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Nurse Telephone Follow-up Post Initial Chemotherapy: A Quality Improvement Project
Get PDFWith the evolution of cancer care and chemotherapy agents over the last 15 years there has been an evident shift in care from the inpatient to the ambulatory setting. There is a growing need for cancer care, particularly in the ambulatory (outpatient) setting. Patients receiving chemotherapy in the outpatient setting return home immediately after completing treatment and do not have direct medical and nursing supervision to monitor for and address side effects or adverse reactions of treatment in a hospital inpatient setting. Nurse telephone follow-up post initial chemotherapy allows for assessment and timely management of potential side effects experienced after the administration of chemotherapy in the outpatient setting. The purpose of this quality improvement project was to develop a standardized nurse telephone follow-up procedure post initial chemotherapy. The author developed an electronic script guideline and documentation tool along with a process for conducting the nurse-initiated calls. The project design included an educational activity and a post evaluation of the telephone follow-up procedure. Fifteen biotherapy/chemotherapy nurses participated in a four week pilot. During the four week pilot period 14 out of 34 first time chemotherapy patients received telephone follow-up utilizing the script guidelines. Ten nurses (N=10, 67%) completed the post evaluation survey. Results indicated that overall the script guidelines for telephone follow-up post initial chemotherapy was well received by staff and utilized appropriately. Replication of this project should include examining the impact of telephone follow-up on patient satisfaction and outcomes. The APRN is essential in promoting evidence-based practice and bringing it into the daily practices of staff nurses to improve the quality of care for patients and their families
Perceived Barriers to End-of-Life Care Discussions in Cancer Patients from the Perspective of Ambulatory Oncology Nurses
Get PDFWith the advancing age of the population, the increasing incidence of cancer, and all of the advances in cancer therapy, comes the ability to prolong life in cancer patients well beyond what was possible even ten years ago. Along with the progress of advanced surgical and radiation techniques, there is now an ever-expanding array of chemotherapy, biotherapy, and immunotherapy being used on patients in all age groups and in all stages of cancer. These advances have thrilled researchers and physicians, as they now have a multitude of options to offer cancer patients, perhaps even as late as third or fourth line therapy. If traditional chemotherapy fails, it is very likely that a new novel agent will be offered to the patient, regardless of age and performance status. Cancer patients often have an unwavering amount of hope and faith in their physician, and these treatments, while promising and encouraging, add to the growing problem of delaying end-of-life care discussions in patients, often until they are exhausted of all hope and quality of life. The Institute of Medicine has made dying well from cancer a top priority and states that those with palliative needs deserve access to expert-level care and those who meet the criteria of a six month or less prognosis should be offered hospice. Ambulatory oncology nurses are in a unique position to add to the discussion of barriers to end-of-life care discussions in cancer patients and, for this reason a qualitative research study was conducted
Nurses\u27 Perception of Mobile Communication in an Acute Care Setting
Get PDFCommunication is at the center of providing health with care. Good communication between nurses, patients, and among members of the health care team is paramount in delivering patient-centered care. The literature has demonstrated that mobile communication devices can improve quality and efficiency of communication among clinicians, mobilize information, improve clinical workflow, improve response time, and provide cost savings. The research has also revealed unintended consequences such as interruptions in care, increase in errors, caregiver distractions, and reductions in workflow processes. There is currently limited evidence in the literature regarding the perceptions of nurses regarding the use and satisfaction of mobile communication devices. This study examined a convenience sample of nurses (n=64) working in an acute care setting. Donabedian’s process, structure, and outcome model was used to guide this exploratory research. Registered Nurses (RNs) participated in a self-reported one-time survey on perceptions of the use of wireless mobile communication devices. The survey consisted of a 34 response Likert questionnaire which included questions about the mobile devices’ impact on communication, the personal impact the device had on nurses, the perceptions of training and implementation, the devices’ involvement in patient safety, and the overall impact of using the device. The results suggest an increase in the speed and reliability of communication with the use of a mobile communication device, improved response time to patient issues, and improved communication. However, nurses responded unfavorably regarding the impact on patient safety. Trends in data demonstrated nurses with less experience scoring more favorably than nurses with more experience. Most nurses responded unfavorably to the overall impact these devices had
Racial Construction and Hierarchical Privilege in the Dominican Republic
Get PDFThe first step to solving any problem is admitting you have one. The Dominican government is in denial of a problem that is clearly noticeable to others. The government claims that there is no racial discrimination in the country and that anything said by the international community asserting the opposite is just a conspiracy against the State. Regardless of the Dominican Republic’s position, it is clear that immigration policies in the Dominican Republic are a source of racialization. Immigration policy was the vehicle the government used to drive the national processes of racialization, the construction of racial identities, and the continuance of and disputes over racial boundaries in the country. Dominicans of Haitian descent, black Dominicans, and Haitian immigrants have been facing many obstacles that have been intentionally placed to obstruct them from enjoying the right to citizenship that had been guaranteed to them by the Dominican Constitution up until 2010. This paper analyzes the process of racialization in the Dominican Republic. In order to analyze racialization, I will examine different pieces of legislation passed by the Dominican government, among them a 2013 Dominican Constitutional Court ruling, which revoked citizenship from Dominicans of Haitian descent. Having examined the different pieces of legislation, as well as different international treaties that protect individuals from being discriminated against, I have come to the conclusion that the ruling along with other anti-Haitian policies undertaken by the Dominican government are discriminatory, and constitute a direct violation of human rights
Commencement Program 2017
Get PDFThis commencement program is for baccalaureate and advanced degrees.https://digitalcommons.ric.edu/commencement_programs/1129/thumbnail.jp
Off the Verge: Teaching De-escalation Through Simulation
Get PDFWorkplace violence is an ongoing concern for nurses in healthcare settings and it is imperative nurses are equipped with the knowledge and skills to de-escalate a potentially violent situation. Verbal de-escalation should be the first intervention nurses use to curtail patient aggression, and training in effective de-escalation techniques is essential to increase nurses’ confidence and decrease the use of restraints. As an undergraduate student at Rhode Island College (RIC), this writer identified the need for this training and developed a simulation where nursing students could practice verbal de-escalation skills with a live-actor in the controlled, safe environment of the RIC School of Nursing Simulation Center. The students’ confidence was measured using a pre- and post-simulation survey and improved in nearly all categories after participating in the trial run of this Emergency Department-based simulation. Additionally, the feedback and results from this project indicate a simulation developed by a student, for peers, was effective in addressing an identified educational need. Generous financial support from the Anne and Bob De Stefano Fund for Undergraduate Research made it possible to hire professional improvisational actors and design and implement a simulation that mirrors actual practice
Hair cortisol and lifetime discrimination: Moderation by subjective social status
Get PDFDiscrimination has been associated with elevated cortisol as measured in saliva, blood, and urine. This study investigated the association between lifetime discrimination and hair cortisol concentrations, considered a measure of chronic stress. We recruited 180 young adults from diverse backgrounds. Participant responses to lifetime discrimination, home stress, and subjective status measures were recorded. Lifetime discrimination significantly predicted hair cortisol concentrations, supporting past research that discrimination experiences impact neuroendocrine systems. To our knowledge, these are the first findings associating hair cortisol concentrations with discrimination and supports prior evidence positing discrimination as a chronic stressor that serves as a risk factor for chronic disease
Eye on Ethics: Client Access to Electronic Records - Ethical Challenges
No full textMany health, mental health, and social service providers have opened their notes to clients. With a nod to transparency, these professionals embrace the idea that clients have a right to view their records and that such access may enhance clients\u27 engagement with treatment and other interventions
More Than Its Sound: The Political, Economic, and Social Reasons Behind the Saxophone\u27s Exclusion from the Symphony Orchestra
Get PDFThe purpose of this project is to uncover the reasons why the saxophone was not integrated into the orchestra. Through an examination of political, economic, and cultural accounts of Paris during the nineteenth century, this paper attempts to examine the effects on the saxophone’s reception. During the nineteenth century, French composers had a vehement fascination with timbre and the manipulation of its effects as a new aesthetic dimension in music; the perfect environment for an entirely new timbre to be added to ensembles, let alone introduced. The multitude of acclaim that the saxophone received from prominent composers, critics, and other noteworthy musical figures upon its arrival to the French capital does not add up with the ultimate dismissal it received by the orchestra as in institution. Therefore, because of the excessive amount of commendations—many that explicitly say the saxophone could be, or is destined to be the newest expressive tool in the symphony orchestra—the instrument’s timbre must not be the ultimate reason for its quick dismissal. This paper consults general historic events and individual accounts from music critics, musicians, composers, instrument makers, and military leaders in attempt to determine why the saxophone was not added to orchestral forces around the time it was invented
Supporting People as They Age in Community: Housing
Get PDFAging in community can be a healthier, happier option for many seniors, but only if they have the right resources and support, starting with suitable housing. Homes must be affordable for retirees on fixed incomes and adapted for those with physical limitations. Older people living on their own need access to community services to keep them healthy and connected. Without affordable, age-friendly housing and access to services, aging in community can be stressful, isolating, and limiting, rather than empowering