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Ultrasound-Guided Intravenous Insertion: A Boon to Outpatient Infusion?
No full textUltrasound-guided peripheral intravenous (USPIV) insertion is widely used across healthcare settings. With proper education, healthcare providers can use portable ultrasound technology to visualize and confirm accurate vessel cannulation, thereby ensuring success with peripheral intravenous (PIV) placement, which in turn might reduce patient treatment delays, increase patient satisfaction, and reduce pain. This single-center quality improvement study investigated the implementation and effectiveness of USPIV insertion in patients at a medium-sized Midwestern referral hospital's outpatient infusion department. With a focus on patient satisfaction and nurses' perceived difficulty, the study aimed to evaluate the impact of portable ultrasound technology on PIV placement compared with standard of care/landmark PIV techniques. While the primary outcomes of patient satisfaction and nurse-perceived difficulty in PIV placement showed no statistically significant difference, the results highlight high patient satisfaction (mean of 3.51, scale of 5, SD = 1.04) and minimal pain in the ultrasound group (mean of 1.27 on scale of 10), Notably, although the ultrasound group had significantly longer PIV insertion times (median of 283 seconds) than standard approaches (median of 183 seconds), the ultrasound group demonstrated a significantly higher success rate on the first attempt (93% vs. 73% in standard group). The number of PIV insertion attempts influenced treatment delays which contribute to overall workflow efficiency. Despite challenges in nurse training and confidence, the findings support the potential benefits of routine ultrasound use for PIV insertion in outpatient infusion departments
Evaluating the Effectiveness and Efficiency of Follow-Up Phone Calls After Hospital Dismissal
No full textReadmissions and surgical site infections following dismissal from the hospital are rarely positive outcomes; however, interventions have been utilized at a large Midwestern tertiary healthcare facility to avert readmissions. This study was a program evaluation aimed at measuring the effectiveness and efficiency of a standing process of a small group of vascular surgery advanced practice providers who utilize provider-initiated follow-up phone calls 7 to 10 days after hospital dismissal post femoral artery endarterectomy. Data were collected using a random sampling of retrospective chart reviews, a time study, and qualitative findings from advanced practice provider survey responses. Effectiveness was measured by reviewing the readmission rate within 30 days of dismissal and the surgical site infection rate of the reviewed randomized charts. Efficiency was measured via a cost analysis of this program and a process evaluation, as no standardized process existed. Findings included an effective program, with readmission rates below national and facility benchmarks and a surgical site infection rate within the expected range. Additionally noted were cost differences between using an advanced practice provider and a registered nurse to perform the phone calls. Finally, though a similar list of topics was covered during the phone calls, a standardized process may lead to greater efficiency
Multiple Evaluations of a Washington D.C. Food Pantry
No full textDespite food insecurity being a risk factor for diet related disease there is little research about how well food pantry food offerings meet the recommended Dietary Reference Intakes (DRI) or the DGA 1. Furthermore, food insecurity and use of the charitable food system increased from 2022-2023 2. A food pantry in Washington, D.C. was evaluated using the Healthy Food Pantry Assessment Tool (HFPAT) 3. Following the assessment the offerings from the pantry were recorded over six weeks to account for any variability in offerings and establish the average take home groceries. The average take home groceries were then compared to the Dietary Reference Intakes for a reference older adult male who resembles the typical population served by this pantry. The recoded offerings were compared to the cost of the same items at three different grocery stores within 0.5 miles of the pantry. This cost data was used to find the average amount of money saved by acquiring food from the pantry rather than the local grocery stores. The food pantry scored a 58/100 possible points on the Healthy Food Pantry Assessment Tool. The average food offerings provided 33% of the recommended calories, 33.3% of the recommended carbohydrates, 81% of the recommended fiber, 16% of the recommended protein, 14.5% of the recommended fat, and 44.9% of the recommended sodium content for the reference person over a 14-day period. The food offered from the pantry cost, on average, $33.06 at the three proximate grocery stores. The food acquired at this food pantry is not enough to fulfill any of the Dietary Reference Intakes for the reference person. Future research should address how best to fill these gaps, and the best way to educate pantry users about what else they need to meet the Dietary Reference Intakes
Can Vegetarian Athletes Consume the Required Amount of Iron?
No full textIntroduction: Dietary considerations play a pivotal role in the performance and well-being of athletes, with iron emerging as a critical micronutrient essential for optimal athletic function. Amidst the diverse dietary practices observed among athletes, vegetarianism has garnered attention for its potential impact on iron intake and status. Vegetarian diets, characterized by excluding meat, fish, and poultry, pose unique challenges in meeting iron requirements due to the absence of heme iron, which is predominantly found in animal products. Iron is crucial in oxygen transport, energy metabolism, and muscle function; its adequacy is paramount for athletes, particularly those in high-intensity training. While previous research has explored the iron status and dietary habits of vegetarian athletes, knowledge gaps persist regarding the ability of this population to meet recommended iron intake levels. Existing studies have yielded conflicting findings, with some reporting comparable iron levels between vegetarian and omnivorous athletes, while others highlight potential deficiencies among vegetarians. However, these studies often vary in methodology, sample characteristics, and dietary assessment tools, underscoring the need for further investigation. This thesis seeks to address this gap in knowledge by comprehensively examining the iron intake, absorption, and status of vegetarian athletes. By integrating dietary assessments, iron biomarker analyses, and performance evaluations, we aim to elucidate the complex interplay between vegetarianism, iron metabolism, and athletic performance. By systematically comparing our findings with existing literature, we endeavor to provide valuable insights into the dietary and physiological factors influencing iron status in vegetarian athletes. Ultimately, this research aims to inform evidence-based strategies for optimizing iron intake and absorption in this population, thereby supporting their athletic endeavors, and promoting overall health and well-being. Objective: This study aims to investigate whether vegetarian athletes can consume the required amount of iron to meet their nutritional needs and support optimal athletic performance. Method: Participants of a diverse population of vegetarian athletes aged 18-37, representing various sports disciplines in different geographical locations will use a food frequency survey, combining qualitative dietary information with quantitative iron intake data. A validated online food frequency questionnaire survey, supplemented with data on the iron content of foods, was used to assess participants' dietary habits and iron intake. Results: Preliminary findings indicate that while vegetarian athletes may face challenges in meeting the recommended daily intake of iron, particularly from non-heme sources, there is considerable variability among participants. Factors such as dietary diversity, meal planning strategies, supplementation practices, and individual iron requirements may influence the ability of vegetarian athletes to consume adequate amounts of iron. The total calculated iron intake, combining contributions from dietary sources and supplements, was 14.4mg +- Standard deviation 7.06mg. This provides valuable insights into the overall iron consumption among vegetarian athletes, highlighting their ability to meet recommended dietary allowances and potentially address any deficiencies. The participants' iron intake ranged from 4.3 mg to 23.3 mg per day. This variability in iron intake reflects individual differences in dietary habits, supplement use, and adherence to nutritional guidelines. Conclusion: This study's results underscore the importance of tailored nutrition interventions and individualized dietary recommendations to ensure that vegetarian athletes can meet their iron needs and optimize their athletic performance. Future research should focus on longitudinal studies to assess the impact of dietary interventions and supplementation strategies on iron status and athletic outcomes in vegetarian athletes
Effect of Vitamin D Supplementation on Endocrine And Cardiometabolic Profiles in Women with Polycystic Ovary Syndrome: Systematic Review and Meta-analysis
No full textVitamin D deficiency has become a concern among women with polycystic ovary syndrome (PCOS) and may contribute to exacerbation of symptoms and development of comorbidities. Few studies have been conducted to examine the therapeutic use of vitamin D supplementation. The aim of this meta-analysis was to assess the effect of vitamin D supplementation on endocrine and cardiometabolic profiles, specifically looking at insulin resistance and cardiovascular risk factors, in women with PCOS. PubMed was screened for randomized controlled trials on supplementation of vitamin D in women with PCOS. The measured outcomes for this study were: fasting glucose, fasting insulin, HOMA-IR, total cholesterol, LDL, HDL, triglycerides, and hs-CRP. A total of three studies and 218 total participants were included in this study with vitamin D dosages ranging from 3,200-20,000 IU for 12-24 weeks. Results of random-effects models indicated that no significantly different effects between intervention and placebo groups were observed for fasting glucose (SMD: -0.11; 95% CI -0.52, 0.30; p=0.1796), fasting insulin (SMD: 0.12; 95% CI -0.37, 0.6; p=0.4688), HOMA- IR (SMD: .07; 95% CI -0.22, 0.37; p=0.6701), total cholesterol (SMD: -0.02; 95% CI -0.31, 0.28; p=0.9723), LDL (SMD: 0.01; 95% -0.62, 0.64; p=0.2036), HDL (SMD: 0.60; 95% CI 0.10, 1.10; p=0.6128), triglycerides (SMD: -0.08; 95% CI -0.37, 0.22; p=0.7742), or hs-CRP (SMD: 0.04; 95% CI -0.47, 0.56; p=0.2906). Results of this study failed to show a significant effect of vitamin D supplementation on endocrine and cardiometabolic profiles compared to a placebo. Future research should include larger trials for a longer duration of treatment and continue to compare different dosages of vitamin D to a placebo to help determine an effective dose
A Phenomenological Study of The Nature And Perceptions of Sexual Harassment Among Pk-12 Public School Employees
No full textSexual harassment among employees in public school workplaces is critical that is understudied. Despite extensive research in various workplaces, post-secondary schools, and military, there is a gap in the research regarding sexual harassment in public schools. This qualitative, phenomenological study addressed the broad question: "What are the perceptions and experiences of employees in a public school district regarding sexual harassment within their workplaces?" Eleven volunteers were selected through purposive, and critical-case sampling. Data were collected via semi-structured, flexible interviews and reflexive journaling. Three categories, twelve themes, and four findings were identified using Moustakas's (1994) modified van Kaam seven-step method. Identified categories were perceptions related to (1) the nature and understanding of sexual harassment, (2) public school workplace culture, and (3) leadership response and accountability. The twelve themes included perceptions about (1) varied definitions (2) lived experiences (3) confusion about boundaries, (4) fear and need for silence, (5) support, (6) normalization, (7) tolerance and permission, (8) leadership response, (9) leadership disposition and skill-set, (10) fear of repercussions, (11) inconsistencies about leadership response, and (12) clarity, dialogue, training, and policy. The findings were (1) all-encompassing perceptions, (2) comprehensive understandings about sexual harassment, (3) comprehensive understanding about public school culture, and (4) comprehensive understandings about leadership response and accountability. The study unveiled insights that may raise consciousness about an understudied phenomenon. Findings showed a need for clarity, transparent dialogue, meaningful training, and progressive policy. Findings can be used to improve conditions for employees, students, and stakeholders. Findings may inform future research in other workplace settings
Mentorship: The Resource to Increased Social Capital in Graduate Studies
No full textAn established mentorship program in an academic, professional, or personal setting has substantial benefits to both mentor and mentee. The purpose of this study is to understand the impacts of an established mentorship program specifically targeted towards graduate students. The research includes a literature review of related research on mentorship, academic related content, and a study of Midwest four-year colleges and universities. The findings of the literature review were consistent with the many benefits offered from an effective mentorship program in an academic setting, the benefits of a properly established program, and how this could contribute to meet the increasing demands for higher education and future career opportunities. The barriers and struggles identified for students in post-secondary education are directly addressed through mentorship and supported for increased social capital, that has long-term impacts on the individual, institutions, and their communities. Further recommendations include additional research and a recommendation for a formal mentorship program to be established at Viterbo University
Nurse-Led Oral Care Intervention to Reduce Non-Ventilator Hospital Acquired Pneumonia
No full textThe prevention and reduction of hospital acquired infections is a central focus for healthcare organization across the country. Hospital acquired pneumonia, more specifically non-ventilator hospital acquired pneumonia (NV-HAP) is a leading threat to patient safety. Currently, there is no standard of practice or protocol to prevent NV-HAP, specifically on general care floors. Non-ventilator hospital acquired pneumonia can be prevented by targeting modifiable risk factors, such as comprehensive oral care. Emerging evidence supports the use of chlorhexidine gluconate as an antibacterial agent in the prevention of NV-HAP. Oral care is a nursing intervention; therefore, nursing plays a critical role in the prevention of pneumonia. This nurse-led oral care quality improvement project was implemented to improve patient outcomes with a goal to improve oral care adherence documentation, thus decreasing patients’ risk for NV-HAP. To achieve this goal, the author educated nursing staff on the benefits of oral care as a means of pneumonia prevention and implemented oral care kits to incoming patients on a nursing unit at a Midwest tertiary hospital. Following the 3-month intervention period, the nursing unit saw a decrease in NV-HAP cases and a decline in documentation adherence compared to the year prior. Ongoing oral care education and continued implementation of oral care kits is crucial to establish this nursing practice change. It is essential that nurses and other healthcare staff view oral care as a key intervention in the fight against hospital acquired pneumonia
Burnout, Compassion Fatigue, and Compassion Satisfaction Among Registered Nurses During COVID-19
No full textThe COVID-19 pandemic took an emotional toll on many, but the effect on registered nurses who worked with patients diagnosed with COVID-19 has been substantial. The pandemic brought growing interest in the phenomena of burnout, compassion fatigue (secondary traumatic stress), and compassion satisfaction. The focus of this project was to complete exploratory research on the effects of the COVID-19 pandemic on these phenomena. This exploratory research was completed with a demographics and ProQOL-V survey to obtain quantitative data. In addition, qualitative data were obtained with individual interviews conducted with nurses working on a medical COVID-19 unit to discuss and identify direct experiences of working with patients with COVID-19. Nurses (N = 27) completed the survey for a participation rate of 64%. Findings revealed that 81.5% of the sample experienced moderate levels of burnout and 74.1% experienced secondary traumatic stress. Interestingly, 81.5% of nurses experienced moderate levels of compassion satisfaction. Thirteen (31%) nurses consented and completed interviews. From the thematic analysis of the interviews, the themes identified included staffing shortage/increased workload, lack of leadership support/resources, high acuity patients/teamwork, negative feelings/social isolation, COVID-19 beliefs/media, and leaving bedside nursing. Many of these themes tied in closely to recent literature and Watson’s theory of caring. Of the sample of nurses interviewed (N =13), 10 of 13 said staffing shortages contributed to burnout and compassion fatigue. Knowledge of these results can inform future research on interventions and solutions to prevent these negative feelings in the current healthcare setting in the face of another life-changing pandemic