A Correlational Study Exploring Nurse Work Anxiety and Animal-Assisted Therapy.

OBJECTIVE: The aim of this study was to perform a correlational study to explore nurse work anxiety. BACKGROUND: Nurses experience work anxiety with chronic stressful situations, high-acuity assignments, and rigorous patient care standards. The purpose of this study was to determine whether animal-assisted therapy during active worked hours would reduce nurse work-related anxiety. METHODS: Animal-assisted therapy interventions were performed for both day and night shifts. Beck's Anxiety Inventory (BAI) tool was used pre and post intervention. Each nurse interacted with the therapy dog for at least 10 minutes. RESULTS: Pet-assisted therapy as an intervention for nurses during work reduced work-related anxiety (t = 5.878, P < 0.05). A Pearson's correlational study displayed a strong positive correlation between the animal-assisted therapy and reduction in BAI scores (r = 0.7717, R2 = 0.5955). CONCLUSION: This prospective study has shown that nurse work anxiety significantly decreased during worked hours of active bedside care when the nurses actively engaged with a therapy dog.

Exploring the Relationship Between Patient Falls and Levels of Nursing Education and Certification.

OBJECTIVE: To examine if increasing the percentage of nurses with bachelor degrees (BSNs) and/or certified nurses leads to improved patient outcomes, specifically the number of reported falls. BACKGROUND: Research suggests a link between higher levels of education and expertise and positive patient outcomes, including falls. The Institute of Medicine recommends an increase in BSN nurses. METHODS: This was a retrospective cross-sectional cohort analysis using data from the National Database of Nursing Quality Indicators from 2010 to 2016 from multiple medical centers in Central and Southern Illinois. RESULTS: With every 1-unit increase in the percentage of BSN nurses or certified nurses, a reduction in total patient falls per 1000 patient-days can be expected in the amount of 0.02 to 0.04 and 0.01 to 0.03, respectively, all else held constant. CONCLUSIONS: Improvements to patient outcomes may be optimized with increased percentages of nurses with bachelor degrees and/or certifications.

Nursing Music Protocol and Postoperative Pain.

Pain has always been a major concern for patients and nurses during the postoperative period. Therapies, medicines, and protocols have been developed to improve pain and anxiety but have undesirable risks to the patient. Complementary and alternative medicine therapies have been studied but have not been applied as regular protocols in the hospital setting. Music is one type of complementary and alternative medicine therapy that has been reported to have favorable results on reducing postoperative pain, anxiety, and opioid usage. However, music lacks a protocol that nurses can implement during the perioperative process. This paper is an in-depth literature review assessing a best practice recommendation and protocol that establishes a consensus in the use of music therapy. The results suggest that music therapy may consist of calming, soft tones of 60-80 beats per minute for at least 15-30 minutes at least twice daily during the pre- and postoperative periods. It is suggested that music only be used in conjunction with standards of care and not as the primary intervention of pain or anxiety. This evidence suggests that proper use of music therapy can significantly reduce surgical pain. Implementing these protocols and allowing the freedom of nursing staff to use them may lead to greater reductions in surgical pain and anxiety and a reduction in opioid use.

Relationship Between Standardized Glycemic Protocols and Healthcare Cost.

Rising healthcare costs and the management of diabetes are financially straining to healthcare organizations. The study purpose was to examine whether a direct relationship existed between the cost of hospitalization, length of stay, excess admission days, and discharge blood glucose (DC-BG) levels and utilizing a standardized glycemic protocol. A retrospective cohort analysis was conducted of adult diabetes mellitus type 2 (DM-2) patients' pre-diabetic protocol (January 1, 2011-December 31, 2011) and post-diabetic protocol (August 1, 2012-October 31, 2012). The sample included DM-2 inpatients aged ≥ 18 years admitted without complications and/or with abnormal fasting blood glucose. Pre-protocol sample comprised n = 346 subjects and post-protocol sample comprised n = 149 subjects. Patients who received the diabetic protocol in 2012 experienced a decrease in the DC-BG (p < .05) and decrease in excess admission days (p < .05). Evidence supports that utilizing a standardized glycemic protocol improves glycemic control and reduces healthcare cost.

The relationship between uncontrolled glycemia and the cost of hospitalization.

PURPOSE/OBJECTIVE: The purpose of this study was to examine the relationship between hospitalization cost and discharge blood glucose levels among adult diabetes mellitus type 2 patients hospitalized with uncontrolled glycemia without complications. DESIGN: Retrospective cohort analysis examined healthcare billing and laboratory data. SETTING: The study was performed in Chicago, Illinois, in a 269-bed medical center between January 1, 2011, and December 31, 2011. SAMPLE: Patients were placed into 1 of 2 groups at discharge: blood glucose level less than 250 mg/dL or blood glucose level 250 mg/dL or greater. RESULTS: Of the 579 patients with uncontrolled glycemia, 366 met inclusion criteria: diabetes mellitus without complications (International Classification of Diseases, Ninth Revision; 250.0) with abnormal fasting blood glucose (International Classification of Diseases, Ninth Revision; 790.21). Discharge blood glucose levels were 250 mg/dL or greater in 74 patients and less than 250 mg/dL in 292 patients. Mean age of the 2 cohorts was 71.4 (SD, 13.41) years. The majority was male (52.1% and 59.7%, respectively). The median healthcare cost for the entire sample was $3964.34. The mean cost of healthcare for the group with blood glucose of 250 mg/dL or greater at discharge was $4182.65, with a mean length of stay of 8.22 (SD, 3.468) days, while the mean cost of healthcare for the group with blood glucose of less than 250 mg/dL at discharge was $3826.25 and mean length of stay 7.826 (SD, 6.073) days. Analysis of cost was conducted using Pearson χ and was significant for α = .05 (P = .037). The odds ratio of having increased healthcare cost with blood glucose of 250 mg/dL or greater was 1.732 with a 95% confidence interval of 0.998 to 3.012. CONCLUSION: The group discharged with blood glucose levels of 250 mg/dL or greater accrued greater cost during hospitalization than did patients who were discharged with blood glucose levels of less than 250 mg/dL. IMPLICATIONS: Today's healthcare system is struggling with cost containment, quality control, and standardization of care. Clinical nurse specialists can evaluate current patient care practices and ensure that the practice setting is fiscally beneficial to future patients and healthcare organizations.