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Artículo en Inglés | MEDLINE | ID: mdl-31274681


BACKGROUND AND PURPOSE: Cannabinoid hyperemesis syndrome (CHS) was first described in the literature in 2004. The pathophysiology of CHS remains largely unknown. The syndrome is becoming more prevalent in inpatient settings and emergency departments as the legal usage of cannabis proliferates, although it is often not recognized when encountered. While symptoms of CHS are becoming better defined, early recognition and comprehensive treatment plans with reproducible outcomes remain elusive. Symptoms can be further complicated by the presence of chronic conditions or comorbidities. The purpose of this article is to consolidate findings from the literature, identify commonalities in clinical characteristics and pathogenesis, and highlight diagnostic and treatment approaches. METHODS: Data collection methods include a review of the literature on CHS published in the past 10 years. Case study data were gathered from a patient interview and chart review. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Through better recognition of CHS, nurse practitioners and other providers can promptly and accurately diagnosis the condition and improve treatment plans for these patients.

Crit Care Nurs Q ; 42(3): 256-264, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31135476


The article reports results of an interrogative literature review designed to study the acquisition of research-based knowledge among practicing nurses who provide direct patient care for decision making at the point of care. Findings reveal that despite the amount of research done on the use of evidence-based practice among nurses, gaps continue to exist between what is known and what is done in practice. Nurses often cite the lack of time and support and the lack of knowledge as predominant factors that keep them from using evidence-based practice at the point of care. The past research has primarily been completed using a retrospective approach. There is a paucity of research that evaluates specific nursing behaviors that support evidence-based practice in daily patient care.

Práctica Clínica Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Personal de Enfermería en Hospital/psicología , Toma de Decisiones , Humanos , Factores de Tiempo
MedEdPORTAL ; 15: 10791, 2019 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-30800991


Introduction: The science of patient safety demonstrates that good communication is essential for effective interprofessional collaboration. Methods: We created a low-stakes, formative assessment with which medical students, pharmacy students, and nursing students could practice several of the Interprofessional Education Collaborative competencies. We aimed to enable students to practice collaborative care, respect for other disciplines, and shared accountability. Senior students from medicine, nursing, and pharmacy worked in teams to disclose a medical error to a standardized patient. The activity began with an icebreaker exercise wherein students learned about each other. Next, each team planned a strategy for error disclosure and collaboratively disclosed the error. Standardized patients evaluated the team's performance. Subsequently, students regrouped for a debriefing. The participating institutions administered a survey to their students. Results: In total, 1,151 students participated: 464 fourth-year students from the University of Houston College of Pharmacy, 450 third- and fourth-year students from Baylor College of Medicine, and 237 fourth-year students from Texas Woman's University Nelda C. Stark College of Nursing, all in Houston, Texas. Postsession survey data showed that students thought they achieved the relevant competencies. Students' understanding of the perspectives of the other two disciplines improved. Students found the simulation encounter and debriefing effective in helping them consider the contributions of other disciplines to patient care. Discussion: This interprofessional standardized patient activity enabled collaborative problem solving. The debriefing discussion broadened students' understanding of the expertise of the other disciplines and promoted shared accountability. Students found this activity engaging and effective.

Adv Emerg Nurs J ; 39(3): 217-223, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28759513


Marfan syndrome is an autosomal dominant connective tissue disorder that affects multiple systems, including the skeletal, ligamentous, oculofacial, pulmonary, abdominal, neurological, and cardiovascular systems. Cardiovascular complications, which involve the aorta and aortic valve, contribute most significantly to patient morbidity and mortality. A literature review was conducted on pathophysiology of the disease and recommendations for early diagnosis and treatment. Diagnosis largely relies on clinical features and a thorough history. Echocardiogram is used for monitoring aortic abnormalities and disease progression. Aortic valve-sparing surgery is indicated in any valvular abnormality and in patients with a murmur. Aortic root replacement is indicated prophylactically in women who want to give birth with diameters greater than 40 mm, anyone with a diameter greater than 50 mm, and progressive dilatation of greater than 5 mm per year. Medical management involves antihypertensive therapy. It is imperative for all health care providers to understand the clinical features, progression, and management of Marfan syndrome to appropriately care for their patients. Ensuring regular follow-up and adherence to medical and surgical prophylaxis is essential to patient well-being.

MedEdPORTAL ; 13: 10595, 2017 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-30800797


Introduction: Patient safety education is required in medical, nursing, and pharmacy training, and interprofessional education offers an ideal format for teaching the core concepts of patient safety. This training activity was developed to fulfill interprofessional education core competencies for communication and teamwork and was nested within a required patient safety course taught at a medical school. However, the activity can easily be adapted as a stand-alone offering that can be included in a preclinical doctoring course, offered as an elective, or hosted at a college of nursing or pharmacy. Our goal was to prepare learners for the clinical environment by providing a context for patient safety, communication, and teamwork. Methods: Students participate in a 1.5-hour large-group activity that explores a case from the perspectives of each discipline. Faculty from all three disciplines sequentially present and debrief the case using focused questions to guide students' reflections and interactions between team members. Results: We have presented this activity for 4 consecutive years. Students complete a questionnaire with retrospective pre-post ratings of their perspectives on the activity and its impact on their awareness of disciplinary roles and responsibilities, communication errors, and strategies for addressing interdisciplinary conflicts. Results show statistically significant increases in the items of interest. Discussion: This interprofessional education offering is effective in terms of increasing awareness and knowledge among members of three health care disciplines, improving awareness of potential kinds of communication errors, and helping students consider the role of interdisciplinary interactions.

J Am Assoc Nurse Pract ; 28(8): 453-9, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26693842


BACKGROUND AND PURPOSE: Our aim was to provide the outcome of a structured Model of Care (MoC) Evaluation Tool (MCET), developed by an FAANP Best-practices Workgroup, that can be used to guide the evaluation of existing MoCs being considered for use in clinical practice. Multiple MoCs are available, but deciding which model of health care delivery to use can be confusing. This five-component tool provides a structured assessment approach to model selection and has universal application. METHODS: A literature review using CINAHL, PubMed, Ovid, and EBSCO was conducted. CONCLUSIONS: The MCET evaluation process includes five sequential components with a feedback loop from component 5 back to component 3 for reevaluation of any refinements. The components are as follows: (1) Background, (2) Selection of an MoC, (3) Implementation, (4) Evaluation, and (5) Sustainability and Future Refinement. IMPLICATIONS FOR PRACTICE: This practical resource considers an evidence-based approach to use in determining the best model to implement based on need, stakeholder considerations, and feasibility.

Prestación de Atención de Salud/métodos , Estudios de Evaluación como Asunto , Prestación de Atención de Salud/normas , Humanos