Interventions to Promote Physical Activity in Chronically Ill Adults: What Does the Evidence Tell Us?

By Sylvia Foley, AJN senior editor

It sounds like a no-brainer: physical activity can have great health benefits for people who are chronically ill. But which interventions promote physical activity in this population most effectively? Many studies evaluating such interventions have been conducted; but “without the benefit of a statistical analysis across studies it can be difficult to detect patterns and interpret results,” say the authors of this month’s CE feature, Todd M. Rupper and Vicki S. Conn.

In 2008 Conn and colleagues did just that, performing a meta-analysis that summarized the findings of 163 reports on 213 independent tests of interventions used to promote physical activity among more than 22,000 adults with various chronic illnesses. Now, in this article, Rupper and Conn discuss the implications of  the findings from that meta-analysis, describe the strategies and practices most commonly used, and identify which ones have proven most effective. Among the take-aways: […]

Rapid Response Teams Seen Through the Nurse’s Eyes: What A New Study Reveals

By Sylvia Foley, AJN senior editor

How do nurses who activate a call by their facility’s rapid response team feel about the experience? And why does it matter? These questions lie at the heart of a qualitative study by nurse researcher Susan E. Shapiro and colleagues, who report on their findings in this month’s CE feature (for optimum reading, open the PDF version). For the study, which was funded by the Robert Wood Johnson Foundation, Shapiro and colleagues interviewed 56 staff nurses from 18 hospitals in 13 states; all of the nurses had participated in at least one rapid response team activation. Based on the data, the researchers identified three categories, posed as questions, that best described the nurses’ experiences:

  • Why was the team activated?
  • What did the team bring to the bedside?
  • How did the activating nurses feel about the experience?

Nurses tended to activate the rapid response team when a patient had signs and symptoms “that were either unexplained or significantly different from baseline,” when the nurse had a “gut feeling” that something was amiss, or when the nurse felt a patient needed urgent attention and couldn’t get the treating physician to respond. Overall, the activating nurses appreciated the added expertise and resources that rapid response team members brought to the bedside. As one nurse said, “You don’t have to figure it out; there’s going to be other minds there to work through it.” […]

Nursing Handoffs: Do We Know What Constitutes Best Practice?

By Sylvia Foley, AJN senior editor

A systematic literature review on nursing handoffs, written by nurse researcher Lee Ann Riesenberg and colleagues and featured as a CE article this month, might just shock you. The researchers found that although there is  “abundant evidence that poor communication and variable procedures result in inadequate handoffs,” surprisingly little is known about what makes nursing handoffs effective. Which is kind of incredible, given how crucial handoffs are to providing safe and effective patient care.

Of the 95 English-language articles that met the researchers’ inclusion criteria, just 20 reported on research on nursing handoffs, and only 3 were found to be of reasonably good quality (scoring above 10 on a 16-point scale). The researchers concluded that although “the Joint Commission is calling for structured handoffs . . . we found very little evidence to support the use of any specific structure, protocol, or method.”

Barriers and Strategies
But the researchers were able to identify, categorize, and list numerous barriers to and strategies for handoffs that were mentioned in the literature. […]

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