From Pathophysiology to Prevention: Implementing a Vaccine-Preventable Diseases Project for Pre-Nursing Students.

BACKGROUND: Information about vaccine-preventable diseases (VPDs) and vaccinations should be included throughout nursing curricula to prepare future nurses to promote vaccination with patients and combat misinformation. METHOD: In a large, pre-nursing course, faculty designed a self-directed activity focused on VPDs and vaccinations that required students to analyze various sources and create presentations about these topics. RESULTS: Student feedback indicated the learning outcomes of this educational intervention were largely met and that students felt positive about this type of activity overall. CONCLUSION: Including information in early nursing courses regarding VPDs and vaccinations can positively influence students' knowledge, confidence, and perceptions of these topics. Independent student projects involving higher cognitive domain levels can be successfully integrated into large pre-nursing courses. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Difficult diagnosis: Disseminated gonorrheal infection manifesting as septic arthritis.

ABSTRACT: Disseminated gonococcal infection is the causative agent of approximately 0.6%-1.2% of septic arthritis cases in North America and Europe. Typical presentations of this disorder include tenosynovitis, dermatitis, polyarthralgia, or oligoarticular purulent arthritis affecting the distal joints. Diagnosis is contingent on clinical presentation, with urine nucleic acid amplification testing as the preferred diagnostic modality. Synovial fluid cultures, along with imaging, can confirm diagnosis. The recommended treatment is a third-generation cephalosporin, such as intravenous ceftriaxone for 7-14 days and a dose of oral azithromycin.

The effect of discharge care plans on statin prescription rates.

BACKGROUND: Stroke discharge care bundles have been proposed to address inadequate provider statin prescription rates. LOCAL PROBLEM: Discontinuation of statins has been associated with a 37% relative risk increase in mortality in patients with a stroke diagnosis. The project site had a statin prescription rate of 86.2%. METHODS: The project was initiated at a 641-bed regional community teaching medical center. Statin prescription rates upon discharge on patients with the diagnosis of transient ischemic attack or stroke were evaluated and noted to be below the benchmark of 95%. Possible interventions to improve this benchmark were discussed with key stakeholders such as the information technology team, stroke care outcomes team, and neurology service providers. The proposed intervention was incorporated into the electronic health record. Provider prescription rates were tracked monthly along with the use of the proposed intervention. A one-sided z-test was used to analyze the data collected. INTERVENTIONS: A stroke discharge power plan within an electronic health record was modified to increase the rate of statin prescriptions. The key modification included checking off the prescription of a statin on discharge. Reinforcement of its use was done through monthly reminders. RESULTS: Use of discharge care plan yielded 100% compliance. Overall compliance was 9.7%. The null hypothesis of the one-sided z-test was 89%. The p -value for all tests was <0.05. CONCLUSION: The use of a stroke discharge care plan within an electronic health record can positively affect secondary stroke prevention by increasing statin prescription rates.