The University of Texas at Tyler
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Alarm Fatigue Prevention Benchmark Project
Get PDFHealthcare technology is constantly evolving to find ways to help provide better outcomes for patients. Clinical monitoring is technology that helps healthcare staff recognize deterioration of the patient which allows them to intervene earlier, which increases the patient’s chance for survival. The monitors are connected to the patients to monitor vital signs such as heart rate, oxygen saturation, respirations, and blood pressures. They allow staff to get real time feedback of the patient’s condition and determine if the patient is getting better or any interventions need to be done due to clinical deterioration.
However, all technology has setbacks and downfalls. Clinical monitoring is no exception. Staff that are around clinical monitoring can experience alarm fatigue due to the excessive noise and high frequency of false alarms. The fatigue can cause them to miss important alarms as they become conditioned to believe that the alarm is false. This can be very dangerous to patients as it can cause poor outcomes such as injury or death due to the lack of interventions
EVALUATION OF A DISTRICT’S LEADERSHIP DEVELOPMENT PIPELINE
Get PDFLeading a school campus is an increasingly challenging and critical task that requires effective leadership. It is important to identify the specific leadership skills needed to create a culture conducive to learning, meet the unique needs of a particular campus and community, and enable continuous improvement. The leadership development pipeline aimed to identify, develop, and support potential school leaders, fostering their growth through targeted professional development, mentoring, and support. This mixed methods embedded experimental model study evaluated the effectiveness of a district\u27s leadership development program, focusing on best practices for school leaders. The study employed a combination of quantitative data from surveys and assessments alongside qualitative data gathered through interviews, focus groups, and case studies. This approach provided a comprehensive understanding of a district’s leadership development program\u27s effectiveness in building culture and leading learning to strengthen the pipeline of ready leaders. The research underscored the benefits of investing in personalized, comprehensive leadership training programs and implementing well-structured succession planning. The research also emphasized the need for targeted professional development opportunities via a learn-by-doing experiential approach. The findings informed the creation of a more systematic approach to building leadership capacity, incorporating a Plan-Do-Study-Act (PDSA) cycle of Improvement Science. Recommendations included utilizing a Leadership Task Force to develop a leadership competency framework encompassing all stakeholders, systematically identifying high-potential leaders early, fostering a supportive and collaborative school culture, and ensuring alignment of systems and practices with district values and goals. It was revealed that implementing these measures resulted in enhanced academic achievements for every student as well as cultivated a pipeline of skilled leaders ready for leadership succession
Spreading Kindness and Generosity: Nonprofits, Fundraising and Volunteering in East Texas
Get PDFIn this issue of the Hibbs Brief, we discuss kindness and generosity in our communities and their economic impact on our region. We explore figures associated with nonprofit organizations and volunteering in Texas, particularly for the East Texas region and the Tyler Metropolitan Statistical Area (MSA)
Optimization of the Illumina COVIDSeq™ protocol for decentralized, cost-effective genomic surveillance
Get PDFA decentralized surveillance system to identify local outbreaks and monitor SARS-CoV-2 Variants of Concern is one of the primary strategies for the pandemic’s containment. Although nextgeneration sequencing (NGS) is a gold standard for genomic surveillance and variant discovery, the technology is still cost-prohibitive for decentralized sequencing, particularly in small independent labs with limited resources. We have optimized the Illumina COVIDSeq™ protocol for the Illumina MiniSeq instrument to reduce cost without compromising accuracy. We slashed the library preparation cost by half by using 50% of recommended reagents at each step and normalizing the libraries before pooling to achieve uniform coverage. Reagent-only cost (~ $43.27/sample) for SARS-CoV-2 variant analysis with this normalized input protocol on MiniSeq instruments is comparable to what is achieved on high throughput instruments such as NextSeq and NovaSeq. Using this modified protocol, we tested 153 clinical samples, and 90% of genomic coverage was achieved for 142/153 samples analyzed in this study. The lineage was correctly assigned to all samples (152/153) except for one. This modified protocol can help laboratories with constrained resources to contribute in decentralized COVID-19 surveillance in the postvaccination era
SARS-CoV-2 Next Generation Sequencing (NGS) data from clinical isolates from the East Texas Region of the United States
Get PDFThe SARS-CoV-2 virus has evolved throughout the pandemic and is likely to continue evolving into new variants. Some of these variants may affect functional properties, including infectivity, interactions with host immunity, and disease severity. And compromised vaccine efficacy is an emerging concern with every new viral variant. Next-generation sequencing (NGS) has emerged as the tool of choice for discovering new variants and understanding the transmission dynamics of SARS-CoV-2. Deciphering the SARS-CoV-2 genome has enabled epidemiological survivance and forecast of altered etiologically. Clinical presentations of the infection are influenced by comorbidities such as age, immune status, diabetes, and the infecting variant. Thus, clinical management and vaccine efficacy may differ for new variants. For example, some monoclonal antibody treatments are variantspecific, and some vaccines are less efficacious against the omicron and delta variants of SARS-CoV-2. Consequently, determining the local outbreaks and monitoring SARS-CoV-2 Variants of Concern (VOC) is one of the primary strategies for the pandemic’s containment. Although next-generation sequencing (NGS) is a gold standard for genomic surveillance and variant discovery, the assays are not approved for variant diagnosis for clinical decision-making. Advanta Genetics, Texas, USA, optimized Illumina COVID-seq protocol to reduce cost without compromising accuracy and validated the Illumina COVID-Seq assay as a Laboratory Developed Test (LDT) according to the guidelines prescribed by the College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA)
(Semi)automated approaches to data extraction for systematic reviews and meta-analyses in social sciences: A living review protocol
Get PDFBackground: An abundance of rapidly accumulating scientific evidence presents novel opportunities for researchers and practitioners alike, yet such advantages are often overshadowed by resource demands associated with finding and aggregating a continually expanding body of scientific information. Across social science disciplines, the use of automation technologies for timely and accurate knowledge synthesis can enhance research translation value, better inform key policy development, and expand the current understanding of human interactions, organizations, and systems. Ongoing developments surrounding automation are highly concentrated in research for evidence-based medicine with limited evidence surrounding tools and techniques applied outside of the clinical research community. Our objective is to conduct a living systematic review of automated data extraction techniques supporting systematic reviews and meta-analyses in the social sciences. The aim of this study is to extend the automation knowledge base by synthesizing current trends in the application of extraction technologies of key data elements of interest for social scientists. Methods: The proposed study is a living systematic review employing a partial replication framework based on extant literature surrounding automation of data extraction for systematic reviews and meta-analyses. Protocol development, base review, and updates follow PRISMA standards for reporting systematic reviews. This protocol is preregistered in OSF: (Semi)Automated Approaches to Data Extraction for Systematic Reviews and Meta-Analyses in Social Sciences: A Living Review Protocol on August 14, 2022. Conclusions: Anticipated outcomes of this study include: (a) generate insights supporting advancement in transferring existing reliable methods to social science research; (b) provide a foundation for protocol development leading to enhancement of comparability and benchmarking standards across disciplines; and (c) uncover exigencies that spur continued value-adding innovation and interdisciplinary collaboration for the benefit of the collective systematic review community
LEVERAGING RESULTS-DRIVEN ACCOUNTABILITY TO IMPROVE ACADEMIC AND BEHAVIORAL OUTCOMES FOR STUDENTS WITH DISABILITIES
Get PDFThe Office of Special Education Programs’ (OSEP’s) vision for Results-Driven Accountability (RDA) is that OSEP will target its work and investments to best support States in improving results for infants, toddlers, children, and youth with disabilities. State Education Agencies (SEAs) are accountable to OSEP regarding Results Driven Accountability reporting and supporting school districts in the process of improving outcomes for students in special populations. RDA is an accountability system to report data to district and campus leaders related to academic achievement, postsecondary readiness, and disproportionate analysis of students who are Bilingual Emergent/English as a Second Language Learners (BE/ESL), experiencing homelessness, in foster care, or military-connected also called Other Special Populations (OSP), or who are receiving special education services (SPED). The achievement gap is widening between students in general education and special education, among various racial and ethnic groups, and within other special populations of students. Disproportionality is analyzed in the areas of identification, placement, and discipline for each ethnic student group in special education. Leaders seeking to improve student academic performance and behavior can engage in learning more about transformational leadership with an equity focus, teacher professional development, fidelity of implementation, Positive Behavior Interventions and Supports (PBIS), and Social Emotional Learning (SEL). District and campus leaders who include analysis of RDA data into the continuous improvement process in their schools to examine identification, placement, instructional, and disciplinary practices, procedures, and strategies can improve student outcomes for students with disabilities
TOWARD THE DESIGN, SYNTHESIS, AND CHARACTERIZATION OF ABIOTIC COILED-COIL PEPTIDES VIA SOLID-PHASE COPPER-CATALYZED AZIDE-ALKYNE CYCLOADDITION (SP-CUAAC) CLICK REACTION FOR THE PREPARATION OF CONTROLLED SELF-ASSEMBLY MOLECULAR BUILDING BLOCK
Get PDFThe production of cutting-edge materials, the development of novel medications, drug delivery systems, technological advancements, and biosynthesizing all depend on molecular building blocks. Proteins are required for the creation of intricate, well-organized structures, and coiled-coil protein domains are vital subunits for the oligomerization of protein complexes, gene expression, and the structural components of biological materials. The numerous interactions between a wide variety of amino acids make it difficult to assemble protein complexes with a particular shape. In the current study, we successfully designed and synthesized four different 32-residue peptides, each of which had two modified amino azide residues. These peptides were then used in solid-phase copper-catalyzed azide-alkyne cycloaddition (SP-CuAAC) click reactions to incorporate aryl aldehyde and acyl hydrazide functionalities into peptide oligomers. Although, results from LCMS indicate that individual peptides and click reaction product were successfully synthesized. Furthermore, we analyzed the orthogonality of peptide pairs by size exclusion chromatography (SEC) for self-assembly of paired coiled coil peptide and show successful association of dimeric coiled coils
The Introduction of a Family Advisory Council in a Neonatal ICU
Get PDFHaving a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a patient and family advisory council (PFAC) can help reduce this stress on parents and lead to better care and outcomes for the infants as well. It can also lead to improved patient satisfaction scores if parents are able to feel well supported by the staff. This council will be comprised of a diverse group of former parents and families who will meet to discuss and give input on unit operations. They can give their insight into how changes might affect families. Giving these former families a voice for the collective current parent will ensure that any changes keep family centered care at the forefront of care delivery. The cost of implementation is low, due to the council positions being volunteer based. By using patient satisfaction scores which are already collected, as well as qualitative pre- and post-intervention surveys, the implementation team will be able to show the effectiveness of this council and provide rationale for indefinite continuation
Evidence Based Change to Improve Outcomes in Cardiac Patients
Get PDFAccording to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.
Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need for additional resources in the acute care setting for prevention and management of a newly acquired heart condition. In October of 2012, Centers for Medicare & Medicaid Services (CMS) created the Hospital Readmissions Reduction Program (HRRP) which reduces payment to those facilities that have “excess readmissions” within a 30-day period for common health conditions that include acute myocardial infarction, heart failure, and coronary artery bypass graft surgery (CMS, 2023). There is a unique opportunity for nursing interventions to make significant changes in the outcomes for this patient population at the acute care level and beyond.
The focus of this project is to have a nurse navigator in an acute care facility that primary focus is patients with coronary artery disease and a newly placed coronary stent during a recent hospital admission. In effort to reduce readmissions and improve outcomes for these patients. Therefore, it is recommended for acute care facilities to allocate resources for a nurse navigator to monitor, track, and lead an interdisciplinary committee to promote early intervention for those patients discharged with a newly acquired diagnosis of coronary artery diseas