3511 research outputs found
Sort by
ERAS Protocol for Lower Extremity Orthopedic Procedures
Get PDFThe demand for total knee arthroplasty (TKA) and total hip arthroplasty (THA) will continue to rise as life expectancy increases. Coupling increased age with the increased prevalence of both obesity and osteoarthritis, the need for total joint arthroplasties is likely to increase (Oseka & Pecka, 2018). The frequency of arthroplasty procedures and the associated recovery period lead to heavy economic demands felt by most healthcare systems (Stowers et al., 2016). To address this burden, enhanced recovery after surgery (ERAS) protocols have been implemented at institutions and are designed to improve patient outcomes while simultaneously limiting cost and reducing readmission rates after surgery (Kaye et al., 2019a). Objectives of this quality improvement project were to research prevailing evidence-based literature on ERAS protocols, develop a facility specific protocol, and introduce the customized THA and TKA ERAS protocol to members of the perioperative team. Results of the post-implementation knowledge assessment demonstrated nurse anesthetists had a strong understanding of ERAS. Participants also indicated that the customized ERAS protocol would be implemented into practice. Obtaining surgeon and other perioperative staff buy-in to the protocol may further enhance patient safety and perioperative experience and reduce economic burden through decreased length of stay and postoperative complications
Improving Patient Outcomes by Preventing Airway Injuries Associated with Video Laryngoscopes
Get PDFVideo laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH MAC Video Laryngoscope. A pocket reference tool was also created and distributed to all participants after the presentation. The participants completed a 10-question pre-test before the presentation and a 10-question post-test immediately following the presentation and simulation experience. The results from both tests were evaluated to determine the overall impact and effectiveness of the presentation and simulation experience. A post-implementation survey was also utilized, which consisted of an 11-question Likert Scale Survey with two open-ended questions. This was used to collect participant perceptions on how well the material was presented and the usefulness of the educational tools provided. The results of this quality improvement project implied there was an immediate impact on the participants’ level of knowledge related to the proper use of video laryngoscopes to avoid injury to the patient. The survey results suggested that the participants had an increase in confidence of video laryngoscope use when presented with a difficult intubation, along with the reinforcement of accurate use according to manufacturer guidelines. Recommendations of this project would be to continue to provide awareness to anesthesia providers of the potential airway injury risk associated with video laryngoscopy with further education and simulation experiences
The misuse of convenient care and importance of establishing a primary care provider
Get PDFOver the last decade, there has been substantial increase in the use of urgent care (UC) and convenient care (CC) clinics nationwide. While these clinics are valued and serve a purpose in our communities, more patients are utilizing their services exclusively in place of primary care (PC), resulting in millions of Americans not receiving essential preventative care and chronic disease management. An extensive literature review evaluated current and effective interventions used to decrease inappropriate use of CC clinics, while simultaneously exploring strategies in increasing patient compliance with routine comprehensive health management. Based on literature review findings, an education-based project was implemented at a rural CC clinic that serves a large volume of patients without a primary care provider (PCP). Over an eight-week implementation phase, an educational template was electronically incorporated into patient discharge instructions and reviewed verbally by the convenient care provider (CCP). The template explained current definition and scope of practice of emergency departments, UC, CC, and PC clinics. Additionally, the template outlined which respective establishment to visit for numerous common ailments and important health care needs. A total of forty-six patients were identified without a PCP. The patients were counseled and given the printed education. Through initial interview, thirty percent of these patients were found to misunderstand the purpose of the CC clinic. Following counsel and education delivery, forty-eight percent of patients without a PCP reported new motivation to establish care with one. The CCP, who dually served as project stakeholder, reported positive feedback regarding the educational tool and found it valuable, despite COVID-19 barriers and limitations. The CCP continues to use the tool in daily practice and has shared it amongst fellow providers for use. It is recommended that our exploration into the misuse of this CC clinic be furthered with future project implementations that may focus on the role of the current patient advocate coordinator
Increasing Low-Dose CT Screening in Primary Care
Get PDFAbstract
Lung cancer was ranked as the second most common cancer diagnosed in 2020 and had the highest death rate compared to all other cancers, excluding nonmelanoma skin cancers (ACS). Early detection is key in decreasing the mortality of lung cancer. A low dose CT (LDCT) is a yearly screening tool developed to detect lung cancer early in high-risk patients yet is much underutilized in primary care. The purpose of this project is to increase the number of LDCT orders placed for qualified patients to decrease the lung cancer mortality rate. There were two main methods for this project: education and mailed fliers. Provider education was increased with lunch and learn CME sessions and initiation of two new screening tools in the primary care offices. A flier was initiated to be mailed to be patients who may qualify for an LDCT. The project was 5 months long with a total of 157 LDCT ordered and performed by the targeted organization, a 65% increase in orders over baseline. Due to unexpected barriers and limitations of the mailed flier, it was unable to be sent out. The data for mailing took 60+ days to obtain via data analysts which was not enough time to get approval from marketing to mail fliers. This project was conducted on a smaller scale in one county, future replications can easily be implemented in a larger and more diverse primary care setting to reach more patients
Increasing Compliance and Patient Outcomes In Hypertensive Patients Using the Hill- Bone High Blood Pressure Compliance Scale
Get PDFHypertension has been globally rated the most common non-communicable disease as well as the most common cause of premature death (Johnson, et al., 2019). The identified problem of focus for this project was to increase medication compliance within hypertensive patients as well as increase provider knowledge of compliance issues with the utilization of the Hill-Bone High Blood Pressure Compliance Scale. We administered a case study via Qualtrics to Illinois nurse practitioners via the ISAPN email list-serve. We provided an anonymous pre-and post-survey to each participant regarding their current area of practice, patient history taking behaviors, and views on the ease of use of the Hill-Bone High Blood Pressure Compliance Scale. Each individual was walked through a case study using the scale as if it were being used on a real patient. We had a total number of 87 nurse practitioners participate in our implementation process with 27 completing partial survey and 60 participants completing the survey in its entirety. Our implementation process provided us with the knowledge that 89.66% of the surveyors had never used the Hill-Bone Scale within their practice. The majority of providers agreed that they would consider using the tool within their practice and that barriers such as poor health literacy and poor communication were a major issue with medication compliance. After reviewing our case study, the APRNs reported that they were more likely to discuss medication compliance, dietary intake, and salt intake with their patients. The APRNs also agreed that the implementation of the Hill-Bone High Blood Pressure Compliance Scale could help increase blood pressure medication compliance among their patients. Evidence is clear that improving medication compliance for patients with hypertension is important. We recommend that the Hill-Bone High Blood Pressure Compliance Scale be implemented into practice to demonstrate the positive impact on the compliance of hypertensive patients
Improving Depression Awareness and Screening in a Community College
Get PDFDepression is a serious and disabling mental health problem impacting nearly 265 million people worldwide. Approximately 17.3 million U.S. adults aged 18 or older suffered at least one major depressive episode in the last year. Of those afflicted, individuals 18-25 years of age had the highest prevalence of depression. Undiagnosed or untreated depression can lead to long-term disability or suicide which is the 2nd leading cause of death for 10–34-year-old persons. Early recognition of depressive symptoms can improve long-term outcomes of individuals by enhanced connection to mental health services. The overall goal of this project was to improve depression awareness and understanding in a community college setting using mental health education and the patient health questionnaire (PHQ-2). An online live educational presentation about depression and the PHQ-2 screening tool was provided to invited faculty and staff of a small central Illinois community college. A short survey of questions was administered to show baseline knowledge and personal feelings prior to the educational presentation. After completing the educational presentation, a follow-up survey of questions using the same format was given to evaluate changes in depression knowledge and screening tool application to the practice setting. Results showed an overall increase in knowledge about depression which included a positive increase in faculty and staff ability to recognize depressive symptoms. More than half of the participants indicated the PHQ-2 was a useful tool that could be used with community college students. Shortly after the online educational presentation, a college committee was formed to develop and implement professional development education for faculty and staff on mental illness including recognition of symptoms and resource referral. Although there was no commitment from the college to implement use of the PHQ-2 tool in student interactions, project sustainability was shown through commitment to continued education to promote awareness of depression and other mental illnesses
Improving Management of Mineral Bone Disease in Dialysis Patients with End Stage Renal Disease
Get PDFDialysis patients suffer from a far greater mortality rate than the general population, making health promotion and management essential to prevent hospitalizations and complications. Mineral bone disease (MBD) remains a major complication for many of these patients. Maintaining strict dietary goals is necessary in preventing this complication, as well as decreasing morbidity and mortality for those on dialysis. This project aimed to provide education related to mineral bone disease and dietary guidelines that aid in prevention, to increase patient knowledge and allow them to make better dietary choices. All patients were provided with in person education, given a booklet containing the information and dietary choices, and given a pocket guide with better food options and foods to limit. Participants in the study were requested to complete a 6-question questionnaire using a 5-point Likert scale to assess their choices and knowledge regarding foods that aid in prevention of MBD both before and after the education. There was statistically significant increase in the patient reported knowledge of mineral bone disease and a decrease in patient reported attempts to eat healthy using a 2-sample t-test. The staff at the clinics were happy with the education packets and planned to continue using the resources provided
From Stress to Success: Leveraging the Online Experience for Information Systems Students
Get PDFThe development of the coronavirus and universities’ unprecedented and abrupt transition to remote learning were disruptions to higher education that impacted stress levels for both graduate and undergraduate students. However, remote learning could be implemented in a method with lower stress that also helps prepare students for an increasingly digital workplace. Additionally, different modes of remote learning could enable students to enhance their digital competencies. In this paper I describe a teaching practice in which I modified one undergraduate and one graduate course to reduce the stress of remote learning and provide opportunities for students to enhance their digital competencies of adaptability, conceptual thinking, and digital literacy. Overall, the students and I found the experience to be positive. I will continue this practice in online courses even once the mode of delivery for higher education campuses returns to face-to-face
Examining Faculty Attitudes and Strategies that Support Successful Flipped Teaching
No full textIn this NSF-funded project, a team of experienced STEM educators & researchers designed, developed, and studied the implementation of flipped teaching by faculty in their STEM classrooms at two institutions: here at SIUE and at St. Louis Community College. Flipped teaching is an instructional practice where traditional teaching is reversed, with instruction occurring outside of class time, allowing classroom time to be focused on the application of content. By employing mixed methods, including in-depth interviewing of faculty participants, a rich dataset was gathered and analyzed, advancing the understanding of the aspects of successful flipped teaching implementation, as well as the barriers to engaging STEM faculty in the adoption of this teaching strategy. This project also produced a set of design principles for flipped teaching and a flipped teaching model applicable to these two common yet different types of higher education institutions. The project also supported the successful implementation of flipped teaching by 24 faculty members over the three years of the project. This program is headed by Dr. Chaya Gopalan of the Department of Applied Health.
The project had three overarching research questions: How do faculty perceive and implement flipped teaching? How does faculty implementation of flipped teaching at a four-year master’s university compare with faculty implementation at a two-year community college? What are the essential design principles for implementing a successful flipped classroom at each type of institution
Utilization of Telephone Outreach and Telemedicine to Improve Diabetic Outcomes
Get PDFDiabetic adherence is paramount to achieving adequate glycemic control. Telephone outreach and utilization of telemedicine can improve diabetic adherence through closer monitoring and removing barriers to access for care. The goal of the project was to improve the dashboard HbA1c quality metric within the IM office. The office dashboard HbA1c metric initially was in the “red threshold”, which means \u3c70% of patients aged 18-75 years old with diabetes had a HbA1c \u3c8%. This project involved performing telephone outreach to contact diabetic patients who were due for office follow-up to offer telemedicine as a convenient option for patient evaluation. In addition, the secondary goals of the project included identifying social determinants presenting barriers to diabetic care plan adherence. The results indicated telephone outreach and telemedicine use may help achieve better glycemic control in diabetic patients. This project demonstrated improvement in HbA1c dashboard metrics to the “yellow threshold”, indicating 71% of patients (18-75 years old) in the office with diabetes had a HbA1c \u3c8%. Several limitations were identified, including a short implementation window (6 weeks), lack of ability to assess whether providers were instituting project recommendations, staff engagement, and internet bandwidth/technology literacy issues when using telemedicine. From a long-term implementation perspective, the project showed telephone outreach and telemedicine are useful tools that can positively impact poorly controlled diabetic patients to improve glycemic control. However, the limitations of the project will likely need to be addressed to achieve long-term implementation of the project methods