Nursing最新文献

Abstract: Meaningful recognition plays a critical role in improving nurse engagement, job satisfaction, and retention. This project introduced the Recognition Toolbox, a structured initiative implemented at an urban academic medical center aimed at strengthening recognition at both the hospital-wide and unit levels. Guided by the American Association of Critical Care Nurses Healthy Work Environment Standards and implemented using the Plan-Do-Study-Act cycle, the initiative addressed gaps in staff appreciation. Postintervention results showed an increase in active unit-based recognition programs from 25% to 62%, staff effectiveness ratings in the moderately to extremely effective categories increasing from 21.59% to 41.18%, and DAISY Award nominations rising from 54 to 170. Turnover rates declined from 22.7% to 15.7%. These findings support the impact of meaningful recognition efforts on workforce stability and staff morale.

Abstract: The United States faces a persistent nursing shortage, intensified by a critical lack of nurse educators and the underrepresentation of faculty from diverse racial and ethnic backgrounds. This shortage restricts the capacity of nursing schools to enroll and graduate enough students, contributing to workforce gaps, increased burnout, and high attrition rates across the health care system. Racial and ethnic minority populations experience disproportionately higher rates of chronic illness, mortality, and lower life expectancy-inequities often rooted in structural barriers and a lack of culturally responsive care. A nursing workforce that reflects the cultural and ethnic diversity of the communities it serves is essential for reducing disparities, enhancing patient outcomes, and delivering equitable care. The Nurse Education Track initiative-a local, grant-funded program discussed in detail in this article-aims to enhance the diversity and quality of the nursing workforce by recruiting nurses from underrepresented backgrounds, such as minorities, veterans, individuals with disabilities, and diverse age groups, into advanced nursing education programs. This initiative seeks to address the critical gap in diverse nurse educators, which negatively impacts the recruitment, retention, and graduation rates of underrepresented nursing students. By fostering a more inclusive nurse educator workforce, the NET program will contribute to improved health care outcomes, greater cultural competence in nursing education, and the reduction of health disparities.

Abstract: Peripheral nerve blocks (PNBs) are a key component of multimodal analgesia, offering effective postoperative pain control with minimal adverse effects. Widely utilized in various surgical procedures involving the upper and lower extremities, thorax, abdomen, and spine, PNBs enhance perioperative care by reducing opioid consumption, improving pain management, and minimizing anesthesia-related complications. The use of ultrasound-guided techniques has significantly improved the efficacy and safety of PNBs, ensuring precise needle placement, reducing complication rates, and increasing patient satisfaction. Compared with traditional systemic analgesia and general anesthesia, PNBs provide superior regional analgesia with fewer adverse effects, making them an essential tool in modern anesthesia practice. Despite their benefits, PNBs are associated with certain risks, including local anesthetic systemic toxicity, nerve injury, bleeding, and infection. Proper patient selection, preoperative evaluation, and nursing vigilance are crucial in mitigating complications and optimizing patient outcomes. This article explores the role of PNBs in perioperative pain management, highlighting their advantages, techniques, and considerations to ensure safe and effective implementation in clinical practice.

Abstract: Chronic myelomonocytic leukemia (CMML) is a rare, aggressive type of leukemia that can exhibit myeloproliferative and myelodysplastic features and has a propensity to transform into acute myeloid leukemia (AML). CMML is characterized by specific cytogenetic abnormalities and identified laboratory findings that support the diagnosis. Clinical manifestations of the disorder depend on disease subtype. Current treatments are supportive with a goal of increasing time to transformation into AML and decreasing end-organ damage. The only known cure for CMML is allogeneic stem cell transplant. This article discusses the pathophysiology, diagnosis, complications, and management of CMML, as well as nursing considerations when caring for patients with this hematologic malignancy. It aims to define unique characteristics of CMML to aid nurses in providing effective care to these patients.

Abstract: Clinical recommendations regarding nephrostomy management draw from best practices in wound and catheter care and urinary system pathophysiology. However, existing challenges include inconsistencies in dressing techniques, patient education, and outpatient follow-up. This article discusses a project that assessed current management approaches-addressing patient experiences, material procurement difficulties, and interdisciplinary strategies-and proposed a structured care framework based on expert consensus.This project established a standardized nephrostomy care pathway by integrating scientific evidence with real-world management considerations. The framework proposed by experts enhances patient autonomy, optimizes nursing interventions, and addresses systemic inefficiencies.