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Obesity is a global health challenge, with 39% of the adult population considered overweight and 13% considered obese as measured in 2016 (World Health Organization (WHO), 2018). The obesity rate in Bermuda was 34.4% in 2014. It is associated with many comorbidities such as cardiovascular disease, Type 2 Diabetes mellitus, musculoskeletal disorders and cancer (Bernews, 2017). In the United States, recent efforts have been made to provide the public with clearer information (kilocalories, portion size, salt, sugar and fat content) of the nutritional qualities of fast food and in restaurants. Bermuda residents are lacking nutritional information on locally produced foods and in restaurants and thus are unable to make informed food choices. The addition of nutritional labelling and caloric details to locally-produced bakery foods and on restaurant menus (including take-away food) could be beneficial. Consequentially, there are potential opportunities for Health Promotion by healthcare professionals. Nursing diagnoses may provide patient-centred guidance for positive changes in food choices and nutrition that reduce the risk of obesity.

Educating inpatients and their family members regarding patient safety and protection is an important and challenging task for nursing staff. However, the effects of the conventional patient instruction with printed materials are usually not as good as expected owing to the learners' low learning engagement. In this study, a learning engagement-promoting model is proposed for developing interactive e-book systems for patient education. To evaluate the proposed approach, an experiment was conducted to explore the effects of the system on the learning outcomes and perceptions of inpatients' family members. The results show that the proposed approach significantly improved their learning performance as well as their learning attitudes, motivation, and satisfaction when compared to the conventional paper-based instruction. On the other hand, it was found that their state anxiety was not significantly affected by the approach. It is concluded that the interactive e-book-based learning approach can facilitate the inpatients' family members to well prepare for taking care of the patients without affecting their state anxiety.

Background: There have been significant concerns about the care and treatment of people with intellectual disabilities (ID) when attending general hospitals, which have led to inquiries that highlight service and systems failures. One response has been the development of Learning Disability Liaison Nursing (LDLN) Services across the UK that aim to ensure that additional, specialist support is available for patients, their carers and general healthcare professionals. Methods: A mixed-methods study to investigate the impact of LDLN Services across four Scottish NHS boards was undertaken. In total, 323 referrals made over 18 months were analysed along with qualitative data drawn from interviews and focus groups with a sample of 85 participants including patients with ID (n = 5), carers (n = 16), primary care healthcare professionals (n = 39) and general hospital professionals (n = 19) and learning disability liaison nurses (n = 6). Results: The referral patterns to the four liaison nursing services closely matched the known health needs of adults with ID, with common admissions being due to neurological, respiratory and gastrointestinal issues. The LDLN role was seen to be complex and impacted on three key areas: (i) clinical patient care; (ii) education and practice development; and (iii) strategic organisational developments. Specific patient outcomes were linked to issues relating to capacity and consent to treatment, fostering person-centred adjustments to care, augmenting communication and the liaison nurses acting as positive role models and ambassadors for people with ID. Conclusions: The LDLN Services were valued by stakeholders by achieving person-centred outcomes. With their expert knowledge and skills, the liaison nurses had an important role in developing effective systems and processes within general hospital settings. The outcomes highlight the importance of supporting and promoting LDLN Services and the challenges in delivering the multifaceted elements of the role. There is a need to take account of the complex and multidimensional nature of the LDLN role and the possible tensions between achieving clinical outcomes, education and practice developments and organisational strategic initiatives. (Contains 1 figure and 5 tables.)

Patient education is a crucial aspect of nursing practice, but much of the research about it is quantitative and has been conducted in urban medical centers. These urban-based studies have limited utility for nurses working in rural hospitals where the populations they serve often have unique and challenging health contexts and cultures. Since rural residents value knowledge that comes from within their own culture, we used phenomenology and hermeneutics to learn from patients about their experiences of receiving patient education in rural hospitals. Fifteen patients, 7 females and 8 males from 4 rural hospitals participated in non-structured, audio-recorded interviews where we asked them to describe their experiences of receiving patient education. The findings emphasize the need for patients to receive patient education in ways that help them be self-reliant. The findings also suggest the need to involve family members as co-educators when providing patient education to patients hospitalized for familial chronic illnesses. (Contains 3 tables.)

Guided reflection by six nurses who completed a counseling and health course supported the distinction between using counseling skills and practicing counseling. In a nursing context, counseling means assisting patients in exploring feelings and discovering coping strategies for their focal problems. (SK)

Proves that theory can be a practical approach to nursing care delivery by applying theory to the new nursing role of the case manager. Applies the author's theory of health and looks at its implications for various aspects of provider practice. (Author)

Discusses the teaching behavior of nurses when dealing with the elderly. Analyzes methods frequently used by nurses when teaching self-care skills to older adults. (JOW)

Personal computer technology has arrived in health care. Specific technological advances are optical disc storage, smart cards, voice recognition, and robotics. This paper discusses computers in medicine, in nursing, in conglomerates, and with patients. Future health care will be delivered in primary care centers, medical supermarkets, specialized hospitals, or extended care facilities. (MLW)

The article delves into the topic of safety in critical care nursing, particularly in intensive care units (ICUs), through interviews with nurses and nurse leaders in Sweden. It highlights the importance of maintaining a safety mindset, fostering commitment to patient safety, and continuous learning to ensure safe care practices. The document also includes research articles on patient safety culture, qualitative research methods, and the impact of the COVID-19 pandemic on ICUs, offering insights for enhancing healthcare practices and quality of care. [Extracted from the article]

Background: Smoking is a significant global public health concern, presenting substantial risks to individuals' health. Smoking cessation is essential for improving patients' well-being, and nurses play a critical role in assisting patients to quit smoking. However, there is a lack of research on nurses' specialized roles in smoking cessation interventions for patients. Objective: To define the specific responsibilities of nurses in facilitating smoking cessation among patients, and provide guidance for future nursing interventions in smoking cessation. Methods: The scoping review process was conducted for Arksey and O'Malley's framework. Based on the three-step search strategy of Joanna Briggs Institute (JBI), a comprehensive search was performed across ten databases including PubMed, CINAHL, Web of Science, Embase, Cochrane Library, OVID, PsycINFO, CNKI, Wan Fang Data Knowledge Service Platform, and VIP Database for Chinese Technical Periodicals, covering studies from the inception of the databases to February 2024. The inclusion and exclusion criteria were developed using the JBI (participants, content, and context) principle. Randomized controlled trials or quasi-experimental studies with nurse-led or involved smoking cessation interventions for patients were included. Data extraction was conducted independently by two reviewers. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Results: In total, 53 studies were eligible for the final charting and synthesis. The analysis identified six key roles that nurses played in smoking cessation interventions: assessors, educators, practice facilitators, coordinating collaborators, organizers, and supervisors. Among these, the roles of assessors, educators, and practice facilitators were the most commonly reported. The motivation interview and 5A method were the predominant techniques employed for smoking cessation. Nurses primarily promoted smoking cessation through the distribution of pamphlets, face-to-face education, and the provision of smoking cessation guidance. The primary participants in these studies were patients with chronic obstructive pulmonary disease (COPD). Conclusions: Nurses play an indispensable role in smoking cessation interventions, occupying multiple critical roles. However, this review identified a gap in the pre-intervention training of nurses, indicating a need for enhanced training programs to better prepare nurses for effective smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Aims: To explore healthcare professionals' perceptions and experiences of take‐home naloxone initiatives in acute care settings to gain an understanding of issues facilitating or impeding dispensing. Design: Systematic literature review. Data Sources: Cochrane, MEDLINE and CINAHL were searched from 15/03/2021 to 18/03/2021, with a follow‐up search performed via PubMed on 22/03/2021. The years 2011 to 2021 were included in the search. Review Methods: A systematic literature review focused on qualitative studies and quantitative survey designs. Synthesis without meta‐analysis was undertaken using a thematic analysis approach. Results: Seven articles from the United States of America (5), Australia (1) and Canada (1) with 750 participants were included in the review. Results indicate ongoing stigma towards people who use drugs with preconceived moral concerns regarding take‐home naloxone. There was confusion regarding roles and responsibilities in take‐home naloxone dispensing and patient education. Similarly, there was a lack of clarity over logistical and financial issues. Conclusion: Take‐home naloxone is a vital harm reduction initiative. However, barriers exist that prevent the optimum implementation of these initiatives. Impact: What is already known:Deaths due to opioid overdose are a global health concern, with take‐home naloxone emerging as a key harm reduction scheme.Globally, less than 10% of people who use drugs have access to treatment initiatives, including take‐home naloxone.An optimum point of distribution of take‐home naloxone is post‐acute hospital care. What this paper adds:There is role confusion regarding responsibility for the provision of take‐home naloxone and patient education. This is exacerbated by inconsistent provision of training and education for healthcare professionals.Logistical or financial concerns are common and moral issues are prevalent with some healthcare professionals questioning the ethics of providing take‐home naloxone.Stigma towards people who use drugs remains evident in some acute care areas which may impact the use of this intervention. Implications for practice/policy:Further primary research should examine what training and education methods are effective in improving the distribution of take‐home naloxone in acute care.Education should focus on reduction of stigma towards people who use drugs to improve the distribution of take‐home naloxone.Standardized care guidelines may ensure interventions are offered equally and take‐home naloxone 'champions' could drive initiatives forward, with support from harm reduction specialists. Reporting Method: This has adhered to the PRISMA reporting guidelines for systematic reviews. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Where available, Parkinson's Nurse Specialists (PNS) provide a range of care, support, guidance, and advocacy for people with Parkinson's (PwP), and, where appropriate, their care partners (CP). Parkinson's is a complex and progressive condition. Consequently, evaluating health outcomes is not a reliable method to understand the value and impact of PNS. Previous research has identified PNS can improve the subjective well-being of PwP in the community, also that barriers to care include heavy caseloads and a lack of time. Yet little is known about the value of the role of the PNS, particularly about the impact of pharmacological management and review. This research aims to close this research gap by providing explanatory theories of the impact and value of PNS to PwP, their CP, and other professionals. Methods: A social constructivist grounded theory approach was used. Semi-structured interviews were conducted with three groups, PNS, PwP, and CP. Interviews were analysed using NVivo for coding and categorising and Word for memo-writing. Data was analysed inductively and iteratively to identify contexts, social processes, actions, and behaviours, before final emergent theories were identified. Results: 46 semi-structured interviews (PNS 18, PwP 19, CP 9) led to four data categories and 13 sub-categories that delineated PNS value. (1) Expert Counsel; provision of emotional support, education, and lifestyle guidance; CP inclusion; provision from diagnosis; and across all stages of Parkinson's. (2) Conduit of Care; signposting, referral, and connection to PwP, CP, others; PNS barriers and facilitators; (3) Team/Partnership; continuity and partnership, 'working together'; (4) Pharmacological Support, PNS prescribing; concordance; speed of treatment. Where PNS were accessible they could offer personalised support and partnership, so providing person-centred care that improves health and well-being. Conclusion: Where a PNS is accessible due to service availability and manageable caseloads, to provide person-centred care, they deliver several benefits to PwP and CP which improve health and perceived well-being. Where PNS are not available, PwP and CP often struggle to manage their Parkinson's with negative impacts on health and well-being. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusions Implications for the Profession and Patient Care Reporting Method Patient or Public Contribution To develop and test the validity of an artificial intelligence–assisted patient education material for ostomy patients.A methodological study.The study was carried out in two main stages and five steps: (1) determining the information needs of ostomy patients, (2) creating educational content, (3) converting the educational content into patient education material, (4) validation of patient education material based on expert review and (5) measuring the readability of the patient education material. We used ChatGPT 4.0 to determine the information needs and create patient education material content, and Publuu Online Flipbook Maker was used to convert the educational content into patient education material. Understandability and applicability scores were assessed using the Patient Education Materials Assessment Tool submitted to 10 expert reviews. The tool inter‐rater reliability was determined via the intraclass correlation coefficient. Readability was analysed using the Flesch–Kincaid Grade Level, Gunning Fog Index and Simple Measure of Gobbledygook formula.The mean Patient Education Materials Assessment Tool understandability score of the patient education material was 81.91%, and the mean Patient Education Materials Assessment Tool actionability score was 85.33%. The scores for the readability indicators were calculated to be Flesch–Kincaid Grade Level: 8.53, Gunning Fog: 10.9 and Simple Measure of Gobbledygook: 7.99.The AI‐assisted patient education material for ostomy patients provided accurate information with understandable and actionable responses to patients, but is at a high reading level for patients.Artificial intelligence–assisted patient education materials can significantly increase patient information rates in the health system regarding ease of practice. Artificial intelligence is currently not an option for creating patient education material, and their impact on the patient is not fully known.The study followed the STROBE checklist guidelines.No patient or public contributions. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of underserved people with chronic diseases and decreasing providers in rural areas have contributed to the care shortage in the United States. Nurse-led telehealth/mobile care models have potential benefits for this population. However, there is a substantial gap in the literature regarding this topic. Purpose: To examine the available literature on nurse-led telehealth/mobile health care models with a particular focus on care model settings, nursing roles, care components, achieved outcomes, and the identification of both facilitative factors and encountered challenges. The ultimate goal is to offer recommendations based on these findings, thereby aiding the development or refinement of evidence-based care models that meet to the unique needs of low-income populations. Methodology: Literature published from 2010 to 2023 was searched in six electronic databases (Cumulative Index to Nursing and Allied Health Literature, Communication and Mass Media Complete, Medline, APA PsycINFO, Social Sciences Index, and Web of Science databases). Results: Commonalities identified among included studies with significant improvements were the provision of home monitors and education to participants, multiple engagements, and extensive community and/or family involvement. Conclusions: Nurse-led telehealth/mobile health care models for chronic diseases are an emerging approach. Nurse educators must ensure that future nurses are adept in diverse telehealth modes, collaborating across disciplines. Leveraging advanced practice registered nurses and interdisciplinary teams provides holistic care. Implications: Our review outlined recent research findings that suggest enhanced patient outcomes through technology, communication, and community support. In addition, we offered suggestions for future research and practice, emphasizing the importance of exploring the requirements of diverse and underserved communities. [ABSTRACT FROM AUTHOR]

Aim: To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital. Background: Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability. Design: A narrative inquiry. Methods: Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data. Results: The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation. Conclusion: Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians. Implications for the Profession and/or Patient Care: Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly. Reporting Method: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting. Patient or Public Contribution: The consumer researcher was involved in design, data analysis and publication preparation. [ABSTRACT FROM AUTHOR]

Urodynamic testing is an invasive procedure that causes pain and anxiety. Patient education is an evidence-based nursing intervention that relieves pain and anxiety and increases patient satisfaction. This study was carried out to compare the effects of different education methods utilized before a urodynamic testing procedure on patients' pain, anxiety, readiness for the procedure, and satisfaction. The study is a randomized controlled clinical trial. Participants (n = 80) were randomly assigned to four groups. While patients in the control group were provided with routine clinical information, patients in the intervention group were given education with brochures, videos, and brochure-supported videos. The research data were collected by using a Data Collection Form with items about participants' descriptive characteristics, the Visual Analog Scale, and the State Anxiety Inventory. It was determined that pain expectation before urodynamics and the severity of pain during urodynamics were lower in intervention groups than in the control group. Pain expectation before urodynamics was lower in the brochure-supported video education group than in the brochure education group. Anxiety levels were lower and satisfaction levels were higher in the video education and brochure-supported video education groups than in the control and brochure education groups. Of the methods utilized, it was determined that the most effective one was brochure-supported video education as it affected all parameters positively. [ABSTRACT FROM AUTHOR]

The professional experiences of school nurses who work outside of urban areas are not often described. We used data from a 2019 statewide survey of school nurses to describe differences between the urban and non-urban (urban cluster and rural) school nurse workforce in New Mexico. Non-urban school nurses were twice as likely as urban nurses to provide clinical services to multiple school campuses (P <.001) and more likely to serve both elementary and secondary school settings (P =.002). They were less likely than urban school nurses to be bachelor's prepared, or to have received recent continuing education on diabetes (P <.001), reproductive health (P = 0.02), LGBQ+ and transgender student health (P <.001, for each), and suicide risk assessment and screening (P =.012). Our findings underscore concerns about geographic differences in the school nursing workforce in terms of educational preparation and student access that could potentially limit the school nurse role in advancing child health equity. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine patients' preoperative COVID‐19 fear levels, hygiene behaviours, postoperative personal protective clinical measures, and their correlations with each other. Design: This research is a cross‐sectional type of study. Methods: The study sample consisted of 131 patients hospitalized in the general surgery inpatient ward of a hospital in Turkey. The sample was determined by G‐Power analysis. The data were collected in two stages in a research hospital between 1 April 2021 and 1 March 2022. Sociodemographic and Clinical Information Form, COVID‐19 Fear Scale, COVID‐19 Hygiene Scale were used before surgery; COVID‐19 personal protective clinical measures questionnaire was used after surgery. Descriptive statistics, independent t‐test, ANOVA test, Wilcoxon test and Spearman correlation analysis were used to evaluate the data. Results: It was determined that preoperative COVID‐19 fear levels, hygiene behaviours, and the personal protective clinical measures developed after the surgery were above moderate. A statistically significant and positive correlation was found between the COVID‐19 Fear Scale and the preoperative COVID‐19 Hygiene Scale and postoperative COVID‐19 personal protective clinical prevention questionnaire total score and sub‐dimension score averages. Patients' COVID‐19 fears, preoperative and postoperative hygiene behaviours are statistically significantly associated with each other at a low level; postoperative clinical precautions and preoperative hygiene behaviours are statistically significantly associated with each other at a high level. Conclusion: The results of this study show that patients are terrified of COVID‐19 while they are hospitalized due to surgical intervention during the pandemic process, and they increase their hygiene measures. It is thought that the results of the study will guide the regulation of clinical measures, patient education, and nursing care to be developed for patients during pandemic periods. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Effective communication between nurses and cancer patients is essential for patient satisfaction and optimal health outcomes in outpatient oncology settings. This study explored the communication experiences of Iranian cancer patients receiving outpatient treatment. Methods: Semi-structured interviews were conducted with 14 adult cancer patients undergoing chemotherapy, radiotherapy, or follow-up treatment at an outpatient clinic in Urmia, Iran. Qualitative content analysis was used to analyze the data. This study adhered to the standards set forth in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Three main categories emerged from the interviews with Iranian cancer patients: communication dynamics, barriers to communication, and effective communication outcomes. Patients expressed a desire for nurses who actively listen, provide emotional support, and offer thorough education about their disease and treatment options. However, they also identified barriers to effective communication, including negative nurse behaviors (such as lack of empathy), heavy workloads, gender and language discordance, and logistical challenges within the clinic setting. When communication was positive, patients reported increased commitment to their treatment plans, improved coping mechanisms, reduced stress levels, and greater satisfaction with their overall care. Conclusions: This study revealed the multifaceted nature of communication in outpatient oncology settings from the patient's perspective. Findings underscore the need for interventions that enhance nurse communication skills, address workload issues, promote cultural sensitivity, and optimize clinic logistics. These efforts can significantly improve patient experiences and treatment outcomes during cancer treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and Patient Care Impact Reporting Method Patient or Public Contribution What does this Paper Contribute to the Wider Global Clinical Community? To describe vaccination roles of primary care nurses during the COVID‐19 pandemic in Canada.This analysis was part of a larger mixed‐methods case study.We conducted semi‐structured qualitative interviews from May 2022 to January 2023 with primary care nurses across four provinces: British Columbia, Ontario, Newfoundland and Labrador, and Nova Scotia. We asked participants to describe their roles during various stages of the pandemic, facilitators and challenges encountered and possible roles that nurses could have played. We used thematic analysis and analysed codes relevant to vaccination.We interviewed a total of 76 nurses and identified four key functions of primary care nurses' roles in COVID‐19 vaccination: (1) education, (2) vaccine administration, (3) outreach and (4) advocacy. Themes outlined nurses' roles with respect to patient education, addressing vaccine hesitancy, partaking in vaccination roles outside of regular primary care practice and supporting accessibility in COVID‐19 vaccination. Specific tasks varied by nursing professions.Primary care nurses fostered trust through existing patient–provider relationships to enhance roles and activities related to education, outreach and advocacy in COVID‐19 vaccination. Some COVID‐19 vaccine‐related roles were more easily integrated into primary care, whereas others competed with routine primary care roles.Findings highlight the vital contributions of primary care nurses towards COVID‐19 vaccination efforts in Canada. Leveraging nursing expertise can enhance future pandemic response efforts and improve patient care by addressing barriers to vaccination and promoting equitable access to vaccination services.This study addresses a knowledge gap by describing the vaccination‐related roles of primary care nurses during the pandemic. Findings illustrate that nurses demonstrated adaptability through their engagement in vaccine education, administration, outreach and advocacy. This research informs resource allocation, policy development and workforce planning for future vaccination efforts during a pandemic response.The authors have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines included in the Empirical Research Qualitative reporting method.No patient or public contribution. Provides insight into the pivotal roles of primary care nurses during the COVID‐19 vaccination efforts in Canada, highlighting their diverse contributions towards education, vaccine administration, outreach and advocacy. Offers implications for future pandemic planning by informing resource allocation, policy development and workforce planning for vaccination efforts. [ABSTRACT FROM AUTHOR]

Background: General hospitals in China have been establishing General Practice Departments (GPD). Although General Practice Nurses (GPNs) are an important part of this medical system, their training has not been synchronised. This study explored the working status of nurses in GPDs in general hospitals in Beijing to provide a theoretical basis for the training and development of GPNs in China. Methods: We conducted in-depth, individual interviews with outpatient nurses at 19 hospitals in Beijing between March and April 2021. We employed a qualitative analysis to interpret participant narratives and used a codebook thematic analysis to analyse the interview data and extract themes. Results: The analysis revealed four themes: (i) a lack of full-time GPNs in GPDs of most tertiary hospitals, (ii) the inability of GPNs to fully express their potential and skills owing to their limited roles, (iii) insufficient standardised patient education provided by nurses in GPDs, and (iv) a lack of systematic and relevant training for nurses working in general practice settings. Conclusions: To promote the development of GPNs, GPDs in general hospitals in China should hire full-time GPNs, define their job duties in alignment with their values, and provide standardised training to strengthen their core competencies. [ABSTRACT FROM AUTHOR]

Background: Today, the human population faces an increasing array of emerging environmental challenges. Despite its importance, nurses often neglect ecological issues, which can compromise patient health. While the ecological nursing perspective has the potential to lead to innovative care approaches that benefit patients, the nursing profession, and the environment, the concept of ecological care lacks a clear definition and its dimensions remain unclear. This study aimed to analyze and clarify the concept of 'ecological care' in the nursing discipline. Methods: Walker and Avant's analysis method was used to identify descriptions, antecedents, consequences, and empirical referents of the concept of 'ecological care' in nursing. We searched the databases (PubMed, Scopus, PsycINFO, CINAHL, ERIC, SID, and IranDoc) using the keywords "ecological," "nurse," and "nursing" using Boolean operators "AND" and "OR" in the title and abstract fields both in English and Persian to identify relevant literature on ecological care in nursing. Results: Ecological care, as a multidimensional concept, encompasses ecological thinking, ecological attitude, ecological awareness, ecological sensitivity, and ecological literacy. This entails the optimal utilization of environmental factors to provide patients with high-quality care and preserve ecological sustainability through environmentally friendly behaviors. Conclusions: The findings highlight the need to elucidate, endorse, and solidify ecological thinking in all aspects of nursing care including nursing management, education, and research, which can lead to improved care quality, patient safety, and sustainability. Within this framework, nursing educators could play an essential role in integrating ecological care into nursing education. The study emphasizes the need to integrate ecological thinking into all aspects of nursing. [ABSTRACT FROM AUTHOR]

Value-based care (VBC) aims to improve patient health outcomes relative to the cost of care by shifting from traditional fee-for-service models to patient-centered, outcome-driven approaches. This framework is particularly important in nephrology, where high costs associated with chronic kidney disease (CKD) and end stage kidney disease have prompted the adoption of new care models. Key programs such as the Comprehensive End-Stage Renal Disease Care Model and the Kidney Care Choices program have introduced multidisciplinary teams and early-stage CKD interventions to improve patient outcomes and reduce costs. This article highlights the essential role of interdisciplinary collaboration in VBC, with registered nurses, nurse practitioners, pharmacists, social workers, dietitians, and physicians coordinating care to address clinical and non-clinical needs. Case studies demonstrate the effectiveness of coordinated efforts in medication management, patient education, and addressing social determinants of health. These examples underscore the potential for VBC to significantly improve patient outcomes in kidney care while addressing health care inequities and reducing overall costs. Findings emphasize the importance of early interventions, interdisciplinary teamwork, and targeted support for patients with CKD in achieving VBC outcomes. [ABSTRACT FROM AUTHOR]

Obesity is a chronic, prevalent, and complex health condition that adversely impairs physical and mental health. The World Health Organization calls for integrating obesity care into existing chronic disease management programs within primary healthcare services. This scoping review aimed to examine registered nurses' roles in the primary healthcare management of individuals with obesity. A scoping review was conducted using the Johanna Briggs Institute methodology framework. Thematic analysis was used to identify and categorize nurses' roles in primary healthcare obesity management of adults. Of 1142 documents included in this review, 15 papers met the inclusion criteria. Thematic analysis yielded the following six themes representing nurses' major roles: patient-centred care, patient assessments, therapeutic interventions, care management, patient education, and professional development. This review identified that the literature on nurses' roles primarily described their focus on lifestyle interventions (mainly nutrition and physical activity), anthropometric measurements, health planning, goal setting, supportive care, monitoring progress, and arranging follow-up. The Discussion highlights the importance of determining RN knowledge gaps and biases. More research is required to determine the need for additional RN pre-and or post-education related to obesity as a complex chronic disease. [ABSTRACT FROM AUTHOR]

Abstract Background Osteoporosis is a common condition that increases the risk of fracture and mortality. In Taiwan, clinical guidelines recommend pharmaceutical therapy for patients with a T-score of ≤ − 2.5; however, Taiwan’s National Health Insurance (NHI) only covers these medications for those with a history of fragility fractures. This gap in coverage necessitates a discussion of out-of-pocket treatment options. To address this, we provided an integrated care program with patient education and shared decision-making by nurse case managers specializing in osteoporosis. We evaluated whether education by nurse case managers influences patients with a T-score ≤ − 2.5, who are not covered by the NHI, to choose out-of-pocket pharmaceutical therapy. Methods We retrospectively reviewed medical records of patients who underwent bone density scanning at our hospital between January 2014 and December 2021. We identified 4,462 patients with a T-score of ≤ − 2.5 who were ineligible for NHI-covered anti-osteoporotic therapy and analyzed trends in out-of-pocket medication use. Since the integrated care program began in 2018, we evaluated whether education by nurse case managers between 2018 and 2021 influenced patients’ decisions to pay out-of-pocket for therapy. After the implementation of the integrated care program, we identified 2,910 patients with a T-score ≤ -2.5 who were ineligible for NHI-covered anti-osteoporotic therapy. Of these, 640 opted for out-of-pocket treatment, while 2,270 chose conservative care. After a 1:1 propensity score match based on age and sex, logistic regression was used to analyze the impact of nurse case manager education on these decisions. Results Between 2014 and 2021, 888 of the 4,462 patients chose out-of-pocket pharmaceutical therapy. Before the implementation of the integrated care program and patient education by nurse case managers (2014–2017), 16% of the patients opted to pay out-of-pocket for anti-osteoporotic therapy. After the program was implemented (2018–2021), the rate increased significantly to 22% (P

Abstract Background Patient health literacy (HL) affects health and wellbeing on both individual and population levels. The ability to receive, understand, manage and act upon health information can be positively influenced by nurses’ use of HL strategies. This study examined the relationship between nurses’ use of a HL checklist (intervention) and before and after patient HL scores, and the effects of frequency and types of strategies used in specialty consultations in Spain. Methods This quasi-experimental, non-randomized study used the HLS19-Q12 to calculate HL scores for 149 patients. Calculations were performed both before and after a nursing intervention that consisted of using a HL checklist. Paired samples t-test assessed the difference between patient HL scores pre- and post-nurse intervention. Frequency analysis and Pearson correlation where used to examine frequencies of nursing HL strategies used and associations with HL scores. Results The mean difference between the HLS19-Q12 scores before and after intervention was − 9.94, with a standard deviation of 11.50. There was a statistically significant effect of the intervention on HL score (t = -10.00, p

Background: Patient education (PE) is a fundamental patient right and an essential tool for improving health outcomes and enhancing patient satisfaction. However, barriers to effective PE exist, and understanding these obstacles is crucial for addressing them.Objectives: This study aimed to conduct a systematic review of the barriers to PE in Iran.Methods: A systematic review was conducted to analyze published articles on the barriers to PE in Iran, available in both English and Persian. The search was performed across multiple databases, including PubMed, Science Direct, and ProQuest, and academic search engine of Google Scholar, and Iranian databases such as MagIran, SID, IranDoc, and IranMedex, covering the period from January 1, 2000, to January 1, 2022. Specific keywords such as "barrier", "education", "learning", "client", "Iran" and "patient" were employed, resulting in a total of 185 articles related to the topic. Ultimately, 47 studies were included in the review.Results: The review encompassed 47 studies, comprising 32 descriptive, 9 qualitative, 3 intervention, and 3 review studies. The findings identified five categories of barriers: environmental barriers, nurse-related barriers, patient-related barriers, managerial barriers, and educational barriers removal.Conclusion: Educating patients presents challenges due to various barriers. To address these obstacles, it is imperative for managers to support nurses by providing necessary resources, adequate funding, dedicated nursing personnel, suitable infrastructure, and training in innovative teaching techniques.

Background: Many patients with advanced cardiovascular disease need Coronary Artery Bypass Graft (CABG) surgery, indicating the importance of cardiac rehabilitation. Our study explored the combined efficacy of simulation (using demonstration and return-demonstration approach) with music on post-Open Heart Surgery (OHS) outcomes. Materials and Methods: This randomized, controlled trial was conducted at Imam Reza Hospital, Mashhad, Iran, on 90 patients awaiting OHS. The participants were allocated to 3 groups: education via simulation, education via simulation enhanced by instrumental music, and conventional instruction. Evaluations were performed pre-education and 2-days post-surgery using the activity measure for post-acute care (AM-PAC) “6-Clicks” Questionnaire, 18-item Nursing Outcomes Classification (NOC) index, and State-Trait Anxiety Inventory (STAI). JASP software (JASP Team, 2023, Version 0.17.3) was employed for statistical analyses, using RM-ANOVA and ANCOVA test. Results: The results revealed a significant effect in immediate post-intervention and 2-day follow-up periods across all outcome measures (all p < 0.05), except for activity. Post hoc tests demonstrated substantial variations in effect sizes between intervention and control groups. Both intervention groups had significantly greater impact than the control group, particularly the composite group, showing heightened effects in state and trait anxiety and respiratory scores (p < 0.05). Conclusions: The combined use of the simulation with rhythmic music in phase one cardiac rehabilitation notably improved post-surgical outcomes, outperforming the method without music. This approach shows promise as an effective instructional strategy in cardiac rehabilitation stages.

Objective: This study aims to investigate the effect of video-assisted patient education (VPE) on knee functions, quality of life (QoL) and decrease complications in total knee replacement (TKR) patients.Methods: This study is designed as a prospective, parallel, two-arm, randomized clinical trial. It included 44 patients who underwent elective TKR at an orthopedics and traumatology clinic. The VPE group received VPE including early postoperative care for TKR, activities of daily living, and gradual exercise program in addition to the existing routine care at the clinic. The control group received only routine care. The results were collected with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF-36) scores measured at baseline, 1st and 3rd months after TKR. Results: The mean scores of the VPE group on the pain, stiffness, and physical function of the WOMAC were significantly lower in 3rd month after TKR than the control group. The VPE group had significantly higher scores than the control group on SF-36 of all subcategories except pain, emotional role, and mental health in 3rd month after TKR.Conclusion: The VPE can improve knee function and QoL in TKR patients. Nurses can use the VPE method in patients to improve knee functions and QoL after TKR.

Abstract Background World falls guidelines recommend that hospitalised older patients receive individualised falls prevention education, yet no studies have sought older people’s feedback on how best to deliver falls prevention education in hospitals. The objective of the study was to explore the perspectives of older people and their caregivers about barriers and enablers to implementation of a tailored hospital falls education program. Methods A qualitative descriptive design was used. Three focus groups and 16 semi-structured interviews were conducted. A purposive sample of older people who had previous hospital admissions and caregivers of older people were selected to review a co-designed patient falls education program (the revised Safe Recovery program). They provided feedback on how to implement the program in hospital settings. Data were thematically analysed taking an deductive-inductive approach. Results Participants were 37 older people [female n = 24 (64.9%), age range 64 to 89 years] and nine caregivers (female n = 8). The first theme was that the Safe Recovery Program resources were of high quality, enabling strong patient engagement and increased knowledge and awareness about falls prevention in hospitals. The second theme identified practical strategies to enable program delivery in hospital wards. The key enablers identified were: timing of delivery around wellness and the patient’s mobility; tailoring messages for each older patient; key staff members being assigned to lead program delivery. Participants recommended that staff assist older patients to set appropriate behavioural goals in relation to preventing falls in hospitals. They also recommended that staff raise older patients’ confidence and motivation to take action to reduce the risk of falls. Providing resources in other languages and alternative shorter versions was recommended to enable broad dissemination. Conclusions Older people and their caregivers advised that implementing falls education in hospitals can be enabled by using high quality resources, delivering falls education in a timely manner and personalising the education and support to individual needs.

In recent years, the complexity and diversity of health-related factors, changing disease patterns incommunities, the impact of socio-economic factors on health, and the multifaceted challenges ofhealth systems have increased the participation of nongovernmental organizations (NGOs) in healthactivities and programs.

Introduction: The aim was to determine the effect of arteriovenous fistula (AVF) care training given to hemodialysis (HD) patients on the self‐care behaviors of patients. Methods: The randomized controlled experimental study was conducted in the HD unit. The study was carried out with a total of 66 patients. Patients in the intervention group were trained using the AVF Care Education Book for 4 weeks. The study data were collected using the scale for evaluating self‐care behaviors related to AVF in HD patients (ASBHD‐AVF). Shapiro–Wilk and Kolmogorov–Smirnov tests, independent t‐tests, and ANOVA were used in the SPSS 25.0 package program. Results: As a result of the research, it was determined that the average ASBHD‐AVF score of the patients in the trained intervention group increased from 54.52 ± 7.41 to 73.77 ± 3.05 (p <0.05). The mean ASBHD‐AVF score of the patients in the control group increased from 56.14 ± 4.51 to 58.14 ± 5.93 (p >0.05). When the difference between the two groups was examined, it was determined that the average ASBHD‐AVF score of the patients in the intervention group was statistically significantly higher than the control group (p <0.05). Conclusion: AVF care education given to HD patients improves patients' self‐care behaviors. Improved fistula self‐care behaviors of patients will contribute to the healthy functioning of the AVF and the effective HD treatment of patients. [ABSTRACT FROM AUTHOR]

Objective: The early identification and diagnosis of transplant-associated thrombotic microangiopathy (TA-TMA) are essential yet difficult in patients underwent hematopoietic stem cell transplantation (HSCT). To develop an evidence-based, nurse-leading early warning model for TA-TMA, and implement the healthcare quality review and improvement project. Methods: This study was a mixed-methods, before-and-after study. The early warning model was developed based on quality evidence from literature search. The healthcare quality review and improvement project mainly included baseline investigation of nurse, improvement action and effectiveness evaluation. The awareness and knowledge of early parameter of TA-TMA among nurses and the prognosis of patients underwent HSCT were compared before and after the improvement. Results: A total of 1 guideline, 1 evidence synthesis, 4 expert consensuses, 10 literature reviews, 2 diagnostic studies, and 9 case series were included in the best evidence. The early warning model including warning period, high-risk characteristics and early manifestation of TA-TMA was developed. The improvement action, including staff training and assessment, suspected TA-TMA identification and patient education, was implemented. The awareness and knowledge rate of early parameter of TA-TMA among nurses significantly improved after improvement action (100% vs. 26.7%, P < 0.001). The incidence of TA-TMA was similar among patients underwent HSCT before and after improvement action (2.8% vs. 1.2%, P = 0.643), while no fall event occurred after improvement action (0 vs. 1.2%, P < 0.001). Conclusion: The evidence-based early warning model and healthcare quality improvement project could enhance the awareness and knowledge of TA-TMA among healthcare providers and might improve the prognosis of patients diagnosed with TA-TMA. [ABSTRACT FROM AUTHOR]

Aims To evaluate a self-administered digital education resource for patients after a heart attack (adapted simplified Chinese version of Cardiac College™) on secondary prevention knowledge and health behaviour change outcomes. Methods and results Chinese immigrants recovering from a heart attack were recruited from cardiac rehabilitation programmes at four metropolitan tertiary hospitals. Participants provided access to Cardiac College™ (adapted simplified Chinese version), a self-learning secondary prevention virtual education resource over 4 weeks. The web-based resources include 9 booklets and 10 pre-recorded video education sessions. Assessments included health literacy, secondary prevention knowledge, self-management behaviours, self-reported physical activity, and a heart-healthy diet. Satisfaction, acceptability, and engagement were also assessed. From 81 patients screened, 67 were recruited, and 64 (95.5%) completed the study. The participants' mean age was 67.2 ± 8.1 years old, 81.2% were males, and the majority had no English proficiency (65.6%). Following the intervention, significant improvements were observed for secondary prevention knowledge overall and in all subdomains, with the most improvement occurring in medical, exercise, and psychological domains (P < 0.001). Dietary and self-management behaviours also improved significantly (P < 0.05). According to participants, the educational materials were engaging (100%), and the content was adequate (68.8%); however, 26.6% found the information overwhelming. Overall, 46.9% were highly satisfied with the resources. Conclusion A self-learning virtual patient-education package improved secondary prevention knowledge and self-care behaviour in Chinese immigrants after a heart attack. The culturally adapted version of Cardiac College™ offers an alternative education model where bilingual staff or translated resources are limited. [ABSTRACT FROM AUTHOR]

This quality improvement project implemented a nurse-led high-risk screening referral protocol for earlier identification of women at increased risk for breast cancer. The Breast Cancer Risk Assessment Tool was used at the mammography appointment, which led to improved electronic communication and significant increases in high-risk clinic consultations, breast magnetic resonance imaging, genetic counseling, and additional testing. Patients reported high satisfaction with advanced practice providers, which indicates increased comfort levels. [ABSTRACT FROM AUTHOR]

Aim: To develop and test the psychometric properties of an expanded catheter self‐management scale for patients with in‐dwelling urinary catheters. Design: A cross‐sectional validation study. Despite the utility of the original 13‐item catheter self‐management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self‐management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self‐management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self‐management. Methods: A total of 101 adult community‐dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23‐item expanded catheter self‐management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. Results: The 23‐item expanded catheter self‐management scale yielded a 5‐factor solution, labelled as: (i) self‐monitoring of catheter function, (ii) proactive, help‐seeking behaviour function, (iii) bowel self‐care function, (iv) hygiene‐related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self‐management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self‐management scale and catheter‐related problems. Conclusion: The 5‐factor structure provided a comprehensive assessment of key aspects of urinary catheter self‐management essential to reduce the likelihood of catheter‐related hospital presentations. Implications: The expanded catheter self‐management scale can be used to assess and monitor effective patient‐centred interventions for optimal self‐management to prevent catheter‐related problems and improve the quality of life of patients. Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter.The findings of this study show the correlation between catheter self‐management skills and catheter‐related problems.The expanded catheter self‐management scale (E‐CSM) assists with analysing the self‐management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co‐designing interventions. This paper reports the psychometric analysis of the expanded catheter self‐management scale (E‐CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ‐IDC Study' (Alex et al. in Collegian, 29:405–413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study. [ABSTRACT FROM AUTHOR]

Background: Idiopathic intracranial hypertension is a challenging serious disease with significant burden on individuals and society. It's increasing incidence with the obesity epidemic increasing blindness risk which more press on service capacity. Aim: To examine the health coaching effectiveness in controlling idiopathic intracranial hypertension. Subjects and Method: Subjects: A purposive sample of 45 patients fulfill the inclusion criteria were selected. Setting: Medical & Surgical neurology and Ophthalmology outpatients’ clinics at two University and Al-Qasr Teaching Hospitals. Design: Quasi-experimental research design allowed for accomplishment of study goal. Tools: four tools were utilized included, patients’ biodemographic questionnaire, headache diary assessment questionnaire, disease related objective and subjective assessment questionnaire and disease related health coaching practices questionnaire. Results: Patients’ weight preintervention was 84 Kg which reduced to 73 Kg and 65 Kg after three and six months respectively. Serum potassium level elevated from 3.6 to 4.4 after three and six months respectively. Also, systolic and diastolic blood pressure, headache attacks and analgesic use per week were significantly decreased after three and six months of intervention. Eye related disorders as blurred vision; papilledema degree was significantly decreased after intervention by three and six months. Conclusion: The nursing health coaching program application has proven potent effectiveness on patients’ intracranial pressure reduction reflected on patients’ little headache attacks per week, decreased disease related signs and symptom’s severity and frequencies, resolved papilledema with improved visual function. Recommendations: Nursing health coaching program should be applied among all patients with idiopathic intracranial hypertension as an effective non- pharmacological, non-surgical conventional method. [ABSTRACT FROM AUTHOR]

The antibiotic stewardship programme (ASP) is a new concept initiated by WHO, but nurses are not yet ready to adopt the program. The training and empowerment of nurses are the best strategies for enhancing their knowledge and engagement in ASP. This mixed-method study was used to assess perceived roles and barriers of nurses' involvement in ASP. An online survey was conducted among 420 clinical nurses to identify their role, and 23 individual interviews were performed among nurses and infection control practitioners to explore the barriers and recommendations to overcome the identified barriers. The majority of the nurses agreed with the sixteen identified roles in ASP, of which 'antibiotic dosing and de-escalation' (82.61%), 'IV to PO conversion of antibiotic, outpatient antibiotic therapy' (85.23%), and 'outpatient management, long-term care, readmission' of the patients (81.19%) had the lowest agreement from the participants. The major themes generated through the qualitative interviews were a lack of knowledge about ASP, poor communication between multidisciplinary teams, lack of opportunity and multidisciplinary engagement, lack of formal education and training about ASP, lack of ASP competency and defined roles in policy, role conflict or power/position, availability of resources, and lack of protected time. Nurses play an integral role in the successful implementation of antibiotic stewardship programs. The empowerment of nurses will help them to adopt the unique role in ASP. Nurses can significantly contribute to antibiotic stewardship efforts and improve patient outcomes through addressing these challenges. [ABSTRACT FROM AUTHOR]

Colonoscopy is an essential method for diagnosing and treating colorectal cancer, relying on effective bowel preparation to thoroughly examine the large intestinal mucosa. Traditional education involves printed instructions and verbal explanations but does not guarantee clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. A mobile medical model using Android devices for bowel preparation education was tested in a single-blind, randomized trial. This trial enrolled outpatients undergoing colonoscopy at the Endoscopy Center for Diagnostic and Treatment between 27 October 2021 and 31 December 2022. This study introduced the ColonClean app alongside traditional methods. After examination, endoscopists rated the preparation quality using the Aronchick scale. A data analysis was conducted using SPSS 25.0 to determine if there was a significant improvement in bowel preparation quality between the control group (traditional method) and the experimental group (traditional method plus the ColonClean app). Forty patients were recruited in each group. In the experimental group, all ratings were "fair", with 75% receiving an "excellent" or "good" rating, showing statistical significance (p = 0.016). The ColonClean app improves bowel preparation quality more effectively than traditional care instructions. [ABSTRACT FROM AUTHOR]

Although nursing seems to understand itself and its practice as complex, the literature is less clear about what this actually means. While complexity is discussed as an attribute of nursing, it is also suggested that complexity in nursing remains misunderstood and poorly articulated, is devalued, is not considered as a measure of health outcomes and remains invisible. Despite the overarching lack of a definition, some nurse scholars have conceptualized complexity as a complex intervention. For these authors, complexity becomes a complex intervention defined as that which is composed of component parts interacting in a variety of ways that influence the delivery of and outcomes of health‐related interventions for populations. Conceptualizing complexity as a complex intervention forces nursing to embrace and adopt a received interpretation of complexity as expressed through complexity theory and complexity science. While complexity theory may afford us some tools for thinking about complexity, when we deconstruct nursing complexity to explicitly determinate and quantifiable tasks, this artificially narrowed orientation to complexity reveals an oversimplified explanation of the complexities associated with nursing and serves to blind us to its real qualities. Through a consideration of complexity from a Western philosophical tradition, I demonstrate that when nursing adopts the received interpretation of complexity as a complex intervention, this perspective on complexity contains nursing epistemologically and ontologically. I offer an extended conceptualization of complexity framed upon the consideration that nurses assume complexity and do not reduce it; that nurses have the capacity to not be paralysed by complexity and have developed logics to mobilize it in productive ways. Mobilizing complexity through navigating paradox and contradiction shapes an orientation to complexity that embraces an extended epistemology. This extended epistemology is characterized by a 'yes/and' mindset that expresses the dynamic and generative relationship between forms of knowledge which reflects complexity that characterizes nursing. [ABSTRACT FROM AUTHOR]

Background: Despite the innovative advancements in diabetes care, providers may not recognize patients with type 2 diabetes mellitus (T2DM) who qualify for a continuous glucose monitoring (CGM) device or the benefits of a telemedicine program for improving self-management behaviors. Objective: This quality improvement (QI) project aimed to determine if an advanced practice registered nurse (APRN)-led telemedicine program using CGM could improve glycemic control and self-management in patients with insulin-dependent T2DM. Methods: A 6-week telemedicine program was developed and implemented using the CGM's time-in-range to deliver patient-specific education. Clinical metrics were collected at each visit. All patients completed a pre- and postintervention Diabetes Self-Management Questionnaire-Revised (DSMQ-R) survey. Results: A repeated measures analysis of variance revealed that the telemedicine program had a statistically significant impact on time-in-range outcomes, F (2, 14) = 18.203, p <.001. Paired-samples t tests indicate that APRN-led education improved body mass index, t (8) = 4.232, p =.002; decreased systolic blood pressure, t (8) = 2.90, p =.010, and diastolic blood pressure, t (8) = 3.21, p =.007; and increased self-management skills as evidenced by DSMQ-R, t (8) = −5.498, p <.001. Conclusions: This QI project highlights multiple interventions for improving diabetes management in a primary care facility. Implications for Nursing: An APRN-led telemedicine program integrating CGM time-in-range data can improve glycemic control and self-management skills in patients with T2DM who administer insulin. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your awareness of the growing importance of personalised medicine in cancer services • To enhance your understanding of the support needs of patients who undergo genomic testing • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Knowledge of genomics and genetic testing is increasingly being used to inform cancer diagnosis, prognosis and effective treatment, known as personalised or precision medicine. The NHS aims to embed genomics into diagnostic pathways, meaning that it is becoming a routine aspect of cancer care. Therefore, it is important that cancer nurses have an understanding of genomics and personalised medicine so that they can provide appropriate information and support to patients and families. This article is designed to equip nurses with the skills to start essential genomic conversations with patients to support them through their cancer pathways. It focuses on Lynch syndrome, an inherited condition that increases the risk of developing certain cancers, and explains the genetics, testing, surveillance and psychological aspects of care for patients and families affected by this syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)