Betsy Kennedy

Assessing Learning Styles: Practical Tips for Patient Education

Nurses must facilitate and support patient and family decision-making and improvement in health outcomes using instructional skills. Complex patient needs and nursing responsibilities necessitate thoughtful consideration for maximizing the effectiveness of patient teaching encounters. This article reviews assessment of patient learning styles in combination with context for an individualized approach, as well as motivation for adult learners as a framework for organization of patient teaching. Methods and modes of patient teaching are discussed as well as tips for overcoming barriers to planning and implementing patient teaching.

Myocardial infarction in pregnancy.

The number of women experiencing myocardial infarction (MI) in pregnancy is relatively negligible. However, the incidence of MI in pregnancy may be on the rise, and maternal and neonatal morbidity and mortality is significant. While diagnosis may be difficult, perinatal nurses must be knowledgeable about the risk factors and various means of treatment for the woman and family experiencing this acute complication of pregnancy. Precis: MI in pregnancy is rare, but can produce significant maternal and fetal morbidity and mortality. Challenges in diagnosis and treatment of MI in pregnancy are discussed.

Acute volume resuscitation following obstetric hemorrhage.

Hemorrhage remains a leading cause of pregnancy-related morbidity and mortality. A rapid collaborative approach to management of the woman experiencing excessive blood loss is required to optimize outcomes. Successful treatment of the hemorrhaging pregnant woman is dependent on early recognition of bleeding and clinical manifestations of shock, treatment of the underlying cause of the hemorrhage, and simultaneous restoration of adequate circulating volume as well as blood component therapy. Early communication with providers, identified triggers for changes in patient condition, and drills/simulations with the multidisciplinary healthcare team are critical strategies for improving response and outcomes.

Burn injuries and pregnancy.

Although burn injuries during pregnancy are considered relatively rare, the exact incidence is not known. Multiple factors influence morbidity and mortality resulting from burn injuries during pregnancy. These factors include the depth and size of the burn, the womans underlying health and age, and the estimated gestational age of the fetus. Associated inhalation injury and development of other significant secondary complications also influence maternal and fetal outcomes. Successful burn care requires a team approach in which almost every healthcare discipline is represented. Initial care is almost always provided by a specially trained emergency medical team in an out-of-hospital setting. During this phase, the ability of the team to communicate with emergency hospital personnel facilitates appropriate clinical management at the scene. In addition, continued communication regarding the womans status and responses to treatment allows critical care specialists within the hospital to ensure that necessary personnel and resources are available when the patient arrives. From the time the pregnant woman is admitted to a hospital for additional acute and critical care through the extensive process of rehabilitation from burn injuries, providing care often evokes strong emotions and requires specialized skills to achieve the most positive outcomes.

Collaborative Strategies for Management of Obstetric Hemorrhage

Obstetric hemorrhage is a significant cause of perinatal morbidity and mortality that requires prompt recognition and collaborative intervention to prevent poor outcomes. Medical and surgical management goals include controlling bleeding, supporting tissue oxygenation and perfusion, and monitoring for coagulopathies and complications.

Transforming a Curriculum to Progress the Associate Degree Nurse to Advanced Practice.

The educational preparation of associate degree nurses to the master’s level requires attainment of baccalaureate-level content. This preparation involves specialized curriculum and varied teaching techniques. Using adult learning theory and aspects of competency-based learning, students and faculty may participate in a gratifying and successful educational experience. The revision of an ongoing associate degree to baccalaureate-level curriculum is presented in this article.

Advancing In-Hospital Clinical Deterioration Prediction Models

Background Early warning systems lack robust evidence that they improve patients’ outcomes, possibly because of their limitation of predicting binary rather than time‐to‐event outcomes. Objectives To compare the prediction accuracy of 2 statistical modeling strategies (logistic regression and Cox proportional hazards regression) and 2 machine learning strategies (random forest and random survival forest) for in‐hospital cardiopulmonary arrest. Methods Retrospective cohort study with prediction model development from deidentified electronic health records at an urban academic medical center. Results The classification models (logistic regression and random forest) had statistical recall and precision similar to or greater than those of the time‐to‐event models (Cox proportional hazards regression and random survival forest). However, the time‐to‐event models provided predictions that could potentially better indicate to clinicians whether and when a patient is likely to experience cardiopulmonary arrest. Conclusions As early warning scoring systems are refined, they must use the best analytical methods that both model the underlying phenomenon and provide an understandable prediction.

Acute Myocardial Infarction in Pregnancy: An Update.

Despite current trends that indicate increasing incidence, acute myocardial infarction remains an uncommon event in pregnant women, yet an important contributor to perinatal morbidity and mortality. Diagnosis and treatments represent a complex challenge during pregnancy, and timeliness and coordination of both are critical. This article reviews the comprehensive, collaborative approach necessary for management of acute myocardial infarction during pregnancy to optimize outcomes for the woman, neonate, and family.

Mitral stenosis: implications for critical care obstetric nursing.

Pregnancy complicated by mitral stenosis poses a significant risk for maternal morbidity and mortality. The perinatal nurse is challenged to use obstetric and cardiac physiologic principles in planning and guiding care during the intrapartum period. Nursing assessments and interventions based on these principles promote positive outcomes.

Principles & PracticeMitral Stenosis: Implications for Critical Care Obstetric Nursing

Pregnancy complicated by mitral stenosis poses a significant risk for maternal morbidity and mortality. The perinatal nurse is challenged to use obstetric and cardiac physiologic principles in planning and guiding care during the intrapartum period. Nursing assessments and interventions based on these principles promote positive outcomes.