scholarly journals Nurse Sensitive Indicators and How COVID-19 Influenced Practice Change

Nurse Leader ◽  
2021 ◽  
Author(s):  
Karen A. Grimley ◽  
Nicole Gruebling ◽  
Arati Kurani ◽  
David Marshall
2021 ◽  
Vol 79 ◽  
pp. S355
Author(s):  
I.G. Rizvi ◽  
A. Abroaf ◽  
R. Veeratterapillay ◽  
A. Rogers ◽  
M. Shaw ◽  
...  

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S313-S314
Author(s):  
Marilou Corpuz ◽  
Ruchika Jain ◽  
Gregory Weston ◽  
Priya Nori ◽  
Priya Nori ◽  
...  

Abstract Background COVID infections in inpatient psychiatry units present unique challenges during the pandemic, including behavioral characteristics of the patients, structural aspect of the unit, type of therapy for the patients. We present COVID outbreaks in psychiatry units in two hospitals in our medical center in Bronx, NY, and describe our mitigation strategies. Methods Hosp A: In the early period of the pandemic in NY, 2 patients in the inpatient psychiatry unit tested positive for SARS-CoV-2 PCR. The unit was temporarily closed to new admissions. Hosp B: On 4/1, one of the patients in a 22 bed Psych unit, admitted since 3/10/20, developed fever, cough and tested positive for COVID-19 PCR. Two of her close contacts tested positive for SARS-COV-2 PCR. Results Hospital A: In total, 5 of the 29 patients (17.2%) in the unit were SARS-CoV-2 positive, all of whom were asymptomatic. Hospital B: Testing of the remaining patients showed positive PCR in 10/14. PCR tests of healthcare workers (HCW) were positive in 13/46. Except for the index patient, all the patients were asymptomatic but 32/46 HCW reported symptoms. One negative patient subsequently turned positive. Infection control and prevention strategies instituted in both hospitals were the same with subtle differences due to dissimilar burden of infection and structure of the units. Table 1 shows the timing of the outbreak and the rapid institution of preventive measures in each of the hospitals. There was still difficulty with patients regarding adherence. Some of the patients refused to stay in isolation and would roam. Compliance with masking and hand hygiene was problematic. Communication was of paramount importance. Multiple meetings were held between the Psychiatry staff, Infection Control and Prevention team, executive leadership of the hospital. Environmental Services and Engineering were also involved. Communications with the NY State Department of Health occurred frequently. Conclusion Strategies for management of COVID-19 patients in inpatient psychiatric units depends on the density of infected patients in the hospital and in the community. The implementation of practice change may need to be rapidly adjusted depending on the situation and available resources. Contingency plans should be formulated early on. Disclosures Gregory Weston, MD MSCR, Allergan (Grant/Research Support)


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
R. W. McDowell ◽  
Z. P. Simpson ◽  
A. G. Ausseil ◽  
Z. Etheridge ◽  
R. Law

AbstractUnderstanding the lag time between land management and impacts on riverine nitrate–nitrogen (N) loads is critical to understand when action to mitigate nitrate–N leaching losses from the soil profile may start improving water quality. These lags occur due to leaching of nitrate–N through the subsurface (soil and groundwater). Actions to mitigate nitrate–N losses have been mandated in New Zealand policy to start showing improvements in water quality within five years. We estimated annual rates of nitrate–N leaching and annual nitrate–N loads for 77 river catchments from 1990 to 2018. Lag times between these losses and riverine loads were determined for 34 catchments but could not be determined in other catchments because they exhibited little change in nitrate–N leaching losses or loads. Lag times varied from 1 to 12 years according to factors like catchment size (Strahler stream order and altitude) and slope. For eight catchments where additional isotope and modelling data were available, the mean transit time for surface water at baseflow to pass through the catchment was on average 2.1 years less than, and never greater than, the mean lag time for nitrate–N, inferring our lag time estimates were robust. The median lag time for nitrate–N across the 34 catchments was 4.5 years, meaning that nearly half of these catchments wouldn’t exhibit decreases in nitrate–N because of practice change within the five years outlined in policy.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shoba Ramanadhan ◽  
Anna C. Revette ◽  
Rebekka M. Lee ◽  
Emma L. Aveling

AbstractQualitative methods are critical for implementation science as they generate opportunities to examine complexity and include a diversity of perspectives. However, it can be a challenge to identify the approach that will provide the best fit for achieving a given set of practice-driven research needs. After all, implementation scientists must find a balance between speed and rigor, reliance on existing frameworks and new discoveries, and inclusion of insider and outsider perspectives. This paper offers guidance on taking a pragmatic approach to analysis, which entails strategically combining and borrowing from established qualitative approaches to meet a study’s needs, typically with guidance from an existing framework and with explicit research and practice change goals.Section 1 offers a series of practical questions to guide the development of a pragmatic analytic approach. These include examining the balance of inductive and deductive procedures, the extent to which insider or outsider perspectives are privileged, study requirements related to data and products that support scientific advancement and practice change, and strategic resource allocation. This is followed by an introduction to three approaches commonly considered for implementation science projects: grounded theory, framework analysis, and interpretive phenomenological analysis, highlighting core analytic procedures that may be borrowed for a pragmatic approach. Section 2 addresses opportunities to ensure and communicate rigor of pragmatic analytic approaches. Section 3 provides an illustrative example from the team’s work, highlighting how a pragmatic analytic approach was designed and executed and the diversity of research and practice products generated.As qualitative inquiry gains prominence in implementation science, it is critical to take advantage of qualitative methods’ diversity and flexibility. This paper furthers the conversation regarding how to strategically mix and match components of established qualitative approaches to meet the analytic needs of implementation science projects, thereby supporting high-impact research and improved opportunities to create practice change.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Schloemer ◽  
P Schröder-Bäck

Abstract Background To improve the health of different populations, health systems need healthcare professionals who are able to innovate health services. In order to empower students from various healthcare professions to change health service practice in a sustainable way, a training was developed based on the PIET-T models of transferability (Schloemer & Schröder-Bäck, 2018). It was evaluated at three universities in Germany and the Netherlands. Objective The aims of the training were to enable students to: 1. Critically analyze existing evidence about successful and unsuccessful transfers of evidence-based interventions to specific “real-world” contexts (1 day), 2. Conduct an assessment of transferability with case studies using problem-based learning (1 day), 3. Practice implementation research in a healthcare organization (4 months, 4 hours/week). The training was evaluated through discussions, a written reflection and a questionnaire in order to understand students' learning experiences. Results Two bachelor programs for occupational, physical and speech therapists, and one master program for public health professionals took part from 09/2019 to 03/2020, including 66 students. Students valued the training as important, 73 % found it helpful for professional practice. They reflected various ideas how to use the PIET-T models for practice change. Although the implementation research process was perceived as high workload, students valued the experience of getting to know barriers and solutions in a practical setting. Conclusions The students of all programs value the practical relevance of teaching with profession-related specifications. Practical application of the PIET-T models opens up new approaches in teaching in order to educate knowledge on improvement of health services in different contexts. Key messages Empowering students to improve healthcare requires practical training. Training on transferability helps students develop skills for improvement of health services.


2013 ◽  
Vol 27 (47) ◽  
pp. 1007-1015
Author(s):  
Nasim Asghary ◽  
Ahmad Shahvarani ◽  
Ali Reza Medghalchi

The purpose of this study was to explore a professional development program that involved 15 teachers. Functional thinking was used as a centerpiece of the program for work with teachers of Grades 1-5 during 6 months of the study. We used the concern-based adaptation model (CBAM) as a methodology to track the process of change of teachers and to understand the trajectories through which teachers may progress. Two questions guided the investigations: 1. How does implementation of the professional development program focused on functional thinking impact teachers' concerns? 2. How did teachers' practice change due to the implementation of the innovation program? The result of the study showed effectiveness of process of change in teachers, both in stages of concerns and level of use of the innovation.


Sign in / Sign up

Export Citation Format

Share Document