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Effect of a Community Hospital’s Sustainable and Enhanced Fall Prevention Quality Improvement Program on Inpatient Falls and Falls with Injury: A Before and After Study
Full text linkThe frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 months prior to implementation will be compared to 3 months following implementation of the revised fall prevention program. Frequencies of falls and falls with injury will continue to be monitored for each month following the initial 3-month period
Evaluating Advanced Nurse Clinicians’ Readiness to Use Augmented Reality for Delivery of Simulated Teaching Sessions
Full text linkBackground
Since the start of the COVID-19 pandemic, nurses have adapted numerous new processes and procedures. Keeping patients safe is dependent on the education and experience of providers caring for them. By utilizing the capabilities of augmented reality (AR), clinical nurse educators (CNEs)/advanced nurse clinicians (ANCs) can provide real-time learning while providing feedback to nurses during simulated instructional experiences. AR instructional methods hold promise for educators due to staff shortages, time constraints, and inadequate facility space for in-person teaching sessions.
Purpose
The purpose of this doctoral project was to evaluate the ANCs readiness to adopt new AR technology, the Microsoft HoloLens, as a teaching strategy.
Methods
In this pretest-posttest design, four educational sessions were employed to explore the ANCs perceived usefulness (PU) and perceived ease of use (PEU) of the HoloLens headset.
Results
Four educational sessions on AR, the Microsoft HoloLens AR headset, and its use for training of nurses were held. The total sample size of ANCs that attended a session was 14. The perception of the HoloLens PU and PEU as a teaching strategy total pre and post survey mean scores increased from 59.07 to 77 respectively (p \u3c.001). This shows significance that the ANCs perceived the HoloLens to be easy to use and useful to their job performance.
Discussion
The study results were significant; however, it also implies that ANCs were likely to adopt this technology prior to the educational session(s). Both PU and PEU 2 increased after the educational sessions, which demonstrates ANCs readiness to adopt this new technology into their training of nurses
A bi-objective hybrid vibration damping optimization model for synchronous flow shop scheduling problems
Full text linkFlow shop scheduling deals with the determination of the optimal sequence of jobs processing on machines in a fixed order with the main objective consisting of minimizing the completion time of all jobs (makespan). This type of scheduling problem appears in many industrial and production planning applications. This study proposes a new bi-objective mixed-integer programming model for solving the synchronous flow shop scheduling problems with completion time. The objective functions are the total makespan and the sum of tardiness and earliness cost of blocks. At the same time, jobs are moved among machines through a synchronous transportation system with synchronized processing cycles. In each cycle, the existing jobs begin simultaneously, each on one of the machines, and after completion, wait until the last job is completed. Subsequently, all the jobs are moved concurrently to the next machine. Four algorithms, including non-dominated sorting genetic algorithm (NSGA II), multi-objective simulated annealing (MOSA), multi-objective particle swarm optimization (MOPSO), and multi-objective hybrid vibration-damping optimization (MOHVDO), are used to find a near-optimal solution for this NP-hard problem. In particular, the proposed hybrid VDO algorithm is based on the imperialist competitive algorithm (ICA) and the integration of a neighborhood creation technique. MOHVDO and MOSA show the best performance among the other algorithms regarding objective functions and CPU Time, respectively. Thus, the results from running small-scale and medium-scale problems in MOHVDO and MOSA are compared with the solutions obtained from the epsilon-constraint method. In particular, the error percentage of MOHVDO’s objective functions is less than 2% compared to the epsilon-constraint method for all solved problems. Besides the specific results obtained in terms of performance and, hence, practical applicability, the proposed approach fills a considerable gap in the literature. Indeed, even though variants of the aforementioned meta-heuristic algorithms have been largely introduced in multi-objective environments, a simultaneous implementation of these algorithms as well as a compared study of their performance when solving flow shop scheduling problems has been so far overlooked
An interval multi-criteria decision-making model for evaluating blockchain-IoT technology in supply chain networks
No full textSupply Chain (SC) networks benefit from the integration of Blockchain Technology (BT) and the Internet of Things (IoT) in many ways, from data protection and transparency to fraud prevention, traceability, and cost reduction. As the technology is new, there is a lack of knowledge and experience in selecting suitable platforms for SC networks. Choosing the right platform is a difficult and complex task involving multiple and conflicting criteria. This study presents a novel practical approach for evaluating and selecting a BT-IoT platform in SC networks using multi-criteria decision-making. First, an extensive literature review is conducted to determine the most suitable criteria for BT-IoT platform selection. Then, using the interval Weighted Influence Non-linear Gauge System (WINGS) method, the weights of the criteria are calculated, and finally an interval VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) technique is used to assess the suitability of the platforms. The proposed approach uses the experts’ preferences, considers the interdependencies among criteria in the weighting process, and enables implementation in a hierarchical and interconnected network. We present a case study in the food industry to demonstrate the applicability of the proposed model. Additional sensitivity analysis is conducted to exhibit the efficacy of the proposed model in selecting a suitable and robust platform in SC networks
Performance Improvement Project Implementing Rapid Cycle Deliberate Practice Simulation to Improve Team Performance During Administration of Moderate Sedation by Non-Anesthesia Providers in the Interventional Platform
Full text linkA steady increase in procedures in interventional platforms has required the administration of moderate sedation and analgesia by non-anesthesia providers. Of concern is managing the delicate balance between different levels of sedation on a continuum to ensure safe and effective care. Moderate sedation achieves suppression of consciousness while maintaining a patent airway and intrinsic respiratory drive compared to deep sedation where airway patency and respiratory function can be compromised. Administration of moderate sedation by non-anesthesia providers in interventional platforms leads to a higher rate of procedural complications. Rapid Cycle Deliberate Practice (RCDP) simulation will be utilized to educate non-anesthesia providers and to develop their crisis resource management (CRM) skills. The purpose of this performance improvement project is to implement a rapid cycle deliberate practice simulation training for non-anesthesia providers administering moderate sedation in interventional platforms to improve crisis resource management skills as determined by current evidence-based practice (EBP)
An Evidence-Based Teaching Plan for Preventing Wrong-Site Block Placement During Regional Anesthesia
Full text linkWrong-site regional anesthetic block placement is a threat to patient safety and quality perioperative care. The adverse outcomes for patients, providers, and institutions demonstrate safety risks that are linked to inconsistent use of comprehensive guidelines in clinical practice. The purpose of this Doctor of Nursing Practice Project is to create a comprehensive evidence-based Teaching Plan for preventing wrong-site block (WSB) placement during regional anesthetic induction and for use in institutions by anesthesia providers to prevent wrong-site anesthetic block placement. The teaching plan focuses on four main constructs to prevent WSBs, which include the incidence of WSBs, the consequences of WSBs, significant contributing factors to WSBs, and proposed methods to prevent WSBs. Following the literature review and development of a draft Teaching Plan, a Qualtrics survey was distributed to an expert panel for completion of a content validity form. The final draft Teaching Plan serves as an educational guide for clinicians to use in safe regional anesthetic management
The evolution of psychological involvement and customer loyalty: a longitudinal analysis of fitness facility members
No full textPsychological involvement is a leading concept within sport management used to understand consumers’ behavior and their connection with a sport entity. Despite the concept’s importance, there is limited evidence on the longitudinal dynamics of its three facets (pleasure, centrality, and sign). To examine the relationships between the facets of psychological involvement and customer loyalty (attitudinal loyalty and visit frequency) over time, we conducted a three-wave longitudinal investigation using data from new fitness center customers (n = 150). Results indicate that while the impact of pleasure on attitudinal loyalty decreased from time 1 to time 2, the relationship between centrality and attitudinal loyalty increased during the same time period. Our findings further demonstrate that baseline pleasure (t1) has a sequential relationship with visit frequency (t3), first through baseline attitudinal loyalty (t1), and then through future attitudinal loyalty (t2). Our results imply that pleasure and centrality are salient to loyalty development
Differences in Anxiety in New-To-Practice Traditional and Non-Traditional Registered Nurses in Clinical Practice
Full text linkNew-to-practice RNs experience anxiety during licensure preparation and orientation. Such anxiety is anticipated to linger for approximately 6 months as the RN transitions to practice and adapts to professional nursing. Many new-to-practice RNs report feelings of anxiety. Their anxiety can negatively affect the quality and safety of nursing care and increase nurse turnover. Unfortunately, the literature on anxiety in traditional post-licensure in new-to-practice RNs in clinical practice lacks information on non-traditional post-licensure new-to-practice RNs\u27 experiences when starting professional practice roles in health care settings. This descriptive comparative study compares differences in anxiety in new-to-practice RNs of traditional and non-traditional Bachelor of Science Nursing (BSN) programs. Anxiety levels could compromise client safety and quality nursing care and increase nurse turnover. The study recruited a convenience sample (N = 72) of new-to-practice RNs. The new-to-practice RNs were currently employed in nursing positions in hospitals for less than 1 year of nursing practice. The Spielberger State form of the State-Trait Anxiety Inventory was administered via Qualtrics. The anxiety of the total sample was moderately high. The hypothesis tested that anxiety scores differed when comparing new-to-practice RNs that graduated from a traditional program schedule (n = 32) versus a non-traditional schedule (n = 35) in one university’s BSN program was not supported. However, the highest-ranked items were, I am tense, I feel strained, I am presently worrying over possible misfortunes. I feel frightened. I feel nervous, I am jittery, I feel indecisive, I am worried, and I feel confused. These items’ scores were consistent for both the traditional and non-traditional new-to-practice RNs