Nurses are faced with unprecedented challenges and opportunities. Healthcare delivery models are transforming that require adaptive and flexible nurses. The primary role of the frontline nurse is providing patient care. To be successful in this role it requires numerous competencies supported by evidence-based data. Frontline bedside nurses are fundamental to the success of value-based care delivery models. These transformational models rely on robust nursing contributions for success. Most frontline nurses don't understand value-based care models and their role in promoting positive outcomes for reimbursement. This issue is a tool kit to empower our frontline nurses for challenges they are facing with transformations occurring at their bedside practice site. The articles will be a best practice handbook for frontline nurses by providing resources to develop clinical skills to provide safe, quality, and accountable patient care needed for new healthcare delivery models.

Evidence synthesis is the evaluation or analysis of research evidence and opinion on a specific topic to aid in decision-making in health care. Although the science of evidence synthesis has developed most rapidly in relation to the meta-analysis of numerical data linked to theories of cause and effect, the further development of theoretical understandings and propositions of the nature of evidence, its role in health care delivery, and the facilitation of improved global health have increased rapidly since 2000. The articles appearing in this issue examine the role of evidence synthesis in nursing and health care and are written by expert translational scientists from across the world. Three introductory articles overview evidence synthesis and its role in evidence-based health care; methods, issues, and trends in the systematic review of health care evidence; and the development of a robust evidence base for nursing. Subsequent articles explore the impact of systematic reviews on policy and practice in a variety of settings, including perioperative care, pediatrics, rehabilitation and long-term/continuing care, mental health, and public health. The final articles discuss the impact of evidence on health policy and practice and the complexities of translating evidence into policy and practice. These articles show the importance of synthesizing evidence and translating policy and practice into action in our quest to improve health care and health outcomes.

This issue begins with an overview that distinguishes evidence-based practice (EBP) and translation science, followed by a description of Hawaii’s statewide EBP program that uses active and multifaceted translation science strategies to facilitate the rate and extent of adoption of EBP changes. With one exception, the remaining articles describe individual EBP projects from five different health care facilities that used the Iowa Model to guide their work. Each article includes an evidence summary, a description of implementation strategies, an evaluation of the innovation, and lessons learned. These completed projects were initiated between 2009 and 2012, address a variety of topical nursing issues, and, for the most part, focus on preventing complications (ie, blood sugar elevations, increased lengths of stay, extubation failures, noise-related injury, pain, surgical site infections, pneumonia, restraint use, delirium, and fever). An additional article describes the use of evidence to inform simulation-based learning, a possible strategy for ensuring competencies in and compliance with EBP interventions. Nursing leaders will come away with solid information about utilizing EBP to improve patient outcomes. The Hawaii program demonstrates that health care quality can be realized by employing the best available evidence and empowering the nursing workforce. It also offers a glimpse of the care that the future nursing workforce could provide to create a health system that provides accessible, affordable and quality care to everyone in the United States.

This issue of Medical Clinics, guest edited by Drs. Marc Shalaby and Edward Bollard, is devoted to Quality Patient Care: Making Evidence-Based, High Value Choices. Articles in this issue include: Cardiovascular testing in asymptomatic patients: carotid duplex, cardiac stress testing, screen for PVD; Utility of echocardiogram in the evaluation of heart murmurs; Evidenced-based recommendations for the evaluation of palpitations in the primary care setting; Radiologic evaluation of common orthopedic complaints: low back pain, non-traumatic knee/shoulder/hip pain, and ankle injuries; Indications and usefulness of common injections for non-traumatic orthopedic complaints – shoulder, trochanteric bursa, epidural injections, tennis elbow, and knee; The evidence-based evaluation of chronic cough; Evaluation of uncomplicated headache; Evaluation of syncope; Pre-operative assessment: Cataract surgery, pre-operative EKG testing, screening for cardiopulmonary disease, urinalysis, coagulation studies, other lab assessments; The approach to occult GI bleed; The role of EGD surveillance for patients with Barrett’s esophagus; The evidence-based evaluation of iron deficiency anemia; Cancer screening in the elderly; Utilization and safety of common over the counter dietary/nutritional supplements, herbal agents and homeopathic compounds for disease prevention; Utilization of oxygen for the patient with dyspnea; IV fluids, enteral or parenteral nutrition; and Symptom control at the end of life.

The articles appearing in this geriatrics-focused issue are consistent with the collaborative and translational concepts held by a life course perspective. Each supports interprofessional collaboration and some are either authored or coauthored by interdisciplinary colleagues. Three goals are reflected in these articles: keeping community-dwelling older adults safe, sensible, and secure with solutions that will enable them to stay healthy, wise, and aware. Topics include maintaining physical functions, benefits and consequences of weight-bearing exercise on foot health; cancer prevention; managing nocturia’s effect on sleep quality and safety; protection from financial exploitation; and providing safe and affordable living environments. Several articles address physical or cognitive challenges that include monitoring medication adherence, threat of anxiety and stigma in dementia, and approaches to managing self-care in the home for persons with dementia. These evidence-based articles address emerging and best practices to support targeted interventions for persons in community-dwelling home settings. They provide a frame-work of person-centered approaches that foster good health in older age, a central tenet of aging in place and the global response to population aging.

This book covers teaching cultural competence in colleges and universities across the United States, providing a comprehensive reference for instructors, researchers, and other stakeholders who are looking for material that will assist them in working to prepare students to become culturally competent.

In this issue of Critical Care Nursing Clinics, guest editor Deborah Garbee brings her considerable expertise to the topic of Older Adults in Critical Care. Top experts in the field provide readers with the latest on Delirium in Older Adults, Sepsis Across the Continuum, Progressive Supranuclear Palsy, and more. - Contains 14 relevant, practice-oriented topics, including Improving Outcomes in Cardiovascular Geriatric Patients Related to Polypharmacy; Biofilm and Hospital-Acquired Infections in Older Adults; Implementation of Acute Care for Elders (ACE) and Nurses Improving Care for Healthsystem Elders (NICHE) in Critical Care; and more. - Provides in-depth clinical reviews on older adults in critical care, offering actionable insights for critical care nurses. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Enhance patient care with the help of aromatherapy! Clinical Aromatherapy: Essential Oils in Healthcare is the first and only peer-reviewed clinical aromatherapy book in the world and features a foreword by Dr. Oz. Each chapter is written by a PhD nurse with post-doctoral training in research and then peer reviewed by named experts in their field. This clinical text is the must-have resource for learning how to effectively incorporate aromatherapy into clinical practice. This new third edition takes a holistic approach as it examines key facts and topical issues in aromatherapy practice and applies them within a variety of contexts and conditions. This edition also features updated information on aromatherapy treatments, aromatherapy organizations, essential oil providers, and more to ensure you are fully equipped to provide patients with the best complementary therapy available. Expert peer-reviewed information spans the entire book. All chapters have been written by a PhD nurse with post-doctoral training in research and then peer reviewed by named experts in their field. Introduction to the principles and practice of aromatherapy covers contraindications, toxicity, safe applications, and more. Descriptions of real-world applications illustrate how aromatherapy works in various clinical specialties. Coverage of aromatherapy in psychiatric nursing provides important information on depression, psychosis, bipolar, compulsive addictive, addiction and withdrawal. In-depth clinical section deals with the management of common problems, such as infection and pain, that may frequently be encountered on the job. Examples of specific oils in specific treatments helps readers directly apply book content to everyday practice. Evidence-based content draws from thousands of references. NEW! First and only totally peer-reviewed, evidence-based, clinical aromatherapy book in the world. NEW Chapter on integrative Healthcare documenting how clinical aromatherapy has been integrated into hospitals and healthcare in USA, UK and elsewhere. NEW Chapter on the M Technique: the highly successful method of gentle structured touch pioneered by Jane Buckle that is used in hospitals worldwide. All chapters updated with substantial additional references and tables.

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.