Nursing research
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Valid and reliable instruments are needed to measure communication interaction behaviors between nurses and mechanically ventilated intensive care unit patients who are without oral speech. ⋯ Preliminary results suggest that the revised CIBI has good face validity and shows good interrater reliability for many of the behaviors, but further refinement is needed. The use of dual raters with adjudication of discrepancies is the recommended method of administration for the revised CIBI.
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Delirium increases mortality and length of stay among hospital inpatients. Little is known about the incidence of delirium among inpatients receiving care in internal medicine nursing units in Spain. ⋯ Increased age and presence of a urinary catheter were associated with increased onset of delirium, whereas higher levels of independence in activities of daily living were protective.
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Assessing the impact of individual journal articles provides information for understanding trends in science and translation of findings on practice. Citation analysis is an important way to highlight the contributions of individual author/investigator and journals on nursing practice. ⋯ The findings provide insights into priorities and trends in nursing research and translational science.
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Although higher levels of registered nurse (RN) staffing in nursing homes are related to better care quality, licensed practical nurses (LPNs) provide most licensed-nursing care; prior research is mixed regarding how this influences quality. The nature of LPN practice, and RN direction of that practice, follows in part from state nurse practice acts (NPAs). ⋯ Care quality was better in states where the NPA clearly described LPN scope, but only when there was also greater RN availability (p < .05). Classifying scope of nursing practice regulations moves beyond traditional staffing measures to inform understanding of the effects of the RN-to-LPN staffing ratio on quality of care in nursing homes.
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Studies about nurse staffing and patient outcomes often lack adequate risk adjustment because of limited access to patient information. ⋯ Inadequate risk adjustment may lead to biased estimates about nurse staffing and patient outcomes. Combining physiological measures with commonly used administrative data is a promising risk-adjustment approach to reduce potential biases.