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Effecticeness of Malignant Hyperthermia Simulation Training and Educational Powerpoint on Confidence, Knowledge, and Communication Skills in Critical Care Nurses
Full text linkBackground: Malignant hyperthermia (MH) is a high acuity low occurrence event. It is classified as an autosomal dominant inherited skeletal muscle disorder, caused by the improper release of calcium from the sarcoplasmic reticulum. When the acute events of malignant hyperthermia are left untreated, the mortality rate is 80-90%. Outside of the operating room, MH is rarely observed but can occur to a patient for 24 hours after transfer from the operating room. Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness of an educational presentation and MH simulation on intensive critical care (ICU) registered nurse’s (RN) confidence, knowledge, and role clarity while managing an MH crisis at a large regional hospital. Methods: The Awareness to Adherence model and Johns Hopkins Evidence-Based Practice model provided guidance for implementation. Critical care registered nurses were invited to a PowerPoint presentation accompanied by an interactive MH simulation performed by the PI. A mixed-methods, quality improvement design using a pre-and post-test survey was used to collect data. Results: A mixed-methods quality improvement design was used to measure ICU RNs’ confidence, knowledge, and role clarity before and after MH education and simulation. Sixteen ICU RNs participated in the project. Descriptive statistics were utilized to analyze data from the sixteen paired pre- and post-test surveys. Preintervention 13% agreed or strongly agreed they knew the initial treatment for MH, post-intervention this increased to 100%, and 94% stated that they could calculate and reconstitute Dantrolene following education and simulation. Conclusion: This project showed that the interventions were successful in enhancing individuals' confidence and knowledge of MH management, which in turn can reduce the morbidity and mortality of patients during an MH crisis. The results of the project suggested that simulation training is an effective tool to improve confidence, knowledge, and role clarity in an MH crisis while preparing for life-threatening emergencies in a safe and controlled environment
Transatlantic terrorism : British and American literature, 1859- 1991
Full text linkThrough a critical literary studies engagement with how terror is negotiated in literature from across periods and oceans, it becomes clear to me that a literary studies approach to expanding the historical and analytical dimensions of terrorism’s configurations throughout history would entail seeing how racial terror manifests in literary works. It becomes meaningful to investigate where terror and terrorism-- even if direct usage of this term is messy—materialize in transliterary and transatlantic contexts. This is type of literary studies approach to transatlantic connections is significant when looking at works of literature that chart the progression the from New World colonialism, then to plantation slavery, and to Jim Crow racial terror. In each terrain of terror and juncture of time access to freedom and the human are being negotiated, granted, or denied highlighting the perverse nature of liberal humanism in times of exploitation, expansion, and subjection. Proceeding from nineteenth-century white British authors to twentieth-century African American authors entails witnessing how the colonial and plantation terror regimes of bygone periods remain productive in modernized capacities. I begin by looking at the relationship between New World colonialism and the Salem witch trials in Elizabeth Gaskell’s 1859 novella “Lois the Witch,” as a way of situating terror not as emerging during the nineteenth-century, but of considering this Victorian author’s perspective on terrorism as a key feature of New World colonialism. From this reference point, I next look to Dion Boucicault’s 1859 play The Octoroon to address the Anglo-Irish playwright’s assessment of the politics of racialization, sexualization, commodification inherent to plantation terrorism. Boucicault’s play helps to establish a more concrete view of the interplay between race, gender, and finance that ground the plantation as an organized site of terror. I shift then to my analysis of two African American authors, James Baldwin and Bebe Moore Campbell, both of which draw creative inspiration from the 1955 lynching of Emmett Till in Mississippi. Baldwin’s 1964 play Blues for Mister Charlie is a meaningful work for exploring how extrajudicial forms of racial terror, like that of lynching, are mobilized and legitimized through state institutions like the church and courtroom. Moore’s 1991 novel Your Blues Ain’t Like Mine showcases post- emancipation racial terror as continuing the legacy of slavery through not only acts of overt physical violence like that of lynching, but through the fracturing of black families and exploiting labor for the advancement of a New Plantation. In this way, Transatlantic Terrorism traces the beginnings, pasts, and presents of terror. From Gaskell’s portrait of colonial terror to Boucicault’s dramatization of plantation terror, and lastly to Baldwin’s and Campbell’s articulations of post-emancipation racial terror, this project tracks the emergence and supposed end to a process of commercialized racialization. As Baldwin’s and Campbell’s works can attest to, slavery’s racial, gendered, sexual, and economic exploits remain operational in a time we don’t expect it to, which also remains grotesquely efficient in the present
An analysis of the relationship between North Carolina pre-service music teachers’ perceived preparedness to teach online, methods classes, and TPACK : a pilot study
Full text linkThe purpose of this pilot study was to investigate the relationship between North Carolina pre-service music teachers’ perceived preparedness to teach online, Technological, Pedagogical, and Content Knowledge (TPACK) score, and online pedagogy instruction included in methods classes. An online survey was emailed to members of the North Carolina Music Educators Association designated as collegiate. The survey respondents (n = 14) completed two categorical grouping questions, Likert-type items about perceived preparedness to teach in brick-and-mortar (face-to-face) and online settings, and Likert-type items measuring each of the seven TPACK domains. Most participants reported they did not learn about online music pedagogy in their methods classes. Additionally, only one participant reported having had the opportunity to observe an online music class, and no participants reported having had the opportunity to complete a field experience in an online music classroom. Results from a Related-Samples Sign Test indicated that participants perceived themselves as more prepared to teach music in brick-and-mortar (face-to-face) settings than in online settings. A Friedman One-Way Repeated Measure Analysis of Variance by Ranks test indicated that TPACK domain scores differed from each other. Specifically, the content knowledge (CK), pedagogical knowledge (PK), technological knowledge (TK), pedagogical content knowledge (PCK), and technological content knowledge (TCK) domains differed from the technological-pedagogical knowledge (TPK) and technological, pedagogical, and content knowledge (TPACK) domains. A Kendall’s Tau correlation indicated a strong, positive association between participants’ perceived preparedness to teach online score and TPACK scores. Music teacher preparation programs may consider focusing on integrating technology, including online music pedagogy, across methods classes to better prepare pre-service music teachers for online instructional settings
Sampling from the space of persistence diagrams
Full text linkThe efficacy of using persistent homology as a tool to understand “the shape of data” has been demonstrated in a variety of different machine learning problem domains. Like many other unsupervised techniques within machine learning, the quintessential persistent homology pipeline is one-directional; data goes in, we use persistent homology to compute information about topological invariant that are present with that data, and a succinct summarization of this information, a persistence diagram, comes out. In this work, we investigate the opposite direction of this pipeline. Using Random Walk Metropolis (RWM), we explore spaces of grayscale images and weighted graphs whose persistence diagrams approximates a given target persistence diagram, presenting sampling schemes that make this process tractable. Following an overview of relevant terminology and results, we show that our methods may be used to generate images and weighted graphs whose underlying persistence diagrams closely approximate a given target
Interventions to Increase Osteoporosis Screening in Patients with Seizure Disorder on Antiepileptic Medications
Full text linkPeople with epilepsy (PWE) are at above-average risk for fracture due to the biochemical bone changes that result from the use of antiepileptic drugs (AEDs). Osteoporotic fractures can lead to considerable morbidity and mortality while simultaneously having negative effects on healthcare cost. There is no recommended routine screening for osteoporosis in people who are at high risk for osteoporotic fractures for other reasons except being female and post-menopausal
Dangers of Electronic Nicotine Delivery System Use: Healthcare Provider Screening in College Students
Full text linkPurpose: This quality improvement project sought to increase intent to screen for Electronic Nicotine Delivery System (ENDS) use in college students by providing an in-person educational PowerPoint for healthcare providers regarding the dangers of ENDS. Background: While smoking rates among college students have plummeted over the last decade, vaping rates have reached epidemic levels. The negative consequences of nicotine addiction and (ENDS) use are well documented in the literature. The lack of screening and prevention efforts for ENDS use presents a gap in the care currently offered to college students. Screening allows providers to educate students on vaping dangers and encourage cessation efforts. Methods: Participants received education highlighting ENDS risks and negative health impacts, a screening tool for clinic employees to screen students for ENDS use, and how to ACT (Ask-Counsel-Treat) in 2-3 minutes. Providers were surveyed pre/post-education and six weeks after the screening tool implementation with a closed-end Likert scale survey that evaluated providers’ perceptions and self-efficacy. Results: Improving providers’ ENDS knowledge increased intent to screen for ENDS, increased willingness to provide patient education regarding ENDS, and increased provider inclination to advise against ENDS. Recommendations & Conclusions: With updates to the electronic medical record (EMR) and placement of ENDS screening with cigarette and tobacco use screening, future studies to examine if screening rates continue to rise in this population after providers are educated on the dangers of ENDS are crucial
Continuing education seminar’s impact on knowledge and retention among athletic trainers
Full text linkThe athletic training profession requires continuing education to maintain the national practice credential. Even with this mandate, there is little evidence on the effectiveness of continuing education in the profession of athletic training. A total of 48 certified athletic trainers, from two samples, with an average of seven years of experience, started this study. A web-based survey assessed educational history, current use, perceived and actual knowledge of electrical stimulation. Participants completed a pre-seminar survey and attended a 1.5-hour presentation. Participants completed a post-seminar survey immediately following the seminar presentation and one-month later. All surveys assessed perceived and actual knowledge, and the post survey included ratings of the seminar. A total of 41 participants completed the post-seminar survey and 30 of those completed the one-month follow-up survey (62.5% response rate). Most (82.9%, n = 34) participants rated the seminar as excellent and 100% rated the presentation as founded in the best available evidence. Nearly all participants indicated that the seminar would improve their competence and practice as an athletic trainer, improve their treatment plans for acute and post-operative pain, aided their learning, and was helpful and appropriate for their experience/skill. This is supported by the findings for perceived and actual knowledge. Following the presentation, participants (n = 41) demonstrated a significant improvement in perceived and actual knowledge scores, t(40)= 5.08, p < .001. Participants that completed the one-month follow-up survey (n=30) demonstrated a significant increase in perceived knowledge from the pre-seminar to post-seminar survey and remained significantly higher than the pre-seminar at the one-month follow-up survey. These participants also demonstrated a significant increase in actual knowledge from the pre-seminar to post-seminar survey, t(29)= 3.03, p = .003, and remained significantly higher than pre-seminar at the one-month follow-up surveys, t(29)= 3.69, p < .001. These findings suggest that the presentation was effective for improving both perceived and actual knowledge scores in athletic trainers and was well received by the participants
The effects of racial threat on the use of expulsions and suspensions in North Carolina Public Schools
Full text linkThe current research study examined the effects of racial threat to understand its influence on the use of expulsions, in-school suspensions, and out-of-school suspensions in North Carolina Public Schools. This study also examined this relationship to see if locale would affect this relationship at all. The data from this study was pulled from two publicly available sources, specifically Civil Rights Data Collection and Common Core of Data. The data examined from these two sources focuses exclusively on data from the 2017-2018 academic school year. Results from the multiple regression models used to estimate the relationship between each response variable and predictor variables offered mix results. The results from the first regression models showed that the proportion of Black students in schools proved to be positively and significantly related to the use of expulsions, in-school suspensions, and out-of-school suspensions. After controlling for locale, the relationship between the proportion of Black students and the use of in-school suspensions and out-of-school suspensions remained unchanged. The relationship between the proportion of Black students and the use of in-school suspensions and out-of-school suspensions remained positively and significantly related to one another when locale was and was not being controlled for in these models. While the effects of racial threat remained unchanged, locale still mattered in the explanation of the use of in-school and out-of-school suspensions
Implementation of Cardiac Emergency Drills on a School Campus to Obtain Heart Safe School Status
Full text linkBackground: Outside of the hospital, cardiac arrest (OHCA) has high morbidity and mortality ifbystanders do not have the tools (AEDs) and knowledge (CPR/AED skills) to act appropriatelyin a cardiac emergency. Cardiac arrests can occur in individuals with no known history ofcardiac disease and occur in both children and adults. Purpose: The purpose of this qualityimprovement project is to implement cardiac emergency drills on a school campus to obtainHeart Safe School Status through the Project Adam Organization. Methods: This projectinvolved planning a series of eight CPR/AED drills on a large preK-12 school campus.Quantitative data included the percentage of items completed in the Project Adam Drill checklist.Qualitative data included participant feedback on the drill process. Results: A total of 16% offaculty/staff participated in the drills (N = 38). The overall score on the Project Adam Drillchecklist was 86.67%. All qualitative feedback was positive. With the completion of the drills,the school successfully moved one step closer to Heart Safe School Status through the ProjectAdam Organization. Recommendations and Conclusions: School nurses are in an idealposition to lead campus-wide emergency planning/preparedness by implementing CPR/AEDdrills on their campuses. Future exploration of CPR/AED drills could include initiating drills inother settings (gyms/recreational centers/college campuses), tracking progress over time,tracking progress when changes are made to emergency plans, and considering adding in theinvolvement of students in drills
A framework to increase instructional coaches' capacity to support equitable and inclusive instruction for beginning teachers in North Carolina
Full text linkDespite decades of research and many frameworks designed to address the inequities and exclusion in the public school system, large achievement gaps, inequitable systems, and exclusive policies exist. The scholar-practitioner believes instructional coaches are well-positioned to address the inequities and exclusion that exist in the public school system when properly trained. This improvement initiative aimed to increase the capacity of instructional coaches working in the North Carolina New Teacher Support Program (NCNTSP) to support equitable and inclusive instructional practices for the beginning teachers they support. A professional development series called “Sharpening Our Transformational EDI Skills” was offered to all NCNTSP instructional coaches statewide. The improvement initiative was designed using the Improvement Science methodology