Nurse Practitioner Care Model: Meeting the Health Care Challenges With a Collaborative Team.

In today's environment, organizational delivery systems must produce high-quality, efficient, and cost-effective services. Central to restructuring care delivery is the evolving role of the nurse practitioner (NP) and the integration of the role as part of the health care workforce. The NP Care Model was designed and introduced to the organizational workforce in a medical center to coordinate, manage, and monitor the outcomes of high-risk patients with chronic disease efficiently. This program focused specifically on patients with heart failure who were discharged to home and identified to be at high-risk for early readmissions. The Healthy Heart Initiative prograrr coordinated by the NP addressed targeted causes of rehospitalization (lifestyle, medication and diet noncompliance, and lack of self-care disease management). The program objective of improved financial performance were met by reducing the 30-day readmission rate. Operational effectiveness and quality patient outcomes were met through the design and implementa tion of the NP Care Model, and overall patient reported satisfaction.

Balancing "we" and "me".

The open office is the dominant form of workspace design for good reason: It fosters collaboration, promotes learning, and nurtures strong culture. But what most companies fail to realize is that collaboration has a natural rhythm that requires both interaction and private contemplation. Companies have been trying for decades to find the balance between public and private workspace that best supports collaboration. In 1980 52% of U.S. employees lacked workspaces where they could concentrate without distraction. In response, high-walled cubicles took over the corporate landscape. By the late 1990s, the tide had turned, and only 23% of employees wanted more privacy, and 50% wanted more access to other people. Ever since, firms have been beefing up spaces that support collaboration and shrinking areas for individual work. But the pendulum seems to have swung too far: Once again, people feel a pressing need for privacy, not only to do heads-down work but to cope with the intensity of work today. To address these needs, according to the authors, we have to rethink our assumptions about privacy. Traditionally defined in physical terms, privacy is now about the individual's ability to control information and stimulation. In this article, the authors examine workspace design through the new lens of privacy and offer insights on how to foster teamwork and solitude.

Teaching evidence-based practice using a mock trial.

The mock trial, which is an educational tool used in many different professions, is a scripted form of debate that teaches the critical thinking process. Using the mock trial approach, two nurse educators at one medical center taught nursing staff and students the major elements of evidence-based practice. The verdict to be decided in the trial was whether family-witnessed resuscitation should be used in practice. This article outlines the steps taken to carry out this endeavor. Nursing faculty can use this mock trial approach to teach a variety of concepts in nursing education.

Studies of muscarinic neurotransmission with antimuscarinic toxins.

M1 and M4 muscarinic receptors are the most prevalent receptors for acetylcholine in the brain, and m1-toxin1 and m4-toxin are the most specific ligands yet found for their extracellular faces. Both toxins are antagonists. These toxins and their derivatives with biotin, radioiodine and fluorophores are useful for studying M1- and M4-linked neurotransmission. We have used the rat striatum for many studies because this tissue express exceptionally high concentrations of both receptors, the striatum regulates movement, and movement is altered by antimuscarinic agents, M1-knockout and M4-knockout. These toxins and their derivatives may also be used for studies of M1 and M4 receptors in the hippocampus and cortex.