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Telemetry Nurses Knowledge of Alarm Fatigue and Interventions for Change: An Education Program Development
Get PDFAlarm fatigue is known to be one of the top safety concerns in the healthcare setting. The Joint Commission recognized Alarm safety as one of the 2017 National Patient Safety Goals. Alarm fatigue occurs when a healthcare worker becomes overwhelmed and often desensitized to patient monitor alarms. It has been established that interventions including ECG daily electrode and battery changes, skin prep for electrode placement, and adjusting alarm parameters to fit patient needs can lead to a reduction in false or nuisance alarms. In order for these interventions to be carried out successfully, education of nurses regarding alarm fatigue and interventions for change needs to be completed. Education is one of the most important phases of creating change. The purpose of this program development project was to determine the effectiveness of an educational program on alarm fatigue awareness for telemetry unit nurses. A program development project was developed utilizing a pre-test, educational intervention, and a post-test design. Tests were used to evaluate the nurses’ knowledge improvement related to the educational intervention. Sixteen out of a possible 60 telemetry nurses completed the pretest portion of this quality improvement project. (N=16, 26.6%). Fourteen of a possible 60 nurses attended the educational session and completed the post-test portion of this quality improvement project. (N=14, 23%). For the purpose of presenting the first four questions, only those tests with matching pre-and-post responses were utilized, (N=14). The mean scores from pre-tests were 51.2% and mean post-test scores were 92% which revealed an increase by 40.8% after an educational intervention. The APRN can assist in establishing and implementing an educational program. This educational program can help to implement interventions and provide evidenced based research to support the prevention of alarm fatigue
The Cookbook of Eduardo da Graça
Get PDFHandwritten cookbook by Eduardo da Graça, who emigrated from Cape Verde to the United States in 1925. He worked as a chef at the Minden Hotel in Providence, Rhode Island where he kept this notebook of favorite recipes
Rhode Island State House (Francis and Gaspee Street)
No full textWork on the Rhode Island State House began in 1892, the design being awarded to McKim, Mead & White, whose design won a competition, in which several different designs for the new state capitol were contenders. Prior to the completion of the present day State House, Rhode Island used a rotation system in which the governor and legislature would move between different state houses, at one time including as many as five. By the later half of the 19th century, only the Old Providence and the Newport State House\u27s were employed in this system. This view, taken from the Francis and Gaspee Street perspective, clearly presents McKim, & Mead & Whites American Renaissance design, which incorporated Renaissance and Classical design elements in rejection of Victorian era designs, which McKim felt were gaudy and whose ornamentation he felt was idiosyncratic.https://digitalcommons.ric.edu/ri_architecture/1008/thumbnail.jp
The Gospel of Pseudo-Matthew, the Rule of the Master, and the Rule of Benedict
Get PDFThe reliance of the apocryphal Gospel of Pseudo-Matthew on the Rule of Benedict has been long acknowledged. The most significant scene to demonstrate intertextuality between the Rule of Benedict and Pseudo-Matthew is chapter 6, which depicts Mary\u27s ascetic life in a community of virgins. This scene adds much that is not in the main source, the Greek Protevangelium of James, based on the Benedictine life of work and prayer. Recent work on the sources of the apocryphal gospel, however, gives rise to questions about the sources involved in Pseudo-Matthew, especially opening up the possibility that the author of the apocryphon looked to multiple texts for various expansions. This article suggests that the author also relied on the Rule of the Master. Thus, the case of the Rule of the Master, Rule of Benedict, and Pseudo-Matthew is one of complex intertextuality with implications for how the text relates to monasticism
Smartphone Apps in Anesthesia: The Next Generation
Get PDFThe number of smartphones in use around the world is increasing daily, as are the apps that are available. Apps are being designed to aid in many aspects of health care practice, including anesthesia, to augment care of patients. The purpose of this study was to ascertain whether student registered nurse anesthetist (SRNAs) enrolled in Rhode Island College School of Nursing/ St. Joseph Hospital School of Nurse Anesthesia program were using smartphones routinely in their practice, if they were using anesthesia-specific smartphone applications (apps), and if so, what types of apps they were using. Rogers’ Diffusion of Innovations (2003) was the theoretical framework that guided this non-experimental quantitative descriptive study. Following review by the Rhode Island College IRB, 12 participants completed a survey developed by the researcher. Of the respondents, 100% reported using apps to assist in clinical practice, seven participants reported using drug specific apps more than seven times a week, and nine participants reported using apps for case specific information more than seven times a week. The decision to include anesthesia apps as part of a SRNAs clinical practice is one that each clinician must make based on knowledge, experience, and evidence-based care. However, further research is needed to understand the role of smartphone apps in anesthesia care by SRNAs and CRNAs
Dexmedetomidine and Postoperative Delirium in the Adult Cardiac Surgical Population: A Systematic Review
Get PDFPostoperative delirium (POD) is a major complication following surgery and is considered the most common complication among older adults following cardiac surgery; with up to 87% of patients being affected (Whitlock, Vannucci, & Avidan, 2011). Dexmedetomidine, a highly selective α2 agonist, inhibits the release of norepinephrine presynaptically causing analgesia and inhibits central nervous system stimulation in the postsynaptic neurons causing decreased blood pressure and heart rate; together, contributing to the effects of analgesia, anesthesia, and sedation (Naaz & Ozair, 2014). The purpose of this systematic review was to analyze the current literature and examine the effects of dexmedetomidine on POD in the adult cardiac surgical population. A comprehensive literature review was completed using CINAHL, PubMed, and Medline focusing on the pathology of postoperative delirium, the physiology of cardiac surgery, and the pharmacodynamics of dexmedetomidine. Guidelines set forth by PRISMA and Inouye and Charpentier’s multifactorial model were utilized to assist in the identification of eligible studies. Study analysis was completed by creating study specific and data outcome tables. Critical appraisal of individual RCTs was performed utilizing the Critical Appraisal Skills Programme (CASP) checklist. A cross study analysis table was also created comparing the results of all eligible studies against one another. The findings of this systematic review determined that in the adult cardiac surgical population, dexmedetomidine was associated with a decreased incidence of POD; however, the results for time to extubation, ICU LOS (length of stay), and hospital LOS varied amid the studies examined
Increasing the Knowledge of Critical Care Nursing Staff Related to Sepsis: A Program Development Project
Get PDFSepsis can lead the body into organ failure, tissue damage, amputations, and in severe cases, even death. Yale New Haven Health-Westerly Hospital has several new RN’s that are at a novice level of knowledge about how to treat and care for the septic patient. Knowledge of the signs and symptoms of sepsis can lead to a quicker diagnosis and improve patient outcomes. The purpose of this program development project was to improve the knowledge of sepsis identification and treatment by providing education to the critical care nursing staff at Yale Westerly Hospital.
A non-probability convenience sampling plan was utilized. Fifteen nurses out of a potential twenty nurses completed the pre-test and post-test component. Each participant’s test score from the pre-test in comparison to the post-test improved after the education component of the project was implemented. Pre-test scores encompassing the entire exam, ranged from 35% to 60% and post-testing scores ranged from 65% to 85%. The mean score of the pre-test was 52% and the mean score of the post-test was 78.6%. The mean scores from the pre-test compared to the post-test improved by 26.6%. More experience in the critical care setting did influence the average test scores in both the pre and post-test. APRN’s are in a unique position to enable educational programs and assess educational needs of a certain department. The APRN can deliver education not only for the novice nurses, but for all nurses throughout the experience spectrum
A Pilot Study of Airborne Hazards and Other Toxic Exposures in Iraq War Veterans
Get PDFDuring their deployment to Iraq in support of Operation Iraqi Freedom (OIF) , many Veterans were exposed to a wide array of toxic substances and psychologic stressors, most notably airborne/ environmental pollutants from open burn pits. Service members do not deploy whilst unhealthy, but often they return with a multitude of acute and chronic symptoms, some of which only begin to manifest years after their deployment. Our findings, while preliminary in nature, suggest that Iraq War Veterans who participated in our survey reported a decrease in overall physical fitness and increased respiratory clinical symptoms compared with pre-deployment periods. The objective of this report is to provide information that will benefit how combat Veterans are cared for post-deployment. Strategies for a wider and more comprehensive assessment and medical screening process post-deployment are recommended
Mirrors of Ourselves: The Spector and Its Reflections
Get PDFThis project is the result of one semester of studying the uses of the ghost as a literary device and one semester applying those uses. The first work is an exercise in terror, the next two are short ghost stories.
The Gray Mile was initially published in Waxing & Waning: A Literary Journal
Effects of Workplace Violence on Nurses Working in the Emergency Department
Get PDFWorkplace violence has been a trending topic of discussion across the country and is a concern for employees nationwide. The Emergency Department has been consistently documented as one area where workplace violence is most prevalent and presents a greater risk for occupational hazard. The escalating acts of violence toward emergency department nurses across the country have drastically increased and nurses have become targets of verbal and emotional abuse, subjected to threatening behavior, and have become victims of physical assaults. The purpose of this project was to identify the effects of workplace violence on nurses working in the Emergency Department. A quantitative descriptive study using modified Emergency Nurses Association (ENA) Workplace Violence staff assessment survey was used to identify emergency department nurses’ experiences with workplace violence. The mixed method design included a descriptive survey as well as series of open-ended questions to elicit personal accounts of violence in the workplace. A total of 36 nurses in the Emergency Department at Newport Hospital, a 129 bed community hospital in Newport, RI were surveyed. The results of the survey identified 95.45% (n=21) of nurses have experience some form of workplace violence. Physical violence such as being hit, punched, slapped, kicked, pinched, pushed, shoved, and scratched was experienced by at least half of nurses. Additionally, documented effects of workplace violence on staff members included burnout, low department morale, physical and emotional distress, and contributed to overall job dissatisfaction. The study identified workplace violence as an issue and recognizes the effects of violence on staff members is of significant concern that should be addressed with leadership support to recognize and decrease workplace violence in the ED