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Aims and Objectives: This literature review aims to define best nursing practice for lower limb ulcer care promoting stabilisation of this physiological consequence of diabetes mellitus and to help provide improved integration of health-within-illness for the patients., Background: According to the Centers of Disease Control, the number of people with diabetes has risen from 20·8 million in 2005 to over 23·6 million in 2007. Research has identified best practice algorithms for care of the diabetic foot, yet none for the ulcerations on the limb from the knee to the ankle., Design: The design of this literature review is to compile research from both nursing and medical communities to develop a best practice for the stabilisation of a lower limb ulcer. A literature search was conducted based on the theoretical framework of stabilisation of a chronic condition., Methods: Twenty-nine articles were identified for use in the evaluation of best practice of lower limb ulcerations. Each article was synthesised using a protocol tool., Results: Control of hyperglycaemia, infection control, ulcer debridement, use of dressings and compression therapy to relieve venous congestion were all identified as important factors in the treatment of lower limb ulcerations., Conclusions: This systematic literature review has resulted in a 'best nursing practice algorithm' for the stabilisation and care of lower limb ulcerations regardless of underlying cause. This care algorithm could be used in collaboration with other health care providers to promote stabilisation of lower limb ulcers and improve the overall quality of life of patient cohort., Relevance to Clinical Practice: The results of this study yield a suggested 'best practice' algorithm for the stabilisation of a lower limb ulcer--treat and control hyperglycaemia; prevent and/or control infection of the ulcer; routine debridement of the ulcer; using the most appropriate type of dressings for each patient; and the application of compression therapy. This algorithm can also be used for to frame patient teaching regarding appropriate treatments and therapies to promote the patient's self-care and stabilisation of the ulcer., (© 2010 Blackwell Publishing Ltd.)

1. The two major classifications of stroke are ischemic and hemorrhagic. Ischemic strokes account for 75% of all strokes and result from the complete occlusion of an artery. Hemorrhagic strokes, often caused by aneurysm or hypertension, are caused by the rupture of a cerebral blood vessel and bleeding into the surrounding tissue. 2. The signs and symptoms of stroke may include unilateral weakness or paralysis, a sagging of one side of the face, double or blurred vision, vertigo, numbness or tingling, and language disturbances. 3. Management of ischemic stroke may include thrombolytic agents (e.g., heparin, warfarin) if the individual is treated within 6 hours after the onset of symptoms. Diagnostic tests may include, computed tomography scan, transesophageal echocardiagraphy, Doppler ultrasonography, and electrocordiography. 4. Occupational health nurses can be actively involved in helping workers modify their risks for stroke, developing and implementing an action plan if an individual is experiencing a stroke, and facilitating the individual's reentry into the worksite after rehabilitation is completed.

Aims: The aim was to assess the current literature investigating health activism within nursing practice., Design: This was a scoping review of the literature utilizing the updated Levac et al.'s framework., Data Source/review Methods: A search of the CINAHL, PubMed, Scopus and Allied Health databases was conducted for peer-reviewed, English research published between January 2000 and April 2021., Results: Thirty-one articles met the criteria for inclusion in this study. The included research in nursing and health activism was heterogeneous in topic and method and primarily conducted in North America. Four themes resulted from the inductive thematic analysis: (1) Doing Health Activism, (2) Facilitators to Engaging in Health Activism, (3) Barriers to Health Activism Engagement and (4) Limited Education. Activism was not consistently defined and the term was used interchangeably with advocacy., Conclusion: There is a gap between nursing scope of practice, and education and skills in health activism. There is limited research regarding health activism and what constitutes as health activism. There is an opportunity to improve health activism awareness and skills within the nursing profession and undergraduate education and to produce nursing research on health activism., Impact: Health activism is integral to the nursing role, however, evidence suggests nurses lack confidence to engage in activism as practice. This is important for nurses across the world and in all care specialities., (© 2022 John Wiley & Sons Ltd.)

Purpose of Study: Evaluate the relationship between unplanned acute care utilization after discharge from an index hospital admission and registered nurse and patient perceptions of available instrumental support the patient would have after discharge., Primary Practice Setting: Three hospitals in a large regional hospital system in the southeastern United States., Methodology and Sample: Retrospective, secondary quantitative analysis of 13,361 patient records (mean age 58.4 years; 51% female) from index hospitalizations evaluating patient and nurse responses to 2 questions that specifically address instrumental support on both the patient and nurse versions of the Readiness for Hospital Discharge Survey (RHDS) and subsequent unexpected care received (emergency department [ED] visit, observation stay, hospital readmission) in the acute care setting within 60 days of discharge. Logistic regression was used to evaluate the relationship between RHDS scores and unplanned care received., Results: Patients who required hospital-based acute care within 60 days after discharge had lower average RN-RHDS scores than those who did not require hospital-based acute care., Implications for Case Management Practice: Including a nursing assessment of potential postdischarge expected instrumental support may be helpful in identifying patients who are at a higher risk of experiencing postdischarge acute care utilization. Monitoring ED visits and observation stays in addition to readmissions will facilitate capturing significantly more points of care received after discharge and provide additional information regarding postdischarge care utilization., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

To date, assessment tools for older people are different between hospitals and nursing homes in China. The difference between assessment tools can lead to poor communication of information between hospitals and nursing homes, which causes discontinuity of care and adverse outcomes when older people are transferred between these different settings. Continuity Assessment Record and Evaluation (CARE) is a comprehensive geriatric assessment tool developed in the United States of America. This study aimed to evaluate the reliability and validity of the Mandarin Version of CARE for older people who are transferred between hospitals and nursing homes. Using a convenience sampling method, 120 older people in hospitals and 120 older people in nursing homes in Shanghai were selected to test the internal consistency, interrater reliability and criterion-related validity of CARE from May to November 2017. When used among hospital, 70.0% (7/10) of the subscales had a Cronbach's alpha coefficients of greater than 0.7, 94.3% (50/53) of the items had an intraclass correlation coefficient (ICC) of greater than 0.75. When used in nursing homes, 90.0% (9/10) of the subscales had a Cronbach's alpha coefficients of greater than 0.7, 94.3% (50/53) of the items had an ICC of greater than 0.75. For both settings, the correlation coefficients of the subscales with their corresponding instruments for criterion-related validity were all greater than 0.8 (p < .01). The Mandarin version of CARE exhibits good reliability and validity. It can be used as an assessment tool for transition between hospitals and nursing homes., (© 2020 John Wiley & Sons Ltd.)

Aims and Objectives: To explore home care nurses' experiences of implementation and use of checklists developed for improving continuity of care for older patients (65+ years)., Background: The Norwegian Coordination Reform was implemented to improve coordination between hospitals and communities and facilitate a quicker return to home community after hospital discharge. To follow-up, national learning networks were initialised to improve pathways for chronically ill older patients, including the development and use of standardised checklists., Design: An explorative qualitative design was chosen., Methods: Three focus group interviews were conducted, including 18 registered nurses from eight municipalities in southern Norway. Systematic text condensation was used to analyse the interview texts. The COREQ checklist was followed., Results: Three categories emerged from the analysis. (a) "The implementation process" included the experiences of a chaotic beginning, the importance of involvement, the leaders' role and resource allocation. (b) "Pros and cons of checklists in use" included the informants' experiences of checklists' usefulness for nurses and the patients. (c) "Competence needed" included the need for a comprehensive set of formal, experiential and social competences., Conclusion and Relevance to Clinical Practice: The leaders' role, support and engagement are decisive for a successful implementation. To succeed and establish solid routines, allocating resources when implementing new laborious routines, such as checklists, is important. To improve holistic continuity of care to chronically ill older patients, checklists should be customisable to each patient's needs, be comprehensive enough to grasp the essence in what to be done at several time points, but at the same time brief enough to be operational. Checklists can be a useful tool for home care nurses, if customised to the individual municipality and the staffs' working routines. It is important that the staff have versatile and extensive competencies enabling them to use the checklists appropriately., (© 2019 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.)