Following the survey, themes emerged, and changes were implemented including the following: an alarm management policy was created, tools were provided to staff for easy usage, staff were educated using hands-on practice at an annual training summit, and sustainability was created through continuation of alarm management assessment and improvement.

Physical inactivity is a major factor in increasing women's risk for chronic disease, disability, and premature mortality. This study compared the effectiveness of five behavioral counseling (BC) sessions with a comparison group receiving one BC session based on the five A's (ask, advise, assist, arrange, and agree) to increase moderate-intensity physical activity, muscle strengthening, and stretching activity. The health promotion model provided the framework for the intervention. A pretest/posttest comparison group design was used, with random assignment of 46 women recruited from an urban midwestern community. A significant group interaction was found only for cardiorespiratory fitness (p < .001). Significant time effects were found (p < .001) for both groups in increasing handgrip, leg strength, and flexibility. BC is a promising intervention to achieve physical activity behavior change with older women.

Shared governance in health care empowers nurses to share in the decision-making process, which results in decentralized management and collective accountability. Share governance practices have been present in hospitals since the late 1970s. However, shared governance in ambulatory care clinics has not been well established. The subjects of this quality project included staff and administrative nurses in a clinic system. The stakeholder committee chose what model of shared governance to implement and educated clinic staff. The Index of Professional Nursing Governance measured a shared governance score pre- and postimplementation of the Clinic Nursing Council. The Clinic Nursing Council met bimonthly for 3 months during this project to discuss issues and make decisions related to nursing staff. The Index of Professional Nursing Governance scores indicated traditional governance pre- and postimplementation of the Clinic Nursing Council, which is to be expected. The stakeholder committee was beneficial to the initial implementation process and facilitated staff nurse involvement. Shared governance is an evolutionary process that develops empowered nurses and nurse leaders.

No abstract

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States associated with nearly 26,000 cases of cancer annually. With the recent addition of Gardasil 9, three vaccines are now licensed by the Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices (ACIP) for HPV prevention. While providers are the preferred source in educating individuals on HPV and HPV vaccination, low uptake percentages indicate that providers are missing valuable opportunities to educate and strongly recommend HPV vaccination. It is critical to examine perceived barriers and attitudes among providers related to HPV and HPV vaccination to identify factors that influence vaccination coverage. This paper aims to expand provider knowledge and awareness of factors that may facilitate an increase in HPV vaccination coverage and subsequent cancer prevention.