Nancy M. George

Assessing sleep in adolescents through a better understanding of sleep physiology.

OverviewAdolescents need about nine hours of sleep per night, yet most teens get far less. Inadequate sleep has consequences not only for academic performance but also for mental and physical health; it has been linked to lowered resilience and an increased risk of cardiovascular and metabolic diseases. Its imperative that assessment of sleep become a routine part of adolescent health care. An understanding of sleep physiology is essential to helping nurses better assess and manage sleep deprivation in this population. Sleep assessment involves evaluating the three main aspects of sleep: amount, quality, and architecture. The authors provide an overview of sleep physiology, describe sleep changes that occur during adolescence, and discuss the influence of these changes on adolescent health. They also provide simple questions that nurses can use to assess sleep and risk factors for disrupted sleep, and discuss patient education and other interventions.

Faith community nursing scope of practice: extending access to healthcare

Abstract The role of the Faith Community Nurse (FCN) is a multifaceted wholistic practice focused on individuals, families, and the faith and broader communities. The FCN is skilled in professional nursing and spiritual care, supporting health through attention to spiritual, physical, mental, and social health. FCNs can help meet the growing need for healthcare, especially for the uninsured, poor, and homeless. The contribution of FCNs on primary prevention, health maintenance, and management of chronic disease deserves attention to help broaden understanding of the scope of FCN practice.

Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners

Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedians Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting.

Potential to improve outcomes: Causes of 30-day readmission after cardioverter defibrillator implantation

Under newly restructured Centers for Medicare and Medicaid Services guidelines, hospitals are at risk for reduction in reimbursement for patients with heart failure (HF) who are readmitted within 30 days after discharge. Patients with HF who are admitted for an implantable cardioverter defibrillator (ICD) are routinely admitted with a primary diagnosis of HF. To reduce the occurrence of readmission, this article identifies the causes of 30-day readmission and recommends that patient follow-up after ICD placement should include assessment and management of HF symptoms.

A Quality Improvement Project To Educate Nurses on Coudé Catheter Placement.

When only physicians are trained to insert Coudé catheters, there is an increased burden to both the patient and the providers. Training nurses for placement of Coudé catheters can improve care and allow for better use of health care resources.

Steatocystoma multiplex and adolescent development: A case report

ABSTRACT Steatocystoma multiplex, a benign genetic skin disorder, can have a large developmental impact on an adolescent. The prevalence of this skin disorder is unknown. What is known is that it shows no prevalence based on gender or race/ethnicity. This skin disorder is characterized by numerous small, yellow or skin-colored cystic lesions that occur primarily on the trunk and extremities. Understanding this benign condition, treatment options, both medical and surgical, in the context of adolescent development can assist nurses to intervene where appropriate. Nurses are excellent clinicians for dealing with this type of skin condition that requires not only medical and possibly surgical treatment but also psychological supportive care. For adolescents to transition successfully to adulthood, they must have the coping tools in place that help them deal with this lifelong condition.