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A Narrative on the Witch-Hunt Narrative: The Moral Dimensions
Get PDFRoss Cheit’s The Witch-Hunt Narrative raises a number of complex moral issues. Cheit’s principal purpose is to challenge the belief that our society has overreacted to claims about the sexual abuse of children. Both directly and indirectly, Cheit’s in-depth analysis broaches moral concerns pertaining to the integrity of child abuse allegations, investigations, civil litigation, and criminal prosecution, with an emphasis on the mixed motives of the parties involved in key cases. This article provides an overview of ethical questions pertaining to gathering information from very vulnerable individuals, informed consent, institutional review, protection of research participants, the use of deception and coercion, confidentiality and privacy, reporting research results, and conflicts of interest. In addition, the author discusses the phenomenon of whistle-blowing as it pertains to professionals’ ethical judgments about disclosure of wrongdoing and misconduct. The author outlines key ethics-related concepts, applies relevant moral theory, and explores the implications of the moral issues raised by The Witch-Hunt Narrative for child sexual abuse victims, perpetrators, child welfare and law enforcement professionals, scholars and researchers, and the public at large
Ventilator-Associated Pneumonia and the Effectiveness of Endotracheal Tubes Coated with Silver Sulfadiazine
Get PDFVentilator-associated pneumonia (VAP) is a consequence of intubation and mechanical ventilation. Bacteria colonize the inner-lumen of endotracheal tubes (ETT) and develop into a biofilm. One method to reduce/eliminate the develop of biofilms within the ETT is lining the inner-lumen with silver-sulfadiazine. A systematic review was conducted to evaluate the effectiveness of silver-coated ETTs for patients that develop VAP. Multiple databases were searched to identify key literature related to silver-coated ETTs and VAP. Inclusion and exclusion criteria were identified to finalize the studies that were included in this systematic review. Five key studies were included in this review. Studies were further evaluated with PRISMA, a data collection table, the Critical Appraisal Skills Programme (CASP) and the Critical Appraisal for Summaries of Evidence (CASE) worksheet. All studies found either a reduction or elimination of bacteria within the ETT, breathing circuit, or lungs of the study subjects. In addition to the reduced colonization found across the studies, one study found a reduction in the mortality rate for the intervention group following a diagnosis of VAP. Certified Registered Nurse Anesthetists (CRNA) play an important role in educating staff about the impact silver-coated ETTs have on patient outcomes throughout periods of intubation and mechanical ventilation. Additionally, CRNAs are well positioned to identify patients pre-operatively that may require prolonged intubation following surgery. By advocating for silver-coated ETTs for these patients, CRNAs can improve patient outcomes by reducing the likelihood of these patients developing VAP
IPLWS/RIC at Day of Portugal WaterFire Providence, 2017
No full texthttps://digitalcommons.ric.edu/iplws_films/1000/thumbnail.jp
Concussion: Improving Nurses\u27 Knowledge in the Emergency Department
Get PDFPatients presenting to the emergency department (ED) after trauma from a fall, motor vehicle collision, or assault frequently develop a mild traumatic brain injury (MTBI) also called concussion. There is no specific treatment for concussion, therefore, the focus shifts to managing symptoms. Countless EDs experience overcrowding leading to time and resource constraints, therefore nursing discharge education is brief and may only review symptoms which require immediate medical attention. This ED discharge practice leaves the patient on their own to manage symptoms and if the patient is unaware, they may perform activities that exacerbate their condition. The purpose of this project was to evaluate the impact of an educational program on ED nurses’ knowledge of concussion/MTBI and the current Centers for Disease Control and Prevention (CDC) recommended education for patients and families discharged home.
The study took place at a large level I trauma center, using a nonprobability convenience sample of ED nurses. A pre-intervention post-test design was used to measure nurses’ knowledge regarding concussion. The intervention consisted of a poster board and informational packet that provided nurses with evidence-based information about concussion and discharge instructions. Fifty-one nurses (28%) completed the pre-test with a mean score of 61.96% and total scores ranged from 30% to 90%. Twenty-eight nurses (15%) completed the post-test with a mean score of 78.2% and a range of 40% to 100%. There was an overall improvement in the total scores by 16.24%. These findings suggest that an evidence-based educational intervention increases ED nurses’ knowledge regarding concussion and appropriate discharge education for concussion patients
What Are the Factors Contributing to the Delay in Hip Fracture Repair?
Get PDFHip fracture injuries are identified as one of the most serious healthcare problems affecting older adults (CDC). The prognosis after hip fracture is unfavorable and approximately 25% of elderly patients will die within one year after the event. Surgical repair is a critical element in the management of a hip fracture. Delay of surgery prolongs hospital stay and increases the risk of medical complications. Despite evidence showing early time to surgery reduces morbidity and mortality for patients with hip fractures, time delays to surgery still exist. The purpose of this quality improvement project was to explore patient- and hospital-specific barriers to early surgery for older adults with hip fractures in a community hospital. Kathleen Stevens’ ACE Star Model was used as a conceptual framework to guide this project. A retrospective chart review was conducted with a total of 62 charts consisting of 55 females and 8 males who experienced a hip fracture. Data collected included age, gender, time from emergency room arrival to admission, time from admission to operative intervention, current medications on admission, current use of tobacco and alcohol, type of surgical intervention, and length of stay. Average length of time from admission to surgery was 29 hours. Eight charts were identified with a delay of greater than 48 hours to surgery. Patient-specific barriers were identified. Further research is indicated to determine hospital-specific barriers to early surgery
Nurses Perceptions\u27 of Bedside Reporting on an Intensive Care Unit Following Implementation
Get PDFShift handoffs were included in The Joint Commission\u27s 2009 National Patient Safety Goals, which requires that shift hand-offs must include up-to-date information about the care, treatment, current condition, and recent or anticipated changes with the patient. Bedside reporting addresses The Joint Commission\u27s Goal 13, a safety strategy that encourages the patient\u27s active involvement in care. The demand for quality care while caring for the sick population with multisystem complex diagnoses calls healthcare provides to look at ways to provide more efficient care while improving patient safety and outcomes.
Bedside reporting is one nursing intervention which can be implemented to improve communication, increase patient safety and improve the quality of care. While on the surface the benefits of bedside reporting seem clear, some who have tried to implement bedside shift reports have faced significant challenges. This quality project surveyed 32 nurses on a trauma unit to determine their perceptions of bedside reporting following implementation over 2 years ago. Nurses were provided with a ten question survey based on a Likert scale of 1-5. One additional qualitative question asked nurses ‘perceptions and thoughts about the bedside reporting process.
Results overall revealed that although many nurses were aware of the benefits of bedside reporting and its practical uses, most nurses still were hesitant with its daily practice. Despite strong evidence demonstrating the benefits of bedside reporting, many issues still remain regarding the sustainability after implementation
The Impact of Smoke Free Housing on Sick Visits and Hospitalization for Respiratory Illness in Children Ages 0-12
Get PDFThis project analyzes the impact of smoke-free family public housing on the respiratory health of children ages 0 – 12. The purpose of this pilot correlational study was to examine the relationship between the initiation of smoke-free policies in family public housing units and health outcomes in children 0 - 12 years. A comprehensive literature review of environmental tobacco health risks and tobacco-free public housing policy is presented. Two theoretical frameworks which guided the project, the Social Ecological Model and the Health Impact Pyramid, are described with an emphasis on health policy as a significant catalyst for positive health outcomes. The methodology, which includes a convenience sample of Neighborhood Health Plan of RI (NHPRI) claims for a cohort of children 0 – 12 years old living in selected smoke-free family public housing units in Providence, RI, was reviewed. Claims data pre and post housing policy change were evaluated to determine whether the implementation of smoking bans in family public housing units in the City of Providence were associated with a decrease in claims of hospitalizations and sick visits for respiratory diseases/illnesses in a cohort of children insured by NHPRI who lived in these units
Assessing Registered Nurses Knowledge of Comfort Measures Only: A Quality Improvement Project
No full textEnd of life care is a growing specialty in healthcare and requires specialized knowledge and care by the nurse. Many patients end their life in an acute care setting which may be lacking in providers who are well versed in end of life care, specifically comfort measures. Therefore, assessing the registered nurses knowledge of comfort measures only, as a component of end of life care, is a critical first step in improving end of life patient and family experience. By identifying current provider knowledge of comfort care and the understanding of practice guidelines, a specific and relevant educational program can be developed. This project will evaluate the level of self-reported knowledge of registered nurses who are caring for patients designated with comfort measures only orders. With successful completion of this project, the educational needs for these registered nurses will be identified and utilized to improve education and care delivery for patients who are on comfort measures only
Drama and Global Citizenship in the High School Classroom: Student Response and Teacher Growth
Get PDFThesis explores student engagement with a unit of lessons that used drama pedagogy to explore the Syrian Civil War and discussed possible solutions
The Montessori Experiment in Rhode Island (1913-1940): Tracing Theory to Implementation Over 25 Years
Get PDFThis article highlights archived documents pertaining to a 25-year experimental classroom implemented by Clara Craig, then supervisor of training at the Rhode Island Normal School. Craig is notable as she was the only participant in the first International Montessori Training Course in Rome, Italy, in 1913, to gain approval from the Rhode Island Board of Education to study the Montessori Method. Her administrative position at the Rhode Island Normal School provided her with a rare opportunity to influence both teacher preparation and classroom curriculum upon her return. The article traces implementation of the Montessori Method and its Americanized revision, serving as one of the earliest longitudinal examples (1913–1940) of a state-sanctioned Montessori classroom, well beyond the acknowledged first-wave era (1911–1917). Craig’s experience provides a historical perspective that can inform current Montessori initiatives working within complex education and policy contexts