Beth Ann Swan

Optimizing vitamin D status to reduce colorectal cancer risk: an evidentiary review.

Vitamin D deficiency is common in the general public and in patients with cancer. Optimizing vitamin D intake is increasingly recognized in cancer risk reduction, particularly in decreasing colorectal cancer risk. Therefore, summarizing the current evidence to promote best practices related to vitamin D intake and colorectal cancer risk reduction is important. The objectives of this article are to examine the current evidence regarding the impact of vitamin D on colorectal cancer risk reduction and provide practice recommendations for clinicians. Relevant research articles from 2002-2008 were retrieved from multiple electronic databases. Reference lists of relevant articles also were searched manually. Twenty-five research reports were selected for this article: 4 randomized, controlled trials; 11 cohort or case-control studies measuring serum 25-OH-D levels; and 10 cohort studies reporting vitamin D intake. This review generated three themes: raising 25-OH-D levels to a vitamin D sufficient state (32-100 ng/ml) achieved colorectal cancer risk reduction, increasing the intake of vitamin D reduced colorectal cancer risk, and increasing vitamin D intake to 1,000 IU daily is safe and likely sufficient to raise serum 25-OH-D levels above 32 ng/ml to achieve colorectal cancer risk reduction. Several practice recommendations are suggested.

A Nurse Learns Firsthand That You May Fend For Yourself After A Hospital Stay

Following her husband’s stroke, it falls to a registered nurse and nursing school dean to coordinate care and manage her recovering spouse’s transitions among several hospitals and home.

Implementing an MSN Nursing Program at a Distance Through an Urban-Rural Partnership

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed.

A Comparison of Usage and Outcomes Between Nurse Practitioner and Resident-Staffed Medical ICUs.

Objective: To compare usage patterns and outcomes of a nurse practitioner–staffed medical ICU and a resident-staffed physician medical ICU. Design: Retrospective chart review of 1,157 medical ICU admissions from March 2012 to February 2013. Setting: Large urban academic university hospital. Subjects: One thousand one hundred fifty-seven consecutive medical ICU admissions including 221 nurse practitioner-staffed medical ICU admissions (19.1%) and 936 resident-staffed medical ICU admissions (80.9%). Interventions: None. Measurements and Main Results: Data obtained included age, gender, race, medical ICU admitting diagnosis, location at time of ICU transfer, code status at ICU admission, and severity of illness using both Acute Physiology and Chronic Health Evaluation II scores and a model for relative expected mortality. Primary outcomes compared included ICU mortality, in-hospital mortality, medical ICU length of stay, and post-ICU discharge hospital length of stay. Patients admitted to the nurse practitioner–staffed medical ICU were older (63 ± 16.5 vs 59.2 ± 16.9 yr for resident-staffed medical ICU; p = 0.019), more likely to be transferred from an inpatient unit (52.0% vs 40.0% for the resident-staffed medical ICU; p = 0.002), and had a higher severity of illness by relative expected mortality (21.3 % vs 17.2 % for the resident-staffed medical ICU; p = 0.001). There were no differences among primary outcomes except for medical ICU length of stay (nurse practitioner-resident-staffed 7.9 ± 7.5 d vs resident-staffed medical ICU 5.6 ± 6.5 d; p = 0.0001). Post-hospital discharge to nonhome location was also significantly higher in the nurse practitioner–ICU (31.7% in nurse practitioner–staffed medical ICU vs 23.9% in resident-staffed medical ICU; p = 0.24). Conclusions: We found no difference in mortality between an nurse practitioner–staffed medical ICU and a resident-staffed physician medical ICU. Our study adds further evidence that advanced practice providers can render safe and effective ICU care.

Kids into health careers: a rural initiative.

PURPOSE To describe a project that introduces middle school and high school students living in Pennsylvanias rural geographic regions to nursing careers through outreach extended to students regardless of gender, ethnicity, or socioeconomic status. METHOD The authors employed many strategies to inform students about careers in nursing. The methods included: working with guidance counselors, participating in community health fairs, taking part in school health career fairs, collaborating with Area Health Education Centers, serving on volunteer local education advisory boards, developing a health careers resource guide, and establishing a rural health advisory board. FINDINGS Developing developmentally appropriate programs may have the potential to pique interest in nursing careers in children of all ages, preschool through high school. Publicity is needed to alert the community of kids into health care career programs. Timing is essential when planning visits to discuss health care professions opportunities with middle and high school students. It is important to increase the number of high school student contacts during the fall months. Targeting high school seniors is particularly important as they begin the college applications process and determine which school will best meet their educational goals. CONCLUSIONS Outcome measures to determine the success of health career programs for students in preschool through high school are needed. Evaluation methods will be continued over the coming years to assess effectiveness.

A teaching-learning initiative with tablet computing.

DOI: 10.1097/NXN.0b013e31826ac8de technology with teaching-learning strategies in the undergraduate nursing curriculum. Tablet computing has the potential to enhance educational experiences by providing a delivery option for teaching and learning practices that enable learners to interact with content, and each other, in immediate and seamless ways. The literature that exists on integrating tablet computers in the health professions focuses on the use of tablet computing for teaching medical students and enhancing resident clinical rotations. This article describes the stages of a tablet computing integration initiative in a school of nursing including (1) creating the infrastructure, (2) planning technology requirements, (3) designing faculty development sessions focused on curricular integration, and (4) building ongoing communication and support for students.

Designing a New Model for Clinical Education: An Innovative Approach.

To keep pace with the ever-changing health care delivery system, it is important to transform the way future nurses are educated, both in classroom and in clinical settings, to care for people along the life and care continuum, not only in acute-care settings. The purpose of this article is to describe a new approach to educating baccalaureate nursing students using immersion practicums that expose students to population health, transitions of care, care coordination, and the multiple roles a nurse engages in along the continuum. The curriculum includes 5 immersions, each with a specific life and care continuum focus to develop anticipatory thinkers.

A Retrospective Analysis of Nursing Students' Clinical Experience in an All-male Maximum Security Prison

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today’s changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison.