Developing the Value Proposition for Registered Nurse Care Coordination and Transition Management Role in Ambulatory Care Settings

The Patient Protection and Affordable Care Act (2010) established clear provisions for Patient-Centered Medical Homes and Accountable Care Organizations. In both, care coordination and transition management are methods to provide safe, high-quality care to at-risk populations such as patients with multiple chronic conditions. The emphasis on care coordination and transition management offers opportunities for nurses to work at their full potential as an integral part of the interprofessional team. Development of a model for the registered nurse in care coordination and transition manage- ment provides nurses the opportunity to develop the knowledge, skills, and attitudes to be a resource to the team and to patients, and to con- tribute to high-quality patient and organization outcomes

Developing the Value Proposition For the Role of the Registered Nurse In Care Coordination and Transition Management in Ambulatory Care Settings

The Patient Protection and Affordable Care Act (2010) established clear provisions for Patient-Centered Medical Homes and Accountable Care Organizations. In both, care coordination and transition management are methods to provide safe, high quality care to at-risk populations such as patients with multiple chronic conditions. The emphasis on care coordination and transition management offers opportunities for nurses to work at their full potential as an integral part of the interprofessional team. Development of a model for the registered nurse in care coordination and transition management provides nurses the opportunity to develop the knowledge, skills, and attitudes to be a resource to the team and to patients, and to contribute to high-quality patient and organization outcomes

The Cost of Isolation

Background: Recent research has found that family (e.g., informal, unpaid) caregivers to those in long-term care can experience significant risk of social isolation, a harmful social outcome linked to poor health and wellbeing. For many, the COVID-19 global pandemic has been a time marked by challenges that have exacerbated existing risk of social isolation and has likely impacted mental health and wellbeing among caregivers. As such, this paper outlines a protocol to investigate the extent to which the COVID-19 pandemic has impacted the psychological health and well-being of family caregivers of people living in residential long-term care. Methods/Design: A descriptive phenomenological design and photovoice methodology will be used alongside focus groups to capture the perspectives and voices of 15-20 family caregivers. Data will be analyzed thematically, and themes will be developed collaboratively alongside participants. A secondary analysis will be guided by a cumulative inequality lens to consider how the COVID-19 pandemic has differentially affected caregivers. Discussion: The results will fill a significant gap in the existing literature on caregiver isolation during this pandemic and inform the development and/or refinement of caregiver supports

Postoperative Delirium Prevention in the Older Adult: An Evidence-Based Process Improvement Project

Postoperative delirium is a major complication in hospitalized older adults. Implementation of a screening tool and evidence-based delirium-prevention protocol on a surgical unit increased nurses’ knowledge regarding delirium, increased identification of delirium, and produced medical treatment alterations leading to positive patient outcomes

Developing a Business Case for the Care Coordination and Transition Management Model: Needs, Methods, and Measures

In this descriptive qualitative study, nurse and healthcare leaders\u27 experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed

Health Care Reform: Current Updates and Future Initiatives for Ambulatory Care Nursing

Executive Summary: While the signing of the Patient Protection and Affordable Care Act was a historical event marking the beginning of health care reform in the United States, it signaled the start of a golden age for ambulatory care nursing. Ambulatory care RNs are well-positioned to fully participate in health care reform initiatives. RNs are well-positioned to lead, facilitate, and/or participate in all patient care medical homes\u27 and accountable care organizations\u27quality and safety initiatives through enhanced use of major ambulatory care RN role dimensions such as advocacy, telehealth, patient education, care coordination and transitional care, and community outreach. RNs are also well-positioned to provide patient-centered care, coordinate care, and manage transitions across ambulatory care settings. For the golden age of ambulatory care nursing to become a reality, initiatives surround competencies, education modules, and leadership must be addressed immediately

Helicobacter pylori-Induced Histone Modification, Associated Gene Expression in Gastric Epithelial Cells, and Its Implication in Pathogenesis

Histone modifications are critical in regulating gene expression, cell cycle, cell proliferation, and development. Relatively few studies have investigated whether Helicobacter pylori, the major cause of human gastric diseases, affects histone modification. We therefore investigated the effects of H. pylori infection on histone modifications in a global and promoter-specific manner in gastric epithelial cells. Infection of gastric epithelial cells by wild-type H. pylori induced time- and dose-dependent dephosphorylation of histone H3 at serine 10 (H3 Ser10) and decreased acetylation of H3 lysine 23, but had no effects on seven other specific modifications. Different cag pathogenicity island (PAI)-containing-clinical isolates showed similar abilities to induce H3 Ser10 dephosphorylation. Mutation of cagA, vacA, nonphosphorylateable CagA mutant cagAEPISA, or disruption of the flagella showed no effects, while deletion of the entire cagPAI restored the H3 Ser10 phosphorylation to control levels. Analysis of 27 cagPAI mutants indicated that the genes that caused H3 Ser10 dephosphorylation were similar to those that were previously found to induce interleukin-8, irrespective of CagA translocation. This effect was independent of ERK or p38 pathways and type I interferon signaling. Additionally, c-Jun and hsp70 gene expression was associated with this histone modification. These results demonstrate that H. pylori alters histone modification and host response via a cagA-, vacA-independent, but cagPAI-dependent mechanisms, which contribute to its persistent infection and pathogenesis