<p> Mobile phones especially smart phones have become increasingly more popular over the years. In 2016, the number of mobile phone users worldwide was 4.61 billion and it is projected by 2019 to pass the 5 billion mark. According to the 5^th Annual Makovsky/Kelton &ldquo;Pulse of Online Health&rdquo; Survey, 66 percent of Americans would use a mobile application or &ldquo;app&rdquo; to manage health-related issues. </p><p> The Senior Saver app is a mobile healthcare application targeted to coordinate care for seniors and make transition of care easier and smoother between family members and providers. The Senior Saver app is designed to be the &ldquo;lifesaver&rdquo; helping to save senior lives and saving the family members and providers from extra stress and/or problems.</p><p>

<p> The purpose of this qualitative phenomenological study was to explore emergency nurses&rsquo; perception of patient-initiated violence in eastern Tennessee. Twenty-four rural eastern Tennessee nurses participated in the study. The 24 participants were assigned to one of four gender specific focus groups. The focus groups offered qualitative data associated with the phenomenon. Themes and subthemes emerged from the analysis of participants responses using Colaizzi&rsquo;s (1978) strategies. The responses were segmented and compared to identify similar phrases or words. The data analysis detected five themes. Victimization manifested as participants&rsquo; feelings and a lack of executive leadership support. Re-victimization due to rural nurses&rsquo; continual exposure to patients who previously committed violent acts. A lack of executive leadership support was identified. Self-care deficit resulting from the participants&rsquo; post-exposure symptoms. Distinct gender differences were evident in this study. Implications include exploring an open dialogue between emergency nurses, nursing leadership, and executive leadership to develop policies that support the rural emergency nurse and establish policies that mitigate violence. Gender differences can be explored through individual discussion with emergency leadership leading to an individualized action plan that can foster self-care, employee engagement, and retain staff at the bedside.</p><p>

Nurses are an integral part of the health care system and their job encompasses a wide range of responsibilities including the promotion of health, prevention of illness and care for physically, mentally ill and disabled people. Nurses have a mandate to be responsible and accountable to the public they serve. For these reasons, it is crucial that nurses possess attitudes that allow them to provide optimal care in a supportive manner for patients. Despite the fact that considerable research on the experiences of nurses caring for the mentally ill in general hospitals has been done globally, none has been conducted in the Eastern Cape, South Africa. Additionally, no studies could be obtained from anywhere in the world on the experiences of non-psychiatric trained nurses caring for mental health care users on 72 hour observations. Studies indicated that nurses have different experiences when caring for mental health care users. It was therefore considered necessary to find out how non-psychiatric trained nurses perceive the caring of mental health care users during the 72 hour observations. The research design used to explore and describe their experiences was qualitative, descriptive, explorative, phenomenological and contextual in character. Semi-structured interviews were conducted with eight (8) participants who were purposively selected. This was done after necessary permission from the Department of Health and informed consent from the research participants. Steps were taken throughout the course of the study to ensure trustworthiness. Data were analysed using Tesch’s methods and the services of an independent coder were used. The results indicate that there are different experiences with regard to the caring for mental health care users during the 72 hour observations. The major themes identified are: feelings experienced by these nurses, lack of knowledge, challenges and strategies used for coping with a violent user, need for support from security staff and lack of policies. v Guidelines as a supportive action are suggested. From the results of the study recommendations are made in the areas of nursing education, nursing practice and nursing research. It is concluded that for non-psychiatric trained nurses to provide optimal care to mental health care users, the nurses need knowledge and skills in order to facilitate the promotion, maintenance and restoration of mental health of these patients as an integral part of health.

The objective of this research study was to describe and explore challenges faced by professional nurses in implementing six ministerial priority standards of care in selected units of an identified institution in O.R. Tambo region. Nurses are trained and employed to provide nursing care to patients according to scope of practice set by their statutory body (South African Nursing Council). Setting of standards forms part of quality improvement in nursing care and standards need to be monitored and evaluated (Muller 2006:206). In South Africa, the Minister of Health has identified six priority areas to fast-track improvement and ensure quality in health services. These priority areas are as follows: attitudes and values of health workers, cleanliness of the facility, waiting times, patient safety and security, infection prevention and control, and availability of medicines (National Health Plan: Strategic plan 2010/2013). Standard of nursing care in OR Tambo region according to available statistics, is lower than the expected ministerial standards, regardless of continued monitoring and evaluation. Staff attitudes is an ongoing problem, long queues, linen shortages, low standards of cleanliness as well as shortage of medication remain a challenge in health care institutions. This study is a qualitative, descriptive, exploratory, and contextual study that explored challenges faced by professional nurses in implementing the six ministerial priority standards of care. A purposive sampling of 10 professional nurses, meeting the selection criteria was utilised. In depth, semi structured interviews were used as a method of data collection. A digital voice recorder was used to record the interviews and consent from participants was obtained. Ethical considerations were adhered to. The interview question was: “What challenges are you facing in implementing expected standards of care with reference to the six ministerial priority standards of care?” Data was analysed using content thematic analysis approach. An independent coder with a Master’s degree and studying towards a doctorate helped with coding the results of the interviews. The Theory for Health Promotion in nursing as propounded by Botes (2006) was used to analyse the findings. The approach used was based on the external environment and its dimensions – social, physical and intellectual. v The findings of the research revealed the following themes: Lack of resources, demotivation of nurses, attitude of nurses, lack of monitoring and evaluation, environment and overcrowding, lack of patient safety, negligence, availability of policy and procedure manuals, and incompetency of health care professionals. The findings of this study revealed that nurses faced many challenges with regard to improving the standard of nursing care. According to Botes (2006), the purpose of nursing research is functional by nature, it provides guidelines for practice. Therefore in this study, a description of guidelines to improve nursing care has been done. Trustworthiness of the findings was ensured by utilising Lincoln and Guba’s model of trustworthiness. Limitations of the research are highlighted and recommendations for further and related studies are made.

<p> The medical literature is replete with studies on the issues of quality of care and patient safety. Several initiatives have been undertaken nationally to improve the quality of care and reduce the incidence of in-hospital adverse events. The report <i>Crossing the Quality Chasm: Building a Healthcare System for the 21^st Century</i>, posited to transform the healthcare system and improve the quality of care required a paradigm shift from a paternalistic to a patient-centric healthcare delivery model. It was further reiterated in the report that safety is a systems property and patients should be safe from harms and injuries caused by the system. The report envisioned a retooled, realigned and a coordinated health care delivery system where health information technology (HIT) would provide new and improved channels for information flow and communication between all stakeholders involved in healthcare delivery. To accelerate the adoption of health information technology, the American Recovery and Reinvestment Act (ARRA) of 2009 included a Health Information Technology for Economic and Clinical Health (HITECH) component and $27 billion in incentives for eligible providers and eligible hospitals through the Centers for Medicare and Medicaid Services (CMS). Beginning in 2011, the CMS has paid a total of $35,663,068,148 in incentives to eligible providers and hospitals. Hence, it is essential to evaluate whether this investment in incentives for meeting the requirements for meaningful use has translated into improved outcomes of care in acute care hospitals, which have met the requirements for meaningful use of electronic health record (EHRs). The purpose of this study is to determine the effects of meeting the requirements for meaningful use on clinical outcomes of care in acute care hospitals and to examine if there is a statistically significant difference in the clinical outcomes of care between acute care hospitals, which have met the requirements for meaningful use (MU) and acute care hospitals, which have not met the requirements for meaningful use. </p><p> A cross-sectional descriptive study was conducted to determine the effects of meeting the requirements for meaningful use on the quality and safety of patient care delivered in acute care hospitals in the all fifty states and the District of Columbia. The data, for the study, was obtained from 2014&ndash;2015 CMS Hospital Compare database, CMS EHR Incentive Program, CMS Inpatient Prospective Payment System (IPPS) database, and American Hospital Association (AHA) database. The unit of analysis for the study was acute care hospital. </p><p> Principal Findings: There is a positive association between acute care hospital meeting the requirements for meaningful use and its clinical outcome measures for common conditions (AMI, CHF, &amp;PN) as measured by 30-day readmission and 30-day mortality rates, when controlling for organizational characteristics (size, type, teaching status, and location) and case mix index (CMI). There is also a positive association between an acute care hospital meeting the requirements for MU and patient safety as measured by PSI-90 and hospital-acquired infections (HAI). Two one-way ANOVA test was conducted to measure the difference between groups. The results of the one-way ANOVA did not reveal a main effect of meeting the requirements for meaningful use on quality of care between hospitals, which have met the requirements for meaningful use and acute care hospitals which have not met the requirements for meaningful use. The main effect, MUSTAGE was not significant at the 95% confidence level, <i> F</i>(2, 1647) = 0.94, <i>p</i> = .389, indicating there were no significant differences in Quality by MUSTAGE levels. However, the results of one-way ANOVA for safety were significant, <i>F</i>(2, 2019) = 5.24, <i>p</i> = .005, indicating there were significant differences in patient safety among the levels of MUSTAGE. The eta squared was 0.01 indicating MUSTAGE explains approximately 1% of the variance in patient safety between acute care hospital which has met the requirements for meaningful use, and acute care hospital that has not met the requirements for meaningful use. Conclusions: The HITECH Act and the incentives included for meeting the requirements for meaningful use has promoted increased adoption of advanced capabilities of EHRs to meet the requirements for MU2 as the majority of the hospitals in the United States had met the requirements for MU2 in 2016. This increase in the adoption and use of EHRs had a positive effect on quality of care and patient safety. The increase in the adoption and use of EHRs has also led to the increased creation of structured and standardized medical records which will be easier to exchange with providers involved in care. (Abstract shortened by ProQuest.) </p><p>

<p> More than one third of all Americans are obese, causing a myriad of health ailments that put excessive strains upon the U.S. healthcare system. It is estimated that medical costs attributed to these health complications such as heart disease, stroke and diabetes, are nearly $150 billion dollars. These statistics, along with the increasing amount of older adults due to the aging Baby Boomer generation, will only continue to increase these costs. Fitness initiatives are instrumental in lowering the rates of obesity and increasing overall health and wellness for these individuals. </p><p> Long Beach Mobile Fitness, LLC will provide on-site athletic training services to assisted living communities and business districts that provide adapted CrossFit techniques, along with other athletic training programming to clients within the City of Long Beach and the surrounding areas. Low start-up and monthly costs, along with the ease of transporting a mobile gym facility, allows Long Beach Mobile Fitness, LLC the flexibility to provide fitness programming to a wide range of clientele with ease.</p><p>

<p>ABSTRACT The current increase in the population of older adults has created a high demand for more informal caregivers. Informal caregivers complain of many problems in providing care including psychological stresses and anxieties, as well as physical, emotional, financial, and other social burdens. The purpose of this phenomenological study was to understand and describe the essence of the lived experiences of informal caregivers. The study was also intended to make health professionals and policy makers aware of such problems. The study adopted a qualitative methodology and a hermeneutical phenomenological design. Purposeful sampling was used in selecting participants with informal caregiving experience. Eleven informal caregivers were interviewed via telephone for data collection. Data was analyzed using Nvivo 11 for the identification and description of patterns and themes from the perspectives of participants. Eight themes that emerged from data analysis were: (a) Gender, many females engaging in caregiving, (b) Caregivers feeling stressful, (c) Love played a crucial role in caregiving, (d) Need for training for caregivers, (e) Being cared for by loved family members, (f) Impacts on job performance, (g) Living arrangements between caregiver and care receiver, and (h) Lack of support from family, community or state agencies. The conclusions focused on the need for support to informal caregivers such as caregiver training, adult day care services, care leave or respite care, increased access to services, care payments, and expansion in the informal caregiver workforce.

<p> Due to the mounting rate of patients suffering from PTSD starting at a young age, there have been many studies and guidelines to help improve the conditions of these patients. Though there are many hospitals focusing on treatment of patients suffering from mental diseases, none of these hospitals or clinics concentrate on the welfare of the children suffering from PTSD specifically. The business plan discussed here addresses this concern. It is a healing center &ldquo;Golden Circle&rdquo; providing care and treatment to young adults aged between 13&ndash;25 years suffering from PTSD especially after road traffic accidents located in Los Angeles County. Golden Circle business plan is proposed to help identify the market trends and areas of concern by studying the company analysis, market potential and demand, competitor analysis, customer analysis, marketing strategy, feasibility and SWOT analysis, legal and regulatory issues and finally the financial analysis. Golden Circle is anticipated to help the society as well as generate good profit.</p><p>

<p> The rigors of labor and childbirth are incredibly demanding on the mother's body physically, emotionally, and psychology. Most new mothers deliver in a hospital setting where they are discharged after approximately two days. However, the mother's health and well-being does not improve that drastically within those two days of post-delivery recovery. Common struggles that new mothers face include postpartum depression, intimate partner violence, mood and body changes, as well as nutrition and sleep deprivation. Therefore, it is not only important to be attentive to the newborn but to the mother's recuperation as she adjusts to postnatal life. While there are many options for new mothers to deliver their baby through hospitals or birth centers, there is a lack of postnatal care facilities in comparison. </p><p> Pamper Partum, LLC is a private company with an organizational mission to offer quality service and care that eases the transition to motherhood, to empower a new mother through education and community support, and to reduce any preventable risks associated with the postnatal period. Pamper Partum, LLC is an all-inclusive healthcare facility that provides services such as breastfeeding assistance, peer-support groups, private counseling, nutrition, general health care, and 24/7 infant monitoring in a state-of-the-art nursery. Pamper Partum, LLC will seek to be the first postnatal care facility that serves Orange County.</p><p>

<p> The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner&rsquo;s novice to expert model was chosen as the theoretical framework to guide the additional training, critical thinking, problem-solving, and skill acquisition necessary for team member inclusion. The practice-focused question for the project answered whether DUC team nurses, through advanced training and demonstrated procedural competence, have been effective with DUC insertions. Sources of evidence included primary and secondary articles in peer-reviewed journals, as well as clinical evidence collected from internal sources. During the project time-line, 463 DUC team consultations were recorded with an insertion success rate of 89.6%. Based on the DUC team concept, additional didactic content and simulation training may be developed for other cognitive and skill-based clinical procedures. The implications for positive social change include improved patient safety and comfort, as well as cost savings for the organization and overall healthcare system.</p><p>