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Fall Risk Screening with Interventions for the Elderly
Get PDFBackground: Falls are an important safety concern among the elderly. A practice change project to decrease falls in the elderly population was implemented in a Patient-Centered Medical Home (PCMH) setting in Oregon with the purpose to determine whether staff was satisfied with the change effort. This endeavor encompassed two other clinics in a broader system which also embraced the change initiative.
Methods: An electronic survey was offered to staff over a two week period to assess their satisfaction with the implementation of the tools used to screen the elderly for falls with those at risk receiving appropriate interventions. The Hendrich II was chosen to determine fall risk; the Falls Prevention Action Guide for Providers (FPAGFP) guided implementations for those susceptible to falls. The University of Portland (UP) institutional review board (IRB) approved this project.
Results: Of the 20 respondents who completed the surveys, 14 were providers and residents, and 6 were MAs. All staff valued assessing the elderly for fall risk in clinical practice. All but one of the MAs indicated it was easy/very easy to incorporate use of the Hendrich II into their workflow. The majority of the providers indicated the tools were beneficial to help reduce falls in the elderly. No correlation existed between providers who believed in the effectiveness of the use of the FPAGFP to guide their actions to reduce falls and the belief that using the tool took time away from the patient encounter.
Conclusion: This practice change project was beneficial in that it identified the majority of elderly at risk for falling and provided strategies for providers to choose to reduce the risk. Analyzing survey results for change endeavors is a helpful step to determine if there are apparent trends in responses. Focused group discussions may aid in the identification of reasons for suboptimal screening and implementation practices with direction provided for ways to improve them. Providers and MAs who are using the tools effectively could be mentors for those who are struggling to implement them into their daily practice
Implications of Gender and Racial Intersectionality in the K-8 Classroom
Get PDFThe purpose of this mixed methods study was to seek a better understanding of the phenomenon of intersectionality of gender and race/ethnicity as is it is experienced by White female K-8 teachers. The study explored the possibility that a positive relationship might exist between teachers\u27 intersectionality awareness and their dispositions as culturally responsive educators and social justice activists. Twenty-one K-8 classroom teachers from a Pacific Northwest metropolitan school district completed the web-based Identity and Equity Awareness Survey which included items related to participants\u27 equity training experience and perceived benefits. Additionally, thirteen items borrowed from social psychology and Women\u27s Studies research were related to participants\u27 understanding of intersecting social identities. Qualitative data were collected through participants\u27 written comments.
Although a weak positive correlation (.20) was found between teachers\u27 amount and satisfaction with equity training experiences and their intersectionality awareness, discrepancies and contradictions found between the quantitative and qualitative data suggest that the survey instrument did not measure dispositions of culturally responsive educators. Furthermore, the findings suggest that teachers\u27 increased participation in standardized equity professional development increased their use of \u27equity speak\u27 and associated protocols. The equity language and protocols likely prevented teachers\u27 from developing the critical consciousness and authentic language needed to interrogate and contest the inequities they have learned to name. The implication being that the dominant culture epistemological approach to equity professional development reifies the systemic oppressions it claims to transform
Integral Ecology, Epigenetics and the Common Good, Reflections on Laudato Si and Flint, Michigan
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Exploring Health Information Exchange (HIE) Through Collaboration Framework: Normative Guidelines for IT Leadership of Healthcare Organizations
Get PDFHealth Information Exchanges (HIEs) hold the promise to integrate patient data residing across disparate information systems in various hospitals to improve care coordination, patient engagement, and provisioning of real-time information to physicians. This research posits that collaboration is the key to HIE’s success. Drawing from the extant literature on collaboration, we discuss collaboration-related challenges that healthcare IT leaders are facing and provide normative guidelines that they can implement during the HIE initiation phase as well as the maintenance phas
Proportional Insulin Infusion in Closed-Loop Control of Blood Glucose
Get PDFA differential equation model is formulated that describes the dynamics of glucose concentration in blood circulation. The model accounts for the intake of food, expenditure of calories and the control of glucose levels by insulin and glucagon. These and other hormones affect the blood glucose level in various ways. In this study only main effects are taken into consideration. Moreover, by making a quasi-steady state approximation the model is reduced to a single nonlinear differential equation of which parameters are fit to data from healthy subjects. Feedback provided by insulin plays a key role in the control of the blood glucose level. Reduced β-cell function and insulin resistance may hamper this process. With the present model it is shown how by closed-loop control these defects, in an organic way, can be compensated with continuous infusion of exogenous insulin