Browsing by Author "Ledbetter, Leila"
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Item Open Access Evaluation of DNP program essentials of doctoral nursing education: A scoping review(Journal of Professional Nursing, 2023-05-01) Waldrop, Julee; Reynolds, Staci S; McMillian-Bohler, Jacquelyn M; Graton, Margaret; Ledbetter, LeilaBackground: In 2021, the American Association of Colleges of Nurses revised the core competencies for professional nursing education. The revision includes a call for a transformation from a traditional approach to a competency-based approach for teaching and learning. Purpose: The purpose of this systematic scoping review was to provide a fuller understanding of how DNP programs have historically evaluated and documented attainment of the essentials of doctoral nursing education in a summative manner in order to inform developing methods for addressing the newly endorsed advanced-level competencies in nursing education. Methods: A systematic scoping review was completed using PRISMA for Scoping Reviews Guidelines. Databases searched included PubMed (MEDLINE), CINAHL, Education Full Text, Web of Science, and ProQuest Dissertations and Theses. Included reports needed to discuss student competencies and reflect the summative evaluation of the DNP essentials in a DNP program. Data extracted included title, lead author name, lead author affiliation, type of program, aims, design, process, results, competencies included, and DNP project inclusion. Results: Of the 2729 reports initially identified, five met inclusion criteria. These articles described diverse methods for documenting student attainment of DNP competencies including leadership narratives, electronic portfolios, and clinical logs. Conclusion: DNP programs have used summative evaluation methods to document fulfillment of the DNP essentials, but a competency-based education approach requires additional formative evaluations that incrementally support learners' progression toward achieving competencies. Faculty can modify exemplars presented from a review of the literature to serve as summative or formative evaluations of DNP advanced-level nursing competencies.Item Open Access Outcomes After Revision Anterior Shoulder Stabilization: A Systematic Review.(Orthopaedic journal of sports medicine, 2020-05) Lau, Brian C; Johnston, Tyler R; Gregory, Bonnie P; Bejarano Pineda, Lorena; Wu, Mark; Fletcher, Amanda N; Hu, Jessica H; Ledbetter, Leila; Riboh, Jonathan CBackground
Primary shoulder stabilization is successful, but there continues to be a risk of recurrence after operative repair, particularly in the young athlete. It is important for surgeons to understand the outcomes after various revision stabilization techniques to best counsel patients and manage expectations.Purpose
To analyze recurrent instability and revision surgery rates in patients who underwent revision anterior glenohumeral stabilization procedures with either arthroscopic repair, open repair, coracoid transfer, free bone block, or capsular reconstruction.Study design
Systematic review; Level of evidence, 4.Methods
We performed a systematic review of level 2 to 4 evidence studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical studies of revision anterior glenohumeral stabilization (arthroscopic repair, open repair, coracoid transfer, free bone block, or capsular reconstruction) with a minimum 2-year follow-up were analyzed. The rate of recurrent instability, rate of revision surgery, patient-reported outcomes, and range of motion were extracted and reported. Study methodological quality was evaluated using the Downs and Black quality assessment score.Results
A total of 37 studies met inclusion criteria and were available for analysis: 20 studies evaluated arthroscopic repair, 8 evaluated open repair, 5 evaluated Latarjet procedure, 3 evaluated bone block, and 2 evaluated capsular reconstruction. There was 1 study included in both arthroscopic and Latarjet procedures, for a total of 1110 revision cases. There was 1 level 2 study, and the remainder were level 3 or 4 with poor Downs and Black scores. Participants analyzed were most commonly young (weighted mean age, 26.1 years) and male (78.4%). The weighted mean clinical follow-up after revision surgery was 47.8 months. The weighted mean rate of recurrent instability was 3.8% (n = 245) after the Latarjet procedure, 13.4% (n = 260) after open repair, 16.0% (n = 531) after arthroscopic repair, 20.8% (n = 72) after bone block, and 31.0% (n = 35) after capsular reconstruction. The weighted mean rate of additional revision surgery was 0.0% after bone block, 0.02% after the Latarjet procedure, 9.0% after arthroscopic repair, 9.3% after open repair, and 22.8% after capsular reconstruction. Patient-reported outcomes and objective measures of range of motion and strength improved with all revision techniques.Conclusion
The current review identifies a deficiency in the literature pertaining to consistent meaningful outcomes and the effect of bone loss after revision shoulder stabilization. Published studies demonstrate, however, that revision shoulder stabilization using arthroscopic, open, coracoid transfer, or bone block techniques yielded satisfactory objective and patient-reported outcomes. The Latarjet procedure exhibited the lowest recurrent instability rate. This study confirms that recurrent instability remains a common problem, despite revision shoulder stabilization. The quality of research in revision shoulder stabilization remains poor, and higher quality studies are needed to establish best practices for treatment of this complex problem.Item Open Access Reporting and utilization of Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures in orthopedic research and practice: a systematic review.(Journal of orthopaedic surgery and research, 2020-11-23) Horn, Maggie E; Reinke, Emily K; Couce, Logan J; Reeve, Bryce B; Ledbetter, Leila; George, Steven ZBACKGROUND:The Patient-Reported Outcomes Measurement Information SystemⓇ (PROMISⓇ) is a dynamic system of psychometrically sound patient-reported outcome (PRO) measures. There has been a recent increase in the use of PROMIS measures, yet little has been written about the reporting of these measures in the field of orthopedics. The purpose of this study was to conduct a systematic review to determine the uptake of PROMIS measures across orthopedics and to identify the type of PROMIS measures and domains that are most commonly used in orthopedic research and practice. METHODS:We searched PubMed, Embase, and Scopus using keywords and database-specific subject headings to capture orthopedic studies reporting PROMIS measures through November 2018. Our inclusion criteria were use of PROMIS measures as an outcome or used to describe a population of patients in an orthopedic setting in patients ≥ 18 years of age. We excluded non-quantitative studies, reviews, and case reports. RESULTS:Our final search yielded 88 studies published from 2013 through 2018, with 57% (50 studies) published in 2018 alone. By body region, 28% (25 studies) reported PROMIS measures in the upper extremity (shoulder, elbow, hand), 36% (32 studies) reported PROMIS measures in the lower extremity (hip, knee, ankle, foot), 19% (17 studies) reported PROMIS measures in the spine, 10% (9 studies) reported PROMIS measures in trauma patients, and 6% (5 studies) reported PROMIS measures in general orthopedic patients. The majority of studies reported between one and three PROMIS domains (82%, 73 studies). The PROMIS Computerized Adaptive Test (CAT) approach was most commonly used (81%, 72 studies). The most frequently reported PROMIS domains were physical function (81%, 71 studies) and pain interference (61%, 54 studies). CONCLUSION:Our review found an increase in the reporting of PROMIS measures over the recent years. Utilization of PROMIS measures in orthopedic populations is clinically appropriate and can facilitate communication of outcomes across different provider types and with reduced respondent burden. REGISTRATION:The protocol for this systematic review was designed in accordance with the PRISMA guidelines and is registered with the PROSPERO database (CRD42018088260).Item Open Access Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review.(Orthopaedic journal of sports medicine, 2021-03) Lau, Brian C; Pineda, Lorena Bejarano; Johnston, Tyler R; Gregory, Bonnie P; Wu, Mark; Fletcher, Amanda N; Ledbetter, Leila; Riboh, Jonathan CBackground
Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients.Purpose
To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures.Study design
Systematic review; Level of evidence, 4.Methods
All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score.Results
Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72).Conclusion
Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization.Item Open Access Systematic Review of Otologic and Neurotologic Surgery Using the 3-dimensional Exoscope(Otology & Neurotology Open) Chiang, Harry; Ledbetter, Leila; Kaylie, David M