Patricia Gonce Morton

Exploring the factors that influence functional performance among nursing home residents.

Objective: To promote healthy aging in older nursing home (NH) residents, it is important to identify factors that impact functional performance. Using the Disablement Process Model, it was hypothesized that variables from all levels of the model would significantly impact the ability of a NH resident to get up from a chair. Method: A stepwise multiple logistic regression model was used to test the impact of sociodemographic, physiologic, physical, psychosocial, and environmental factors on chair rise. Results: Analysis indicated that three factors, strength, gait, and self-efficacy, were significantly associated with chair-rise ability and together explained approximately 64% of the variance and successfully classified 88.4% of the chair-rise cases. Discussion: These findings indicate that identifying physical and psychosocial variables early in the disablement process will help health care providers tailor medical and restorative care interventions that may help older adults maintain the ability to chair rise.

Publishing in professional journals, part I: getting started.

Publishing in professional journals is a challenging and rewarding experience. By sharing their expertise and experiences through journal articles, nurses contribute to the body of literature that ultimately helps improve the health care system, the nursing profession, and care of patients and their families. The focus of this article is to help nurses implement strategies to get started in the process of publishing journal articles. Topics include facing excuses for not writing, implementing strategies to get started, and executing a plan for the manuscript.

A Perfect Storm: A Window of Opportunity for Revolution in Nurse Practitioner Education

The national landscape surrounding advanced practice nursing roles is undergoing signifi cant change. A “perfect storm” of forces is converging that presents a unique window of opportunity for advanced practice registered nurses (APRNs) to realize their full potential for the provision of high-quality, cost-effective care that will improve the health of families, communities, and the nation. In particular, three of these converging forces are driving the demand for APRNs:

Publishing in Professional Journals, Part II Writing the Manuscript

A great deal of work goes into the planning phase of a manuscript. These important planning steps are necessary to complete before you start the writing process. Often, inexperienced writers do not spend enough time on these vital planning steps, and that oversight can be a major factor in having a manuscript rejected for publication. The purpose of this article is to guide you in the process of writing your manuscript on the basis of your well-designed plan. Topics that are covered include avoiding writers block, making time to write, developing the first draft using appropriate writing style, creating and submitting the final draft, and receiving feedback from the editor.

Anemia evaluation and management in nursing home residents.

Anemia is often an unrecognized and/or undertreated diagnosis in older adults. Failure to diagnose anemia leads to delayed treatment and thus delayed relief of symptoms. Given the potentially significant impact of anemia on cardiovascular disease and physical performance among older nursing home (NH) residents, it is important to evaluate current clinical practice related to anemia.The purpose of this secondary data analysis was to evaluate the frequency of laboratory evaluation and medication treatment for anemia among older NH residents. Results indicated that more than half of NH residents were anemic at baseline, and of those, less than 20% had additional testing done to further evaluate for an underlying cause of their anemia and only 45.3% received any pharmacologic treatment. Future research is needed to clarify the potential benefits of timely diagnosis and appropriate treatment for anemic older adults in long-term-care settings and establish evidence-based guidelines to direct care in this area.

Collaboration between Civilian and Military Healthcare Professionals: A Better Way for Planning, Preparing, and Responding to All Hazard Domestic Events

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

Anemia and its impact on function in nursing home residents: What do we know?

Purpose: To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes. Data Sources: Literature review of current peer‐reviewed research articles. Conclusions: In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community‐dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes. Implications for Practice: Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence‐based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence.

Length of hospital stay and discharge disposition in older trauma patients

As the number of older adults increases and life expectancies are increasing, more incidences of traumatic injury are expected in this population. In this study, the relationships between demographic variables, pain, days from admission to therapy evaluation, length of stay and discharge disposition were examined in 132 older adults who had experienced a traumatic event. Results showed that significant relationships existed between pain, age, comorbidities, injury severity and days from admission to therapy evaluation and length of stay; those with less pain, greater age and had more days between admission and when the first therapy evaluation occurred had longer lengths of stay. In addition, demographic variables, overall length of stay and pain intensity during therapy were associated with discharge location; for longer lengths of stay and higher pain, older trauma patients were less likely to be discharged to home.

Detecting ventricular hypertrophy and atrial abnormality through the electrocardiogram.

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Diagnosis and Treatment of Acute Myocardial Infarction

Rapid diagnosis and treatment of myocardial infarction are essential for maximizing patient survival. Recent advances in early detection of creatine kinase myocardial band isoforms and other chemical markers, as well as increased use of echocardiography, magnetic resonance imaging, and nuclear imaging, have enhanced the diagnostic capabilities for providers caring for a patient suspected of myocardial infarction. In management of myocardial infarction, the focus continues to be primarily on using thrombolytics, percutaneous transluminal coronary angioplasty, and coronary bypass surgery. In addition, an array of pharmacologic agents aimed at reducing cardiac muscle damage, alleviating reperfusion injuries, and preventing thrombus formation are undergoing clinical trials. These agents may hold promise for the future treatment of myocardial infarction.