Iowa Board of Nursing Newsletter, August-September-October 2007, Vol. 26, no. 3

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, August-September-October 2008, Vol. 27, no. 3

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, August-September-October 2010, Vol. 29, no. 3

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, November-December 2006, January 2007, Vol. 25, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, November-December 2007, January 2008, Vol. 26, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, November-December 2008, January 2009, Vol. 27, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, November-December 2009, January 2010, Vol. 28, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Iowa Board of Nursing Newsletter, November-December 2010, January 2011, Vol. 29, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

La pratique infirmière avancée [Advanced practice nursing].

Dans les sociétés contemporaines axées sur le savoir, plus grande sera la proportion de leur population détentrice d'une formation supérieure et engagée en recherche, plus avancé sera leur développement économique et social.1,2 Par contre, dans ces sociétés, le vieillissement de la population, l'importance ccordée aux soins de santé axés sur les maladies chroniques et les coûts financiers de ceux-ci exercent une forte pression sur les systèmes de santé. Les nterventions doivent donc être les plus efficaces possible, avec un rapport coût/efficacité optimal. Cela requiert que les infirmières soient capables d'oeuvrer en pratique avancée, c'est-à-dire capables de développer, implémenter et évaluer des approches cliniques infirmières basées sur des preuves, de tester de nouvelles interventions potentiellement plus efficientes et de promouvoir un programme de recherche portant explicitement sur l'amélioration de la qualité et sécurité des soins en contexte d'interdisciplinarité.

Development of an Economic Dust Palliative for Limestone Surfaced Secondary Roads, HR-297, 1990

This research project was directed at laboratory and field evaluation of sodium montmorillonite clay (bentonite) as a dust palliative for limestone surfaced secondary roads. It had been postulated that the electrically charged surfaces of the clay particles could interact with the charged surfaces of the limestone and act as a bonding agent to agglomerate fine (-#200) particulates and also to band the fine particulates to larger (+#200) limestone particles. Laboratory testing using soda ash dispersed bentonite treatment of limestone fines indicated significant improvement of compressive strength and slaking characteristics. It was recommended that the project proceed to field trials and test roads were constructed in Dallas and Adair counties in Iowa. Soda ash dispersed bentonite solutions can be field mixed and applied with conventional spray distribution equipment. A maximum of 1.5% bentonite(by weight of aggregate)can be applied at one time. Higher applications would have to be staged allowing the excess moisture to evaporate between applications. Construction of higher application treatments can be accomplished by adding dry bentonite to the surfacing material and then by dry road mixing. The soda ash water solution can then be spray applied and the treated surfacing material wet mixed by motor graders to a consistency of 3 to 4 inch slump concrete. Two motor graders working in tandem can provide rapid mixing for both methods of construction. Calcium and magnesium chloride treatments are 2 to 3 times more effective in dust reduction in the short term (3-4 months) but are prone to washboarding and potholing due to maintenance restrictions. Bentonite treatment at the 2-3% level is estimated to provide a 30-40% dust reduction over the long term(18-24 months). Normal maintenance blading operations can be used on bentonite treated areas. Vehicle braking characteristics are not adversely affected up to the 3.0% treatment level. The bentonite appears to be functioning as a banding agent to bind small particulates to larger particles and is acting to agglomerate fine particles of limestone. This bonding capability appears recoverable from environmental effects of winter, and from alternating wet and dry periods. The bentonite appears to be able to interact with new applications of limestone maintenance material and maintains a dust reduction capability. Soda ash dispersed bentonite treatment is approximately 10 times more cost effective per percent dust reduction than conventional chloride treatments with respect to time. However,the disadvantage is that there is not the initial dramatic reduction in dust generation as with the chloride treatment. Although dust is reduced 30-40% after treatment there is still dust being generated and the traveling public or residents may not perceive the reduction.

Iowa Board of Nursing Newsletter, August, September, October, 2014 Vol. 33, no. 3

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.

Pharmacological treatment of behavioral and psychological symptoms of dementia (BPSD) in nursing homes: development of practice recommendations in a Swiss canton

OBJECTIVES: In 2002, the canton of Fribourg, Switzerland, implemented a coordinated pharmaceutical care service in nursing homes to promote rational drug use. In the context of this service, a project was conducted to develop recommendations for the pharmacological management of behavioral and psychological symptoms of dementia (BPSD) in nursing home residents. DESIGN AND METHODS: Selected evidence-based guidelines and meta-analysis sources related to the management of depression, insomnia, and agitation in dementia patients were systematically searched and evaluated. Evidence and controversies regarding the pharmacological treatment of the most common BPSD symptoms were reviewed, and treatment algorithms were developed. RESULTS: Ten evidence-based guidelines and meta-analyses for BPSD management were identified, with none specifically addressing issues related to nursing home residents. Based on this literature, recommendations were developed for the practice of pharmacological management of depression, sleep disturbances, and agitation in nursing home residents. For depression, SSRIs are considered the first choice if an antidepressant is required. No clear evidence has been found for sleep disturbances; the underlying conditions need to be investigated closely before the introduction of any drug therapy. Many drugs have been investigated for the treatment of agitation, and if necessary, antipsychotics could be used, although they have significant side effects. Several areas of uncertainty were identified, such as the current controversy about typical and atypical antipsychotic use or the appropriateness of cholinesterase inhibitors for controlling agitation. Treatment algorithms were presented to general practitioners, pharmacists, and medical directors of nursing homes in the canton of Fribourg, and will now be implemented progressively, using educational sessions, pharmaceutical counseling, and monitoring. CONCLUSION: Based on existing evidence-based studies, recommendations were developed for the practice of pharmacological management of depression, sleep disturbances, and agitation in nursing home residents. It should be further studied whether these algorithms implemented through pharmaceutical care services will improve psychotropic drug prescriptions and prevent drug-related problems in nursing home residents

Infections and functionnal impairment in nursing home residents : a reciprocal relationship

RESUME: Contexte : l'objectif de cette étude de cohorte prospective était de déterminer la relation entre la survenue d'infections et la dépendance fonctionnelle chez des résidents d'établissements de long séjour durant une période de 6 mois. Population et méthode : les patients inclus (1324 résidents) étaient âgés de 65 ans et plus (âge moyen 85.7 ans, 76.6% de femmes), étaient des résidents de 39 EMS du canton de Vaud. Au baseline, des données démographiques, médicales, concernant les facteurs de risque et protecteurs des infections ont été récoltées. Au cours du suivi de 6 mois, les infirmières des EMS ont documenté la survenue de symptômes et signes d'infection en utilisant les critères développés spécifiquement par l'APIC pour les établissements de long séjour. Les mesures du status fonctionnel ont été évaluées au baseline, à 3 mois et à 6 mois. Deux outcomes différents ont été utilisés : a) le déclin fonctionnel défini comme le décès ou une diminution des capacités fonctionnelles au suivi, b) le status fonctionnel mesuré par une échelle standardisée. Résultats : à la fin du suivi, la mortalité était de 14.6%, similaire pour les résidents avec et sans infection (16.2% versus 13.1%, P .11). Durant les 2 périodes de suivi de 3 mois, les sujets ayant présenté une ou plusieurs infections avaient des odds de déclin fonctionnel plus élevés, y compris après ajustement pour les caractéristiques démographiques, médicales et fonctionnelles du baseline, ainsi que la survenue de nouvelles maladies (odds ratio ajustés (OR) = 1.6, intervalle de confiance à 95% (IC) = 1.2-2.2, P = .002 et OR = 1.5, 95% IC= 1.1-2.0, P= .008, respectivement). Comparés aux résidents non infectés, les odds de déclin fonctionnel augmentaient significativement et graduellement chez ceux ayant eu une, respectivement 2 infections ou plus. L'analyse prédisant le score fonctionnel (restreinte aux sujets ayant survécu) a donné des résultats similaires. Finalement, une analyse de survie prédisant le temps jusqu'à la première infection a confirmé une augmentation progressive de la probabilité d'infection chez les sujets avec dépendance fonctionnelle modérée, respectivement sévère, comparés aux sujets indépendants à la ligne de base. Conclusion : chez les résidents de long séjour, les infections sont à la fois cause et conséquence de la dépendance fonctionnelle. Des études futures devraient être entreprises pour investiguer si des programmes de prévention des infections peuvent également contribuer à prévenir le déclin fonctionnel, un facteur important pour la qualité de vie de ces résidents. ABSTRACT: Objectives: To determine the relationship between infections and functional impairment in nursing home residents. Design: Prospective cohort study (follow-up period, 6 months). Setting: Thirty-nine nursing homes in western Switzerland. Participants: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent. Measurements: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow-up and (b) functional status score using a standardized measure. Results: At the end of follow-up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P= .11) During both 3-month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR) = 1.6, 95% confidence interval (CI) = 1.2-2.2, P = .002, and AOR 1.5, 95% CI 1.1-2.0, P .008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects -with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline. Conclusion: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life.

Iowa Board of Nursing Newsletter, December, 2014 Vol. 33, no. 4

Newsletter produced by the Iowa Board of Nursing for nurses to keep them informed to CE classes, renewals, board meetings, etc. Produced 4 times a year. Also known as Nursing Newsletter.