Perspectives From Academic and Practice Leaders on Nursing Student's Education and Role in Medication Reconciliation.

BACKGROUND: Medication reconciliation is a complex process that occurs during hospitalization at admission, transfer and discharge and at each outpatient clinic visit. Despite numerous quality improvement initiatives implemented by healthcare facilities nationwide to refine the process, medication errors still occur. Medication reconciliation processes are institution specific and undergo constant refinement. Few reports are available on the nursing student's role in this contemporary safety process. PURPOSE: The purpose of this study was to assess the nursing student's education and role in the medication reconciliation process from the perspective of academic faculty and hospital nursing leadership. METHODS: Electronic surveys were sent to 90 nurse academic and 160 nurse practice leaders in Ohio during the first quarter of 2015. Surveys were completed by 47% of the academic leaders (42/90) and 23% of the practice leaders (42/160). Survey questions focused on the nursing curriculum regarding medication reconciliation and the student nurse's role in the process during clinical experiences. RESULTS: Faculty from 75% of the schools of nursing reported that the medication reconciliation curriculum was mostly taught in the classroom. Only 24.4% of the schools taught medication reconciliation in an interdisciplinary context with pharmacy students. During clinical time, 33% of faculty reported that students had direct involvement and 33% had the opportunity to observe the process of medication reconciliation. The majority (80%) of practice nurse leaders reported that their facility does not permit nursing students to perform medication reconciliation. Although medication reconciliation processes are specific to each organization, only 52.8% of the practice leaders reported that they provide faculty or nursing students' formal training on their hospital's medication reconciliation policy or site-specific process. CONCLUSION: Students are not receiving adequate education or opportunity to practice medication reconciliation during clinicals. Future alignment of academia, and practice efforts on medication reconciliation are needed.

Sports therapy and recreation exercise program in type 2 diabetes: randomized controlled trial, 3-month follow-up.

BACKGROUND: A sports therapy program in type 2 diabetes helps in glucose control, but little is known how a long-term structured exercise intervention affects the parameters in this disease. Our aim was to measure the impact of a 24-week-long sports therapy program in type 2 diabetes on the concentration of glucose in blood, body composition, and physical fitness level. METHODS: In this prospective longitudinal study, 208 type II diabetic patient (80 male, 128 female, aged: 61±6.86 years) were selected and randomly assigned to a control or an intervention group. The intervention group took part in a sports therapy and recreation sports program for 6 months. Taking into account the rules of training theory and physiotherapy, fitness material of exercising (aerobics, resistance training, muscle strengthening, stretching) and outdoor elements were used during the 3-month sports program, after which it became a 3-month recreation exercise program. In the control group, there was no intervention. RESULTS: The intervention group showed significant decrease in concentration of glucose in blood (mean differences [MD]:-3.23; Confidence Interval [CI] lowest: -3.50; CI highest: -2.95]; P<0.01), weight (MD: -1.68; [-0.82, -0.52] P=0.01), BMI (MD: -0.37; [-0.82; 0.08]; P=0.01), body fat percentage (MD:-1.74; [-2.15, -1.34]; P=0.05) and visceral fat (MD:-0.37; [-0.67, -0.07; P=0.01); right (MD: 5.33; [4.98, 5.68]; P<0.01) and left arm curl (MD: 5.23; [4.87, 5.60]; P<0.01) test, chair stand test (MD: 2.95; [2.65, 3.25]; P=0.00) and the 6-minute walk test (MD: 111.21; [101.12; 121.31]; P<0.01) showed significant improvement. CONCLUSIONS: A 24-week-long sports therapy program is a successful intervention for improving parameters affected by type 2 diabetes.

The History and State of Neonatal Nursing Quality Improvement Practice and Education.

Quality improvement has evolved rapidly in neonatal nursing. This review outlines the history and current state of quality improvement practice and education in neonatal nursing. The future of neonatal nursing includes a stronger emphasis on quality improvement in advanced practice education that promotes doctoral projects that result in clinical improvements. A collective focus will ensure that neonatal nurses not only deliver evidence-based care, but also continually improve the care they deliver.

Back School programme for nurses has reduced low back pain levels: A randomised controlled trial.

AIMS AND OBJECTIVES: (i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques. BACKGROUND: Millions of nurses around the world suffer from occupational-related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques. METHODS: A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n = 67, control group n = 70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3 months. The programme consisted of didactic education, spine-strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses' patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0-100 visual analogue scale. RESULTS: The pre-intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%-97.01% (control group: 8.57% pre-intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre-intervention increased from 10.44%-100% correct execution in the experimental group (control group: pre-intervention test 10.00% and postintervention test 11.42%). CONCLUSION: The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses. RELEVANCE TO CLINICAL PRACTICE: We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes.

Value of Specialty Certification as a Kangaroo Caregiver.

Kangaroo care (KC), also known as skin-to-skin contact, saves lives, but fewer than 50% of newborns and mothers in U.S. hospitals receive KC because of lack of knowledge and skill competency. Because nurses can increase knowledge and skill competency through a certification course, the value of certification as a kangaroo caregiver and administrative incentives for certification as a kangaroo caregiver were evaluated in 71 neonatal intensive care and maternal-newborn unit nurses who completed an electronic questionnaire and the Perceived Value of Certification Tool. Nurses highly valued their KC certification, agreeing with 17 of 18 positive value statements. KC certification increased salary for a few, but institution-based incentives for KC certification are still limited and recognition of KC certification is needed.

How healthy are ambulance personnel in Central Europe?

The health status of ambulance personnel (AP) has an important impact on the quality of patient care. The aim of this study is to analyze the self-fperceived health of AP. A cross-sectional survey was conducted among Hungarian AP, in which anonymous data (n = 364 subjects) were evaluated by descriptive statistics and multivariate logistic regression analyses. Those AP who reported engaging in any amount of exercise experienced better self-rated health (odds ratio [OR]: 1.7 confidence interval [CI] 95% [1.2, 2.7]) and self-rated physical fitness (OR: 2.0 CI 95% [1.2, 2.9]), and reported less limitation in daily activities due to health problems (OR: 2.4 CI 95% [1.4, 4.0]). Those AP who reported feeling more overall stress reported 2.1 times (CI 95% [1.3, 3.2]) worse health and 1.9 (CI 95% [1.2, 2.8]) times worse self-rated physical fitness. Possibly, physical fitness protocols should be implemented and required or advised for all AP.

Building a novel inpatient diabetes management mentor program: a blueprint for success.

The intent of this project was to create a formalized educational program for bedside nurses responsible for inpatient diabetes management. Bedside nurses are recruited to serve as diabetes management mentors. The mentors receive advanced education concerning teaching and learning principles, the AADE7™ Self-Care Behaviors, and diabetes management strategies. They teach their peers, advocate for patients, and facilitate referrals for outpatient Diabetes Self-Management Education (DSME) programs. The focus of these ongoing educational activities is to foster the development of diabetes management mentors and to create teaching tools that mentors can use with peers to address practice gaps or skill deficiencies. The diabetes management mentor is integral in enhancing the care of patients with diabetes in the hospital. The empowerment of bedside nurses as mentors for their peers and their patients is an invaluable asset that helps nurses take ownership of their practice. This role could be applied to other complex disease entities, helping nurses to develop specific management skills to improve patient outcomes and enhance patient satisfaction.

A diabetes management mentor program: outcomes of a clinical nurse specialist initiative to empower staff nurses.

PURPOSE: The purpose of this project was to enhance the knowledge of the bedside nurse in diabetes management. A forum for ongoing support and exploration of clinical problems, along with the distribution of educational tools were the components of this program. BACKGROUND: Diabetes accounts for 30% of patients admitted to the hospital. It has become more challenging to manage as the treatment choices have increased. There are a number of researchers who have identified nurse and physician knowledge of diabetes management principles as suboptimal. DESCRIPTION OF THE INNOVATION: Staff nurses are educated for a role as a Diabetes Management Mentor and are expected to educate/dialogue with peers monthly, model advocacy and diabetes patient education skills, facilitate referrals for diabetes education, and direct staff to resources for diabetes management. OUTCOMES: Diabetes Management Mentors feel more confident in their knowledge of diabetes and their ability to resolve clinical issues as they arise. CONCLUSION: The Diabetes Management Mentor role is another avenue for nurses to refine their clinical knowledge base and acquire skills to share with colleagues while remaining at the bedside. IMPLICATIONS: The clinical nurse specialist is expertly prepared to foster the professional development of bedside nurses while simultaneously making a positive impact on disease management. Opportunity for future investigation includes efficacy of teaching tools on diabetes mastery, the effect of clinical nurse specialist mentoring on a select group of bedside nurses, and the Diabetes Management Mentor's impact on prevention of near-miss events.

The changing face of European healthcare education: the Hungarian experience.

Throughout Europe, higher education is undergoing great changes in order to establish what is being called the European Higher Education Area (EHEA) based on the Bologna process. The goal being the establishment of a uniform, transparent and efficient development of professionals in a higher education system that can react in a flexible way to the changes in the labor market, and to the challenges presented by increasing globalization. The aim of this article is to provide an overview of the Bologna process and to give a summary of the implemented initial stages in the health care higher education of Hungary. As a consequence, the Hungarian higher education in healthcare has undergone considerable reforms to facilitate transition into this new system. The results indicate that the new structure in health sciences is not compatible with other way of European countries of introducing Bologna reforms, although the content of the former BSc curriculum still remained the same. MSc programs are still being discussed.