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Supporting People as They Age in Community: Information and Service Access
Get PDFAs people age, they often rely on the support of public and private programs to help them live healthy, independent lives. What if older people and their caregivers had access to a single website, phone number, or office that could connect them with all the support and resources they need, from applying for Medicare benefits and finding long-term care facilities to accessing transportation and meal delivery services
Standardized Communication and Perioperative Staff Satisfaction
Get PDFPatient safety relies on effective and efficient communication among healthcare providers. Tools, such as standardized checklists, ensure information sharing in a consistent, predictable format. In the perioperative setting, where handoffs occur at several points and among various disciplines, high reliability is essential. This systematic review focused on the impact of standardized communication practices on perioperative staff satisfaction as it relates to sustainability of the new practice. The electronic databases PubMed and Google Scholar were used. Six articles met inclusion for the systematic review and of these six, four were determined to be of high quality through the application of The CASE Worksheet. The handoff tools implemented in these four studies were the electronic anesthesia information management system (AIMS), I-PASS mnemonic that described the illness, patient summary, action list, situation awareness and synthesis by receiver, Peri-op Handoff Protocol and a variation of the ‘Surgical Safety Checklist’ originally developed by WHO. Results of this systematic review suggest that these standardized communication methods are effective in improving perioperative staff satisfaction. Further research may prove helpful to determine if one handoff tool design is superior to the others. While future research could be performed to provide a larger sample size, the limited data gathered from this systematic review shows promising results. Implementing a standardized approach to perioperative communication and patient handoff has been shown in these studies to be beneficial in terms of staff satisfaction. Furthermore, it would be valuable to examine the indirect impact these communication tools have on patient care. Healthcare providers have the responsibility and opportunity to improve patient care through the adoption of standardized communication processes
Teachers\u27 Experiences of Induction: A Narrative Retrospective Inquiry
Get PDFIt is well established that beginning teachers need support to bridge the gap from college teacher preparation to the classroom setting (Fletcher & Strong, 2009; Wong, 2003). In fact, lack of support in this transition has been identified as a leading factor that causes beginning teachers to leave the profession at high rates early in their careers (Andrews, Gilbert & Martin, 2006). Research suggests that coaching is an effective way to support beginning teacher’s learning (Ingersoll & Strong, 2011). The purpose of this qualitative research is to tell the lived experiences of nine teachers who took part of in a statewide induction coaching program. Using narrative inquiry methodology with semi-structured interviews, the study sought to gain the individual stories of past beginning teachers who worked with an induction coach, identify common themes across beginning teachers’ narratives, and to understand what their retrospective stories tell us about working with their induction coach. Four main implications of the findings include the needs of beginning teachers in the field, phases of coaching in reaction to the needs of beginning teachers, qualities of an induction coach, and the need for coaches to mediate the identities of the beginning teacher
Patient Attitudes about Patient Portal Functions
Get PDFAs part the U.S. government’s ongoing efforts to improve health care quality, the Electronic Health Records (EHR) Incentive Program from the Centers for Medicare and Medicaid (CMS) offers financial incentives to eligible health care providers (EP) who adopt, implement, improve, and demonstrate meaningful use of EHR. Beginning 2014, the Stage 2 Meaningful Use core objectives included the ability of patients to use online patient portals to view, download and transmit their health information. As a result, many EP offer a patient portal and encourage sign up, yet not all patients have done so. How patients perceive the patient portal, whether positively or negatively, may affect their adoption and use of the portal. A survey collected attitudes and beliefs about the patient portal from adult, female, primary care patients (n=257). The beliefs of patients who signed up, along with those who had not, were considered within the framework of the theory of planned behavior (TPB) to identify methods to increase patient use of the portal. The TPB correctly predicted portal sign up behavior in attitude (p\u3c0.05) and intention (p\u3c0.05) subscales. Overall, patients viewed portal characteristics as useful, but patients who had signed up identified them as significantly (p\u3c0.01) more useful, and also, were found to have significantly (p\u3c0.05) more education than those who did not sign up. Few methods to increase patient sign up were identified apart from targeted education to promote the portal’s usability and utility. More research is needed to identify potential methods health care providers can use to increase portal use in primary care patient populations. Implications for advanced public health nurse practice, training, policy, and research were identified and recommendations given
Improving Nurse Knowledge and Attitudes of Early Mobilization of the Postoperative Patient
Get PDFMobilization plays an important role in the outcomes of postoperative patients. Early mobilization as an intervention is the most significant general nursing measure in the prevention of complications. Current research demonstrates a decrease in complication rates, reported pain and length of stay when early ambulation is initiated. Despite this evidence, early mobilization as a best practice standard is implemented inconsistently on the women’s health unit of a community hospital. The purpose of this project was to improve nurses’ knowledge and attitudes of early mobilization of postoperative patients. The quality improvement project utilized a pre-survey, educational intervention, post-survey design. Twenty-five nurses (52%) participated in the project. The educational intervention integrated knowledge obtained from the review of literature in the form of a 15 minute Power Point presentation. Pre/post-survey included knowledge-based questions and opinion-based questions. Overall, post-survey scores increased by 16.8% and knowledge were improved when compared to the pre-survey. Nurses’ opinion of the importance of mobilization improved from pre-survey to post-survey. Time and patient’s pain were noted as barriers to early mobilization. Minimal change in nurses’ opinion of these barriers was noted from pre-survey to post-survey. The nurses’ ability to communicate and document mobilization showed the largest improvement from pre-survey to post-survey. The educational in-services were successful in improving the nurses’ knowledge and attitude of early mobilization of the postoperative patient
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 curriculumupon 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
Measuring Vapor Intrusion: From Source Science Politics to a Transdisciplinary Approach
Get PDFInvestigation of indoor air quality has been on the upswing in recent years. In this article, we focus on how the transport of subsurface vapors into indoor air spaces, a process known as ‘vapor intrusion’, (VI) is defined and addressed. For environmental engineers and physical scientists who specialize in this emerging indoor environmental exposure science, VI is notoriously difficult to characterize, leading the regulatory community to seek improved science-based understandings of VI pathways and exposures. Yet despite the recent growth in VI science and competition between environmental consulting companies, VI studies have largely overlooked the social and political field in which VI problems emerge and are experienced by those at risk. To balance and inform current VI studies, this article explores VI science and policy and develops a critique of what we call ‘source science politics’. Drawing inspiration from the creative synthesis of social and environmental science/engineering perspectives, the article offers a transdisciplinary approach to VI that highlights collaboration with social scientists and impacted communities and cultivates epistemic empathy
Nurse Perceptions of Electronic Handoff
Get PDFNursing handoff is the important exchange of pertinent information between nurses that is critical to patient safety. The purpose of this quality improvement project was to explore progressive care nurses\u27 perceptions of usefulness of a new electronic SBAR handoff tool on an inpatient adult acute care setting at an academic medical center. A 10 question survey including eight Likert response and two open-ended response questions was created from content areas of a survey designed to measure nurses\u27 perceptions of usefulness of a computerized tool for shift handover report writing. The anonymous survey was completed by 16 of 24 eligible participants. Descriptive statistics were performed on the study variables and responses from open-ended questions were analyzed for themes. Survey results revealed that nurses perceive the new handoff summary tool to save time and improve consistency of information exchanged. Nurses stated that communication between departments was not improved and that the summary screen does not accurately represent the patient at the time of report. Open-ended question responses revealed that user error may be contributing to some of the dissatisfaction with the tool. Responses indicated that many nurses still prefer a narrative type of handoff and read physician and nursing assessments for this type of description. Further exploration is needed. Implications for practice include the APRN\u27s important contribution to a successful implementation of electronic handoff. The APRN is essential to the success of such changes as they are uniquely prepared to plan, implement, and evaluate this change across the three spheres of influence
Oral Chemotherapy, A Tough Pill To Swallow: A Systematic Review
Get PDFAs patients begin to receive more oral chemotherapies in the place of the traditional parenteral therapies, the responsibility for treatment falls on the shoulders of patients and their caregivers. The responsibility for the “five rights” of medication administration, which include the- right drug, right dose, right time, right route, and right patient are being transferred to patients and care givers. This places patients at risk for medications errors. Patients and care providers assume responsibility for medication administration, often with little or no healthcare education. As the number of patients being prescribed chemotherapies continues to increase, an emphasis on education as well as adherence to therapy should be emphasized. Multiple barriers exist, that negatively affect a people’s ability to adhere with prescribed treatment. A systematic review was conducted to identify the most prevalent barriers to nonadherence in this patient population. The Preferred Reporting Items for Systematic Reviews (PRISMA) checklist and flowchart were utilized to extrapolate, analyze, and synthesize the date. Common themes were identified and organized into three main categories: patient-related factors, system-related factors, and nurse and provider-related factors. The most prevalent were analyzed in further detail which revealed there were multi-factorial causes of nonadherence to oral chemotherapies. Under the patient-related heading, adverse effects and toxicities as well as forgetfulness were seen most commonly in the literature. Within the theme of systemrelated both regimen complexity and financial causes were found, whereas under nurse and provider-related patient education and frequency and length of follow up were most common. The advanced practice nurse (APN) is in the prime position to help counter-act these barriers to adherence. This systematic review served to help identify common causes of nonadherence to patients’ oral chemotherapeutic agents as prescribed
Awake and Asleep: The Words I\u27ve Dreamt
Get PDFThis project is the result of my introduction to formal poetry. It includes several formal poems in different forms, including my own