scholarly journals Effectiveness of the dementia nursing competence e-learning program for nurses in acute care hospitals in Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 826-826
Author(s):  
Mizue Suzuki ◽  
Hiromi Yoshimura ◽  
Soichiro Mimuro ◽  
Keisuke Sawaki ◽  
Nanayo Sasaki ◽  
...  
Keyword(s):  
Acute Care ◽  
Nursing Practice ◽  
Acute Care Hospitals ◽  
Japanese Version ◽  
Nursing Intervention ◽  
Learning Program ◽  
Application Form ◽  
Fourth Period ◽  
Nursing Competence ◽  
E Learning

Abstract Objective The number of older patients with dementia hospitalised in acute care hospitals increased and these patients underwent physical restrictions leading to a degeneration of essential mental and physical function. The dementia nursing competence e-learning program with audio-visual materials has been developed in acute care hospitals. Methods An application form that explained the research was distributed to 1,944 registered nurses from seven hospitals, and 110 people applied. Nurses used an e-learning program for a month in May and practiced applying the knowledge learned from programs June through November 2020. The nurses completed a questionnaire survey at four periods: first (before program/baseline), second (after program), third (three months later), and fourth (six months later). In the second, third, and fourth periods, ‘Technical knowledge of the dementia nursing’ and ‘dementia nursing intervention’ were significantly improved as compared with the first. In the fourth period, ‘confidence of reduce of physical restriction’ showed significant improvement compared to the first. In ‘Ethical sensitivity scale of nurses’, the first of the four sub-scales significantly increased as compared with the first period. In ‘Self-assessment Scale of Nursing Practice for Elderly Patients with Cognitive Impairment with the Aim of Person-centred Care in Acute Care Hospitals’, the fourth sub-scale showed significant improvement compared to the first. In the ‘Personhood’ sub- scale of the Japanese version of Approaches to Dementia　Questionnaire, the fourth period showed a significant increase compared to the first. Conclusion The results suggest that this program was effective and led to reduced physical restrictions in nursing practice.

Qualitative analysis on perceived satisfaction in a b-learning program at a Portuguese University

2014 ◽  
Author(s):  
Célia Quintas ◽  
Ana Luísa Teixeira ◽  
Isabel Fernandes Silva ◽  
Jane Rodrigues Duarte
Keyword(s):  
Knowledge Management ◽  
Qualitative Analysis ◽  
Learning Strategies ◽  
Learning Process ◽  
Virtual Learning Environment ◽  
Learning Approaches ◽  
Learning Program ◽  
Perceived Satisfaction ◽  
E Learning ◽  
Learner Attitude

Knowledge management and learning are buzzwords in today’s society, both in terms of company competitiveness as well as in terms of education. Human resources are thus a priority for individuals and companies. The concept of knowledge management and of learning organizations has been object of increased interest by managers and scholars. The increased focus on these issues brings forth the individual as a crucial element in this process; individuals become key elements in competitiveness (Nonaka & Takeuchi: 1995) and protagonists of their own learning process (Senge: 1992).Additionally, the learning methodologies and strategies have also changed in the past decades, so that currently much is offered by means of b-learning and e-learning courses that, on the one hand, allow students to opt for several learning strategies, and on the other hand, require them to actively participate in their learning path. In fact, the evolution of ICT in studies and the growing experience of both teachers and students have gradually adapted to new methodologies. However, while materials and subject matter have been made easier and more accessible to students who do not attend classroom sessions, an underlying problem has always been present: bridging the physical distance among all the stakeholders involved in the learning process and all the difficulties that may emerge from this.Since its first edition in 2001, this Post-Graduation Program, now in its 12th edition, has undergone several changes, from its study plan to learning regime. As a means of responding to the demands of today’s market and in particular new learning styles, new possibilities have been made for attending the course which range from classroom, to blending and e-learning formats. As a means of fostering group spirit, synchronous and asynchronous participation of all students several changes were introduced this academic year. Besides the use of the Moodle platform, a Virtual Learning Environment (VLE) wiziq has been introduced.In 2013-14, the program includes students from Portugal (including the Azores), Mexico and Nigeria. Moreover, this Post-Graduation Program allows students to opt for f2f, b-learning and e-learning regimes, i.e., within the same group, some students attend classes by means of a VLE, others attend some classes f2f and others using the VLE and others attend f2f classes regularly, though they also have access to the VLE. A program that combines three learning approaches/methodologies/strategies allows the possibility of assessing possible differences in terms of efficiency of these three learning methodologies, considering that these imply a change in expectations, attitude and cognitive process.Our paper focuses on a study carried out in a Post-Graduation Program at a Portuguese university, on perceived satisfaction regarding the use of ICT tools in the program, a theme which has already been object of study at UAL in recent years, both in terms of assessing and monitoring learning progress, of learner attitude toward their learning paths (Fernandes Silva & Rodrigues Duarte. 2011a & b) and the tools and methodologies made available to them and of perceived satisfaction (Fernandes Silva & Quintas: 2013).This paper corresponds to a 1st stage of a broader study that will involve all students in the referred program in 2013-14 as well as all the lecturers. Initially, a qualitative analysis is carried out based on semi-structured interviews; at a 2nd stage, we aim to create a questionnaire to be applied to a wider population.

Physical restraint to patients with dementia in acute physical care settings: effect of the financial incentive to acute care hospitals

2017 ◽  
Vol 30 (7) ◽  
pp. 991-1000 ◽  
Author(s):  
Miharu Nakanishi ◽  
Yasuyuki Okumura ◽  
Asao Ogawa
Keyword(s):  
Acute Care ◽  
Financial Incentive ◽  
Physical Restraint ◽  
Acute Care Hospitals ◽  
Dementia Care ◽  
Lower Percentage ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Insurance Program ◽  
Healthcare Insurance

ABSTRACTBackground:In April 2016, the Japanese government introduced an additional benefit for dementia care in acute care hospitals (dementia care benefit) into the universal benefit schedule of public healthcare insurance program. The benefit includes a financial disincentive to use physical restraint. The present study investigated the association between the dementia care benefit and the use of physical restraint among inpatients with dementia in general acute care settings.Methods:A national cross-sectional study design was used. Eight types of care units from acute care hospitals under the public healthcare insurance program were invited to participate in this study. A total of 23,539 inpatients with dementia from 2,355 care units in 937 hospitals were included for the analysis. Dementia diagnosis or symptoms included any signs of cognitive impairment. The primary outcome measure was “use of physical restraint.”Results:Among patients, the point prevalence of physical restraint was 44.5% (n= 10,480). Controlling for patient, unit, and hospital characteristics, patients in units with dementia care benefit had significantly lower percentage of physical restraint than those in any other units (42.0% vs. 47.1%; adjusted odds ratio, 0.76; 95% confident interval [0.63, 0.92]).Conclusions:The financial incentive may have reduced the risk of physical restraint among patients with dementia in acute care hospitals. However, use of physical restraint was still common among patients with dementia in units with the dementia care benefit. An educational package to guide dementia care approach including the avoidance of physical restraint by healthcare professionals in acute care hospitals is recommended.

Developing a novel diabetes distress e-learning program for diabetes educators: an intervention mapping approach

2021 ◽  
Author(s):  
Jennifer A Halliday ◽  
Jane Speight ◽  
Sienna Russell-Green ◽  
Eric O ◽  
Virginia Hagger ◽  
...  
Keyword(s):  
Cognitive Theory ◽  
Tertiary Education ◽  
Emotional Health ◽  
Intervention Mapping ◽  
Diabetes Distress ◽  
Learning Program ◽  
Program Outcomes ◽  
Mapping Approach ◽  
E Learning ◽  
Diabetes Educators

Abstract Diabetes distress is a common negative emotional response to the ongoing burden of living with diabetes. Elevated diabetes distress is associated with impaired diabetes self-management and quality of life yet rarely identified and addressed in clinical practice. Health professionals report numerous barriers to the provision of care for diabetes distress, including lack of skills and confidence, but few diabetes distress training opportunities exist. The purpose of this paper is to describe how we utilized Intervention Mapping to plan the development, implementation, and evaluation of a novel diabetes distress e-learning program for diabetes educators, to meet a well-documented need and significant gap in diabetes care. A multidisciplinary team (combining expertise in research, health and clinical psychology, diabetes education, nursing, tertiary education, and website architecture) developed a diabetes distress e-learning program. We followed a six-step process (logic model of the problem, program outcomes and objectives, program design, program production, program implementation plan, and evaluation plan) known as Intervention Mapping. The program is underpinned by educational and psychological theory, including Bloom’s Taxonomy of Educational Objectives and social cognitive theory. We developed a short (estimated 4 h) e-learning program for diabetes educators, which draws on the content of the Diabetes and Emotional Health handbook and toolkit. It integrates a 7As model, which provides a stepwise approach to identifying and addressing diabetes distress. Our diabetes distress e-learning program has been developed systematically, guided by an Intervention Mapping approach. In the next phase of the project, we will trial the e-learning.

scholarly journals Prevalence of SARS-CoV-2 antibodies in health care personnel of two acute care hospitals in Linz, Austria

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Margot Egger ◽  
Christian Bundschuh ◽  
Kurt Wiesinger ◽  
Elisabeth Bräutigam ◽  
Thomas Berger ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Health Care Personnel

scholarly journals Effectiveness of Ultraviolet-C Room Disinfection on Preventing Healthcare-Associated Clostridioides difficile Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s33-s33
Author(s):  
Michihiko Goto ◽  
Erin Balkenende ◽  
Gosia Clore ◽  
Rajeshwari Nair ◽  
Loretta Simbartl ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Incidence Rates ◽  
Positive Test ◽  
Negative Binomial Regression Model ◽  
Test Results ◽  
Clostridioides Difficile ◽  
Ultraviolet C ◽  
Healthcare Associated ◽  
Uv C

Background: Enhanced terminal room cleaning with ultraviolet C (UVC) disinfection has become more commonly used as a strategy to reduce the transmission of important nosocomial pathogens, including Clostridioides difficile, but the real-world effectiveness remains unclear. Objectives: We aimed to assess the association of UVC disinfection during terminal cleaning with the incidence of healthcare-associated C. difficile infection and positive test results for C. difficile within the nationwide Veterans Health Administration (VHA) System. Methods: Using a nationwide survey of VHA system acute-care hospitals, information on UV-C system utilization and date of implementation was obtained. Hospital-level incidence rates of clinically confirmed hospital-onset C. difficile infection (HO-CDI) and positive test results with recent healthcare exposures (both hospital-onset [HO-LabID] and community-onset healthcare-associated [CO-HA-LabID]) at acute-care units between January 2010 and December 2018 were obtained through routine surveillance with bed days of care (BDOC) as the denominator. We analyzed the association of UVC disinfection with incidence rates of HO-CDI, HO-Lab-ID, and CO-HA-LabID using a nonrandomized, stepped-wedge design, using negative binomial regression model with hospital-specific random intercept, the presence or absence of UVC disinfection use for each month, with baseline trend and seasonality as explanatory variables. Results: Among 143 VHA acute-care hospitals, 129 hospitals (90.2%) responded to the survey and were included in the analysis. UVC use was reported from 42 hospitals with various implementation start dates (range, June 2010 through June 2017). We identified 23,021 positive C. difficile test results (HO-Lab ID: 5,014) with 16,213 HO-CDI and 24,083,252 BDOC from the 129 hospitals during the study period. There were declining baseline trends nationwide (mean, −0.6% per month) for HO-CDI. The use of UV-C had no statistically significant association with incidence rates of HO-CDI (incidence rate ratio [IRR], 1.032; 95% CI, 0.963–1.106; P = .65) or incidence rates of healthcare-associated positive C. difficile test results (HO-Lab). Conclusions: In this large quasi-experimental analysis within the VHA System, the enhanced terminal room cleaning with UVC disinfection was not associated with the change in incidence rates of clinically confirmed hospital-onset CDI or positive test results with recent healthcare exposure. Further research is needed to understand reasons for lack of effectiveness, such as understanding barriers to utilization.Funding: NoneDisclosures: None

scholarly journals Pathogens Associated With Repeat Versus Single Central-Line–Associated Bloodstream Infections, Acute-Care Hospitals, NHSN

2020 ◽  
Vol 41 (S1) ◽  
pp. s343-s344
Author(s):  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Jonathan R. Edwards
Keyword(s):  
Acute Care ◽  
National Level ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Patient Specific ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
Repeat Infection ◽  
Single Versus

Background: The NHSN is the nation’s largest surveillance system for healthcare-associated infections. Since 2011, acute-care hospitals (ACHs) have been required to report intensive care unit (ICU) central-line–associated bloodstream infections (CLABSIs) to the NHSN pursuant to CMS requirements. In 2015, this requirement included general medical, surgical, and medical-surgical wards. Also in 2015, the NHSN implemented a repeat infection timeframe (RIT) that required repeat CLABSIs, in the same patient and admission, to be excluded if onset was within 14 days. This analysis is the first at the national level to describe repeat CLABSIs. Methods: Index CLABSIs reported in ACH ICUs and select wards during 2015–2108 were included, in addition to repeat CLABSIs occurring at any location during the same period. CLABSIs were stratified into 2 groups: single and repeat CLABSIs. The repeat CLABSI group included the index CLABSI and subsequent CLABSI(s) reported for the same patient. Up to 5 CLABSIs were included for a single patient. Pathogen analyses were limited to the first pathogen reported for each CLABSI, which is considered to be the most important cause of the event. Likelihood ratio χ2 tests were used to determine differences in proportions. Results: Of the 70,214 CLABSIs reported, 5,983 (8.5%) were repeat CLABSIs. Of 3,264 nonindex CLABSIs, 425 (13%) were identified in non-ICU or non-select ward locations. Staphylococcus aureus was the most common pathogen in both the single and repeat CLABSI groups (14.2% and 12%, respectively) (Fig. 1). Compared to all other pathogens, CLABSIs reported with Candida spp were less likely in a repeat CLABSI event than in a single CLABSI event (P < .0001). Insertion-related organisms were more likely to be associated with single CLABSIs than repeat CLABSIs (P < .0001) (Fig. 2). Alternatively, Enterococcus spp or Klebsiella pneumoniae and K. oxytoca were more likely to be associated with repeat CLABSIs than single CLABSIs (P < .0001). Conclusions: This analysis highlights differences in the aggregate pathogen distributions comparing single versus repeat CLABSIs. Assessing the pathogens associated with repeat CLABSIs may offer another way to assess the success of CLABSI prevention efforts (eg, clean insertion practices). Pathogens such as Enterococcus spp and Klebsiella spp demonstrate a greater association with repeat CLABSIs. Thus, instituting prevention efforts focused on these organisms may warrant greater attention and could impact the likelihood of repeat CLABSIs. Additional analysis of patient-specific pathogens identified in the repeat CLABSI group may yield further clarification.Funding: NoneDisclosures: None

scholarly journals The Comparison of Role Conflict Among Registered Nurses and Registered Practical Nurses Working in Acute Care Hospitals in Ontario Canada

2021 ◽  
pp. 084456212110144
Author(s):  
Behdin Nowrouzi-Kia ◽  
Mary T. Fox ◽  
Souraya Sidani ◽  
Sherry Dahlke ◽  
Deborah Tregunno
Keyword(s):  
Emergency Department ◽  
Role Conflict ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical Unit ◽  
Scale Scores ◽  
Surgical Unit

Objectives The study aimed to describe and compare nurses’ perceptions of role conflict by professional designation [registered nurse (RN) vs registered practical nurse (RPN)] in three primary areas of practice (emergency department, medical unit, and surgical unit). Methods This analysis used data (n = 1,981) from a large cross-sectional survey of a random sample of RNs and RPNs working as staff nurses in acute care hospitals in Ontario, Canada. Role conflict was measured by the Role Conflict Scale. Results A total of 1,981 participants (RN = 1,427, RPN = 554) met this study’s eligibility criteria and provided complete data. In general, RN and RPN mean total scale scores on role conflict hovered around the scale’s mid-point (2.72 to 3.22); however, RNs reported a higher mean score than RPNs in the emergency department (3.22 vs. 2.81), medical unit (2.95 vs 2.81) and surgical unit (2.90 vs 2.72). Where statistically significant differences were found, the effect sizes were negligible to medium in magnitude with the largest differences noted between RNs and RPNs working in the emergency department. Conclusions The results suggest the need to implement strategies that diminish role conflict for both RNs and RPNs.

scholarly journals A Statewide Assessment of Antifungal Stewardship Activities in Acute-Care Hospitals in Connecticut

2020 ◽  
Vol 41 (S1) ◽  
pp. s105-s105
Author(s):  
Romina Bromberg ◽  
Vivian Leung ◽  
Meghan Maloney ◽  
Anu Paranandi ◽  
David Banach
Keyword(s):  
Infectious Diseases ◽  
Acute Care ◽  
Antifungal Therapy ◽  
Antibiotic Stewardship ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Acute Care Hospitals ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Stewardship ◽  
Infectious Diseases Consultation

Background: Morbidity and mortality associated with invasive fungal infections and concerns of emerging antifungal resistance have highlighted the importance of optimizing antifungal therapy among hospitalized patients. Little is known about antifungal stewardship (AFS) practices among acute-care hospitals. We sought to assess AFS activities within Connecticut and to identify opportunities for improvement. Methods: An electronic survey assessing AFS practices was distributed to infectious disease physicians or pharmacy antibiotic stewardship program leaders in Connecticut hospitals. Survey questions evaluated AFS activities based on antibiotic stewardship principles, including several CDC Core Elements. Questions assessed antifungal restriction, prospective audit and feedback practices, antifungal utilization measurements, and the perceived utility of a local or statewide antifungal antibiogram. Results: Responses were received from 15 respondents, which represented 20 of 31 hospitals (65%); these hospitals made up the majority of the acute-care hospitals in Connecticut. Furthermore, 18 of these hospitals (58%) include antifungals in their stewardship programs. Also, 16 hospitals (52%) conduct routine review of antifungal ordering and provide feedback to providers for some antifungals, most commonly for amphotericin B, voriconazole, micafungin, isavuconazole, and flucytosine. All hospitals include guidance on intravenous (IV) to oral (PO) conversions, when appropriate. Only 14 of hospitals (45%) require practitioners to document indication(s) for systemic antifungal use. Most hospitals (17, 55%) provide recommendations for de-escalation of therapy in candidemia, though only 4 (13%) have institutional guidelines for candidemia treatment, and only 11 hospital mandates an infectious diseases consultation for candidemia. Assessing outcomes pertaining to antifungal utilization is uncommon; only 8 hospitals (26%) monitor days of therapy and 5 (16%) monitor antifungal expenditures. Antifungal susceptibility testing on Candida bloodstream isolates is performed routinely at 6 of the hospitals (19%). Most respondents (19, 95%) support developing an antibiogram for Candida bloodstream isolates at the statewide level. Conclusions: Although AFS interventions occur in Connecticut hospitals, there are opportunities for enhancement, such as providing institutional guidelines for candidemia treatment and mandating infectious diseases consultation for candidemia. The Connecticut Department of Public Health implemented statewide Candida bloodstream isolate surveillance in 2019, which includes antifungal susceptibility testing. The creation of a statewide antibiogram for Candida bloodstream infections is underway to support empiric antifungal therapy.Funding: NoneDisclosures: None

scholarly journals The Combined Usage of the Global Leadership Initiative on Malnutrition Criteria and Controlling Nutrition Status Score in Acute Care Hospitals

2021 ◽  
pp. 1-7
Author(s):  
Asako Mitani ◽  
Takahito Iwai ◽  
Toshiaki Shichinohe ◽  
Hiroshi Takeda ◽  
Satomi Kumagai ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Care ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Acute Care Hospitals ◽  
Global Leadership ◽  
Nutrition Status ◽  
Nutritional Interventions ◽  
Combined Use ◽  
Conut Score

<b><i>Introduction:</i></b> The Global Leadership Initiative on Malnutrition (GLIM) lacks reliable blood tests for evaluating the nutrition status. We retrospectively compared the GLIM criteria, Controlling Nutrition Status (CONUT) score, and Subjective Global Assessment (SGA) to establish effective malnutrition screening and provide appropriate nutritional interventions according to severity. <b><i>Methods:</i></b> We classified 177 patients into 3 malnutrition categories (normal/mild, moderate, and severe) according to the GLIM criteria, CONUT score, and SGA. We investigated the malnutrition prevalence, concordance of malnutrition severity, predictability of clinical outcome, concordance by etiology, and clinical outcome by inflammation. <b><i>Results:</i></b> The highest prevalence of malnutrition was found using the GLIM criteria (87.6%). Concordance of malnutrition severity was low between the GLIM criteria and CONUT score. Concordance by etiology was low in all groups but was the highest in the “acute disease” group. The area under the curve of clinical outcome and that of the “with inflammation group” were significantly higher when using the CONUT score versus using the other tools (0.679 and 0.683, respectively). <b><i>Conclusion:</i></b> The GLIM criteria have high sensitivity, while the CONUT score can effectively predict the clinical outcome of malnutrition. Their combined use can efficiently screen for malnutrition and patient severity in acute care hospitals.

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