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All My Days
Get PDFThere will be a day, When I look at the spots on my face. When I pull out the hairs of white and grays. When I wish the scars I have would fade
Servant\u27s Cloth
Get PDFThough all things were under your power You wrapped a towel around your waist Came to me quietly And knelt down
The Sleep of Reason
Get PDFinspired by Goya’s art, The Sleep of Reason Produces Monsters, 1799 it’s 3 am and darling, i am slumped at your desk, my sleepy fingers dipped in ink which now puddles with my hair and stickies its strands
Murray Library October 2023 Newsletter
Get PDFWhat\u27s new at the library? News and information about Murray Library at Messiah University written by its staff. Food for Thought events Friends bus trip to DC Friends Dinner and Lecture Trivia Night reca
Increasing Medical-Surgical Nurses\u27 Palliative Care Self-Efficacy Using the CARES Tool: A Quality Improvement Project
Get PDFBackground: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.
Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.
Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs working on a medical-surgical (M-S) unit at rural hospital in Southern Pennsylvania. Participants’ baseline PCSE levels were obtained using the Palliative Care Self-Efficacy (PCSE) Scale. Postintervention, PCSE Scale scores were repeated.
Intervention: After a one-time education session, participants used the Comfort, Airway, Restlessness and delirium, Emotional and spiritual support, and Self-care (CARES) Tool, an evidence-based tangible EOL reference resource, when providing EOL care to patients under the services of palliative care or hospice during a 9-week implementation period.
Results: The difference between participants’ pre- and postintervention PCSE Scale scores had a moderate effect size (d = 0.6) but was not statistically significant (p = .164). However, when participants who did not care for EOL patients during implementation were withheld from analysis, the increase in PCSE Scale scores from pre- to postintervention was statistically significant (p = .029) with a large effect size (d = 1.5).
Conclusion: Clinically significant findings support the CARES Tool being an effective intervention to increases RN PCSE
Telehealth Standardized Patient Simulations and Nurse Practitioner Students’ Self-Confidence and Satisfaction Levels
Get PDFBackground: Telehealth accounts for 22.9% of primary care visits, increasing healthcare accessibility and affordability. Nurse practitioners (NPs) have noted technological and patient interaction-based differences between telehealth and in-person patient encounters. Healthcare organizations expect newly graduated NPs to use telehealth upon graduation.
Problem: Integration of formalized, telehealth-focused education in NP programs is lacking, decreasing telehealth preparation and use among new graduate NPs. Methods: A quality improvement project was conducted. Participants were a convenience sample of Doctor of Nursing Practice/Family Nurse Practitioner students enrolled in an advanced NP pediatrics course at a private, liberal arts university in central Pennsylvania. The National League for Nursing Student Satisfaction and Self-Confidence in Learning © (NLN SCLS) instrument was used to collect data.
Intervention: Two telehealth standardized patient (SP) simulations were integrated into the 6th and 12th weeks of a 16-week advanced NP pediatrics course.
Results: Project limitations prevented analysis of statistical and clinical significance. However, findings were consistent with current literature. Participants’ NLN SCLS © instrument scores demonstrated high levels of confidence and satisfaction after each simulation. Following the second simulation, participants reported an increased likelihood to use telehealth after graduation.
Conclusion: The telehealth SP simulations were positive learning experiences for participants. Thus, the project site intends to continue use of the intervention, providing the framework for longitudinal data collection measuring site-specific effects of telehealth SP simulation integration
Predictive Value of GG Score on Discharge Destination in Patient’s with Neurological Conditions
Get PDFResearch Questions
1. When using section GG of the Care Tool, what items successfully predict discharge destinations?
2. What are the cut off scores for each item that determine the location when using section GG?
3. Does an increase in GG scores between admission and discharge effect the appropriate discharge destination?
It would be beneficial for inpatient rehabilitation hospitals to identify patients at admission that may be at a higher risk to discharge to a location other than home. This high-risk group could include any patient that scores below the mean for GG total score (61.2) or below the mean for GG ADL score (43). The study also identified three other indicators that could be used to classify patients into this high-risk group; increased age, decreased cognition, and living alone prior to admission. Although CMS guidelines require at least three hours of therapy on five out of seven days in an inpatient rehabilitation facility (IRF), this guideline is a minimum standard.16 Identifying patients at admission into a high-risk category would allow the IRF to devote additional therapy time and resources to these patients to try to discharge them home. All disciplines should be informed if an individual is meeting these high-risk criteria as soon as possible to facilitate interdisciplinary collaboration and attention to care. Specific GG categories that should also be specifically noted at admission during an initial evaluation by the therapy team include the patient\u27s ability to don/doff footwear, complete toileting hygiene, complete lower body dressing, complete bed mobility, and complete transfers as these GG categories had the greatest effect size on discharge to home. Both occupational and physical therapists should target intervention sessions to treat impaired body functions and performance skills limiting independence in these categories