Strategies for transitioning from a clinical position to a faculty role

The nation faces a continued shortage of nurses that is projected to worsen in the next decade. The nursing shortage is fueled by a lack of faculty to educate nurses for entry into practice and advanced nursing practice positions. Many faculty enter academia after achieving expertise in a specialty area of clinical practice. These expert clinicians transition to novice faculty, a move that can be challenging and overwhelming. New faculty require guidance in understanding the various academic regulatory organizations; university structure, policies, and regulations; faculty responsibilities related to the university missions of teaching, service, practice, and scholarship; and face challenges with the need for new skills such as classroom management, curriculum development, and an understanding of the different culture and language of academia. The authors provide evidence from the literature and strategies and tips based on their experience for an expert clinician's successful transition from a clinical role to an academic position.

Research in nursing education and the institutional review board/ethics committee

BACKGROUND

Institutional review board (IRB) or research ethics committee approval is intended to protect the rights of human subjects. Assurance that ethical standards are met is essential for educational research and quality improvement (QI) projects involving human subjects.

PURPOSE

The purposes were to describe the requirements of nursing journals for educational studies and QI projects related to education to be reviewed by an IRB or a research ethics committee and to identify the types of statements of approval or exemption to be included in manuscripts.

METHOD

The investigators employed an electronic survey sent to members of the International Academy of Nursing Editors list serve. Responses representing 64 nursing journals were received.

RESULTS

The majority of journals that publish academic educational studies (n = 32, 86.5%) always required IRB or other ethics committee review, and 17 (45.9%) required the same for QI projects related to education. An IRB or research ethics committee review was always required by journals for educational studies (n = 24, 88.9%) and for QI projects (n = 14, 51.9%) involving the professional development of nurses.

CONCLUSIONS

Educational studies that involve human subjects should be reviewed by an IRB or other type of research ethics committee before implementing the study. Any determination of exemption should be made by the IRB or research ethics committee, not by the investigator.

Strategies to Turn a Graduate School Paper Into a Publishable Journal Manuscript

Graduate students complete papers for course requirements, doctor of nursing practice and master's projects, and doctoral dissertations. The valuable information contained in these school papers may be appropriate for publication in professional journals. Graduate students must learn the key differences between school paper and journal article styles. Using this critical information, students can revise their school papers in journal style and achieve a successful publication that contributes to the literature and, ultimately, to the care of patients and their families.

Re-envisioning clinical education for nurse practitioner programs: themes from a national leaders' dialogue

As the need for primary care providers increases, nursing education programs face significant challenges to meet future workforce needs. A more resource-efficient approach for the clinical education of nurse practitioner students is needed. A think tank involving 20 thought leaders representing multiple disciplines was convened to discuss this issue. This article presents seven themes that emerged from this national leaders' dialog: academic practice co-design, standardized preclinical preparation, standardized student assessment, entrustable professional activities, immersive clinical experiences, interprofessional education for team-based care, and innovative education practices.

Publishing in Professional Journals, Part II

A great deal of work goes into the planning phase of a manuscript. These important planning steps are necessary to complete before you start the writing process. Often, inexperienced writers do not spend enough time on these vital planning steps, and that oversight can be a major factor in having a manuscript rejected for publication. The purpose of this article is to guide you in the process of writing your manuscript on the basis of your well-designed plan. Topics that are covered include avoiding writer’s block, making time to write, developing the first draft using appropriate writing style, creating and submitting the final draft, and receiving feedback from the editor.

Publishing in Professional Journals, Part I

Publishing in professional journals is a challenging and rewarding experience. By sharing their expertise and experiences through journal articles, nurses contribute to the body of literature that ultimately helps improve the health care system, the nursing profession, and care of patients and their families. The focus of this article is to help nurses implement strategies to get started in the process of publishing journal articles. Topics include facing excuses for not writing, implementing strategies to get started, and executing a plan for the manuscript.

Exploring the Factors That Influence Functional Performance Among Nursing Home Residents

Objective: To promote healthy aging in older nursing home (NH) residents, it is important to identify factors that impact functional performance. Using the Disablement Process Model, it was hypothesized that variables from all levels of the model would significantly impact the ability of a NH resident to get up from a chair. Method: A stepwise multiple logistic regression model was used to test the impact of sociodemographic, physiologic, physical, psychosocial, and environmental factors on chair rise. Results: Analysis indicated that three factors, strength, gait, and self-efficacy, were significantly associated with chair-rise ability and together explained approximately 64% of the variance and successfully classified 88.4% of the chair-rise cases. Discussion: These findings indicate that identifying physical and psychosocial variables early in the disablement process will help health care providers tailor medical and restorative care interventions that may help older adults maintain the ability to chair rise.

Anemia Evaluation and Management in Nursing Home Residents

Anemia is often an unrecognized and/or undertreated diagnosis in older adults. Failure to diagnose anemia leads to delayed treatment and thus delayed relief of symptoms. Given the potentially significant impact of anemia on cardiovascular disease and physical performance among older nursing home (NH) residents, it is important to evaluate current clinical practice related to anemia.The purpose of this secondary data analysis was to evaluate the frequency of laboratory evaluation and medication treatment for anemia among older NH residents. Results indicated that more than half of NH residents were anemic at baseline, and of those, less than 20% had additional testing done to further evaluate for an underlying cause of their anemia and only 45.3% received any pharmacologic treatment. Future research is needed to clarify the potential benefits of timely diagnosis and appropriate treatment for anemic older adults in long-term-care settings and establish evidence-based guidelines to direct care in this area.

Anemia and its impact on function in nursing home residents: what do we know?

PURPOSE

To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes.

DATA SOURCES

Literature review of current peer-reviewed research articles.

CONCLUSIONS

In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community-dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes.

IMPLICATIONS FOR PRACTICE

Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence-based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence.

HIV peripheral neuropathy: pathophysiology and clinical implications

One of the most debilitating neurological complications of human immunodeficiency virus (HIV), affecting nearly one in three patients, is painful peripheral neuropathy. Although HIV infection can cause distal sensory polyneuropathy (DSP), the advent of highly active antiretroviral therapy (HAART) to treat HIV infection has resulted in a significant number of patients developing a clinically indistinguishable form of toxic neuropathy. The predominant symptom, regardless of etiology, is excruciating unremitting pain, resistant to pharmacological treatments, that leads to a reduction in the ability to conduct activities of daily living and, eventually, inability to ambulate. Since withdrawal from nucleoside therapy is not typically recommended, a more thorough understanding of the etiology and pathophysiology underlying nucleoside-induced peripheral neuropathy, through basic and clinical research endeavors, will aid in the development of new therapeutic treatments aimed at alleviating or ameliorating pain. This article provides the latest information regarding the pathophysiology and clinical implications of HIV peripheral neuropathy.

The Pain Game: Pain Assessment, Management, and Related JCAHO Standards

BACKGROUND

It is a challenge to educators to assist nursing staff in maintaining up-to-date knowledge of pain assessment and management.

METHOD

A learning game, "The Pain Game," was developed to deliver information on current practices and standards related to patient pain assessment and management.

RESULTS

The advantages of using this gaming technique included minimal instructor preparation time, low cost materials, inclusion of participants as peer teachers, and a high level of participant involvement in the learning process.

CONCLUSIONS

The Pain Game has been a well-received educational activity. Not only did knowledge acquisition occur, but the game also provided an enjoyable alternative to more traditional content delivery methods.

Challenging writer's block. How experienced authors make time to write

Each of us can think of a thousand excuses why we can't write for publication. In reality each of these excuses is a writer's block that can be overcome. By using the tips described in this article, you will have the tools to conquer writer's block. With skillful planning you will be successful in publishing and the profession will benefit from your work. Just remember, once you see how nice your work looks in print, you won't be able to stop writing!

Predictors of atrial dysrhythmias for patients undergoing coronary artery bypass grafting

BACKGROUND

Coronary artery bypass grafting is a commonly used and effective procedure for treating coronary artery disease. Atrial dysrhythmias are common after this surgery, but definitive characteristics that predict the development of such dysrhythmias postoperatively have not been determined.

OBJECTIVES

To determine demographic, preoperative, intraoperative, and postoperative factors that are predictive of atrial dysrhythmias that occur after coronary artery bypass grafting.

METHODS

A descriptive design was used to study a convenience sample (N = 162) of adult patients undergoing coronary artery bypass grafting. Data were collected via prospective chart review. Patients were grouped according to whether or not atrial dysrhythmias developed after coronary artery bypass grafting. Univariate analyses followed by multivariate analyses were conducted by using forward stepwise logistic regression to determine variables that are predictive of atrial dysrhythmias after coronary artery bypass grafting.

RESULTS

Postoperative atrial dysrhythmias developed in 52 patients (32.1%). Univariate predictors of postoperative atrial dysrhythmias included older age (P < .001) and presence of right coronary artery disease (P = .004). Multivariate predictors of postoperative atrial dysrhythmias included age (odds ratio by decade = 1.93, 95% CI = 1.86-2.00, P < .001) and right coronary artery disease (odds ratio = 2.67, 95% CI = 1.14-6.23, P = .02). Hospital stay was significantly longer (P = .003) in patients who had postoperative atrial dysrhythmias than in patients who did have these dysrhythmias.

CONCLUSIONS

Age and right coronary artery disease can be used to predict which patients will be at increased risk for atrial dysrhythmias after coronary artery bypass grafting.

Predictors of atrial dysrhythmias for patients undergoing coronary artery bypass grafting

BACKGROUND: Coronary artery bypass grafting is a commonly used and effective procedure for treating coronary artery disease. Atrial dysrhythmias are common after this surgery, but definitive characteristics that predict the development of such dysrhythmias postoperatively have not been determined. OBJECTIVES: To determine demographic, preoperative, intraoperative, and postoperative factors that are predictive of atrial dysrhythmias that occur after coronary artery bypass grafting. METHODS: A descriptive design was used to study a convenience sample (N = 162) of adult patients undergoing coronary artery bypass grafting. Data were collected via prospective chart review. Patients were grouped according to whether or not atrial dysrhythmias developed after coronary artery bypass grafting. Univariate analyses followed by multivariate analyses were conducted by using forward stepwise logistic regression to determine variables that are predictive of atrial dysrhythmias after coronary artery bypass grafting. RESULTS: Postoperative atrial dysrhythmias developed in 52 patients (32.1%). Univariate predictors of postoperative atrial dysrhythmias included older age (P &lt; .001) and presence of right coronary artery disease (P = .004). Multivariate predictors of postoperative atrial dysrhythmias included age (odds ratio by decade = 1.93, 95% CI = 1.86-2.00, P &lt; .001) and right coronary artery disease (odds ratio = 2.67, 95% CI = 1.14-6.23, P = .02). Hospital stay was significantly longer (P = .003) in patients who had postoperative atrial dysrhythmias than in patients who did have these dysrhythmias. CONCLUSIONS: Age and right coronary artery disease can be used to predict which patients will be at increased risk for atrial dysrhythmias after coronary artery bypass grafting.

Risk factors for nosocomial pneumonia in critically ill trauma patients

Nosocomial pneumonia is the most common pulmonary complication in trauma patients and the leading cause of death in nosocomial infections. A comprehensive review of pneumonia studies is provided. The Centers for Disease Control's nosocomial pneumonia pathogenesis model is reviewed and was used to guide the selection of risk factors evaluated in this study. The purposes of this research were to identify underlying dimensions (factors) of variables that increase the risk of nosocomial pneumonia and to identify predictors of nosocomial pneumonia in critically ill trauma patients.

The expanding role of signal-averaged electrocardiography

Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities.

The expanding role of signal-averaged electrocardiography

Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities.

The evolution of internal defibrillators

ICDs have reduced mortality from SCD to 2% per year, which is a record unmatched by any other form of therapy. With continued evolution, ICD systems should become easier to implant, smaller, more effective in managing a variety of abnormal rhythms, and more comfortable for the patient. Implementation of technological innovations in future-generation devices should continue to extend the frontiers as clinicians consider ICDs for an expanding range of therapeutic applications.

Patients at risk for atrial dysrhythmias after coronary bypass grafting

Coronary artery bypass grafting (CABG) is widely used to treat patients with coronary artery disease. The most common complication after CABG is cardiac atrial dysrhythmias. Definitive patient characteristics that predict the development of atrial dysrhythmias postoperatively have not been identified. The authors review past research studies regarding predictors of atrial dysrhythmias and present research-based recommendations for clinical practice.

How to succeed in job interviewing

Effective interviewing skills are critical for any nurse seeking a position in today's challenging job market. The successful applicant is more than just poised, appropriately dressed, and courteous. Jobs go to applicants who are well prepared, qualified, confident, and motivated. To win a competitive edge, convince employers of your genuine desire for the position, your ability to do the job, your positive attitude, and the strengths that distinguish you from other applicants.

How to succeed in job interviewing

Effective interviewing skills are critical for any nurse seeking a position in today's challenging job market. The successful applicant is more than just poised, appropriately dressed, and courteous. Jobs go to applicants who are well prepared, qualified, confident, and motivated. To win a competitive edge, convince employers of your genuine desire for the position, your ability to do the job, your positive attitude, and the strengths that distinguish you from other applicants.

Using a critical care simulation laboratory to teach students

Critical care nursing is a dynamic and continuous process involving knowledge, values and attitudes, and motor skills. When combined with other teaching methods, a critical care simulation laboratory provides learners with an effective means to achieve the cognitive, affective, and psychomotor competencies necessary for the complexities of clinical practice.

Using a critical care simulation laboratory to teach students

Critical care nursing is a dynamic and continuous process involving knowledge, values and attitudes, and motor skills. When combined with other teaching methods, a critical care simulation laboratory provides learners with an effective means to achieve the cognitive, affective, and psychomotor competencies necessary for the complexities of clinical practice.

Control of vascular complications after cardiac catheterization: a research-based protocol

Cardiac catheterization has become a common diagnostic procedure. However, many institutions arbitrarily decide the postprocedure method used to achieve hemostasis, the approach to femoral site care, the patient's position while on bedrest, and the length of bedrest. The authors review past research studies and present a research-based protocol for postcatheterization nursing care.

The pacemaker and defibrillator codes: implications for critical care nursing

Scientific advances in the past few decades have resulted in the development of complex devices capable of treating both brady-dysrhythmias and tachydysrhythmias. Because critical care nurses play a vital role in the safe and effective functioning of these devices, they must understand the operation of the devices and patients' physiological and psychosocial responses to the technology. Careful monitoring, open and caring communication, and relevant patient education will make the important difference in patients' adjustment to use of an antidysrhythmic device.