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Implementation of a Fall Root Cause Analysis Investigation and Intervention Process: Improving Resident Safety in a Long-Term Care Facility
No full textFalls continue to be a major safety concern for adults aged 65 years or older living in long-term facilities due to their age, weakened conditions, and chronic diseases. To improve resident safety in a long-term care facility in a skilled nursing facility, the Root Causes Analysis (RCA) method was utilized to establish a standardized process for evaluating and documenting falls in hopes of understanding the contributing factors when a fall occurs and how to prevent it from happening again by developing targeted fall prevention interventions. Empira’s Falls Scene Investigation (FSI) Report (Minnesota Department of Health [MDH], n.d.) was adapted and developed into the Root Cause Analysis Fall Investigation and Intervention (RCA-FII) form. Early results indicate the RCA-FII form did not reduce falls. Fall rates for December 2021, was 17.07%, January 2022, was 5.19% and in February 2022, it was 9.02%. However, the RCA-FII form process was followed 92% of the time and helped nurses to consider resident-centered fall prevention interventions. A significant finding indicates a high frequency of falls related to a resident’s medical status/physical condition/diagnosis and transferring. In addition, the most selected individualized fall prevention intervention on the RCA-FII form was frequent monitoring of a resident’s condition. In conclusion, the RCA-FII form is a useful tool in identifying contributing factors of a fall. Furthermore, it can help improve nurses’ critical thinking skills, but the RCA method is complex and will require a collaborative team approach to improve patient safety
The Use of Standardized Patient Simulation to Increase Nursing Student Understanding of Ecological Approaches to Patient Care
No full textCultural competency teaching and bias training has made its way into academic programs; however, these programs often lack the acknowledgment and importance of the ecological aspects of health. Ecological aspects of health (EAH) are described as physical and sociocultural environmental influences that affect a person’s health (Sallis & Owens, 2015). Education influenced by cultural competency poorly addresses structural racism in health care delivery and fails to address social, historical, and economic ideologies that play a critical role in provider and institutional biases (Tsai & Crawford-Roberts, 2017). Cultural competency teaching, or the understanding that there is a cultural difference and response to cultural differences to reach different cultural groups, also often perpetuates stereotypes as the cause of health disparities by indicating the existence of a stereotype and not the historical context in which the stereotype may have originated, not just the implicit bias from providers that may influence these stereotypes (Cultural Competence in Health and Human Services | Npin, 2020; Tsai & Crawford-Roberts, 2017). In a study conducted by Hoffman et al. (2016), of the 121 participants, despite having no genetic difference in pain receptors, there are a substantial number of medical students (α= 0.92) who continue to believe there is a biological difference in pain tolerance, that African Americans have a higher pain threshold than Caucasians. Not only does this lack of knowledge create mistrust, but research also indicates that implicit biases are significantly related to and associated with interactions between the patient and health care provider, treatment options, patient adherence to the treatment plan, and the health outcome of the patient (Hall et al., 2015). Through simulation, implicit bias training, cultural fluency, cultural humility, and EAH can help mitigate the lack of knowledge many students may have
Occupational Therapy Service Delivery in the School Setting
Get PDFBest practice for occupational therapy in the school setting has evolved due to updated AOTA recommendations and legal mandates. The current literature identifies inclusive and collaborative practice as the best framework, but there is a knowledge-to-practice gap between research findings and how OT is practiced in the school. This paper outlines the background on the issue of OT service delivery in the school setting, and the methodology and results of a quality improvement project with Zumbro Education District (ZED) in southeast Minnesota. The purpose of the quality improvement project is to educate stakeholders about the role of OT and best practice in schools within ZED in order to facilitate greater interprofessional collaboration. An educational presentation was created to educate administrators and special education coordinators from ZED’s member districts. Minnesota OT practice guidelines and the OT practice framework informed the content of the presentation, and interviews with special education coordinators and OTs from the region informed the format and educational methods used to create the final product. Several prompts were embedded into the presentation to gather data regarding the participants’ level of awareness about OT practice and the effectiveness of the educational content. The presentation was sent to approximately fifteen potential participants, and four had responded at the time the paper was developed. Responses implied that ongoing education is needed in order to support best practices. OT teams should meet regularly with coordinators, administrators, educators, and other members of the interdisciplinary team to maintain an open dialogue to clarify roles in the school community. Peer and community support are essential to supporting the adoption and maintenance of best practices in the school system
Staff Training for Non-Correctional Employees Working with Justice-Involved Women
Get PDFPurpose. Justice-involved women have unique pathways into the criminal justice system, so it is important staff are trained to address their needs. Staff receiving inclusive practice training and using trauma-informed care principles may be more effective when working with justice- involved populations. There is little known about the impact of inclusive practice training on staff knowledge, so this project aims to investigate the impact of a training session on the knowledge of re-entry staff.
Approach. For this capstone project, I used an evidence-based process to create an employee handbook and provide a 4-hour training. I then used surveys containing Likert-type and open- ended questions to understand staff knowledge and the applicability of the work-related training. To examine the survey data, I used descriptive statistics and thematic analysis.
Outcome. Three staff from two residential re-entry centers and four from Amicus Services of Volunteers of America received the handbook and attended a 4-hour training. Training topics included: Person-centered language, cultural humility, trauma-informed care, gender identity and gender expression, self-care, and crisis-de-escalation. Staff reported having little to no previous training on inclusive practices, cultural humility, person-centered language, and policy. Following the inclusive practice training, staff reported an increased desire to implement such practices in their daily work with justice-impacted populations.
Implication. Regular staff training led by outside entities provides tools for addressing vicarious trauma and gender-inclusive practices
Training for Caregivers of Children and Adolescents with Trauma-Related Food Difficulties
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The Child Response to the SPOON Chair and its Impact on Feeding
Get PDFThis thesis examined how caregivers and their child with a disability living in Uganda responded to a low-cost feeding chair created by the SPOON foundation as part of a larger pilot study investigating the feasibility, usability, and acceptability of the chair. Utilizing a mixed methods design, 20 child-caregiver pairs participated in a one-hour session to test the SPOON chair during feeding. Caregivers also participated in a focus group discussion to give feedback about the chair. Results indicated the chair increased recommended anatomical and postural alignment needed for safe feeding, eating, and swallowing. Children also tolerated sitting in the chair with positive changes in affect observed. This pilot study revealed the need for slight modifications to the final chair design including reducing the seat height; increasing the chair width; and adding a longer seat belt, footrest, and additional chest strap. Following minor changes to the design, further intervention studies should be completed to ensure comprehensive data is collected
Healthcare Students’ Experiences and Perceptions of Education During COVID-19: An Evidence-Based Practice Project
Get PDFWorking Through Ideological Conflict: Utility of Authentic Leadership to Build Community
Get PDFMany people find it difficult to communicate across ideological differences, particularly if those differences are politically-charged. An abundance of research describes the differences between the two dominant political philosophies of the United States, liberalism and conservatism, but little research has been conducted on how to develop and maintain a community inclusive of these ideological differences. This qualitative research project gathered information from six self-identified leaders and 41 survey participants of varying ages, genders, political affiliations, races, and religions over the summer of 2021. Three categories of findings emerged: (a) how ideological differences make community-building challenging; (b) when and how people engage in ideological conflict; and (c) using skills and strategies to make ideological conflict constructive. Data analysis using Authentic Leadership Development Theory revealed that the characteristics of authentic leadership (“internalized regulatory processes, balanced processing of information, relational transparency, and authentic behavior” (Avolio & Gardner, 2005, p. 322)) are well-suited to facilitate conflict dialogue involving ideological issues. In order to support one’s desire to live among and respond to differences, recommendations and implications are provided
Conducting Health-Care-Related Research on a Student-Developed Nutrition Assessment Tool to Provide Cross-Cultural Care in a Local Community Health Clinic
No full textSerum β-carotene concentrations are inversely associated with self-reported fat intake in United States adults.
No full textBioavailability of dietary β-carotene (BC) is dependent on dose, quantity, dispersion, and presence of fat in the diet. Fats are comprised of a variety of fatty acids, which may impact the bioavailability of carotenoids. However, there is a gap in research on whether specific fatty acid classes affect serum BC concentrations in population samples. The primary objective of this study was to assess the association between reported fat and fatty acid intake and serum BC concentrations utilizing data from the National Health and Nutrition Examination Surveys (NHANES) 2003–2006. Data from 3278 NHANES participants 20–85 years old were analyzed to estimate the relationships between serum BC concentrations and reported saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid intakes. Multiple linear regression estimated ln(serum BC) based on reported fatty acid intakes adjusted for age, sex, race/ethnicity, and reported dietary BC intakes. Mean and standard error (SE) for serum BC concentrations were 14.31 ± 0.05 μg/dl. Means and SE for total fat, SFA, MUFA, and PUFA were 85.7 ± 1.3, 26.9 ± 0.4, 31.1 ± 0.5, and 17.8 ± 0.4 g, respectively. There was a significant trend for association between serum BC and reported total fat intakes (r = −0.002, p \u3c 0.0001), but the association was not strong. Multiple linear regression showed positive associations between serum BC concentrations and higher reported dietary PUFA consumption. PUFA alpha-linolenic acid intakes are positively associated with serum BC concentrations, while MUFA palmitoleic acid and SFA stearic acid were inversely associated with serum BC. The inverse association between MUFA and SFA suggests there may be multiple post-digestion factors affecting serum carotenoid concentrations