scholarly journals COSPAR Constellation of Small Spacecraft: Implementation Phase

2021 ◽  
Vol 212 ◽  
pp. 19-22
Keyword(s):  
Implementation Phase ◽  
Small Spacecraft

Meningkatkan Kemampuan Guru dalam Menerapkan Model Pembelajaran Problem Centered Learning Melalui Focus Group Discission di Sekolah Dasar Negeri 187/X Bangun Karya Tahun 2019/2020

2020 ◽  
Vol 10 (1) ◽  
pp. 86
Author(s):  
Mujiem Mujiem
Keyword(s):  
Elementary School ◽  
Action Research ◽  
Focus Group ◽  
Initial Conditions ◽  
Learning Model ◽  
Class Action ◽  
Learning Activities ◽  
Implementation Phase ◽  
The Subject ◽  
Academic Year

This research is a classroom action research that aims to improve the ability of teachers to apply the problem centered learning model of learning in the Elementary School 187/ X Bangun Karya, Academic Year 2019/2020. The subject of this study was a teacher at 187 / X Bangun Karya Elementary School, Rantau Rasau District, Tanjung Jabung Timur District, Jambi Province. This class action research was carried out in two cycles, each cycle consisting of two meetings. The results of the evaluation are converted into a recapitulation table of the results of cycle I. The conversion results state that the research has not yet reached the target, it needs to be continued with cycle II. The results of observers in the implementation phase of the second cycle showed that all parts of the learning activities were going well, so that there were no more parts of the learning activities that needed to be improved. While the results of the second cycle are converted with the results of the recapitulation table states that the study has reached the target limit of completeness criteria in the first cycle that is equal to 50% and an average of 68.7 in the initial conditions of improvement in the second cycle completeness criteria to be 100% and the average namely 91.7 states that the Focus Group Discission can improve the ability of teachers to apply the Problem Centered Learning learning model in learning in 187 / X Public Elementary School Build Work Year 2019/2020.

Managing Caregiver Burden among Families of Patients with End-Stage Renal Disease

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemisi Okikiade Oyegbile ◽  
Petra Brysiewicz
Keyword(s):  
Renal Disease ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
End Stage Renal Disease ◽  
Qualitative Data ◽  
Government Support ◽  
Implementation Phase ◽  
The Family ◽  
Stage Renal Disease ◽  
End Stage

Family caregivers of patients with end-stage renal disease (ESRD) play a significant role in providing substantial care for a prolonged period for their sick relatives, often with very limited resources, making it a difficult environment. Government support for family caregivers of patients with ESRD is lacking in Nigeria, increasing their vulnerability to caregiver burden and its consequences. An action research study using a complimentary mixed-method approach was used to develop the intervention model for managing caregiver burden. Quantitative data were collected to measure the extent of caregiver burden using a Zarit Burden Interview questionnaire for 96 family caregivers, while individual in-depth interviews with 15 participants provided the qualitative data. Integrating the quantitative and qualitative data led to the identification of four moderators to manage the caregiver burden in this study. The model for managing caregiver burden was developed from the findings, using stressors and associated moderators of caregiving, and the role played by culture and finance in this context. An implementation checklist was developed, which was used by registered nurses to implement the concepts in the model with the family caregivers during the model implementation phase. Family caregivers of patients with ESRD need to be supported by nurses during the caregiving process. Nurses can increase caregivers’ identity and knowledge of the disease as a way of preventing the family caregivers from being overwhelmed by their caregiving role.

The Institute for Healthcare Improvement–NeuroPoint Alliance collaboration to decrease length of stay and readmission after lumbar spine fusion: using national registries to design quality improvement protocols

2020 ◽  
Vol 33 (6) ◽  
pp. 812-821
Author(s):  
Scott L. Zuckerman ◽  
Clinton J. Devin ◽  
Vincent Rossi ◽  
Silky Chotai ◽  
E. Hunter Dyer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Length Of Stay ◽  
Discharge Planning ◽  
Lumbar Fusion ◽  
Nonparametric Tests ◽  
Learning System ◽  
Design Quality ◽  
Implementation Phase ◽  
Healthcare Improvement ◽  
The Impact

OBJECTIVENational databases collect large amounts of clinical information, yet application of these data can be challenging. The authors present the NeuroPoint Alliance and Institute for Healthcare Improvement (NPA-IHI) program as a novel attempt to create a quality improvement (QI) tool informed through registry data to improve the quality of care delivered. Reducing the length of stay (LOS) and readmission after elective lumbar fusion was chosen as the pilot module.METHODSThe NPA-IHI program prospectively enrolled patients undergoing elective 1- to 3-level lumbar fusions across 8 institutions. A three-pronged approach was taken that included the following phases: 1) Research Phase, 2) Development Phase, and 3) Implementation Phase. Primary outcomes were LOS and readmission. From January to June 2017, a learning system was created utilizing monthly conference calls, weekly data submission, and continuous refinement of the proposed QI tool. Nonparametric tests were used to assess the impact of the QI intervention.RESULTSThe novel QI tool included the following three areas of intervention: 1) preoperative discharge assessment (location, date, and instructions), 2) inpatient changes (LOS rounding checklist, daily huddle, and pain assessments), and 3) postdischarge calls (pain, primary care follow-up, and satisfaction). A total of 209 patients were enrolled, and the most common procedure was a posterior laminectomy/fusion (60.2%). Seven patients (3.3%) were readmitted during the study period. Preoperative discharge planning was completed for 129 patients (61.7%). A shorter median LOS was seen in those with a known preoperative discharge date (67 vs 80 hours, p = 0.018) and clear discharge instructions (71 vs 81 hours, p = 0.030). Patients with a known preoperative discharge plan also reported significantly increased satisfaction (8.0 vs 7.0, p = 0.028), and patients with increased discharge readiness (scale 0–10) also reported higher satisfaction (r = 0.474, p < 0.001). Those receiving postdischarge calls (76%) had a significantly shorter LOS than those without postdischarge calls (75 vs 99 hours, p = 0.020), although no significant relationship was seen between postdischarge calls and readmission (p = 0.342).CONCLUSIONSThe NPA-IHI program showed that preoperative discharge planning and postdischarge calls have the potential to reduce LOS and improve satisfaction after elective lumbar fusion. It is our hope that neurosurgical providers can recognize how registries can be used to both develop and implement a QI tool and appreciate the importance of QI implementation as a separate process from data collection/analysis.

scholarly journals Procedural times in early non-intubated VATS program - a propensity score analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Metelmann ◽  
Johannes Broschewitz ◽  
Uta-Carolin Pietsch ◽  
Gerald Huschak ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surgical Procedure ◽  
Recovery Time ◽  
Propensity Score Analysis ◽  
Wedge Resection ◽  
University Hospital ◽  
Implementation Phase ◽  
Score Analysis ◽  
Significant Difference ◽  
Procedural Time

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

scholarly journals Perceived risk of lock-in in the front-end phase of major transportation projects

2021 ◽  
Author(s):  
Chantal C. Cantarelli ◽  
David Oglethorpe ◽  
Bert van Wee
Keyword(s):  
Perceived Risk ◽  
Risk Perceptions ◽  
Decision Makers ◽  
Project Proposal ◽  
Implementation Phase ◽  
Perceptions Of Risk ◽  
Transportation Projects ◽  
Front End ◽  
Mediating Factor ◽  
Lock In

AbstractLock-in is defined as the tendency to continue with an inefficient decision or project proposal. The front-end phase is critical to project success, yet most studies have focused on lock-in in the implementation phase. Moreover, little is known about the way in which decision-makers perceive the risk of lock-in. In this paper we identify determinants of lock-in in the front-end phase and we reveal decision-makers’ perceptions of risk of lock-in. Our findings show that risk attitudes towards lock-in vary with the level of risk aversion. However, this is not sufficiently acute to drive the level of regret needed to avoid lock-in. This implies that decision-makers do not accurately assess the risk of lock-in and as such their risk perceptions are a mediating factor in the formation of lock-in. Based on escalation of commitment, path dependency, and prospect theory, the main contribution lies in providing a more comprehensive understanding of lock-in in the front-end phase.

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