2313 research outputs found
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Evidence-Based Practice Evaluation of the Effectiveness of the University at Buffalo Concussion Clinic’s Educational Information for Primary and Urgent Care Providers
No full textClinical Problem: The educational level and training of health care providers in managing concussions in schools and institutions are poorly described in the literature. Current literature and community resources are largely focused on adolescent/youth concussion treatment and education all while the adult and geriatric community show increasing numbers of falls and head injuries without adequately allocated resources and research.
Significance: Emergency department providers and resources are increasingly exhausted and overcrowded, solidifying the need for more advanced practice nurses in primary and urgent care settings. Many health care providers are unfamiliar with current concussion and mild traumatic brain injuries, thus the need for continued education, enhanced assessment, and available resources is increasing.
PICOT Question: The PICOT question for this evidence-based project is, “Regarding health care providers practicing in the primary and urgent care setting, would completing a concussion education seminar increase provider knowledge, experience, self-efficacy, and adherence to best practice over 3 months?”
Clinical Change: The purpose of this initiative, like others before it, is to evaluate current practice beliefs and knowledge before and after educational intervention for health care providers to improve the delivery of care (Taylor et al., 2017).
Desired Outcome: With concussion education and dissemination of up-to-date evidence-based concussion guidelines, it is the aim of the researcher that fewer concussions are undiagnosed, avoiding a cascade of physical and psychological complications
Increasing Older Adult Engagement in Advance Care Planning in the Primary Care Setting: An Evidence-Based Practice Proposal
No full textClinical Problem: Clinical observation and research revealed that, despite current advance care planning (ACP) methods, the completion of advance directives (ADs) is low. Although webbased strategies to increase older adult engagement in ACP have been studied, they have not been applied in current practices. Web-based ACP tools have been found to be feasible, easily accessible, and effective for improving ACP knowledge, communication, and documentation (van der Smissen et al., 2020). However, they are not yet standardized in the primary care setting.
Significance: The burden created by a lack of engagement in ACP is vast. The wishes of those at the end of life may be unknown, which can result in the delivery of unwanted treatment. An emotional burden on patients and their loved ones can also result from a lack of end-of-life preparation (Meghani & Hinds, 2015). There is a significant impact on healthcare costs in relation to unwanted treatment at the end of life (Howard, Bernard, Klein, Elston et al., 2018). Increasing older adult engagement in ACP has the potential to reduce these burdens and improve the quality and consistency of their received patient care.
PICOT Question: This evidence-based practice proposal aims to answer the question, “Among older adult patients in the primary care setting, would a web-based tool increase engagement in advance care planning?”
Clinical Change: The proposed clinical change is the promotion of the PREPARE website (www.prepareforyourcare.org) by primary care providers to increase ACP engagement among adult patients, aged 55 or older.
Desired Outcome: The desired outcome of implementing the proposed clinical change is an increase in the overall engagement of older adults in ACP in primary care. This includes documentation of completed ADs and patient-reported engagement in contemplation about their wishes and ACP discussions.
Summary: Through a review and synthesis of the literature, it was determined that web-based interventions are effective for promoting older adult engagement in ACP. This evidence-based proposal delineates an implementation plan for an ACP website called “PREPARE” to be adapted for the primary care setting. The objectives are reducing the burden that comes with a lack of ACP engagement and achieving patient-centered outcomes
The Impact of Nurse Manager Leadership Style on Nurse Satisfaction through Nurse Intent to Leave
No full textPurpose: The purpose of this research study is to evaluate the effects of nurse manager leadership style on staff nurse satisfaction through intent to leave.
Design: A quantitative nonexperimental, correlational design was used in this study.
Methods: A Survey Monkey link to the Multifactor Leadership Questionnaire 5X-short form with four additional intent to leave questions was emailed to nurses working in a Western New York Hospital. The survey consisted of 29 multiple choice questions using a Likert scale of 0-4 as well as four intent to leave questions using a Likert scale of 1-5. Data were analyzed, and a Pearson correlation coefficient was calculated.
Findings: A total of 33 participants completed the online survey. Intent to leave was analyzed, and the results showed 15% of participants were thinking of leaving their current job with 6% thinking of leaving their current workplace. Individual transformational leadership questions were divided into five categories, idealized influence attributed, idealized behaviors, inspirational motivation, intellectual stimulation, and individual consideration. A moderate negative, statistically significant relationship was demonstrated by transformational leadership and intent to leave.
Discussion: Nurse manager leadership style has an effect on staff nurses\u27 intent to leave. Transformational leadership styles were shown to decrease the intent to leave of the nurse on the unit and the workplace
Expression of Multiple engrailed Family Genes in Eyespots of Bicyclus anynana Butterflies Does Not Implicate the Duplication Events in the Evolution of This Morphological Novelty
Full text linkGene duplication events often create genetic redundancy that can either lead to the appearance of pseudogenes or, instead, create opportunities for the evolution of novel proteins that can take on new functions. One of the genes which has been widely studied with respect to gene duplication is engrailed (en). En-family proteins are expressed in a morphological novelty, eyespots (in the center and in the outer gold ring), in the African squinting bush brown butterfly Bicyclus anynana, as well as in a more conserved pattern, the posterior compartment of a wing. In the present study, we used whole-genome sequencing and transcriptome data to show the presence of three en-family genes and their differential expression on the pupal wings of B. anynana using in situ hybridization. The results suggest two duplication events of en-family genes, the first evidence of a two-fold duplication in the Lepidoptera. We propose that all copies initially had posterior wing compartment expression and all copies subsequently gained a novel expression domain associated with eyespot centers. Two copies secondarily lost the posterior compartment expression, and one copy alone gained the outer ring expression domain. By dating the origin of both duplication events, however, we conclude that they predate the origin of eyespots by at least 60 mya, and hence our data does not support the retention of the multiple en gene duplicates in the genome via their involvement with the novel eyespot evolutionary innovation
Living with Heart Failure: What are the Social Supports Factors that Impact Heart Failure Patient Self-Confidence
No full textThis study aims to display the gap in heart failure patient social support and selfconfidence. The exploration of the way those with heart failure perceive the disease since their diagnosis is important to understand their compliance, behaviors, and communication that surround their disease. Heart failure adherence will be examined through the Conceptual Model for the Relationship of Social Networks and Social Support to Health. The Social Support Survey Instrument will assess the gaps in a participant’s emotional, tangible, affectionate support, and social interaction to manage their disease
Supporting the Needs of Students with Exceptionalities through the Creation of Positive and Highly Effective Learning Environments
No full textBarriers and Facilitators to Antidepressant Medication Adherence in Home Care
No full textThis study aimed to identify the barriers and facilitators of antidepressant medication adherence in home care. Participants were invited to participate in the study via letters mailed to their homes by a care manager at the Visiting Nursing Association of Western New York. Three 30-45 minute interviews were transcribed verbatim and were analyzed using content analysis with four major barriers and facilitators emerging from the data. The major barriers were lack of provider initiative to discuss mental health, lack of established rapport with the provider, lack of education on antidepressants, and lack of provider follow up. The facilitators were perceived benefits of taking the antidepressants, an established routine to take antidepressants, an established trust in the provider, and having a positive attitude. The findings of this study serve as data that can be used by nurse practitioners and providers in practice to enhance their rapport with patients, tailor their education and interventions to this patient population, and promote the utilization of home care agencies to provide at home services to better increase continuity of care and patient contact to enhance antidepressant medication adherence
Head-Scratching: Caucus Confusion, Censure, Lonesome George [Podcast Episode]
No full textFrom publisher:
A day after the Iowa Democratic Caucus, we’re told results are still just around the corner. But the damage from a historic vote-counting fail is already being felt, and Iowa could be the biggest loser. Meanwhile, we’ll look at the big issues that might come up in tonight’s State of the Union Address by checking out the guest list. Also on today’s show: Democrats float an alternative to impeachment, and why one lonely creature might not have been the last of his kind