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1.
J Contin Educ Nurs ; 54(1): 32-39, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36595727

RESUMO

Background Nurse residency programs (NRPs) have been proposed to meet the educational needs of new graduate nurses and facilitate the transition into practice. Although most studies indicate the benefits of NRPs to assist nurses during transition into practice, only one study compared an NRP with a control group. This study examined whether nurses in an NRP transitioned into practice more successfully than nurses in a traditional orientation program. Method This study enrolled 106 newly employed graduate nurses into study arms by unit: a nurse residency intervention group or a control group of standard nursing orientation. Casey-Fink Readiness for Practice, Nurse Retention, and Nurse Job Satisfaction surveys measured group outcomes. Results Readiness for practice improved significantly for nurse residents, as did nurse retention perceptions, indicating that nurse residents were more likely to be retained at the organization. The 1- and 2-year nurse retention rates during the 3 years of the study showed marked improvement. Conclusion The NRP resulted in improved readiness for practice, improved nurse retention, and higher job satisfaction compared with standard orientation. [J Contin Educ Nurs. 2023;54(1):32-39.].


Assuntos
Educação de Pós-Graduação em Enfermagem , Internato e Residência , Humanos , Satisfação no Emprego , Inquéritos e Questionários , Competência Clínica
2.
Clin J Oncol Nurs ; 24(3): 324-327, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32441688

RESUMO

Nursing informatics is an evolving field in the burgeoning context of technologic and digital advances in health care. Nurse informaticists are integral in translating these advances into evidence-based clinical practice to improve the quality and safety of patient care and professional practice. This article describes the role and operationalization of nurse informaticists in the oncology setting. A case study is presented to exemplify how nurse informaticists can lead interprofessional teams in evaluating opportunities for process or quality improvement and implementing and evaluating digital solutions to improve oncology care.


Assuntos
Enfermagem Baseada em Evidências/normas , Relações Interprofissionais , Papel do Profissional de Enfermagem , Informática em Enfermagem/normas , Enfermagem Oncológica/normas , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
J Arthroplasty ; 35(8): 2027-2032, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32307293

RESUMO

BACKGROUND: America is amid an opioid epidemic, best characterized by liberal prescribing practices; widespread opioid misuse, abuse, and diversion; and rising rates of prescription-related opioid overdose. While many contributors to opioid overprescribing exist, orthopedic surgery is identified as a key driver. The purpose of this study is to determine predictors of ongoing opioid use >15 days post-total knee arthroplasty (TKA) and those patients prescribed >1350 morphine milligram equivalents (MMEs) in the 15 days following surgery. METHODS: A retrospective cohort study was conducted in patients undergoing TKA (January 2016-December 2017) in an integrated healthcare system. Outcomes of interest were patient and clinical characteristics. RESULTS: A total of 621 patients were included in the study. The majority were female (57.6%), were non-Hispanic/Latino white (92.3%), and from metropolitan areas (64.3%) with fewer than 110,000 population. Mean age was 66.3. Being female (odds ratio [OR] = 1.547, P = .092), having a higher body mass index (OR = 1.043, P = .036), and receipt of more postdischarge prescriptions in the 60-day follow-up period (OR = 8.815, P < .0001) were associated with a greater likelihood of receipt of opioid prescriptions for more than 15 days. Older patients (OR = 0.954, P = .01) and those discharged to home (OR = 0.478, P = .045) were less likely to receive >1350 MME; longer length of stay (OR = 1.447, P = .013) was more likely in those prescribed >1350 MMEs. CONCLUSION: Several predictors were associated with longer duration and higher doses of opioid prescriptions post-TKA. Further research is needed to ascertain the challenges of opioid prescribing from both the metropolitan surgical team and rural healthcare provider perspective.


Assuntos
Analgésicos Opioides , Artroplastia do Joelho , Assistência ao Convalescente , Idoso , Artroplastia do Joelho/efeitos adversos , Feminino , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologia , Alta do Paciente , Padrões de Prática Médica , Estudos Retrospectivos
4.
J Neonatal Perinatal Med ; 13(2): 215-221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31707377

RESUMO

BACKGROUND: An exclusive human milk diet (EHM) including fortification with a human milk-based fortifier has been shown to decrease the occurrence of necrotizing enterocolitis (NEC) but growth velocity may be less for infants receiving EHM compared to a bovine diet. OBJECTIVE: The objective of this study was to determine if growth is improved by earlier fortification of breast milk for preterm infants supported with a human milk based fortifier. STUDY DESIGN: A multi-center retrospective cohort study of the outcomes of infants of 500- 1250 g birth weight whose breast milk feedings were fortified at >60 mL/kg/day (late) versus <60 mL/kg/day (early) of enteral feeding volume. RESULTS: Median±IQR range for gestational age (27.6±3.4 vs 27.0±2.9 weeks, p = 0.03) and chronic lung disease (CLD: 42.6 vs 27.6%, p = 0.008) were higher, and weight gain (12.9±2.6 vs 13.3±2.6 g/kg/day, p = 0.03) was lower in the late (N = 102) vs the early (N = 292) group. Adjusted multiple linear regression analysis found that early fortification was associated with improved growth velocity for weight (p = 0.007) and head circumference (HC) (p = 0.021) and less negative changes in z-scores for weight (p = 0.022) and HC (p = 0.046) from birth to discharge. Adjusted multiple logistic regression found that early fortification was associated with decreased occurrence of CLD (p = 0.004). No other outcomes, including NEC, were associated with early versus late fortification. CONCLUSION: The study results suggested that early HM fortification appears to positively affect growth for infants whose human milk feedings are fortified with a human milk based fortifier without adverse effects. The incidence of CLD was also reduced in the early fortification group.


Assuntos
Nutrição Enteral/métodos , Alimentos Fortificados , Cabeça/crescimento & desenvolvimento , Leite Humano , Aumento de Peso , Doença Crônica , Enterocolite Necrosante/epidemiologia , Enterocolite Necrosante/prevenção & controle , Feminino , Idade Gestacional , Crescimento , Humanos , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Modelos Lineares , Modelos Logísticos , Pneumopatias/epidemiologia , Masculino , Fatores de Tempo
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