Abstract P848: A Better Way to NIHSS

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Alex M GRAVES ◽  
Jamie Jones ◽  
Alyssa Bragg
Keyword(s):  
Learning Styles ◽  
Visual Fields ◽  
Computer Training ◽  
Care Providers ◽  
Hospital System ◽  
Computer Based Training ◽  
Scoring Errors ◽  
Stakeholder Input ◽  
Chart Audits ◽  
Scoring Accuracy

Introduction: “A Better Way to NIHSS” evaluated feasibility and effectiveness of in-person National Institutes of Health Stroke Scale (NIHSS) training compared to traditional training across a 17-hospital system. Stroke practitioners are encouraged and sometime required to be NIHSS certified. Despite the ubiquity of the scale, it presents challenges for care providers. Items with poor reliability, improper technique, and scoring errors may lead to a lack of recognition of neurologic decline. Standard computer-based training may not effectively prepare RNs. An updated in-person course was needed to improve practitioner satisfaction and scoring accuracy. Hypothesis: We hypothesized that we could improve practitioner satisfaction, scoring accuracy and system efficacy by developing and implementing an in-person NIHSS course. Methods: Pitfalls of traditional computer training were identified by a stroke APN. In collaboration with national and regional subject matter experts, evidence-based curriculum was developed. Emphasis was placed upon live demonstration of exam technique, and student return-demonstration for psychomotor competency. Tools were provided to meet visual and read/write learning styles. Over 1-year, a hospital system collaborated to standardize the curriculum, HR certification and tracking process, and instructor training. Instructors received 1-on-1 training and mentorship to effectively deliver content. Instructors in training often co-taught classes until they were comfortable, had speaker notes to assist them, and training sessions geared to their needs. Standardized evaluation tools, stakeholder input, data, and random chart audits were utilized to evaluate effectiveness. Results: Over 18 months, 14 instructors were trained and 896 RNs certified. Evaluations showed improved learner knowledge, skills, and confidence. Educator training led to improved instructor evaluations. Documentation showed improved accuracy of scoring during random chart audits. Items with greatest improvement were limb ataxia, facial droop, visual fields, and aphasia. Conclusion: Systems should consider implementing and offering in-person NIHSS course to reduce the incidence of improper exam technique and scoring errors.

scholarly journals Real-time Communication With Health Care Providers Through an Online Respiratory Pathogen Laboratory Report

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Paul A Christensen ◽  
Randall J Olsen ◽  
Katherine K Perez ◽  
Patricia L Cernoch ◽  
S Wesley Long
Keyword(s):  
Real Time ◽  
Health Care Providers ◽  
Influenza Season ◽  
Respiratory Pathogen ◽  
Observation Data ◽  
Care Providers ◽  
Laboratory Observation ◽  
Web Browser ◽  
Hospital System ◽  
Laboratory Report

Abstract We implemented a real-time report to distribute respiratory pathogen data for our 8-hospital system to anyone with an Internet connection and a web browser. Real-time access to accurate regional laboratory observation data during an epidemic influenza season can guide diagnostic and therapeutic strategies.

scholarly journals Environmental Sound Training in Cochlear Implant Users

2015 ◽  
Vol 58 (2) ◽  
pp. 509-519 ◽  
Author(s):  
Valeriy Shafiro ◽  
Stanley Sheft ◽  
Sejal Kuvadia ◽  
Brian Gygi
Keyword(s):  
Cochlear Implant ◽  
Low Cost ◽  
Computer Training ◽  
Environmental Sound ◽  
Sound Perception ◽  
Environmental Sounds ◽  
Computer Based Training ◽  
Home Based ◽  
Average Improvement ◽  
Computer Based

Purpose The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart, followed by 4 environmental sound training sessions conducted on separate days in 1 week, and concluded with 2 posttest sessions, separated by another week without training. Each testing session included an environmental sound test, which consisted of 40 familiar everyday sounds, each represented by 4 different tokens, as well as the Consonant Nucleus Consonant (CNC) word test, and Revised Speech Perception in Noise (SPIN-R) sentence test. Results Environmental sounds scores were lower than for either of the speech tests. Following training, there was a significant average improvement of 15.8 points in environmental sound perception, which persisted 1 week later after training was discontinued. No significant improvements were observed for either speech test. Conclusions The findings demonstrate that environmental sound perception, which remains problematic even for experienced CI patients, can be improved with a home-based computer training regimen. Such computer-based training may thus provide an effective low-cost approach to rehabilitation for CI users, and potentially, other hearing impaired populations.

scholarly journals A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO

10.2196/15889 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e15889 ◽  
Author(s):  
Ingrid Konstanse Ledel Solem ◽  
Cecilie Varsi ◽  
Hilde Eide ◽  
Olöf Birna Kristjansdottir ◽  
Elin Børøsund ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Development Process ◽  
Evidence Based ◽  
Care Providers ◽  
Design And Development ◽  
Management Intervention ◽  
Intervention Content ◽  
Stakeholder Input ◽  
User Centered

Background Chronic pain conditions are complicated and challenging to live with. Electronic health (eHealth) interventions show promise in helping people cope with chronic illness, including pain. The success of these interventions depends not only on the technology and intervention content but also on the users’ acceptance and adherence. Involving all stakeholders (eg, patients, spouses, health care providers, designers, software developers, and researchers) and exploring their input and preferences in the design and development process is an important step toward developing meaningful interventions and possibly strengthening treatment outcomes. Objective The aim of this study was to design and develop a user-centered, evidence-based eHealth self-management intervention for people with chronic pain. Methods The study employed a multidisciplinary and user-centered design approach. Overall, 20 stakeholders from the project team (ie, 7 researchers, 5 editors, 7 software developers, and 1 user representative), together with 33 external stakeholders (ie, 12 health care providers, 1 health care manger, 1 eHealth research psychologist, and 17 patients with chronic pain and 2 of their spouses) participated in a user-centered development process that included workshops, intervention content development, and usability testing. Intervention content was developed and finalized based on existing evidence, stakeholder input, and user testing. Stakeholder input was examined through qualitative analyses with rapid and in-depth analysis approaches. Results Analyses from stakeholder input identified themes including a need for reliable, trustworthy, and evidence-based content, personalization, options for feedback, behavioral tracking, and self-assessment/registration as factors to include in the intervention. Evidence-based intervention content development resulted in one face-to-face introduction session and 9 app-based educational and exercise-based modules. Usability testing provided further insight into how to optimize the design of the intervention to the user group, identifying accessibility and a simple design to be essential. Conclusions The design and development process of eHealth interventions should strive to combine well-known evidence-based concepts with stakeholder input. This study, designing and developing the pain management intervention EPIO, illustrates how a stakeholder-centered design approach can provide essential input in the development of an eHealth self-management intervention for people with chronic pain. Trial Registration ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104

Developing CAHPS for cancer care prototype: Progress and next steps.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 134-134 ◽  
Author(s):  
Steven Garfinkel ◽  
Elizabeth Frentzel ◽  
Christian Evensen ◽  
San Keller ◽  
Kathleen J. Yost ◽  
...  
Keyword(s):  
Field Test ◽  
Cancer Care ◽  
Structural Equation ◽  
Discriminant Validity ◽  
Quality Care ◽  
A Priori ◽  
Measurement Properties ◽  
Equation Modeling ◽  
Care Providers ◽  
Stakeholder Input

134 Background: The CAHPS Survey for Cancer Care Prototype (application for CAHPS trademark in process) represents a significant advancement towards helping cancer care providers understand patients’ experiences of care. Although a number of standard commercial surveys are in use, currently none are available that both (1) capture the aspects of care most important to patients and (2) allow comparisons of those aspects of care across treatment centers and modalities. Methods: We developed a survey instrument that incorporated patient, clinician, and other stakeholder input throughout the development process. The survey measures patients’ perceptions of observable provider behaviors that are indicative of high quality care. Field test data were collected from 1,367 of 2,826 eligible patients (48% response rate) treated with surgery, radiation, or medical oncology from 6 accredited cancer treatment centers across the US. Classical psychometric methods were used to evaluate the measurement properties of composite scales per standard CAHPS methodology. Results: Based on a priori conceptualization, patient and stakeholder input, and empirical analyses, we identified 5 composites measuring shared decision-making, exchanging information about treatment, affective communication, access to care, and patient self-management. A confirmatory factor analysis using structural equation modeling showed an excellent fit (CFI > 0.96; RMSEA < 0.05) between the observed data and the structure for these five composites. Cronbach’s alpha for these composites ranged from 0.71-0.88, discriminant validity was good for all scales, and correlations with overall ratings of cancer care providers were moderate (0.31) to high (0.69). Evaluation of the precision with which the composites distinguish among cancer centers indicated that the measures were reliable; however, a second field test with a greater number and variety of centers will be needed to establish a standard sampling approach and confirm these results. Conclusions: We anticipate wide-spread adoption of this measure by cancer care providers to direct quality improvement efforts due to great interest and involvement in this project on the part of stakeholders.

Knowledge and attitudes of permanent chemotherapy-induced alopecia among health care providers.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 142-142
Author(s):  
Jenna Rose Stoehr ◽  
Cory Kosche ◽  
Jennifer N. Choi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Care Providers ◽  
Chi Square ◽  
Hospital System ◽  
Medical Specialties ◽  
General Internal ◽  
Correct Definition ◽  
Significant Difference

142 Background: Reports of permanent chemotherapy-induced alopecia (PCIA) are increasing in the field of oncodermatology, but there is a dearth of information regarding how it is recognized and managed by health care providers (HCPs) across different medical specialties. Methods: An electronic survey was distributed to HCPs (resident physicians, attending physicians, and nurse practitioners) in the departments of dermatology, oncology, and general internal medicine (GIM) within one Midwestern hospital system. Results: Of the 62 participants (response rate: 13%), there were 19 from dermatology, 20 from oncology, and 23 from GIM. Responses were analyzed with descriptive statistics, and chi-square and ANOVA tests. There was a significant difference in the number of subjects that had heard of PCIA prior to starting the survey (Derm: 79%, Onc: 30%, GIM: 22%, p<0.05). A larger percentage of dermatology and oncology HCPs knew the correct definition of the condition (alopecia persisting >6 months) than GIM (42% and 45% vs. 17%) and significantly more had encountered patients with the condition (47% and 45% vs. 17%). More providers in dermatology and GIM knew how to diagnose PCIA compared to oncology (84% and 83% vs. 70%). Dermatology HCPs were the only participants who had attempted to treat patients with PCIA. Most providers across the three specialties believed that patients would accept PCIA treatment that was topical, oral, injectable, and required frequent administration or monitoring, but not treatment that was expensive or high risk. A majority of HCPs surveyed (94%) agreed that the diagnosis of PCIA is important. However, there was a significant difference in the confidence of HCPs in diagnosing and managing PCIA. A minority of dermatology providers (2/19) specified that they would refer to an alopecia or oncodermatology specialist, while the majority of oncology and GIM providers would refer to dermatology. Conclusions: The results of this survey identify knowledge gaps about PCIA amongst health care providers. Therefore, education and multidisciplinary engagement should be pursued in order to improve awareness, diagnosis, referral, and management of PCIA as part of survivorship care.

Some Conditions under Which Integrated Computer-Based Training Software Can Facilitate Learning

1996 ◽  
Vol 15 (4) ◽  
pp. 345-367 ◽  
Author(s):  
Narciso Cerpa ◽  
Paul Chandler ◽  
John Sweller
Keyword(s):  
Cognitive Load ◽  
Computer Software ◽  
Computer Training ◽  
Computer Application ◽  
Hard Copy ◽  
Computer Based Training ◽  
Extraneous Cognitive Load ◽  
Computer Based ◽  
Split Attention ◽  
Software Group

When students are required to learn a new computer application program, frequently they need to split their attention between material in a manual and material on the screen because neither is self-contained. Previous work has indicated that split-attention can interfere with learning because the need to mentally integrate material imposes an extraneous cognitive load. Alternatively, even if the screen-based material is self-contained, the material of a redundant manual, if processed by learners, can also impose an extraneous cognitive load. Under these circumstances, learning may be facilitated by the use of self-contained, screen-based material alone. In Experiment 1, the first author developed a windows spreadsheet, computer-based training package with an integrated format, to test these hypotheses. The split-attention effect was investigated by comparing the performance of a group of students using the integrated computer-based training software with that of a group using a conventional manual plus the computer software to be learned. The redundancy effect was investigated by comparing a group using the computer-based training software with a group using the same computer-based training software plus a hard-copy of this training software. Results from Experiment 1 supported the above cognitive load hypotheses. Specifically, in areas of high information complexity, the integrated computer-based training software group clearly outperformed both the conventional manual plus computer software group, and the computer-based training software plus hard-copy group, thus demonstrating both split-attention and redundancy effects. Experiment 2 partially replicated this result, as well as providing support for a cognitive load explanation of results by measuring mental load. In the light of these findings and previous research, it is suggested that cognitive load is a major factor in all aspects of instructional design. Computer training software that reduces extraneous cognitive load by adopting integrated computer-based training formats can considerably facilitate learning.

Improving patient satisfaction in hospital care settings

2011 ◽  
Vol 24 (4) ◽  
pp. 163-169 ◽  
Author(s):  
Koichiro Otani ◽  
Patrick A Herrmann ◽  
Richard S Kurz
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Effective Intervention ◽  
Care Providers ◽  
Health Care Managers ◽  
Intervention Programme ◽  
Improve Patient Satisfaction ◽  
Hospital System ◽  
Care Managers ◽  
Improve Patient

Health-care managers have to address many aspects of the organization, and patient satisfaction is clearly one of the critical aspects for managers. To respond to the need of health-care managers, there have been many patient satisfaction studies. However, these studies focus on which attributes (factors such as nursing care and physician care) are more influential; they do not provide specific aspects for each attribute. In order to develop an effective intervention programme to improve patient satisfaction, more specific research outcomes are needed. This study utilized data collected between January 2007 and June 2008 from 32 hospitals representing a large, national private not-for-profit hospital system. The patient satisfaction survey included the Consumer Assessment of Healthcare Providers and Systems, Hospital version questionnaire items, and there are 31,471 cases. Two-stage multiple linear regression analyses were conducted with control variables (age, gender, perceived health, education and race). It was found that patients' highest priority is to be treated with courtesy and respect by nurses and physicians. An effective intervention programme to improve patient satisfaction would include a training programme, where care providers understand that patients want them to show courtesy and respect. Then, well-trained and empathetic nurses and staff members can comfort patients, and consequently improve patient satisfaction.

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