The findings of this review support the use of transitions-of-care interventions such as tailored discharge planning and postdischarge phone calls.

The continued use of healthcare interventions without an evidence base increases healthcare costs without positively impacting patient care outcomes. Reports disseminated by bodies such as the Institute of Medicine and initiatives such as the Institute for Health Care Improvement's 5 Million Lives Campaign have increased emphasis on improving outcomes. Results of a descriptive correlational study indicated that 64% of the nurses surveyed read 7 or more specialty journals, 53% read 1 or more general nursing journal, 20% did not regularly read any professional journal, and none of the nurses surveyed read a journal that was primarily dedicated to the publication of original research. Almost half of the nurses indicated that the hospital library was the nearest location to conduct searches, and 34% indicated that they did not know what literature-searching capabilities were available to them. Although knowledge in itself is not sufficient for behavior change, it is an essential prerequisite. Regular reading of journals either through personal subscriptions or access through facility libraries can encourage the adoption of new evidence through lifelong learning. Modeling and skill building in use of readily available Internet resources can serve as a mechanism to increase awareness of and skill in accessing current information. Evidence-based changes can then be empirically examined, implemented, and evaluated in examining nursing's contribution to the daily operation of the healthcare organization.

Ventilator-associated pneumonia (VAP) is a subset of hospital-acquired pneumonias and is a serious, sometimes fatal, complication in patients who need mechanical ventilation. In addition, pay-for-performance initiative has placed increased emphasis on preventing nosocomial infections including VAP. Facilities may not be reimbursed for costs associated with prevalence infections. This article presents a review and meta-analysis of the prevention of VAP through the aspiration of subglottic secretion.

The results of this review indicate the combination of topical chlorhexidine and intranasal mupirocin is effective in reducing S aureus-associated SSIs.

To foster optimal living, the health, illness, function and motivation as well as age of older adults must be considered. They should be encouraged to pursue physical, social and intellectual activity, which can enable them to have active and fulfilling lives.

The purpose of this project was to compare student outcomes in an undergraduate research course taught using both World Wide Web-based distance learning technology and traditional pedagogy. Reasons given for enrolling in the traditional classroom section included the perception of increased opportunity for interaction, decreased opportunity to procrastinate, immediate feedback, and more meaningful learning activities. Reasons for selecting the Web group section included cost, convenience, and flexibility. Overall, there was no significant difference in examination scores between the two groups on the three multiple-choice examinations or for the course grades (t = -.96, P = .343). Students who reported that they were self-directed and had the ability to maintain their own pace and avoid procrastination were most suited to Web-based courses. The Web-based classes can help provide opportunities for methods of communication that are not traditionally nurtured in traditional classroom settings. Secondary benefits of the World Wide Webbased course were to increase student confidence with the computer, and introduce them to skills and opportunities they would not have had in the classroom. Additionally, over time and with practice, student's writing skills improved.

Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

With the growing complexity of healthcare, the ability to communicate becomes essential within the interprofessional team. Healthcare organizations have great expectations for new graduate nurses to communicate skillfully while promoting safe patient care. Nursing students may lack experience with interprofessional communication skills and are fearful of making mistakes which may jeopardize patient safety and undermine student self-confidence. Hand-off is the communication of information between people or disciplines. A student hand-off communication activity was developed and implemented as a clinical skillbuilding activity across several undergraduate clinical nursing courses. Evaluation of this activity revealed positive perceptions from both students and staff.