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Experiences of caregivers caring for a family member who is using hemodialysis
No full textIn this qualitative phenomenological study using a purposive sample, six caregivers of patients on hemodialysis were interviewed about their experiences of caring for a family member who uses hemodialysis. Six major themes and 12 subthemes were identified. Perceptions of caregivers are that caregiving is hard work and stressful; however, caregivers found the experience to be meaningful, even though the stress may interfere with their own health status. Study limitations include a small sample that may not represent the entirety of caregivers\u27 perspectives. Implications for practice include developing informal and formal support systems and exercise programs that help this population manage the stress associated with caregiving for family members using hemodialysis
Building a Culture of Health and Health Equity through Native American Nurses
No full textIn an effort to inspire Native Americans to consider a career path that can help build healthier communities, the Future of Nursing: Campaign for Action teamed with the National Alaska Native American Indian Nurses Association (NANAINA) to produce a 90-second video showing a day in the life of a Native American nurse. The nurse featured is Lisa Martin, PhD, RN, PHN, immediate past-president of NANAINA and associate professor with St. Catherine University in St. Paul, Minnesota. Martin is also a diversity consultant for the Campaign for Action and is a member of the Lac du Flambeau Band of Chippewa Indians in Wisconsin.The video, made in collaboration with GoodHealthTV—the nation’s only health and wellness educational network created specifically for American Indians and Alaska Natives—aims to inspire Native Americans to enter the nursing field.The cause that the video promotes is critically important for two reasons.First, the health of Native Americans continues to warrant attention, attention lacking in part because Native Americans are woefully underrepresented in nursing. A greater number of Native American nurses would mean a greater number of nurses focused on and closely attuned to individuals’ and communities’ needs. Second, and closely related: By incorporating the Native American “lifeways” and the social determinants of health into care, Native American nurses would be more likely to offer culturally appropriate care.Both of those reasons are even more important during a global crisis such as the Covid-19 pandemic. This virus is hitting Native Americans particularly hard and nurses, including Native Americans, are on the front lines caring for every patient.NANAINA is a member of the Campaign’s Equity, Diversity, and Inclusion Steering Committee, which advises the Campaign. With the video, NANAINA and the Campaign hope to encourage viewers to consider a career in nursing—whether it is a high school student thinking about next steps or an adult looking for a change. The goal is to inspire Native Americans to consider that career path to help build healthier communities and achieve health equity through a more diverse nursing workforce.The video started airing February 18 on GoodHealthTV, which reaches nearly 14 million people in 35 states each year. Its programming airs in more than 352 facilities serving American Indian and Alaska Native communities. These locations include Indian Health Service medical sites, urban health clinics, community buildings and centers, and tribal-owned and operated facilities.AARP Multicultural Leadership, an internal division at AARP, provided the Campaign for Action with the opportunity to produce the video with NANAINA and GoodHealth TV. Winifred Quinn, PhD, FAANP(H) and Scott Tanaka, MSW, led this project with assistance from Mary Boyle, MS; Jennifer Peed, MSW; and Aidan McCallion, MS
Budd Chiary Syndrome Poster, 2020.ppt
No full textI have contributed in the sonography department research poster preparation and led the students group responsible for Budd-Chiary Syndrome poster
Budd-Chiary Syndrome Paper.docx
No full textAbstractBudd-Chiari Syndrome is a pathology of the liver caused by obstruction of the hepatic veins. This disease is rare in the USA and more common in Asia, which is a good reason to misdiagnose and unable to provide adequate and timely treatment to such patients. Delay in making a diagnosis of such a disease might lead to complications and cost the life of the patient. In this paper, the definition, etiology, clinical manifestation, laboratory values, method of diagnosis, treatment and follow-up methods of the disease are included
Utilizing Program Champions and a Learning Management System for Accreditation: Innovative Strategies to Enhance Faculty Engagement
No full textBackground:Nursing program accreditation ensures quality nursing education and care to communities at large. The accreditation process is often stressful with limited faculty engagement. The purpose of this quality improvement project is to use innovative strategies to enhance faculty engagement in the accreditation process. These innovative approaches facilitate faculty development through the accreditation process by integrating work as part of the faculty role. Using active learning strategies enhances faculty engagement, provides faculty development, and encourages faculty to practice at their full-scope of the academic nurse educator role.Method:Utilizing Kotter\u27s 8-step process to accelerate change, a leadership team of faculty and administration formed to implement a new accreditation process. Kotter emphasizes the use of change agents. Therefore, each of the seven degree programs nominated a faculty-champion outside the existing leadership. Champions are change agents to bridge communication between faculty and the leadership team. The systematic process was conceptualized as a book with each accreditation standard written as a chapter. All faculty are enrolled in a learning management system course where each module contains the instructions, support, and assignments for each accreditation requirement. These modules will be combined to write our self-study book.Results:Data is being collected from the learning management system to track faculty engagement and identify gaps. At the end of the accreditation cycle, a survey and key informant interviews will be completed and analyzed to evaluate faculty engagement and faculty understanding of the accreditation standards alignment with program outcomes.Conclusion:Accreditation presents a sense of urgency and stress. Kotter\u27s change process is guiding our department through an innovative quality improvement project utilizing diverse new leaders as champions, with a goal of inspiring faculty engagement and creating a meaningful, sustainable process. This process could be replicated in other nursing programs to further the goals of accreditation
Learning Concepts of Quality Improvement and Safety in Nursing Using a Personal Quality Improvement Project
No full textLearning Concepts of Quality and Safety using a Personal Quality Improvement ProjectNurse educators need to be keenly aware of the ever-changing needs of the workforce, our communities and our accreditors. It is well known that nurses play a unique and critical role in improving healthcare quality and safety. The expectation for nursing leaders to have knowledge, skills and attributes associated with Quality and Safety in healthcare are clearly outlined in the American Academy of Colleges of Nurses (AACN) Masters Essentials (AACN, 2008) and in Progress to Date: Revision of The AACN Essentials (Case-Wirth, McCurren, McFadden and Higgins, February 1st 2020). In a recent quality cycle review of a graduate level curriculum a notable gap in quality and safety was identified. To address this gap, a course needed to be developed. Potential barriers to the development of this course included its necessary online format, a limited time frame (one semester) and needing to meet the expected student learner outcomes for a diverse set of programming. Resources used to develop the course were vast, however one source greatly influenced the final course. This source, a massive open online course (MOOC) offered by Case Western University in collaboration with Coursera titled Take the Lead on Healthcare Quality Improvement was taken by the author during spring/summer of 2017 (Dolansky, Moore and Singh, n.d.). The completion of a quality improvement proposal and/or project through this MOOC using a step wise process mirrored the project processes used in other courses within the graduate program and embraced the active learning strategies that resonate so well with students. However; the reality of the time limitations given the length of a semester required thinking about how this type of learning could be implemented in a shorter and more concentrated period of time without losing the depth or meaningfulness. Using Fink’s Backwards Design framework (2013), Quality and Safety for the Advanced Practice Nurse was developed using a project-based approach. Content was front loaded in the first half of the 15-week term and a 60 hour practicum occurred during the second half of the term. During the didactic front loading, students were engaged participated in the development of their “Personal Quality Improvement Project (PQIP)” using a six-step process. These formative assessments gave students the opportunity to use the knowledge, skills and tools acquired during the didactic content, and plan for implementation of their projects, their summative assessment, in the second half of the term during the practical application. Topics ranged from increasing activity levels, eating healthier, financial health to reduction of procrastination habits. Students used quality improvement tools identified in the didactic portion of the course to implement, track, evaluate and then present their outcomes. Informal feedback from students suggests that using this process to force student self-care was a novel way to both gain the skills necessary for implementing QI in practice and to provide students an opportunity to engage in self care that they had long been neglecting. Continued evaluation of the course using both formal and informal student feedback will provide opportunities to continue to improve this course. References: Case-Wirth, J.; McCurren, C.; McFadden, J. and Wiggins, M. (2020, February). Progress to Date: Revision of The AACN Essentials. Presentation presented at the American Association of Colleges of Nursing Doctoral Education Conference, Naples, Florida. https://www.aacnnursing.org/Portals/42/Downloads/Essentials/doc-conf-essentials-pp.pdfFink, D. (2013). Creating Significant Learning Experiences: An integrated approach to designing college courses. San Francisco, CA: Jossey-Bass. Dolansky, M., Moore, S. & Singh, M. (n.d.) Take the Lead on Healthcare Quality Improvement. [MOOC]. Coursera. https://www.coursera.org/learn/hcqualityimprovementOgrinc, G., Headrick, L., Moore, S., Barton, A., Dolansky, M., Madigosky, W. (2018). Fundamentals of Health Care Improvement: A Guide to Improving Your Patients’ Care (3rd ed.). Oakbrook Terrace, IL: Joint Commission Resources
C-Terminal Tail Polyglycylation and Polyglutamylation Alter Microtubule Mechanical Properties
No full textMicrotubules are biopolymers that perform diverse cellular functions. Microtubule behavior regulation occurs in part through post-translational modification of both the α- and β-subunits of tubulin. One class of modifications is the heterogeneous addition of glycine and/or glutamate residues to the disordered C-terminal tails (CTTs) of tubulin. Because of their prevalence in stable, high-stress cellular structures such as cilia, we sought to determine if these modifications alter microtubules’ intrinsic stiffness. Here, we describe the purification and characterization of differentially modified pools of tubulin from Tetrahymena thermophila. We found that post-translational modifications do affect microtubule stiffness but do not affect the number of protofilaments incorporated into microtubules. We measured the spin dynamics of nuclei in the CTT backbone by NMR spectroscopy to explore the mechanism of this change. Our results show that the α-tubulin CTT does not protrude out from the microtubule surface, as is commonly depicted in models, but instead interacts with the dimer’s surface. This suggests that the interactions of the α-tubulin CTT with the tubulin body contributes to the stiffness of the assembled microtubule, thus providing insight into the mechanism by which polyglycylation and polyglutamylation can alter microtubule mechanical properties