Variability surrounding what practice scholarship should entail and how to incorporate into academic life exists among DNP-prepared faculty teaching across nursing programs.DNP-prepared faculty entering an academic role are expected to maintain a clinical practice, teach/advise students, and fulfill service obligations, often leaving minimal time to build a program of scholarship.Building upon the archetype of external mentors for PhD researchers, we introduce a new model for external mentorship for DNP-prepared faculty to facilitate scholarship.In the first dyad to use this model, the mentor-mentee met/exceeded all contractual goals, including presentations, manuscripts, leadership behaviors, and role navigation within higher education. More external dyads are currently in development.Securing an external, seasoned mentor as a match for a junior member of the faculty in a yearlong partnership demonstrates promise for positive change in the scholarship trajectory of DNP-prepared faculty in higher education.
The use of electronic cigarettes (e-cigarettes) is experiencing unprecedented growth. This can be contrasted to the use of conventional cigarettes which showed a decrease among adults with the current smoker prevalence dropping from 20.9% in 2005 to 17.8% in 2013. There is some data that e-cigarettes are attracting both former smokers and never smokers, and in particular, young people as users. Currently most states do not tax e-cigarettes. Taxation and regulation may have a similar overall goal of decreasing smoking but regulation tends to focus reduced availability of products. In terms of tobacco control, taxation focuses on the demand side of the equation. Taxation is a distinct strategy from regulation and has been shown to decrease new adopters of conventional cigarettes. A variety of potential taxation strategies can be considered by policymakers based on different assumptions about e-cigarettes and their utility, ranging from untaxed to taxation at moderate levels compared to conventional cigarettes to taxation equal to conventional cigarettes. Until more evidence for the benefits of e-cigarettes is presented, it seems prudent to view them as a potentially harmful and addictive product that ought to be regulated and taxed in an equivalent manner to conventional cigarettes.
This study was an investigation of the association of attitudes toward guns with self-reports of alcohol/drug use, and impulsivity.Participants included 160 male and female high school students, who completed five questions regarding attitudes toward guns, in addition to questions about alcohol/drug use.Data were analyzed using t-tests.Males were more likely to feel that a home was safer with a gun.Feeling positively about a gun was associated with alcohol use in males and impulsive, aggressive behavior in males and females.A greater understanding of attitudes toward guns must take into account gender, alcohol use, and impulsive and aggressive tendencies.
PURPOSE The purpose of this pilot study was to determine the cerebral blood flow velocity and resistance changes and vital signs following a painful stimulus in the premature infant. SUBJECTS A convenience sample of 12 infants was randomly assigned to one of 2 treatment groups. In the final analysis, there were 10 infants younger than 24 hours of age and between 25 and 32 weeks' gestational age. DESIGN A randomized 2-period, 2-group, crossover design was used. METHODS Cerebral blood flow velocity and resistance were measured via a Doppler head ultrasound transducer placed over the anterior fontanel. Vital signs were measured with a cardiorespiratory monitor. The infant then received the heel stick procedure or the sham procedure (heel preparation with no heel puncture). Each infant served as his or her own control. After each procedure, there was ultrasound and vital sign measurement at 15, 60, 120, 180, 240, and 300 seconds. Thereafter, the alternate treatment was used and 6 more measurements were taken. MAIN OUTCOME MEASURES Cerebral values: peak systolic velocity (PSV) and resistive index (RI); vital signs: heart rate, respiratory rate, oxygen saturation (SpO2), and blood pressure. RESULTS Treatment groups were similar at baseline except for gestational age. There were no carryover or period effects in the crossover design for the primary outcomes except for SpO2. There was a significant group effect (heel stick compared with sham) (P = .009) for peak systolic velocity; however, there were no significant differences between groups at each time point. Two subjects had a distinctive pattern based on simultaneous changes in flow and resistance: when flow velocity increased, resistance decreased. This may be reflective of risk for intraventricular hemorrhage (IVH). Mean arterial blood pressure (MAP) was not significant. However, heart rate was significantly different between stick and sham at 15 seconds (P = .022); respiratory rate was significant at 180 seconds (P = .029); and SpO2 was significant at 3 different time points. There were no significant correlations between PSV and mean arterial blood pressure and PSV and SpO2 when comparing stick to sham. CONCLUSIONS This is a study based on a small sample size. However, the Doppler-measured peak systolic velocity increases significantly after a painful stimulus. The clinical implication of this finding needs to be established.
Larsson BA, Tannfeldt G, Lagercrantz H , et al. Venipuncture is more effective and less painful than heel lancing for blood tests in neonates. Pediatrics1998 May; 101 : ;882 –6 [OpenUrl][1][Abstract/FREE Full Text][2] Question Is venipuncture of the dorsal side of the hand less painful and more efficient than heel lancing for blood testing in newborns? Randomised controlled trial. The maternity ward at a hospital in Stockholm, Sweden. 120 consecutive healthy full term infants who required testing for phenylketonuria (PKU). Infants with any illness or abnormality were excluded. Follow up was 97.5% (51.5% girls). Infants were allocated to venipuncture (VP) with a 0.9 × 40 mm microlance needle (n=50), heel lance with a small lancet (SL) (n=50), or heel lance with a large lancet (LL) (n=20). Before the VP, the dorsum of the hand was gently squeezed to visualise the vein. The SL was placed on the skin, and when pressure was applied to the end of the device a 2 mm lancet penetrated the skin. The LL required hand power to penetrate the skin with a sharp … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.aulast%253DLarsson%26rft.auinit1%253DB.%2BA.%26rft.volume%253D101%26rft.issue%253D5%26rft.spage%253D882%26rft.epage%253D886%26rft.atitle%253DVenipuncture%2BIs%2BMore%2BEffective%2Band%2BLess%2BPainful%2BThan%2BHeel%2BLancing%2Bfor%2BBlood%2BTests%2Bin%2BNeonates%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.101.5.882%26rft_id%253Dinfo%253Apmid%252F9565419%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=101/5/882&atom=%2Febnurs%2F2%2F1%2F10.atom
The changing landscape of health care in America requires that clinicians be skilled in responding to varying patient expectations and values; provide ongoing patient management; deliver and coordinate care across teams, settings, and time frames; and support patients' endeavors to change behavior and lifestyle--education that is in short supply in today's academic and clinical settings (Institute of Medicine, 2003). Nursing education needs to innovate at the micro and macro system levels for the 21st century. It cannot be business as usual. In order to truly transform care, practice and education will need to partner on curriculum development and the professional socialization of the new nurse.
Substantial discrepancies exist in how research, evidence-based practice (EBP), and quality improvement (QI) are taught to nursing students across academic levels. As nursing education programs adopt the new The Essentials: Core Competencies for Professional Nursing Education and move toward competency-based education, prelicensure and advanced nursing students will need to demonstrate research, EBP, and QI competencies; therefore, faculty must possess the knowledge and skills to teach these paradigms' differences and integration.
Haemodynamic instability in the preoperative neonate with cyanotic congenital heart disease impacts morbidity and mortality. The use of cerebral and somatic oximetry may provide an early warning of impending shock, prior to acidosis. A 2.78 kg infant presented with transposition of the great vessels. Cerebral and somatic oximetry was initiated. The infant became febrile, with tachycardia and poor urine output (B). Tachypnoea and tachycardia (D) worsened, followed by apnoea and unresponsiveness (E). The patient was intubated and assisted ventilation begun. Arterial blood gas revealed pH 7.11, PaCO2 16, PaO2 70, base deficit −24. The infant developed cardiac arrest requiring resuscitation. The patient was emergently placed on extracorporeal life support (F), subsequently developing asystole. Life support was discontinued and the infant died. Autopsy did not elucidate a cause of death. A rapid response to declining cerebral and renal rSO2 values may have prevented this untimely death. Rapid decline preceded the development of acidosis, a commonly used marker of distress in the preoperative neonate with congenital heart disease. We suggest routine preoperative monitoring in the infant with cyanotic congenital heart disease, using two-site cerebral and renal oximetry.
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