The Walk to Save: Benefits of Inpatient Cardiac Rehabilitation.

Hospital immobilization after a cardiac event can cause complications. The pathophysiology of complications, research concerning benefits of early ambulation, and recommendations from the American College of Sports Medicine are discussed.

Do nurses provide a safe sleep environment for infants in the hospital setting? An integrative review.

BACKGROUND: Sudden infant death syndrome (SIDS) may be the most preventable cause of death for infants 0 to 6 months of age. The American Academy of Pediatrics (AAP) first published safe sleep recommendations for parents and healthcare professionals in 1992. In 1994, new guidelines were published and they became known as the "Back to Sleep" campaign. After this, a noticeable decline occurred in infant deaths from SIDS. However, this number seems to have plateaued with no continuing significant improvements in infant deaths. OBJECTIVES: The objective of this review was to determine whether nurses provide a safe sleep environment for infants in the hospital setting. Research studies that dealt with nursing behaviors and nursing knowledge in the hospital setting were included in the review. DATA SOURCES: A search was conducted of Google Scholar, CINAHL, PubMed, and Cochrane, using the key words "NICU," "newborn," "SIDS," "safe sleep environment," "nurse," "education," "supine sleep," "prone sleep," "safe sleep," "special care nursery," "hospital policy for safe sleep," "research," "premature," "knowledge," "practice," "health care professionals," and "parents." STUDY ELIGIBILITY CRITERIA: The review included research reports on nursing knowledge and behaviors as well as parental knowledge obtained through education and role modeling of nursing staff. Only research studies were included to ensure that our analysis was based on rigorous research-based findings. Several international studies were included because they mirrored findings noted in the United States. All studies were published between 1999 and 2012. PARTICIPANTS: Healthcare professionals and parents were included in the studies. They were primarily self-report surveys, designed to determine what nurses, other healthcare professionals, and parents knew or had been taught about SIDS. SYNTHESIS METHOD: Integrative review. RESULTS: Thirteen of the 16 studies included in the review found that some nurses and some mothers continued to use nonsupine positioning. Four of the 16 studies discussed nursing knowledge and noncompliance with AAP safe sleep recommendations. Eleven of the 16 studies found that some nurses were recommending incorrect sleep positions to mothers. Five of the 16 studies noted that some nurses and mothers gave fear of aspiration as the reason they chose to use a nonsupine sleep position. LIMITATIONS: In the majority of the studies, the information was self-reported, which could impact the validity of the findings. Also, the studies used convenience sampling, which makes study findings difficult to generalize. CONCLUSIONS AND IMPLICATIONS: The research indicates that there has been a plateau in safe sleeping practices in the hospital setting. Some infants continue to be placed in positions that increase the risk for SIDS. The research also shows that some nurses are not following the 2011 AAP recommendations for a safe sleep environment. Clearly, nurses need additional education on SIDS prevention and the safe sleep environment, and additional measures need to be adopted to ensure that all nurses and all families understand the research supporting the AAP recommendation that supine sleep is best. Further work is needed to promote evidence-based practice among healthcare professionals and families.

Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP).

After a cardiovascular event, patients and their families often cope with numerous changes in their lives, including dealing with consequences of the disease or its treatment on their daily lives and functioning. Coping poorly with both physical and psychological challenges may lead to impaired quality of life. Sexuality is one aspect of quality of life that is important for many patients and partners that may be adversely affected by a cardiac event. The World Health Organization defines sexual health as '… a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences ….'(1(p4)) The safety and timing of return to sexual activity after a cardiac event have been well addressed in an American Heart Association scientific statement, and decreased sexual activity among cardiac patients is frequently reported.(2) Rates of erectile dysfunction (ED) among men with cardiovascular disease (CVD) are twice as high as those in the general population, with similar rates of sexual dysfunction in females with CVD.(3) ED and vaginal dryness may also be presenting signs of heart disease and may appear 1-3 years before the onset of angina pectoris. Estimates reflect that only a small percentage of those with sexual dysfunction seek medical care;(4) therefore, routine assessment of sexual problems and sexual counselling may be of benefit as part of effective management by physicians, nurses, and other healthcare providers.

Enhancing health promotion during rehabilitation through information-giving, partnership-building, and teach-back.

PURPOSE AND CONCEPTUAL FRAMEWORK: This clinical article explores how Street, Gordon, and Millay's framework of evidence-based communication strategies of information-giving and partnership-building can be used by rehabilitation nurses and other rehabilitation team members in their practice to help patients with health promotion. METHOD (INTERVENTION STRATEGIES): This clinical article gives practical suggestions for using the information-giving strategies of control, description, instructions, options, outlook, rationale, recommendations, and risks; and the partnership-building strategies of agreement, decision-making, questions, and requests to assist patients. CONCLUSION AND CLINICAL RELEVANCE: Combined with the teach-back method, these strategies have been shown to increase the likelihood that patients will lose weight, adopt a regular exercise program, and bring chronic illnesses such as hypertension and diabetes under control, which is also likely to increase patients' functional ability and independence. These strategies can be used by rehabilitation nurses and all members of the rehabilitation team in acute, sub-acute, out-patient, and in-home rehabilitation programs.

Culturally tailored education for African Americans with type 2 diabetes.

Research shows culturally tailored education can lead to significant improvements in self-care in African Americans with type 2 diabetes. Practical recommendations are provided for medical-surgical nurses to implement culturally tailored education in their patient care.

Increasing awareness in African American BSN students of the health risks of obesity.

This paper reports on the perceived effectiveness of a program to increase awareness of the health risks of obesity among African-American students. Thirty (n = 30) senior level Bachelor of Science in Nursing students attending a Historically Black College and University (HBCU) took a knowledge test, then participated in an hour-long educational session on obesity. Following the session, the students completed a 10-item post-test to evaluate the effectiveness of the program in increasing awareness of obesity as a risk for heart disease and diabetes. The findings suggested a need to further educate African-American students on the consequences of obesity as well as recommendations to advance the science of personal and family risk awareness in nursing students.

Overcoming nursing faculty shortages and bridging the gap between education and practice.

The nurse faculty shortage and new requirements for teaching have led to thousands of qualified applicants being turned away from prelicensure nursing programs. In response, the Chief Nursing Officer in one organization created nursing faculty consultant positions to collaborate with faculty, teach prelicensure students in clinical practice, ensure the consistency of care by students in the hospital system, and enhance the relationships between schools of nursing and the organization. In the past 4 years the nursing faculty consultants have been employed they have taught over 500 nursing students from six different nursing programs.

Nurses' experiences with bed exit alarms may lead to ambivalence about their effectiveness.

The literature reports conflicting evidence regarding the effectiveness of any single intervention, including bed exit alarms, in preventing falls. Yet bed exit alarms are widely used in healthcare settings as part of comprehensive fall-prevention programs even though no large-scale randomized controlled trials have demonstrated their effectiveness. As a part of a quality improvement project, bed alarms were piloted on two nursing units in a Level I trauma center. Nurses' patterns of use, their experiences and beliefs about bed alarms, and the literature regarding bed exit alarms were explored. Alarms were used with confused and agitated patients who did not fall. Nurses said that bed alarms may have helped prevent falls, but, even with bed alarms in use, nurses still needed to monitor their patients hourly. The conflicting experiences of nurses using the alarms, combined with nurses' comments and literature both supporting and not supporting bed alarms, shed light on the dilemma nurses face when prioritizing safe patient care and the ambivalence some nurses experience regarding bed alarms.

Turning the nightmare of complex regional pain syndrome into a time of healing, renewal, and hope.

Complex regional pain syndrome is a lifelong chronic pain disorder. The medical treatment and nursing interventions, which can turn this nightmare into a time of healing, renewal, and hope, are described.