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Increasing Nurses\u27 Knowledge and Confidence Using the Teach-back Method to Teach Fall Prevention Strategies to Residents in Long Term Care
Get PDFFall prevention in health care settings, either acute care or long-term care, has been identified as an area of focus for quality improvement. The Joint Commission and the Centers for Medicare and Medicaid have developed goals and recommendations for all areas of health care to follow to decrease falls and improve patient and resident quality of life. Direct care nurses are relied upon to provide the education and to assist in preventing falls, but often do not measure the retention of the information provided. The purpose of this quality improvement project was to provide education on the teach-back method to nurses working in a small, family owned long-term care facility. Benner’s skills acquisition theory and Kellogg’s Logic Model were used as the theoretical framework for developing the project and education. The aim was to increase knowledge and confidence using the teach-back method. An educational program was developed to provide education to the nurses. The education was followed by the opportunity to practice using the teach-back method in a role-playing scenario. Pre and post education tests were provided to determine if the education increased the nurses’ knowledge of the method. Thirty-three percent (N=10) of the nurses employed at the facility participated. Prior to the education, 40% (n=4) of the participants felt the teach-back method was not a practical method for teaching fall prevention strategies to the residents, as compared to 80% (n=8) in the post test. With a greater focus by regulatory agencies on fall prevention programs in long-term care settings, the advanced practice registered nurse can take on the role of leader in guiding nurses through the process of improving education and resident outcomes
Assessment of the Level of Health Promotion Among Undergraduate Nursing Students at Rhode Island College: A Quantitative and Qualitative Analysis
Get PDFThe purpose of this pilot study was to conduct a preliminary assessment of the level of health promotion among undergraduate students at Rhode Island College. Results are analyzed and possible solutions discussed. Avenues for future research/reassessment are proposed
Documentation of Vital Signs During the Post-Operative Phase
Get PDFPost-Anesthesia Care Units (PACUs) were introduced in the 1930s to address excessive post-operative morbidity and mortality rates. The PACU provides an area where patients recovering from anesthesia can be observed intensely and treated appropriately until they return to a stable physiological state. Measurement of vital signs has always been a central task of the nurses providing care in the PACU; abnormal vital signs indicate an unstable patient and the possibility of an adverse event. Over time, both hospital policies on conduct of care in the PACU, including documentation of vital signs, and the technology for measuring vital signs have evolved. Measurement of vital signs has been automated, with indicators measured either continuously or at timed intervals. This automation may produce unintended consequences including conflicts between the technology and policy and the tendency for nurses to document vital signs as a matter of routine rather than a means of delivering patient-centered care. This retrospective chart review was conducted to identify the prevalence of non-compliance with hospital policy on frequency of vital sign documentation in adult ASA I and II patients of any gender undergoing general anesthesia for an outpatient procedure. The results of this study showed non-compliance occurred in 18% of the sampled records. Recognizing such gaps in vital sign documentation, will better enable the Advanced Practice Nurse (APN) to facilitate effective discussions about the benefits of appropriate documentation and patient care. The APN can support nurses and their organization by advocating for continued involvement in policy development and staff education
The Anchor: Artifact of Rhode Island College
Get PDFWhat do we know about the origins of the large anchor on the quad? We completed a cooperative object study to demystify the history and significance of the anchor. The entire class learned to use the open source tool, Timeline JS, to produce the interactive timeline exhibited here. To find images and write text, we relied on archives, oral history, consultation with experts, and contemporary sources. We presented our timeline contributions during in-class presentations on September 25, 2018.
The interactive timeline is preserved and available online: https://ricdigitalcommons.com/FYS100-25
Understanding Campus Copyright & Creative Commons
Get PDFPresentaion (slide, PDF) for the members of Rhode Island College campus community on information and guidelines regarding copyright law.
Not intended or offered as professional legal advice
The Inequities of Motherhood: The Challenges of Obstetric Anesthesia in Low-Income Countries
Get PDFThe maternal mortality rate (MMR) is unconscionably high around the world, with women in low to middle income countries (LMICs) disproportionately passing away from potentially preventable causes. While this is a complicated and multifaceted problem, anesthesia has been identified as a contributing cause of death. From the moment the parturient enters the operating room, the anesthetist is responsible for their well-being. This integrative review was designed to further explore relationship between anesthesia and the MMR in LMICs. Twelve articles published within the last 15 years were selected through an extensive literature search using Medline and CINAHL. Each article was examined using the Polit and Beck (2017) assessment criteria followed by a cross table analysis. The results identified common themes across the studies including lack of infrastructure such as access to reliable power, water and oxygen, resources such as medications and basic anesthesia equipment, training focusing on maternal care and anesthesia and continuing education for providers. Knowing these deficiencies in anesthetic care, nurse anesthetists can assist in implementing changes to help reduce the MMR. Recommendations include encouraging hospitals and governments to make updating hospital infrastructure a priority, reaching out to groups such as the World Health Organization who help fund basic equipment such as pulse oximeters, establishing relationships with medical institutions in other regions to provide training and guidance, and focusing on the development of non-physician anesthetist programs to increase the number of proficient providers
Anesthetic Use and Cancer Recurrence in the Surgical Oncological Patient: An Integrative Review
Get PDFThis integrative review compared anesthetic usage and its impact on the cancer patient. Immunosuppression from anesthesia can have major impacts on the human body’s immune system and lead to a decrease in overall patient survival and an increase in cancer recurrence rates. A search was completed using electronic databases including CINAHL, PubMed Health, and Medline Plus. The studies were located with keyword searches and inclusion and exclusion criteria was used to locate a final 8 studies for the review. A critical appraisal was completed using Polit and Beck’s critical analysis tables, displaying key characteristics of the studies chosen. Outcomes reviewed included overall survival rates, cancer recurrence rates, time to recurrence and biomarker identification. The findings presented more beneficial outcomes with regional anesthesia, but larger prospective randomized studies are needed to validate these findings. Regional anesthesia has shown to increase time to recurrence, decrease recurrence rates, and limit the increase in immune biomarkers. However, regional anesthesia does not fully support an increase in overall survival rates. More research and randomized control trials are warranted on this topic. Overall, this integrative review has supported the use of regional anesthesia for more positive outcomes in the oncological surgical patient over general anesthesia
An Integrative Review of Fluid Management in Cardiac Surgery
Get PDFAdequate fluid administration during and after cardiac surgery is essential to ensure adequate oxygen delivery to the tissues, while simultaneously avoiding the dangers of hypervolemia and fluid overload. In both cardiac and non-cardiac surgery there has been debate on what the best approach to fluid management is, what hemodynamic parameters should be used to assess fluid requirements, and what type of fluids should be used. There are several studies in non-cardiac surgery that examine these issues, while they are fewer in the field of cardiac surgery. An integrative review design was used to examine the current evidence on fluid management practices in cardiac surgery. Thirteen studies were included in this review. They included four studies of surveys on fluid management practices, eight studies that utilized goal directed therapy (GDT), and one observational study on fluid administration practices in cardiac surgical patients. The results showed that arterial blood pressure (ABP), central venous pressure (CVP), and echocardiography were used most often to monitor volume status. Crystalloids were used most frequently for volume replacement. In the studies utilizing GDT, fluid administration was often based on stroke volume variation (SVV) and cardiac index (CI) goals. A slight trend towards increased fluid administration was seen in the GDT groups. Fluid bolus volumes ranged from 100 to 500 ml. The GDT groups had a slight trend toward decreased length of both hospital and ICU stay. An important limitation of the review was that none of the studies were conducted in the United States of America
Examining the Effectiveness of Retrieval-based Learning Strategies in First Generation College Students
Get PDFRetrieval-based learning activities involve actively bringing information to mind. Previous research has shown this to be an effective way to produce meaningful learning. This research investigated the efficiency of this strategy amongst first-generation college students. Twenty-eight students were recruited from the Preparatory Enrollment Program (PEP) at Rhode Island College. In this within-subjects experiment, students participated in two learning activities, counterbalanced for order. Students learned two texts. With one text, they engaged in a retrieval-based learning activity by actively recalling as much information as they could remember and writing it down. With the other text, they simply read. Students completed reading comprehension and speed of processing tests. Then, they answered short-answer questions about the texts to assess how much they learned. Lastly, they filled out surveys to provide information about how they typically study. The results indicated that retrieval-based learning strategies did not produced any meaningful learning compared to the control. Additionally, speed-of-processing abilities have no interaction with the learning condition, however those who performed higher on the reading comprehension task did perform better in the final assessment. When making judgments about the learning activities, students found free recall to be more difficult than the control. Lastly, about half of the students report using retrieval in some way during their own studying, but they still report more use of rereading
Fatally Female: A Study of the Treatment Of Women in True Crime Narratives
Get PDFThis thesis studies book-length literature from four cases of violent crime—the unsolved murder of Elizabeth Short in 1947, the prosecution of O.J. Simpson by Deputy Assistant District Attorney Marcia Clark, the shooting at Columbine High School by Harris and Klebold, and the trial of American exchange student Amanda Knox for the murder of her roommate in Italy in 2007–in order to analyze the way in which authors characterize the women and events involved in each case. Regardless of their positioning to the crime, the women who are close to these cases are repeatedly criticized by those chronicling their actions for failing to act in ways that preserve orthodox gender roles. To define the way in which gender is constructed and policed within society, the theoretical works of Laura Mulvey, Judith Butler, and Simone de Beauvoir are referenced. Analyzing the literature and theory surrounding each case reveals that true crime literature can suggest a code of conduct for women to follow by linking perceived deviant gender behavior to fatal outcomes and circumstances. Despite the horrible violence that each case contains, disapproval centers around women’s clothing choices, manner of speaking, and bodies