The purpose of this experimental pilot study was to determine the short- and long-term efficacy of directed verbal prompts and positive reinforcement on the level of eating independence (LEI) of elderly nursing home patients with dementia. Twenty-four subjects from a dementia unit were randomly selected and randomly assigned to three experimental groups and three control groups. The LEI scale was used to measure eating frequency and task performance at six consecutive meals during pretest and posttests, T2 and T3. During the treatment phase, which consisted of nine consecutive meals, prompts were administered to each experimental group and positive reinforcement was given when a subject completed eating tasks. Short-term effects were assessed on 2 consecutive days following treatment (T2) and long-term effects on 2 consecutive days, 7 days following treatment. Significant differences were found in eating performance but not in frequency. Experimental groups retained treatment at both posttests. The dementia diagnosis should not preclude the possibility that eating skills may be reacquired.

This study compared differences in knowledge of pain assessment and pharmacologic and nonpharmacologic pain management strategies among 232 L.P.N.s and R.N.s from three hospitals. Twenty-three adult medical, surgical, and special care units were represented. The "Knowledge of Pain Management" tool measured knowledge of pain assessment, drug and nondrug strategies, and was based on AHCPR guidelines. Scores ranged from 24% to 92%. There were significant differences in scores across hospitals and between R.N.s and L.P.N.s. The mean score was 72% for L.P.N.s and 75% for R.N.s. There was a significant difference in pharmacologic scores between L.P.N.s versus A.D./A.A.-R.N.s, B.S.N-R.N.s, and M.S.N.-M.S.-R.N.s but not between L.P.N.s and diploma-R.N.s. There were significant differences in overall knowledge scores between L.P.N.s versus B.S.N.-R.N.s but not A.D./A.A.-R.N.s, diploma-R.N.s, and M.S.N./M.S-R.N.s. Finding suggest the need for aggressive nursing education programs offered in academic and clinical settings to assist nurses in effectively managing the universal phenomenon of pain.