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Sepsis Recovery in Home Health Care: Perspectives on Patient Education from Nurses and Patients
No full textThe Surviving Sepsis Campaign advocates for sepsis survivors to receive patient education during post-acute care, including home health care (HHC), to empower their self-care. Patient education is a key component of HHC. This qualitative study will: Characterize the self-care self-efficacy and knowledge regarding sepsis and its aftercare management among sepsis survivors recently discharged from hospitals and currently receiving HHC. Identify materials, content, mode of delivery, facilitators and barriers encountered, and strategies used by HHC nurses when delivering sepsis patient education. Describe barriers and facilitators influencing sepsis survivors\u27 receipt and knowledge of sepsis aftercare management within HHC
“Overpriced & Over Dosed”: Thematic Analysis of Perceived Root Causes of US Maternal Mortality Rate
No full textMaternal mortality in the United States (US) is a problem of growing concern. In 2021 maternal mortality accounted for 32.9 deaths per 100,000 with non-Hispanic Black clients having a mortality rate of 2.6 times higher than non-Hispanic Whites. Of utmost concern, is the determination that over 80% of pregnancy related deaths were preventable. With the growing press around this topic, the authors sought to analyze the public’s perceived root causes for the increase in poor maternal outcomes. As maternal/ child experts, the authors know that client perception may not always be medically reliable; therefore, this study aims to gain understanding from public opinion to analyze if public perceptions of harm are more systemic or individual towards provider competence. Social media is an emerging source of data since it is readily available, free, contains large data sets, convenient, and a safe space for contributors to discuss openly. R/Science, a subcommunity on Reddit, was used to analyze the member’s perceptions of the root causes towards the maternal mortality rates. Inductive and deductive thematic analysis approaches were utilized to code comments using the Social Determinants of Health (SDoH) conceptual framework and social ecological model as a theoretical framework in theme identification. Interrater reliability resulted in kappa = 1 across codes. Themes identified included Health and Wealth. Complete analysis shows support for further research that involves understanding systematic issues beyond individual decisions. Specifically, promoting targeted education and early interventions towards maternal mortality risks designed for individual persons, healthcare providers, and communities
Exploring Health Care Access Among Lesbian, Gay, Bisexual, and Transgender (LGBT) Populations
No full textPURPOSE: The purpose of this project is to explore the current experiences and needs of the lesbian, gay, bisexual, and transgender (LGBT) population, including health care and mental health utilization, patterns, locations, adequacy of LGBT-friendly health and mental health care providers. There are an estimated 90,000 LGBT individuals over the age of 14 in Orange County. LGBT populations are unique and are known to have significant health disparities, particularly if they are from racial or ethnic groups or have a disability. LGBT individuals are known to experience adverse situations when accessing health care and mental health services, including issues with fear, stigma, discrimination, homophobia. or abuse by healthcare providers. This study will be the first of its kind in Orange County.METHODS: Seventy-five participants were recruited for this quantitative cross-sectional study utilizing a convenience sample from two organizations serving the LGBT community, including an AIDS Service Organization and another providing mental health services. In both groups, the clients are known to access health care and mental health services on a regular basis. An online survey was created using Qualtrics and sent to all active adult patients (age ≥ 18 years). Statistical testing was done to examine descriptive data and to look for differences and similarities within and between racial and ethnic groups, as well as between each of the four LGBT sub-populations – lesbian, gay, bisexual and transgender.RESULTS: Body weight was most frequently ranked as a top physical health concern and depression/thoughts of suicide was most frequently identified as a priority mental health issue. Findings also include trouble finding an LGBT competent provider, delays or being unable to access care, worried about losing insurance. Most participants needed to visit multiple different locations to receive care and preferred a one-stop shop.CONCLUSIONS: No known research until now has characterized priority health issues and explored LGBT access to healthcare in Orange County, California. Understanding the healthcare experiences of LGBT individuals and the barriers faced when accessing healthcare informs effective solutions that improve access and quality of care for members of the LGBT community in Orange County, California and beyond
VR-Glasses and Serious Games to Promote Well-Being and Reduce Stress of Older Persons in Hospitals
No full textOver the last decades an increasing number of older persons in the population, is recognized worldwide, followed by a rising number of older patients in clinical settings (UN, 2024). Isolation, stress, less activities for the patients (Schneider, 2019), staff shortage and limited time resources are illustrated (Buchnan & Catton 2023, WHO, 2020). Technical innovations may help assist patients reduce stressors. Well examined are effects of training cognitive skills within a virtual reality environment (Apochi et al., 2024, Chan et al., 2024). VR-Glasses and serious games with immersive experiences form an environment by shielding personal surroundings and settings (Doerner et al. 2019, Hussain et al., 2024).
This pilot study examines the ability to use VR-Glasses and serious games to increase well-being and decrease stress of patients in hospital settings. In this study the usability and effects of this technology in older patients were explored.
Prior Data-collection research of literature, technical solutions and variety of serious games was conducted. Over a period of five weeks, eight older patients in a hospital used the VR-glasses with the serious game. Measurement at three times (Week 1, 3 and 5) included physical parameter like heart rate with an oximeter, respiratory frequency manual counted, level of stress captured with a 5-Stage-Likert-Scale and examine the well-being with the WHO 5-Well-Being Index by the patients. Data were analyzed descriptive. Study was proved by an Ethics Advisory Board (Beth_38_22).
Heart rate and respiratory frequency changed in a positive manner. Stress levels were reduced, patients felt optimistic. All patients showed an increasing rating in the WHO five Well-Being Index. Patients rejected auditive stimulation within the games because they felt uncomfortable. They accepted the device and had no problems in applying this technology. In addition, patients were more motivated to be physical active and to interact with others.
The results provide positive effects on stress, well-being, more activity and interaction with others. Other studies state similar results (Apochi et al., 2024, Chan et al., 2024). Acceptance of devices in older persons is also reported in another work. (Hosseini et al., 2024). VR-Glasses and serious game can support well-being of patients in hospitals. The results are encouraging and should be validated in a larger cohort, like the aspect of interfering sound within serious games in older people
Enduring Uncertainty Through the Lens of Osteoporosis: A Mixed Methods Study
No full textOsteoporosis is a chronic illness that affects individuals globally, is underdiagnosed, and often poorly managed. Uncertainty is a phenomenon experienced by individuals diagnosed with chronic illness and is defined as the inability to determine the meaning of illness-related events. Experiencing uncertainty can lead to decreased quality of life (QOL), delays in decision-making, and negative impacts on relationships.
Purpose: This study aimed to determine if individuals diagnosed with osteoporosis experience uncertainty and to determine the lived experience of individuals with osteoporosis. Mishel’s Uncertainty in Illness Theory was used as the theoretical framework.
Method: Participants completed The Mishel Uncertainty in Illness Scale-Community Form (MUIS-C) and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health scale, and interviews utilized Interpretative Phenomenological Analysis (IPA). Data were collected through semi-structured interviews with fourteen Caucasian women who all had a diagnosis of osteopenia or osteoporosis.
Results: Based on the two survey results, a significant negative correlation was found between levels of uncertainty and physical health status. For example, those with higher levels of uncertainty had lower physical health status. The qualitative study focused on describing the experience individuals had with the diagnosis of osteoporosis. Thematic analysis revealed five themes that could be chronologically processed: The Sentinel Event, Adapting to Chronic Disease, Navigating Uncertainty, Being Less Than, and What the Future Holds.
Conclusion: The findings of this study conclude that patients with osteoporosis experience uncertainty. This finding can guide healthcare providers on how to share knowledge and education about the disease of osteoporosis with individuals. This inclusive approach is crucial for ensuring that preventive measures and management strategies are tailored to the diverse needs of all individuals, fostering equity and efficacy in osteoporosis care
Evolution of Scientific Production in Rehabilitation Nursing: A Bibliometric Analysis
No full textThis study provides a comprehensive analysis of the evolution of scientific production in rehabilitation nursing from the earliest records in 1946 to 2024. Using PubMed as the primary search platform, a total of 11,837 articles were identified, showcasing a significant increase in research output, especially from the 2000s onwards, with a marked rise in publications in recent years[1]. The bibliometric analysis highlights key trends, including exponential growth in research focused on clinical practice, intervention efficacy, and care management, with 820 articles published in 2023 alone.
The analysis further explores the distribution of themes through co-occurrence maps, identifying distinct research clusters. The red cluster highlights the centrality of nurses\u27 clinical practice and competencies in rehabilitation, while the yellow cluster focuses on nursing interventions, control groups, and outcome evaluations[2]. The green cluster emphasizes clinical and economic aspects of rehabilitation, such as infection management and hospital discharge rates[3]. Finally, the blue cluster underlines the importance of evidence-based practice, with an emphasis on systematic reviews and clinical trials[4].
This evolving scientific landscape reflects the growing importance of rehabilitation nursing in both clinical practice and research, underpinned by a focus on evidence-based care and the continuous evaluation of interventions[5]. The study offers valuable insights into current trends and provides direction for future research, particularly in addressing the clinical and economic challenges in rehabilitation nursing
Care Coordination: 20 years of Lessons Learned and Future Visions
No full textProblem/Purpose: Health systems are challenged to provide and lead care coordination for patients with efficient, effective discharge plans. All healthcare systems need care coordination programs focused on high-risk patient populations to help throughput. A family-centered team approach can be used for children with complex healthcare needs. The purpose of this presentation is to describe a hospital-based care coordination program; outline implementation strategies and processes; discuss staffing mix; and share lessons learned and future visions.Program Description: A hospital-based care coordination program for children with complex healthcare needs was developed over 20 years ago in an academic medical center in the Midwest United States. Care coordination problems in primary care were resulting in negative patient outcomes; for example, primary providers felt care was fragmented and lacked coordination leading to missed appointments, care delays, and miscommunication. Families reported not feeling prepared for discharge, variations in discharge instructions, and dissatisfaction with care process transitions. Given patient complexities and financial challenges in health care today, new models of efficient, cost-effective, family-oriented care coordination are critical.Evaluation: Core program components include a dedicated coordinator; standardized discharge processes; devoted resources; and clear communication and escalation processes. Since 2001, 9,000 children have been served with common diagnoses being tracheostomy, genetic disorders, and complex cardiac conditions. Current inclusion criteria are patients having 3 or more services involved and/or a condition/disease lasting at least 1 year. Staffing ratios are 1 coordinator to 15-20 patients. Total hospital charges have been reduced by an estimated $3 million (35% decrease).Implications: Care coordination programs are critical in aligning discharge processes with positive family and organizational outcomes. While some challenges remain for managing a high-performing care coordination program, healthcare systems need new efficient, cost-effective, and family-oriented modes of healthcare delivery. Sharing program development allows for expansion to more healthcare areas across the care continuum. Lessons learned can be valuable when outlining the core components needed to develop successful care coordination programs that can be replicated for other high-risk patient populations
Adverse and Positive Childhood Experiences Affect General Health in Asian American Emerging Adults
No full textBackground: Positive childhood experiences (PCEs) are safe, stable, and nurturing relationships and environments in childhood.1 Both PCEs and adverse childhood experiences (ACEs) are common and can co-occur. Empirical studies have shown that PCEs not only buffer the negative effects of ACEs,2, 3, 4 but also positively impact physical and mental health outcomes independent of ACEs.5, 6, 7, 8 However, few studies have simultaneously examined the influence of ACEs and PCEs in Asian American populations. This study examined the association between ACEs and general health and assessed whether PCEs moderated this association among Asian American emerging adults from diverse backgrounds.
Methods: Asian American emerging adults (18-25 years), self-identifying as Asian Indian, Chinese, or Hmong Americans, were recruited online from November 2021 to November 2022. Participants completed surveys on ACEs (Philadelphia ACEs Survey), PCEs (Benevolent Childhood Experiences Scale), and general health (PROMIS Adult Global Health Scale v1.2.).
Results: In this sample (n = 814), higher cumulative ACE score was significantly associated with lower global health raw sum score (β = - 1.16, p \u3c .001). In the multiple linear regression model, the interaction term of ACEs x PCEs was significant (β = - 0.06, p = .009), indicating that PCEs moderated the relationship between ACEs and general health. Interestingly, participants with higher PCEs (+1 SD) showed a steeper decline in global health raw sum score as ACE scores increased compared to those with lower PCEs (-1 SD) and average PCEs, suggesting that the negative impact of ACEs on health was more pronounced in individuals with higher PCE scores.
Conclusions: Consistent with previous research, Asian Americans are similar to other populations,9 as ACEs were negatively associated with general health. While PCEs moderated this relationship, higher PCEs did not mitigate the negative effects of ACEs. This finding aligns with findings from a systematic review indicating that PCEs do not always attenuate the impact of ACEs on health outcomes.10 The interaction between ACEs and PCEs may depend on factors such as timing, frequency, intensity, and duration, which should be further evaluated in future research. Advanced statistical approaches may also help clarify the complex interplay between ACEs and PCEs in shaping long-term health. Intervention programs that both prevent ACEs and foster PCEs in diverse communities are needed
New Semester, New Skills: Building Your Test-Taking Toolkit [September 2025 Episode]
No full textTransform your academic performance with proven test-taking strategies that separate high-achieving nursing students from the rest. Master strategic question analysis, time management, and NCLEX-style thinking that leads to immediate score improvement
Utilization of Artificial Intelligence Algorithms in Perioperative Management and Reduction of Pain
No full textThe aim of this evidence-based project was to improve anesthesia provider awareness of the benefits of artificial intelligence algorithms in perioperative pain management.
Traditional approaches to intraoperative pain management reflect suboptimal real-time pain monitoring and potential opioid under or overdosing that impact clinical outcomes and patient satisfaction. Artificial Intelligence (AI) shows promise in providing data-driven personalized solutions for optimizing pain management to enable real-time adjustments, and deliver safe patient-centered care. AI-powered algorithms serve as a supportive tool to enhance clinical practice, improve safety, and sponsor patient tailored care.
A literature search utilized PubMed, EMBASE, Cochrane Library, and ScienceDirect. Keywords included adults, pain management, artificial intelligence, anesthesia, AI-assisted and/or guided pain management, nociception monitoring, AI algorithms, and intraoperative and/or perioperative opioid administration and/or delivery.” The search results were limited to publications from 2018 to 2024 of Level I-IV evidence published in English in the adult population 18 years and older. The Johns Hopkins Research Evidence Appraisal Tool was employed to assess the quality of the studies for inclusion.
AI-assisted technologies have shown sensitivity and specificity in detecting noxious stimuli, facilitating nociception assessment in anesthetized patients undergoing surgery without compromising anesthesia quality or hemodynamics. The evidence indicates a direct association with a nearly 30% reduction in opioid use, ensuring more precise interventions, shorter extubation time, and faster recovery by minimizing opioid-related complications such as postoperative nausea and vomiting, and respiratory depression. Research on the current state of AI-assisted strategies emphasizes their potential to enhance patient outcomes by exploring AI\u27s role in pain management during surgery, highlighting strengths and weaknesses and common restrictions, including sample size, ethical considerations, and economic implications. Future research should corroborate the benefits, limitations, and broader applicability of AI and explore the opportunities for interdisciplinary utilization of AI-generated data to enhance the perioperative patient experience