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The Research to Practice column aims to provide advanced practice registered nurses (APRNs) with an analysis of current research topics with implications for practice change within emergency care settings. The article, "Antibiotics for Exacerbations of Acute Chronic Obstructive Pulmonary Disease?" conducted by D. Vollenweider, A. Frei, C. Streurer-Stey, J. Garcia-Aymerich, and M.A. Puhan (2018), examines a Cochrane systematic review and meta-analysis of randomized controlled trials. The investigators evaluate the findings that compare clinical outcomes including adverse events, re-exacerbation, treatment failure, and mortality among intensive care unit patients, inpatient, and outpatient populations treated with antibiotics or placebo medications for acute chronic obstructive pulmonary disease (COPD) exacerbations. The findings are discussed in the context of narrowing the evidence gap to improve clinical recommendations. Their findings have implications for APRN practice, including the signs and symptoms associated with an underlying bacterial triggered COPD exacerbation and the patient populations most likely to benefit from antibiotic therapy. [ABSTRACT FROM AUTHOR]

The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. Our current column discusses factors associated with the quality of the death and dying experience in the emergency department (ED) from the perspective of health care providers with implications for APRN practice and strategies using the following study: McCallum, K. J., Jackson, D., Walthall, H., & Aveyard, H. (2018). "Exploring the quality of the dying and death experience in the emergency department: An integrative literature review," International Journal of Nursing Studies, 85, 106-117. Our case involves a man with metastatic colon cancer where his oncology nurse practitioner recommends no further treatment and tells him he has approximately 6 months to live. [ABSTRACT FROM AUTHOR]

This article, "Is the pelvic examination still crucial in patients presenting to the emergency department (ED) with vaginal bleeding or abdominal pain when an intrauterine pregnancy is identified on ultrasonography? A randomized controlled trial," by J. A. Linden et al. (2017) seeks to determine whether excluding a pelvic examination among patients presenting to the ED with first-trimester vaginal bleeding or lower abdominal pain, and indication of intrauterine pregnancy recorded on ultrasound increases morbidity. The findings are discussed in the context of changing practice and patient preference. Emergency nurse practitioners should remain informed about changing practices to ensure that patients receive safe care. Although pelvic examination does provide additional information for specific clinical conditions, the current practice to always include it in the evaluation of a pregnant patient with vaginal bleeding or pelvic pain may no longer be relevant given the improved diagnostic capabilities available within the ED setting. [ABSTRACT FROM AUTHOR]

The Research to Practice Column is designed to improve translational research critique skills of advanced practice nurses. In this issue, the article "Risk of Acute Kidney Injury After Intravenous Contrast Media Administration" (J. S. Hinson, et al., 2017) is discussed in the context of a patient presenting to the emergency department with acute abdominal pain. The study was designed to assess the risk of acute kidney injury and adverse clinical outcomes in patients receiving intravenous contrast for computed tomography. Advanced practice nurses need to be aware of advances in types of intravenous contrast and current recommendations for administration of intravenous contrast for diagnostic purposes in patients at risk for acute kidney injury to facilitate making timely and accurate diagnoses. [ABSTRACT FROM AUTHOR]

Emergency department census rates and manpower gaps have continued to rise over the past decade, creating a demand for well-prepared emergency nurse practitioners (ENPs). The implementation of the consensus model for advanced practice nurses has brought acknowledgment by leading health care, physician, and nursing organizations of the ENP specialty as critical to building a high-quality emergency care workforce. Recognition of the ENP's unique skill set, and therefore need of specialty certification, has led to a growing interest in the expansion of nurse practitioner curricula in emergency care. This article describes a novel approach for ENP education based on an interprofessional training model, with an in-depth discussion of curriculum development and clinical placement, as well as program outcomes and implications. [ABSTRACT FROM AUTHOR]

The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and emergency nurse (RN) and to assist with the translation of research into practice. For each column, a topic and a research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. In the current column, we examine the findings of J. Kravitz, P. Dominici, J. Ufberg, J. Fisher, and P. Giraldo (2011) from their article, titled "Two Days of Dexamethasone Versus 5 Days of Prednisone in the Treatment of Acute Asthma: A Randomized Controlled Trial." [ABSTRACT FROM AUTHOR]

Abstract This column critiques the findings from a retrospective medical record review, "Doctor, my tooth hurts, the costs of incomplete dental care in the emergency room," by E. Davis, A. Deinard, & E. Maiga (2010). The study was designed to examine characteristics of patients presenting to emergency departments (EDs) with dental related problems and their associated costs of care. The study also looked at the frequency of dental related return visits speculated to represent ineffective ED treatment of underlying dental problems. We discuss the findings from this study in the context of growing concern about dental health disparities within the United States, including implications for advanced practice nurse management of dental related problems in the ED. [ABSTRACT FROM AUTHOR]