QOL-48. INTERDISCIPLINARY SPIRITUAL CARE TRAINING IN PEDIATRIC NEURO-ONCOLOGY

Abstract INTRODUCTION Pediatric neuro-oncology requires attention to not only cancer biology and therapeutics, but also to the suffering of the patient. In addressing patient suffering, consensus guidelines direct attention to the spiritual distress and resources of patients and families. A lack of training has been a key barrier to integrating this aspect of health into patient care. METHODS A neuro-oncologist and a chaplain participated in a train the trainer for the Interprofessional Spiritual Care Education Curriculum (ISPEC) through the George Washington University’s Institute for Spirituality and Health. After the train the trainer, the online curriculum was offered to interdepartmental team members, combined with in-person discussion groups, which met weekly for six sessions. A survey was given before and after the training, and Likert scores were analyzed using the Wilcoxon rank-sum non-parametric test. OUTCOMES: 17 interdisciplinary members participated in the training. These members included neuro-oncologists, neuro-surgeons, rehabilitation physicians, nurse practitioners, nurses, physical therapists, music therapists, a child life specialist, a school liaison, and a patient experience specialist. The training resulted in multiple improvements, including increased ability to identify spiritual issues (p=.0278) and increased ability to respond to these issues (p=.0056). CONCLUSION ISPEC addressed a key barrier to providing generalist spiritual care to patients with pediatric brain tumors. Diverse disciplines were represented during the training. With implementation of interdisciplinary spiritual care, outcomes that may be measured in the future include improved quality of life, patient satisfaction, and the resilience of both patients and team members.

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Nurse Practitioner’s Clinical Triggers for Referral to Other 3D Team Members

Innovation in Aging ◽

10.1093/geroni/igaa057.2680 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 745-745

Author(s):

Shawn Ladda

Keyword(s):

Older Adults ◽

Community Health ◽

Nurse Practitioners ◽

Physical Therapists ◽

Exercise Program ◽

Health Educator ◽

Problem Solving Therapy ◽

Team Members ◽

Resource Information ◽

Registered Dietician

Abstract This presentation features how 3D Team nurse practitioners (NP) use results of clinical assessments to determine whether older adults and caregivers enrolled in the study are referred to other Team members; these assessment results are called “clinical triggers”. Other team members who receive referrals based on NP-generated clinical triggers include: Licensed Clinical Social Workers, who deliver Problem Solving Therapy to older adults with significant depressive symptoms; Occupational Therapists, who deliver an evidence-based dementia care intervention; Physical Therapists, who deliver an adapted Otago exercise program; Registered Dietician, who provides nutrition and dietary instruction; and Community Health Educator, who provides community resource information to address social determinants of health. All clinical triggers will be detailed in this presentation, along with a description of each intervention delivered by other team members except the Community Health Educator. Case studies will be presented to illustrate how study participants receive multiple interventions from the 3D Team.

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71 Developing A Portfolio for Advanced Practitioners Working with Older People

Age and Ageing ◽

10.1093/ageing/afab030.32 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

L MacDiarmid

Keyword(s):

Action Research ◽

Older People ◽

Nurse Practitioners ◽

Professional Competence ◽

Written Feedback ◽

Advanced Practice ◽

Participatory Action ◽

Advanced Level ◽

Team Members ◽

Acute Trust

Abstract Introduction Advanced Nurse Practitioners (ANP’s) have a professional responsibility to ensure that they maintain professional competence (Whiteing, N. in Hinchcliffe and Rogers Eds pp192–219, 2008). The aim of the portfolio is to assist ANP’s in developing evidence demonstrating continued advanced level practice. At the time of the study, there was a dearth of evidence relating to competencies for qualified ANP’s, working with older people. The aim was to move away from the traditional confines of “nurse does this, doctor does this”, and to embrace the concept of developing skills to meet the clinical demands of service provision for our older people. Methods Participatory action research methodology was adopted—using the Review, Plan and act cycle (Edwards and Talbot, p63 1999; Holloway & Wheeler p155–156, 1996). Review A literature search and review of competencies relating to advanced practice and older people was undertaken. Plan A portfolio of knowledge and skills was collated utilising the information from the review. A matrix was created incorporating four Pillars of Advanced Practice (SGHD 2008), the Nursing and Midwifery Code (NMC, 2015) and modified competencies for Joint Royal Colleges of Physicians Training Board Geriatric curriculum (JRCPTB), (2010, amended 2013 and 2015). The portfolio was sent out to existing team members, and local Consultant Geriatricians based in the Acute Trust and local University for comment and amendments were made. Act The portfolio was used by staff as a trial and evaluated. Written feedback was obtained through questionnaires. Results The portfolio was well evaluated by staff using it, including recommendations for improvement. Portfolio has been shared at national groups and via social media and has been well received. Conclusions An Advanced Practice Portfolio of capabilities is being used, based on action research cycles, enhancing the level of care received by older people.

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An Exploratory Study of Spiritual Dimensions Among Nursing Students

International Journal of Nursing Education Scholarship ◽

10.2202/1548-923x.1915 ◽

2010 ◽

Vol 7 (1) ◽

Cited By ~ 9

Author(s):

Mary A Wehmer ◽

Mary T Quinn Griffin ◽

Ann H. White ◽

Joyce J. Fitzpatrick

Keyword(s):

Nursing Students ◽

Spiritual Care ◽

Well Being ◽

Spiritual Practices ◽

Religion And Spirituality ◽

Spiritual Experiences ◽

Daily Spiritual Experiences ◽

Before And After ◽

Spiritual Well Being ◽

The Relationship

This exploratory descriptive study of spiritual experiences, well-being, and practices was conducted among 126 nursing students. Participants reported a higher level of spiritual well-being and life scheme than self-efficacy for well-being and life-scheme. Thus, students appeared to view the world and their role in it slightly more positively than their ability to affect their lives and make decisions. The students reported the most frequent spiritual experiences as being thankful for blessings; the next most frequent spiritual experiences having a desire to be close to God, feeling a selfless caring for others, and finding comfort in ones religion and spirituality. Students used both conventional and unconventional spiritual practices. Further study is necessary to study the relationship among spiritual practices, daily spiritual experiences, and spiritual well-being among nursing students and to evaluate these before and after implementation of specific educational offerings focused on spirituality and spiritual care in nursing.

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Assessing the Frequency Nurse Practitioners Incorporate Spiritual Care into Patient-Centered Care

The Journal for Nurse Practitioners ◽

10.1016/j.nurpra.2017.03.005 ◽

2017 ◽

Vol 13 (5) ◽

pp. 368-375 ◽

Cited By ~ 4

Author(s):

Barbara Baele Vincensi ◽

Marvin Solberg

Keyword(s):

Nurse Practitioners ◽

Spiritual Care ◽

Patient Centered Care ◽

Patient Centered ◽

Centered Care

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888. Improving outcomes with revised preoperative universal decolonization protocol

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1076 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S479-S479

Author(s):

Silvia I Gnass

Keyword(s):

Surgical Procedures ◽

Baseline Period ◽

Surgical Team ◽

Team Members ◽

Surgical Infection ◽

Before And After ◽

Trial Basis ◽

The Impact ◽

Before And After Study ◽

Patient Infection

Abstract Background In order to improve outcomes, including reduced surgical infection rate and costs, a revised universal preoperative decolonization protocol was implemented on a trial basis. Methods In a 12 month before and after study at a public teaching hospital in southern California, an alcohol based nasal antiseptic was introduced in place of nasal povidone iodine (PVI) for all surgical patients pre-operatively, paired with chlorhexidine (CHG) bathing which was already in place. All surgical procedures were included, the most common being cholecystectomy, cesarean section and hip fracture. The alcohol nasal antiseptic was selected to replace the PVI nasal antiseptic based on efficacy, staff preference and cost. At the same time, surgical team members began self-application of the alcohol nasal antiseptic each day prior to surgical procedures. This was not mandatory and compliance was not tracked, though informal feedback and observation revealed most surgical team members were applying the nasal antiseptic prior to cases daily. Results In comparison to the 6 month baseline period where there were 27 SSI in 1188 procedures, during the 6 month study period there were 10 SSI in 1253 procedures, representing a 63% reduction (p=.0162) for all types of procedures. We have observed a reduction of 17 SSIs in 2019, compared to the previous year, during the 6 months period. That means a saving of $589,420 during the same period. Conclusion Preoperative universal decolonization with alcohol based nasal antiseptic in place of nasal PVI, paired with CHG bathing, was effective in reducing SSI rate and associated costs. Further study is needed to measure and assess the impact of surgical team member nasal decolonization on patient infection risk and rate. Disclosures All Authors: No reported disclosures

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Knowledge convergence among pre-service mathematics teachers through online reciprocal peer feedback

Knowledge Management & E-Learning: An International Journal ◽

10.34105/j.kmel.2017.09.001 ◽

2017 ◽

pp. 1-18 ◽

Cited By ~ 1

Keyword(s):

High School Students ◽

Mathematics Teachers ◽

Concept Maps ◽

Peer Feedback ◽

School Students ◽

Team Members ◽

Knowledge Representations ◽

Before And After ◽

Knowledge Convergence ◽

Group Members

This research focused on pre-service mathematics teachers’ sharing of knowledge through reciprocal peer feedback. In this study, pre-service teachers were divided into groups of five and engaged in an online reciprocal peer feedback activity. Specifically, after creating an individual concept map indicating high school students’ possible solutions to an algebra problem, pre-service teachers shared their individual maps with team members and engaged in online discussion, commenting on the concept maps of other group members and responding to peers’ feedback. Similarities in team members’ knowledge representations before and after this peer feedback activity were compared in order to analyze their knowledge convergence. It was found that a team member’s knowledge was more likely to match that of other team members after the online reciprocal peer feedback activity. Qualitative analysis was also conducted in order to explore the possible influence of a team’s interaction process on members’ knowledge convergence. It was also found that, after engaging in this peer feedback process, pre-service teachers demonstrated greater improvement in their convergence of concepts relating to problem-solving strategies than in the concepts representing problem context and domains.

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Impact of Donation Physicians on Deceased Organ Donation: A Systematic Review

10.21203/rs.3.rs-200397/v1 ◽

2021 ◽

Author(s):

Janet E. Squires ◽

Laura D. Aloisio ◽

Wilmer John Santos ◽

Danielle Cho-Young ◽

Monica Taljaard ◽

...

Keyword(s):

Systematic Review ◽

Organ Donation ◽

Interrupted Time Series ◽

Deceased Donor ◽

Organ Donors ◽

Consent Rate ◽

Team Members ◽

Study Selection ◽

Before And After ◽

Deceased Organ Donation

Abstract Background: An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Methods: A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020. Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by two team members; all discrepancies were resolved by consensus. Two team members independently extracted data from studies. Results: A total of 1,017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), three (25%) were cohort studies, and three (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8 to 143% (Mdn = 33%), an increase in actual organ donors from 15 to 113% (Mdn = 27%), an increase in donor consent rate from -3 to 258% (Mdn = 12%) and an increase in deceased donor transplants from 13 to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions: Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.

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Organization and Structure of the Cardiothoracic Intensive Care Unit

Advances in Medical Technologies and Clinical Practice - Modern Concepts and Practices in Cardiothoracic Critical Care ◽

10.4018/978-1-4666-8603-8.ch004 ◽

2015 ◽

pp. 86-104

Author(s):

Michael H. Wall

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Patient Outcomes ◽

Nurse Practitioners ◽

Physician Assistants ◽

Cost Of Care ◽

Team Members ◽

Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

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