RESUMEN
PURPOSE: This quality improvement project was introduced at an addiction treatment center to implement the Centers for Disease Control and Prevention's (CDC's) hepatitis C virus (HCV) treatment guidelines and offer anticraving medications to patients to improve standards of care of patients with substance use disorders. LITERATURE REVIEW: Patients with opioid use disorders are at the highest risk of contracting HCV. More than 80% of people in the United States with opioid use disorders who use intravenous drugs have contracted HCV. Despite the high prevalence of HCV, patients at treatment centers are being screened only for HCV antibodies (HCV-AB) and are not receiving the CDC's HCV treatment guidelines. The CDC has treatment recommendations of hepatitis panels, full STD testing, and early follow-up care. METHOD: This quality improvement project utilized the Plan-Do-Study-Act tool. With the application of Plan-Do-Study-Act, for patients identified with HCV-AB, the established CDC HCV treatment guidelines were followed, and the clinical progress of the implementation of the guidelines was monitored. Chart reviews comparing compliance of guidelines before and after the study were implemented. PARTICIPANTS: A convenience sample of 125 patients were collected, and of these, 32 patients were found to be HCV-AB+. FINDINGS: The findings revealed that 18.75% of patients followed the CDC's HCV recommendations after the quality improvement project compared with 6.25% of patients before the intervention. The number of HIV testing offered increased by 40.00% as a result of the implementation of the project.
Asunto(s)
Hepatitis C , Trastornos Relacionados con Opioides , Humanos , Estados Unidos , Hepacivirus , Mejoramiento de la Calidad , Hepatitis C/tratamiento farmacológico , Hepatitis C/prevención & control , Hepatitis C/epidemiología , Centers for Disease Control and Prevention, U.S.RESUMEN
The death of one's mother during childhood is the severing of one of the most important human bonds. The child may suffer periods of grief that continue into adulthood and throughout life. The nurse has a vital role in assisting women traumatized by loss of a mother at a young age. This article discusses the experience of maternal loss and notes care needs of the motherless child-adult woman. Identification of women in this situation should be made as early as possible.
Asunto(s)
Cristianismo , Pesar , Núcleo Familiar/psicología , Rol de la Enfermera/psicología , Apego a Objetos , Adaptación Psicológica , Adolescente , Niño , Femenino , Humanos , Relaciones Madre-Hijo , Calidad de VidaRESUMEN
Team-focused, high-performance cardiopulmonary resuscitation (TF-HP-CPR) improves the return of spontaneous circulation (ROSC) among patients with out-of-hospital cardiac arrest (OHCA) events. In 2010, the American Heart Association began endorsing TF-HP-CPR (). A rural-area Virginia emergency medical services (EMS) system receives assistant medical oversight from an emergency nurse practitioner (ENP). The ENP is responsible for assisting the physician medical director in promoting continuous quality improvement (QI) within the EMS system. In January 2018, a QI project implemented a TF-HP-CPR protocol. The QI project encompassed the provision of education for EMS personnel about TF-HP-CPR with mock code evaluations. The protocol incorporated a newly designated blind insertion airway device and integrated the routine monitoring of end-tidal carbon dioxide (ETCO2) values. The QI project also introduced postresuscitation attempt report cards that were completed by the team leader at the conclusion of each CPR event. A random 16-week sample of patients with OHCA just before implementation of the QI project was analyzed and compared with patients who experienced an OHCA event within a 16-week period after implementation of the TF-HP-CPR protocol. The preimplementation group had 13 patients compared with 11 patients in the postimplementation group. The rate of ROSC in the preimplementation group was 38.46% compared with 54.55% in the postimplementation group. Although the rate of ROSC increased by 16.09%, the findings were not statistically significant (p = 0.6824) and were perceived to be likely due to the small sample sizes. The implementation of a TF-HP-CPR protocol improved the rate of ROSC among patients with OHCA; however, the findings were not statistically significant. A more extensive study is essential for further evaluation.
Asunto(s)
Reanimación Cardiopulmonar/métodos , Protocolos Clínicos , Servicios Médicos de Urgencia/organización & administración , Grupo de Atención al Paciente , Servicios de Salud Rural/organización & administración , HumanosRESUMEN
Nurses provide care for people of many cultures. Understanding the patient's culture and incorporating cultural beliefs and practices into care are important to the patient's holistic well-being. Cultural and professional awareness creates culturally congruent care. Biblical teachings remind us to love one another; laws require culturally appropriate care, and nursing theory lays the path for understanding. The purpose of this article is to present a Christian view of caring, the theoretical and ethical underpinnings of cultural care, and the organizational and legal aspects of doing what is right.
Asunto(s)
Competencia Cultural , Enfermeras Parroquiales , HumanosRESUMEN
PURPOSE: To explore the lived experience of women over the age of 21 who lost their mothers before the age of 18. METHODS: Using qualitative methodology, motherless child-adult women were gathered through emails, word of mouth, and snowballing techniques. Interviews were conducted at the convenience of the women. The women coparticipated with identification of emerging themes using thematic analysis. RESULTS: Eight women who lost their mothers before the age of 18 participated. Eight themes emerged: (1) Understanding: For wounded hearts only; (2) Coming apart: Finding my mother's daughter and self-worth; (3) Unconditional love: Grieving for and identifying with my champion; (4) Finding help: Filling the empty place with God; (5) Pitying the motherless child: Making it worse; (6) Filling in: Others as mother; (7) The ebb and flow: Grieving; and (8) Becoming mother: Taking on the Role. CLINICAL IMPLICATIONS: The nurse has the opportunity to improve care for women who lost their mothers before the age of 18 years. During pregnancy, childbirth, and childrearing, the woman may feel sad and anxious without the guidance of her mother. Special ways of caring may be instituted to provide her comfort such as allowing and encouraging her to bring a special item of her mother's to procedures and events so that she may feel connected with her, allowing someone to stand in for her mother, perhaps assisting in finding of another motherless child adult to be with her as needed, and the voicing of understanding of her loss while remaining nonjudgmental about her emotions during these times.
Asunto(s)
Actitud Frente a la Muerte , Relaciones Madre-Hijo , Núcleo Familiar/psicología , Percepción , Adulto , Anciano , Femenino , Pesar , Humanos , Acontecimientos que Cambian la Vida , Persona de Mediana Edad , Madres/psicologíaRESUMEN
Faced with the knowledge that smoking is dangerous, women continue to smoke cigarettes, and the number is growing. In contrast, breast cancer is being diagnosed earlier, and women are listening to the call for mammograms and examination screenings. Why then, are women not listening to the call to never start or stop smoking? In nursing today it has become necessary to put forth a greater effort to call attention to the toll of lung cancer and other smoking related diseases. There is significant disparity in smoking groups targeted for research. One particular group has been ignored in past research, the middle-aged woman. Research is needed to understand why women use tobacco products in this group and to find what is needed to discourage smoking. In this article, we explore nursing research in the area of middle-aged women and tobacco use. Interlaced throughout the literature review is the story of a 57 year old female and her experiences with smoking.