This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980-February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand-searched for further publications. Criteria for inclusion included full-text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis.
This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process.
Effective feedback can enhance student learning, but limited evidence exists on whether nursing students actually use and learn from written feedback. This descriptive survey explored nursing students' perceptions regarding the amount and type of written feedback required to enhance their learning. In stage one, 362 students completed a 28-item questionnaire regarding feedback experiences and preferences; in stage two, 227 students selected a preferred feedback option for a final topic assignment. Findings revealed that many of the students wished to be engaged with the feedback process and believed effective written feedback can and does enhance their learning. However many students also reported learning barriers-including absent, inadequate, ambiguous, inconsistent, and ineffective feedback-indicating a significant disconnect between desired and actual feedback. Recommendations include a greater focus on engaging nursing students in the feedback process and evaluating the effectiveness of written feedback for individual students.
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