The purpose of this study was to investigate the association between cognitive processes and medication adherence among community-dwelling older adults. Ninety-five participants (M = 78 years) completed a battery of cognitive assessments including measures of executive function, working memory, cued recall, and recognition memory. Medication adherence was examined over 8 weeks for one prescribed medicine by use of an electronic medication-monitoring cap. In a simultaneous regression, the composite of executive function and working memory tasks was the only significant predictor (beta =.44, p <.01). Findings suggest that assessments of executive function and working memory can be used to identify community-dwelling older adults who may be at risk for failure to take medicines as prescribed.
Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes.
Do Nurse Residency Programs (NRPs) reflect the professional socialization process? Residency facilitators in 34 Magnet hospitals completed Residency Program Questionnaires constructed to reflect the goals, themes, components, and strategies of the professional socialization process described in the literature. NRPs in 4 hospitals exemplified the complete two-stage (role transition and role/community integration) process. In 14 hospitals, NRPs were of sufficient length and contained components that reflected the professional socialization process. In 16 hospitals, NRPs exemplified the "becoming" role transition stage. What components are most effective in the professional socialization of new graduate nurses? A total of 907 new and experienced nurses, nurse managers, and educators working on clinical units with confirmed healthy work environments in 20 Magnet hospitals with additional "excellence designations" were interviewed. Components identified as most instrumental were precepted experience, reflective seminars, skill acquisition, reflective practice sessions, evidence-based management projects, and clinical coaching-mentoring sessions. Suggestions for improvement of NRPs are offered.
Implementation of structures that promote interdisciplinary and intradisciplinary collaboration and decision-making positively affect development of HWE. Gap analysis of the steps/components of the eight work processes/relationships essential to HWE may enable achievement of HWEs on all hospital clinical units.
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