Using Critical Care Simulations to Prepare Nursing Students for Capstone Clinical Experiences.

The purpose of this innovative learning strategy was to decrease students' fear and anxiety within the critical care environment before the initiation of a critical care capstone clinical experience by enhancing their familiarity of the critical care environment through deliberate practice and experiential learning. This will in turn increase student knowledge and competence in the critical care setting.Critical care units are often used during a capstone clinical experience to enhance critical thinking and clinical reasoning. Student preparation for these rotations, however, is varied and often inadequate. The resulting fear and anxiety impair learning and also contribute to an unsafe environment for this at-risk population.Before the capstone experience, students participated in 3 simulation experiences, each addressing a core concept of critical care nursing. Faculty engaged students during the simulations, while modeling the confidence and critical thinking of a critical care nurse.After both the critical care simulation and the capstone rotation, students stated that the simulation allowed them the time in a safe environment to critically think through the steps to care for critical patients before the capstone rotation. The experience provided them with increased confidence necessary to discharge the responsibilities of a critical care nurse-attention to critical thinking and reasoning.Mindfully constructed simulations with clear objectives help to inoculate the student against fears associated with high-risk patients. This decrease in fear and anxiety before a hands-on clinical experience may improve patient safety. More confident students are also better able to engage in both experiential and deliberate learning, resulting in a more enhanced and meaningful clinical experience.

Tube Decompression for Staged Treatment of a Calcifying Odontogenic Cyst-A Case Report.

The calcifying odontogenic cyst is a rare developmental odontogenic lesion with a distinguishing cystic lining containing "ghost" epithelial cells. The variation in clinical, radiographic, and histologic findings makes the treatment decision difficult for these lesions. There are very few reports on treatment, with enucleation and curettage being the standard surgical method of choice for the cystic type and excision of the tumor for the solid type. A 2-stage surgical approach consisting of initial decompression with tube placement followed by a secondary procedure of enucleation and curettage is common for other large odontogenic cysts, such as dentigerous and odontogenic keratocysts. To the authors' knowledge, this is the first case managed with an intended 2-stage approach in the form of decompression followed by enucleation and curettage.

An evaluation of how glaucoma patients use topical medications: a pilot study.

PURPOSE: Multiple factors can influence patients' adherence to topical ophthalmic intraocular pressure-lowering medications. An important factor that is often overlooked is the method of eye drop administration, including the handling, storing, and actual administering of eye drops. These aspects of patients' eye drop administration, which may be strongly related to the success of prescribed therapies, are evaluated. METHODS: A 2-page questionnaire was distributed to 253 sequential glaucoma patients at the time of their regular clinical visit with one of two geographically distinct glaucoma specialists. In addition to providing demographic data, the patients were asked to complete a 2-page questionnaire about their current use of eye drops. RESULTS: The study participants had a mean age of 71.5 years (SD, 15.1 years) and were predominantly female (59.8%) and white (72.6%). Approximately 17% of them relied on others for the administration of drops and most commonly cited inadequate vision and trouble with manual dexterity leading to this dependency. Of those who self-administered drops, only 16.3% used a mirror. The most common location for administration was the bedroom (46.8%), followed by the bathroom (23.4%) and kitchen (16.1%). Almost 16% reported "rarely" or "never" washing their hands. CONCLUSIONS: Although most individuals may have little difficulty with the use, storage, and handling of eye drops, this study demonstrates that broad variation in reported practices exists. This finding suggests a need for better instruction in eye drop administration and illuminates some of the methodological problems that could be overcome to reduce patients' frustration, improve compliance, and increase efficacy.