The Medical-Surgical Nursing Certification Board (MSNCB) encourages certification for all registered nurses who provide care in a medical-surgical setting. Initial certification is achieved through successful testing by...The Medical-Surgical Nursing Certification Board (MSNCB) encourages certification for all registered nurses who provide care in a medical-surgical setting. Initial certification is achieved through successful testing by written examination. The certification examination is based on Benner's Nursing Model. Questions on the examination fall within the seven domains of nursing practice: Helping Role, Teaching-Coaching Function, Diagnostic and Patient Monitoring, Effective Management of Rapidly Changing Situations, Administering and Monitoring Therapeutic Interventions and Regimens, Monitoring and Ensuring the Quality of Health Care Practices, and Organizational and Work Role Competencies. The examination is designed to assess comprehensive knowledge of medical-surgical nursing. The medical-surgical practitioner must understand diseases, diagnoses, and treatment modalities to function as a caregiver and educator. The topic of this article is a part of the comprehensive examination given by MSNCB. The following scenario and questions offer an example that potential certificants may use to test their knowledge. For more information about MSNCB, visit www.amsn.org/certification.
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 del...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.
Analysis of surgical nurses' attitudes toward postoperative vital sign (VS) assessment found tradition and ritual rather than research continue to drive postoperative VS assessment practices. Recommendations for practice...Analysis of surgical nurses' attitudes toward postoperative vital sign (VS) assessment found tradition and ritual rather than research continue to drive postoperative VS assessment practices. Recommendations for practice, education, and research are made based on these findings.
Evidence-based practice for multiple types of bariatric surgeries is addressed, along with complications, signs and symptoms of a postoperative emergency with the correct course of action, and general postoperative care.Evidence-based practice for multiple types of bariatric surgeries is addressed, along with complications, signs and symptoms of a postoperative emergency with the correct course of action, and general postoperative care.
PURPOSE: To explore the evolution of suspected deep tissue injury (sDTI) pressure ulcers and identify the role of early identification and intervention in hindering tissue destruction. In contrast to previously published...PURPOSE: To explore the evolution of suspected deep tissue injury (sDTI) pressure ulcers and identify the role of early identification and intervention in hindering tissue destruction. In contrast to previously published evidence, the foundational research identified a significant trend of sDTI recovery which warranted further analysis. SUBJECTS AND SETTINGS: A single-site, 24-month retrospective, IRB-approved study evaluated 77 adult (age 18 or older) hospitalized subjects with 128 wound care nurse-identified sDTIs over the course of 1 day to 14 weeks for 377 encounters. METHODS: Data from a 24-month period (2010-2012) were analyzed during the primary study. In addition to demographics, the evolution process including site, initial presentation, measurements, tissue consistency, and treatment, were assessed. In response to findings of significant sDTI recovery, a secondary in-depth analysis focused on commonalities and variables for clarity of their contribution to the isolated improved patient outcomes. RESULTS: In addition to clearer delineation of demographics, co-morbid conditions, and evolutionary patterns, the researcher identified patient outcomes in stark contrast to those previously published in the literature. A significant outcome of resolution of sDTI pressure ulcers was observed. Upon further review, the role of absorbent soft silicone, multi-layer, self-adherent bordered foam (Mepilex) in these outcomes was elucidated clearly.
Results of a survey measuring frequency, types, and reasons for missed care at three acute care hospitals in North Carolina are described. Results also are compared to those of a previous, similar study in the midwestern...Results of a survey measuring frequency, types, and reasons for missed care at three acute care hospitals in North Carolina are described. Results also are compared to those of a previous, similar study in the midwestern United States.
Results of a qualitative study of the experience of 15 acute care nurses with disruptive physician behavior and its impact on communication are reported. Findings will help educators and leaders prepare nurses by coachin...Results of a qualitative study of the experience of 15 acute care nurses with disruptive physician behavior and its impact on communication are reported. Findings will help educators and leaders prepare nurses by coaching and educating them on the importance of communication and patient advocacy.
Cummings J, Soomans D, O'Laughlin J
… +5 more, Snapp V, Jodoin A, Proco H, Archer M, Rood D
Medsurg Nurs
· 2015 · PMID 26434033
PURPOSE: To determine how well an institutionally developed nurse dysphagia screening tool correctly identified the presence (sensitivity) or absence (specificity) of dysphagia in patients following acute stroke. METHODS...PURPOSE: To determine how well an institutionally developed nurse dysphagia screening tool correctly identified the presence (sensitivity) or absence (specificity) of dysphagia in patients following acute stroke. METHODS: A method-comparison design was used to compare results of the Nurse Dysphagia Screen to the dysphagia evaluation by a speech and language pathologist (SLP). Each newly diagnosed participant served as his or her control, with both dysphagia evaluations (nurse, SLP) occurring within 2 hours of each other. Sensitivity and specificity of the Nurse Dysphagia Screen was calculated using standard formulas. RESULTS: For 49 patients evaluated following stroke, average age was 71.7 (SD +/- 13.5). Twenty-five subjects were female and 24 were male. The majority of the participants had strokes identified as ischemic in origin (n=35). The SLP found 18 (37%) participants had a positive dysphagia assessment. The Nurse Dysphagia Screen was positive in 16 of 18 participants screened positive by SLP, resulting in some type of dietary restriction. The Nurse Dysphagia Screen was negative in 28 of the 31 patients screened as negative by SLP. Sensitivity and specificity of the Nurse Dysphagia Screen were 89% and 90%, respectively. CONCLUSIONS: An easy-to-use, institutionally developed nurse dysphagia screening tool successfully identified patients with swallowing difficulties after stroke later diagnosed by SLP.
Although the gluten-free diet has been recognized as therapeutic for individuals suffering from celiac disease, it has been promoted recently for other indications, such as autism, chronic fatigue syn- drome, and irritab...Although the gluten-free diet has been recognized as therapeutic for individuals suffering from celiac disease, it has been promoted recently for other indications, such as autism, chronic fatigue syn- drome, and irritable bowel syndrome, or simply as a healthy dietary choice for anyone. The basics of the gluten-free diet are explored, with evidence-based indications and nursing implications when patients choose gluten-free.