Gastroschisis: Impact of Bedside Closure on Ventilator-Associated Outcomes

Aim In our practice, preformed silos are routine rather than reserved for difficult cases. We aimed to identify whether silo and bedside closure can minimize: general anesthetic (GA) exposure, need for intubation and ventilation, or days intubated for neonates with simple gastroschisis (SG). Methods After approval, patients were identified via the neonatal discharge log (April 2010 to April 2019). Data were collected by case-note review and analyzed with respect to GA, ventilation, and core outcomes. Results Of 104 patients (50 female, mean birth weight 2.43 kg, mean gestational age 36 + 2 weeks), 85 were SG and 19 complex. Silo application was initial management in 70 SG, 57 completed successful bedside closure (by day 4 of life—median). Fifteen SG had initial operative closure.Of the 70 SG managed with silo, 46 (66%) had no GA as neonates. Twelve required GA for line insertion. Thirteen patients with initial silo had closure in theater (7 opportunistic at time of GA for line). Nine required intubation and ventilation out-with the operating theater during neonatal management. Seven had already been intubated at delivery; 3 because of meconium aspiration.One-hundred percent of those treated with operative closure had GA, 1 patient subsequently required surgery for subglottic stenosis. Time to full feeds did not differ between groups. Conclusion Silo and bedside closure allow the majority of SG neonates to avoid GA or intubation in the neonatal period, without increased risk of complication. However, it is important that the nursing expertise required to manage these patients safely is not underestimated.

The Contribution of Nursing to the Health of New Zealand

<p>Nursing in New Zealand, has been a recognised profession for one hundred years. Throughout this time the profession has made a significant contribution to the health of communities, nationally and internationally. Despite the obvious effort and achievement, the evidence of this contribution is not well known, is documented in a few literature sources only although it is talked about widely as part of 'myth and legend'. Nurses, now as never before, are challenged to show how they 'add value' and to explain why nursing expertise is essential to safe service delivery. Finding a way to communicate this contribution has been identified as one of the most important issues facing the profession. This thesis explores the concept of contribution and presents a model, the 'Contribution Model', to show how nursing can articulate the action and achievements that show how nursing professionals have and will continue to contribute to health gain in New Zealand. Through the application of the 'Contribution Model' and framework presented in this thesis, nursing is shown to have made a contribution to health gain by using the broad range of knowledge, skills and experiences in a wide range of settings, to provide care wherever and whenever required. Case studies and scenarios from history, observation and prediction are used to show how the actions and achievements of nursing meet the expectations of individuals, the community and society: past, present and future.</p>

The Contribution of Nursing to the Health of New Zealand

<p>Nursing in New Zealand, has been a recognised profession for one hundred years. Throughout this time the profession has made a significant contribution to the health of communities, nationally and internationally. Despite the obvious effort and achievement, the evidence of this contribution is not well known, is documented in a few literature sources only although it is talked about widely as part of 'myth and legend'. Nurses, now as never before, are challenged to show how they 'add value' and to explain why nursing expertise is essential to safe service delivery. Finding a way to communicate this contribution has been identified as one of the most important issues facing the profession. This thesis explores the concept of contribution and presents a model, the 'Contribution Model', to show how nursing can articulate the action and achievements that show how nursing professionals have and will continue to contribute to health gain in New Zealand. Through the application of the 'Contribution Model' and framework presented in this thesis, nursing is shown to have made a contribution to health gain by using the broad range of knowledge, skills and experiences in a wide range of settings, to provide care wherever and whenever required. Case studies and scenarios from history, observation and prediction are used to show how the actions and achievements of nursing meet the expectations of individuals, the community and society: past, present and future.</p>

Nurse Leader Expertise for Pandemic Management: Highlighting the Essentials

ABSTRACT The COVID-19 pandemic requires military nurse leaders in various patient care settings to engage in disaster response. Evidence supports essential leadership attributes for nurses that include skilled communication, organizational influence, and personnel management. Yet, nursing expertise that shapes nurse leader responsibilities during disaster management remains unclear. A description of how military nurse leaders contributed their nursing expertise during the COVID-19 pandemic response at one U.S. Military health care facility is provided to begin to delineate disaster management responsibilities.

The Impact of Family Strengths Oriented Therapeutic Conversations on Parents of Children with a New Chronic Illness Diagnosis

A growing number of families with children are dealing with a new diagnosis of chronic illnesses or health problems that are demanding. Nurses are in a prime position to provide support and empowerment to these families. The aim of the study was to evaluate the benefits of two sessions of a Family Strengths Oriented Therapeutic Conversation (FAM-SOTC) intervention, offered by advanced practice nurses (APNs) to mothers ( N = 31) of children and adolescents in Iceland with newly diagnosed chronic illnesses/disorders. Families of children with Juvenile Idiopathic Arthritis (JIA), epilepsy, Type 1 diabetes (T1DM), or with sleep disturbance with attention-deficit/hyperactivity disorder (ADHD), reported significantly higher family support, greater conviction about their illness beliefs, increased quality of life, and greater satisfaction with health care services after receiving two sessions of the FAM-SOTC intervention (Time 2) compared to before the intervention (Time 1). The findings emphasize the importance of the APN’s role and family nursing expertise in supporting families of children with a new diagnosis of chronic illnesses or disorders who are in active treatment.

Evaluasi penyelenggaraan program keahlian keperawatan di Sekolah Menengah Kejuruan (SMK)

Penelitian ini bertujuan untuk melakukan analisis terhadap jalannya penyelenggaraan program keahlian keperawatan di tingkat sekolah menengah kejuruan. Jenis penelitian ini adalah penelitian evaluasi mengguna-kan pendekatan dekriptif kualitatif dengan model evaluasi CIPP. Subyek pada penelitian ini adalah kepala sekolah, wakil kepala kurikulum, wakil kepala sarana dan prasarana, ketua program keahlian keperawatan, bursa kerja khusus, guru keperawatan, dan pegawai tata usaha. Teknik pengumpulan data penelitianini menggunakan observasi, wawancara, dan studi dokumentasi. Pada penelitian ini mengunakan teknik analisis data Miles dan Huberman. Validasi data dilakukan dengan triangulasi teknik dan triangulasi sumber. Hasil penelitian menunjukkan komponen context dalam kategori baik, komponen input dalam kategori baik, komponen process dalam kategori baik tetapi terdapat beberapa kendala, komponen product dalam kategori cukup karena tidak memenuhi kriteria yang ditentukan yaitu jumlah kesesuaian kerja lulusan kurang dari 50%. AbstractThis research aims to analyze the implementation of the nursing skills program at the vocational high school level. The type of research is evaluation research using a qualitative descriptive approach with the CIPP evaluation model. The subjects in this research were the headmaster, deputy head of curriculum, deputy head of facilities and infrastructure, head of nursing expertise program, special job fair, nursing teachers, and administrative staff. The research data collection technique uses observation, interviews, and documentation studies. Data validation uses technical triangulation and source triangulation. The results showed the context component was in the good category, the input component was in a good category, Process components are in good category but there are some constraints, while the product component in the sufficient category because it does noit meet the specified criteria, the amount of work suitability of graduates is less 50%.

Cardiomiopatia não compactada: estudo de caso sob a ótica da sistematização da assistência de enfermagem

Objetiva-se identificar os principais diagnósticos de enfermagem do cliente portador de miocardiopatia nãocompactada, descrevendo as intervenções de enfermagem associadas. Trata-se de um estudo de caso clínico,embasado na identificação de problemas, elaboração dos diagnósticos de enfermagem segundo a taxonomiaNANDA 2015-2017; e a implementação de intervenções, a partir dos registros em prontuário da Sistematização daAssistência de Enfermagem e outros dados clínicos. Estudo desenvolvido em um hospital universitário na cidadedo Rio de Janeiro, com coleta de dados entre março e maio de 2015. Evidenciou-se diagnósticos de ansiedade,débito cardíaco diminuído, falta de adesão e disposição para autocontrole da saúde melhorado. Concluí-se aevidente relação entre a falta de adesão à terapêutica proposta e as repercussões patofisiológicas. O plano deação, de expertise do enfermeiro, pode identificar padrões de comportamento e planejar ações para educação docliente para auto-avaliação de sinais e sintomas de descompensação, melhorando a qualidade de vida.Palavras-chave: Cardiomiopatia Dilatada; Avaliação em Enfermagem; Diagnóstico de Enfermagem. ABSTRACTThe aim is to identify the main nursing diagnoses applied to patients with noncompaction cardiomyopathyand the associated nursing interventions. This is a case study, based on care problems identification, with thedevelopment of nursing diagnoses according to NANDA taxonomy 2015-2017; and the interventions, based onthe nursing care records and other medical data. The study was conducted in a public hospital in the city of Rio deJaneiro, with data collection between 2015 March and May. The results showed anxiety, decreased cardiac output,compliance behavior and willingness to self-management of have current living were considered as importantnursing diagnoses. It concludes that the evident relationship between the lack of compliance to the proposedtherapy and pathophysiological implications. The action plan and nursing expertise can identify behavioralpatterns and actions for patient education for self-assessment of signs and symptoms of health status decrease,improving the quality of life.Keywords: Dilated Cardiomyopathy; Nursing Assistance; Nursing Diagnosis.