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Onboarding of New CNAs
No full textAbstract
This quality improvement project at the sisters’ care facility seeks to enhance the onboarding process for Certified Nursing Assistants (CNAs) by addressing high turnover rates, building CNA confidence, and ensuring competency. The project focuses on developing a CNA preceptor cohort, creating an evidence-based skills checkoff list, and standardizing the onboarding process to achieve a 100% compliance pass rate.
The project included establishing and training a preceptor cohort of experienced CNAs. This team is familiar with the skills checklist, ensuring its effective use during the onboarding process. These foundational steps will enhance CNA competence, retention, and care quality by implementing standardized practices.
Challenges, such as resistance to change and time constraints, have been noted. However, this initiative provides a sustainable framework to support CNA training and retention, aligning with evidence-based practices to enhance staff preparedness and improve the overall quality of care.
Keywords: CNA onboarding, quality improvement, turnover reduction, competency in healthcare, preceptors, and mentorship in healthcare
Development of an Endometriosis Toolkit to Support Clinicians in Providing Quality Care for Women
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Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.
Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.
Methods: This Doctor of Nursing Practice (DNP) quality improvement project delivered a 1-hour educational session on endometriosis to nurse practitioners (NPs) at the California Association for Nurse Practitioners (CANP) conference. A case study was used to introduce the Endometriosis Toolkit for Practitioners. Pre- and post-session surveys were administered to measure improvements in knowledge and toolkit usage.
Interventions: The DNP project provided a 1-hour, evidence-based educational session, introducing NPs to an endometriosis toolkit and demonstrating its practical application in clinical practice.
Results: Nineteen NPs completed the pre-session survey, and seventeen completed the post-session survey. The findings revealed an 82% overall increase in knowledge and an 88% agreement to implement the toolkit in practice, thereby meeting the project’s goals.
Conclusions: This DNP project significantly enhanced NPs’ understanding of endometriosis, underscoring the essential role of targeted education and practical resources in improving patient care outcomes.
Keywords: endometriosis, clinical guidelines, practitioner toolkit, healthcare resources, primary car
U.S-Venezuelan Relations: Personality and Foreign Policy Decision Making
Get PDFHugo Chavez and Nicolas Maduro, the authoritarian socialist regime leaders in Venezuela, are known for their social programs and their stance against the U.S., but only Maduro cut off diplomatic relations with the U.S., one of the most significant FP decisions of his administration. This research examines the role that the personalities of these leaders may have played in explaining their distinct FP towards the U.S. Personality helps find traits that shift a leader’s behavior that then influence how they make decisions. Previous research has shown that personality is a helpful tool for understanding leaders\u27 strategies, but it has not been used to analyze these two leaders. Consequently, I adopted a methodological framework to find how leaders\u27 personalities affected their FP decisions. I conducted a leadership trait analysis, an analysis of their sensitivity to the political context, and an analysis of the variables influenced by the leader’s leadership style. This analysis revealed that the two leaders have the same leadership style. However, their same leadership style leads them to tackle issues based on circumstances. Both leaders then address issues on a case-by-case basis, leading to different FP decisions. Secondly, another contributing factor to the differences in FP decisions is how they interpreted information and their level of experience in FP. Lastly, the third factor showed that differences arise because leaders bend their personalities based on context. Overall, these findings explain that both leaders’ personalities served to understand their differences in foreign policy decisions toward the U.S
Contributing Factors to Tooth Decay and Dental Caries Among Children in California
No full textEarly Childhood Caries (ECC) is one of the most prevalent oral diseases affecting children from low-income families in California. This literature review examines the contributing factors to ECC, including race, socioeconomic status, parental education, and access to dental care using multiple databases including PubMed and Google Scholar. The review highlights significant disparities among ethnic minority groups with higher rates of untreated caries observed in Hispanic, African American, and Asian children. Many interventions such as community-based programs and educational initiatives for healthcare providers and parents have been effective in reducing the prevalence of ECC and improving oral health outcomes among these populations. The findings emphasize the need for a comprehensive, culturally competent approaches and enhancing access to dental care to address these disparities and ensure equitable oral health for all children
Quality Improvement Evaluation in Support of a Structured Onboarding Process for CNAs
No full textAbstract
An onboarding program for newly hired Certified Nursing Assistants (CNAs) is important for stabilizing competency and ability to perform high-quality care for residents in a residential facility. However, an onboarding program at an 80-bed residential living facility has not been consistent, which leads to concerns about the quality of care and competency levels. To address these issues, a project was conducted at this facility that serves a diverse population of elderly residents who require various levels of care. The focus was on newly hired CNAs who often face challenges in their roles due to inadequate onboarding. With this, feedback from both new and current CNAs was utilized to analyze the procedures. Interventions included the development of a prospective onboarding program that incorporates training, effective communication, and performance evaluations which aim to enhance overall CNA competency. The measures evaluated the effectiveness of the current onboarding program through surveys including pre- and post-onboarding competency assessments. In conclusion, enhancing the onboarding experience for CNAs will significantly benefit both staff and residents. By providing a more structured onboarding process, the team can cultivate a more skilled workforce, elevate the quality of care, and ultimately align with the organization’s goals and priorities.
Keywords: CNA onboarding, Certified Nursing Assistant training, healthcare onboarding best practices, new hire orientation in healthcare, competency assessment, quality of care, residential living facilit
“We Have to Fight for Change”: Intersecting and Ongoing Crises Amongst Farmworker Families Along the Monterey Bay Central Coast
Get PDFThis study examines the crises farmworkers are experiencing along the Monterey Bay Central Coast. It analyzes and reviews housing insecurity, deficit to basic needs, and the environmental impact of storms and pesticides exposure. In January of 2023, the central coast experienced an immense amount of rain, atmospheric rivers, and a levee break that the Salinas and Pajaro Valley communities\u27 infrastructure could not handle. These storms caused even more financial and economic peril for the already struggling farmworkers and their children. This research aims to highlight the importance of farmworking families in the community and what social barriers they face. Information about the housing crises and environmental impact of climate change in the area is utilized to exemplify how farmworkers and their children\u27s livelihoods are impacted. It is important to state that pesticide usage is a significant issue in the farmworker community, and it is slightly mentioned within this paper but is not the central focus.
Data regarding the deficit to basic needs and community resources are also highlighted in this research. This research uses a human rights lens by analyzing the social injustices taking place within Monterey and Santa Cruz County. A critical race theory and Community Cultural Wealth lens is utilized to further analyze collected data and research. In total, there are four chapters to this study. The original iteration of this study was a conference proposal that I attended in October of 2023.
Since presenting at the conference this research has expanded and evolved. The original presentation was created during a time that I had not collected data, but was presented to inform conference attendees and get their feedback. One goal for this research is for it to remain accessible and useful for researchers and readers. This is an example that conducting research is not a linear experience but a fluid and flexible one. I want readers to know and understand you will not know everything or have all of the answers to your research at the beginning. It begins with an idea, a passion, or an interest and blossoms into thorough research over time. The final product of the presentation explains the three intersecting crises affecting the farmworker community with data anaylsis included.
Chapter one includes the description of the conference, theme of the conference, submission guidelines, conference submission, theoretical framework, significance of the research, and positionality statement. Chapter two provides a breakdown of the intersecting and ongoing crises, and an understanding of the Universal Declaration of Human Rights Violations,. Chapter three comprises the methodology used to interview two leaders in the community who work to meet farmworkers’ basic needs, and the findings and analysis of those interviews. Chapter four reviews the purpose and preparation for the presentation and feedback and connections. It also contains recommendations for action and recommendations for future research, and the conclusion. The appendix can be located at the very end of this research, it contains the presentation powerpoint, interview questions, housing costs, feedback and revisions, and how that feedback is utilized
Graphic Medicine for Library Outreach
Get PDFAccording to a National Academy of Sciences working group investigating the mental health crises in higher education, student wellbeing is an issue that needs to be addressed at the campus level, not siloed in specified departments and units. University libraries can be an integral part of student wellness initiatives, and this poster presentation will present one academic library’s engagement in student wellness initiatives. This poster will:
Highlight the ways campus partnerships facilitated streamlined library engagement in student wellness
Identify student centric initiatives and acquisitions
Identify funding sources used for those initiatives and acquisitions
Discuss outcomes of library wellness initiatives
Queering the Care Chain & Migration Discourse
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This thesis seeks to fill the gaps between migration and domestic labor discourses that lack a queer, decolonial conception of the queer migrant community in the US. Dominant conceptualizations of care work exclude LGBTQ+ migrant individuals who are forced into the “informal” sector of labor as a by-product of the settler-colonial state, neoliberalism, and globalization. Centering queer migration approaches and decolonial practices will help to illuminate how gender, race, and sexuality are consistently excluded in discussions of migrant domestic workers. To investigate how migration discourse and understandings of care work continue to impose Western heteronormative perceptions of migrants, I utilize a critical discourse analysis using two major case studies Doméstica: Immigrant Workers Cleaning and Caring in the Shadows of Affluence (Hondagneu-Sotelo 2007) and Servants of Globalization: Migration and Domestic Work (Parreñas 2015) consisting of Latina and Filipina care workers experiences in the US. The findings suggest that there are implicit heteronormative conceptualizations of migrant women and queer individuals in care work. Throughout both case studies, they reveal and reproduce heteronormative assumptions about migrant domestic workers; and as a result, reinforce monolithic representations of migrant women and privilege, heteronormative ideas, practices, and institutions, which ultimately contribute to the ongoing erasure of queer migrant BIPOC in care work.
Keywords: queer migration discourse, informal labor, care work, domestic work, decolonial theory, heteronormativit
Assesing Electronic Waste Management Strategies in Ghana
Get PDFIn an era of rapid technological innovation, managing electronic waste (E-waste) is an increasing challenge globally. African countries are increasingly becoming the key destination of electronic waste due to two primaries factors which are the emergence of unregulated private markets from international and domestic recycling loopholes and stricter regulations on E-waste import and recycling methods in Asian countries like China and India. This study focuses on the complexities surrounding electronic waste (E-waste) in Ghana and provides management recommendations to mitigate the environmental health consequences. Using a qualitative method and peer-reviewed journals, this study investigates the current state of E-waste management practices, analyzes the impact on local communities and ecosystems, and evaluates the effectiveness of existing policies. The findings not only reveal the connection between improper disposal, environmental contamination, and potential health risks but also the low-level of awareness among the communities and the weakness of the regulatory framework in Ghana. This research provides valuable insights on sustainable E-waste management strategies, offering a foundation for policymakers and fostering awareness about responsible electronic consumption in Ghana. Regulatory frameworks, paired with health risk monitoring and public awareness programs need to be developed and enforced