Faculty Bibliography

Within the context of Levine's conceptual framework, this study evaluated fatigue and protein calorie malnutrition affecting adult, long-term ventilated patients during the weaning process. Levine's principles of energy and structural integrity provided the basis for an evaluation of the fatigue and prealbumin levels for 11 patients. During the weaning process (1 to 4 weeks), fatigue data were collected at multiple points while prealbumin levels were collected weekly. Statistically significant findings revealed that long-term ventilated patients had distinctive fatigue trends in addition to trends associated with low prealbumin levels, which can affect the patient's weaning ability.

Therapy associated with treatment-related anemia continues to be of great concern for health care providers. Patient satisfaction, patient adherence, and growing insurance reimbursement concerns related to Epoetin alpha therapy for anemia initiated the development of a nursing-led process improvement team at New York University (NYU) Medical Center. Multiple patient groups were identified and treated for anemia with Epoetin alpha through the guide of a standardized pathway providing a convenient and effective treatment plan. The treatment delivery had to be consistent with institutional reimbursement requirements while avoiding significant cost to the patient. Patient populations diagnosed with HIV anemia, HIV oncology, presurgical anemia, and medically complex anemia can now receive appropriate ambulatory treatment. This article describes the formation of the "Epo-Depot" and the logistics involved to service these patients with anemia.

The aging of the American population and its effects on healthcare centers require strategies and programs to ensure best practices for older patients. The authors describe an educational program, modification of a Geriatric Resource Nurse Model, and the use of a Geriatric Nurse Practitioner in implementing and integrating the clinical, psychosocial, and financial aspects that influence care needed by elderly patients and their families.