Villanova University College Research Articles

From Academic-Practice Partnership to Professional Nursing Practice Model.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "From Academic-Practice Partnership to Professional Nursing Practice Model," found on pages 104-112, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 28, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the benefits and barriers to participation in a community-based academic-practice partnership. Identify three changes in the practice environment that transform the practice of staff nurses working in partnership model clinical units. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. This study used a qualitative descriptive design to examine the role of the expert staff nurse or clinical liaison nurse (CLN) participating in a community-based academic-practice partnership. Little is known about the influence of participation by expert nurses in community hospital settings. Focus groups were conducted with nine CLNs to explicate their experiences in a unit-based leadership practice model. Eight themes were identified: Reciprocal Learning Between Staff Nurses and Students; Reciprocal Learning Between Student and Patient; Working Around the System; Building Relationships; Valuing the CLN Role; Faculty Recognition of CLNs; Transforming Practice; and a variant theme, Recognition That Some Nurses Neither Value nor Enjoy Working With Students. The benefits of developing partnerships in community hospitals can be far reaching and may be of interest to educators and leaders in the profession. When a practice environment focused on evidence and was fueled by student enthusiasm reinvigorates staff nurses, their work world suddenly transforms. J Contin Educ Nurs. 2017;48(3):104-112.

Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review" found on pages 19-28, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 29, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Discuss problematic barriers during care transitions. 2. Describe the significance of interprofessional collaboration in the delivery of quality health care. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. The purpose of the current project was to (a) examine the type of information accompanying patients on transfer from acute care to skilled nursing facilities (SNFs), (b) discuss how these findings meet existing standards, and (c) make recommendations to improve transfer of essential information. The study was a retrospective convenience sample chart audit in one SNF. All patients admitted from an acute care hospital to the SNF were examined. The audit checklist was developed based on recommendations by local and national standards. One hundred fifty-five charts were reviewed. Transferring of physician contact information was missing in 65% of charts. The following information was also missing from charts: medication lists (1%), steroid tapering instructions (42%), antiarrhythmic instructions (38%), duration/indication of anticoagulant medications (25%), and antibiotic medications (22%). Findings support the need for improved transitional care models and better communication of information between care settings. Recommendations include designating accountability and chart audits comparing timeliness, completeness, and accuracy. [Journal of Gerontological Nursing, 43(3), 19-28.].

Accelerated Second-Degree Bachelor of Science in Nursing Graduates' Transition to Professional Practice.

Few studies have investigated accelerated second baccalaureate degree nursing program (ASBSN) graduates' transition to practice. ASBSN graduates (N = 7) were interviewed within 12 to 15 months of graduation about their transition to practice. Using interpretive description, data were analyzed to identify common themes. Eleven themes emerged, including (a) Intense Situations Evoked Strong Emotions, (b) Patient Safety Was Paramount as I Built Confidence, (c) Being on My Own Was Frightening, and (d) The ASBSN Program Mirrored the Intensity of Real-Life Nursing and Helped Me Transition to Practice. ASBSN graduates' transition shared similarities with traditional baccalaureate nursing program graduates. They experienced stress, needed support, and contributed to the health care team as they gained confidence. The intensity of the interviewees' ASBSN program prepared them for real-life nursing practice. Graduates' accounts of their transition should persuade staff development professionals to plan postorientation development that considers previous education, work experience, and potential for organizational leadership. J Contin Educ Nurs. 2017;48(1):14-19.

Pharmacological Approaches for the Management of Persistent Pain in Older Adults: What Nurses Need to Know.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Pharmacological Approaches for the Management of Persistent Pain in Older Adults: What Nurses Need to Know" found on pages 49-57, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until November 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe age-related barriers to pain assessment and key aspects of the assessment process. 2. Identify benefits and risks associated with commonly prescribed analgesic medications for the treatment of later life pain. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. The current article addresses pharmacological treatment issues regarding the management of persistent pain in later life, which is a worldwide problem associated with substantial disability. Recommendations from guidelines were reviewed and data are presented regarding the benefits and risks of commonly prescribed analgesic medications. The evidence base supports a stepwise approach with acetaminophen as first-line therapy for mild-to-moderate pain. Oral nonsteroidal anti-inflammatory drugs are not recommended for long-term use. In properly selected older patients, opioid drugs should be considered if pain is not adequately controlled. Careful surveillance to monitor for benefits and harms of therapy is critical, given that advancing age increases risk for adverse effects. Key aspects of the pain care process that nurses routinely engage in are covered, including conducting pain assessments prior to initiating therapy, addressing barriers to effective pain care, educating patients and family members about the importance of reducing pain, discussing treatment-related risks and benefits, and formulating strategies to monitor for treatment outcomes. Finally, a case is presented to illustrate issues that arise in the care of affected patients. [Journal of Gerontological Nursing, 42(12), 49-57.].

Charge Nurses' Experiences With Horizontal Violence: Implications for Leadership Development

A safe work environment is a prerequisite for the provision of high-quality patient care. Horizontal violence can undermine the culture of safety and the well-being of the nurses in the work unit. Charge nurses, whose role encompasses both staff and manager responsibilities, play an important role in team building and care delivery. Yet, little is known about their experience with horizontal violence. A lack of adequate leadership education and role delineation may predispose charge nurses to horizontal violence. A descriptive study was conducted to describe the incidence of horizontal violence of charge nurses. The Horizontal Violence Scale was used to collect data from a convenience sample of 366 charge nurses. Charge nurses reported experiencing horizontal violence with some regularity. Nurse leaders must critically evaluate the work culture and provide appropriate education and support to charge nurses to combat horizontal violence. J Contin Educ Nurs. 2016;47(11):493-499.

Multidisciplinary Comprehensive Care for Early Recommencement of Oral Intake in Older Adults With Severe Pneumonia.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Multidisciplinary Comprehensive Care for Early Recommencement of Oral Intake in Older Adults With Severe Pneumonia" found on pages 21-29, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until September 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the effect of multidisciplinary comprehensive care (MDCC) on oral intake in older adults with severe pneumonia at the time of discharge. 2. Explore the impact of MDCC on the length of stay for hospitalized older adults with severe pneumonia. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. The current study was designed to assess the effect of multidisciplinary comprehensive care (MDCC) on (a) oral intake at discharge and (b) hospital stay duration in older adult patients with severe pneumonia. Participants were divided into two groups: receiving and not receiving MDCC. MDCC comprises regular assessment of swallowing ability, aspiration risk management, improvement of oral hygiene, serving of nutritious texture-modified foods, and encouragement of early mobilization. The MDCC group (164 women, 206 men; mean age = 82.7, SD = 8.4 years) had severe pneumonia as well as high proportions of poor premorbid physical function and consciousness disturbance compared to the non-MDCC group (45 women, 56 men; mean age = 81.1, SD = 8.6 years). Nevertheless, MDCC was an independent determinant of hospital stay duration and oral intake (Functional Oral Intake Scale score ≥4) at discharge with Cox regression analysis (hazard ratio = 1.42, 95% confidence interval [1.09, 1.85]). MDCC may promote early oral intake and hospital discharge in older adults with severe pneumonia. [Journal of Gerontological Nursing, 42(10), 21-29.].

Outcomes of an Interdisciplinary Transitional Care Quality Improvement Project on Self-Management and Health Care Use in Patients With Heart Failure.

Heart failure (HF) accounts for most U.S. Medicare hospital admissions. The purpose of the current study was to evaluate the effectiveness of a care transitions quality improvement (QI) intervention on self-management and readmission rates in older adults with HF. A quasi-experimental, descriptive study was conducted with 66 patients with HF in three medical units in a 489-bed Midwestern acute care hospital. The intervention included a nurse coach visit and follow up, pharmacy medication education and reconciliation, and HF clinic referral. Outcomes were assessed within 48 hours of admission and 30 days after discharge using the Self-Care of Heart Failure Index and medical record review. Following implementation, readmission rates decreased from 24% to 13%. Participants demonstrated a greater improvement in use of self-management strategies to control symptoms than the non-intervention group (p < 0.02) and more readily identified their symptoms of HF (p < 0.04). The evolution of population health, with increasing numbers of older adults living at home with complex chronic conditions, will require establishment of active partnerships among pharmacists, physicians, nurse specialists, home care nurses, and patients. [Journal of Gerontological Nursing, 43(1), 23-31.].

Care Aides' Relational Practices and Caring Contributions.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Care Aides' Relational Practices and Caring Contributions" found on pages 24-30, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Define the application of Swanson's Middle Range Theory of Caring in care aides' relational care practices for nursing home residents. 2. Describe how nursing home managers can empower care aides to provide care. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. The current study was a qualitative focused ethnography aimed at exploring the complexities of care; working environments; and knowledge, skills, and efforts of care aides who work in nursing homes. Over the past decade, dramatic shifts in staffing patterns in Canadian nursing homes have transformed care aides' assistive and caring roles. Care aides are now the central and most accessible service providers to nursing home residents. In the current article, the authors (a) conceptualize care aide work as caring rather than caring activities, (b) explore relational care as a foundational and significant component of care aide work, (c) interpret care aides' relational care practices through the lens of Swanson's Middle Range Theory of Caring, and (d) describe how nursing home managers can empower care aides to do this work. [Journal of Gerontological Nursing, 42(11), 24-30.].

Effect of Evidence-Based Practice Programs on Individual Barriers of Workforce Nurses: An Integrative Review.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Effect of Evidence-Based Practice on Individual Barriers of Workforce Nurses: An Integrative Review" found on pages 398-406, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until August 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Identify individual barriers in the implementation of evidence-based practice (EBP) by nurses. Describe interventions of the programs reviewed in the article that directly affect barriers to clinical nurses' adoption of EBP or the use of research. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Individual barriers such as a lack of research awareness, electronic database navigation skills, and research comprehension prevent nurses from implementing evidence-based practice (EBP). The aim of this review article is to examine EBP programs and their influence on individual barriers among workforce nurses. A keyword search of online databases was conducted for original research published from 2004- 2015. A review of cited references and footnote searching of significant articles was conducted to identify additional relevant articles. Twenty articles met the inclusion criteria. Although there was great variation among EBP programs, the majority of participants reported increased awareness, value, belief, knowledge, and skill as it relates to research utilization and EBP. This review suggests that individual barriers to EBP may be influenced by clinically based EBP programs. However, a lack of randomized controlled studies and inconsistencies in measurement make it difficult to recommend best practices for developing EBP programs for nurses in the clinical setting. J Contin Educ Nurs. 2016;47(9):398-406.

It Could Never Happen Here: Promoting Violence Prevention Education for Emergency Department Nurses.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.1 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "It Could Never Happen Here: Promoting Violence Prevention Education for Emergency Department Nurses," found on pages 356-360, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Suggest strategies targeted for emergency department nurses to prevent or mitigate their exposure to workplace violence. Describe specific patient behaviors that will help emergency nurses in identifying potentially violent patients. Review the importance of following written facility violence prevention policies, as well as reporting all violent events. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. This article describes the necessity for emergency department nurses to receive violence prevention training to identify and mitigate violent events before they occur. In the emergency department setting, violence is a frequent occurrence and continues to be a growing concern. Despite the growing numbers, focus on training of staff in violence minimization and prevention has decreased. This article outlines three important safety topics and interventions that can be used to assist nurses when managing potentially violent patients: creating a safe emergency department environment, recognizing and evaluating the behaviors of a potentially violent patient, and identifying nurses' behaviors that may trigger patient violence. Nurses educated in violence prevention will be better prepared to recognize potentially violent patients, use specific strategies to prevent violence, and manage a violent event in a safe, professional manner. J Contin Educ Nurs. 2016;47(8):356-360.

Assessing Health Practitioner Knowledge of Appropriate Psychotropic Medication Use in Nursing Homes: Validation of the Older Age Psychotropic Quiz

How to Obtain Contact Hours by Reading This Article Instructions 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf . To obtain contact hours you must: 1. Read the article, “Assessing Health Practitioner Knowledge of Appropriate Psychotropic Medication Use in Nursing Homes: Validation of the Older Age Psychotropic Quiz” found on pages 21–27, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until August 31, 2019. Contact Hours This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Activity Objectives 1. Describe the scope and role of nursing in the appropriate administration of psychotropic medications in nursing homes. 2. Explain the process of validating the Older Age Psychotropic Quiz and the strategy for determining assessment measures in the use of psychotropic medications. Disclosure Statement Neither the planners nor the authors have any conflicts of interest to disclose. Despite widespread concern over psychotropic medication use, their regular administration continues in nursing homes. Consequently, it is vital that health practitioners in this setting have adequate knowledge of appropriate use. The Older Age Psychotropic Quiz (OAPQ) was developed to assess this knowledge, with psychometric testing reported herein. The 10-item OAPQ was constructed after substantial literature review and consultation with 10 experienced senior care professionals. Data from 36 nursing students, 461 nursing home staff, and 30 senior care pharmacists were used for validation analyses. Satisfactory construct validity was identified via the group comparison method (χ 2 [2, n = 101] = 79.21, p &lt; 0.001). Internal reliability was strong (alpha = 0.89). Test–retest reliability was acceptable over time ( r = 0.77). Factor analysis resulted in a two-factor solution. Psychometric analyses support the OAPQ for use in the nursing home setting. [ Journal of Gerontological Nursing, 42 (9), 21–27.]

Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project," found on pages 306-313, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the unique nursing challenges that occur in caring for older adults in rural areas. Discuss the Improving Rural Geriatric Care through Education (iRuGCE) project, including the facilitators and challenges to its implementation. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Rural elders are the fastest growing segment of the U.S. population, with a projected increase of 32% in the next 20 years. Shortages in geriatric-prepared workers are particularly critical in rural areas. This article describes Improving Rural Geriatric Care through Education (iRuGCE), a feasible, scalable, and collaborative continuing education project. iRuGCE was designed to improve geriatric nursing practice. Project goals were to identify, mentor, and facilitate an RN geriatric site champion in critical access hospitals (CAHs) to complete national certification in gerontological nursing, and to design a continuing education program that met the specific needs of the CAHs via delivery of three continuing education sessions per year. Evaluation of the project is promising. Preliminary results suggest that iRuGCE has a positive effect on nurse-sensitive patient satisfaction scores, such as communication with nurses, responsiveness of hospital staff, pain management, communication about medicine, discharge information, and willingness to recommend the hospital. J Contin Educ Nurs. 2016;47(7):306-313.

Association Between Sarcopenia and Nutritional Status in Older Adults: A Systematic Literature Review.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Association Between Sarcopenia and Nutritional Status in Older Adults: A Systematic Literature Review" found on pages 33-41, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the geriatric syndrome of sarcopenia. 2. Identify the outcome of the sarcopenia studies. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Sarcopenia is an important geriatric syndrome with high prevalence rates and one of the most common causes of reductions in mobility, quality of life, and increasing dependency on care. The current study examined the relationship between sarcopenia and nutritional status in adults 60 and older. A systematic literature search was conducted, and data from 33 publications were included. The currently available literature indicates that sarcopenia is correlated with poor nutritional status (e.g., low body mass index, unfavorable nutritional risk screening results, decreased nutritional laboratory parameters, anorexia). Comparison of the studies' results were complicated by the lack of a generally accepted definition for sarcopenia, as well as the use of many different instruments to detect sarcopenia. The co-occurrence of malnutrition and sarcopenia is of great relevance. Future scientific work should focus on the formation of consistent definitions and instruments for the detection of sarcopenia to improve data comparisons. [Journal of Gerontological Nursing, 42(7), 33-41.].

Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal/family caregivers. 2. Identify how professional caregivers and health care providers can support informal/family caregivers. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Informal care given by family caregivers is an important part of the total care provided to older adults with multimorbidity. The current study aimed to describe how older adults with multimorbidity experienced care from family caregivers. Interviews were conducted with 24 participants (mean age = 86 years). Older adults with multimorbidity felt gratitude toward family caregivers for their willingness to help with everyday life and for representing their interests in contacts with health care providers. Family caregivers also had a significant impact on older adults' psychological well-being. However, the results also showed that older adults often felt they were a burden to their family caregivers and that their independence might be reduced. Older adults with multimorbidity should have the opportunity to be more involved in and have more influence over their health care so that they do not have to depend on representation by family caregivers. [Journal of Gerontological Nursing, 42(8), 24-31.].

Simulation Training in Early Emergency Response (STEER).

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Simulation Training in Early Emergency Response (STEER)," found on pages 255-263, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until May 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Define the purpose of the Simulation Training in Early Emergency Response (STEER) study. Review the outcome of the STEER study. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Little has been published about nurses' responses in the first 5 minutes of in-hospital emergencies. This study aimed to test a simulation curriculum based on institutional priorities using high-intensity, short-duration, frequent in situ content delivery based on deliberate practice. The study design was a prospective, single-center, mixed-methods quasi-experimental study. Scenarios used in this study were ventricular fibrillation, opiate-related respiratory depression, syncopal fall, and hemorrhagic stroke. The convenience sample included 41 teams (147 participants). Improvements were noted in initiating chest compressions (p = .018), time to check blood glucose (p = .046), and identification of heparin as a contributor to stroke (p = .043). Establishing in situ simulation-based teaching program is feasible and well received. This approach appears effective in increasing confidence, initiating life-saving measures, and empowering nurses to manage emergencies. Future studies should evaluate and improve on the curriculum, on data collection tools quantitatively, and on overcoming barriers to high-quality emergency care. J Contin Educ Nurs. 2016;47(6):255-263.

Population-Focused Practice Competency Needs Among Public Health Nursing Leaders in Washington State.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Population-Focused Practice Competency Needs Among Public Health Nursing Leaders in Washington State," found on pages 212-219, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until April 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe supports and barriers to adopting population-focused care in public health nursing practice. Describe the benefit of using practice models to assess staff readiness for adopting evidence-based guidelines or practice competencies. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Public health nurses (PHNs) need effective strategies to reduce health disparities, requiring a workforce that can practice with a population-focus across the continuum of care and with an ecological approach to health. A statewide leadership group of county-level PHN leaders in Washington assessed their training needs in population-focused knowledge and skills. Interview findings from 17 members were coded based on the Quad Council PHN Competencies. Recommendations were organized around the Push-Pull Infrastructure (PPI) practice model established to help bridge the practice-research gap. The PHN leaders in Washington State want to strengthen their own leadership skills and provide support to staff in transitioning to population-focused care. This article describes the assessment findings of PHN leaders' training needs using the PPI practice model and explores how the PPI might serve to develop evidence-based training for PHNs and local health department staff. J Contin Educ Nurs. 2016;47(5):212-219.

Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing" found on pages 25-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until May 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Identify the worldwide shortage of nurses specializing in gerontological nursing. 2. Describe the results of using music therapy to create positive attitudes toward older adults. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Nursing students generally have a negative attitude toward older adults. Preparing nurses to meet the care needs of an expanding aging population is a challenge for nursing educators. The purpose of the current study was to explore whether incorporating music therapy into a practical geriatric nursing course at a nursing home cultivates positive attitudes toward older adults, raises students' willingness to work with older adults, and increases their interest in specializing in gerontological nursing after graduation. Focus groups were conducted to collect data from three participant groups (N = 20). Verbatim transcripts of audiorecorded interviews were analyzed using content analysis, which revealed four themes: (a) better appreciation and understanding of music therapy, (b) role modeling instructors' successful experience and positive attitude toward older adults, (c) changing attitudes toward older adults, and (d) improving interaction skills with older adults. Results suggested music can be integrated into a gerontological nursing course to enhance students' motivation to learn, empathize, and approach older adults. [Journal of Gerontological Nursing, 42(6), 25-31.].

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based practice and critical thinking. • Identify the relationship between evidence-based practice and critical thinking. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Evidence-based practice is not a new concept to the profession of nursing, yet its application and sustainability is inconsistent in nursing practice. Despite the expansion of efforts to teach evidence-based practice and practically apply evidence at the bedside, a research-practice gap still exists. Several critical factors contribute to the successful application of evidence into practice, including critical thinking. The purpose of this article is to discuss the relationship between critical thinking and the current evidence-based practice implementation models. Understanding this relationship will help nurse educators and clinicians in cultivating critical thinking skills in nursing staff to most effectively apply evidence at the bedside. Critical thinking is a key element and is essential to the learning and implementation of evidence-based practice, as demonstrated by its integration into evidence-based practice implementation models.

From Chaos to Competency: Implementing a New Competency Model in a Multihospital System.

The demonstration of nurses' competency has been a challenge for nurse educators for a multitude of reasons. Standardizing competencies across a health care system is especially challenging. One multihospital health care system embarked on a journey to standardize and implement competencies across the system. Using a collaborative approach, the Wright model of competency assessment was selected and implemented across the system. Lessons learned include (a) the full engagement of Wright's model by all nursing stakeholders is essential, (b) indicators and outcomes must align with quality improvement data, and (c) the needs of each unit must be individualized, and the methods of verification must be closely aligned with the measurable competency. After implementation of this model, the health system now has a standard definition, identification, methodology, and evaluation for competencies. In addition, there are now standard time frames for assessment and evaluation and increased accountability for staff involvement.

Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care.

The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize care-resistant behavior to provide mouth care to older adults with dementia. The original intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), matured during the clinical trial study into a relationship-centered intervention, with emphasis on developing strategies that support residents' behavioral health and staff involved in care. Relationships that were initially pragmatic (i.e., focused on the task of completing mouth care) developed into more personal and responsive relationships that involved deeper engagement between mouth care providers and nursing home (NH) residents. Mouth care was accomplished and completed in a manner enjoyable to NH residents and mouth care providers. The MOUTh intervention may also concurrently affirm the dignity and personhood of the care recipient because of its emphasis on connecting with older adults.