Electronic Health Record Instruction in First-Semester Nursing Students: A Comparative Study

The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million life-threatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated in the classroom, simulation, and skills labs. Existing studies have only examined student preferences for their use, with little or no data on improvement in quantifiable outcomes. The purpose of this study was to investigate if the use of an AEHR improved self-efficacy, reduced anxiety, and enhanced competence compared to a traditional PowerPoint presentation on EHR usage. Bandura’s social cognitive theory was the guiding framework of this study. This study used a quasi-experimental design with first-semester students enrolled in a Baccalaureate of Science in Nursing (BSN) program. The control group received EHR instruction in a traditional 1-hour PowerPoint lecture. The intervention group received a 1-hour instructional session using and navigating in an AEHR (Lippincott DocuCare). Pre- and postinstruction measures and surveys showed undergraduate nursing students who received hands-on AEHR instruction had increased self-efficacy, less anxiety, and increased competency compared to peers who received the traditional instruction. The results of this study indicate that the use of an AEHR in nursing curricula may be a more effective teaching strategy to improve students’ self-efficacy, anxiety, and competency

Implementation and Outcomes of Complementary Therapies in Hospice Care: An Integrative Review

Complementary therapies are increasingly integrated into hospice care, emphasizing the need to examine the evidence regarding implementation and effects on end-of-life outcomes. This review synthesizes the evidence regarding the implementation of complementary therapies and effects on end-of-life outcomes in hospice care. Whittemore and Knafl’s five-step integrative review process was applied. Using predefined search terms, research-based articles between 2006 and 2020 were reviewed. Twenty-three quantitative/mixed method studies conducted across eight countries met the final review criteria. Most commonly used complementary therapies were music, biofield therapies (reiki, therapeutic touch), and massage therapy. Most studies reported significant findings on physical symptoms (pain, dyspnea, fatigue, gastrointestinal symptoms, agitation) and/or psychosocial/spiritual symptoms (anxiety, depression, spirituality, well-being, quality of life); 40% of studies had both significant and nonsignificant findings. Methodological limitations included study design (few randomized controlled trials), small sample size, high attrition rate, lack of racial/ethnic diversity, unstandardized intervention implementation, and multiple outcome measurement instruments. Complementary therapies are promising components of hospice care; however, rigorous studies are needed to validate the effect on end-of-life outcomes and determine the most efficacious implementation. Complementary therapy studies face challenges consistent with end-of-life research; however, efforts to design rigorous trials and address methodological issues are required to enhance the state of the science

Food of Bobcats and Coyotes from Cumberland Island, Camden County, Georgia

Fifty scats of bobcats and 105 scats of coyotes from Cumberland Island, Camden County, Georgia, were examined during this study. Major foods of bobcats were mammals (81.8% volume), followed by birds (13.8%) and vegetation (4.2%), with only 0.2% invertebrates. Major foods of coyotes were plant materials (46.6% volume), mammals (43.8%), and invertebrates (6.0%). This is apparently the first report of coyote foods from Cumberland Island

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field