Current Continuing Education Articles in the AGH Library

To obtain one of these articles, please contact your library.
AGH, AGH-Suburban and CGH - 412-359-3040 or email to docdel@wpahs.org

West Penn - 412-578-4708 or email to medlib@wpahs.org
West Penn-Forbes - 412-858-7705 or email to mpapciak@wpahs.org
AKMC - 724-226-7092 or 724-367-2384 or email to cjones@wpahs.org

This list is updated monthly; if you would like to have the list emailed directly to you, please send an email to library@wpahs.org . 

Previous lists are available:

March 2009

April 2009

June 2009

Record: 1
Title: Adherence to the low-sodium diet plays a role in the
interaction between depressive symptoms and prognosis in patients with heart
failure.
Authors: Song EK
Source: Journal of Cardiovascular Nursing (J CARDIOVASC NURS), 2009 Jul-Aug;
24(4): 299-307 (36 ref)
Abstract: Background: Although a low-sodium diet (LSD) is important in
self-management of patients with heart failure (HF), the impact of LSD on
event-free survival has not been investigated. Depressive symptoms predict
worse event-free survival, in part, by affecting adherence to self-management.
However, there are few investigations of the relationship among depressive
symptoms, adherence to the LSD, and event-free survival. Purpose: The purpose
of this study was to determine the relationships among adherence to the LSD,
depressive symptoms, and event-free survival. Methods: A total of 254 patients
(57% male, 62 +/- 14 years, 52% New York Heart Association class III/IV,
ejection fraction of 36% +/- 14%) were recruited from outpatient HF clinics in
Korea. Twenty-four-hour urinary sodium excretion was collected as an indicator
of patient adherence to the LSD. Patients were grouped based on the cut point
of 3 g of urinary sodium excretion. Depressive symptoms were assessed by the
Korean version of Beck Depression Inventory, and patients were split into 2
groups at the cutoff of the Korean version of Beck Depression Inventory.
Event-free survival for 12 months was determined by medical records.
Hierarchical Cox proportional hazards regression was used to determine the
association of depressive symptoms and adherence to 3-g sodium intake on
event-free survival. Results: After controlling for age, sex, etiology of HF,
body mass index, New York Heart Association class, ejection fraction,
N-terminal B-type natriuretic peptide, and total comorbidity score,
nonadherence to 3-g sodium intake (hazard ratio = 1.56, 95% confidence
interval = 1.05-2.32) and depressive symptoms (hazard ratio = 2.21, 95%
confidence interval = 1.47-3.33) independently predicted event-free survival.
Patients with sodium intake higher than 3 g and with depressive symptoms
demonstrated a 3.7 times higher risk for cardiac events compared with patients
with sodium intake lower than 3 g and without depressive symptoms (P < .001).
Conclusion: Improvement of adherence to the LSD and treatment for depressive
symptoms could improve event-free survival.

Record: 2
Title: An ecological model for premature infant feeding.
Authors: White-Traut R; Norr K
Source: JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN),
2009 Jul-Aug; 38(4): 478-90 (113 ref)
Abstract: Premature infants are at increased risk for poor health, feeding
difficulties, and impaired mother-infant interaction, leading to developmental
delay. Social-environmental risks, such as poverty or minority status,
compound these biological risks, placing premature infants in double jeopardy.
Guided by an ecological model, the Hospital-Home Transition: Optimizing
Prematures' Environment intervention combines the auditory, tactile, visual,
and vestibular intervention with participatory guidance provided by a nurse
and community advocate to address the impact of multiple risk factors on
premature infants' development.

Record: 3
Title: Continuous ST-segment monitoring: protocol for practice.
Authors: Sandau KE; Smith M
Source: Critical Care Nurse (CRIT CARE NURSE), 2009 Aug; 29(4): 39-51 (48 ref)
Abstract: The purpose of continuous ST-segment monitoring is to provide an
alert for potential ischemia.

Record: 4
Title: Diabulimia: what it is and how to recognize it in critical care.
Authors: Ruth-Sahd LA; Schneider M; Haagen B
Source: Dimensions of Critical Care Nursing (DCCN), 2009 Jul-Aug; 28(4): 147-55 (31 ref)
Abstract: Critical care nurses must be able to recognize the signs of symptoms
of diabulimia-a potentially life-threatening disorder. Skipping insulin is
used as a means of weight control in some persons with diabetes, particularly
in young women. This article focuses on the assessment, pathophysiology,
critical care nursing interventions, and psychosocial initiatives of interest
to critical care nurses in the care of patients with diabulimia.

Record: 5
Title: Facilitating attachment after international adoption.
Authors: Murphy NL
Source: MCN: The American Journal of Maternal Child Nursing (MCN), 2009
Jul-Aug; 34(4): 210-7 (30 ref)
Abstract: Americans have increasingly turned to international adoption (IA) as
an alternative way to build a family. Unfortunately, IA families are often
being developed under conditions of loss, and sometimes these families
struggle to form healthy attachments to each other. Disordered attachment (the
failure to form a reciprocal, loving bond between parent and child) can occur,
and can have devastating consequences. In some instances, IA children have
been relinquished into state foster care systems; other families simply
struggle for years caring for a developmentally delayed child who appears to
have no emotion for his/her adoptive family. Nurses are likely to have contact
with IA families and can use their education about attachment and bonding to
help facilitate attachment in these developing families. Swanson's caring
theory provides a clinically useful guide to meet this need.

Record: 6
Title: Functional and cognitive recovery of patients with traumatic brain injury: prediction tree
model versus general model.
Authors: Oh H; Seo W
Source: Critical Care Nurse (CRIT CARE NURSE), 2009 Aug; 29(4): 12-23 (32 ref)
Abstract: A prediction model for recovery or mortality after brain injury must
be quick and simple enough to use without special training.

Record: 7
Title: HIPP lead to self-health: healthy infection prevention practices in intensive care units.
Authors: Grota PG; Meinzen S; Burleson-Rine P
Source: Critical Care Nursing Quarterly (CRIT CARE NURS Q), 2009 Jul-Sep;
32(3): 242-52 (25 ref)
Abstract: Healthy infection prevention practices (HIPP) include hand hygiene,
respiratory etiquette, environmental cleanliness, and use of personal
protective equipment. These healthy practices are most used to protect
individuals against exposure to bacterial and viral infections in the
workplace, as well as in the home. Most often these infection prevention
behaviors in critical care units are promoted to protect the patient from
healthcare-associated infections. Yet, these practices are just as important
to the health of the critical care nurse. Self-health in the workplace is
essential to creating a healthy workplace environment, which is the goal of
many intensive care units today. The benefits of creating a healthy work
environment are improvement of patient/nurse satisfaction and nurse retention.
HIPP reduce the risk of the critical care nurse's exposure to microbial
pathogens such as methicillin-resistant Staphylococcus aureus and influenza.
Pathogens that cause infections may contaminate the hands, the clothing,
equipment, and blood, putting the nurse at risk for unhealthy hands, unhealthy
flora, and unhealthy blood. The intensive care nurse is encouraged to embrace
HIPP to nurture self, as well as protect the patient.

Record: 8
Title: How to care for a patient with a tracheostomy.
Authors: Regan EN; Dallachiesa L
Source: Nursing (NURSING), 2009 Aug; 39(8): 34-40 (12 ref)
Abstract: Learn all about managing a "trach" to protect your patient from
complications.

Record: 9
Title: Hypoxia in the term newborn: part three--sepsis and hypotension, neurologic,
metabolic and hematologic disorders.
Authors: Rohan AJ; Golombek SG
Source: MCN: The American Journal of Maternal Child Nursing (MCN), 2009
Jul-Aug; 34(4): 224-35 (26 ref)
Abstract: Causes of hypoxia and cyanosis in the term newborn can be found
within all physiologic systems and take the form of hundreds of specific
diagnoses. In the first and second parts of this series, a wide range of
cardiac and pulmonary causes for newborn hypoxia and cyanosis have been
examined. Because they are familiar, cardiac and pulmonary diagnoses often
represent our reactionary opinions-the options that we first entertain even
before a proper systematic approach to the infant has been taken. In this
final of a three part series, neurologic, hematologic and metabolic disorders
are explored as a cause for abnormal oxygenation, as well as sepsis and
hypotension. It is within these final categories that we find many of the
obscure possibilities for neonatal hypoxia-the diagnoses that often require
rigorous testing, or more sophisticated laboratory interpretation. Without
consideration of these elusive entities, however, appropriate treatment and
referral will be unnecessarily delayed.

Record: 10
Title: Improving self-management and reducing hospital readmission in
Authors: Ryan M; Aloe K; Mason-Johnson J
Source: Clinical Nurse Specialist: The Journal for Advanced Nursing Practice
(CLIN NURSE SPEC), 2009 Jul-Aug; 23(4): 216-23 (28 ref)
Abstract: Heart failure accounts for a vast number of hospital admissions and
rehospitalizations among older adults. The complexity of this condition
necessitates an evidence-based, patient-focused, interdisciplinary approach to
care. This article presents the efforts of clinical nurse specialists, a nurse
manager, and nursing staff on a progressive cardiac care unit to develop,
implement, and evaluate a pilot evidence-based group discharge education
program for patients with heart failure and their families. The journey taken
to launch this initiative is described, and program outcomes are presented.
Major emphasis throughout the project was placed on promoting patients'
self-management of their condition and further integrating evidence-based
practice within the organization.

Record: 11
Title: 'It depends': medical residents' perspectives on working with nurses: a qualitative study
shows that residents don't necessarily view nurses as colleagues and collaborators.
Authors: Weinberg DB; Miner DC; Rivlin L
Source: American Journal of Nursing (AM J NURS), 2009 Jul; 109(7): 34-44 (22 ref)
Abstract: OBJECTIVE: Using the theory of relational coordination, which holds
that in high-pressure settings such as hospitals, high-quality communication
and strong relationships are necessary for coordinated action, we sought to
determine the quality of the nurse-physician relationship by examining the
communication and interaction between nurses and residents from the residents'
perspective. METHODS: A sample of 20 medical and surgical residents, selected
by a snowball sampling technique, were interviewed about the quality of their
communication and relationships with nurses in the workplace. RESULTS:
Residents' responses were influenced by their perceptions of nurses'
cooperativeness and competence, and their impressions of nurses' professional
preparation and demeanor varied widely. Although 19 of 20 residents reported
instances of poor communication or problematic relationships with nurses, most
believed that this posed no significant threat to patient care because the
nurses' role, as they saw it, was one of simply following orders. CONCLUSIONS:
Given the strong doubts some residents expressed about nurses' cooperativeness
and competence, the nursing profession should consider strengthening nursing
education and clearly delineating nurses' roles and competencies.

Record: 12
Title: Knowledge of limited health literacy at an academic health center.
Authors: Jukkala A; Deupree JP; Graham S
Source: Journal of Continuing Education in Nursing (J CONTIN EDUC NURS), 2009
Jul; 40(7): 298-304 (23 ref)
Abstract: BACKGROUND Health care providers' awareness and knowledge of the
impact that limited health literacy has on the health care system and the
individual patient was measured. In addition, the usefulness of the Limited
Literacy Impact Measure (LLIM) was examined. METHODS Two hundred forty
providers and students attending a university-sponsored presentation on health
literacy were invited to participate. RESULTS Participants were most
knowledgeable about the impact on patients and less knowledgeable about the
impact on the health care system. CONCLUSIONS Health care provider knowledge
and awareness of limited health literacy continues to be a challenge.
Educational programs developed for providers and patients are needed to
address the health literacy crisis. Improving health literacy will improve
health outcomes while reducing the use of unnecessary health care services.

Record: 13
Title: Legally speaking... when can you say no?
Authors: Brooke PS
Source: Nursing (NURSING), 2009 Jul; 39(7): 42-7 (3 ref)
Abstract: Accepting inappropriate responsibilities can have serious legal
consequences for you and your career. Learn to identify the situations where
saying no is the best policy.

Record: 14
Title: Oral care interventions and oropharyngeal colonization in children receiving mechanical
ventilation.
Authors: Pedreira MLG; Kusahara DM; de Carvalho WB; Nunez SC; Peterlini MAS
Source: American Journal of Critical Care (AM J CRIT CARE), 2009 Jul; 18(4):
319-29 (39 ref)
Abstract: Background Recent progress in identification of oral microorganisms
has shown that the oropharynx can be a site of origin for dissemination of
pathogenic organisms to distant body sites, such as the lungs. Objective To
compare the oropharyngeal microbiological profile, duration of mechanical
ventilation, and length of stay in the intensive care unit of children
receiving mechanical ventilation who had pharmacological or nonpharmacological
oral care. Methods A randomized and controlled study was performed in a
pediatric intensive unit in São Paulo, Brazil. A total of 56 children were
randomly assigned to an experimental group (n=27, 48%) that received oral care
with use of 0.12% chlorhexidine digluconate or a control group (n=29, 52%)
that received oral care without an antiseptic. Oropharyngeal secretions were
collected and cultured on days 0, 2, and 4, and at discharge. Results The 2
groups had similar demographic characteristics, preexisting underlying
diseases, and pharmacological, nutritional, and ventilatory support.
Gram-negative bacteria were the predominant pathogens: Acinetobacter
baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enter-obacter
species. The 2 groups did not differ significantly in the colonization of
normal (P= .72) or pathogenic (P= .62) flora, in the duration of mechanical
ventilation (P= .67), or in length of stay in the intensive care (P= .22).
Conclusion Use of chlorhexidine combined with nonpharmacological oral care did
not decrease the colonization profile, duration of mechanical ventilation, or
length of stay in critically ill children receiving mechanical ventilation.

Record: 15
Title: Patients' perceptions of nurses' skill.
Authors: Wysong PR; Driver E
Source: Critical Care Nurse (CRIT CARE NURSE), 2009 Aug; 29(4): 24-38 (36 ref)
Abstract: To what extent is the observed technical skill of a nurse during a
procedure a factor that patients use to assess the nurse's skill?

Record: 16
Title: Post--breast cancer lymphedema: part 1: the condition affects
many and its impact can be profound, yet diagnostic criteria are still not
standardized.
Authors: Fu MR; Ridner SH; Armer J
Source: American Journal of Nursing (AM J NURS), 2009 Jul; 109(7): 48-55 (28 ref)
Abstract: Lymphedema, which can be a debilitating sequela to breast cancer
treatment, is characterized by an abnormal accumulation of lymph in the arm,
shoulder, breast, or thoracic area. It may appear gradually or suddenly, and
although it usually develops within three years of a breast cancer diagnosis,
it can arise much later; survivors remain at lifetime risk. The condition can
cause physical discomfort and pain, impaired function, and emotional distress.
It's imperative that survivors' risk of lymphedema be reduced and that those
who develop it receive help to manage it. Part 1 of this two-part article
describes post-breast cancer lymphedema and discusses its diagnosis and
measurement. Part 2 (next month) will discuss risk reduction, treatment, and
implications for nurses.

Record: 17
Title: Putting a face on systemic lupus erythematosus.
Authors: Pullen RL Jr.; Brewer S; Ballard A
Source: Nursing (NURSING), 2009 Aug; 39(8): 22-9 (6 ref)
Abstract: By recognizing the signs and symptoms of this unpredictable
autoimmune disorder, you can steer your patient to treatment to improve her
quality of life.

Record: 18
Title: Spirituality and support for family presence during invasive
procedures and resuscitations in adults.
Authors: Baumhover N; Hughes L
Source: American Journal of Critical Care (AM J CRIT CARE), 2009 Jul; 18(4):
357-67 (49 ref)
Abstract: Background Many health care professionals believe that they provide
holistic care. The role of spirituality, a known variable of holism, has not
been explored in relation to the support among health care professionals for
family presence during invasive procedures and resuscitative efforts in
adults. Objective To determine the relationship between spirituality of health
care professionals and their support for family presence during invasive
procedures and resuscitative efforts in adults. Methods In this descriptive
correlational study, 108 participants (physicians, physician assistants, and
nurses) completed the Howden Spirituality Assessment Scale and a survey to
measure their support for family presence. Results A significant positive
relationship was found between spirituality and support for family presence
during resuscitative efforts in adults (r = 0.24, P = .05) and a significant
negative correlation was found between support for family presence and the age
of the health care professional (r = - 0.27, P = .01). No significant
correlations were found between any of the study variables and invasive
procedures in adults. Conclusions Adopting a more holistic perspective may
support family presence, especially during resuscitative efforts in adults.
Allowing the option for patients' families to remain present promotes holistic
family-centered care.

Record: 19
Title: Systemic inflammatory response syndrome score and race as
predictors of length of stay in the intensive care unit.
Authors: NeSmith EG; Weinrich SP; Andrews JO; Medeiros RS; Hawkins ML; Weinrich M
Source: American Journal of Critical Care (AM J CRIT CARE), 2009 Jul; 18(4):
339-47 (35 ref)
Abstract: Background Identifying predictors of length of stay in the intensive
care unit can help critical care clinicians prioritize care in patients with
acute, life-threatening injuries. Objective To determine if systemic
inflammatory response syndrome scores are predictive of length of stay in the
intensive care unit in patients with acute, life-threatening injuries. Methods
Retrospective chart reviews were completed on patients with acute,
life-threatening injuries admitted to the intensive care unit at a level I
trauma center in the southeastern United States. All 246 eligible charts from
the trauma registry database from 1998 to 2007 were included. Systemic
inflammatory response syndrome scores measured on admission were correlated
with length of stay in the intensive care unit. Data on race, sex, age,
smoking status, and injury severity score also were collected. Univariate and
multivariate regression modeling was used to analyze data. Results Severe
systemic inflammatory response syndrome scores on admission to the intensive
care unit were predictive of length of stay in the unit (F=15.83; P<.001), as
was white race (F=9.7; P=.002), and injury severity score (F=20.23; P<.001).
Conclusions Systemic inflammatory response syndrome scores can be measured
quickly and easily at the bedside. Data support use of the score to predict
length of stay in the intensive care unit.

Record: 20
Title: Teaching patients to tame their hypertension.
Authors: Dumont C; Hardware J
Source: American Nurse Today (AM NURSE TODAY), 2009 Jul-Aug; 4(7): 20-5 (5 ref)

Record: 21
Title: The perioperative nurse's role in table-enhanced anterior
total hip arthroplasty.
Authors: Munro CA
Source: AORN Journal (AORN J), 2009 Jul; 90(1): 53-72 (10 ref)
Abstract: The anterior approach to total hip arthroplasty (THA), when performed
with the patient in the supine position, is enhanced by the use of a
radiolucent, orthopedic table. This technique has numerous advantages:
enhanced intraoperative fluoroscopy because of the patient's supine position
on a radiolucent table, improved femoral exposure, and reduced soft tissue
trauma. Criteria for patient selection is not limited as it may be for other
arthroplasty techniques. The role of the perioperative nurse during an
anterior THA is to ensure optimal function of the orthopedic table and provide
safe patient care. A clear understanding of the surgical techniques used and
the functions of the table are imperative.

Record: 22
Title: Today's sterilizer is not your father's water heater.
Authors: Moore TK
Source: AORN Journal (AORN J), 2009 Jul; 90(1): 81-92 (14 ref)
Abstract: Today's sterilizers are sophisticated, automatic, and computerized
devices that accurately execute programmed jobs, creating uniform conditions
inside pressure vessels to achieve sterilization. Specialized knowledge is
necessary to ensure that the right cycle is selected; this requires an
educated and competent operator. Perioperative nurses need to understand
regulatory requirements for sterilizers, sterilizer design and performance
validation, sterilizer cycle functions for everyday use, and everyday
sterilization procedures.

Record: 23
Title: Unlocking the secrets of locked-in syndrome.
Authors: Palmieri RL
Source: Nursing (NURSING), 2009 Jul; 39(7): 22-30 (11 ref)
Abstract: Your patient depends on you for all of her basic needs. Help her and
her family cope by providing emotional support and teaching them how to
communicate.