Using the SMART-EST Goals in Lifestyle Medicine Prescription.

Lifestyle modifications can effectively decrease chronic disease risk but studies show little to no time during patient encounters is spent on lifestyle medicine counseling. The SMART-EST goal framework facilitates both a rich discussion of lifestyle medicine and a comprehensive patient-centered action plan for health behavior change. The tenets of the SMART-EST goal-setting process are discussed.

Collaborative Student Leadership Conference.

In April 2008, the New Careers in Nursing (NCIN) Program launched a collaborative initiative between the American Association of Colleges of Nursing and the Robert Wood Johnson Foundation. One of the main goals of this initiative was to provide leadership development through structured activities for NCIN scholars. In order to meet this goal, 3 participating NCIN schools came together to plan and conduct a collaborative student-focused, scholar-led leadership conference for accelerated nursing students. Admittedly, collaboration among institutions of higher education is sometimes not a standard practice. Although sharing the common goal of preparing future nurses to provide high-quality care, many schools of nursing often compete for scarce resources including recruitment of faculty and students, securing clinical placements, and new graduates and alumni compete for jobs. However, there are advantages to sharing financial and intellectual resources in order to ensure a richer educational experience for NCIN scholars and for all accelerated nursing students. Using the Robert Wood Johnson Foundation monies awarded for our Legacy Project, 3 NCIN program liaisons overseeing accelerated nursing programs in Nebraska met to discuss the advantages and disadvantages related to planning and conducting a collaborative student leadership activity for NCIN scholars and their peer-accelerated nursing students. The program liaisons wanted to establish common goals for the endeavor and ensure the use of approaches that would foster leadership development of the NCIN scholars and establish mechanisms by which the group would create a collaborative environment. Although the 3 collaborating colleges were and continue to be competitors for prospective accelerated students, the benefit of collaborating on a joint leadership development project for the NCIN scholars and their peers was clear. Program liaisons recognized that this opportunity would strengthen leadership development and provide relevant experience for the NCIN scholars and result in a conference for other accelerated nursing students.

Breaking Through the Economic Barriers of Anesthesia Information Management Systems.

Anesthesia information management systems (AIMS) are being increasingly used to assist the delivery and documentation of anesthesia services in the United States. The major benefits of AIMS cited in the literature are the ability to (1) reduce costs, (2) facilitate quality assurance and quality improvement processes, (3) increase the accuracy and completeness of the anesthesia record, and (4) improve adherence to recommended guidelines. The major drawback, especially for rural hospitals, is the cost. This article identifies 2 of the main elements of AIMS that exist in information technology and data systems already present in a hospital. In this project, the medication dispensing system was used to achieve a 70% reduction in drug costs, and a simple electronic database was created, which detected adverse events that were missed with the legacy quality assurance system. There was no additional cost to the hospital to realize these benefits because this project utilized technologies and data systems already in place and staff time was part of the normal workload. This project showed that it is possible to achieve 2 of the major benefits of an AIMS without the major cost of purchasing one.

Implementing Collaborative Learning in Prelicensure Nursing Curricula: Student Perceptions and Learning Outcomes.

This study evaluated learning outcomes and student perceptions of collaborative learning in an undergraduate nursing program. Participants in this 3-phase action research study included students enrolled in a traditional and an accelerated nursing program. The number of students who passed the unit examination was not significantly different between the 3 phases. Students had positive and negative perceptions about the use of collaborative learning.

Women's experience of hospitalized bed rest during high-risk pregnancy.

OBJECTIVE: To describe the lived experience of the hospitalized pregnant woman on bed rest. DESIGN: A qualitative, phenomenological design. SETTING: Three high-risk antepartum units in the midwestern United States. PARTICIPANTS: A self-selected, convenience sample of 11 high-risk pregnant women. METHOD: Phenomenological study using thematic analysis of completed handwritten journals and/or online blogs. RESULTS: Women described the battles that they fought each day for the lives of their unborn children. Using an imagery of war, three categories emerged: (a) the war within, (b) fighting each battle, and (c) bringing in reinforcements. CONCLUSIONS: Women experience many different emotions and stressors during restricted bed rest. A nurse's understanding of this experience is essential to provide adequate care and coping strategies for women at this time.

Seroprevalence of hepatitis B surface antigen among pregnant women attending the Hospital for Women & Children in Koutiala, Mali.

OBJECTIVE: To establish the rate of seroprevalence of the hepatitis B surface antigen in pregnant women in south-eastern Mali, and to decrease mother-to-child transmission. METHODS: In a descriptive cross-sectional comparison study, 3 659 pregnant women attending a non-governmental hospital in Koutiala, Mali, during 2008 and 2009 were screened for the hepatitis B surface antigen during antenatal clinic attendance or when admitted for delivery. A chart review compared the hepatitis B virus (HBV)-positive women to HBV-negative women used as controls to identify potential risk factors for HBsAg positivity. The variables compared were age, parity, type of genital excision, birthweight of baby and HIV status. RESULTS: A total of 293 (8.0%) pregnant women tested positive for HBsAg. Their average age was 27.6 years, average parity of 2.8 births, 90% had Type 2 genital excision, 21% had low birthweight infants, and 14 (0.4%) women also tested positive for HIV. Infants born to HbsAg-positive women were immunised with the hepatitis B vaccine in the delivery room. Two hundred and eighty-four HBV-negative women were compared with the HBV-positive women. None of the differences of means or relationships was statistically insignificant. CONCLUSION: In view of the high endemicity and lack of easily identifiable risk factors, free maternal HBV screening should be provided to all women in Mali, and the infants born to HBsAg-positive women should be immunised within 12 hours of birth.