3511 research outputs found
Sort by
Development of an Emergency Preparedness Protocol in an Office Setting
Get PDFOffice-based practices are not as stringently regulated as hospitals or ambulatory surgical centers. The lack of government oversight places the responsibility heavily on office-based practitioners to properly exercise their professional ethics to ensure their patients are receiving the highest quality of care while remaining safe. The purpose of this quality improvement project was to develop and implement an emergency activation protocol for a local gastroenterologist office in Southern Illinois that promotes emergency preparedness. The emergency activation protocol provided recommendations for staff training on emergency preparedness, mock codes, checking the crash cart, monitoring of the patient, medications available, and equipment that should be easily accessible. A checklist for assigned roles in an emergency scenario and a code tracking form was also created. Staff was educated on the emergency activation protocol by a video recorded Zoom lecture and then participated in a simulated mock code event. A survey was conducted with the use of the Likert scale, and the results revealed that the staff believed their confidence in handling a medical emergency improved after the implementation of the project. The facility plans to continue to utilize the protocol to enhance provider preparedness for a medical emergency in the office setting
Healthy Jacksonville
Get PDFAbstract
According to the Morgan County Community Needs Assessment, a significant opportunity for improvement exists in healthcare access among individuals in the northeast region of Jacksonville, Illinois. Tools to screen clients, interventions to identify the healthcare needs, and access to appropriate resources can promote improved health of individuals and the community. The Healthy Jacksonville Initiative was created to improve access to healthcare and community resources for the underserved people of Jacksonville, Illinois. The goal of this project was to implement a community resource registry and individualized needs assessment for community health care workers to use in order to better serve the clients of the Healthy Jacksonville Initiative and people in the surrounding community.
Community healthcare workers implemented the tools in practice for five months. A brief, post-intervention survey was obtained to evaluate the community healthcare workers’ opinions on the tools ease of use, efficiency, and relevance in their workflow. The results of the surveys indicate community healthcare workers affiliated with the Healthy Jacksonville Initiative found the tools overall beneficial in practice. Follow-up evaluation is required to determine if long-term implementation would be successful for community health workers to aid the participants of the Healthy Jacksonville Initiative and people of the surrounding community
Increasing the Completion of Advance Directives in Patients with Chronic Obstructive Pulmonary Disease in the Primary Care Setting
Get PDFWhen considering patients with COPD, current evidence indicates that discussions related to prognosis, illness trajectory, and goals of care between the provider and patient do not happen as they should. Consequently, without any advanced directives, the default in crisis is “do everything”. This gap in practice supported the need to implement an evidence-based assessment protocol regarding advance care planning needs in patients with COPD. The purpose of this project was to increase the number of COPD patients having advanced directives in a mid-western primary care clinic. The protocol included a chart review to assess for completed advanced directives among patients scheduled to be seen in the primary care setting. Subsequently, staff received education regarding the importance of advance directives and instruction on how to offer information to patients. Of the 105 charts reviewed during the first week of implementation, none had a completed advance directive in place. All patients met criteria for completion of advance directives and 11 completed advance directive forms were returned in the first week. Upon formal evaluation of the protocol staff identified the protocol easy to understand, feasible for daily use, and beneficial to practice. Two primary care providers have initiated this protocol in their clinics
Efforts to Improve Breast Cancer Screening in a Rural Primary Care Clinic
Get PDFBreast cancer is the second-leading cause of cancer-related deaths among women in the United States. The American College of Obstetricians and Gynecologists (ACOG) recommend women at average risk of breast cancer to begin screening mammography starting at age 40. Mammography has been recognized as the most substantial tool to detect breast cancer. However, many rural organizations have seen a decrease in mammography compliance rates. The goal of this project was to create an evaluation and follow-up protocol for women in a rural primary care clinic who meet the criteria for ACOG’s guidelines for breast cancer screening which promotes increased compliance rates. The healthcare staff at a rural primary care clinic were educated and provided handout materials on the barriers to mammography. The staff was then instructed to hand out the Patient Mammography Questionnaire to determine if patients in this clinic found mammography barriers to be similar. Based on the results of the questionnaire, an infographic was developed and placed in each examination room during the month of October (Breast Cancer Awareness month). The staff also did reminder phone calls, as well as, postcards to attempt to increase compliance. By the end of the fourth quarter, compliance increased by 1
Examining Black Art Therapy Graduate Students\u27 Experiences with Racial Battle Fatigue
Get PDFABSTRACT Examining Black Art Therapy Graduate Student’s Experiences with Racial Battle Fatigue by Marilyn Holmes Chairperson: Jayashree George, DA, ATR-BC, LMFT, SEP Racial Battle Fatigue (RBF) is a term used to describe the psychological and physiological symptoms Black students experience after repeated exposure to microaggressions in higher academic settings (Smith, Yosso, & Solorzano, 2006). In this study, I sought to explore the specific experiences with RBF of current and former Black art therapy in their graduate programs and supervision. Supervision is an essential and necessary aspect of art therapy education that involves power dynamics that can be complicated by race. I also sought to explore the strategies these current and former graduate students are using to cope with RBF. Further, if art is one of those strategies, this inquiry seeks to explore the art experience. This research project used semi-structured interviews with art therapy students and emerging professionals to examine their graduate educational experience. This study found that Black art therapy graduate students do experience RBF both in the classroom and in their internship/practicum experiences and use art among a myriad of other strategies to alleviate their symptoms. The people who participated in this study also provided ideas and strategies to mitigate and prevent the symptoms of RBF for future Black art therapy graduate students. Keywords: race, racial battle fatigue, art therapy, art therapy students, emerging professional
Communication Apprehension about Death, Religious Group Affiliation, and Religiosity: Predictors of Organ and Body Donation Decisions
Get PDFCommunication willingness has previously been identified as an important communication factor in influencing individuals’ decisions to become an organ donor. Missing from this conversation is the role of communication apprehension about death and its impact on donation decisions. The purpose of this study was to examine the relationships between communication apprehension about death, religiosity, and religious affiliation, and donation decisions. Three hundred and thirty-three individuals participated in an online survey. Findings suggest that communication apprehension about death, especially communication avoidance about death, negatively impact donation decisions. Additionally, religiosity and affiliation with a specific religion also negatively impact donation decisions. These variables were also predictors of organ and body donation. The findings show a need for more research on what prevents conversations about donation. Additionally, the stark difference between organ donation likelihood and body donation likelihood underscore the need for communication scholars to examine communication about body donation
Implementation of Enhanced Recovery After Surgery (ERAS) Protocol after cystectomy: A Quality Improvement Project to Evaluate Bowel Function with implementation of ERAS Protocol
Get PDFAbstract
The purpose of this Quality Improvement project was to develop and implement an enhanced recovery after surgery (ERAS) protocol for cystectomy patients at a regional hospital in central Illinois. Specific goals included reducing patient’s length of hospital stay, reducing occurrence of postoperative ileus after surgery as well as educating the nurses involved in patient care about effective implementation the protocol. An educational presentation and knowledge assessment via testing was developed and subsequently presented to the nurses both inpatient and outpatient at the host facility. A specific protocol was crafted after discussion with stakeholders and the ERAS protocol was finalized and implemented at the facility as well. The outcome measures examined were the patient’s length of stay and occurrence of postoperative ileus. In addition, a blinded post education survey was provided to nursing staff to evaluate knowledge of the ERAS protocol. The findings demonstrated a positive trend toward decreased length of stay with no occurrence of postoperative ileus which was at 53.3% prior to implementation. Post education evaluation for the nurses also showed significant improvement in knowledge base of ERAS protocol. Limitations of this project are secondary to the lower number of post ERAS patients for the project compared to the retrospective group. However, Post ERAS patients demonstrated significantly improved postoperative outcomes thereby entrenching the ERAS protocol as the standard of care for all urology surgeries at this institution
Development of a Propofol Administration Protocol for Soy or Egg-Allergic Patients
Get PDFThe use of propofol for anesthesia and the prevalence of food allergies are both increasing. Propofol’s preparation contains soybean oil and egg lecithin, raising concerns about cross-sensitivity. No widely accepted practice protocol regarding the administration of propofol in soy or egg-allergic patients exists, and the evidence of anaphylactic reactions in this population is inconclusive. This project involved the creation of a protocol that details the use of propofol for soy or egg-allergic patients at a regional medical center in central Illinois.
Collaboration with clinical stakeholders and an extensive review of the literature guided the development of an algorithm based protocol that recommends propofol administration to all patients, regardless of food allergies. Preparedness to possibly treat a mild reaction to patients with a history of anaphylaxis is the only special consideration. Nine anesthesia providers and one pharmacist attended an educational presentation that summarized current evidence and introduced the new protocol. A survey evaluated the presentation and perceptions of the acceptability of the new protocol. The results revealed an increase in the staffs’ knowledge and support for the implementation of the protocol. By adopting this protocol into practice, stakeholders will reduce unnecessary variations in anesthetic practice and improve the quality of care
Developing and Implementing Guidelines for Amniotic Fluid Embolism
Get PDFKnowing that amniotic fluid embolism (AFE) is such a rare but harmful condition, a hospital in Metro-East St. Louis requested the creation of a checklist to ensure that all anesthesia providers quickly recognize and initiate appropriate management for AFE. The quality improvement project involved identifying the best evidence and collaborating with facility stakeholders to implement the use of an updated, evidence-based checklist to guide providers in the management of AFE. Via an open discussion PowerPoint presentation, CRNAs and anesthesiologists at the facility were provided education about AFE and the importance of using a checklist to facilitate management of AFE. The checklist that was implemented at the facility was published by Stanford Anesthesia Cognitive Aid Group. A post education presentation survey was developed collaboratively with facility stakeholders. The survey results were overwhelmingly positive with all respondents reporting that following this project intervention, they were more likely to recognize AFE and use the AFE checklist to manage AFE. Ultimately this project has the potential to save a life at the facility. Collaboration with the external and internal stakeholders occurred continually throughout the development of the project to ensure that the goals of the project were met, ending with successful adaptation of the checklist
Steep Trendelenburg Associated Postoperative Vision Loss Prevention Education
Get PDFPostoperative vision loss (POVL) is a rare, but devastating complication that has been reported following robot-assisted laparoscopic surgeries that require prolonged steep Trendelenburg positioning. A central Illinois hospital had recently established a robot-assisted surgical program but lacked active interventions to reduce POVL risk due to a knowledge gap of the anesthesia providers. Following a comprehensive literature review, a PowerPoint educational program was provided at an anesthesia staff meeting. An evidence-based cognitive aid to provide a quick reference of POVL risk reduction strategies was created by the author in collaboration with the stakeholder. Once approved, the cognitive aid was attached to the anesthesia machine. A post-presentation survey was used to evaluate the effectiveness of the teaching methods and to determine if the anesthesia staff intended to incorporate the teachings into their practice. The results of the survey indicated all participants perceived an increase in their knowledge and reported a willingness to implement POVL risk reducing strategies. A POVL Checklist was used to track which interventions were used in the hospital during a two-month period. Although few surgeries consistent with POVL risk were conducted, four completed POVL Checklists were submitted and indicated practice change. The predicted long-term impact is that the cognitive aid will continue to be used with appropriate patients, evidence-based interventions will be implemented to reduce POVL risk, and the providers will revise the guidelines when new evidence is available