Objectives. We provided oral health care services at 2 sites using a nurse practitioner–dietitian team to increase dental workforce capacity and improve access to care for low-income preschool children. Methods. Our team provided oral health assessments and education, fluoride varnish application, and dentist referrals. The primary endpoint was participants’ access to oral health care. Secondary endpoints included increasing the practice scope of registered dietitians through training programs for oral health assessment and the application of fluoride varnishes for children. The oral health and hygiene and dietary habits of the participants were also determined. Results. From 2010 to 2013, 4360 children received fluoride varnishes in 7195 total visits. Although the proportion of children with dental caries at the first visit was greater at the urban site, both sites were similar by visits 2 and 3. The number of caries declined with increased program visits, which coincided with an increase in the proportion of participants visiting a dentist. Conclusions. Progress toward eliminating dental health disparities requires addressing barriers to dental care access. We showed that expanding access to oral health services through nurse practitioner–dietitian cooperation improved access to preventive fluoride varnishing use in low-income children.
Power and politics need to be translated into practice through development of authority and autonomy within the staff nurse role. The purpose of the research described was to identify and compare aspects of agreement or disagreement between nurse leaders and staff about staff nurses' authority and autonomy to deliver patient care. Findings indicated that significant differences exist between staff nurses' and nurse leaders' sense of staff nurse autonomy, and importance of authority and autonomy, differences that can lead to serious misunderstandings and power struggles. These differences, especially concerning management support, can seriously hinder both nurse leaders and staff nurses' success in restructuring cost-effective quality care.
Negotiation was important in these dyadic care relationships, and thus attention to assisting CGs and CRs to develop negotiation skills is needed. More research is needed to substantiate and expand this theory of CG and CR dyadic identity development, and to examine linkages between negotiated processes and outcomes.
Spirituality is a part of holistic care for clients and families. This qualitative, descriptive study examined spirituality in 60 caregivers and 60 care receivers, equally divided between Caucasians and African Americans. Themes were coping (subthemes of formal religion and social support) and meaning (subthemes of positive attitude, retribution or reward, and all encompassing). Needs of caregivers and care receivers include opportunities for formal religion (communion, prayer), social support (visiting, respite), and interactions to assist them find meaning in their caregiving and care receiving. Implications for nurses include collaborating with clergy to support the spiritual needs of caregivers and care receivers.
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