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The evaluation of aortic valve calcium burden is important when planning for transcatheter aortic valve implantation (TAVI). Although a robust golden standard methodology is available for calcium evaluation on noncontrast-enhanced (NCE) computed tomographic (CT) series, a standard reference for calcium assessment on contrast-enhanced CT series is currently lacking.

Two hundred and forty-four preprocedural CT scans from patients who had received TAVI were analysed. We correlated the aortic calcium volumes obtained on CE series at three thresholds [450, 850, and 'probe + 100' Hounsfield Units (HU)] with the Agatston score obtained on NCE scans. A subgroup analysis was performed taking into account the contrast enhancement of the left ventricular outflow tract (LVOT), with a prespecified cut-off of 300 HU.

The overall population analysis showed higher correlation with the Agatston score using the 850 HU threshold (r = 0.45, P < 0.0001); no correlation was found with the 450 HU threshold, whilst the 'probe set in the software is 450 HU, whereas in patients with LVOT HU of at least 300 the correct threshold is 850 HU.
Antibiotics have been shown to be an essential component in the treatment of open extremity fractures. The American College of Surgeons' Trauma Quality Improvement Program, based on a committee of physician leaders including orthopedic trauma surgeons, publishes best-practice guidelines for the management of open fractures. Accordingly, it established the tracking of antibiotic timing as a metric with a plan to use that metric prior to trauma center site reviews. Our hypothesis was that this physician-led effort at the national level would provide the necessary incentive to effect change within our institution.

A retrospective review of all patients treated at our institution for open extremity fractures was performed over three time periods separated by two quality initiatives. The first initiative was an institution-driven effort to increase awareness and educate specific departments about the importance of prompt antibiotic administration. alpha-Naphthoflavone purchase The second initiative was the tracking of antibiotic order and vels of evidence.In an effort to streamline educational initiatives at our institution, we developed the Nursing Education and Competency Algorithm and the Nursing Education and Competency Advisory Panel. The Nursing Education and Competency Algorithm serves as a framework in differentiating education and competency through standardization of practice. Utilizing the algorithm assists in distinguishing initiatives as one time, on-going, or if they are specific to a specialty. The Nursing Education and Competency Advisory Panel serves as a vetting structure to improve collaboration through decision-making and shared governance.
We aimed to quantify faculty and student perceptions of scholarly activities for doctor of nursing practice (DNP) and PhD leaders.

The American Association of Colleges of Nursing describes DNP as a practice-focused degree and PhD as a research-focused degree. In 2016, the Council on Graduate Education for Administration in Nursing (now Association for Leadership Science in Nursing) published in the Journal of Nursing Administration sample practice objectives for DNP and research objectives for PhD leaders.

Using the published objectives, we surveyed faculty and students to quantify congruence with the publication and consistency within groups. The data informed intraprofessional education constructed using action research.

There was low congruence between faculty and student responses with the article. PhD faculty had the least, and PhD students, the greatest, consistency in survey responses.

Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.
Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.
To examine changes in registered nurse (RN) perceptions of electronic documentation over a 4-year period.

The investigators previously reported differences in RN perceptions prior to and 1 year after adoption of a comprehensive electronic health record (EHR).

Investigators repeated the study 4 years after adoption, using the Nurses' Perceptions of Electronic Documentation tool and interviews with a subset of RNs.

Nurses scored higher on ease of use domain and lower on concern about the EHR domain and showed no difference on the impacts of the EHR domain. Interviews revealed that 4 years later, some aspects of documentation were easier; the tool was comprehensive, but not without risk, and nurses remained ambivalent about the EHR.

Use of EHR technology impacts nursing work. It is important to understand how nurses' perceptions change over time. This study gives nursing leaders insight into adoption and acceptance of an EHR.
Use of EHR technology impacts nursing work. It is important to understand how nurses' perceptions change over time. This study gives nursing leaders insight into adoption and acceptance of an EHR.Nurse managers are an integral part of the healthcare system and have powerful influence at the point of service. The experience of joy and meaning in the work of healthcare contributes to achievement of positive outcomes. This study aimed to learn how nurse managers described joy and meaning in their practice. Results included 5 themes to mentor and be mentored, to focus on the patient, to create and cultivate environments, to be optimistic, and to be empowered by leaders. The themes are described and illustrated with participant quotes. Specific implications for organizations and leaders are discussed.Mobile supplemental hospitals were an important asset to community response in preparing for the recent pandemic. MED-1 is a Mobile Emergency Department that has adapted and evolved to the changing needs of communities in times of disaster and nondisaster. An overview of the asset (MED-1), the operations, and use is provided to demonstrate how mobile supplemental hospitals can effectively meet a range of healthcare needs. Innovative utilization of MED-1 has secured its future as an effective resource averaging 100 days of deployment per year.
In the literature, an abundance of stories exist describing patient situations and caregiver actions, but only 2 studies were identified that outline DAISY honorees' actions and behavioral characteristics.

This study utilized patient nomination data and DAISY honoree insight to identify and gain better understanding of the characteristics and behavioral traits of DAISY nurses.

A grounded theory approach and purposive sample were used in this study, which was conducted in 2 phases using 2 different data sets. In phase 1, the NarrativeDx AI platform generated insights from DAISY nomination comments. In phase 2, a survey was administered to DAISY honorees collecting descriptive data that were analyzed in SPSS, whereas insights on DAISY nurses were collected via open-ended responses and analyzed using NVivo software.

Three themes emerged in phase 1 from DAISY nomination data caring, knowledge/skills, and reliability. A total of 37 DAISY honorees participated in phase 2. Most participants were bachelor's dnding of this exemplary group of nurses. Insights could be incorporated into training and practice programs aimed at increasing patient and nursing satisfaction.
Hospital flow disruptions have been linked to treatment delays, longer length of stay (LOS), poor patient outcomes, and overburdened staff leading to disengagement.

This project was designed to evaluate and determine if the bed reaggregation was successful at meeting its goals.

Donabedian's framework guided the following evaluation points 1) patient placement accuracy, 2) LOS variance, 3) emergency department (ED) boarding times, 4) hospital bypass hours, 5) operational declination rates, 6) patient satisfaction, and 7) RN engagement. Data were analyzed using pre-post percent change and χ analysis.

Primary placement of patients, LOS variance, and operational declinations improved. Hours on bypass and ED boarding times were not reduced. RN engagement scores varied widely with significant decreases on 2 of the reaggregated units. Patient satisfaction scores varied, but overall did not decrease.

Further consideration is needed for improving hospital bypass, ED boarding times, and RN engagement.
Further consideration is needed for improving hospital bypass, ED boarding times, and RN engagement.
To examine the association between organizational safety climate (OSC), in-hospital mortality (IM), and failure to rescue (FTR) in 2 hospitals, 1 with and 1 without crew-resource-management training.

OSC is 1 of the most important organizational factors that promotes safety at work; however, there is a lack of research examining the relationship between OSC and patient deaths in hospitals.

We utilized a matched 2-group comparison of surgical patients and surveyed surgical staff to assess the relationship between OSC, FTR, and IM.

The OSC assessment was completed by 261 surgical team members. A total of 1764 patients had at least 1 FTR complication; however, there was no association between OSC with FTR or IM for either hospital.

Nurse leaders should remain vigilant in building work teams with strong hospital safety climates. More research is needed to explore the relationship between OSC and patient outcomes.
Nurse leaders should remain vigilant in building work teams with strong hospital safety climates. More research is needed to explore the relationship between OSC and patient outcomes.This article describes a survey exploring the use of professional introductions by nurses.For this project, a survey inquiring about introduction practices was administered to nurses attending a regional research conference.This article describes the formation of a Regulatory Advisory Council to address regulatory preparedness. The council used quality improvement methods to address data and findings from previous mock surveys and created 2 categories of work, an environment of care and clinical standards group, with checklists and work streams to improve organizational success with regulatory readiness.Acute care nurse practitioners (NPs) are educated, clinically trained, and board certified to care for acutely and critically ill patients, largely in hospital settings. Acute care NPs can positively impact patient care outcomes and are often added to acute care teams to drive optimal, reliable, efficient, and safe care, often referred to as "high value" care.In this month's Magnet Perspectives column, guest author Kathleen Martinez, MSN, RN, CPN, joins Rebecca Graystone, MS, MBA, RN, NE-BC, for an in-depth look at the explosive growth of ambulatory care nursing over the past decade. The authors take a deep dive into multiple factors contributing to this rapid evolution, the role of the Magnet Recognition Program in accelerating and supporting ambulatory care and the nurses who provide it, and the prospects for continued growth in the decade ahead.
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