Background: Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in critically ill patients. The Institute for Healthcare Improvement 100,000 Lives Campaign made VAP a target of prevention and performance improvement. Additionally, the Joint Commission on Accreditation of Health Organizations' 2007 Disease Specific National Patient Safety Goals included the reduction of healthcare-associated infections. We report implementation of a performance improvement project that dramatically reduced our VAP rate that had exceeded the 90 th percentile nationally.

Guided by Orem's self-care deficit nursing theory, the purpose of this descriptive comparative study was to examine the emotional support, physical help, and health of caregivers of stroke survivors. Seventy-three caregivers from the Midwest participated in a parent study that examined their experience of caring during the first 12 months after stroke. Caregivers were randomized to an online intervention of support and education (n = 36 Web users) or a control group (n = 37 non-Web users). A secondary analysis of data collected during telephone interviews at baseline, 3, 6, and 12 months after stroke was performed. No significant mean differences were found between Web and non-Web users in the above variables at these points in time. Consequently, the caregivers were merged into one group, and the relationships among the variables at the different points in time were analyzed. Significant, moderately positive relationships were found between emotional support and physical help at baseline, 3, and 12 months. There were also significant, moderately positive relationships between emotional support and caregiver health at 6 and 12 months. Results highlight the importance of caregivers (dependent care agents in Orem's terms) establishing an adequate self-care system that provides emotional support and physical help. Findings also denote the need for nurses (as caring agents) to assess caregiver health later in the caring process and be aware of its relationship to emotional support.

No abstract

The purpose of this study was to evaluate the effect of a nurse-directed smoking cessation intervention for adults hospitalized in a small community hospital using a quasiexperimental, prospective, longitudinal design with biochemical validation of self-reported tobacco abstinence. Sixty-eight inpatients were assigned to either a control (n = 30) or an intervention group (n = 38). The control group received smoking cessation literature. The intervention group received smoking cessation literature and a nursing intervention. Each member of the intervention group was randomly assigned to a one or four telephone call subgroup for post discharge nurse follow-up at 3 months. Fifty-five participants completed the study. Smokers receiving the nurse-directed intervention were significantly more likely to be tobacco abstinent at 3 months (n = 17, 55%) than smokers in the control group (n = 5, 21%). Within the intervention group, tobacco abstinence at 3 months was not significantly different between the one and four telephone call groups. For the total sample, smoking relapse was significantly higher for participants who lived with another smoker.

The youth of the sample underscores the need for providers to discuss EC with adolescents, who continue to need a prescription to access EC. The low repeat use of EC is consistent with international data and supports the use of EC as a back-up method for routine, ongoing contraceptive users. It is important for nurse practitioners to provide accurate information and access to EC, proactively, as part of ongoing health and wellness education to all reproductive-aged women.