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Implementation of a Situation, Background, Assessment, Recommendation (SBAR) Patient Handoff Tool in the Electronic Medical Record (EMR)
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Purpose and Problem: Handoffs that are poorly conducted are implicated in 80% of preventable adverse events in healthcare facilities. Within a Pediatric Rehabilitation Facility in Maryland Heights, Missouri it was observed that nurse handoffs were not conducted and lacked the use of a standardized evidence-based tool, resulting in nurse dissatisfaction with the handoff process and miscommunication. Recognized by the World Health Organization, The Joint Commission, and Agency for Healthcare Research and Quality, the Situation, Background, Assessment, Recommendation (SBAR) evidence-based tool is effective in improving handoff communication, improving nurse satisfaction, reducing adverse events, and promoting patient safety. The purpose of this Quality Improvement (QI) project was to implement a patient handoff tool into the electronic medical record (EMR) based on the SBAR method to help improve handoff communication and documentation. Methods: Nurses were educated on the SBAR method and tool prior to implementation of the tool. A survey was distributed pre-implementation and again at the end of the 12-week implementation period. Observation audits were conducted weekly to determine nurse compliance with the use/documentation of the SBAR handoff tool. Results: Findings indicated nurse compliance with the use of the SBAR handoff tool for day shift was 99.35% and for night shift was 99.37%. Meaning there was only a 1.43 standard deviation for day shift and a 1.29 standard deviation for night shift. Demonstrating the stated goal of increasing the minimum staff compliance to 80% with the use of a standardized shift report tool in the EMR was met. Comparison of pre and post survey mean responses showed modest improvements in items related to the use of an SBAR tool during handoff and there was an increased dissatisfaction with the amount of time it took to give handoff using an SBAR tool. Nurses stated that handoff took longer due to the cosigning requirement of the handoff. Conclusion: Use of the SBAR tool improves nurse-to-nurse communication when used during handoffs. Future Plan-Do-Study-Act (PDSA) cycles and data collection should take place for ongoing quality improvement and analysis
Vaccine Hesitancy, Provider Time, and Decision to Vaccinate
Get PDFProblem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?
Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from June 1, 2022, through December 31, 2022. A convenience sample of all newborns entering a Midwest pediatric primary care clinic was included (N = 210).
Results: A total of 64.3% of caregivers said yes to all items at every visit (n = 135) and 35.7% said no to at least one item (n = 75). 119 individual teaching sessions with a total discussion time of 23.3 hours were provided. The results of a two-tailed Mann-Whitney U test assessing for significant differences in the length of discussion time and caregivers saying Yes or No to items at each visit were found to be not statistically significant. However, a strong clinical effect was seen with 50% of caregivers agreeing to a previously refused item after receiving vaccine education, regardless of length.
Implications: While no clear evidence was determined on how provider discussion time may affect a caregiver’s decision to vaccinate their children, the strong clinical effect seen in this project further supports the need for continued research into determining the most effective way to mitigate vaccine hesitancy and improve childhood vaccination rates
Comparison between the Effectiveness of mySci and OpenSciEd Curricula on the Achievement and Attitudes of Eighth Grade Science Students
Get PDFEducators have struggled with maintaining student engagement in science, especially as students transition from primary to middle school and upper grades (Vedder-Weiss & Fortus, 2012). A recent push in science education has been the adoption of the Next Generation Science Standards (NGSS), released in 2013, whose development was guided by A K-12 Framework for Science Education (NGSS Lead States, 2013). As a result, more educators have been incorporating curricula that require students to ascertain disciplinary core ideas using lenses of cross cutting concepts while engaged in science and engineering practices; the three dimensions of NGSS performance expectations (PE) also known as three-dimensional learning when in practice. Two curricula, mySci (Washington University in St. Louis Institute for School Partnership, 2020) and OpenSciEd (OpenSciEd, 2021), were compared in terms of student academic achievement and attitudes towards science. The research questions were: (1) To what extent is there a difference between achievement in science by eighth grade students experiencing the OpenSciEd curriculum and those experiencing mySci curriculum as measured by end of unit assessment scores? (2) To what extent is the difference between attitudes toward science by eighth grade students experiencing the OpenSciEd curriculum and those experiencing mySci curriculum as measured by My Attitudes Toward Science (MATS) survey (Hillman et al., 2016)
The Public Muse in Congress: The Punctuation of American Federal Arts Policy
Get PDFIn 1989, American federal arts policy changed suddenly and drastically when the National Endowment for the Arts (NEA) gained unprecedented attention in Congress for controversial grant awards that supported two visual artists. Prior to this, federal arts policy was an insulated subsystem run by experts applying high art aesthetic standards to grantmaking. Informed by punctuated-equilibrium theory (PET), this investigation of congressional rhetoric shows that Republican policy entrepreneurs during this time effectively set a new, more negative tone about federal arts policy by harnessing conservative culture wars messages. The change in tone preceded federal arts policy’s arrival on the broader congressional agenda that resulted in substantive changes to policy, including prohibiting the NEA from supporting “obscene” artwork and fellowships for individual artists, diversifying advisors and grant panelists, restricting types of grant funding, and more. These policy changes effectively addressed the vagueness of the agency’s enabling legislation, introduced a new decision-making paradigm to the grantmaking process, and increased public accountability. The federal arts policy subsystem was punctuated and it is likely that political polarization, and especially the efforts of Republicans, amplified the macro-political intervention. By the end of the crisis, American federal arts policy had achieved a more democratic partial equilibrium. The punctuation of the American federal arts policy subsystem, especially changes to the policymaking process, continues to define American federal arts policy to this day
Examining the Interrelations between Rational Choice Inputs: Implications for Criminological Theory and Research
Get PDFAn essential component of any rational choice theory of criminal behavior is the notion that crime decisions are driven by an individual’s expected gains and losses to illicit activities. More specifically, offenders are typically presumed to balance the pleasures of the various benefits to crime against the pains associated with crime’s risks and costs, the presumption being that the offender will pursue criminal acts in the event he or she believes the expected utility to crime exceeds that which can be achieved through strictly legal means. Although criminologists have managed to test some of the more basic implications of this choice calculus, so to speak, many of the more nuanced predictions of this calculus have received relatively minimal scholarly attention. In particular, little is currently known about the extent to which a person’s perceptions of the rewards, risks, and costs to crime will exert a combined influence on his or her criminal proclivities. Put differently, we have yet to rigorously examine whether the perceived incentives to crime will be interdependent on one another in shaping an offender’s involvement in criminal activities. Not only is the criminological literature largely bereft of any formal discussion of any such interdependencies (insofar as what theory would seem to imply about the interrelations between rational choice inputs), but also any direct empirical examination of those interdependencies still has yet to be carried out. This dissertation sought to fill this gap in the literature by deriving three primary sets of hypotheses from prior scholarship on rational choice theories of crime (namely, Becker’s [1986] model), each of which outlines the directionality, and overall functional form, of the potential interdependent relationships between the rewards, risks, and costs to crime. Each hypothesis was then examined using self-report data derived from the Pathways to Desistance Study, the results of which were largely supportive of the existence of a generally interdependent link between rational choice variables
Neurodiverse Perceptions of Inclusivity in the Workplace
Get PDFThe increase in neurodivergent professionals in the workplace has led to a significant need for researchers to examine neurodiversity inclusion in the workplace. Research has portrayed workplace inclusion as the perception that the individual is a valued member of a workgroup through satisfactory experiences of belongingness and uniqueness. Through semi-structured interviews with 20 neurodivergent professionals, this study examined how they view inclusion, exclusion, and cope with exclusion in the workplace. The neurodivergent participants identified six inclusion and six exclusion categories. Results were largely consistent with previous inclusion research, however, one novel category, flexible accommodations, suggests the importance of considerate accommodations that are easy to implement, low cost, and significantly matter to neurodivergent employees. Participants also identified six coping strategies that provide insight into how they cope with exclusion which vary from masking to educating others on their strengths and needs. These results underscore the importance of neurodiversity awareness, and intentional and informed neurodiversity inclusive practices. This research adds to both the theoretical and practical application of neurodiversity inclusion. Practitioners can utilize this research to progress their culture to improve the inclusion of neurodivergent employees, which previous research shows that inclusion practices improve firm performance and provides neurodivergent individuals a pathway to success in their work
Factors Affecting Technology Integration for Teachers at K-12, Adult Education, and Higher Education Institutions Since Virtual Learning Due to COVID-19
Get PDFThis quantitative study investigates instructors\u27 perceptions of the factors influencing technology integration in their instruction, spanning the years 2019-2023, encompassing the transition from virtual to in-person learning after COVID-19. It examines technology integration barriers and supports experienced by instructors in the Midwestern United States, namely Missouri, during this period. Additionally, it explores how the virtual learning experience during the pandemic has influenced instructors\u27 self-perceptions of their digital competence. The study encompasses three education sectors: K-12, adult education, and higher education, providing a unique multi-sector perspective. By delving into the post-COVID-19 educational environment, this research aims to offer valuable insights. The methodology involved an online survey.
Results of this study show that despite the abrupt transition to remote learning due to COVID-19, barriers such as lack of time and training that have been identified in previous studies (Basarmak et al., 2020; Ertmer et al., 2012; Ertmer & Ottenbreit-Leftwich, 2010) for decades still prove to have a large impact on the ability of educators to effectively integrate technology in their instruction. It echoes the importance of addressing barriers such as time constraints and emphasizes the need for comprehensive professional development programs, especially in the post-COVID landscape. The findings suggest that institutions should prioritize dedicated time and consistent support for technology integration, particularly in the evolving post-pandemic educational landscape
The Permanence of Racism in Tennessee Public Schools
Get PDFThe qualitative case study exposed the permanence of racism beginning in the antebellum public schools of Nashville and continued in the current actions in the Tennessee legislature with the expulsion of two Black male legislators. Critical race theory is used as the main descriptor for the actions of White politicians and legislators in Tennessee who continue the oppressive treatment of Black people in the state of Tennessee.
White members of the Tennessee legislature have attempted to strategically continue white supremacy in their decision to display a depiction of one of the most deplorable, racists in the history of the state of Tennessee, Nathan Bedford Forrest. They also splintered the voting power of people of color by changing the voting districts in Nashville and Memphis in an attempt to eliminate adequate representation in the legislature.
Critical race theory can be used to establish equality for everyone in the United States. It is not indoctrination. Unfortunately, there is still a segment of Americans who prefer to disavow the truth about the history of the United States. We cannot move forward without the acknowledgment of the deplorable actions of the past. This is the reason racism continues. We are not in a post-racial time period. We have reverted back to a time period in which individuals believe it is acceptable to use disrespectful words and comments directed toward people who look different. This is how the permanence of racism works
umsllibraries | Reels | 2023-08-29
No full textPosted Text: Welcome to UMSL Libraries, Tritons! We hope you all have an amazing semester. #UMSL #UMSLLibrariesPost Description: This 2023 video offers a short tour of the UMSL Library’s main floor and the Mercantile Library downstairs—the former now fully renovated.https://irl.umsl.edu/instagram/1009/thumbnail.jp