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Simulation training has been used in many avenues such as aeronautics, law enforcement, and healthcare to assist in training personnel to learn a new task and perform highly technical procedures. Simulation training has demonstrated beneficial for providing low-use, high-risk jobs such as landing a plane with a complete engine failure, performing reconstructive surgery, and even emergent lifesaving procedures. Our simulation training group chose to develop our custom hands-on training to perform emergent re-sternotomy on the post-open-heart patient based upon this belief. The goal of this project was to assist the bedside intensive care nurse in their self-perception of being comfortable and proficient in helping the physician with the procedure of an emergent re-sternotomy on the post-surgical open-heart patient. Measurement of self-perception of comfort and proficient was measured with a pre/post-questionnaire. The pre/post-questionnaire results showed improvement ranging from an increase in self-scoring from 1.2 to 1.7, with statistical significance demonstrated with a p <0.05.

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BACKGROUND: Myasthenia gravis (MG) is a rare and chronic autoimmune neuromuscular disease that causes weakness among skeletal muscles responsible for mobility and breathing. Individuals with MG who have difficulty breathing may need to schedule an emergent provider visit where a negative inspiratory force (NIF) measurement test is performed to measure respiratory strength. PURPOSE: Examine the feasibility of individuals with MG to perform NIF respiratory function monitoring in the home setting and determine its impact on their perceived quality of life. METHODS: This is a quantitative one-group pretest-posttest study of 30 individuals (18-75 years old) who carry the diagnosis of MG and have been stable with treatment for at least 30 days. Participants completed the Brunnsviken Brief Quality of Life Scale (BBQ-LS) and the System Usability Scale (SUS) prestudy. Participants were required to independently perform and record their NIF measurements twice daily for 14 days. After completing the 14 days, participants completed the BBQ-LS, SUS, and an end-of-study survey. RESULTS: There was a significant difference in BBQ-LS scores at baseline (M = 62.97, SD = 17.84) and poststudy (M = 98.2, SD = 13.63) (t[29] = -5.39, p <.000). System Usability Scale scores were significantly different at baseline (M = 77.25, SD = 11.05) than at study completion (M = 94.42, SD = 5.64) (t[29], = -8.04, p = .000). CONCLUSION: Study results indicate that it is feasible for individuals with MG to perform NIF readings in the home setting and demonstrated an increase in the perceived quality of life. IMPLICATIONS: Future large-scale studies can help determine the adoption of handheld NIF monitoring at home for individuals with MG.

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Myasthenia gravis (MG) is an autoimmune neuromuscular disorder that can affect the ocular, bulbar, neck, proximal limb, and respiratory muscles. This case study presents two similar individuals diagnosed with MG that presented with varying symptomatology and also with a different response to therapy. These two patients represent a unique patient group that represents only 10% of patients diagnosed with MG.

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Qualitative research can be an unfamiliar type of research for some individuals in the nursing PhD program, and it can also be an unfamiliar aspect of any healthcare individual's experience. This paper presents my first experience with different aspects of qualitative research and the application of Merton's theory of unanticipated consequences to this experience.

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Myasthenia gravis is a chronic neuromuscular disorder that causes skeletal muscle weakness. Typically, myasthenia gravis affects the ocular, bulbar, neck, proximal limbs, and respiratory muscles. Although the presentation is typically observed with complaints of vision and bulbar symptoms such as diplopia, dystonia, and dysphagia, this article presents a case study of an elderly man with a history of increasing upper extremity weakness with complaints of worsening hand dexterity and intermittent episodes of expressive aphasia. After cervical laminectomy with fusion, this gentleman was admitted to the medical intensive care unit, in a complete myasthenic crisis.

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This article presents a case study of a young man with a history of epilepsy and the use of a propofol infusion to control his symptoms. Propofol-related infusion syndrome is presented.

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