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Light can be a noxious stimulus during hospitalization. The study evaluated use of a red night-light intervention for hospitalized adults. The red light was found to be a feasible intervention and well received by participants., Environmental light is necessary for completing many patient care tasks. However, research has found light also can hinder patient recovery (Tahkamo et al., 2018). Although light is needed to perform [...]

Hospital readmissions are responsible for considerable health care costs. About 35% of patients with end stage renal disease (ESRD) who are hospitalized are readmitted within 30 days of discharge (United States Renal Data System, 2017). Studies point to the considerable percentage of readmissions that are preventable through effective discharge planning and patient follow-up after discharge (Mistiaen & Poot, 2006). Telephone follow up is a high-quality, low-cost method of providing discharge follow up. This project examined the effectiveness of an evidence-based quality improvement process in providing post-discharge telephone follow up to adult patients on hemodialysis by experienced nephrology nurses through standardized unit workflow and leveraging of the electronic medical record (EMR). Results indicated a lower percentage of admissions from the emergency department (59.9% pre- vs. 55.4% post-intervention) and a lower percentage of 30-day readmissions (28.4% pre- vs. 24.6% post-intervention). Key Words: Chronic kidney disease, end stage renal disease, post-discharge follow-up, 30-day readmissions., The Institute of Medicine (IOM) (2001) identifies quality improvement projects that improve communication and collaboration between the patient and healthcare providers as a key to improving health care. Avoidable readmissions [...]

Problem: Paroxysmal sympathetic hyperactivity (PSH) is a complicated phenomenon that presents as autonomic instability and muscle overactivity in individuals who experience severe brain injury. Identifying potential modifiable environmental nociceptive stimuli is necessary for developing interventions that impact clinical outcomes. Objective: The aim of this study was to identify physical environmental nociceptive stimuli that could hinder recovery for children who experience PSH after severe brain injury. Methodology: This study measured quantitative physical characteristics coupled with data from semistructured interviews, with parents and clinical nurses, to explore the elusive PSH phenomenon after severe brain injury in children. Results: Eight subjects were enrolled in the cohort study. Temperature showed a statistically significant association with PSH (P = .02), with lower temperatures associated with an increased chance of PSH. Blankets were also associated with PSH (P= .009), with the use of blankets associated with a greater chance of PSH. Persons, gown, position, head-of-bed elevation, incontinence of urine and stool, light level, and noise level did not point to a statistically significant association with PSH. Six nursing interviews were conducted with 2 guardian interviews. Themes that are emerging from the qualitative interviews included the priorities of strategies to target auditory, tactile, and visual stimuli. Conclusion: Paroxysmal sympathetic hyperactivity environmental strategies need to be explored further in subsequent studies. Environmental interventions could complement pharmacological strategies for the management of this elusive phenomenon with the goal of improving outcomes in children who experience severe brain injury and show PSH. Keywords: brain injury, paroxysmal sympathetic hyperactivity, pediatrics, symptoms, Paroxysmal sympathetic hyperactivity (PSH), which previously had been referred to as storming, is a cluster of symptoms that includes recurrent hyperthermia, hypertension, tachypnea, tachycardia, diaphoresis, and/or dystonia and has been [...]

At the 2014 AMSN Convention in Orlando, FL, we hosted a Town Hall on the integration of nutritional care to optimize patient outcomes. It was immediately apparent that medical-surgical nurses [...]

Feeding the patient is paramount to battling malnutrition in hospitalized patients. Although 'feeding the patient' sounds simplistic, many complexities stand in the way of consistently meeting the nutritional needs of [...]