Barbara Krainovich-Miller

Evidence-based practice challenge: Teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students

The TREAD Evidence-Based Practice Model is a framework for faculty to use in graduate research courses so students can become excellent consumers of the best available evidence to use in their clinical decision making in the practice setting. This model is based on competency in information literacy as the basis for developing evidence-based search strategies to find, appraise, and synthesize Level I evidence, including systematic reviews, meta-analyses, and evidence-based practice guidelines. This model emphasizes the use of standardized critical appraisal tools, such as the Critical Appraisal Skills Programme (CASP) or Appraisal of Guidelines for Research and Evaluation (AGREE), to facilitate user-friendly rapid appraisal of Level I evidence. Faculty are challenged to embrace this paradigm shift, to unlearn how they learned, and to teach their graduate research course focusing on the importance of Level I evidence to enable their graduates to make informed advanced practice decisions and improve patient outcomes.

SHAPING THE ADVANCED PRACTICE PSYCHIATRIC-MENTAL HEALTH NURSING ROLE: A FUTURISTIC MODEL

As advanced practice psychiatric-mental health nursing has transitioned from earlier models of practice, elements of clinical specialist and psychiatric nurse practitioner roles are being blended to produce a new type of practitioner. The challenge of preserving mental health expertise while expanding advanced practice primary and primary mental health care competencies is addressed in several nursing education models. At New York Universitys Division of Nursing, faculty have designed a program around elements identified as essential to the autonomy demanded of the evolving role, knowledge, and skills basic to broad based health care and mental health care delivery with quality patient care outcomes and the competencies necessary for accountability as care providers in a changing health care delivery system. Essential elements, resources to identify them, and strategies to attain them are discussed. Approaches that promote student, clinician, and faculty development and maximize education affirm the specialtys capacity for innovation and the professions capacity for new direction and futuristic change.As advanced practice psychiatric-mental health nursing has transitioned from earlier models of practice, elements of clinical specialist and psychiatric nurse practitioner roles are being blended to produce a new type of practitioner. The challenge of preserving mental health expertise while expanding advanced practice primary and primary mental health care competencies is addressed in several nursing education models. At New York Universitys Division of Nursing, faculty have designed a program around elements identified as essential to the autonomy demanded of the evolving role, knowledge, and skills basic to broad based health care and mental health care delivery with quality patient care outcomes and the competencies necessary for accountability as care providers in a changing health care delivery system. Essential elements, resources to identify them, and strategies to attain them are discussed. Approaches that promote student, clinician, and faculty development and maximize education affirm the specialtys capacity for innovation and the professions capacity for new direction and futuristic change.

Oral Health in Pregnancy

Oral health is crucial to overall health. Because of normal physiologic changes, pregnancy is a time of particular vulnerability in terms of oral health. Pregnant women and their providers need more knowledge about the many changes that occur in the oral cavity during pregnancy. In this article we describe the importance of the recognition, prevention, and treatment of oral health problems in pregnant women. We offer educational strategies that integrate interprofessional oral health competencies.

Preventive Dental Care: An Educational Program to Integrate Oral Care Into Pediatric Oncology

BACKGROUND: Early childhood dental caries (dental cavities) is an infectious process. The development of oral problems during cancer care results in pain, fever, and delay in treatment. OBJECTIVES: The objective of this project was to integrate preventive oral care into pediatric oncology care. METHODS: This project consisted of an educational program for pediatric oncology providers who completed pre‐ and postprogram surveys assessing oral health knowledge, attitudes, and practice; attended an oral health education session; and performed oral assessment and fluoride varnish application on children during cancer treatment. FINDINGS: Three major outcomes resulted from this project: (a) 15 nondental healthcare providers attended the education session and 11 became certified by the American Academy of Pediatrics, (b) 53 pediatric patients with cancer received an oral assessment and fluoride varnish during the two‐month project, and (c) oral health assessment and fluoride varnish was instituted as a standard of care.