DiversityNursing Blog

The trend of wearable devices (smart accessories) like bracelets, sunglasses and watches, is rarely focused on the elderly population. However, Mexican Francisco Lopez-Lira Fennel, who lives in Spain, wants these devices to be used by older adults benefiting them with the first smart watch that remotely monitors real-time health status.

The aim of the bracelet is to constantly supervise seniors who live alone and could not get help in case of a medical emergency from a fall caused by an accident to a heart attack or an anxiety attack, explained the Mexican, who is also the founder of the company "Cualli Software".

The idea was to design a simple and practical device to offer seniors the assurance that someone is on the lookout for them 24 hours a day, even without living in the same house. Everyday situation in Spain, since according to data from the National Statistics Institute, in that country about 10 percent of Spanish households is inhabited by adults over 64 who live alone.

The smart watch, or bracelet, is a specialized health system, designed for remote monitoring of vital signs of the elderly. Using three sensors; it measures the pulse, temperature and movement, also has an audio channel, small speakers and a microphone to communicate with a call center or via smartphone with a relative who can assist them by pressing the only button on the appliance.

Thanks to wireless internet (wi-fi), or the implementation of a cellular chip to provide 3G data network, it can make an emergency call and contact a doctor. Also, it is complemented with an app for smartphones and tablets with Android and iOS systems that can be downloaded by the remote caregiver for the elderly, and thus get the data of vital signs just by checking the mobile device, because measurements are automatically uploaded to the cloud.

López -Lira Fennel, who is also a member of the Mexican Talent Network, Chapter Spain, adds other features to the bracelet, like the accelerometer and screen orientation, which serve to accommodate it to movement.

Despite the innovative device, its creator stresses that "it doesn't seek to be a smart watch, because it lacks a touchscreen, nor promotes interaction through e-mail or social networks, so it is configured for the elder adult to just put it on and not worry about knowing how to handle it, having a permanent link to the call center to check his vitals or to relatives via smartphone".

The bracelet will facilitate the work of nurses and doctors who work in nursing homes or hospitals, with its help they will be able to monitor the patient remotely, instead of requiring a person to be physically there. This is because every 30 seconds it uploads information to the cloud (blood pressure, pulse, or accidentes) for it to be seen by the doctor as well as a history of the last three months, thus giving the opportunity to prevent health complications.

In order to obtain more funds to achieve a sustainable commercial product, the employer participated in the contest, "I am an entrepreneur, I am of the Mutua", where he was among the 12 projects finalists from a total of 500 participants and also in the "passion> IE "Accenture and IE Business School, being selected among the 4 finalists in the category "Health of the future". The plan, once with a commercial product, is to promote it in Europe and migrate to the US market. (Agencia ID)

Source: www.news-medical.net

By Jodie Diegel, BSN, MBA, RNC, LNCC

Laura* is severely disabled, but when she spent time with Lunar, her caregivers at Little Angels, a non-profit skilled nursing facility in Elgin, Ill., witnessed something they had never seen. Laura began to move her fingers back and forth. Lunar is not a doctor or a therapist, but a 6-year-old specially trained miniature therapy horse from the Northern Illinois-based non-profit organization Mane in Heaven that I started in 2012. Mane in Heaven specializes in animal-assisted activity and therapy visits. Our horses visit with people with physical, mental and emotional challenges ­— from people with severe disabilities to Alzheimer’s and dementia patients to patients who are undergoing treatment for cancer.

Laura’s reaction was no surprise to me. We witness this type of reaction all the time when Lunar — with her chestnut brown coat and blonde eyelashes and her gentle demeanor — or one of her fellow mini-horses meet our clients. I recall another visit between a young man who was blind and disabled and Turnabout, a 3-year-old mini-horse. Turnabout is the only boy in the bunch and has the biggest personality. When the young man put his hands on Turnabout’s face, they obviously made a connection because the man laughed exuberantly again and again. 

It brings us joy to see the light, laughter and hope our minis provide to people experiencing profound illnesses or disabilities — not to mention that these visits can lead to improved physical, mental and emotional well-being. 

I remember when the idea of working with mini-horses came to me. I was surfing the Internet one evening in December 2011 after volunteering with my two therapy dogs, Buffet and Dudley, when an advertisement caught my eye. “Mini Therapy Horses for Sale,” it said. I thought, “I have two big horses, so I know horse behavior, and I’ve done a lot of obedience training with my two therapy dogs. I can train mini-horses to do the same thing that Buffet and Dudley do.” 

But I knew I couldn’t do it alone. Two months later, I had established a volunteer board of directors, including founding board member and friend Dina Morgan, RN, and had acquired three mini-horses — Lunar, Turnabout and 3-year-old Mystery, our smallest horse. In 2013, 2-year-old Jenella joined the group. 

Mane in Heaven volunteers and mini-horses began site visits in June 2013, and since then our volunteers and horses have visited with thousands of people in need. We have relationships with numerous providers and non-profit organizations in the region, including Marklund, a home for infants, children, teens and adults with serious developmental disabilities; Gigi’s Playhouse, which cares for children and adults with Down Syndrome; Wings, which advocates for survivors of domestic violence, as well as homeless women and children; JourneyCare, which specializes in palliative medicine and hospice care; and Rush University Medical Center, a premier hospital located in Chicago. 

A site visit usually lasts up to two hours and involves an exchange of unconditional love between the horses and our clients. People watch, pet, brush, hug and take pictures with the minis. Rather than thinking and talking about themselves and their problems, our clients focus on the animals. When our horses visit a care facility, the residents laugh and interact more, are mentally stimulated by the entertainment and are able to recall personal memories more readily. 

When Corin Garcia, 19, from Palos Hills, Ill., met Lunar at a Mane in Heaven visit at Rush University Medical Center, it changed her whole perspective on her pending treatment. Corin told me it was a day she dreaded more than anything — admission day for “four tedious, boring days of chemotherapy,” she said. But Corin’s attitude changed when her she met Lunar. “I was in an awful mood, yet when two miniature horses walked through the door my mind cleared all its negative thoughts and my heart instantly melted. Being around these beautiful creatures made the worse day turn into the best I have ever had in the hospital.”

Mane in Heaven does not charge for visits; we rely on donations and fundraising, so fundraising is important work for our volunteers. Interest is growing in our services, thanks, in part, to media coverage by CNN, the Associated Press, and local media outlets. Having the support of volunteers helps us to maximize donations, but we hope to find others who believe in our mission and will also support us financially. While our horses are tiny, there are still significant expenses associated with running our organization. One day we’d love to open our own therapy center and acquire more horses, so we can serve more people. 

Running a nonprofit business is challenging while also working full time, but I really never feel like this is work for me. While I may have had the vision for Mane in Heaven, our volunteers have made it a reality. We have a group of amazing and generous volunteers who help special horses help special people. Everyone has challenges in their lives, but whether we are with the minis at training sessions or on visits, we always feel happier and joyful after some “mini love.” We are the privileged ones to be on the other end of the rope.

Source: http://news.nurse.com

By DANNY HAKIM

ATHENS — Fotini Katsigianni wears a white nurse’s hat that protrudes prominently from the top of her head. She is head nurse at Evangelismos Hospital, one of the city’s most prominent.

So she was surprised last month when she was approached by a man in the hospital’s hallway. At the time, Ms. Katsigianni’s husband was a patient there. The strange man extended an arm with a business card and averted his face, so she could not identify him. He offered to rent her a cut-rate nurse.

“He told me for 30 euros I could have whatever I want!” Ms. Katsigianni said, laughing at the idea of the head nurse being solicited to buy illegal nursing care.

First the men come to the hospitals of Greece during visiting hours, leaving business cards with pictures of nurses under pillows and in waiting rooms. Then the women come at night, mostly foreigners from countries like Georgia, Romania and Bulgaria. They are the nurses of Greece who aren’t really nurses.

Greece’s dire finances have gutted its health care system. Universal coverage effectively ended under the austerity measures imposed under the terms of the country’s bailout. Budget cuts have also thinned the ranks of hospital staff nurses, who are supposed to handle medical tasks like changing IVs.

Now, when patients come to a hospital in Greece, they increasingly have to hire their own nurses just to receive basic care. While private nurses have long been a feature of Greek health care, the country’s wrenching economic crisis has left many patients with neither the money nor the insurance coverage to hire licensed caregivers.

Instead, patients are turning to illegal nurses, often immigrants with little or no training. One top official said he believed that half of the nursing care came from 18,000 illegal providers.

The situation reflects the grip of the black-market economy on Greece, where even paying skilled workers like mechanics and plumbers under the table to avoid taxes is commonplace. Frustrations among Greeks over the deterioration of living standards helped feed the left-wing Syriza Party, which came to power last month vowing to reject austerity policies.

Illegal nurses typically pose as family members or say they are longtime personal employees of a patient. In reality, temp agencies employing these women send men into the hospitals to distribute business cards advertising 12 hours of nursing care for less than $60. By contrast, a contract nurse at another hospital, Sotiria, costs nearly $70 for 6 hours and 40 minutes, though those who still have insurance can be reimbursed for about a third of the cost.

Thanos Maroukis, a professor at the University of Bath, England, who has studied the problem, said temporary agencies are taking “over control of the hospital’s workplace,” adding, “It’s incredible what’s happening, but it’s true.”

Nurses are just the beginning. Almost anything can be rented.

“We have the same thing with TVs, with ambulances, I would say with bedding,” said Anastasios Grigoropoulos, the chief executive of Evangelismos Hospital. “Or chairs.”

Chairs are carried in by strangers who rent them to groups of visiting relatives. Or they bring televisions.

In many other developed countries, hospital security would simply expel unauthorized visitors. But administrators face staff shortages and impoverished patients. They also say they lack the legal jurisdiction to act without police intervention.

“Because of the crisis, the last three years, we see more and more illegal nurses,” said Mr. Grigoropoulos. “You can’t do anything.”

He has called the police, and a few days earlier, Evangelismos was raided. Several illegal nurses were arrested, but that is a fairly rare event, because the police have had their own cutbacks.

Government agencies, too, have been overwhelmed. An influx of immigrants since the 1990s swelled a pool of cheap labor.

These immigrants “filled the space and found themselves in every clinic and every hospital,” said Dimitrios Papachristou, a senior official at the Social Insurance Institute, a state agency known by its Greek acronym, IKA, which provides insurance and pensions to 2.2 million Greek workers, including nurses. “Why is that? There was a great demand by the patients” for cheaper care, Mr. Papachristou said.

Part of the problem, he said, was that his agency had been given the task of conducting inspections of nursing credentials, a task beyond its typical expertise.

“Let me give you an example,” he said. “I’ll send an inspector to a hospital to inspect contract nurses who work there. So I find at that hospital 15 people who are working there do not have an IKA permit.”

But often he does not have the authority even to issue fines. Instead, his agency reports such incidents to hospital directors, and they decide whether to call the police.

“It’s an extremely illogical thing,” he said.

Because most illegal nurses are immigrants, Golden Dawn, the far-right extremist party, has attempted some of its own “raids” on hospitals, advancing its xenophobic agenda.

But some of the real nurses having trouble getting work are themselves immigrants, like Eleni Souli, a 41-year-old Albanian who married a Greek man and works as a contract nurse. She was sitting among a group of eight other nurses at a cafe outside another Athens hospital recently. All had studied for two to four years to become nurses, and they poured out their frustration over coffee and cigarettes.

“They are not nurses," Ms. Souli said of the illegal workers.

Maria Skiada, 54, has been a nurse for 23 years. She said she recently saw a woman who did not even use gloves when she cleaned up.

“That is how you get bugs all around the hospital,” she said.

Ms. Souli said doctors would sometimes be surprised at how infections spread.

“When they see that in the blood work of a patient, they’ll see something and say, ‘Where did he get that from?’ ”

She counted eight illegal nurses at the clinic where she worked the previous evening. “At night,” she said, “it’s full of them.”

That was clear in another part of town, at Sotiria Hospital, on a recent chilly night.

A young Georgian woman in a striped blue shirt was caring for a patient. She said she had already been working at the patient’s home and came with him to the hospital, a claim administrators say is frequently used. A second woman peeked out of the room next door, then waved away questions, saying she could not speak Greek.

“They take food out of our mouths. That’s how it is,” said Stavroula Antoniou, 46, a licensed nurse who works on temporary contracts at Sotiria. She emphasized that her bitterness was not tinged with racism and that many legitimate nurses were foreign-born.

“We’ve earned this,” she said of her job. “We’ve studied and we’ve sat in classrooms.”

Dr. Miltiadis Papastamatiou, Sotiria’s chief executive, said retired nurses were often not replaced, “and that’s led to the needs of both patients and staff not being adequately met,” though he downplayed the extent of the problem at Sotiria.

But a staff nurse there, who would not give her name for fear of losing her job, acknowledged the severity of the issue.

“We know what’s going on,” she shrugged. “Everybody knows.”

Source: www.nytimes.com

Eve, an artificially-intelligent 'robot scientist' could make drug discovery faster and much cheaper, say researchers writing in the Royal Society journal Interface. The team has demonstrated the success of the approach as Eve discovered that a compound shown to have anti-cancer properties might also be used in the fight against malaria.

Robot scientists are a natural extension of the trend of increased involvement of automation in science. They can automatically develop and test hypotheses to explain observations, run experiments using laboratory robotics, interpret the results to amend their hypotheses, and then repeat the cycle, automating high-throughput hypothesis-led research. Robot scientists are also well suited to recording scientific knowledge: as the experiments are conceived and executed automatically by computer, it is possible to completely capture and digitally curate all aspects of the scientific process.

In 2009, Adam, a robot scientist developed by researchers at the Universities of Aberystwyth and Cambridge, became the first machine to independently discover new scientific knowledge. The same team has now developed Eve, based at the University of Manchester, whose purpose is to speed up the drug discovery process and make it more economical. In the study published today, they describe how the robot can help identify promising new drug candidates for malaria and neglected tropical diseases such as African sleeping sickness and Chagas' disease.

"Neglected tropical diseases are a scourge of humanity, infecting hundreds of millions of people, and killing millions of people every year," says Professor Steve Oliver from the Cambridge Systems Biology Centre and the Department of Biochemistry at the University of Cambridge. "We know what causes these diseases and that we can, in theory, attack the parasites that cause them using small molecule drugs. But the cost and speed of drug discovery and the economic return make them unattractive to the pharmaceutical industry.

"Eve exploits its artificial intelligence to learn from early successes in her screens and select compounds that have a high probability of being active against the chosen drug target. A smart screening system, based on genetically engineered yeast, is used. This allows Eve to exclude compounds that are toxic to cells and select those that block the action of the parasite protein while leaving any equivalent human protein unscathed. This reduces the costs, uncertainty, and time involved in drug screening, and has the potential to improve the lives of millions of people worldwide."

Eve is designed to automate early-stage drug design. First, she systematically tests each member from a large set of compounds in the standard brute-force way of conventional mass screening. The compounds are screened against assays (tests) designed to be automatically engineered, and can be generated much faster and more cheaply than the bespoke assays that are currently standard. This enables more types of assay to be applied, more efficient use of screening facilities to be made, and thereby increases the probability of a discovery within a given budget.

Eve's robotic system is capable of screening over 10,000 compounds per day. However, while simple to automate, mass screening is still relatively slow and wasteful of resources as every compound in the library is tested. It is also unintelligent, as it makes no use of what is learnt during screening.

To improve this process, Eve selects at random a subset of the library to find compounds that pass the first assay; any 'hits' are re-tested multiple times to reduce the probability of false positives. Taking this set of confirmed hits, Eve uses statistics and machine learning to predict new structures that might score better against the assays. Although she currently does not have the ability to synthesise such compounds, future versions of the robot could potentially incorporate this feature.

Professor Ross King, from the Manchester Institute of Biotechnology at the University of Manchester, says: "Every industry now benefits from automation and science is no exception. Bringing in machine learning to make this process intelligent -- rather than just a 'brute force' approach -- could greatly speed up scientific progress and potentially reap huge rewards."

To test the viability of the approach, the researchers developed assays targeting key molecules from parasites responsible for diseases such as malaria, Chagas' disease and schistosomiasis and tested against these a library of approximately 1,500 clinically approved compounds. Through this, Eve showed that a compound that has previously been investigated as an anti-cancer drug inhibits a key molecule known as DHFR in the malaria parasite. Drugs that inhibit this molecule are currently routinely used to protect against malaria, and are given to over a million children; however, the emergence of strains of parasites resistant to existing drugs means that the search for new drugs is becoming increasingly more urgent.

"Despite extensive efforts, no one has been able to find a new antimalarial that targets DHFR and is able to pass clinical trials," adds Professor King. "Eve's discovery could be even more significant than just demonstrating a new approach to drug discovery."

The research was supported by the Biotechnology & Biological Sciences Research Council and the European Commission.

Source: www.sciencedaily.com

Nurses are an important part of the medical workforce. They provide crucial supplementary services and are primary caregivers in a lot of industries. As such, the demand for nurses is high, though there are variations according to different states. As the country’s population and access to medicine continues to grow, the demand for nurses does as well.

Source: http://online.adu.edu

BY EMMANUELLE SALIBA

After a howling blizzard with hurricane-force winds socked Boston with 21 inches of snow on Tuesday, some nurses and doctors hitched rides with police or put on skis and snowshoes to get to work.

Kelli O'Laughlin, one of the doctor's at Brigham and Women's Hospital who skied to work, found her ride "fun" and "exhilarating." She told NBC's Miguel Almaguer that doctors have to come in to work because"the emergency department is one of those places where 24 hours a day, 7 days a week it's always going."

"Our sincerest thanks to all employees that have gone to extraordinary lengths to get to the hospital during the storm," wrote the hospital in an Instagram post along with a photo of pathology technician Vivian Chan on snowshoes.

Source: www.nbcnews.com

Written by James McIntosh

While violence intervention programs have demonstrated that they can be an effective way of preventing violent injury, little has been known about their financial implications. A new study now suggests that these interventions could save various sectors millions of dollars.

Researchers from Drexel University have analyzed the cost-benefit ratio of hospital-based violence intervention programs (HVIPs) and report that - as well as benefiting victims' lives - HVIPs can make costs savings of up to $4 million over a 5-year period in the health care and criminal justice sectors.

"This is the first systematic economic evaluation of a hospital-based violence intervention program, and it's done in a way that can be replicated as new evidence emerges about the programs' impacts across different sectors," states lead author Dr. Jonathan Purtle.

As a major cause of disability, premature mortality and other health problems worldwide, HVIPs have a crucial role to play in helping victims from experiencing further suffering.

The provision of case-management and counseling from combinations of medical professionals and social workers has been associated with not only reducing rates of aggressive behavior and violent re-injury but also improving education, employment and health care utilization for service users.

Many HVIPs still require a sustainable source of funding

Intervention typically begins in the period immediately after a violent injury has been sustained. Not only is this a critical moment in terms of physical health, but it can also be a time when victims may start thinking about retaliation or making changes in their lives.

"The research literature has poetically referred to the time after a traumatic injury as the 'golden hour,'" says study co-author Dr. Ted Corbin.

In 2009, around six programs were in operation and, as word of their success has spread, more and more HVIPs have been initiated.

Calculating the potential financial benefits of HVIPs is crucial, as for many of these programs a stable and sustainable source of funding does not exist. Instead, many rely on a variety of different financial sources such as insurance billing, institutional funding, local government funding and private grants.

For the study, published in the American Journal of Preventive Medicine, the researchers conducted a cost-benefit analysis simulation in order to estimate what savings an HVIP could make over 5 years in a hypothetical population of 180 violently injured patients. Of these, 90 would receive HVIP intervention and 90 would not.

Costs, rates of violent re-injury and violent perpetration incidents that a population would be estimated to experience were calculated by the authors using data from 2012.

The authors made a comparison between the estimated costs of outcomes that would most likely be experienced by the 90 hypothetical patients receiving HVIP intervention - including $350,000 per year costs of the HVIP itself - and the costs of outcomes predicted for 90 patients not receiving any HVIP intervention.

The net benefit of the interventions

A total of four different simulation models were constructed by the researchers to estimate net savings and cost-benefit ratios, and three different estimates of HVIP effect size were used.

Costs that were factored into the simulations included health care costs for re-injury, costs to the criminal justice system if the victims then became perpetrators and societal costs for potential loss of productivity.

Each simulation calculated that HVIPs produced cost savings over the course of 5 years. The simulation model that only included future health costs for the 90 individuals and their potential re-injury produced savings of $82,765. The simulation model including all costs incurred demonstrated savings of over $4 million.

Dr. Purtle acknowledges that estimated lost productivity costs may have been slightly high due to an assumption in their data that all individuals in the simulation were employed. However, he believes that there are also many social benefits to HVIPs that cannot be financially quantifiable:

"Even if the intervention cost a little more than it saved in dollars and cents to the health care system, there would still be a net benefit in terms of the violence it prevented."

The authors believe that the findings of their study could be useful in informing public policy decisions. By demonstrating that HVIPs can be financially beneficial, the study suggests that an investment in HVIPs is one that pays off for everyone concerned.

Source: www.medicalnewstoday.com

By MICHELLE CASTILLO

Pets are getting some pain relief thanks to a centuries-old method that has helped some of their owners: acupuncture.

A dachshund named Samson benefitted from the treatment. Samson was pawed aggressively by another dog at the park and needed surgery immediately. After his first procedure, it was clear he was still in some pain. Doctors recommended a second surgery, but owner Ellie Sutton wasn't so keen to make Samson go under the knife again.

"I wouldn't want to risk something like paralysis," Sutton told CBS News. She decided "to try every other kind of step first."

To her surprise, the veterinarian suggested acupuncture, the traditional Chinese medicine method of inserting needles into the skin to stimulate parts of the body.

Veterinary acupuncturists can use .2 to .3 mm needles that range in length from .5 inches to 1.5 inches on pooches.

"A lot of people come for acupuncture because they've exhausted a lot of the traditional Western medicine roots, whether it's medication or surgery," Dr. Marc Seibert, Samson's vet, told CBS News. Siebert is the owner and medical director of Heart of Chelsea Animal Hospital and Lower East Side Animal Hospital in New York City.

Seibert explained there are two main theories behind how acupuncture works. Eastern medicine teaches that energy flows through channels in the body called meridians. When the meridians are blocked, the person -- or the animal -- experiences physical pain. The acupuncture needles help direct the energy to the correct path.

Western medicine, on the other hand, suggests that acupuncture may help by bringing oxygen to the area that the doctor is trying to treat. Hormones called endorphins, which promote feelings of well-being, are released, and the anti-inflammatory parts of the immune system kick in.

"Most people think of acupuncture as a pain reliever, but it's more than that," says Dr. Ihor Basko, a holistic veterinarian in private practice in Honolulu, certified by the International Veterinary Acupuncture Society in Ft. Collins, Colo., told Paw Nation. "Acupuncture can boost the immune system and improve organ functions, and it has other benefits. It can complement conventional medicines and procedures without dangerous side effects."

Not everyone is convinced the method works. Veterinarian Craig Smith, the complementary-care expert for the American Veterinary Medical Association, told U.S. and World News Report that it's hard to know for sure if canines and felines are feeling relief from their pain.

"While many people treating pets with acupuncture report success, there isn't any data that proves it works," he said.

Ellie Sutton admitted that a lot of the "energy flow" talk is hard for her to believe. But she says Samson has definitely benefited from the treatment.

"The fact is he walks better afterwards," she said.

Source: www.cbsnews.com

By Debra Anscombe Wood, RN

While credentials may seem like an alphabet soup after one’s name, the letters tell the world much about a nurse’s qualifications, including licensure, certifications and fellowships.  

“Credentials are not only a source of pride for the nurse, but communicate to patients, colleagues and hospital leaders the nurse’s commitment to standards of excellence,” said Mary Frances Pate, PhD, RN, CNS, associate professor at the University of Portland School of Nursing in Oregon and chairwoman of the board of directors for AACN Certification Corporation, the certification organization for the American Association of Critical-Care Nurses.

Other academic nurses agree. “Credentials matter to the public,” said Rebecca M. Patton, MSN, RN, CNOR, FAAN, Lucy Jo Atkinson Scholar in Perioperative Nursing at Case Western Reserve University in Cleveland, adding that they also demonstrate growth and lifelong learning valuable to the nurse and to nurse managers and administrators.

Depending on the position, “some nursing positions require certification demonstrating expertise, and some do not,” said Robert Hanks, PhD, FNP-C, RNC, assistant professor and clinical/FNP track director at the University of Texas Health Science Center at Houston School of Nursing. 

Marianne Horahan, MBA, MPH, RN, CPHQ, director of certification services at the American Nurses Credentialing Center, reported an increase in certification applications this year, in part because of employers’ promotion of certification. A new “Success Pays” program allows the hospital to directly pay for successful exam completion. 

Employers also seek nurses with degrees, as evidence suggests organizations with a higher percentage of BSN- or MSN-prepared nurses have greater patient outcomes, said Paulette Heitmeyer, MSN/ED, RN, CNO at Marina Del Rey Hospital in California. 

Pate said nurses whose clinical skills and judgment have been validated through certification often make patient care decisions with greater confidence, recognize problems and intervene appropriately.

While many believe credentials lead to better care and patient outcomes, research is limited. The Institute of Medicine recently released a research agenda to help fill this gap. 

Nurses should list the highest degree first, immediately after their name, then licensure, any state designations, national certifications, awards, honors and other recognitions, according to the ANCC. 

“Certification provides a foundation for lifelong learning and professional development,” Horahan said. “The purpose of certification is to assure the public that this individual has mastered the body of knowledge and acquired skills in the specialty.”

Source: http://news.nurse.com

By David McNamee

It has been a dramatic plot device within countless movies and soap operas, but now a new study from Northwestern Medicine and Hines VA Hospital, both in Illinois, has attempted to answer the question: can the voices of family members and loved ones really wake coma patients from unconsciousness?

A coma is defined as an unconscious condition in which the patient is unable to open their eyes. When a patient begins to recover from a coma, they progress first to a minimally conscious or "vegetative state," though these states can last anywhere from a few weeks to several years.

Lead author Theresa Pape was inspired to conduct the new study - the results of which are published in the journal Neurorehabilitation and Neural Repair - while working as a speech therapist for coma patients with traumatic brain injuries. Pape observed that patients appeared to respond better to family members than to strangers.

From this, Pape began to wonder if patients' ability to recover might be increased if therapists were able to stimulate and exercise people's brains while they were unconscious.

As part of the randomized, placebo-controlled study, 15 patients with traumatic closed head injuries who were in a minimally conscious state were enrolled to Familiar Auditory Sensory Training (FAST). The 12 men and three women had an average age of 35 and had been in a vegetative state for an average of 70 days before the FAST treatment began.

At the start of the study, Pape and her colleagues used bells and whistles to test how responsive the patients were to sensory information. They also assessed whether the patients were able to follow directions to open their eyes or if they could visually track someone walking across the room.

Magnetic resonance imaging (MRI) was also used to get a baseline impression of how blood oxygen levels in the patients' brains changed while listening to both familiar and unfamiliar voices tell different stories.

The therapists then asked the patients' families to look at photo albums to identify and piece together at least eight important stories concerning events that the patient and their family took part in together.

"It could be a family wedding or a special road trip together, such as going to visit colleges," Pape explains. "It had to be something they'd remember, and we needed to bring the stories to life with sensations, temperature and movement. Families would describe the air rushing past the patient as he rode in the Corvette with the top down or the cold air on his face as he skied down a mountain slope."

Patients were more responsive to unfamiliar voices after 6 weeks of therapy

The stories were rehearsed and recorded by the families and then played to the coma patients for 6 weeks. Following this listening period, the MRI tests were repeated, with blood oxygen levels being taken while the patients listened to their stories being told by familiar and unfamiliar voices.

The MRI recorded a change in oxygen levels when the unfamiliar voice was telling the story, but there was no change from baseline levels for the familiar voice.

Pape says that these findings demonstrate a greater ability to process and understand speech among the patients, as they are more responsive to the unfamiliar voice telling the story: "At baseline they didn't pay attention to that non-familiar voice. But now they are processing what that person is saying.''

At this point in the treatment, the researchers also found that the patients were less responsive to the sound of a small bell ringing than they had been at the start of the study. The team believes that this indicates the patients were now better able to discriminate between different types of audio information and decide what is most important to listen to.

"Mom's voice telling them familiar stories over and over helped their brains pay attention to important information rather than the bell," Pape says. "They were able to filter out what was relevant and what wasn't."

The first 2 weeks were found to be the most important period for treatment and demonstrated the biggest gains. The remaining 4 weeks of treatment saw smaller, more incremental gains.

"This gives families hope and something they can control," Pape says of the treatment, recommending that families work with a therapist to help construct stories that augment the other therapies the patient may be undergoing.

Now, the team is analyzing the study data to investigate whether the FAST treatment strengthened axons - the fibers that make up the brain's "wiring" and transmit signals between neurons.

Source: www.medicalnewstoday.com