Open Access Kent State (OAKS)

Novel and unconventional strategies continue to emerge in response to the SARS-CoV-2 virus (COVID-19). One recent innovative response is high-flow nasal cannula (HFNC) use for adults experiencing the respiratory effects of COVID-19. HFNC provides warmed, humidified oxygen at higher fractions of inspired oxygen (FiO2) levels and flow rates than conventional oxygen therapy, potentially reducing the number of patients requiring intubation and mechanical ventilation. Increased HFNC use stems from an attempt to mitigate the virus’s devastating pulmonary effects, including alveolar inflammation that leads to scarring and respiratory compromise, which persist after the virus has been treated.

However, HFNC is controversial because of limited and inconsistent research and the risk for aerosolization of virus particles. This article discusses the delivery of HFNC, its benefits and risks, and nursing considerations. 

BACKGROUND:

After hospitalization for a cardiac event, older adults are frequently discharged to a skilled nursing facility (SNF) for postacute care. The American Association of Cardiopulmonary Rehabilitation recommends that cardiac care be integrated into procedures at SNFs.

OBJECTIVE:

We undertook this research to describe the characteristics of patients in SNFs after a cardiac event and the cardiac care delivered at SNFs.

METHODS:

A dual approach included (1) a retrospective medical record review of consecutive patients admitted to 2 hospital-based SNFs after a cardiac event (n = 80), and (2) surveys from healthcare professionals (n = 21) working in these facilities.

RESULTS:

Thirty-two percent of patients were not candidates for cardiac rehabilitative interventions because they had been rehospitalized, discharged to long-term care facilities, or manifested contraindications to exercise. No standard assessment of exercise tolerance was evident, and although 70% of patients were discharged home, cardiac-specific discharge education was seldom evident. Healthcare professionals in SNFs reported that standard procedures for cardiac care services were lacking.

CONCLUSION:

The integration of cardiac care into SNFs is important to ensure the safety of therapy and improve the transition of patients from SNFs to outpatient cardiac rehabilitation programs.

Librarians from the 8 campus system of Kent State University came together in the early fall of 2007 to discuss ways to enhance the institution’s collection development efforts. It was agreed to begin with a subject area common to all campuses, nursing. If successful, this pilot project could be applied as a model for adding more disciplines and inspire other institutions to consider employing similar cooperative collection development methodology. To date, the 8 campus libraries have worked together to evaluate and select an ebook vendor that provides access to a collection of over 1,700 titles in nursing and allied health and have increased access to content for online nursing journals. Perhaps the most significant achievement was the creation of an approval plan profile for selecting nursing books. The libraries parceled out sections of the LC classification system for selecting book titles. In some cases, selecting responsibilities were assigned for campuses with a particular program within nursing or allied health. In other cases the selection assignments were randomly assigned. For the random assignments, books selected through this method were also randomly assigned to an “owning” campus housing the book, based on an algorithm that weighted the randomization by each campus’ financial commitment to the project—the more a campus contributed financially the more books would be housed at that campus. Throughout the 2-year process, thought was given to how this project would be employed within other similar institutions.

Clinic management teams comprising an administrative director, a head nurse, and a physician manager are interdisciplinary management units in an ambulatory care setting of a large teaching hospital. This article reviews the development of these integrative teams and the factors critical to their success.

The authors discuss the importance that ethics education in the allied health professions plays in helping to develop interpersonal skills, social consciousness and human values, and describes an integrated ethics education program that transcends an entire curriculum concentrating on the development of the student's moral compass. After discussing the challenges of integrating theory and practice, the authors discuss how the integrated the cross-curricular model with the management model and describe the different kinds of educational activities that the students are exposed to in this approach.

This study compared gender differences in outcomes of patients who had had coronary bypass surgery and either attended structured cardiac rehabilitation programs or participated in home programs. The principal advantages related to patients' attending a structured hospital-based outpatient rehabilitation program, compared to a home program, included increased exercise adherence for males and females, increased knowledge about the condition for males, and increased stress control for females. Return to work, self-efficacy, and aspects of self-care such as adherence to a medication regimen and smoking cessation were not significantly different, regardless of type of program, for either sex. In general, females at home fared the worst regarding lifestyle changes, showing decreased exercise adherence, decreased ability to control stress, and no significant increase in knowledge about their medical condition.