Clinical Nurse Specialists on the Night Shift.

BACKGROUND: Night-shift nurses care for complex and acutely ill patients but are frequently more junior compared with day shift. They often have less access to support resources such as educators and clinical nurse specialists (CNSs). This article describes the addition of night CNS positions, their roles, and associated outcomes. INTERVENTION: The night CNSs were implemented to perform a highly flexible set of activities including proactive rounding on high-risk patients and medications; code/rapid response support; education; nursing practice/policy reinforcement; providing psychosocial support to nurses, patients, and families; and responding to consults. To capture work effort at night and truly define the role of the night CNS, a shared consultation log was created. OUTCOMES: Between October 2017 to April 2019, 6053 CNS encounters were captured in 24 different categories. The top 5 reasons for consultation included policy/procedure education or change, education/in-service, nursing practice review/reinforcement, medication/blood administration, and clinical assist. Five hundred sixty-nine rapid response/codes have been responded to. There was also a 17% increase in event reporting on the night shift. Outcomes have continued to support additional budgeted positions for the nights and weekends. IMPLICATIONS: Night CNS expertise and knowledge are vital to offsetting novice nurse deficits in advanced assessment, which is paramount to patient outcomes. They provide support with on-the-spot education and empower individual development. Organizations should strongly consider implementation of this role or, if that is not possible, consider flexible scheduling into evening hours to support night staff.

Acute effects of thermally processed pili (Canarium ovatum, Engl.) pomace drink on plasma antioxidant and polyphenol status in humans.

OBJECTIVE: Pili (Canarium ovatum, Engl.) pomace is an underutilized agricultural waste that possesses great potential to be regarded as a functional food ingredient. The aim of this study was to measure the polyphenol content and antioxidant activity of pili pomace drink and determine the influence of heating on these parameters. Moreover, it sought to assess the acute effects of thermally processed pili pomace drink on plasma antioxidant and polyphenol status in humans. MATERIAL AND METHODS: Ten healthy adults received a single dose (130 ml) of pili pomace drink following an overnight fasting, and blood was collected at 0, 30, 60, 120 and 240 min after ingestion of pili pomace. Plasma total polyphenol content was measured using Folin-Ciocalteu method, while total antioxidant capacity (TAC) was determined using ferric reducing antioxidant power (FRAP) assay in uricase-treated and untreated plasma samples. RESULTS: Significant changes in plasma antioxidant and polyphenol levels were observed, reaching maximum levels at 120 and between 30 - 60 min, respectively (p<0.05). Both plasma polyphenols and TAC remained significantly above baseline values throughout the entire test period (p<0.05). CONCLUSION: Results raised the possibility that an acute consumption of this phenolic-rich pili pomace drink may enhance plasma antioxidant and polyphenol status in humans. Future studies on other unidentified metabolites from pili pomace that may have enhanced the antioxidant activity of plasma should be done.