitalists achieved significantly shorter LOS for patients with ischemic stroke compared to community-based neurologists. These data suggest that neurohospitalists can also improve compliance with quality metrics necessary for Joint Commission Primary Stroke Center designation.

Stories of breast cancer through art.

PURPOSE/OBJECTIVES: To describe the use of an art exhibit, created in response to breast cancer survivor stories, and additional supplementary activities to increase cancer awareness and provide support to those with cancer. DATA SOURCES: Published articles and books, personal experiences. DATA SYNTHESIS: Art has been used to educate and promote the expression of emotions. Using an art exhibit as the central feature, a planning committee composed of staff members and volunteers developed a repertoire of activities to improve cancer awareness and provide support to cancer survivors. Visitor and staff reactions to the event were profound. CONCLUSIONS: Art can capture the most intimate and personal aspects of the cancer experience. This event was a novel and effective way to increase awareness about the cancer experience. The event brought together patients, family members, friends, staff members, and the community and facilitated new partnerships to help people with cancer. IMPLICATIONS FOR NURSING: Nurses are well equipped to direct the therapeutic use of art and support the potential reactions of viewers. Nurses can promote the benefit of art exhibits for cancer education, support, and awareness and use their knowledge and skills in planning and implementing supplementary activities.

Learning and support preferences of adult patients with cancer at a comprehensive cancer center.

PURPOSE/OBJECTIVES: To identify content items for an inclusive education curriculum for adult patients with cancer, as well as describe their learning and support preferences, determine the level of information provided to them, and assess the patients' interest in potential new services. DESIGN: Exploratory, descriptive survey research. SETTING: A National Cancer Institute-designated Comprehensive Cancer Center. SAMPLE: All consenting adult patients with cancer who had appointments in the outpatient care setting during a two-week period (N = 1,310). METHODS: A 3-phase study identified core components of an inclusive educational curriculum, conducted structured interviews of patients with cancer, and validated findings in a selected sample. FINDINGS: The surveys were completed and returned by 48% (n = 625) of the patients. The most favored method for learning about all cancer topics was discussions with physicians (66%). Other preferred methods included brochures or booklets provided by physicians or nurses (33%), discussions with nurses (34%), self-selecting print media from information displays (20%), and talking with other patients with cancer (14%). Statistically significant differences in learning preferences were found among subgroups defined by age, gender, and education. CONCLUSIONS: Patients preferred interactive, interpersonal communication with physicians or nurses. In addition, the prevailing method of education delivery for patients with cancer was providing print materials that support and enhance knowledge shared in the patient-healthcare team communication. IMPLICATIONS FOR NURSING: This study confirms the importance of the learning and support preferences of patients with cancer. To implement a successful education program for their patients, nurses must be aware of patients' preferences for learning new information. Time must be set aside for one-on-one communication with patients, and print materials must be easily accessible to healthcare providers to support the patient-education process.