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Providing Education to Improve Rapid Response Knowledge and Comfort of Nursing Staff
No full textBackground: Rapid response systems (RRS) were designed to provide early intervention for deteriorating patients, preventing cardiac arrest through timely assessment and interventions with the support of a rapid response team. It is recommended that non-ICU nursing staff receive focused education to improve their knowledge and comfort levels relating to RRS. Purpose: This quality improvement project aimed to increase medical-surgical nurses’ knowledge and comfort levels with the rapid response process through an education intervention. Methods: Medical-surgical nurses received education on the rapid response process, focusing on signs of clinical deterioration, the activation process and indications, primary nurse responsibilities, and communication techniques. A follow-up retrospective post-pre survey was conducted to evaluate improvements in comfort and knowledge related to the rapid response process. Results: Survey results showed statistically significant improvements in comfort and knowledge levels with p-values <0.05 for each self-rated question. True or false questions provided objective data that identified areas for improvement for future education. Hands-on education was identified as a future opportunity to enhance knowledge and comfort levels further. Conclusions: This quality improvement project implemented formal education on the rapid response process in a medical-surgical unit and found an improvement in nurses’ knowledge and comfort levels regarding the process. Some results indicated a need for further education on specific topics. Simulation-based education would likely be beneficial for future education
Proactive Prescribing Enhancing Hospice Care Through Anticipatory Pharmacy Practices
No full textPurpose: This project aims to reduce avoidable hospitalizations, alleviate caregiver stress, improve patient comfort during the end-of-life phase through assessing RN case manager confidence in educating families about anticipatory medications and rolling out the educational pamphlet as a teaching tool. Background: Hospice care prioritizes comfort and quality of life for individuals with terminal illnesses. However, inadequate symptom management, caregiver burden, and frequent hospitalizations remain persistent barriers to effective hospice delivery (Virdun et al., 2015; O’Hara et al., 2010). Delays in medication access often lead to distress, emergency interventions, and unplanned hospitalizations, which undermine the goals of hospice care. Anticipatory prescribing, a proactive approach that ensures symptom management medications are available at the start of care, has been associated with improved comfort and reduced crisis events (Au, Baker, & Hindmarsh, 2022; Charlesworth, 2020). Methods: The project was conducted at a local hospice in Tucson, Arizona. A multidisciplinary team reviewed current prescribing practices and developed an anticipatory pharmacy protocol that included a standard set of medications for common end-of-life symptoms such as pain, dyspnea, agitation, and nausea. Educational sessions were conducted for hospice staff and caregivers to support medication administration. Data on symptom control, hospitalization rates, and RN case manager comfort with anticipatory prescribing and caregiver education were collected and compared pre- and post-implementation. RN comfort was assessed using a structured survey tool designed to measure confidence in initiating and educating on comfort medications. Results: Seven hospice nurses completed pre- and post-intervention confidence surveys, with average confidence scores increasing from 1–2 (not at all/slightly confident) to 4–5 (confident/very confident), representing an approximate 70% improvement across all domains. Among 20 patients who received the standardized education pamphlet, 12 (60%) effectively utilized comfort medications, and none required hospitalization for uncontrolled symptoms within 30 days. In comparison, the retrospective control group (n=20) experienced 4 hospitalizations (20%), including 2 related to uncontrolled pain despite medication availability. Pharmacy costs decreased to 3.3% of direct costs, the lowest in six months, accompanied by fewer on-call visits and improved home symptom control. Conclusions: Integrating anticipatory prescribing into hospice admission protocols may significantly enhance the quality of end-of-life care. While the upfront cost of early medication delivery may increase, it is outweighed by reductions in crisis interventions and hospital-related expenditures. These findings support the need for broader adoption of anticipatory pharmacy practices across hospice settings to promote patient-centered, cost-effective care
Enhancing Pediatric Nurses' Competence in Infant Care and Parental Guidance Through Educational Interventions
No full textBackground: Inpatient pediatric nurses often receive limited formal education on pediatric health promotion, as undergraduate curricula prioritize adult/geriatric content, and continuing education emphasizes acute care management. These gaps leave nurses underprepared to deliver developmentally appropriate guidance to parents, despite the importance of bedside education in improving pediatric outcomes. At Tucson Medical Center (TMC), the combined pediatric/pediatric intensive care unit (PICU) experienced high nurse turnover in 2024-2025, with most new hires during that time being recent graduates or transfers from adult care. Stakeholder feedback highlighted gaps in foundational knowledge and hesitancy in providing parent education, particularly for infants. Purpose: The purpose of this quality improvement project was to evaluate whether a structured, evidence-based educational session on newborn and infant care could enhance inpatient pediatric nurses’ self-perceived competence in infant health promotion and increase their intent to integrate education into bedside practice. Methods: A 55-minute educational session, titled “Diapers, Diet, and Development: Infant Care 101,” was delivered to nursing and support staff. Pre- and post-intervention surveys measured nurses’ self-perceived competency, knowledge, willingness to provide bedside education, perceived relevance of the content, and intent to implement the content in their practice. Quantitative data were analyzed with descriptive statistics and measures of central tendency, while qualitative data were reviewed for thematic insights. Results: 18 pre-survey answers and 11 post-survey answers were analyzed (n=11). Nurses demonstrated a 26% improvement in their self-perceived competency in infant care topics after the intervention. Most participants (91%) rated the content as highly relevant, and all expressed intent to apply the information in practice. Qualitative feedback highlighted the value of nonacute pediatric education and identified future topics of interest, including guidance on breastfeeding, pain management, and vaccine education. Conclusion: This intervention enhanced nurses’ self-perceived competence and motivation to provide health promotion education at the bedside. Findings support the incorporation of pediatric health promotion into unit-based continuing education and onboarding, with future research needed on the long-term impact, broader implementation, and parent perspectives
Active Classrooms, Focused Minds: Empowering School Staff to Support ADHD Through Movement
No full textAttention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that negatively impacts children’s behavior, executive function, and academic outcomes. Children in Title 1 schools, who often face compounded barriers such as physical inactivity and limited behavioral health support, are particularly vulnerable. Evidence supports physical activity as an effective non-pharmacologic strategy to improve attention, behavior, and executive functioning in children with ADHD. However, school staff frequently lack training and confidence in implementing these strategies. This quality improvement project aimed to enhance the knowledge and confidence of elementary school teachers in using movement-based interventions to support students with ADHD. Guided by the Iowa Model of Evidence-Based Practice, the project involves an educational session for school staff at Eagle Ridge Elementary School in Maricopa County, Arizona. Pre- and post-surveys were utilized to assess changes in teacher knowledge and confidence regarding the use of physical activity for ADHD symptom management. Data were analyzed using descriptive statistics and paired t-tests to evaluate the intervention’s effectiveness. Results were expected to demonstrate improvements in staff preparedness and willingness to integrate movement strategies into classroom routines. The long-term goal of this project was to reduce classroom disruptions, improve student engagement, and support educational equity for underserved children with ADHD. Findings will inform future efforts to scale physical activity interventions in school environments as part of a holistic, prevention-oriented approach to ADHD management in primary care
Early Literacy Promotion: Increasing Parental Reading Frequency To Improve Developmental Outcomes
No full textBackground: Early childhood communication and language literacy are crucial aspects of children's communication development. Children who are read to regularly from a young age are more likely to meet their developmental milestones. Despite this, many parents do not read to their children frequently enough. Purpose: The purpose of this DNP quality improvement (QI) project was to increase the number of days parents are reading per week to their children aged two weeks to two years to improve communication development in children, as well as improve parent attitudes towards reading with their children. The results were intended to improve outcomes at Maricopa County Nurse Family Partnership only, with no intent to apply the findings more broadly. Methods: During home visits with Maricopa County Nurse Family Partnership nurses, parents with children aged 2 weeks to 2 years will be provided with an educational activity and an age-appropriate book. They will then complete a post/pretest that will evaluate shared reading frequency before the intervention and intended shared reading frequency, parent confidence, perceived benefit of educational activity, and knowledge regarding shared reading with their child. Results: Twenty-six of thirty-three parents, or 79%, participated in this quality improvement project. Data analysis identified a statistically significant improvement in shared reading frequency per week. Additionally, data support increased parents’ confidence and knowledge regarding shared reading with their child. Conclusions: The educational intervention improved shared reading time and increased parent confidence and knowledge regarding shared reading with their child
Dietary Counseling in Primary Care: A Tool for Cardiac-Focused Mediterranean Diet Education
No full textBackground: Cardiovascular disease (CVD) is the leading cause of death in the United States (US). The Mediterranean diet has been studied and shown to significantly improve cardiovascular outcomes. Providing dietary education, including the Mediterranean diet, in primary care is recommended by the American Heart Association (AHA) and U.S. Preventative Services Task Force (USPSTF) for patients with cardiovascular disease. However, primary care providers may lack the tools to provide effective dietary education. Purpose: The purpose of this project was to develop and implement an evidence-based patient handout to support providers in educating patients with CVD about the Mediterranean diet. Methods: This project was implemented at a primary care clinic in Bountiful, Utah. Participating providers received education on the Mediterranean diet and an accompanying patient handout to use during clinic visits. Providers completed pre- and post-education surveys assessing their confidence in providing dietary counseling. Survey results were analyzed to assess changes in provider confidence following the intervention. Results: Six providers participated. Average confidence scores increased across all survey domains, including educating patients on the Mediterranean diet (3.33 to 4.83), answering patient questions (4.00 to 5.00), tailoring education for CVD (3.83 to 4.83), and providing specific diet examples (3.33 to 5.00). Conclusions: A brief provider education session and patient handout improved provider confidence in delivering Mediterranean diet counseling in primary care. Integrating simple, evidence-based tools may help bridge gaps in dietary education for patients with cardiovascular disease
Editorial Foreword
No full textEditorial ForewordThis material published in Arizona Journal of International and Comparative Law is made available by the James E. Rogers College of Law, the Daniel F. Cracchiolo Law Library, and the University of Arizona Libraries. If you have questions, please contact the AJICL Editorial Board at http://arizonajournal.org/contact-us/
Trapped in Transit: Understanding public transport performance and user experience in La Molina
No full textSustainable Built Environments Senior Capstone ProjectThis study examines how the Corredor Rojo bus service operates along Av. Javier Prado Este in La Molina can prevent long commute times by integrating user perception with lessons learned from regional public bus transportation systems. La Molina’s mobility problem is caused by its dependence on a single public transport exit route, which concentrates demand, creating delays for residents who rely on this transportation mode. Previous research on transit efficiency highlights the importance of dedicated bus infrastructure and system management that prioritize and incentivize the use of public transport; however, these elements remain limited in the current infrastructure assigned to the Corredor Rojo service, the only formal bus service in the district. Addressing this gap is essential as commuting time not only affects the efficiency of travel but affects the social equity of users who cannot transition to private transport options. Using a mix-method approach, the study combines a document review of successful medium-scale bus systems in Bogota and Chile, surveys of frequent Corredor Rojo users in La Molina, and on-site observations along Av. Javier Prado Este key node in the mentioned district. Findings indicate that overall travel time irregularities and user dissatisfaction are caused by the absence of exclusive bus lanes, insufficient enforcement of policies that prohibit invasion of private vehicles into these bus lanes, and the inadequacy of the current management system. The surveys support this as the majority of respondents indicated that their travel times were longer than expected. By comparing the existing challenges in the district with successful examples of regional bus systems, this research provides practices and strategies to improve the operation of the Corredor Rojo, such as implementing continuous exclusive lanes, strengthening enforcement mechanisms, and improving system management could significantly reduce commute times and improve equity within La Molina’s urban mobility.This item is part of the Sustainable Built Environments collection. For more information, contact http://sbe.arizona.edu
DESIGN FOR EXISTENCE OR FOR DEVELOPMENT? A CRITIQUE OF URBAN INTERVENTION AT THE QUEBRADA VERDE TOWN CENTER
No full textSustainable Built Environments Senior Capstone ProjectIn the town of Quebrada Verde, urban intervention initiatives are not aligned with the magnitude of the socio-environmental problems facing this community. The infrastructure gap and the focus of municipal proposals may not currently be focused on advancing the community by providing efficient urban infrastructure for a populated center with a vulnerable ecosystem next to it, such as Lomas de Lucumo, one of the green lungs of the capital city of Lima in Peru.
This research establishes the guidelines for the growth of Quebrada Verde in relation to a landscape with the fragile ecosystem of Lomas de Lucumo for its conservation. This study focuses on the critique of urban improvements implemented to enhance Quebrada Verde and identifies the barriers that could be preventing better urban quality in the area.
Through document analysis, direct observation of the site, collection of complementary documents, and interviews with specialists in this context, it is confirmed that the measures taken by the municipality towards the population aim to remain educational and even symbolic. However, the scale of the needs, together with spatial development, suggest proposals that respond directly in the urban environment, not only for the benefit of the community but also for the ecosystem in which they coexist.
This study concludes that a dignified and permanent intervention proposal could be more effective when there is collaborative work with the community. Design strategies and examples that can be replicated in the urban context are proposed to generate resilience and activate public spaces for community interaction.This item is part of the Sustainable Built Environments collection. For more information, contact http://sbe.arizona.edu
A DIGITAL PRONUNCIATION GUIDE FOR SINGERS: Selected Turkish Art Songs by Ahmet Adnan Saygun and Turgay Erdener
No full textTurkish vocal repertoire still lacks sufficient linguistic and musical resources compared to the well-established traditions of European art song in languages such as German, French, and Italian. This creative project addresses this gap by developing a digital guide designed specifically for non-native Turkish-speaking performers, educators, and students. Through a combination of research, performance, and resource-building, this project investigates selected art songs by two significant Turkish composers: Turgay Erdener (b. 1957), a living contemporary Turkish composer, and Ahmed Adnan Saygun (1907–1991), a prominent figure of integrating Western compositional techniques with Turkish musical heritage.The outcome of this project is a website that provides International Phonetic Alphabet (IPA) transcriptions, word-for-word English translations, audio recordings, poetic translations, performance recordings, interpretive suggestions, and contextual information on both the works and their composers. In addition to digital access, a Turkish IPA guidance document, prepared specifically for this project, will be available for future studies. These efforts will substantiate the rightful place of Turkish vocal works alongside other national traditions within the canon of Art Song and perpetuate performances and study for educators and performers around the world