The Infant Cuddler Study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome

Abstract Objectives St. Michael’s Hospital launched a volunteer cuddling program for all infants admitted into the neonatal intensive care unit in October 2015. The program utilizes trained volunteers to cuddle infants when caregivers are not available. This was a pilot study to assess the impact of a volunteer cuddle program on length of stay (LOS) and feasibility of implementation of the program. Methods A mixed methods approach was utilized to measure both quantitative and qualitative impact. A pilot cohort study with a retrospective control group assessed the feasibility of implementing a volunteer cuddling program for infants with neonatal abstinence syndrome (NAS). Length of stay was used as a surrogate marker to measure the impact of cuddling on infants being treated for Neonatal Abstinence Syndrome. Focus groups using semi-structured interviews were conducted with volunteers and nurses at the end of the pilot study. Results LOS was reduced by 6.36 days (U=34, P=0.072) for infants with NAS in the volunteer cuddling program. Focus groups with both bedside nurses and program volunteers described a positive impact of cuddling programs on infants, families, staff, and volunteers alike. Conclusions The study results suggest that the volunteer cuddling program may reduce LOS in infants with NAS and have potential economic savings on hospital resources. However, larger prospective cohort studies are needed to confirm these results.

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Comparing Neonatal Intensive Care Unit Nursing Support in Mothers With ‎Newborn Abstinence Syndrome (NAS) and Mothers of Healthy Neonates ‎

International Journal of Medical Toxicology and Forensic Medicine ◽

10.32598/ijmtfm.v9i4.26184 ◽

2019 ◽

Vol 9 (4) ◽

Author(s):

Seyedeh Najmeh Hosseini ◽

Arash Ghodousi ◽

Narges Sadeghi ◽

Somayeh Abbasi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Control Group ◽

Abstinence Syndrome ◽

Nursing Support ◽

Study Results ◽

Significant Difference ◽

The Impact

Background: The experience of having neonates in the Neonatal Intensive Care Unit (NICU) is a psychological crisis. It might cause many emotional problems for parents. Entire parental support is among the duties of the healthcare team. Therefore, this study aimed to compare the nursing support received by the mothers with Newborn Abstinence Syndrome (NAS) and the mothers of other neonates admitted to the NICU. Methods: The present cross-sectional descriptive-analytic study was conducted in the selected hospitals in Kerman Province, Iran. In total, 62 mothers with NAS and 61 non-addicted mothers with neonates admitted to the NICU were selected through convenience sampling method. The inclusion criteria were neonates under the care of parents, neonate admitted to the NICU for at least 24 hours, opiate dependence in the case group mothers, and no substance dependence in the control group mothers. The amount of nursing support for mothers having neonates with NAS was compared with that of the control mothers. The study groups were homogenized in terms of the study variables (neonate age, gender, and the duration of hospitalization). The required data were collected by the Nurse-Parent Support Tool (NPST) and analyzed in SPSS. Results: The study results revealed that among the neonates of 123 mothers, 75(60.97%) were boys, and 58(39.02%) were girls. The majority of neonates in both groups were breastfed. The mean±SD age of the mothers in the case and control group were 31.93±7.25 and 28.99±4.36 years, respectively. The nursing support level was desirable in both groups, and no significant difference was found in this regard (P>0.05). Furthermore, the level of nursing support in emotional, information-communication, self-esteem, and quality caregiving support dimensions was desirable in both groups. Conclusion: The obtained results revealed that nurses’ support was desirable in both groups. The prevalence of maternal addiction and the impact of this social harm on neonates who were admitted are essential. Furthermore, families having neonates with NAS need more support from the healthcare staff and nurses, in comparison with healthy parents; thus, the importance of this issue should be addressed in training and briefing courses for nurses.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00717-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Philippe Delmas ◽

Assunta Fiorentino ◽

Matteo Antonini ◽

Séverine Vuilleumier ◽

Guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Patient Flow ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Research Areas ◽

Study Results ◽

The Impact ◽

And Task

Abstract Background The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/design A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A, noise; B, task interruptions; C, noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within 2 h. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion Study results will inform the design of large-scale investigations and will help identify teaching, training, and research areas that require further development.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

10.21203/rs.3.rs-15514/v3 ◽

2020 ◽

Author(s):

philippe delmas ◽

Assunta fiorentino ◽

matteo antonini ◽

severine Vuilleumier ◽

guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Patient Flow ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Research Areas ◽

Study Results ◽

The Impact ◽

And Task

Abstract Background: The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/Design: A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A: noise, B: task interruptions, C: noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within two hours. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion: Study results will inform the design of large-scale investigations and will help identify teaching, training and research areas that require further development.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

10.21203/rs.3.rs-15514/v2 ◽

2020 ◽

Author(s):

philippe delmas ◽

Assunta fiorentino ◽

matteo antonini ◽

severine Vuilleumier ◽

guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Patient Flow ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Research Areas ◽

Study Results ◽

The Impact ◽

And Task

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Engaging community pharmacists in quality improvement (QI): a qualitative case study of a partnership between a Higher Education Institute and Local Pharmaceutical Committees

BMJ Open Quality ◽

10.1136/bmjoq-2020-001047 ◽

2021 ◽

Vol 10 (1) ◽

pp. e001047

Author(s):

Asam Latif ◽

Nargis Gulzar ◽

Fiona Lowe ◽

Theo Ansong ◽

Sejal Gohil

Keyword(s):

Quality Improvement ◽

Focus Groups ◽

Qualitative Methodology ◽

Positive Impact ◽

Community Pharmacists ◽

Educational Institute ◽

Collaboration And Communication ◽

Improve Service Quality ◽

The Impact

BackgroundQuality improvement (QI) involves the use of systematic tools and methods to improve the quality of care and outcomes for patients. However, awareness and application of QI among healthcare professionals is poor and new strategies are needed to engage them in this area.ObjectivesThis study describes an innovative collaboration between one Higher Educational Institute (HEI) and Local Pharmaceutical Committees (LPCs) to develop a postgraduate QI module aimed to upskill community pharmacists in QI methods. The study explores pharmacist engagement with the learning and investigates the impact on their practice.MethodsDetails of the HEI–LPCs collaboration and communication with pharmacist were recorded. Focus groups were held with community pharmacists who enrolled onto the module to explore their motivation for undertaking the learning, how their knowledge of QI had changed and how they applied this learning in practice. A constructivist qualitative methodology was used to analyse the data.ResultsThe study found that a HEI–LPC partnership was feasible in developing and delivering the QI module. Fifteen pharmacists enrolled and following its completion, eight took part in one of two focus groups. Pharmacists reported a desire to extend and acquire new skills. The HEI–LPC partnership signalled a vote of confidence that gave pharmacists reassurance to sign up for the training. Some found returning to academia challenging and reported a lack of time and organisational support. Despite this, pharmacists demonstrated an enhanced understanding of QI, were more analytical in their day-to-day problem-solving and viewed the learning as having a positive impact on their team’s organisational culture with potential to improve service quality for patients.ConclusionsWith the increased adoption of new pharmacist’s roles and recent changes to governance associated with the COVID-19 pandemic, a HEI–LPC collaborative approach could upskill pharmacists and help them acquire skills to accommodate new working practices.

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The Impact of Scientific Creative Thinking Skills on Scientific Process Skills

SHS Web of Conferences ◽

10.1051/shsconf/20184801060 ◽

2018 ◽

Vol 48 ◽

pp. 01060

Author(s):

Sibel Demir Kaçan ◽

Fatma Şahin

Keyword(s):

Teacher Candidates ◽

Creative Thinking ◽

Positive Impact ◽

Thinking Skills ◽

Control Group ◽

Process Skills ◽

Scientific Process ◽

Scientific Creativity ◽

The Impact ◽

Experimental Group

The research aims to determine “the Impact of Scientific Creative Thinking Skills on Scientific Process Skills”. Thus, the research was performed with 24 teacher candidates in the control group and 24 teacher candidates in the experimental group in the second class of the Department of Science Teaching in a university in Istanbul Province. In the experimental group of the research, the laboratory program to be designed by the researchers on the basis of scientific discussion and research; and in the control group, the conventionally designed laboratory program were applied for an academic semester. The research data was gained through “Scientific Creativity Test” to be developed by Hu and Adey [14] and adapted by Kadayıfçı [16]; “Scientific Process Skills Test” to be developed by Okey, Wise and Burns, and adapted by Geban, Aşkar and Özkan into Turkish. The conclusions to be reached by the research are in favour of the experimental group and the last application, and it has positive impact on the opinions of the teacher candidates related with the development of the scientific creativity skills.

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Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients

Palliative & Supportive Care ◽

10.1017/s1478951511000423 ◽

2011 ◽

Vol 9 (4) ◽

pp. 401-406 ◽

Cited By ~ 20

Author(s):

Dana Lustbader ◽

Renee Pekmezaris ◽

Michael Frankenthaler ◽

Rajni Walia ◽

Frederick Smith ◽

...

Keyword(s):

Length Of Stay ◽

Palliative Medicine ◽

Intervention Group ◽

Hospital Length Of Stay ◽

Rank Test ◽

Control Group ◽

Do Not Resuscitate ◽

Log Rank Test ◽

The Impact ◽

Reduced Time

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.

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The Use of Procalcitonin as a Sepsis Marker in a Community Hospital

The Journal of Applied Laboratory Medicine ◽

10.1373/jalm.2018.026955 ◽

2019 ◽

Vol 3 (4) ◽

pp. 545-552

Author(s):

Nathalia De Oro ◽

Maria E Gauthreaux ◽

Julie Lamoureux ◽

Joseph Scott

Keyword(s):

Lactic Acid ◽

Length Of Stay ◽

Community Hospital ◽

Unit Length ◽

Hospital Setting ◽

Control Group ◽

Before And After ◽

Quasi Experimental ◽

Current Cutoff ◽

The Impact

Abstract Background Procalcitonin (PCT) is a biomarker that shows good sensitivity and specificity in identifying septic patients. Methods This study investigated the diagnostic accuracy of PCT in a community hospital setting and how it compared to that of lactic acid. It explored the impact on patient care before and after PCT implementation regarding costs and length of stay. Two comparative groups were analyzed using an exploratory descriptive case–control study with data from a 19-month period after PCT implementation and a retrospective quasi-experimental study using a control group of emergency department patients diagnosed with sepsis using data before PCT implementation. Results Post-procalcitonin implementation samples included 165 cases and pre-procalcitonin implementation sample included 69 cases. From the 165 sepsis cases who had positive blood cultures, PCT had a sensitivity of 89.7%. In comparison, lactic acid's sensitivity at the current cutoff of 18.02 mg/dL (2.0 mmol/L) was 64.9%. There was a 32% decrease in median cost before and after PCT implementation, even with the length of stay remaining at 5 days in both time periods. Conclusions There was a significant decrease after the implementation of PCT in cost of hospitalization compared to costs before implementation. This cost is highly correlated with length of stay; neither the hospital nor the intensive care unit length of stay showed a difference with before and after implementation. There was a positive correlation between lactic acid and PCT values. PCT values had a higher predictive usefulness than the lactic acid values.

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Evaluation of Targeted Pharmacist Interventions to Reduce Length of Stay in an Acute Care Practice Model

Annals of Pharmacotherapy ◽

10.1177/1060028018815064 ◽

2018 ◽

Vol 53 (5) ◽

pp. 471-477 ◽

Cited By ~ 2

Author(s):

Mary-Haston Leary ◽

Kathryn Morbitzer ◽

Bobbi Jo Walston ◽

Stephen Clark ◽

Jenna Kaplan ◽

...

Keyword(s):

Length Of Stay ◽

Acute Care ◽

Positive Impact ◽

Pharmacy Practice ◽

Care Practice ◽

Readmission Rates ◽

A Value ◽

Pharmacist Interventions ◽

Semistructured Interviews ◽

The Impact

Background: Despite widespread recognition of the need for innovative pharmacy practice approaches, the development and implementation of value-based outcomes remains difficult to achieve. Furthermore, gaps in the literature persist because the majority of available literature is retrospective in nature and describes only the clinical impact of pharmacists’ interventions. Objective: Length of stay (LOS) is a clinical outcome metric used to represent efficiency in health care. The objective of this study was to evaluate the impact of pharmacist-driven interventions on LOS in the acute care setting. Methods: A separate samples pretest-posttest design was utilized to compare the effect of pharmacist interventions across 3 practice areas (medicine, hematology/oncology, and pediatrics). Two time periods were evaluated: preimplementation (PRE) and a pilot period, postimplementation of interventions (POST). Interventions included targeted discharge services, such as discharge prescription writing (with provider cosignature). Participating pharmacists completed semistructured interviews following the pilot. Results: A total of 924 patients (466 PRE and 458 POST) were included in the analysis. The median LOS decreased from 4.95 (interquartile range = 3.24-8.5) to 4.12 (2.21-7.96) days from the PRE versus POST groups, respectively ( P < 0.011). There was no difference in readmission rates between groups (21% vs 19.1%, P = 0.7). Interviews revealed several themes, including positive impact on professional development. Conclusion and Relevance: This pilot study demonstrated the ability of pharmacist interventions to reduce LOS. Pharmacists identified time as the primary barrier and acknowledged the importance of leaders prioritizing pharmacists’ responsibilities. This study is novel in targeting LOS, providing a value-based outcome for clinical pharmacy services.

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Does the Tax System Reduce Tax Evasion in Light of the Governance Mechanisms? Evidence From Jordan

Research in World Economy ◽

10.5430/rwe.v12n2p99 ◽

2021 ◽

Vol 12 (2) ◽

pp. 99

Author(s):

Ashraf Bataineh

Keyword(s):

Tax Evasion ◽

Income Tax ◽

Social Impact ◽

Positive Impact ◽

Governance Mechanisms ◽

Official Statistics ◽

Tax System ◽

Study Results ◽

The Impact ◽

Awareness Level

This study aims to measure the impact of tax system elements on reducing the tax evasion, in light of the governance mechanisms in Jordan. The study sample consists of (140) tax auditors at the Jordanian Income tax and sales department, and to achieve the study objectives the researcher designed a questionnaire and distributed it on the study sample members. Study results show that elements of the tax system (tax legislations, tax administration, and Taxpayer) have a positive impact on reducing the tax evasion, in light of governance mechanisms. study recommends the need to raise the tax awareness level among members of the Taxpayer, work to reduce the continuation of making adjustments on tax laws and legislation, and give a sufficient period of time to ensure that desired economic and social impact being achieved from these adjustments, with the need to announce the official statistics of tax evasion’s figures and ratios, because the unofficial statistics on tax evasion have been tarnished by some exaggeration where work should concentrate on increasing penalties of tax evaders.

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