Relying on myself: The lived experience of being at risk for falling in the hospital among older adults.

Inpatient fall rates have not significantly decreased the last decade. Older adults have an estimated 50% greater inpatient fall rate than younger adults. How older adults perceive their own fall risk affects their adherence to fall prevention recommendations. The aim of this phenomenological study was to understand the lived experiences of being at risk for falling in the hospital among older adults. Nine participants (N=9) aged 65 years and older (female=55%) were interviewed twice using online video-conferencing after hospital discharge, and interview data was analyzed using van Manen's interpretive phenomenological method. Five major interpretive themes emerged: Relying on Myself, Managing Balance Problems in an Unfamiliar Environment, Struggling to Maintain Identity, Following the Hospital Rules, and Maintaining Dignity in the Relationships with Nursing Staff. Hospitalized older adults employed their self-efficacy to manage balance problems in the hospital. Additional fall prevention interventions supporting hospitalized older adults' self-management of fall risk are needed.

Activity Monitoring and Heart Rate Variability as Indicators of Fall Risk: Proof-of-Concept for Application of Wearable Sensors in the Acute Care Setting.

Growing concern for falls in acute care settings could be addressed with objective evaluation of fall risk. The current proof-of-concept study evaluated the feasibility of using a chest-worn sensor during hospitalization to determine fall risk. Physical activity and heart rate variability (HRV) of 31 volunteers admitted to a 29-bed adult inpatient unit were recorded using a single chest-worn sensor. Sensor data during the first 24-hour recording were analyzed. Participants were stratified using the Hendrich II fall risk assessment into high and low fall risk groups. Univariate analysis revealed age, daytime activity, nighttime side lying posture, and HRV were significantly different between groups. Results suggest feasibility of wearable technology to consciously monitor physical activity, sleep postures, and HRV as potential markers of fall risk in the acute care setting. Further study is warranted to confirm the results and examine the efficacy of the proposed wearable technology to manage falls in hospitals. [Journal of Gerontological Nursing, 43(7), 53-62.].

Epistemic Injustice and Nurse Moral Distress: Perspective for Policy Development.

The focus of this article is epistemic injustice as an underlying explanation for the lack of communication associated with moral distress in frontline nurses who provide end-of-life care. Improvements in interprofessional collaboration and communication in this challenging area of practice are needed, as supported by research on moral distress and related studies. Policy development that addresses interprofessional practice inclusive of all healthcare providers, particularly frontline nurses, in deliberations about end-of-life treatment deliberations and decisions is proposed.

The role of resilience and mindful leadership in oncology nursing.

When oncology nurses think of the word resilient, they often describe the term in the context of the patients and families they care for each day. When patients face a diagnosis of cancer, their lives have suddenly been altered in a frightening manner. Everything changes, and they must find a way to navigate the troubled waters ahead. 
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Implementing evidence-based practice using an interprofessional team approach: part two.

The complexity inherent in the inpatient oncology population requires effective interprofessional collaboration and integrated evidence-based practice (EBP), drawing from each of the disciplines to achieve desired outcomes. Each member of the team lends a strength and expertise that, when combined, often results in outcomes greater than the sum of its parts (Hall & Weaver, 2001; Petri, 2010; Pullon & Fry, 2005). EBP promotes the use of research to solve issues raised in day-to-day nursing practice. This article provides an overview and summary of an evidence-based project to increase compliance of sequential compression devices (SCDs) in gynecologic oncology and urology patients on a post-surgical inpatient unit using the Plan, Do, Study, Act (PDSA) model for continuous quality improvement (CQI) (Institute for Innovation and Improvement, 2013).

Implementing evidence-based practice using an interprofessional team approach.

Translational research has been defined as "bench-to-bedside" research or "laboratory-to-clinical" research. Benefits to this type of research are that it fast tracks biomedical advances to improve the quality of care and life for patients with cancer (Callard, Rose, & Wykes, 2011). The challenge, however, is translating the research findings to the bedside in a timely fashion. Burns and Foley (2005) described an estimated 20-year delay in getting research findings translated to care delivery.

Financial savvy: the value of business acumen in oncology nursing.

Have you given serious thought to your individual ability to affect the high cost of health care? If so, you may have determined that the opportunity to have any meaningful effect on cost of services for patients with cancer is limited. You may believe that budgets are the responsibility of nursing leadership. Indeed, the development of the unit or department budget is an activity that many of us have no direct (or even indirect) role in completing. Once the budget is finalized, we are frequently given directives to control our costs and improve the financial bottom line for our employers. One could argue that this is a particularly difficult missive for oncology nurses with the soaring costs of chemotherapy and biotherapy drugs, the expenses incurred to provide supportive care needed by patients with cancer, and the need to provide services to the increasing number of cancer survivors.

Professional development for oncology nurses: a commitment to lifelong learning.

Think back to the day you graduated from your entry-level nursing program. The feelings we experienced at that time are likely universal, whether that day was one year ago or more than 40 years ago. No more tests, no more papers, no more clinical skills practice, and no more preparing the dreaded nursing care plan. School was finished. We all looked forward to passing our nursing boards and getting our first real nursing jobs. Certainly, we all had some vague idea that during our life as nurses we would, at some time, have to learn a new skill, or work with a new type of equipment; however, many of us did not seriously contemplate or acknowledge that we were embarking on a career path that expected us to be lifelong learners. Little did we know that engaging in the process of lifelong learning is not necessarily something that comes naturally; it is, in fact, a personal commitment that each of us makes to the pursuit of learning throughout our professional career.

Tough courage: Oncology Nursing Forum addresses childhood cancer then and now.

Cancer is a devastating diagnosis for anyone, but none more so than for children and their parents--so many questions to be asked, so much information to sift through and absorb, and so many difficult decisions to be made. It is no wonder that a diagnosis of childhood cancer is often met with fear, anger, guilt, and feelings of being overwhelmed, yet also a determined resilience on the part of families to do whatever it takes to help their child get well again (Rishel, 2010).

Conceptual framework for the study of parental end-of-life decision making in pediatric blood and marrow transplantation.

PURPOSE/OBJECTIVES: To describe a conceptual framework that will facilitate research and practice concerning parental end-of-life decision making in pediatric blood and marrow transplantation (BMT). DATA SOURCES: A review of relevant literature from Ovid, CINAHL, EBSCO, MEDLINE, PsycINFO, and various sociology and theology databases was combined with experiential knowledge. DATA SYNTHESIS: The method of concept and theory synthesis and derivation as described by Walker and Avant was used in the development of this framework. CONCLUSIONS: Use of the proposed conceptual framework is expected to provide the organization necessary for thinking, observation, and interpretation of parental end-of-life decision making in pediatric BMT. IMPLICATIONS FOR NURSING: The ability to describe the process of parental end-of-life decision making in pediatric BMT will help nurses to provide appropriate counseling, education, and support for these children and their families at the end of life. In addition, the process will help nurses to promote the well-being of the children's families after end of life.