Rhabdomyolysis After Laparoscopic Nephrectomy

BACKGROUND AND OBJECTIVES: Laparoscopic renal surgery has become a widely applied technique in recent years. The development of postoperative rhabdomyolysis is a known but rare complication of laparoscopic renal surgery. Herein, 4 cases of rhabdomyolysis and a review of the literature are presented with respect to pathogenesis, treatment, and prevention of this dire complication. METHODS: A retrospective review of over 600 laparoscopic renal operations over the past 8 years was performed. All cases of postoperative rhabdomyolysis were identified. A Medline search was performed to find articles related to the development of postoperative rhabdomyolysis. Cases of rhabdomyolysis developing after laparoscopic renal surgery and common risk factors between cases were identified. RESULTS: The incidence of postoperative rhabdomyolysis in our series is 0.67%. It is similar to the rate reported in other series. Male sex, high body mass index, prolonged operative times, and the lateral decubitus position are all risk factors in its development. CONCLUSION: The prevention and optimal management of postoperative rhabdomyolysis following laparoscopic renal surgery has yet to be defined. The risk factors we identified should be carefully addressed and minimized. A better understanding of the pathogenesis of rhabdomyolysis will also be a key component in its prevention

Exploring the Lived Experiences of Staff Nurses Transitioning to the Nurse Manager Role

OBJECTIVE: The objective of this study was to discover the experience of nurse managers (NMs) who had transitioned from a staff nurse position. BACKGROUND: Nurses who become NMs may receive little or no training or support during the transition process. This study sought to gain the perspective of NMs who transitioned into the role. METHODS: A phenomenology method was used to interview 10 NMs regarding their experience of transitioning into the NM role. Meleis Role Transition theory provided the theoretical framework. RESULTS: Five themes were identified that related to the research questions: expectations, essential knowledge and skills, graduate education prepared, sought support and mentoring from colleagues, and role mastery not possible. Participants experienced role insufficiency due to lack of support and resources. CONCLUSIONS: Further research is needed to understand nurses\u27 experience after completing an NM developmental program, contributing to role mastery

Using VoiceThread to Build a Community of Inquiry in Blended RN-to-BSN Education

VoiceThread, a cloud-based social media tool, was used to create a sense of community in an undergraduate blended nursing leadership course. The purpose of this quasi-experimental study was to explore the use of VoiceThread to build a community of inquiry. The Community of Inquiry and IDEA surveys were completed by 163 students enrolled in an undergraduate nursing leadership course within an RN-BS curriculum. Results indicated using VoiceThread increased student-perceived teacher excellence, supported social presence and teacher presence, and promoted a community of inquiry

Developing System-Level Awareness Through Virtual Clinical Learning

Lack of clinical sites and disparate experiences contribute to the challenge for RN-to-BS nursing programs to provide sufficient leadership and quality improvement opportunities. A virtual clinical learning experience using WordPress was developed as a faculty-graduate student think tank project and implemented in an RN-BS hybrid nursing leadership course. The unfolding case study created an interactive experience to portray use of systems thinking and transformational leadership. Mann-Whitney U analysis identified no significant difference in learning outcomes. The low-cost, easy-to-develop technology counteracted limited clinical sites, allowing for learning on the go with equivalent learning outcomes

Intersection of Quality and Excellence: Characteristics of Redesignated National League for Nursing Centers of Excellence

The purpose of this research was to identify characteristics of redesignated National League for Nursing Centers of Excellence in Nursing Education that represent the intersection between quality and excellence. A qualitative content analysis of six final applications submitted for redesignation disclosed essential resources that supported students, faculty, and staff and identified six characteristics: connections through relationships, communities of learning and service, support for students and faculty, connections through technology, use of innovation, and a systems focus. The systematic focus on excellence in teaching and learning identified in this research represents best practices from exemplary schools worthy of emulation by other nursing education programs

Video observation with guided reflection: A method for continuing teaching education

Background : Best practices for faculty development programs include longitudinal, practice-based formats incorporating experiential learning with opportunities for reflection and community building. Peer coaching for faculty development provides personalized, learner-centered, work-based learning. Implementation of traditional 1-on-1 peer coaching programs is challenging due to time, logistics, and methodological barriers. Objective : We sought to improve observation and reflection skills and to expand personal teaching practices of clinician educators. Methods : In 2016, we developed and evaluated an innovative "1-to-many" peer-coaching model utilizing large group review of video-recorded teaching encounters. Forty-three clinician-educator faculty in general internal medicine at the University of Pittsburgh attended at least 1 of 6 sessions between February and August 2016. Sessions were moderated by a master facilitator who guided direct observation of, and reflection on, observed teaching and highlighted efficacious teaching methods. The study evaluated the acceptability and efficacy of this novel faculty development program qualitatively, with semistructured, postcurriculum telephone interviews with 20 participating faculty. Results : All respondents stated that they would continue to attend faculty development sessions and would recommend them to others. The most frequently cited advantages included exposure to new teaching strategies, direct feedback, safe environment, community of practice, and growth mind-set, yet barriers emerged, such as discomfort reviewing video, difficulty giving feedback across hierarchy, and initial skepticism. None described the curriculum as critical or unsafe. Most reported increased self-reflection and adoption of new teaching behaviors. Conclusions : This peer-coaching, video-based faculty development program was well received, feasible, and effective in changing self-reported teaching attitudes and practices