Nursing research
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Multicenter Study Comparative Study
Anesthesia staffing and anesthetic complications during cesarean delivery: a retrospective analysis.
Obstetrical anesthesia services may be provided by Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, or a combination of the two providers. Research is needed to assist hospitals and anesthesia groups in making cost-effective staffing choices. ⋯ There is no difference in rates of complications between the two types of staffing models. As a result, hospitals and anesthesiology groups may safely examine other variables, such as provider availability and costs, when staffing for obstetrical anesthesia. Further study is needed to validate the use of ICD-9-CM codes for anesthesia complications as an indicator of quality.
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Several pain observation scales have been developed to accurately assess and manage pain in older adults with severe cognitive impairments, communication difficulties, or both. ⋯ As different methods of evaluating reliability and validity were used, and different aims (e.g., type of pain) were pursued, the available scales cannot be compared easily. Nevertheless, a few are promising, given preliminary results. These should be examined further on psychometric properties and usefulness in different populations because optimal pain assessment is necessary for efficient and effective pain treatment.
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More patients are receiving healthcare services from nurse practitioners (NPs) and physician assistants (PAs). These providers are likely to be confronted with a variety of ethical issues as they balance quality care with their patients' rising cost concerns. However, very little is known about the ethical conflicts and causes of these conflicts experienced by these clinicians in their daily practice. ⋯ NPs and PAs are experiencing ethical conflict often associated with their perceived professional obligations to advocate for patients. Being well-prepared in ethics and having sufficient professional independence help clinicians balance the ethical complexities and demands of meeting patients' needs within a constrained healthcare system.
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Family caregivers of stroke survivors experience a variety of negative social, emotional, and health-related outcomes as a result of providing care. ⋯ The revised 15-item BCOS has evidence of satisfactory reliability and validity in family caregivers of stroke survivors. The BCOS is a valuable measure in research and can be used to identify priority areas for nursing interventions designed to improve caregivers' outcomes.
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Innovative theoretical models are needed to explain the occurrence of high-risk sexual behaviors, alcohol and other-drug (AOD) use, and academic engagement among ethnically diverse, inner-city adolescents. ⋯ Findings support the theoretical model's credibility and provide evidence that differentiation of self is an important cognitive factor that enables adolescents to manage chronic anxiety and motivates them to use effective problem solving, resulting in less involvement in health-comprising behaviors and increased academic engagement.