Reproductive Ageing: Current insights and a potential role of NAD in the reproductive health of aging fathers and their children.

In brief: In light of the increasing age of first-time fathers, this article summarizes the current scientific knowledge base on reproductive aging in the male, including sperm quality and health impacts for the offspring. The emerging role of NAD decline in reproductive aging is highlighted. Abstract: Over the past decades, the age of first-time fathers has been steadily increasing due to socio-economic pressures. While general mechanisms of aging are subject to intensive research, male reproductive aging has remained an understudied area, and the effects of increased age on the male reproductive system are still only poorly understood, despite new insights into the potential dire consequences of advanced paternal age for the health of their progeny. There is also growing evidence that reproductive aging is linked to overall health in men, but this review mainly focuses on pathophysiological consequences of old age in men, such as low sperm count and diminished sperm genetic integrity, with an emphasis on mechanisms underlying reproductive aging. The steady decline of NAD levels observed in aging men represents one of the emerging concepts in that regard. Because it offers some mechanistic rationale explaining the effects of old age on the male reproductive system, some of the NAD-dependent functions in male reproduction are briefly outlined in this review. The overview also provides many questions that remain open about the basic science of male reproductive aging.

Quality and Safety in Healthcare, Part LXXXI: Critical Care Nursing and the Beacon Award for Excellence.

ABSTRACT: When the "Standards for Establishing and Sustaining Healthy Work Environments" set forth by the American Association of Critical-Care Nurses are met in a health care system, there is enhanced safety and quality care for the patient, better job satisfaction, and less turnover by the staff. The American Association of Critical-Care Nurses started the Beacon Award for Excellence not only to recognize those who have such high standards but also to encourage units who already have achieved this distinction or are applying for it to do better.

Quality and Safety in Healthcare, Part LXXIX: Chief Nursing Officer Development, Assessment, and Turnover: An Example for Many Other Healthcare Executives.

ABSTRACT: Most executives new to a health care organization should have introductory and development programs during their first year, which should include networking opportunities, special projects to improve skills, independent or assigned course work, multiple types of assessments, and periodic discussions regarding expectations about their work and their progress in achieving them. It is preferable for the organization and the new executive to have information from outside sources about how a person in that position can achieve success and the reasons for turnover in the position. This is discussed in this article, using the chief nursing officer as the example.

Quality and Safety in Healthcare, Part LXXVII: Major Roles of the Chief Nursing Officer.

ABSTRACT: The chief nursing officer serves in multiple roles, but among the most important are being the chief administrator for the division of nursing, the chief voice in the organization to engage and empower nurses as professionals, and a major leader for increasing patient satisfaction, quality, and safety. Each of these roles has overlapping responsibilities, and failure in any one of could result in failure in all of them. If all of these roles are done well, the value of the care rendered by the healthcare organization will be substantially increased.

Quality and Safety in Healthcare, Part LXXVIII: Expected Competencies of the Chief Nursing Officer and Most Other Healthcare Executives.

ABSTRACT: Numerous expected competencies of a chief nursing officer are outlined in this article including communication, ability to build relationships, expertise about the environment of healthcare and its future directions, leadership, expertise in business matters, combating bullying, encouraging shared decision making, and optimizing interdisciplinary teams and the use of advanced practice providers. These skills are also expected of most other healthcare executives, whether or not they are nurses, because using these competencies increases quality, safety, and value for the patients and improves conditions for the healthcare organization and those who work there.

Quality and Safety in Healthcare, Part LXXVI: The Value of Magnet® Hospital Recognition.

ABSTRACT: Magnet recognition has value that benefits patients; nurses, physicians, and other providers; the healthcare organization; and the community. This includes not only better job satisfaction, more empowerment, and less turnover for nurses, but also better outcomes for patients, more research and evidence-based practice, a superior reputation for the organization, and an easier time recruiting for the organization.

Quality and Safety in Healthcare, Part LXXV: The Pathway to Excellence®, the Magnet Recognition Program®, and the Professional Practice Environment for Nurses.

ABSTRACT: The Magnet Recognition Program® and the Pathway to Excellence® program of the American Nurses Credentialing Center are not only designed to improve the working conditions of nurses, but also to elevate nursing as a profession and ultimately increase quality, safety, and outcomes for patients. There is much overlap in the programs but the Magnet Recognition Program® specifically addresses outcomes and the Pathway to Excellence® program specifically addresses the well-being of nurses.

Quality and Safety in Health Care, Part LXXX: The National Database for Nursing Quality Indicators and the Practice Environment Scale of the Nursing Work Index.

ABSTRACT: The National Database for Nursing Quality Indicators is an important source of information used to benchmark nursing by unit category in multiple areas related to not only structure and process but also outcome. It also provides some information regarding best practices and the cost to achieve certain results. The Practice Environment Scale of the Nursing Work Index is a frequently used way to measure the professional practice environment of nurses and the relationship of the latter to quality, safety, and other outcomes.

Utilizing an Evidence-Based Alcohol Screening Tool for Identification of Alcohol Misuse.

BACKGROUND: Alcohol misuse is prevalent among college students and negatively affects their health, relationships, and academics. Alcohol misuse screening for this age group is advised but often overlooked. OBJECTIVE: The aim of this study was to implement an evidence-based alcohol screening tool, the Alcohol Use Disorders Identification Test-Consumption, at a southern university health clinic. METHODS: This quality improvement project used a preintervention/postintervention, mixed-methods design. A survey containing the Alcohol Use Disorders Identification Test-Consumption screening tool is used to identify students with alcohol misuse who are then offered education and follow-up. Students who were found to misuse alcohol were retested 1 month later. Qualitative comments were also gathered about the success of the project. RESULTS: Alcohol misuse at this location is high and usually missed during the student health encounter. Screening and identification of alcohol misuse were increased. The follow-up survey showed a reduced number of students misusing alcohol. CONCLUSION: Alcohol screening and treatment in a university health setting may result in decreased alcohol-related problems. The potential to improve student outcomes at other colleges and universities should be considered.

Enhancing Observers' Learning During Simulations.

Health care facilities are charged with the challenging task of establishing and maintaining quality of nursing care. As more health care facilities adopt patient simulation as a strategy for increasing the quality of nursing care, nursing professional development specialists struggle to ensure that all participants have positive learning experiences. Staff members assigned to the role of observer pose a unique challenge because they do not actively participate and may disengage from the learning process. Instructing the observers to lead the debriefing session transforms them into active participants. The traditional method of observers learning vicariously through role modeling can be enhanced by more active involvement during debriefing. Professional role development, greater feelings of achievement, and improved clinical competence will occur with observer-led debriefing. The focus of this article is to discuss an innovative way to capture and hold the attention of those staff members assigned to the role of observer in patient simulation. J Contin Educ Nurs. 2017;48(10):454-457.