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The purpose of this 1-group, retrospective case study was to analyze the expanded role of registered nurse care coordination (RNCC) on health outcomes in a primary care setting in its real-life context. The convenience sample consisted of 244 adults diagnosed with uncontrolled diabetes mellitus and/or hypertension. Secondary data entered into the electronic health record by the health care team during patient visits pre- and post-implementation of the RNCC program were analyzed. Clinical findings suggest that RNCC may provide a valuable service. Additionally, financial analysis demonstrated that the cost of the RNCC position was both self-sustaining and revenue producing.

This pilot study explored the use of standardized patients in the virtual classroom in efforts to increase family nurse practitioner preparedness to engage in telemedicine care delivery. Using a mixed-methods approach, we determined this innovation significantly increased students' confidence in their ability to perform a telemedicine visit while also improving their satisfaction with the virtual classroom.

Diabetes distal symmetrical peripheral neuropathy (DSPN) is the most prevalent form of neuropathy in industrialized countries, substantially increasing risk for morbidity and pre-mature mortality. DSPN may manifest with small-fiber disease, large-fiber disease, or a combination of both. This review summarizes: (1) DSPN subtypes (small- and large-fiber disease) with attention to clinical signs and patient symptoms; and (2) technological diagnosis and screening for large- and small-fiber disease with inclusion of a comprehensive literature review of published studies from 2015-present (N = 66). Review findings, informed by the most up-to-date research, advance critical understanding of DSPN large- and small-fiber screening technologies, including those designed for point-of-care use in primary care and endocrinology practices.

Background:Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout.Objective:This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses.Method:This study used the Noblit and Hare?s approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis.Ethical considerations:Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases.Results:The synthesis of qualitative research on moral distress resulted in one central theme, ?the battle within,? and five subthemes.Conclusions:The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses? future patient care.

Purpose The purpose of this article is to provide conceptual clarification of secondary traumatic stress (STS) in nurses. Background As an empathetic helping profession, nurses are at increased risk for STS. Interchangeable usage of related terms among multidisciplinary literature has resulted in lack of conceptual clarity resulting in conflation of terms. Conceptual clarity is necessary for a foundation for further research on treatment. Methods Rodgers' evolutionary model of concept analysis. Results Nurses are predisposed to STS due to exposure, empathy, bonding, and personal factors. Essential attributes were found to be posttraumatic stress disorder-like symptoms, biological symptoms, social symptoms, and psychological symptoms. Resultant consequences included an altered worldview, interpersonal difficulties, and decreased occupational commitment. Conclusion This concept analysis, the first focusing on STS, provides conceptual clarity and a concept map of STS within the nursing population.

Background  Healthcare providers, as well as healthcare students, have been found to harbor negative attitudes toward individuals with substance abuse disorders, impacting the care they give and subsequently creating poor patient outcomes. Purpose  This study seeks to determine the effectiveness of an educational intervention, grounded in theory, toward changing nursing student attitudes regarding patients with a substance abuse disorder. Methods  Nursing students participated in a teaching intervention, developed using the experiential learning theory, that utilizes modalities for each kind of learner aimed at reducing bias toward this population. The Medical Condition Regard Scale was used pre/post intervention to determine regard toward patients with the diagnosis of substance abuse. Results  Student nurses maintained the least favorable attitudes toward individuals who abuse substances in comparison with patients with the diagnoses of pneumonia or gastroesophageal reflux disease; there were significant differences in attitudes toward patients who abused substances before and after participation in the educational intervention, with postparticipation attitudes being significantly more positive than attitudes before participation. Students found the educational intervention and debriefing highly satisfactory. Implications  This educational intervention can provide a cost-effective, easy-to-replicate, time-efficient learning activity that could be added to undergraduate nursing curriculum.

BACKGROUND: Growing evidence supports the superior benefits of exposure to mother's own milk (MOM) in reducing prematurity-related comorbidities. Neonatal exposure to donor human Milk (DHM) is a suitable alternative when MOM is insufficient or unavailable. However, the same protective composition and bioactivity in MOM are not present in DHM. Additional evidence is needed to justify and inform evidence-based practices increasing MOM provision while optimizing adequate use of DHM for premature infants. PURPOSE: A systematic review of the literature was conducted to determine differences in neonatal outcomes among premature infants exposed to predominately MOM versus DHM. METHODS/SEARCH STRATEGY: Databases including PubMed, CINAHL and Cochrane were searched (2020-2021) using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines. Evidence was classified using the John Hopkins evidence-based practice levels and quality of evidence. RESULTS: Eleven studies met inclusion criteria. Studied neonatal outcomes included ( a ) growth parameters (n = 8), ( b ) neonatal morbidities (n = 6), and ( c ) gut microbiome (n = 4). Overall, evidence suggests DHM exposure is beneficial but not equivalent to MOM feeding. Compared with DHM, greater doses of MOM are ideal to enhance protection primarily related to infant growth, as well as gut microbiome diversity and richness. IMPLICATIONS FOR PRACTICE: Standardized and evidence-based practices are needed to clearly delineate optimal use of DHM without undermining maternal and neonatal staff efforts to support and promote provision of MOM. IMPLICATIONS FOR RESEARCH: Additional evidence from high-quality studies should further examine differences in neonatal outcomes among infants exposed to predominately MOM or DHM in settings using standardized and evidence-based feeding practices.

Background:  The emphasis on disciplinary and preventive approaches to combating academic misconduct does little to foster student professional identity and core nursing value formation. Problem:  There is a need for pedagogy designed to navigate moral decision-making within ambiguous areas of practice as nursing students integrate personal and professional values while becoming a nurse. Approach:  Rest's theory of moral development offers a framework for constructing purposeful affective learning activities that operationalize moral sensitivity, judgment, motivation, and character, whereas Krathwohl's theory provides a means to identify affective learning objectives. Offering prelicensure nursing students an opportunity to discuss, reflect on, and consider actions and consequences associated with academic and practice-based situations forms the basis for this affective learning module that fosters connections between academic and professional behaviors of integrity. Conclusion:  Rest's theoretical model provides a viable structured approach to moral development. Curriculum designed to engage moral decision-making offers an innovative approach to cultivating student integrity.

Prior exposure of isolated perifused rat islets to the monokine interleukin-1 (IL-1) amplifies their subsequent insulin secretory response to 10 mM glucose. This potentiating effect of the monokine is dose dependent, lasts for at least 45 min after IL-1 removal from the medium, and is not confined to glucose; IL-1 also potentiates the insulin secretory responses to tolbutamide and glyceraldehyde. IL-1 exposure of islets incubated with myo-[2†3H]inositol to label their phosphoinositides (PI) results in an increase in [3H]inositol efflux, an event that persists long after removal of IL-1 from the medium. Direct measurements of labeled inositol phosphate accumulation substantiate the concept that this sustained [3H] inositol efflux response is the direct result of a sustained increase in PI hydrolysis. These results expand the list of compounds that induce time-dependent potentiation in islets to include IL-1. This action of the monokine, mediated at least in part by Pi-derived second messenger molecules, may contribute to its postulated effects on insulin and glucose homeostasis. © 1989 by The Endocrine Society.

Little research has been done to document the value of using nursing diagnosis in home care and the impact that increased acuity levels have had in diagnostic selection. Nursing diagnosis documentation in home care was examined to see whether it had a relation to select client and visit pattern variables. This retrospective chart audit, which piloted a newly developed instrument called the Home Care Audit Tool, utilized a sample of 199 closed records of a large midwestem Visiting Nurse Association. The mean age of the client population was 76 years, with 64% female. There were 269 initial nursing diagnoses cited in the sample records, averaging 1.75 diagnoses per case. The number of recorded visits increased when select nursing diagnoses were cited together in a single case. © 1994, Taylor & Francis Group, LLC. All rights reserved.

When establishing Nursing Ethics Committees (NECs), statewide nursing organizations play an important role in developing and disseminating resources. The Connecticut Nurses Association Ethics and Human Rights Committee surveyed 85 healthcare facilities to identify active NECs. Representatives facilitated other committees by providing guidelines and assistance to those agencies developing NECs — the ultimate goal. © 1994 by Springhouse Corporation.

Meeting students’ learning needs in acute care settings is challenging. The authors discuss dual assignment in the pediatric setting with beginning nursing students. © 1992 Lippincott-Raven Publishers.

Data from an open-ended questionnaire and the comments section of a structured questionnaire were combined and ana-lyzed to determine the challenges faced and alterations in usual daily activities required by mothers caring for a young child at home in a body cast. The sample consisted of 35 mothers who identified themselves as the primary care givers of a child in a body cast. The challenges of caring for a child in a body cast required major adjustments in almost every aspect of the mothers' lives, including household activities, social and community activities, child care activities, personal care activities, occupational activities, and educational activities. © 1995 National Association of Orthopaedic Nurses.