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Occupational Hearing Conservation: A Program Evaluation
No full textNoise-induced hearing loss related to occupational exposure is a factor faced by many employees in diverse work settings. In an Upper Midwest tertiary medical center, Occupational Health Services is tasked with completing audiograms required by the Occupational Safety and Health Administration (OSHA). Employees are required to complete annual testing. Historically, some employees have fallen out of compliance by not completing their testing. Thus, a program evaluation was completed to assess challenges and barriers. This was completed by surveying employees that need to complete testing, supervisors, nursing staff, and scheduling staff. Semi-structured interviews and a review of procedural guidelines were also conducted. Recalling when an employee was due for an audiogram or when an appointment was scheduled was a common response by survey participants. Time away from the work site was identified as a barrier. The process for cerumen removal needed to be streamlined. Education provided during the audiogram was an area that needed consistency. Follow-up when an employee is not compliant with testing was identified as an area that needed to be more concise as well. Recommendations provided to the Hearing Conservation program included restructuring the process of following-up on non-compliance, maximizing the automation process, developing a better process if cerumen removal needs to occur, and sending education ahead of the audiogram so that employees can review it on their own time and come prepared with questions. Each of these strategies would assist the program in improving OSHA- regulated statistics
Reducing Emergency Visits and Hospitalizations in Residents with Heart Failure or Dementia
No full textPreventive care conversations surrounding advanced care planning and decisions regarding emergency department visits and hospitalizations are of utmost importance, especially among the nursing home population. To address this, a quality improvement project was conducted to assess the impact of implementing the Palliative Performance Scale on enhancing care conversations and reducing rates of emergency department visits and hospitalizations among nursing home residents. The project involved a biweekly retrospective chart review spanning 15 weeks, which focused on 16 participants who reside in a long-term care facility with a primary diagnosis of dementia or heart failure. Data collected during the quality improvement project included the Palliative Performance Scale score, age, sex, primary diagnosis, and relevant comorbidities potentially affecting the scores, with assessments conducted biweekly throughout the duration. The key metrics monitored included the initiation of care conferences triggered by a Palliative Performance Scale score of less than or equal to 60%, as well as the number of emergency department visits and hospitalizations for residents. The results showed a notable 25% decrease in emergency department visits and hospitalizations within the expected timeframe, suggesting the benefit of implementing this assessment in the future
Program Evaluation of MOVIN® in a Rural Hospital Setting
No full textA program evaluation of MOVIN®, an inpatient mobility program, was performed in a rural Midwestern hospital setting. The program introduced education on safe and effective mobility and added a staff member to act as an ambulation aide for patients to fulfill provider's activity orders, and if none were present, ambulate medically able patients three times daily. A formative program evaluation was conducted comparing patients between the summer prior to MOVIN®'s implementation to the summer after. Variables analyzed were reflective of readiness for discharge and included length of stay, fall rates, readmission rates, distance ambulated, level of assistance needed with ambulation, and discharge disposition. For the 2022 group, n = 224, and for 2023, n = 231. There was a mean decrease in length of stay by .65 days (p = .02), and a mean increase in distance ambulated by 278.57 ft (p = .35). There was a decrease in readmission rates by .69% and no change in fall rates. There was a 9.03% increase in patients who left the hospital able to ambulate independently and a 2.82% increase in the number of patients who discharged home; however, there were no notable changes in individual patients' level of assistance with ambulation requirements nor in their level of care needed upon discharge (discharge disposition). There was a clinically and statically significant decrease in length of stay and a clinically significant increase in ambulation distance. There were no notable changes in other measured variables
Evaluation Of Dexmedetomidine Use In Peripheral Nerve Blocks Through A Digital Tracking Tool
No full textPeripheral nerve blocks are effective anesthetic techniques with analgesic properties that benefit patients intraoperatively and postoperatively. However, these postoperative pain benefits may be limited due to the duration of action of the local anesthetic that is used. Perineural adjuncts are used to potentiate the duration of peripheral nerve blocks. This project was a retrospective data analysis to assess the duration of peripheral nerve blocks and postoperative pain scores in patients who received adductor canal blocks with local anesthetic alone versus local anesthetic with perineural dexmedetomidine as an adjunct. This quality improvement project had a descriptive study design involving a retrospective data review comparing two groups with 24 participants in each group. Patients receiving dexmedetomidine their adductor canal block had a mean block duration of 20.7 hours compared to 10.7 hours for the local anesthetic group (p < .001). Postoperative pain scores were reduced in the group receiving dexmedetomidine as an adjunct to local anesthetic; however, pain scores were not statistically significant. The use of Dexmedetomidine caused no harm to the patients and demonstrated prolonged analgesic duration and overall pain relief, illustrating potential benefits in its utilization
Imago Dei: A Devotional Journey to Discovering God's Image Within Us
No full textThis paper and research project explore the possibility of Servant Leadership and Scripture lending a helping hand to individuals who are struggling with body image. The specific tenets of Servant Leadership being explored are awareness, empathy, and healing. Starting with what exactly the body image epidemic is, the effects that social media and other online platforms are having on self esteem are discussed. Those that are struggling with body image can find peace through awareness as they start to identify their feelings and accept whatever those feelings are. Empathy helps individuals show grace to themselves and to others who are struggling. Healing can be an individual journey, a process helping others, or both. Scripture adds even more support because Christian teaching can show that humans were made ""imago dei"" (in the image of God), humans were made to be good, and humans were not aware of their physical appearance until after the fall of man. A number of resources, both secular and sacred, were explored in order to find something based in Scripture that could help those struggling with body image, but nothing in a devotional form was found. Therefore, a devotional will be written that uses Scripture and the tenets of Servant Leadership explored in this paper. This will provide a Christian-based resource for individuals who long for something consistent to read, write in, or pray through that will guide them on their journey to self love
Neuroscience of Franciscan Ecological Leadership
No full textI will demonstrate how Cognitive Neuroscience principles can be used to inform traditional Franciscan praxis to work toward the formation of servant leaders to guide ecological conversion. I will first review the principles of ecological conversion as detailed by Pope Francis in Laudato Si and how that relates to traditional Franciscan incarnational theology. I will then explore the importance of engaging our perceptual senses for guiding the spiritual interior conversion necessary for servant leader formation and highlight two examples of Franciscan contemplation practices: Lectio Divina for listening and sacred gazing for sight. Next, I will explore how our modern, hectic lifestyle impacts our brain leading to an increase in anxiety and habitual responses that limits our awareness of our interconnectedness and diminishes our ability to act in a compassionate manner to our fellow creatures. I will then show that by utilizing the traditional Franciscan contemplation practices that focus on the sensory experience of listening and gazing, one can overcome these biological limitations to become the leader the world needs. For the final section, I will examine potential techniques for applying these principles to develop Franciscan servant leaders within a Franciscan University campus
Growth and Bereavement in Adult Men: A Correlational Design
No full textThe present study investigated the linear and curvilinear relationship between Prolonged Grief (PG) and Posttraumatic Growth (PTG) among men. Previous research investigating this relationship have used samples of which the majority were women. Previous research indicates that moderate levels of PG predict higher levels of PTG and that lower and higher levels of PG predict lower levels of PTG. Participants (N = 978) were sampled from online forums and provided surveys which measured symptoms of PG and levels of PTG respectively. Results indicate that there is an inverse curvilinear relationship between PG and PTG as compared to previous research. Given the large sample size of the present study and relatively low effect size, further research is needed to better understand the relationship between PG and PTG among men
A Servant Leader Approach as a Public School Principal
No full textThe leadership style of a servant leader as an administrator is fairly new. At Viterbo University they require two courses for your studies when obtaining a superintendent licensure, but they do not require Servant leadership courses for obtaining a principal licensure. In addition to this, there are only a few books that discuss principal roles using servant leadership style, which I will share more about in this paper. I have also been getting a unique reaction from my family, friends, and colleagues when I tell them that I am currently getting my Master's Degree in Servant Leadership. Servant Leadership has been around since the 1970s when Robert K. Greenleaf published an essay ""The Servant as Leader."" However, looking at it from a principal perspective is a newer concept to most people. I am so incredibly grateful for the opportunity to be getting my Master's Degree in Servant Leadership, along with my principal licensure. I have been in education for twenty years and have always felt that my role is to serve students and families in helping educate the youth. In 2009, I was fortunate enough to have been selected and participated in Servant Leadership courses through the Tomah Area School District. It was in these courses where I learned what qualities are needed to be a servant leader. I was able to apply my leadership skills through teaching, parenting, coaching, and volunteering. It has helped me grow as a leader and shown me how to serve others. Through the seven pillars of servant leadership, I have continued to grow and develop my leadership skills as an educator and instructional coach. I strongly believe this is the path educational leadership should take to align core values, missions, visions, and purposes. By aligning our districts to servant leadership, we will be modeling and practicing service for our younger generations, so that we support and serve alongside one another, to create productive communities, all over the world
Suicidal Ideation in the Emergency Department
No full textPatients presenting to the emergency department with suicidal ideation have a strong impact on the department and require processes and procedures to keep patients and staff safe. This study is a program evaluation conducted at a small Midwestern tertiary healthcare facility, to assess the effectiveness and efficiency of their process used to triage, assess, manage, and determine appropriate disposition of patients who present to the emergency department and are identified as being acutely suicidal. Data were collected using a retrospective chart review, a staff survey, and a triage assessment. Effectiveness was measured using information from the chart review. This review looked at four documentation parameters required by the facility and mandated by the Joint Commission. Effectiveness was also measured by providing a triage assessment to department nurses. Efficiency was measured using the staff survey, which asked staff to identify their level of knowledge and confidence in the process. The proposal for this project included an interview with a third-party organization used in the care of this population. This was unable to be conducted due to inability to contact someone in leadership at the organization. Findings included an ineffective process, with only 8% of the charts audited meeting documentation requirements. Additionally, the process was found to be inefficient, due to staff reporting moderate confidence, and requesting in person education on requirements, expectations, and therapeutic communication. A strength of this program was the nurses' ability to triage appropriately, with 100% of the assessments receiving the appropriate suicide risk assessment