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Support Nurses to Return to School for their BSN: A Needs Analysis of Nurses and Nurse Leaders
No full textPatient and system outcomes improve with BSN-prepared nurses, yet Utah continues to fall below the national average. Importantly, these outcomes also improve when the workforce reflects the population they serve. Purpose: This project explored nurses\u27 and nurse leaders\u27 views on leadership development, support and barriers to returning to school and, particularly for underrepresented minority (URM) nurses. Methods: Surveys captured the perceptions of nurses (n=126) and nurse leaders (n= 59) and thematic analysis identified four major key findings. Results: Themes included 1) what competencies nurses want to explore to become leaders in their healthcare settings, 2) what nurses want to improve their career options, 3) the factors of balancing work, life, and family, and 4) how nurses from underrepresented minority groups are supported when returning to school. Conclusion: Nurses value a BSN degree as a means of furthering their career, becoming a nurse leader, and attaining respect within their workplace. Nurses and nurse leaders recognize gaining a BSN helps advances a nurse\u27s career and improves the health outcomes of patients. Yet, nurses experience many barriers and challenges in returning to school and nurses from URM groups have the same levels of support as others; thus, potentially overlooking systemic inequalities
Adult Level I Trauma Center Pediatric Readiness Needs Assessment
No full textAdult Level I trauma centers often lack pediatric-specific policies and training, hindering their ability to treat pediatric trauma patients effectively. Key issues include the absence of a Pediatric Emergency Care Coordinator (PECC), gaps in policies, limited staff training, inadequate supplies, institutional reluctance, financial constraints, and staff fear of litigation. Goal/Aim: This Doctor of Nursing (DNP) project aimed to identify barriers and best practices for achieving pediatric readiness in an ACS-verified adult Level I trauma center without pediatric verification. Actions Taken: The project utilized the Johns Hopkins Evidence-Based Practice model and SQUIRE 2.0 guidelines. Data collection involved reviewing pediatric standards, staff training programs, cause and effect analysis, and a benchmark survey of sixteen adult Level I trauma centers. Interventions included a literature review, stakeholder engagement, policy review, and SWOT analyses of pediatric cases, staff dialogs, and stakeholder discussions. Summary of Results: Significant gaps were identified in pediatric-specific policies, particularly in patient transport. The absence of a PECC was a critical weakness. Staff discomfort with pediatric cases was due to low exposure and limited training. Organizational resources were underutilized. Benchmark survey insights emphasized collaboration with pediatric trauma centers and the need for regular training and simulation scenarios. The pediatric case review highlighted the need for improved supply and equipment management. Conclusion: Addressing these gaps will enhance the trauma center\u27s ability to provide high-quality pediatric trauma care, aligning with ACS standards and improving patient outcomes
Rx for Joy: Boosting Wellbeing and Fulfillment in Oncology Pharmacist Work
No full textThe October 2024 Better U Survey revealed that only 27% of oncology pharmacists felt energized and showed no signs of burnout, which is significantly lower than the University of Utah\u27s clinical team average of 45%. This project\u27s goal is to increase this rate by 5% by the Fall 2025 survey. To address this, using the IHI framework, we conducted What Matters to You? (WMTY) conversations with oncology pharmacists from three distinct groups and collected "bright spots‚" and "stops" using sticky notes. Feedback highlighted daily improvements, participative management, and camaraderie as key factors contributing to workplace challenges. We identified different needs across groups and established the foundation for projects targeting the disease state groups. Bone Marrow Transplant: Improved coordination of outside labs; Hematology: Improved coordination of oral chemotherapy refills; Medical Oncology: Organizing team potlucks. Our success can be attributed to early pharmacy management support, preparing teams with a project pitch, customizing interventions to specific teams, maintaining anonymity, and gaining provider and nursing leadership support. To ensure lasting improvements, we will ensure our chosen projects are executed by checking in regularly with the teams. We also will continue annual WMTY conversations to reassess team needs and continue participation in joy-in-work training. Citation: Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. Cambridge, MA: Institute for Healthcare Improvement, 2017
Preparing for Tissue and Implant Tracking System Implementation in Interventional Radiology
No full textThis quality improvement project addressed workflow inefficiencies and regulatory risks in the tissue and implant tracking process within the Interventional Radiology (IR) department at a hospital system in the Intermountain West. The existing system lacked interoperability with the electronic health record (EHR), contributing to manual workarounds and increased documentation burden. The project\u27s primary aim was to conduct preparatory activities to support the future implementation of a more efficient and interoperable tracking system. Actions taken included: (1) development and attempted distribution of a staff survey to assess perceptions of the current tracking system and identify workflow barriers, and (2) creation of a current-state workflow diagram based on a semi-structured interview with an IR technologist. While no survey responses were received due to organizational limitations, this highlighted important barriers such as survey fatigue and lack of executive approval. The workflow diagram identified multiple inefficiencies, particularly related to redundant barcode scanning and manual data entry. These findings were synthesized and shared with the implementation team to inform planning, staff education, and stakeholder engagement strategies. The project demonstrated the value of informatics leadership in identifying organizational readiness, facilitating stakeholder communication, and developing visual tools to support implementation planning
Embedding a Wellness Space in Psychiatry Training: Reducing Stress and Improving Trainee Well-Being
No full textBurnout among psychiatry trainees remains a widespread concern despite increasing national attention to physician well-being. While individual-based wellness strategies are common, organization-level interventions that address environmental and structural contributors to stress are less frequently implemented or evaluated. This project aimed to promote psychological recovery and reduce stress by embedding a wellness space directly into the psychiatry training environment. Our team created a dedicated relaxation space within the Huntsman Mental Health Institute (HMHI) touchdown area, designed specifically for resident and fellow use. The semi-private room featured a high-quality massage chair, softer lighting, and calming design features. The space was co-developed with resident input and funded through a GME Wellness Grant. Fifty-one psychiatry trainees were invited to complete validated wellness measures‚ the WHO-5 Well-Being Index (0-25 higher = better well-being) and the Perceived Stress Scale (PSS; 0-40 higher = more stress) at baseline, 12 weeks, and 18 weeks following implementation. Linear mixed-effects models showed statistically significant reductions in perceived stress at both 12 weeks (p=0.013) and 18 weeks (p=0.048), and a significant improvement in well-being at 18 weeks (p=0.006). Among massage chair users, WHO-5 scores improved by 2.6 points (p=0.02), and PSS scores dropped by 2.6 points (p=0.02), both reflecting meaningful benefit. Trainee feedback reinforced these findings: 92% reported reduced stress with chair use, and 100% endorsed improved wellness. This initiative adds to a growing body of evidence that low-cost, structural changes to the work environment can meaningfully improve trainee well-being and foster psychological safety in medical training
Defining features of acute Wernicke\u27s encephalopathy
No full textThis patient presented with acute upbeat nystagmus (UBN) in the setting of intractable nausea and vomiting from a gastrointestinal disorder, which led to thiamine deficiency causing Wernicke\u27s encephalopathy. As in the other Wernicke\u27s case, there is acute UBN and chronic downbeat nystagmus (DBN). Defining ocular motor features of Wernicke\u27s acutely include: spontaneous UBN (nucleus of Roller and intercalatus); anti-Alexander\u27s law UBN (UBN increases in downgaze); horizontal gaze-evoked nystagmus (nucleus prepositus hypoglossi [NPH]-medial vestibular nucleus [MVN] complex); horizontal vestibulo-ocular reflex loss [MVN]; transition from UBN to DBN with convergence (demonstrated in the other video). These signs are often seen prior to ophthalmoparesis