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The development of intravenous fat emulsion (IVFE) is the culmination of physiological, biochemical, nutritional, and medical scientific advancements. IVFEs have the ability to deliver critical nutritional substrates to the patient. Recent literature purports that they may also play roles in modulation of immune functionality and pulmonary physiology, but data supporting these potential benefits are limited. Nutr. 2015;39:768-786)

Clinical practice based on best evidence can help ensure that patients receive safe and appropriate care from nurses. Members of a nursing inquiry council at a pediatric-based organization addressed the issue of patient-administered immunoglobulin therapy in the home care setting through conducting an evidence-based practice (EBP) project. Following the steps of EBP, an EBP change was implemented that allowed families the option of immunoglobulin therapy administration by the patient (or a caregiver) or a home healthcare nurse. Outcomes measured indicated that self-administration positively impacted patient and family satisfaction and posed no additional safety risks.

This article describes a practice change intended to improve patient activation, also described as self-care management, in a sample of uninsured and underinsured patients with one or more chronic diseases who received care at a nurse-managed student-run free clinic project. Chronic diseases are the leading causes of death and disability in the United States. Individuals with chronic illnesses may be uninsured or underinsured and often do not receive adequate medical management, resulting in complications and unnecessary hospitalizations. Lack of knowledge related to self-care has been identified as one risk factor associated with poor health outcomes in medically underserved populations. Student-run free clinics have emerged to provide care to groups that would otherwise not receive health care while simultaneously providing experiential learning for healthcare students. Guided by the Chronic Care Model, an intervention was designed to improve patients' self-care management and chronic disease care delivery offered by the family nurse practitioner and baccalaureate nursing students. The evaluation plan for the Patient Activation Intervention utilized a pretest-posttest design. The Patient Activation Measure tool was administered at the beginning and end of the intervention. Additional outcomes were evaluated using a chart audit tool. A total of 19 unique patients, representing 42 free clinic visits, were evaluated during the intervention period. The mean Patient Activation Measure score was 60.95 (standard deviation AE 12.03) and was indicative of a good foundational understanding of chronic illness and working toward self-management. Chi-square and Fischer's exact test statistics demonstrated a statistically significant (p < .05) difference in the documentation of medication reconciliation, patient-centered goals, and self-management education from baseline to post intervention follow-up appointments. The evidence-based Patient Activation Intervention demonstrated promise as an effective method to increase patient's self-care management and improve patient-centered outcomes for underserved patients when delivered at a nurse-managed student-run free clinic.