Background: Graduate nursing academic faculty rely heavily on clinical preceptors for mentorship and clinical practicum experiences for BSN-DNP degree-seeking family nurse practitioner (FNP) students. Thus, it is important that preceptors have documented clinical competencies to assure the delivery of quality, evidence-based practice that meets regulatory requirements prior to precepting students.Objectives: The objectives of this quality improvement project were to develop and implement APRN competency validation tools (CVTs) in nurse-led clinic settings.Methods: Rapid Cycle Quality Improvement (RCQI) strategies were used to develop and implement APRN CVTs.Results: Three APRN CVTs were successfully developed, tested, refined, and implemented in four nurse-led clinics in rural east Tennessee. With one exception, the APRN preceptors had documentation of clinical competency prior to approval as a SPADES preceptor. Graduate academic faculty, preceptors, and students reported satisfaction with the SPADES project.Conclusion: CVTs are feasible tools for documentation of validated clinical APRN preceptors’ competency in nurse-led clinics. The CVTs and the medical record review checklist are available upon request from the primary author.Implications for Nursing: Use of APRN CVTs provides documentation that the preceptor uses evidence-based practice in the clinic setting prior to precepting students.

Book Summary: This quick reference serves as an authoritative clinical guide to diagnostic treatment and monitoring recommendations for patients with mental disorders in the primary care setting. It offers fast and efficient access to evidence-based diagnostic and therapeutic guidelines for managing psychiatric and mental health conditions. The book guides family and adult advanced practice nurses in making clinical decisions that are supported by the best available evidence, reflecting current research and expert consensus. Additionally, researchers may use this book to identify important clinical questions where more research could be conducted to improve treatment decision making. This comprehensive text is organized by major diagnostic categories, such as anxiety disorders, with specific diagnoses organized alphabetically within each category. It supports informed practice, which increases confidence in differential diagnosis, safe and effective treatment decision making, reliable treatment monitoring and, ultimately, improved patient outcomes. Additionally, DSM-IV-TR diagnostic standard summaries and ICD-9 codes are incorporated for use in the clinical setting. It is an essential resource in everyday practice for all health care providers.

Early childhood caries (ECC) is the most common chronic disease condition in childhood and involves the presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled teeth in children under 72 months of age (American Academy of Pediatric Dentistry, 2010a). ECC is a multifactorial disease that is preventable and requires intervention by the nurse. When teeth are discolored and damaged by dental caries, children may be reluctant to smile, have difficulty talking, miss school, or be unable to focus on studies due to dental pain. This "state of the science" article reviews the literature to determine the risk factors for ECC, assess the prevention strategies, and apply that information to enhance nursing practice. Computerized searches from MEDLINE, CINAHL, and the Cochrane Library were used.

No description available.

No description available.

Gestational diabetes (GDM) occurs in up to 9% of pregnancies. Perinatal depression affects up to 20% of women during pregnancy, and can extend into the postpartum period. A number of studies have linked depression and diabetes, however, whether this applies to GDM or which might come first is less understood. The purpose of this study was to examine the potential relationship between depression identified in the first trimester of pregnancy and the subsequent development of GDM. Women without pre-existing Type I/II diabetes (n = 1021) were evaluated for depression during the first trimester of pregnancy, and medical records were reviewed to identify a positive history of diabetes. Women identified as depressed during the first trimester were more likely to have GDM compared to those not depressed. After controlling for demographic factors and weight-related variables level of depression in the first trimester still predicted later GDM development. Depression identified in early pregnancy may predict increased risk of subsequent GDM development. Due to the numerous maternal, fetal and neonatal complications associated with GDM, early recognition is essential to promote the best possible outcomes for mother and infant. Recognizing depression as a possible risk factor for GDM development could lead to earlier screening and preventative measures.

Objectives: Infants delivered at ≥37 weeks’ gestation are considered full term, but research has demonstrated those born at 37 to 38 weeks (early term) have a higher risk for poor birth outcomes than deliveries at 39 to 41 weeks (full term). Despite this, many deliveries occur electively (scheduled, no medical indication) before 39 weeks. This study examined the risks of elective early-term delivery in a disadvantaged, rural sample and compared these results with national findings. Methods: Data were available for 638 rural women, recruited prenatally from three counties in rural southern Appalachia, who delivered electively at ≥37 weeks. Results: Compared with electively delivered full-term infants, those delivered electively at early term were 7.7 times more likely to be low birth weight, 4.4 times more likely to have a neonatal intensive care unit admission, and 2.5 times more likely to develop jaundice. Those living furthest from the hospital were most likely to deliver electively at <39 weeks. Although rates of elective deliveries <39 weeks were no higher than national rates, adjusted odds ratios (aOR) of associated admission to a neonatal intensive care unit doubled (aOR 4.4 vs aOR 2.2). Conclusions: Results demonstrate that initiatives targeting early-term elective deliveries are needed in rural, disadvantaged regions.

Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS.

No description available.

No description available.