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Development and Evaluation of Nurse Leader Driven Real-Time Feedback to Impact Hand Hygiene Compliance in the Pediatric Emergency Department
No full textPreventing hospital-acquired infections from occurring is a vital component of any bedside care team member's role. One simple but critical way that healthcare professionals can assist in preventing these infections from occurring in a vulnerable population is by performing hand hygiene at appropriate times according to the World Health Organization's guidelines (WHO, 2009). A way to increase hand hygiene compliance while maintaining quality care and patient safety is by performing visual audits of hand hygiene compliance and providing real-time feedback to staff on areas for improvement. A pathway to increase feedback opportunities and visualization is through the employment of in-house hospital supervisors (HS) to conduct hand hygiene compliance audits, examine hand hygiene compliance, and educate staff on proper hand hygiene guidelines. The project was implemented in the pediatric emergency department (PED) at the Medical University of South Carolina (MUSC), a fast-paced environment that provides care for approximately 100 patients per day. The HS team performs in-person rounds through this unit at a minimum of two times per day, once per shift. With the compliance rates within the pediatric ED being less than acceptable, averaging a total compliance percentage for 2023 of 3%, this could lead to many opportunities for administrative nursing staff within the organization to help increase hand hygiene compliance and decrease infection rates over time. Despite a planned intervention being put into place, the project revealed no increase in hand hygiene audits with the HS team completing zero audits over the six-week project life cycle. The HS team expressed concerns about reduced staffing levels and feeling overtaxed with responsibilities, which contributed to their unwillingness to participate in the project. These results highlighted the limitations of relying solely on leadership teams to implement a specific change in a high-demand work environment. Future efforts should focus on engaging a wider team of individuals, providing additional education, and identifying workflows that integrate hand hygiene audits and feedback easily into routines
Development and Evaluation of a Nurse-Leader Directed Vertical Track Initiative in an Academic Emergency Department
No full textEmergency department (ED) overcrowding affects healthcare systems across the world resulting in delayed care and increased length of stay (LOS) for patients presenting for emergency care (Savioli et al., 2022). Extended ED LOS has been associated with poor patient outcomes (Siddique et al., 2021). From fiscal year (FY) 22 to FY24, the median LOS for discharged patients was 230 minutes, though the goal, set according to national standards, was 200. The ED at Pennsylvania Hospital was experiencing significant overcrowding and utilized a Plan Do Study Act (PDSA) framework to guide the implementation of Vertical Track (VT). This doctoral project focused on implementing a VT area to reduce ED LOS. The ED utilized current staff to run VT within a section of the main ED to decrease ED LOS. VT staff included an ED provider, a nurse, and a patient care technician (PCT) who autonomously placed patients into VT who met the inclusion criteria. Discharged Emergency Service Index (ESI) level 3 patient ED LOS in the implementation phase (M=208.35, SD 87.8) was compared to ESI level 3 patient ED LOS in the pre-implementation phase (M = 292.71, SD = 126.1). A significantly lower ED LOS t (1016) = 8.58, p < 0.001) occurred, and ED LOS for discharged ESI level 3 patients decreased by 28.83%. Discharged ESI level 4 patient ED LOS in the implementation phase (M=175.51, SD=90.9) was compared to discharged ESI level 4 patient ED LOS in the pre-implementation phase (M = 190.53, SD = 99.2). A significantly lower ED LOS t (601) = 1.64, p = 0.03) occurred, and the ED LOS decreased by 7.87%. The results of this project may assist other EDs to enhance patient throughput and decrease LOS
Optimizing Employee Training and Development – A Comprehensive Playbook for Enhancing Organizational Success
No full textEmployee training and development through the acquisition of knowledge, skills, and abilities helps employees to fulfill their roles and responsibilities and in turn, increases the organization's ability to meet demands and stay competitive. Business A's problem of practice was low training and development ratings on recent employee engagement surveys. The purpose of this dissertation in practice was to research how organizations served by Business A can improve their employee training and development programs and overall training experience. This study utilized a phenomenological research design with qualitative semi-structured interviews. A total of 12 participants were interviewed representing job role levels from individual contributor to middle manager. Findings revealed seven major themes. Out of these findings, the top four sub-themes with the highest code applications were all related to leadership engagement in employee training and development. This clearly demonstrated a strong need for these organizations to focus on leadership commitment and engagement in employee training and development, the first of seven recommendations. The remaining recommendations focused on employee training and development strategy, training programs, development programs, hiring and developing transformational leaders, training, and development culture, and encouraging collaborative learning through communities of practice (CoP). This dissertation in practice can serve as a playbook for leaders and researchers who aim to improve employee training and development within their organizations, especially those interested in improving leadership commitment and engagement in employee training and development
Interorganizational Communication and Collaboration: Assessing Early Childhood Systems Partnerships to Maximize Collective Impact
No full textEarly childhood development, particularly during the first three years of life, significantly impacts a child's future learning, behavior, and health. However, many families face challenges during this critical period (Prenatal-to-Three Policy Impact Center [PN3PIC], 2021). To ensure young children thrive, an effective early childhood system with intentional coordination and improved communication are crucial components for addressing these issues. The purpose of this study was to assess current collaborative partnerships in the early childhood system, identify gaps in communication, and develop a proposed solution to ensure communication infrastructure is implemented to support a comprehensive early childhood system. The research supports the need for interorganizational collaboration and the communication strategies necessary to sustain partnerships that strengthen collective impact. Existing collaborative frameworks were analyzed to identify key components to support research and knowledge sharing, leadership, communication behaviors, virtual communication, and evaluative methods to assess partner satisfaction. While the existing frameworks provided valuable strategies, none completely fit the needs of the organization. The organizations' coalition of early childhood systems partners were surveyed using an adaptation of the Collaborative Effectiveness Assessment to identify key components to consider in a framework that would best meet their needs. The study identified the need to target new early childhood systems leaders to ensure they understand the mission, administrators to ensure they stay informed about system-level initiatives, and the need for adequate technology to support both in-person and virtual meeting venues with individualized professional development opportunities. The results, interpretations, and implications for future research were discussed and a proposed communication framework was presented
Community Newsletter and Parks, Recreation and Library Activity Guide, Spring 2025
No full textThis pamphlet lists programs and activities available through Kent County Parks and Recreation and the Kent County Public Library in Spring 2025
Transitioning Students with Disabilities from alternative placements to Traditional School Settings
No full textThere is little research being done about the success rates of students with disabilities successfully transitioning out of alternative placements back to their traditional home school buildings. Students with disabilities who reenter their home school are more likely to go back to an alternative placements based on infractions of the school code of conduct than being successful using the skills taught at the alternative placement to stay within their home school. This becomes the question: how can reentry protocols/plans be used to improve students with special education services transitioning back to their home schools? Keywords: students with disabilities, reentry plan, attorney general's report, student code of conduct, alternative placement
