Emory Authors: Design health care systems to protect resilience in nursing

“There is no one definition of resilience. It is a fascinating word because it simultaneously can invoke great meaning—such as the ability to reclaim purpose or dignity following trauma—and imply wholly different things to different people”

“Nurses were intimately familiar with moral distress and burnout prior to COVID-19. When the pandemic began, it brought an avalanche of stressors that piled on top of existing nursing strain from decades of cumulative, unaddressed system dysfunction. The nursing resignations that have followed are not a function of individual nurses’ mental strength or ability to perform self-care during off-hours; they are a function of many health care systems’ failure to recognize and invest in the nursing workforce. The truth is that the majority of nurses show a great capacity for resilience. Resilience is a requirement for long-term success in most nursing roles. (In ideal training settings, this inherent resilience is enhanced
through mentorship and teaching. During the pandemic, it was health care systems that crumbled under mounting pressures while nurses often carried the pieces.”

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Journal of Research in Nursing: Capturing the value and core concepts of the Clinical Research Nurse

“The art and science of the Clinical Research Nurse (CRN) role is found within the weaving of care throughout the research process, and the value added to patient care that this produces. CRNs play a vital role in improving patient care and contributing to enhanced treatment pathways through delivering and leading clinical research activities but research nursing is not simply about task-based actions. Rather, it amplifies the nursing values consistent within patient care provided by nurses across all settings. Recognition of this connection to the nursing process and the inherent skill of the CRN role can be difficult to capture. In addition, the role is often misunderstood within wider clinical practice, and the scope, value, and skills of the CRN are often under-utilized, possibly further exacerbated by a lack of formal research into the topic.”

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Guidance on preoperative fasting

“This multicentre prospective audit from the East Midlands region of the UK demonstrates poor compliance with national and international preoperative fasting guidelines. Patients were fasting from clear fluids and food much longer than is recommended, with the majority of patients undergoing elective surgery fasting >4 h from clear fluids and >12 h from food. Patients undergoing emergency surgery fasted for even more prolonged periods with the
majority fasting >12 h from clear fluids and >24 h from food.” (El-Sharkawy)

El-Sharkawy

El-Sharkawy, A. M. etal (2021). Fasting and surgery timing (FaST) audit. Clinical Nutrition, 40(3), 1405–1412.

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Emory Authors: Opioid utilization after orthopaedic trauma hospitalization among Medicaid-insured adults

“Opioids are vital to pain management and sedation after trauma-related hospitalization. However, there are many confounding clinical, social, and environmental factors that exacerbate pain, post-injury care needs, and receipt of opioid prescriptions following orthopaedic trauma. This retrospective study sought to characterize differences in opioid prescribing and dosing in a national Medicaid eligible sample from 2010–2018. The study population included adults, discharged after orthopaedic trauma hospitalization, and receiving an opioid prescription within 30 days of discharge.”

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Type III Diabetes and its role in dementia/alzheimer’s

“The exact connection between Alzheimer’s disease (AD) and type 2 diabetes is still in debate. However, poorly controlled blood sugar may increase the risk of developing Alzheimer’s. This relationship is so strong that some have called Alzheimer’s “diabetes of the brain” or “type 3 diabetes (T3D)”. Given more recent studies continue to indicate evidence linking T3D with AD, this review aims to demonstrate the relationship between T3D and AD based on the fact that both the processing of amyloid-β (Aβ) precursor protein toxicity and the clearance of Aβ are attributed to impaired insulin signaling, and that insulin resistance mediates the dysregulation of bioenergetics and progress to AD. Furthermore, insulin-related therapeutic strategies are suggested to succeed in the development of therapies for AD by slowing down their progressive nature or even halting their future complications.”

Nguyen TT, Ta QTH, Nguyen TKO, Nguyen TTD, Giau VV. Type 3 Diabetes and Its Role Implications in Alzheimer’s Disease. Int J Mol Sci. 2020 Apr 30;21(9):3165.

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How a good new hire experience can effect retention.

“Employee turnover is a key metric and performance indicator when evaluating the fiscal and operational effectiveness of any health-care facility. This article outlines a turnover analysis and onboarding program performance improvement initiative used by a 187-bed community hospital in the Washington DC metropolitan area to reduce staff turnover. Using an evidence-based approach, we evaluated facility staffing statistics, exit survey data, research literature, and industry exemplars.”
“Exit survey data identified only 50% to 62% of new employees who felt that: hospital orientation provided necessary information for successful employment; they had people to go to with concerns; and they had a realistic understanding of their job.” (Kiel)

Kiel

Kiel, J. M. (2020). An analysis of restructuring orientation to enhance nurse retention. The health care manager, 39(4), 162-167.

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Meaningful Recognition

“Nurse recognition has been viewed as a critical component of a healthy work environment. The American Association of Critical-Care Nurses (AACN) describes elements of meaningful recognition, including a formal process from the organization that has structured and
sustainable processes for recognizing the contributions of individuals. In this sense, meaningful recognition includes identifying and honoring the value a nurse brings to the organization. Nurses who feel recognized have higher compassion satisfaction and lower burnout and describe feelings of gratitude, respect, and appreciation from their patients.” (Joseph)

Joseph

Joseph, M. L., Kelly, L., Davis, M. B. H., Zimmermann, D., & Ward, D. (2023). Creating an Organizational Culture and Climate of Meaningful Recognition for Nurse Managers. JONA: The Journal of Nursing Administration, 53(7/8), 370–377

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