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Implementing a Medication App for Transplant Recipients
Get PDFThe purpose of this benchmark, evidence-based practice project is to evaluate the utility of medication adherence app for transplant recipients to reduce rejection. Studies have shown that medication apps can improve adherence, reduce transplant rejection, and be helpful to patients. The Perx Health app rewards patients for taking their medications, provides patients with reminders, and provides healthcare providers with data from patients. The Perx app will be implemented at a single, large volume, pediatric transplant center. Historical data related to rejection rates and medication level variability indexes will be compared to data collected after app implementation. In addition, patient surveys will be collected to better understand patient perspectives on the app. After one year, data collected will be analyzed and compared to historical data. The results of this project will be disseminated so that medication app implementation may be considered for other patients with chronic conditions
Constant Observation The Benchmark Study
Get PDFConstant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 falls occurring with the implementation of constant observation (Feil & Wallace, 2014). Another study completed in England over a four-year period revealed the impact that constant observation had on decreased self-harm and suicide rates within the hospital setting. With self-harm/suicide rates decreasing from 236 without the implementation of constant observation to a mere 17 with the implementation of constant observation (Janofsky, 2009). Over the years constant observation has proven that it is a remarkable safety intervention and has become the backbone of safe practice for mental health patients reducing the use of physical and chemical restraints.
Despite all the positive reviews from constant observation concerning safety outcomes, there is a disproportionate amount of information about how constant observation affects the patients it is implemented it. There is also an absence of actual therapeutic implementation for this intervention for mental health patients. This is disheartening as this is an intervention commonly used for this patient population and has been named by The Joint Commissions in 2009 as “the primary intervention for mental health patients in the hospital setting” (Sinvani et al., 2019)
DNP Final Report: Developing Competence and Improving Patient Safety with Documentation Training in the Simulated Environment
Get PDFWith the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a pretest related to nursing documentation, were presented with didactic education for nursing documentation, attended a simulation where they encountered a problem, practiced documenting the situation, and completed a posttest. The students were allowed to collaborate and were given instructor feedback. The project increased students\u27 knowledge and confidence in their ability to provide quality nursing documentation, thereby improving patient safety and regulatory compliance. Due to the success of the intervention, the stakeholders decided to turn the training into an interactive module that will be completed every semester prior to clinical attendance
EFFECT ON 360 DEGREE VIDEO STREAMING WITH CACHING AND WITHOUT CACHING
Get PDFPeople all around the world are becoming more and more accustomed to watching 360-degree videos, which offer a way to experience virtual reality. While watching videos, it enables users to view video scenes from any perspective. To reduce bandwidth costs and provide the video with less latency, 360-degree video caching at the edge server may be a smart option. A hypothetical 360-degree video streaming system can partition popular video materials into tiles that are cached at the edge server. This study uses the Least Recently Used (LRU) and Least Frequently Used (LFU) algorithms to accomplish video caching and suggest a system architecture for 360-degree video caching. Two 360-degree videos from 48 users\u27 head movements are used in the experiment, and caching between the LRU cache and LFU cache is compared by changing the cache size. The findings demonstrate that, for varied cache sizes, utilizing LFU caching outperforms LRU caching in terms of average cache hit rate.
In the first part of the research, we compared LRU and LFU caching algorithm. In the second part of the research, a suitable caching strategy model was developed based on user’s field of view. Field of view (FoV) is the term used to describe the portion of the 3600 videos that viewers typically see when watching 3600 videos. Edge caching can be a smart way to increase customer satisfaction while maximizing bandwidth usage (QoE). A 3600-video caching strategy has been developed in this study using three machine learning models that use random forest, linear regression, and Bayesian regression. As features, tiles\u27 frequency, user\u27s view prediction probability, and resolution were used. The created machine learning models are designed to decide the caching method for 360-degree video tiles. The models can forecast the frequency of viewing for 3600 video tiles (subsets of a full video). With a predictive R2 value of 0.79, the random forest regression model performs better than the other suggested models when the outcomes of the three developed models are compared.
In the third part of the research, to compare our machine learning algorithm with LRU algorithm, a python test bench program was written to evaluate both algorithms on the test set by varying the cache size. The results demonstrate that our machine learning approach, which was created for 360-degree video caching, outperforms the LRU algorithm
Identifying the Research and Trends in STEM Education in Pakistan: A Systematic Literature Review
Get PDFAlthough STEM is an essential feature of 21st-century education and learning, there is a lack of awareness about it in Pakistan, especially at the K-12 and tertiary levels. Recently many initiatives have been launched across Pakistan to create more interest in STEM education. In order to assist in raising the level of STEM awareness in Pakistan, this study sought to examine the current state of research and identify recent contributions and gaps in the literature. A systematic literature review was conducted using 22 research papers from five renowned databases. Results produced limited research in this area, with the majority being descriptive and only four being interventional studies. Regrettably, no research explored the engineering component of STEM education. Trends indicate that STEM education research has experienced a downward trend in Pakistan. The observed decline may have occurred due to a lack of understanding among Pakistani researchers regarding the importance of STEM education. Additionally, we identified the current gaps in research on STEM education and subsequently provided recommendations for future research
Prioritizing Sleep in the Cardiac-Surgical Patient
Get PDFPurpose: This project aimed to improve cardiac-surgical patients’ perception of sleep using earplugs and eye masks to reduce noise and light disturbances.
Implications: Sleep is imperative in the post-operative period, and many patients suffer from a lack of sleep. Earplugs and eye masks are a simple, cost-effective tool that can reduce incidences of delirium, reduce post-operative pain, and improve quality of sleep.
Methods: The Richards-Campbell Sleep Questionnaire (RCSQ) was used to survey patients’ perception of sleep pre-intervention. Information sheets were given to the patients about the eye masks and earplugs available in the room and the benefits that could from use. The RCSQ was used to evaluate the patients’ sleep the next day.
Results: There was no change in perceptions of sleep post-intervention, but a lack of subjects was an obstacle. This is an easy, cost-effective project that would benefit from a design change and reimplementation
Music for the Relief of Preoperative Anxiety
Get PDFAnxiety is a phenomenon commonly experienced by patients awaiting surgery (Jlala et al., 2010). Anxiety has been linked to negative impacts “on the induction of anesthesia, wound healing, risk of infection, and postoperative recovery” (Stern, 2013). The alleviation of preoperative anxiety is a positive and desired outcome for perioperative patients. An interview with a patient at University Medical Center yielded some insight into the need for the implementation of additional anxiety alleviating intervention. In the interview, the patient reported feeling distress from being able to hear everything that was happening outside of the patient’s preoperative room and feeling a large amount of preoperative anxiety awaiting the procedure. The patient reported having to wait for 2 hours before an anesthesiologist provided pharmacological anxiety alleviation.
A literature review found that the use of music in the preoperative is a nonpharmacologic treatment modality has been identified as an effective means of alleviating preoperative anxiety (Bradt et al., 2013). The type of music implemented can have an impact on the amount of anxiety alleviated in surgical patients (Kipnis et al., 2016). Additionally, the duration of music can influence the amount of anxiety alleviated in surgical patients (McClurkin & Smith, 2016). With the information from a literature review, an evidence-based intervention was designed.
At University Medical Center (UMC) in Lubbock, Texas, the implementation of music in the preoperative area for the alleviation of patient anxiety occurred. The use of connivence sampling of 10 surgical patients yielded insight into the efficacy of the intervention. The results of the evaluation of the implementation of music in the preoperative area reveal that the intervention is effective in alleviating preoperative patient anxiety. The patients evaluated universally reported satisfaction with the addition of music in the preoperative area
Technology Methods in the Bariatric Postoperative Follow-up Phase Benchmark Study
Get PDFDiet and exercise seem to be the safer option for weight loss, but many individuals struggle to achieve maximum weight loss with these methods. Bariatric surgery has become a growing trend to help combat the obesity epidemic that society is now facing. A large increase in sleeve gastrectomy has been utilized and in 2013, there was a documented 468, 609 cases of bariatric surgery performed worldwide (Sherf Dagan et al., 2017). Bariatric surgery has been shown to provide the greatest level of weight loss when compared to traditional methods that include diet and exercise (Khan, 2016). Weight regain has been seen in up to 50% of patients two years after undergoing bariatric surgery and has been linked to postoperative dietary adherence and behaviors (McGrice & Paul, 2015). Obesity has also shown to be a financial and economic burden to individuals, societies, and healthcare systems. Obesity causes financial strains in the form of healthcare cost but also in terms of individuals who claim disability due to excessive body weight (Tremmel, 2017). The importance ensues with the use of bariatric surgery for the treatment of obesity to alleviate comorbidities and financial strains, and therefore, follow-up for this patient population is of utmost importance to ensure goals of weight loss and dietary adherence are met. Therefore, it is recommended that alternative methods such as the use of technology be integrated into the follow-up process to help bariatric surgery patients with dietary adherence and weight loss
DNP Final Report: Psychosocial Screening for Oncology Patients
Get PDFBackground: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural intervention. Methods: A body of evidence was evaluated and synthesized using the EBP process. From the evidence, a standardized psychosocial distress screening and intervention program was developed and implemented for oncology patients that were admitted to three floors at Methodist Dallas Medical Center. Using the NCCN distress thermometer as well as the 39 questions v problem list, psychosocial distress was considered with the expectation that perceived quality of life would improve. Results: The average initial distress screening was 4.6 out of 10. At the three month follow-up screening, the average score was 3.1, improving by 32%. Most interventions included nutritional support, support groups, palliative and hospice care, and social work, with 92% utilization of referrals by patients
Cultivating Wellness in a Pandemic: Virtually Engaging Higher Education Students with Experiential Activities
Get PDFStudents in higher education experienced extreme challenges during the COVID-19 pandemic and the stress of obtaining a college education during the year between 2020 and 2021. As a result, students’ mental health was impacted, and their coping skills were on trial. In addition, due to COVID-19 safety precautions, many universities have experienced the plight of shifting all classes to an online platform since March of 2020. As a result, higher education educators were faced with the conundrum of effectively teaching students in this virtual learning environment. To cultivate wellness, the authors recommended various experiential activities for higher education educators and discussed how to effectively apply them with students. The objectives of using these activities are to help students regulate their emotions and experiences, alleviate their stress and anxiety, and find new meanings and coping strategies to work through this crisis