Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery. We propose expansion of the Geriatric Cardiac Care model to include broader clinical therapy dynamics. The sample (n = 10,062) included patients over 80 years discharged from acute care following valve surgery. Post-acute care services were used by 68% of octagarians following cardiac valve surgery (1% intermediate rehabilitation, 35% skilled nursing facility, 32% home health). The large percentage of octagarians using PAC point to the importance of integrating geriatric cardiac care into post-acute services to optimize recovery outcomes.

In this study, we evaluated sleep quality changes in persons with advanced heart failure (HF) who were admitted to the intensive care unit. Sleep quality was assessed at admission, during hospitalization, and post-discharge. Statistical tests compared within subject mean sleep quality over time ( n = 22). Poor quality sleep was reported by 96% of participants at admission, 96% during hospitalization, and 86% post-discharge. Significant differences were found between timepoints in global sleep quality, subject sleep quality, sleep duration, and habitual sleep efficiency. A greater proportion of these participants had poor global sleep quality during hospitalization than previously reported. Participants reported better sleep post-discharge than admission and during hospitalization. Interventions enhancing hospital sleep, along with home sleep self-management education, would improve HF outcomes. Implementation science methods are warranted to integrate efficacious interventions in this population.

As the nursing faculty shortage persists, there is an urgent need to develop emerging nurse scholars into research leaders capable of advocating for the profession and expanding on the mission to improve health. To address this need, the Midwest Nursing Research Society (MNRS) commissioned a student task force that led to the development of the Emerging Scholars Network (ESN). The purpose of this article is to describe how the ESN was developed, integrated, and promoted within the MNRS to advance the overall mission and sustainability of the society. The establishment and success of the ESN is described using the Five Developmental Stages of Organization Evolution. These stages include the following: (a) Developing a Concept; (b) Launching a Start-Up; (c) Establishing Credibility; (d) Creating Sustainability; and (e) Road to Maturing and Legacy. Recommendations for continued development of the ESN are provided.

BackgroundAs the number of people with heart failure and treatment complexity increases, many hospitals are implementing Advanced Heart Failure Intensive Care Units (AHFICU). However, little evidence concerning the clinical characteristics of people admitted to AHFICUs exists. Understanding the clinical characteristics of people admitted to the AHFICU will assist nurses with implementing tailored interventions to ensure high‐quality care delivery.AimThe purpose of this study was to describe the clinical characteristics of people who are admitted to and discharged from an AHFICU.Study DesignBaseline data from a longitudinal descriptive study were collected on adults (N = 43) admitted to an AHFICU. Heart failure severity, self‐management ability, cognition, sleep quality, and other clinical characteristics were assessed.ResultsMost study participants were New York Heart Association functional class IV (n = 24) or class III (n = 14), indicating poor functional capacity. Over half had mild cognitive impairment and poor sleep quality was prevalent (92.7%). Participants had adequate levels of heart failure knowledge, but low levels of heart failure self‐management decision‐making and ability.ConclusionsInterventions to address the unique clinical characteristics of AHFICU patients include sleep hygiene, integration of cognitive, sleep, and self‐management assessments into the electronic medical record. Addressing the unique clinical needs of people with heart failure will lead to patient‐centered, evidence‐based, and safe care.Relevance to Clinical PracticeUnderstanding characteristics of this population addresses this evidence gap and targeted clinical interventions to address unique discharge needs of this population are proposed. Sleep quality education should be done throughout hospitalization on sleep strategies and self‐management coaching to facilitate adoption of new sleep routines. Healthcare providers should ensure each patient has care support upon discharge and take cognitive status into consideration during teaching. Addressing self‐management readiness should include providing scenarios as part of discharge preparation. Providers must include addressing comorbidities and how they may affect heart failure self‐management, such as teaching about sleep apnea device use and encouraging compliance.