7277 research outputs found
Sort by
A Quality Improvement Project to Improve Emergency Room Nurses\u27 Identification of Sepsis
No full textBackground: In the United States, there are approximately 1.7 million new cases of sepsis diagnosed every year accounting for approximately 270,000 deaths. Multiple screening tools exist to identify patients at risk for sepsis, with SIRS best serving the emergency room setting. Delays in treatment are associated with increased severity of illness in patients with sepsis. The emergency room serves as the first line in the prompt identification and treatment of patients with sepsis.
Purpose/Specific Aims: The purpose of this project was to increase early identification of sepsis by emergency nurses through an educational intervention focusing on improving general knowledge of sepsis and the application of a validated sepsis screening tool.
Methods: A pretest, educational intervention and posttest design was implemented with a retrospective analysis of pretest and posttest data.
Results: A total of 35 emergency nurses participated in this project. Results showed statistically significant increases in objective knowledge evaluation, self-reported confidence and knowledge regarding sepsis and guidelines. There was also a reported intention to utilize sepsis screening earlier in patient encounters from pretest to posttest.
Conclusion: Results from this project demonstrate increasing knowledge and confidence was effective in motivating emergency nurses to report a change to their future practice. Future research could include a chart review to evaluate how intention to change translates into practical changes. Less experienced nurses (less than 3 years of experience) showed the most improved performance in knowledge-based evaluations from pretest to posttest. Specialized education modules can serve as valuable tools to close the experience gap in some advanced specialties of nursing
Are Medical Support Staff Provided with Sufficient Diversity, Equity, and Inclusion Training?
Get PDFPurpose: This study was conducted to determine the need for workforce development and training of diversity, culture, and inclusion in small healthcare offices in Rhode Island. Method: This study utilized phone interviews from participants in twenty-one primary and specialty care offices throughout Rhode Island. Results: Findings suggested the need for more workforce development and training of DEI within small offices. More education is needed to understand and define the meaning of diversity, culture, and inclusion in these smaller primary care and specialty care settings. Conclusions: A repeat study should be conducted to allow for additional data collection. The geographical and hidden biases that surfaced in this research study should be taken into consideration when gathering date for future studies
Legacy Effects of Forest Clearcutting on Ecosystem Function and Biogeochemical Cycling in a New England Forest
Get PDFTerrestrial soils comprise the largest reservoirs of carbon (C) in the biosphere holding some 2500 Gt C, which is 4x the amount found in plant biomass and 3x the C content of the atmospheric pool. Approximately 1500 Gt of soil C is in an organic form, thus making it available to mineralization by heterotrophic organisms [10]. Changes to the drivers of mineralization such as climate change and aeration due to anthropogenic land use, such as logging, have the potential to strongly affect global carbon and associated nutrient cycles, plant production, and atmospheric composition. With the aim of better understanding the potential long-term implications of forest logging on ecosystem function and soil biogeochemistry we conducted a range of measurements in the field and laboratory to elucidate patterns along a 20-year old clearcut and adjacent 100+ year old forest stand located in two experimental large gaps in Yale Myers Forest, Eastford, CT. A decrease in organic matter and reduced soil biotic activity in the experimental large gaps when compared to the 100+ year old forest due to the potential changes in edaphic conditions and biodiversity associated with disturbance is expected. Leaf litter samples collected from the study sites Kozy Road and Tree Heaven underwent elemental analysis to measure the change in litter carbon and nitrogen throughout the experiment. Soil samples were collected at each litterbag collection throughout the sampling period to provide a surface and subsurface snapshot of the biology at that time in each transect. Soil samples were analyzed for four ecoenzymes that play a pivotal role in carbon and nutrient cycling in soil, B-glucosidase (BG), Acid Phosphatase (AP), Nacetylglucosaminidase (NAG), and Xylosidase (XYLO). Results found an overall increase in average C and N percentages in both Kozy Road and Tree Heaven over the course of this study, which may indicate mineralization and immobilization is occurring and resulting in an accumulation of soil organic matter. The highest EEA values were found for BG and AP. This result may be explained by the fact that BG hydrolyzes cellulose. Acid Phosphatase works upon organic phosphorus and converts it into its inorganic form, an essential nutrient for all life. Labile organic material and organic phosphorus were the primary targets of the ecoenzymes analyzed in this study. In the coming months, we plan to continue to measure and collect data from samples collected beyond the nine month cutoff for this study extending data collection to 12 and 18 months in order to conduct more intensive hypothesis testing and multivariate statistics
Self-Confidence of Public Health Nurses in Cultural Competency During Infectious Disease Investigation
Get PDFInfectious disease (ID) investigation is a core function of local, state, and federal public authorities across the United States. Public health nurses (PHN) are charged with investigating a wide array of infectious diseases, with tuberculosis (TB) being one of the most resource heavy. Strong relationships between healthcare providers and nurses with their patients are crucial for the success of the individual and of the public’s health. As occurred with the COVID-19 pandemic, ID investigation without the participation of the individual affected makes controlling the spread of disease far more challenging. Adherence to treatment for IDs of public health concern, such as TB, is even more critical with the emergence of increasing antibiotic resistance. As the pace of globalization continues upwards there are an increasing number of interactions between healthcare providers, specifically nurses, and patients from vastly different cultural backgrounds. A quality improvement project will be implemented to assess the effect of public health nurse cultural competence training on nurses’ perceptions and confidence in employing training concepts in the course of infectious disease investigation
Program Planning: Bridging End-of-Life Care for Unhoused Individuals with Mental Illness
Get PDFBackground: Unhoused individuals who struggle with Severe and Persistent Mental Illness (SPMI) and/or substance use disorder (SUD) often have inadequate End of Life (EOL) care compared with those who have stable housing. Purpose/Specific Aims: This Program Development Project aims to develop a comprehensive strategy to provide compassionate end-of-life care and medical respite services for vulnerable populations, including the unhoused, mentally ill, incarcerated, and medically fragile individuals.
Methods: The plan will include assessment of the infrastructure needed to ensure that the unhoused have equitable access to care, comparable to that of individuals with stable housing. This will involve budget projections for purchasing a building capable of housing 12 individuals and obtaining the necessary funding for utilities, staff, medical supplies, furnishings, and equipment needed to run the program effectively.
Results: The following goals are proposed: a 25% referral rate to the program within the first 3 months, a 50% referral rate within the first 6 months, and a 75% referral rate within the first 12 months. Patients receiving services will have a hospitalization rate less than 5%, and patients who are receiving services will report 80% improved health outcomes.
Conclusion: According to the literature, unhoused individuals who receive EOL care services have improved health outcomes, highlighting the need for a dedicated infrastructure to provide end-of-life care to this population. Such infrastructure would offer housing for unhoused individuals during their end-of-life phase
Implementation of a Culturally Tailored Educational Intervention for Hispanic Individuals Living with Type 2 Diabetes
Get PDFDiabetes is one of the leading causes of morbidity and mortality in the United States (Trout & et al., 2019). The prevalence of diabetes in the Hispanic community is higher compared to other racial groups (Philis-Tsimikas & et al., 2022). It is critical to address the diabetes disparities within our communities and provide Hispanics who have diabetes with the adequate education and health care needed.
According to the Centers for Disease Control (CDC), many innovative programs and interventions have proven to be effective in the treatment of type 2 diabetes in Latinos and in other minority groups. These innovative, culturally tailored interventional programs which consist of educational sessions that include lectures using telenovelas or small video clips, activities such as cooking healthy ethnic food and exercises such as dancing to ethnic music, group walks, or yoga exercises in their native language have proven to be effective and motivating for the Hispanic population.
This project will investigate the barriers, cost, knowledge deficits, and interventions targeted to the Hispanic community. Also, this educational project will use evidence-based research to address diabetes educational deficits in the Hispanic community with the goals of lowering the risk of diabetes and improving the quality of life for Latinos who have diabetes using culturally tailored techniques. This project will consist of one session of 45 minutes duration for about 5 weeks teaching Hispanics who are at risk of having type 2 diabetes or have diabetes about how to prevent it and manage their disease
The Effects of a Plant-Based Diet on Adult Cholesterol Levels: To Better Understand Root Causes of Cardiovascular Disease A Systematic Review
Get PDFCardiovascular disease is a global health care burden causing morbidity, mortality, and financial burdens on our health care systems. Cardiovascular disease (CVD) is comprised of coronary artery disease, cerebrovascular disease, and peripheral vascular disease. Cardiovascular Disease is the primary cause of death for both men and woman in the United States. Literature has revealed that low density cholesterol (LDL-C) is one of the primary drivers of coronary artery disease. The purpose of this systematic review is to look at plant-based diets\u27 effects on cholesterol levels. In the hope that if we can understand dietary patterns that reduce cholesterol levels we can educate and mitigate the detrimental effects of coronary artery disease. The findings of this study showed significant results showing associations between plant-based diets and lowering outcomes like LDL-C levels in patients, thus in theory reducing risks for cardiovascular disease
Enteral Feeding in Critically Ill Adults: An Evidenced Based Practice Update
Get PDFFor many patients admitted to the Intensive Care Unit (ICU) nutritional support via an enteral feeding tube will be required at some point during their stay. Extensive research has been conducted on the topic of enteral nutrition and best practices for monitoring and delivery of enteral nutrition have continued to evolve. The purpose of this quality improvement project is to identify best practices for monitoring of enteral nutritional intolerance and increase the percentage of targeted nutrition received by patients. Following a review of the literature an Evidenced Based Practice Update was developed for bedside ICU nurses incorporating key recommendations. The distribution of the update will take place after collection of data on the percentage of targeted enteral nutrition delivered to patients for one month then compared to data collected for one month after distribution of the EBP Update. Education sessions will be held on the unit where the update will be reviewed along with conducting a pre- and post-test on the content in the EBP Update. Both the pre/post-test and target nutrition data will be analyzed using t-tests to measure the impact of the intervention. The desired outcome for this project will be an increased percentage of target nutrition delivered to patients and to increase adherence to the practices identified in the update
Effects of Breastfeeding Support Approach on Breastfeeding Decisions: A Quality Improvement Project
Get PDFThis project aims to address the clinical question of how the type of initial breastfeeding support or education provided by a lactation consultant impacts on the breastfeeding decisions and on the feeling of empowerment regarding her feeding decisions of a new mother. A training class for a cohort of International Board Certified Lactation Consultants (IBCLCs) to teach them how to use motivational interviewing and Swanson\u27s Theory of Caring to guide their lactation education was proposed to address this question. The mothers the IBCLCs work with will be surveyed both before and again after the training to evaluate if changing the approach they take makes mothers feel more empowered, and to measure how it influences their breastfeeding decision and satisfaction.
The anecdotal evidence that lactation consultants are becoming more rigid in the care they give, often directing mothers that exclusive breastfeeding should occur in all situations is concerning. The question, \u27Would a more individualized approach that allows for some amount of combination feeding be more beneficial and effective and extend the time of breastfeeding?\u27 is explored in an attempt to provide more a more patient centered approach and to improve breastfeeding outcomes
How Gender Shapes Anger and Aggression
Get PDFDisordered anger has been associated with a range of threats to individual and public health including increased risk of physical and mental health problems as well as aggressive and violent behavior. Previous research has established relationships between anger, anger expression, and gender. Differences in anger expression may be partially attributed to variation in multiple aspects of gender. Existing literature has been reliant on limited gender identity measures and primarily focused on the role of masculinity as a predictor of aggression and violence. The current study aims to address this gap by using continuous gender items to categorize participants into multifaceted profiles of gender (Archetypical Men, Archetypical Women, Intertypical Men, Intertypical Women, and Nonconforming) that are characterized by specific gender identity, expression, and perception scores. The current study explores the relationship between anger and anger expression within and between these gender profiles. An online survey administered a continuous measure of sex and gender along with valid measures of anger and aggression to 152 adult participants. As predicted, results indicated that anger scores were positively associated with anger expression scores. The relationship between anger parameters and anger expression did differ between gender groups, although most comparisons fell short of statistical significance. Unexpectedly, Intertypical Women emerged as the group with the highest anger and anger expression scores. Implications, interpretations, and methodological topics are discussed