Yvonne K. Scherer

A Comparison of Clinical Simulation and Case Study Presentation on Nurse Practitioner Students' Knowledge and Confidence in Managing a Cardiac Event

The study was designed to compare the efficacy of controlled simulation mannequin (SM) assisted learning and case study presentation on knowledge and confidence of nurse practitioner (NP) students in managing a cardiac event. Twenty-three volunteer students were randomly assigned to the experimental (simulation) or control (case study presentation) group. All participants were instructed on atrial arrhythmias, were pre- and post-tested on knowledge and confidence, and completed an evaluation of the experience. There were no statistically significant differences in knowledge test scores, although the control group scored significantly higher on post- test confidence (p=.040). Both groups rated their experience as valuable. The simulation and case study presentation had similar outcomes. Additional research is needed to determine the effectiveness of this teaching modality.

Acute care nurse practitioner education: enhancing performance through the use of clinical simulation.

Full-body patient simulators have been used for a number of years to educate nurse anesthetists and anesthesiologists. These lifelike mannequins operate from a sophisticated computerized system with the ability to generate multiple physiologic events and respond to numerous pharmacologic stimuli. The authors recently integrated the use of the patient simulator into the curriculum to educate their acute care nurse practitioner students. The learning process was divided into three steps: the presimulation experience, the simulation experience, and the postsimulation experience. These steps are described as well as important principles that need to be integrated into each phase of the process. A case scenario on respiratory failure provides an example of the simulation experience. In addition, the advantages and disadvantages of this teaching method, as identified by faculty and students, are discussed.

Effects of Using Nintendo Wii™ Exergames in Older Adults A Review of the Literature

Objective: The purpose of this review is to summarize and synthesize the impact of using the Nintendo Wii™ exergames in older adults. Method: A database search was conducted to identify relevant studies. The search was limited to empirical studies, with particular attention paid to the effects of Wii exergames intervention on cognition, physical function, and psychosocial outcomes in older adults. Results: A total of 22 empirical studies met inclusion criteria and were included in this review. Positive effects included improving physical function, decreasing depression, and increasing cognition and quality of life in older adults. Improved socialization and motivation to exercise were also reported. Discussion: Using Wii exergames does show promise as an intervention to improve physical function, cognition, and psychosocial outcomes in older adults. Evidence supports that Wii exergames is a safe and feasible tool to encourage older adults to engage in exercise.

The nursing dilemma of restraints.

This study provides a data base for developing intervention strategies aimed at helping staff cope with concerns regarding restraints. Most respondents believe patients should be restrained for safety even if it means loss of dignity, and that a caring manner should be conveyed to restrained patients. A large percentage felt that family members did not have the right to refuse the use of restraints, but that they should have that right if they were patients, suggesting negative attitudes toward restraints, of which they are unaware. Personal and professional characteristics, such as knowledge about restraints, years in geriatrics, and experience with elderly family members, showed no significant relationship to attitudes.

Understanding the Effects of a Myocardial Infarction on Sexual Functioning: A Basis for Sexual Counseling

&NA; Sexual counseling is an integral component of the rehabilitative process for clients who have experienced a myocardial infarction (MI). This article describes myths and fears concerning the dangers of resuming sexual intercourse after a heart attack, positions for intercourse, and the effects of intercourse on arrhythmias, angina, and blood pressure. The purpose is to provide the results of empirical research to dispel myths and fears and to consider the causes of sexual dysfunction, the changes MI brings about in sexual activity for men and women, and the effects of age, exercise, and antihypertensive drugs on the resumption of sexual activity. Guidelines are provided for conducting a sexual/cardiac history as part of the counseling model with specific information for the post‐MI client.

Can a Pulmonary Health Teaching Program Alter Patients' Ability to Cope with COPD?

&NA; Many clinical nurse specialists (CNSs) are involved in providing group teaching programs for individuals with chronic obstructive pulmonary disease (COPD). Although knowledge levels often are enhanced by these programs, what is less well known is whether such programs also can affect the coping methods used by those with this disease. The exploratory study described here was part of a larger research project aimed at determining patients’ knowledge, specific psychological parameters (anxiety, hostility, depression), and coping strategies. Thirty people agreed to participate in the study. The Jalowiec Coping Scale (JCS) (Jalowiec & Powers, 1981) was used so that participants could rate each coping method according to the degree of use and to determine whether the methods employed were affective or problem‐solving approaches. There was very little change in the pre‐ and posttest scores on the JCS, indicating that there was little change in coping strategies used. There also were no significant correlations between the JCS scores and the demographic characteristics of age, educational level, and the length of time since diagnosis of COPD. The results of this study seem to indicate that pulmonary rehabilitation programs should place more emphasis on appropriate coping strategies that the COPD patient can incorporate into his or her lifestyle.

A challenge in academia: meeting the healthcare needs of the growing number of older adults.

PurposeThe purposes of this study were to survey nurse practitioners (NPs) to determine their comfort level with knowledge about caring for individuals aged 65 years and older and to obtain their input on enhancing geriatric content in the educational preparation of advanced practice nurses who provide care to older adults but are not specialists in gerontology. Data sourcesThe sample consisted of 500 randomly selected NPs who were certified to practice in New York State. The Geriatric Curriculum Survey designed by the researchers was based on the 47 “Older Adult Care” competencies developed by the American Association of Colleges of Nursing. The survey was mailed to the subjects along with a stamped self-addressed envelope to facilitate its return. Two hundred and twenty–two surveys (44%) were returned. ConclusionsA majority of the respondents were comfortable with their assessment skill knowledge of individuals aged 65 years and older in all areas except those related to cultural/ethnic items. Over half of the respondents were only “somewhat comfortable” with knowledge of management of Alzheimers disease, delirium, dementia, neurological problems, polypharmacy, and sleep issues. Finally, respondents were asked to rate their knowledge comfort level on topics relevant to physical and psychosocial issues of individuals aged 65 years and older. The majority of respondents only felt “somewhat comfortable” with their knowledge on all but one of the nine items in this category. Health promotion and disease prevention was the only item that over 50% of the respondents felt “very knowledgeable” about. Ninety-five percent indicated they would be better prepared to care for individuals aged 65 years and older if a didactic course in geriatrics was required in their program of study. Seventy percent indicated they would consider taking an online course in geriatrics. Implications for practiceBased on the results of this study, an online, four-credit geriatric-focused course “Issues in Geriatric Management” was developed. The course is required in the acute care and adult NP programs. Eventually, this course will be offered as continuing education credit for practicing NPs. The offering of a course focused on geriatrics will help to better prepare NPs to care for the growing number of elderly in this country.

Using Self-Efficacy Theory to Educate Patients with Chronic Obstructive Pulmonary Disease

&NA; The predominant debilitating symptom in patients with chronic obstructive pulmonary disease (COPD) is shortness of breath. Self‐efficacy theory has been used in a case study approach to begin examining the expectations of a patient with COPD who attended a pulmonary education program. Mr. M. was selected for the case study because his condition typifies many of the problems encountered by patients with COPD. Mr. M.s self‐confidence in managing his breathing difficulty was measured by using the COPD Self‐Efficacy Scale (CSES) before an educational program began and again 1 month and 6 months after the program. The CSES measures patients’ confidence in their ability to manage or avoid breathing difficulty in a variety of situations. Mr. M.s scores on the CSES improved in most areas. Incorporating programs to increase patients’ self‐efficacy may have implications for rehabilitation nurses who help patients with COPD manage their breathing difficulty.

Physical and Psychosocial Effects of Wii Fit Exergames Use in Assisted Living Residents A Pilot Study

The purpose of this study was to investigate the physical and psychosocial effects of the Wii Fit exergames incorporating self-efficacy theory on assisted living residents. The study was a quasi-experimental pre/post-test design. Thirty-two participants were recruited from two assisted living facilities. Sixteen participants received the Wii Fit exergames incorporating self-efficacy theory twice a week for 4 weeks. The other participants received a health education program. Physical function, fear of falling, depression, and quality of life were evaluated. T tests were used for data analysis. After the 4-week intervention, the Wii Fit group showed significant improvements in balance (p < .01), mobility (p < .01), and depression (p < .05). The education group showed no significant improvement in any of the outcomes. Integrating concepts of self-efficacy theory with the exergames show promise as a potential tool to improve and maintain physical and psychosocial health for older adults.

Nurses' Knowledge About AIDS in Erie County, New York: A Research Brief

This study describes knowledge about acquired immunodeficiency syndrome (AIDS) among a random sample of 581 registered nurses in Erie County, New York. Data were gathered by mailed questionnaires that included items about the epidemiology, pathophysiology, transmission, and treatment of AIDS. Substantial deficiencies in knowledge were observed. The mean score on an index of knowledge was slightly less than 70%. Respondents were most knowledgeable about the transmission of AIDS and least knowledgeable about issues pertaining to treatment and care. Nurses who had cared for patients with AIDS scored significantly higher overall than those without experience. These data document the need to provide continuing education programs for nurses to prepare them to meet the needs of the increasing AIDS crisis.