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1.
Clin Nurse Spec ; 34(2): 41, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068629
2.
Clin Nurs Res ; 29(1): 13-20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30854876

RESUMO

Older adults with chronic obstructive pulmonary disease (COPD) are at known risk for deconditioning and functional decline during hospitalization. The purpose of this study was to examine correlations between in-hospital mobility activities and functional status indicators in hospitalized older adults with COPD. A predictive correlational, secondary analysis design using multivariate analyses assessed the relationship between mobility events and functional status indicators in patients with COPD (n = 111) and non-COPD (n = 190) diagnoses. Ambulation to the bathroom, ambulation outside the room, and number of days to first out-of-bed activity predicted discharge to home versus extended care facility (ECF; p ≤ .05); days to first out-of-bed activity and out-of-room ambulation predicted reduced length of stay (LOS; p ≤ .05); no variables predicted 30-day readmission. COPD patients experienced more nonweight-bearing activity and longer lengths of stay than non-COPD patients. Specific early weight-bearing activities were associated with positive functional status-related outcomes in hospitalized COPD patients.

3.
Clin Nurse Spec ; 34(1): 3-4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31789955
4.
Clin Nurse Spec ; 33(5): 201-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31403994
5.
Support Care Cancer ; 27(10): 3949-3967, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286232

RESUMO

PURPOSE: The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention in each cancer treatment setting was assigned an evidence level. The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible. RESULTS: A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines. CONCLUSIONS: The evidence supports the use of multi-agent combination oral care protocols in the specific populations listed above. Additional well-designed research is needed on the other BOC interventions prior to guideline formulation.


Assuntos
Assistência Odontológica/métodos , Mucosite/terapia , Neoplasias/tratamento farmacológico , Guias de Prática Clínica como Assunto , Estomatite/prevenção & controle , Estomatite/terapia , Humanos , Oncologia , Projetos de Pesquisa
6.
Nurs Outlook ; 67(5): 511-522, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31030905

RESUMO

BACKGROUND: Advanced practice registered nurses (APRN) are expected to contribute to improved patient outcomes. Traditionally, clinical nurse specialists (CNS) have been the APRN role that led system-level nursing practice initiatives to advance care for specialty populations. Little is known about the work processes used by CNSs to achieve outcomes. PURPOSE: This study identified common processes used by CNSs working in a variety of practice settings and specialties to advance nursing practice and achieve improved clinical outcomes. METHODS: Qualitative descriptive methods were used; a purposeful sample of CNSs with completed system-level projects participated in focus groups. Data were analyzed using standard content analysis process. FINDINGS: CNSs engaged in intricate interactions identified as articulation work involving the management of intersections between people, technology and organizations. This expert work is largely invisible. Self-agency, trust, and influence are a nexus upon which CNS work processes revolve. DISCUSSION: The findings provide insight into CNS work processes, lend credibility to the CNS's leadership abilities, and help explain why the CNS role and practice is often considered invisible and ambiguous.


Assuntos
Prática Avançada de Enfermagem/normas , Enfermeiras Clínicas/estatística & dados numéricos , Papel do Profissional de Enfermagem , Guias de Prática Clínica como Assunto , Melhoria de Qualidade/normas , Qualidade da Assistência à Saúde/normas , Fluxo de Trabalho , Adulto , Prática Avançada de Enfermagem/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos
9.
Clin Nurse Spec ; 32(6): 288-289, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30299328
10.
Clin Nurse Spec ; 32(5): 219-220, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30095518
12.
J Nurs Manag ; 26(7): 874-880, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29573019

RESUMO

AIM: To explore patient and family perspectives of hospital care in an acuity adaptable care model implemented in an urban, public safety-net hospital. BACKGROUND: Specialty care units result in reactionary bed management. Changes in acuity generate costly, disruptive, intra-hospital patient transfers, which negatively affect clinical outcomes while increasing nurse workload. The acuity adaptable care model is a universal bed model structured to support patients in one room while providing staff, equipment and other resources across varying levels of acuity. METHOD: Qualitative descriptive methods were used to analyse the narratives of a purposive sample of patients and family members about receiving care in an acuity adaptable care delivery model. RESULTS: Three content areas emerged from the narratives and were categorized as feeling safe, perceiving continuity of care and valuing family, which culminated in a sense of comfort and healing while in the hospital. CONCLUSION: By bringing care services to the patient instead of taking the patient to the services, the acuity adaptable care model facilitated a perception of a healing environment for patients and family members. IMPLICATIONS FOR NURSING MANAGEMENT: The acuity adaptable care model should be considered when hospital facilities are undergoing major renovation or replacement.


Assuntos
Modelos de Enfermagem , Gravidade do Paciente , Satisfação do Paciente , Qualidade da Assistência à Saúde/normas , Adulto , Ocupação de Leitos/métodos , Ocupação de Leitos/normas , Continuidade da Assistência ao Paciente/normas , Família/psicologia , Feminino , Hospitais/normas , Hospitais/tendências , Humanos , Entrevistas como Assunto/métodos , Masculino , Segurança do Paciente/normas , Pacientes/psicologia , Pesquisa Qualitativa
14.
Cancer Nurs ; 41(1): 33-44, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28059839

RESUMO

BACKGROUND: Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood. OBJECTIVE: The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC. METHOD: An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015. RESULTS: Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted. CONCLUSION: Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms. IMPLICATIONS FOR PRACTICE: Findings help healthcare givers to better understand the symptom experience of their APC patients.


Assuntos
Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/patologia , Avaliação de Sintomas/psicologia , Humanos , Estadiamento de Neoplasias
18.
Clin Nurse Spec ; 30(6): 313-314, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27753666
19.
J Prof Nurs ; 32(4): 271-82, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27424927

RESUMO

Measuring outcomes of clinical nurse specialist (CNS) practice is essential for demonstrating accountability. Literature is limited with respect to the scope of reported CNS outcomes. The National Association of Clinical Nurse Specialists' (NACNS) published listing of CNS outcomes could serve as an outcome measurement framework. Revalidation of these outcomes is an important step in creating a structured outcome measurement approach. The purpose of this descriptive study was to assess CNSs' perceptions of the ongoing validity of NACNS published outcomes. A Web-based survey asked participants to describe, for each of 42 outcomes, the frequency of outcome accountability, importance to practice, and frequency of monitoring. Of the 427 surveys returned, 347 (81%) were included in analysis. Findings demonstrated concordance between identified outcomes and actual CNS practice. When job descriptions included the CNS outcomes, more CNSs reported using the outcomes in practice. Both accountability and importance predicted the monitoring of outcomes (p < .001). This study demonstrated the ongoing validity of NACNS outcomes. Nurse educators must ensure that CNS program curricula are based on the NACNS framework and that successful achievement of program outcomes are congruent with the framework. These outcomes have potential for use as a conceptual framework for guiding future CNS outcome investigations and ongoing monitoring systems. Finally, the findings of this study give voice to CNS practice and provide knowledge about expectations for practice outcomes.


Assuntos
Prática Avançada de Enfermagem/normas , Enfermeiras Clínicas/normas , /normas , Estudos Transversais , Humanos , Internet , Pessoa de Meia-Idade , Inquéritos e Questionários
20.
Clin Nurse Spec ; 30(4): 187-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27309778
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