The known safety, tolerability, and pharmacodynamics of memantine may warrant its off-label use in future studies exploring efficacy in ON.

To provide patient- and family-centered care, health care providers must understand the caregiver experience. Evidence suggests that registered nurses functioning as family caregivers (RNFCs) may have unique experiences and challenges.

The purpose of this study was to explore the lived experiences of RNFCs during an adult family member’s episode of care in the southern United States.

A descriptive phenomenological approach was used to describe the essence of the RNFC experience throughout an episode of care. CH5126766 inhibitor Twenty-five participants were recruited for semistructured, audio-recorded interviews. Data were analyzed using descriptive data analysis and constant comparison techniques.

Participants were predominantly female (88%). The essence of the phenomenon was dual roles. Five themes emerged (1) blurring the boundaries, (2) revealing my identity, (3) having insider knowledge, (4) managing expectations, and (5) learning from my experience.

While caregiver experiences may be similar, RNFCs struggle with dual roles of registered nurse and caregiver, occasionally blurring boundaries of care.

While caregiver experiences may be similar, RNFCs struggle with dual roles of registered nurse and caregiver, occasionally blurring boundaries of care.

Purposeful hourly rounding and information on whiteboards in patients’ rooms have been known to reduce use of call lights.

Call light activation was higher than desired.

This continuous improvement initiative used retrospective data collection (pre-, early- and maintenance postintervention) to assess call light responsiveness.

A bundled purposeful hourly rounding approach was used.

Call light frequency was higher in the early postintervention period than in the preintervention; however, there was no change in the frequency of call lights that extended beyond 5 minutes. In the maintenance postintervention period, compared with the pre- and early postintervention periods, call lights per patient/unit day and call lights extending beyond 5 minutes per patient/unit day decreased (all P < .001).

Activation of a bundled purposeful hourly rounding approach was associated with a decrease in all call lights and call lights extending beyond 5 minutes per patient/unit day.

Activation of a bundled purposeful hourly rounding approach was associated with a decrease in all call lights and call lights extending beyond 5 minutes per patient/unit day.

There is limited evidence available identifying best practices to promote and sustain optimal outpatient-to-inpatient handoff processes to ensure safe and reliable continuity of care.

A sentinel event occurred during the transition of care from the outpatient-to-inpatient setting. A root cause analysis revealed that the facility’s standard operating procedure for patient handoffs was not consistently followed.

A Lean Six Sigma approach was used to improve patient transfer with the implementation of a Situation-Background-Assessment-Recommendation handoff policy. Inferential and statistical process control methods were used to assess performance outcomes pre- and postdissemination.

Over 36 months there was a slow, steady decrease in patient transfer time including reduced variability. The most significant improvement effect occurred in the third year with a 50% reduction in transfer time.

Longitudinal monitoring provides the opportunity to accurately identify beneficial outcomes, which develop downstream from initial quality improvement efforts.

Longitudinal monitoring provides the opportunity to accurately identify beneficial outcomes, which develop downstream from initial quality improvement efforts.

Patients with a heart transplant and depression have higher rates of graft failure and noncompliance.

The heart transplant clinic had no standardized approach to assess for depression.

The heart transplant clinic implemented routine use of the Patient Health Questionnaire (PHQ).

Team members were educated via an online module about depression. A process for depression screening and follow-up was developed and implemented.

From July 2018 to February 2019, there were 834 visits; PHQ2 screens were completed during 779 (93%) of those visits with 40 (5%) positive screens. All 40 patients had PHQ9 assessment, with 33 patients (4%) exhibiting moderate or severe depressive symptoms. All 33 patients were provided with mental health resources and received follow-up. Median time to administer PHQ2 was 2 minutes (range 1-3 minutes).

Implementation of universal depression screening in a heart transplant clinic is feasible, identifies patients with depression, and does not add significant clinical burden.

Implementation of universal depression screening in a heart transplant clinic is feasible, identifies patients with depression, and does not add significant clinical burden.

Alveolar osteitis (AO) may occur after molar extraction. Chlorhexidine (CHX) rinse and CHX gel are widely used to prevent AO. Although previous meta-analyses support the effectiveness of both CHX rinse and CHX gel in preventing AO, important issues regarding these two formulations have not been addressed adequately in the literature.

A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effectiveness of CHX rinse and CHX gel in preventing AO.

PubMed, EMBASE, SCOPUS, and Cochrane databases were searched for randomized controlled trials published before June 2018. The risk ratio (RR) was used to estimate the pooled effect of AO incidence using a random-effect model.

The RRs of AO in patients treated with 0.12% CHX rinse (RR = 0.54, 95% CI [0.41, 0.72]) and 0.2% CHX rinse (RR = 0.84, 95% CI [0.52, 1.35]) were significantly lower than in those treated with the control. Moreover, a significantly lower RR was identified in patients treated with 0.2% CHX gel (RRte health education and case management.

The results support the effectiveness of both CHX rinse and gel in reducing the risk of AO after molar extraction. Each formulation provides unique benefits in terms of ease of application and cost. On the basis of the results of this study, the authors recommend that CHX gel be used immediately after molar extraction because of the convenience and cost-effectiveness of this treatment and that CHX rinse be used by the patient after discharge at home in combination with appropriate health education and case management.