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Staff on a 28-bed surgical unit in a suburban 461-bed medical center implemented 3 interventions to improve patient satisfaction. This quality improvement study investigated the effects of nurse manager rounding, postdischarge phone follow-up, and improved discharge teaching skills on patients' ratings of their care. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores demonstrated a steady upward trend over 18 months following implementation of the changes.

Spirituality is an important resource that individuals use to cope with a chronic illness such as HIV disease. Spirituality has both a religious and an existential component that share the concepts of meaning in life, hope, self-transcendence, and rituals. An integrated perspective utilizing these shared concepts is proposed to assist HIV-positive individuals in coping with the challenges of their disease. Nursing interventions include promoting hope, teaching, sharing information, and creating a sense of empowerment in people with HIV to address spiritual issues. The article concludes with a case study that emphasizes application of the integrated perspective of spirituality with an HIV-positive person.

The purpose of this integrative review was to discuss the utilization and effectiveness of music therapy as an adjunct therapy in symptom management for adult patients in palliative care and/or hospice. This review sought to extend empirical knowledge for the use of music as a therapeutic modality by determining which symptoms are most commonly treated with music interventions and how efficacious treatments are. Guided by the Roy Adaptation Model, music is a positive stimulus to improve coping for patients at end of life. An extensive search using CINAHL and the keywords music therapy, hospice, and symptom management was performed for the period of 2006 to 2013. Inclusion criteria were English language, peer reviewed, adult, and use of music as a therapy for symptom management. Exclusion criteria were articles related to program development/evaluation, pediatrics, mechanical injury symptoms, and nonresearch. Seventeen articles were selected for this review. Anxiety and pain were found to be the most commonly addressed symptoms by music therapy, and the interventions decreased the intensity of these symptoms. Limitations included nonrandom sampling and small sample sizes in 6 studies. Most of these studies were of moderate levels of evidence. Implications for advanced practice nurse practice, education, and research are addressed.