Prevention of Hospital-Acquired Pneumonia: An Integrative Review

Background: Hospital-acquired pneumonia (HAP) not only brings about physical challenges to patients that can lead to death, it also involves financial burdens. Research on how to prevent HAP is a necessity; however, a deficit exists in research concerning prevention of non-ventilator hospital-acquired pneumonia (NV-HAP). The purpose of this study is to synthesize the current research on the nurse’s role in prevention of NV-HAP, identify where additional research is needed, and suggest clinical standards of care to prevent pneumonia in hospitalized patients. Methods: Data for this integrative review was collected from the following databases: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), GoogleScholar, Cochrane Register of Controlled Trials, MEDLINE, and OneSearch. An interview with a local hospital registered nurse was conducted. Results: Four different categories of interventions were researched and the results were synthesized. Oral care, the early mobility bundle and isolations rooms were found to significantly decrease the occurrence of NV-HAP. Incentive spirometry, on the other hand, was not found to effectively decrease NV-HAP. Discussion: While oral care, early mobility and isolation rooms were all found to significantly reduce the occurrence of NV-HAP, these interventions are most effective when the health care workers carrying them out are educated on properly performing each intervention. Conclusion: Enhanced oral care and enhanced mobility should be primary interventions for the prevention of NV-HAP, while incentive spirometry should be considered a secondary intervention. More research is needed to be conclusive on the effectiveness of incentive spirometry and isolation rooms

A Partnership to Improve Health Care in Kosovo: Dartmouth Medical School and Kosovar nurses worked together on a two-year project to rebuild primary health care in the postconflict city of Gjilan

Partnership between a health municipality in Kosova, in the former Republic of Yugoslavia and Dartmouth Medical School, New Hampshire, to rebuild the primary care system after the war. The project, which included nurses from both countries, is described, focusing on the changing roles of nurses

A Synthesis of the Daily Behavior Report Card Literature from 2007 to 2017

Daily behavior report cards (DBRCs) have shown to be effective in addressing academic and behavioral challenges for a variety of students in past literature. The purpose of this literature review and analysis is to update and summarize findings on the use of DBRCs on academic and social behavior for students considered to have disruptive behaviors or identified with disabilities. We identified eleven studies in the literature examining DBRCs with 390 participants with attention‐deficit hyperactivity disorder, specific learning disabilities, emotional behavioral disorders, speech and language, multiple disabilities, other health impairments, or considered to have disruptive behavior in Pre‐K through sixth grade academic settings. We also calculated effect sizes overall for each study and student‐based characteristics. Findings suggest that using DBRCs have a range from weak to strong impact on the academic and social behaviors of students considered to have disruptive behaviors or students with disabilities in classroom settings. We present implications for research and practice

Two remarkable new species of Plusiotis (Coleoptera: Scarabaeidae: Rutelinae) from Mexico and Central America

Affinities, diagnoses, and descriptions are provided for two new species of Plusiotis: P. spectabilis from an unknown locality in Central America and P. dianae from Veracruz state in Mexico. Plusiotis spectabilis is described from a single female and is the largest species in the genus (41 mm in length)

Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: a systematic review and meta-analysis.

PURPOSE: To evaluate the effectiveness of peer-delivered interventions in improving clinical and psychosocial outcomes among individuals with severe mental illness (SMI) or depression. METHODS: Systematic review and meta-analysis of randomised controlled trials comparing a peer-delivered intervention to treatment as usual or treatment delivered by a health professional. Random effect meta-analyses were performed separately for SMI and depression interventions. RESULTS: Fourteen studies (10 SMI studies, 4 depression studies), all from high-income countries, met the inclusion criteria. For SMI, evidence from three high-quality superiority trials showed small positive effects favouring peer-delivered interventions for quality of life (SMD 0.24, 95 % CI 0.08-0.40, p = 0.003, I (2) = 0 %, n = 639) and hope (SMD 0.24, 95 % CI 0.02-0.46, p = 0.03, I (2) = 65 %, n = 967). Results of two SMI equivalence trials indicated that peers may be equivalent to health professionals in improving clinical symptoms (SMD -0.14, 95 % CI -0.57 to 0.29, p = 0.51, I (2) = 0 %, n = 84) and quality of life (SMD -0.11, 95 % CI -0.42 to 0.20, p = 0.56, I (2) = 0 %, n = 164). No effect of peer-delivered interventions for depression was observed on any outcome. CONCLUSIONS: The limited evidence base suggests that peers may have a small additional impact on patient's outcomes, in comparison to standard psychiatric care in high-income settings. Future research should explore the use and applicability of peer-delivered interventions in resource poor settings where standard care is likely to be of lower quality and coverage. The positive findings of equivalence trials demand further research in this area to consolidate the relative value of peer-delivered vs. professional-delivered interventions