A little goes a long way: Strategies to support nursing staff amid COVID-19.

ABSTRACT: This article discusses the impact of staffing shortage on nurses' mental health, and outlines ways, including a successful rounder initiative, for nurse leaders and facilities to address nurses' stress and burnout.

Local anesthetic systemic toxicity: What nurses should know.

ABSTRACT: Local or regional anesthetics are becoming more common pain management options for patients, especially considering concerns regarding opioid use disorders. Though mostly safe, these interventions may carry serious risks such as local anesthetic systemic toxicity (LAST). This article discusses LAST and the importance of recognizing its signs and symptoms.

Faculty and student perceptions about attendance policies in baccalaureate nursing programs.

AIM: To understand perceptions of faculty and students about attendance policies in baccalaureate nursing programs. BACKGROUND: Classroom attendance is an issue of debate across academic disciplines. METHOD: A mixed-methods study was conducted using qualitative data from a stratified random sample of 65 accredited baccalaureate nursing programs; 591 students and 91 faculty from 19 schools responded. RESULTS: Sixty-two percent of faculty thought students who missed class exhibited unprofessional behavior; 69 percent believed students who missed class were less successful in the clinical setting. Students (57 percent) and faculty (66 percent) believed there should be an attendance policy. Twenty-nine students reported needing a break in workload (16.8 percent) or did not find class time valuable (11.8 percent). CONCLUSION: Variability exists in student and faculty beliefs regarding attendance policies. Understanding these viewpoints and utilizing creative teaching approaches will facilitate learning and create an environment of teamwork and mutual respect.

Strange sightings: is it Charles Bonnet syndrome?

"Lilliputian hallucinations" are a hallmark of this curious condition associated with certain common ophthalmic disorders.

Alcohol use and binge drinking in baccalaureate nursing students: A descriptive study.

BACKGROUND: Current literature validates that drinking is a problem on many college and university campuses. While educators are aware that drinking negatively impacts learning, it is imperative that nursing educators understand why this behavior exists and recognize strategies and opportunities to mitigate drinking for students in the nursing major. PURPOSE: The purposes of this study were to understand the prevalence of and reasons for alcohol use and binge drinking in undergraduate baccalaureate nursing students in the United States and identify ways faculty may promote a healthy learning environment to decrease the incidence of alcohol use and binge drinking. METHOD: This descriptive study used a web-based survey methodology. The survey contained a demographic questionnaire, alcohol use survey, and open-ended questions to address reasons for drinking and stressors. The survey was randomly distributed to baccalaureate nursing programs throughout the United States. RESULTS: The final sample included 937 participants. Nursing students abuse alcohol for a variety of reasons including lack of understanding of binge drinking, peer pressure, dealing with mental health issues, and as a way to cope with multifaceted life stressors. Slightly over half (51%) of these participants reported drinking behavior that would be considered hazardous and 3% were in the alcohol dependent category on the alcohol use survey. CONCLUSION: These findings are consistent with social concerns about alcohol use. Nursing students yearned for help and support from faculty regarding how to handle stress and desired faculty to be role models. Faculty who form collaborative partnerships with students, foster healthy coping strategies which may promote academic success and more importantly favorable outcomes as future practicing nurses.

Assessing Postvoid Residual to Identify Risk for Urinary Complications Post Stroke.

BACKGROUND: After a stroke, urinary dysfunction and urinary tract infection are estimated to be approximately 20%. Increased postvoid residual (PVR) is a risk factor for urinary dysfunction and urinary tract infections. These complications can negatively impact recovery weeks after the initial hospitalization. Early identification of risks and patient education are important. PROJECT DESCRIPTION: This project was initiated for those patients admitted for a diagnosis of stroke on a 55-bed neuroscience unit in an acute care hospital. Patients were scanned after the initial void post stroke. Nurses followed a specific bladder scanning algorithm for subsequent scanning if the PVR volume was greater than 100 mL. RESULTS: Seventy-eight patients were scanned in the original phase of the project, and 41 (53%) had PVR volumes greater than 100 mL after the initial void/scan. Of those, 22 patients still had a volume of greater than 100 mL after the second void/scan, and 12 had PVR volumes greater than 100 mL after a third scan. IMPLICATIONS FOR PRACTICE: Patients admitted with stroke have demonstrated increased PVR volumes. Portable ultrasound bladder scanning is a safe, noninvasive method to measure residual urinary volumes. The use of a bladder scanning algorithm encourages nurses' autonomy in assessing and identifying patients at a higher risk for urinary complications. CONCLUSION: Identifying the risk for urinary complications post stroke can lead to early interventions that can improve recovery. This also allows for specific patient education related to preventative measures to reduce risk of urinary complications. The use of a specific bladder scanning protocol is recommended as standard practice for all patients admitted with stroke.

Lithium-Induced Neurotoxicity: A Case Study.

BACKGROUND: In patients presenting with neurological deficits, identifying the cause can be challenging. METHODS: This case study discusses a condition that is not commonly seen. DISCUSSION: Although lithium toxicity syndrome is not as familiar as other causes of neurological issues, this should be considered for any patient who presents with unexplained neurological deficits and a history of taking this medication. CONCLUSION: If toxicity is not recognized early, the patient can be left with irreversible neurological symptoms, also known as syndrome of irreversible lithium-effectuated neurotoxicity, which impacts quality of life or can even cause death.

The Effect of Listening to Music on Postoperative Pain in Adult Orthopedic Patients.

PURPOSE: Pain is a common occurrence after orthopedic surgery. Patients need additional resources to manage their pain. The purpose of this study was to determine if listening to music has a positive effect on pain scores and satisfaction in the postoperative adult orthopedic patient. There are limited studies demonstrating statistically significant decreases in postoperative pain in this group. A secondary purpose was to expose nurses on a standard medical-surgical unit to an intervention, supported by the holistic nursing model that they could use in their care. DESIGN AND METHOD: This study was a descriptive, comparative, quasi-experimental design. Patients listened to prerecorded music on individual CD players and recorded pre-post pain scores with the intervention. A satisfactory survey was completed at discharge. FINDINGS: Results demonstrated a statistically significant reduction in patients' pain scores after listening to music. Length of listening time had no effect. Patients expressed overall satisfaction, and 100% of participants would recommend this intervention to others. CONCLUSIONS: Listening to music is beneficial as an adjunct to pain medication and contributes to increased patient satisfaction. It is hoped that the information gained from this study will lead to an enhancement in the standard of care for postoperative patients.

The Importance of Educating Patients With Stroke About Vitamin D.

There is a growing body of evidence linking vitamin D to more than only bone health. Researchers are discovering connections between low vitamin D levels and increased stroke risk, higher mortality, and poorer outcomes after stroke. Nurses need to be aware of ongoing research regarding vitamin D and include information about this important vitamin with patient education, especially for older patients admitted with stroke symptoms or risks.

Pseudobulbar Affect: What Nurses, Stroke Survivors, and Caregivers Need to Know.

Pseudobulbar affect (PBA) is a neurologic condition that can happen after a patient has had some kind of neurological insult. In this syndrome, involuntary, uncontrollable, and inappropriate emotional outbursts unrelated or out of proportion to the situation are common symptoms. This can be very frustrating and scary. Because stroke survivors and their caregivers are overloaded with information during the transition from hospital to home, information about PBA is not usually discussed. In a survey by the National Stroke Association, 53% of stroke survivors reported that they had some of the symptoms of this disorder. Even if they discussed these symptoms with their health care providers, less than half were given a diagnosis, and less than a quarter received any kind of treatment. The purpose of this article is to give nurses more information about PBA so they can share this with patients and families/significant others and encourage them to seek help if they experience these symptoms once discharged. It is hoped that increased knowledge about this condition will lead to better diagnosis and treatment and increased quality of life for stroke survivors.

Using Technology to Enhance Discharge Teaching and Improve Coping for Patients After Stroke.

BACKGROUND: A diagnosis of stroke is a life-changing event. Effective discharge teaching after a stroke is crucial for recovery, but the overload of information can be overwhelming for patients and caregivers. PURPOSE: The purpose of this study was to examine differences in discharge readiness and postdischarge coping in patients admitted for stroke after the use of individualized postdischarge information/education provided via a technology package (including patient online portal access, e-mail/secure messaging) compared with current standard discharge teaching methods (verbal/written instructions). METHODS: This study used a descriptive comparative design to evaluate the difference between the nonintervention group A and the intervention group B. Patients in group B received additional discharge information via secured e-mail messaging at postdischarge days 2, 6, and 10. Two validated tools, Readiness for Hospital Discharge Form and Post-Discharge Coping Difficulty Scale, were used. RESULTS: One hundred patients were recruited for the study, but the final number of complete data sets collected was 86-42 in group A and 44 in group B. There was no statistically significant difference between the groups in discharge readiness. There was a significant difference in coping scores between the 2 groups, with the technology group exhibiting higher coping. CONCLUSIONS: New technology affords new options to improve discharge readiness and contribute to positive patient coping after stroke. The researchers hope that this study will contribute to the growing body of evidence showing success using aspects of technology to enhance discharge teaching and follow-up after discharge.

Cerebral Mycotic Aneurysm and Infective Endocarditis: A Case Study.

Neurologic complications occur in 20%-40% of patients with infective endocarditis. Mycotic aneurysms are one example of these complications, and although rare, they can confound a patient's recovery and increase morbidity and mortality. This article will examine one patient's experience and the devastating effects that this complication had on his life. The information in this article will help to support neurological nurses in refining care and facilitating the best possible recovery for patients who develop this condition.

Compassionate Care for Patients With Complex Regional Pain Syndrome.

Complex regional pain syndrome (CRPS) is a debilitating condition characterized by specific symptoms such as intense pain and loss of function. This syndrome can be so devastating that it affects quality of life. Often, CRPS is misdiagnosed and misunderstood, which can be extremely frustrating for patients. The purpose of the survey in this study was to query actual patients living with CRPS to gain additional knowledge and suggestions to help improve their care. Respondents expressed a variety of emotions when asked about their healthcare experiences, which suggests that healthcare providers need to be better educated about CRPS so they can provide more compassionate care for patients trying to cope with this condition.

The value of a progressive care environment for neurosurgical patients.

Intensive care is expensive and stressful for patients and families. With rising healthcare costs, hospitals need other options. This retrospective, descriptive study explored the efficacy of using a progressive care environment to manage stable, complex patients out of the intensive care unit. Data were collected on 114 neurosurgical patients using specific inclusion and exclusion criteria before and after implementation of progressive care beds within a standard medical-surgical unit. Patients in the "after" group had a statistically significant decrease in the number of intensive care unit days and overall hospital length of stay. The results suggest that it is possible for positive patient outcomes using this model if these patients are carefully selected, nurses are appropriately educated, and a collaborative approach is used.

Prevention of catheter-associated urinary tract infections in patients with hip fractures through education of nurses to specific catheter protocols.

The majority of patients who experience hip fractures are elderly, and complications in these patients increase length of hospital stays, medical costs, and mortality rates. Catheter-associated urinary tract infections (CAUTI) are one of the common complications in this patient population. Studies have demonstrated that the use of specific indwelling urinary catheter protocols will decrease the catheter use and prevent CAUTI. The purpose of this evidence-based practice change project was to demonstrate that education of nurses on specific catheter protocols decreases the incidence of urinary tract infections in the population with hip fracture. The effectiveness of the education was measured by pre- and posttests given to the nurses. The actual number of CAUTI was also tracked and the outcomes suggest that the education and implementation of specific protocols decreased the overall incidence of CAUTI in these patients.