The role of the specialized nurse in the management of penile cancer is essential to ensure quality care and appropriate support throughout the care pathway. Prior knowledge of the pathology seems essential to us. Organization, communication and education are essential to supporting patients. LEVEL OF EVIDENCE: 3.

UNASSIGNED: To create an educational program and provide a valid, evidence-based course for ultrasound-based tip location during placement of PICC-port for specialized nurses.
UNASSIGNED: We designed three phases for program development. Phase 1: summarizing the evidences as a knowledge foundation; Phase 2: developing an educational program for ultrasound-based tip location during placement of PICC-port; Phase 3: expert panel to validate the developed program.
UNASSIGNED: The educational program was composed of five parts and 12 lessons, with three lessons each devoted to basic knowledge, practice, and testing, respectively. First, the criteria for defining an expert trainer is determined. Second, some basic conditions are confirmed. Third, the image acquisition windows of transthoracic echocardiographic are recommended. Fourth, the knowledge about ultrasound-based tip location is categorized. Fifth, the procedures for ultrasound-based tip location combined with \"bubble test\" were listed. The program\'s content was verified by experts and found to have a validity coefficient of 0.95.
UNASSIGNED: The program, encompassing theoretical and practical components, as well as assessment items, can be applied in specialized nursing education and skills training, and it enhances nurses\' competence in accurately identifying the tip location during the placement of PICC-ports and other central venous access implants.

OBJECTIVE: To validate the predictive value of the European coLlaboration on Acute decompeNsated Heart Failure (ELAN-HF) score, and to assess the effect of self-care behaviour on readmission and mortality in patients after admission with acute decompensated heart failure (ADHF).
METHODS: Quantitative, prospective, single centre, cohort study.
METHODS: N-Terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured on admission and discharge, and were used together with clinical and laboratory parameters to calculate the ELAN-HF score. Patients were stratified into four risk groups (low, intermediate, high, very high) according to their ELAN-HF score. The performance of the ELAN-HF score was evaluated and compared to the original study. Self-care behaviour was assessed by the European Heart Failure Self-care Behaviour Scale (EHFScBS-9). Survival analysis was used to estimate the association between both scores and re-admission for HF and/or all-cause mortality within 180 days.
RESULTS: 88 patients were included. The median age of the study population was 75 years (IQR 69-83), 43% was female. NYHA III/IV functional class was present at discharge in 68 patients (85%) and 27 patients (34%) had a left ventricular ejection fraction < 40%. Complete data and 180 day follow up was available for 80 patients. 55% reached the endpoint of readmission and/or all-cause mortality. There was a significant association between the ELAN-HF score and re-admission and/or mortality < 180 days (HR = 1.25, 95% CI 1.08-1.45, p = 0.003). The median EHFScBS-9 score was 68.1 (IQR 58.3 - 77.8). There was no significant association between the EHFScBS-9 score and readmission and/or mortality < 180 days (HR = 1.01, 95% CI 0.99-1.03, p = 0.174).
CONCLUSIONS: This study confirms the validity and therefore the potential of the ELAN-HF score to triage patients with ADHF before discharge. Using this score may optimize the follow-up treatment on the nurse-led heart failure clinic in order to decrease readmission and mortality. Self-care behaviour was non-significantly associated with readmission and/or mortality in our study population.
BACKGROUND: This study has been registered with the ethics committee MEC-U (Nieuwegein, The Netherlands), registration nr: V.160999/W18.208/HG/mk.

UNASSIGNED: The elderly represents the fastest growing group in our population. Since there is a close relationship between the number of older people and health care expenditure, promoting healthy aging has become an important topic. However, it is essential to understand first the needs of this population in order to create suitable programs and activities.
UNASSIGNED: A qualitative design was used in this study to explore the subjective views of elderly people and to learn more about their health-related needs. A total of 12 participants were recruited using a consecutive sampling strategy. The data were collected through semi-structured interviews and analyzed by employing a summarizing content analysis.
UNASSIGNED: This study has identified 4 areas of health-related needs: Independence and autonomy, social security, structure in daily life and community and belonging, where all categories are interrelated and interact with one other.
UNASSIGNED: Focusing more on community-based approaches would support creating a conducive environment. Also, home visits undertaken by a specialized nurse focused on health risks and disabilities could be an adequate approach to support the elderly population in an efficient way and to offer targeted programs and activities.

The frontline nurses\' experience of nursing with overstretched resources in acute care setting can affect their health and well-being. Little is known about the experience of registered nurses faced with the care of a patient outside their area of expertise. The aim of this paper is to explore the phenomenon of nursing the outlier patient, when patients are nursed in a ward that is not specifically developed to deal with the major clinical diagnosis involved (e.g., renal patient in gynecology ward). Using a hermeneutic phenomenological approach, eleven individual face-to-face in-depth interviews were conducted with registered nurses in New South Wales, Australia. The study identified that each nurse had a specialty construct developed from nursing in a specialized environment. Each nurse had normalized the experience of specialty nursing and had developed a way of thinking and practicing theorized as a \"care ladder\". By grouping and analyzing various \"care ladders\" together, the nursing capacities common to nurses formed the phenomenological orientation, namely \"the composite care ladder\". Compared to nursing specialty-appropriate patients, nursing the outlier patient caused disruption of the care ladder, with some nurses becoming less capable as they were nursing the outlier patient. Nursing the outlier patient disrupted the nurses\' normalized constructs of nursing. This study suggests that nursing patients in specialty-appropriate wards will improve patient outcomes and reduce impacts on the nurses\' morale.