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Biomedical subjects

Janie Heath

Publications and source records attributed to Janie Heath.

At least 19 recordsLinked to original sources
PubMed2006

Application of the Synergy Model with the surgical care of smokers.

The Synergy Model for Patient Care, developed by the American Association of Critical-Care Nurses (AACN), demonstrates that positive patient outcomes are achieved when patient characteristics are matched with nurse competencies. This article describes how effective nursing practice, whether providing smoking cessation counseling or evaluating preoperative laboratory tests, must be centered around the needs and characteristics of patients. Smokers requiring surgical intervention have unique needs and require nurses with competent skills to help promote optimal pulmonary, cardiovascular, and wound healing outcomes.

Attitude to Health↗
PubMed2006

Providing smoking cessation counseling: a national survey among nurse anesthetists.

Current research has demonstrated that smokers have an increased incidence of intraoperative and postoperative complications. Certified registered nurse anesthetists (CRNAs) have knowledge of a patient's smoking status and are in a unique position to provide smoking cessation counseling (SCC). The results from a national survey about SCC practice among CRNAs is revealed in this article.

Adult↗
PubMed2006

Using the Rx for Change tobacco curriculum in advanced practice nursing education.

In today's health care system driven by quality outcome indicators and performance care measures, it is essential for nurses to know how to intervene with tobacco-dependent patients. This article discusses pilot results from the "Rx for Change: Clinician Assisted Tobacco Cessation Curriculum" intervention conducted at Georgetown University School of Nursing and Health Studies using advanced practice students. The results reveal that 6 hours of tobacco-cessation training can increase knowledge and self-efficiency scores.

Adult↗
PubMed2006

Tobacco and its trendy alternatives: implications for pediatric nurses.

Although acute and critical care pediatric nurses may not rank tobacco prevention and cessation among their top patient-care priorities, the importance of providing health education, especially during vulnerable moments, cannot be overlooked. This article provides an overview of trendy tobacco alternatives, such as bidis, clove cigarettes, hookah pipes, and smokeless tobacco, that entice youth. The significant health consequences of these tobacco products and the implications for pediatric acute and critical care nursing practice are also discussed.

Acute Disease↗
PubMed2005

Journey to the Beacon Award: the Georgetown University Hospital perspective.

The medical intensive care unit (MICU) at Georgetown University Hospital in Washington, D.C., was among the first four hospitals to be awarded the Beacon Award from the American Association of Critical- Care Nurses. The Beacon Award is given to those units that prove, through a 42-question application, how they excel and serve as a guiding light to other intensive care units. The MICU's "journey" to the award prompted an introspective look into the unit, its policies, and its methods of providing the highest quality patient care, in an environment that is supportive to the nursing staff.

Attitude of Health Personnel↗
PubMed2005

Defibrillation and biphasic shocks: Implications for perianesthesia nursing.

Cardiac arrests, the majority of which are due to ventricular fibrillation (VF), are a significant threat to survival. The definitive therapy for cardiac arrests due to VF is rapid, early defibrillation. There have been several advances made to modern defibrillators to electively or emergently terminate lethal and nonlethal arrhythmias through external defibrillation. The most recent improvement is in the efficacy of the delivered shock. Biphasic shock waveforms have been shown to be superior to monophasic shocks and are recognized in the current Advanced Cardiac Life Support guidelines by the American Heart Association. Because hospitals are increasingly replacing older models of monophasic capability defibrillators with the newer biphasic capability models, it will be essential for perianesthesia nurses to understand the principles of biphasic technology.

Defibrillators↗
PubMed2005

Critical care providers' perceptions of the use of vasopressin in cardiac arrest.

BACKGROUND: Although published algorithms and guidelines list epinephrine and vasopressin as either/or choices for treatment of ventricular fibrillation and/or pulseless ventricular tachycardia, little is known about how critical care providers respond to this recommendation. OBJECTIVES: To assess the use of vasopressin as a first-line drug of choice for ventricular fibrillation and/or pulseless ventricular tachycardia and describe factors that may influence decision making for using vasopressin. METHODS: A convenience sample from 4 academic medical centers in the United States was recruited to complete a 20-item survey on demographic factors such as year of last Advanced Cardiac Life Support (ACLS) provider course, specialty certification, predominant practice responsibility, and beliefs related to the use of vasopressin for cardiac arrest. Descriptive statistics, Pearson correlation analysis, and logistic regression were used to analyze the data. RESULTS: A total of 214 critical care providers (80% registered nurses) completed the survey. Year of last ACLS course (r=-0.188, P=.006) was a significant demographic factor, and behavioral beliefs (attitude about using vasopressin) had the strongest relationship (r=0.687, P<.001) and were the best predictor for intentions to use or recommend the use of vasopressin (beta=0.589, P<.001). CONCLUSIONS: Despite the recommendation for vasopressin as an agent equivalent to epinephrine for treatment of ventricular fibrillation and/or pulseless ventricular tachycardia, 63% of respondents used epinephrine as a first-line drug of choice. More research is needed to address the classification system for interpreting the quality of evidence that may influence practice.

Academic Medical Centers↗
PubMed2004

Healthy work environments: a validation of the literature.

Nursing leaders are under intense pressure to ensure that safety and quality exist at every point of service. Landmark reports set forth many calls to action to transform systems and processes of care to improve healthcare delivery. Evidence indicates that healthy work environments (HWEs) are at the heart of the solutions to significantly affect patient outcomes and professional nursing practice. Findings from an HWEs literature review and focus groups indicate that nursing leaders must prioritize efforts to improve the culture in the work environment. Three elements emerged to help nursing leaders set the tone and standard of practice for HWEs: (1) effective communication, (2) collaborative relationships, and (3) promoting decision making among nurses.

Communication↗
PubMed2004

Use of community health workers in research with ethnic minority women.

PURPOSE: To explore roles and effectiveness of community health workers in research with ethnic minority women in the United States (US). METHODS: Medline (1966-2002) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) databases were used to locate published research studies on the use of community health workers with ethnic minority women in the US. Key words for searches were community health workers, community health aides, health promoters, and community workers. RESULTS: An integrative analysis of 24 studies showed that, despite varying roles and functions, evidence indicates that community health workers are effective in increasing access to health services, increasing knowledge, and promoting behavior change among ethnic minority women. Other advantages of using community health workers are to provide social support and culturally competent, cost-effective care. Recommendations for future directions of research with community health workers and ethnic minority women include improved conceptualization of the community health worker role, theoretical frameworks for research designs, enhanced methods for evaluating effectiveness, and increased community involvement.

Clinical Competence↗
PubMed2004

Caught in the middle: experiences of tobacco-dependent nurse practitioners.

PURPOSE: To explore how tobacco-dependent nurse practitioners (NPs) describe their experiences with health promotion and disease prevention practices with patients who smoke. DATA SOURCES: Twelve NPs who completed a graduate level NP program of study participated in face-to-face interviews and/or online chat room interviews. CONCLUSIONS: Participants' responses revealed three themes relevant to their experience as tobacco-dependent clinicians with health promotion responsibilities. These themes centered around (a) living as an insider in the world of tobacco addiction, (b) having the outside-in view of living with a tobacco addiction, and (c) being caught in the middle of a tobacco addiction. IMPLICATIONS FOR PRACTICE: All of the tobacco-dependent participants described limited smoking-cessation interventions with their patients. A barrier to implementation of more aggressive interventions, perhaps, is the provider's own tobacco addiction. With increasing evidence that tobacco-dependent health care professionals are not adequately intervening with tobacco-dependent patients, effective strategies are needed to assist and/or support not only tobacco-dependent patients but providers as well.

Adaptation, Psychological↗
PubMed2004

Management of tobacco dependence in older adults: using evidence-based strategies.

Reducing tobacco use is a leading goal of the nation's Healthy People 2010. To improve the health of all Americans during the first decade of the 21st century, tobacco control practices must be a top priority. Tobacco use is a chronic disease with multiple relapses, especially in older adults. Older adult smokers are often less educated, have a low socioeconomic status, are more likely to be female, and have reduced self-efficacy with the cessation process. Older adults suffer disproportionately from smoking-related diseases, yet experience physical, social, and psychological rewards from cessation. Older adults want to quit smoking and do so at similar rates of younger adults. Treating tobacco dependence in older adults should have the same consideration as treatment of other chronic diseases such as diabetes, hypertension, and hyperlipidemia. Clinicians managing the care of smokers can be effective in promoting smoking cessation, regardless of the smoker's age or duration of smoking history. The AHRQ guideline recommends clinicians ask, advise, assess, assist, and arrange follow-up for all smokers. Pharmacological and behavioral therapies are recommended to assist with the cessation process. Gerontological nurses can play a key role in optimizing health and successsful aging by reducing tobacco use in older adults.

Aftercare↗
PubMed2002

Smokers' rights to coronary artery bypass graft surgery.

Imagine a health maintenance organization creating a policy to deny all smokers access to nonemergent coronary artery bypass graft surgery. The cost savings to the organization and society would be potentially significant. Now envision the smoker, a hardworking father with daily angina, and the provider, writing costly prescriptions to manage the angina. What ethical and legal questions do you suppose would present in that setting? Now imagine how you would respond if given this scenario of denying smokers access to nonemergent coronary artery bypass graft. This article discusses the implications of resource allocation with self-inflicted health behaviors such as smoking. Tough questions are raised that explore both the pros and the cons of smokers' rights to coronary artery bypass graft.

Coronary Artery Bypass↗
PubMed2002

Tobacco dependence curricula in acute care nurse practitioner education.

BACKGROUND: Tobacco dependence is the leading preventable cause of death in the United States, yet healthcare professionals are not adequately educated on how to help patients break the deadly cycle of tobacco dependence. OBJECTIVE: To assess the content and extent of tobacco education in the curricula of acute care nurse practitioner programs in the United States. METHODS: A survey with 13 multiple-choice items was distributed to the coordinators of 72 acute care nurse practitioner programs. The survey was replicated and modifiedfrom previous research on tobacco dependence curricula in undergraduate medical education. RESULTS: Fifty programs (83%) responded to the survey. Overall, during an entire course of study, 70% of the respondents reported that only between 1 and 3 hours of content on tobacco dependence was covered. Seventy-eight percent reported that students were not required to teach smoking-cessation techniques to patients, and 94% did not provide opportunities for students to be certified as smoking-cessation counselors. Sixty percent reported that the national guidelines for smoking cessation were not used as a curriculum reference for tobacco content. CONCLUSIONS: The majority of acute care nurse practitioner programs include brief tobacco education. More in-depth coverage is required to reduce tobacco dependence. Acute care nurse practitioners are in a prime position to intervene with tobacco dependence, especially when patients are recovering from life-threatening events. National recommendations for core tobacco curricula and inclusion of tobacco questions on board examinations should be developed and implemented.

Critical Care↗
PubMed2002

Professional nursing portfolios: a global perspective.

In some countries, nurses develop professional portfolios to obtain or maintain licensure, employment, and promotion. A professional portfolio is an important marketing tool that enables nurses to demonstrate their competence. Currently, regulatory bodies worldwide are considering requirements for portfolio development. This global perspective provides information on how to endure a professional portfolio.

Documentation↗
PubMedDate not supplied

Potential reduction exposure products and FDA tobacco and regulation: a CNS call to action.

A new generation of tobacco harm reduction products is stirring controversy and confusion among healthcare providers. These products, known as "potential reduction exposure products" (PREPs), can be described in terms of reported scientific evidence, as "the good, the bad, and the ugly." On the good side, there is sufficient scientific evidence to support the use of Commit, a new over-the-counter nicotine lozenge PREP, approved for smoking cessation. On the bad side, there is no scientific evidence to support the use of Ariva, another over-the-counter nicotine lozenge PREP, marketed as an alternative to cigarettes when smoking is restricted. On the ugly side, both of these PREPs are nicotine delivery systems with "candy-like" appearances; however, one (Commit) has the Food and Drug Administration (FDA) approval and the other (Ariva) does not. This article provides an overview of PREPs and strategies to help clinical nurse specialists (CNSs) address tobacco harm reduction issues.

Candy↗
PubMedDate not supplied

Use of acupuncture for chronic pain: optimizing clinical practice.

Increasingly, individuals are turning to complementary therapies to reduce or cope with chronic pain. Acupuncture, one of the oldest complementary therapies, originated from China more than 2500 years ago. It has steadily gained popularity in the United States over the last few decades as a modality for pain relief among both practitioners and patients. A 1997 National Institutes of Health consensus conference concluded that acupuncture needling releases endorphins and other neurotransmitters in the brain and should be considered as an appropriate pain treatment option. This article will provide an overview about acupuncture principles, discuss current clinical evidence, and identify acupuncture resources to optimize practice for chronic pain management.

Acupuncture Therapy↗