Purpose: A serious complication associated with the use of most antibiotics is antibiotic-associated diarrhea (AAD). The purpose of this article is to report findings from a meta-analysis of available studies on adult hospitalized populations to evaluate efficacy of probiotics for prevention of AAD and Clostridium difficile-associated disease (CDAD). Data sources: A comprehensive, systematic search was conducted to identify all relevant studies on probiotic efficacy for prevention of AAD and CDAD. Data synthesis was done using MAStARI software from the Joanna Briggs Institute (University of Adelaide, Australia). Conclusions: AAD affects one in five people on antibiotics. Risk factors for the development of AAD include the use of broad-spectrum antibiotics and host factors such as age, health status, hospitalization status, and exposure to nosocomial pathogens. About a third of AAD cases have CDAD. Meta-analysis showed that administration of probiotics led to a statistically significant relative risk reduction of 44% for AAD and 71% for CDAD. Implications for practice: Extended hospital stays, readmissions, and higher hospital costs are just some of the consequences of ADD and CDAD. Strategies currently used include discontinuing or changing the inciting antibiotic, restricting high-risk antibiotics, and encouraging the use of antibiotics based on sensitivity reports. Healthcare spending, morbidity, and mortality can potentially be reduced considerably by reducing the occurrence of ADD and CDAD by administering prophylaxis with probiotics concurrently with antibiotics.

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Merger as an organizational change has the potential to create turmoil, unrest, and uncertainty among the employees. Despite the shortage of nursing education workforce, global economic hardships have brought on a recent increase in nursing higher education mergers. The focus on integrated operations of the newly merged organization can burden all involved. Financial and business survival factors can create an unintentional oversight of the employee feelings. Nursing education faculty and administrator’s quality of work lives are related to their performance, which ultimately determines organizational performance. The purpose of this qualitative case study was to evaluate the influence of a nursing higher education merger on the quality of work lives of faculty and administrators. Principal results of this research revealed that faculty and administrators perceived the influence of the nursing higher education merger to be negative in the beginning with a transition to a positive influence over 5 years. Challenges in this merger were related to cultural integration and the magnitude of work required for operationalization. Exact timing of transition of the negative influence to positive was not established and needs further research. These results have implications on the nursing higher education institutions planning future mergers. Nursing education leaders must utilize strategies to address the quality of work life factors during the nursing higher education mergers. Implications of maintaining quality of work lives during an organizational change has the potential to address the nursing and nursing education workforce issues.