Dian Dowling Evans

Characteristics and predictors of short-term outcomes in individuals self-selecting yoga or physical therapy for treatment of chronic low back pain.

To compare clinical and demographic characteristics of individuals self‐selecting yoga or physical therapy (PT) for treatment of chronic low back pain (cLBP) and to examine predictors of short‐term pain and functional outcomes.

Intimate partner violence, depression, and substance abuse in women presenting to emergency departments for care

The Research to Practice column is intended to elevate the research critique skills of the advanced practice nurse and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research paper is then reviewed and critiqued, and finally, the implications for translation into practice are discussed with particular attention to the case study. In this column, we address the topics of intimate partner violence and substance abuse, among African American women by presenting the following study: Hankin, A., Smith, L. S., Daugherty, J., & Houry, D. (2010). Correlation between intimate partner violence victimization and risk of substance abuse and depression among African American women in an urban emergency department. Western Journal of Emergency Medicine, 11(3), 252–256.

Treating venomous snakebites in the United States: a guide for nurse practitioners.

This article discusses the current, evidence-based guidelines for managing venomous snakebites indigenous to the United States. A review of common varieties of venomous snakes, venom effects, risk factors for snakebites, and management strategies are presented to assist nurse practitioners in caring for snakebite victims.

Enhancing care of older adults in the emergency department.

The findings from a recent comprehensive systematic review, in combination with a case study, are used to illustrate the importance of translational research to inform advanced practice nursing. The review article discussed in this column is a comprehensive systematic review of age-friendly nursing interventions in the management of older persons in the emergency department (ED). Two themes were synthesized from the research and texts: (1) the ED can be a foreign and challenging environment for older patients, and (2) older ED patients need specialized care to meet their complex physical and psychosocial needs. At the same time, these authors acknowledged that much more high-quality research is needed in this field. Comments by a certified geriatric nurse practitioner elaborate on these findings and provide practical suggestions for the ED advanced practice registered nurse.

Standards of Practice for Emergency Nurse Practitioners.

ENPs are specialized licensed practitioners, who possess the necessary clinical competencies to provide optimal care to patients in ambulatory, urgent, and emergent care settings. ENP specialization builds upon NP entryinto-practice knowledge and skills and requires a minimum of a master’s level preparation or specialized preparation at the post-master’s or doctoral level. ENPs demonstrate competencies by applying standardized care guidelines in their clinical practice. Other ways of continuing competencies include participation in maintaining continuing education, quality improvement processes and peer reviewsincluding the systematic periodic review of records and treatment planswhile maintaining specialty and population-focused certification in compliance with current laws and regulations.

Heat illnesses in the emergency department: a hot topic

The RESEARCH TO PRACTICE column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. Our current column discusses factors associated with heat-related hospitalizations and deaths with implications for APRN practice and public health prevention strategies using the following study: Hess, J., Saha, S., & Luber, G. (2014). Summertime acute heat illness in U.S. emergency departments from 2006 through 2010: Analysis of a nationally representative sample. Environmental Health Perspectives, 122(11), 1209–1215. Our case involves an adolescent athlete with sickle cell trait participating in athletic practice during the summer.

Determining Psychoneuroimmunologic Markers of Yoga as an Intervention for Persons Diagnosed With PTSD: A Systematic Review:

There is a growing body of research on yoga as a therapeutic intervention for psychological symptoms of post-traumatic stress disorder (PTSD) accompanied by speculations on underlying physiologic mechanisms. The purpose of this systematic review is to identify, qualitatively evaluate, and synthesize studies of yoga as an intervention for PTSD that measured physiologic outcomes in order to gain insights into potential mechanisms. The focus is on studies evaluating yoga as a therapeutic intervention for PTSD rather than for trauma exposure, PTSD prevention, or subclinical PTSD. Multiple databases were searched for publications from the past two decades using terms derived from the question, “In people with PTSD, what is the effect of yoga on objective outcomes?” Eligibility criteria included yoga-only modalities tested as an intervention for formally diagnosed PTSD with at least one physiologic outcome. Results of this review confirmed that, though much of the published literature proposes physiological mechanisms underlying yoga’s effects on PTSD, very few studies (n = 3) have actually evaluated physiological evidence. Additionally, several studies had methodological limitations. In light of the limited data supporting yoga’s beneficial effects on autonomic nervous system dysregulation, we present a theoretical model of the psychoneuroimmunologic processes associated with PTSD and the effects yoga may have on these processes to guide future research. Gaps in the literature remain for mechanisms related to activation of the hypothalamic–pituitary–adrenal axis and inflammation. Additional rigorous mechanistic studies are needed to guide development of effective yoga interventions for PTSD to augment existing evidence-based PTSD treatments.

Prevalence of Pulmonary Embolism in Patients Presenting to the Emergency Department for Syncope

The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and the emergency nurse (RN) and to assist with the translation of research into practice. For each column, a topic and a research study are selected. The research article is then reviewed and critiqued, and the findings are discussed in relation to a patient scenario. In this column, we examine the findings of P. Prandoni et al. (2016) from their article, titled “Prevalence of Pulmonary Embolism Among Patients Hospitalized for Syncope.”

Suicidality risk assessment in adolescents and young adults

The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and the emergency nurse (RN) and to assist with the translation of research into practice. This column focuses on assessing risks of suicide in adolescents and young adults, using as a basis for the discussion a recently developed suicidality screening tool (L. M. Horowitz et al., 2012).

Gait speed in the emergency department: improving assessment among older adults.

The research to practice column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and to assist with the translation of research into practice. This column critiques the findings from a meta-analysis, “Gait speed and survival in older adults,” by S. Studenski et al. (2011). The study was designed to assess the use of gait speed as a physical performance measure that is associated with survival. The findings are reviewed in the context of increasing emergency department (ED) visits among older adults and their unique assessment needs, with implications for APRN best care practices. The implementation of gait speed as a screening tool for identifying adults 65 years of age and older in the ED who may be at risk for adverse events and functional decline will also be discussed.