Bon Secours Memorial College of Nursing

Abstract Introduction Quality of life is the ultimate outcome for a patient who has undergone myocardial revascularization. Among several influencing factors, adherence to drug regimen enhances its level by preventing restenosis of stent or graft and restricting the progress of native CAD. Nurse’s role is to assist patient with myocardial revascularization for maintaining high quality of life by exploring the associated issues in a greater extent. Objectives The objectives of the study were to assess the level of adherence to drug regimen, to explore potential factors of adherence to drug regimen and to assess quality of life among patients who have undergone myocardial revascularization. Methodology A quantitative research approach and prospective longitudinal cohort study design was adopted to collect data from three hundred and fifty (355) patients who have undergone either PTCA or CABG, selected by nonprobability convenience sampling technique. ARMS, SF-36 short form and an interview schedule were used to collect data from the subject at three months’ interval till nine (9) months after revascularisation. Result The study result shows that majority (82%) of the patients with myocardial revascularisation were adherent to drug regimen at initial month after revascularisation but reduced to 52% after nine months(p<0.01). The percentage of adherence with medication was significantly reduced to 74% after 3 months, 75% after 6 months, and 59 % after 9 months among patients with CABG whereas percentage of adherence among patient with PTCA was also reduced to 66% after 3 months, 63% after 6 months and 44 % after 9 months (p<0.01) Age and educational status were independent predictive factors for adherence to drug regimen among patient with PTCA. The potential associated factors related to adherence to drug regimen was no of drugs unavailable at Govt. medicine counter. The two main domains, of quality of life as Physical component summary and Mental component summary of patient with myocardial revascularisation were improved from one month to 9 months after intervention (p<0.001) Physical component summary of Quality of life had a negative relationship with adherence to drug regimen at 3 months, 6 months and 9 months’ time period whereas mental component summary of Quality of life had a significant negative relationship with adherence to drug regimen at 6 months’ time period. Conclusion Adherence to drug regimen was decreased over time but Quality of life was improved among patients with myocardial revascularisation. There was a positive relationship with adherence to drug regimen with PCS domain of quality of life among patients with myocardial revascularisation. Age and educational status were independent predictive or potential factors for adherence to drug regimen among patient with PTCA.

Background: Endotracheal intubation is a life saving procedure in which endotracheal tube is passes through the mouth to the endotracheal tract. It provides a patent airway to the patient who cannot breathe and treated with other methods. Objectives of the study were to assess the effectiveness of demonstration and video assisted teaching by doing pre –test and post – test knowledge score. A quantitative research approach with quasi – experimental design was used to assess the effectiveness of demonstration and video assisted teaching regarding endotracheal intubation and its long term complications among B.Sc nursing 2nd year students of selected nursing colleges of district Kangra (H.P). A simple random method sampling technique was used. Sample size was 80 and data was collected by structured knowledge questionnaire. The validity and reliability of tool was established. Data was analysed by using descriptive and inferential statistics. Results: Finding of the study was revealed that out of 80 subjects (66.3%) had average knowledge, (21.3%) had good knowledge and (12.5%) had poor knowledge in Pre – test whereas in Post – test knowledge score reveals that majority 45% of them had good knowledge and 38.8% had very good knowledge, 16.3% had average knowledge. The overall test depicts that in the pre – test range was 4 - 15, Mean 9.78, Standard deviation was 2.868, Mean percentage of knowledge score was 39.10% and in post-test range was 7-22, mean 16.13, Mean percentage of knowledge score was 64.50%. The calculated ‘t’ value (15.029) was greater than the table value (t – 1.99) at 0.05 level of significance. Hence, it can be inferred that the demonstration and video assisted teaching was effective in increasing the knowledge. Conclusion: The both methods of teaching which is demonstration and video assisted teaching methods are effective in learning. Although both methods helps to enhance the knowledge related to endotracheal intubation and its long term complications.

Cannabis has been cited as the most frequently used drug in this country, and intolerance toward substance use is a recognized concern in nursing. The twofold purpose of this descriptive study was to determine (a) what, if any, were the differences between nurses' attitudes of patient cannabis use in states in which cannabis was legal versus illegal and (b) how do nurses working in diverse care settings differ in their attitudes regarding patient cannabis use. A sample of 809 registered nurses from across the United States were recruited to take part in this study in October 2018. A previously validated 20-question survey was used to collect participants' perceptions of and attitudes toward patient cannabis use. Demographic information collected included age, gender, educational level, years in practice, primary area of practice, and legal status of cannabis in state of practice. An independent t test and analysis of variance were used to analyze group differences. Findings from this study indicated that there was no significant difference in attitudes of nurses in states in which cannabis use was legal (M = 28.76, SD = 7.83) and states in which it was illegal (M = 29.43, SD = 7.65), t(807) = 1.202, p = .230. In addition, no significant differences were found in attitudes across six areas of practice, F(5) = 1.531, p = .178. Furthermore, nursing attitudes were largely positive toward patient cannabis use (M = 29.04, SD = 7.762; range: 20-100). Findings from this study indicate that cannabis use may not carry the same perceived stigma as other illicit substances for nurses and unbiased care may be provided regardless of personal beliefs.

Evidence supports the return on investment for an RN in ambulatory care. Utilizing RNs to their fullest potential in ambulatory practices is essential to effectively manage population health. Bon Secours Health System launched a new role, patient navigator RNs, to ensure seamless transitions of complex patients across care settings, resulting in better patient outcomes and a financial return.

The principal aim of this study was to determine the hospital-acquired pressure injury (HAPI) rate before and after introduction of a repositioning device, measure staff-perceived level of exertion with device use, and assess return on investment. 1 group, before-and-after study. The sample comprised 717 patients cared for in a 17-bed intensive care unit. The study setting was the neonatal intensive care unit at Bon Secours Maryview Medical Center located in the mid-Atlantic United States (Portsmouth, Virginia). A safe patient-handling intervention was implemented as part of a quality improvement initiative. The effect of this system was measured using several outcome measures: (1) HAPI occurrences on the sacral area and buttocks, (2) perceived effort of use by staff, and (3) cost analysis. We used the validated Borg Scale to measure perceived exertion that was ranked on a scale from 6 to 20, where higher scores indicate greater exertion. Cost comparisons were completed before and after introduction of the patient-repositioning system. Cost analysis was determined using internal dollar amounts calculated for each stage of pressure injury. The return on investment was calculated by comparing the cost of HAPIs and the product after the intervention with the costs of HAPIs before the intervention. Analysis revealed a statistically significant reduction in HAPI occurrence from 1.3% to 0% (P = .004) when baseline manual repositioning (standard of care) was compared with use of the repositioning system. Caregivers reported significantly less exertion when using the repositioning device as compared with standard of care repositioning (P < .001). The return on investment was estimated to be $16,911. Use of a repositioning device resulted in significantly reduced HAPIs. Perceived exertion for repositioning the patient with a repositioning device was significantly less than repositioning with standard of care. A cost analysis estimated a return on investment as a result of the intervention on HAPI prevention.

Background: Cognitive development is the construction of thought process, including remembering, problem solving and decision making from childhood through adolescence to adulthood. Nurturing family environments are associated with the positive outcomes for children's development. Research over the last 30 years has demonstrated that the positive interaction between the child and the parents or other caregiver significantly impacts the development of brain. Aim: comparative study between the children (6-12 years) under parental care and the orphans regarding the cognitive development in selected areas of Mangalore. Methods: comparative study design was adopted for the study. A sample of 50 children from orphanage and 50 from schools were selected by simple random sampling technique, lottery methods was used to select 100 sample. A demographic data and structured cognitive questionnaire was used for data collection. Results: the result showed that the highest (72%) of children under parental care and (58%) of orphans had good cognitive development. there is no significant difference between the children (6-12 years) under parental care and orphans (t 98 = 1.747) at P < 0.05 level of significance. And also found that there is a significant association between the level of cognitive development of orphans with age of the children (χ 2 = 40.04 at P< 0,05) and children under parental care with education (χ 2 = 32.09) at P < 0.05 level of significance.