scholarly journals Stroke code simulation benefits advanced practice providers similar to neurology residents

2018 ◽  
Vol 8 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Muhib Khan ◽  
Grayson L. Baird ◽  
Theresa Price ◽  
Tricia Tubergen ◽  
Omran Kaskar ◽  
...  
Keyword(s):  
Clinical Training ◽  
Simulation Training ◽  
Comfort Level ◽  
Advanced Practice ◽  
Pressure Management ◽  
Stroke Patients ◽  
Simulation Education ◽  
Before And After ◽  
Quasi Experimental ◽  
Strongly Agree

BackgroundAdvanced practice providers (APPs) are important members of stroke teams. Stroke code simulations offer valuable experience in the evaluation and treatment of stroke patients without compromising patient care. We hypothesized that simulation training would increase APP confidence, comfort level, and preparedness in leading a stroke code similar to neurology residents.MethodsThis is a prospective quasi-experimental, pretest/posttest study. Nine APPs and 9 neurology residents participated in 3 standardized simulated cases to determine need for IV thrombolysis, thrombectomy, and blood pressure management for intracerebral hemorrhage. Emergency medicine physicians and neurologists were preceptors. APPs and residents completed a survey before and after the simulation. Generalized mixed modeling assuming a binomial distribution was used to evaluate change.ResultsOn a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree), confidence in leading a stroke code increased from 2.4 to 4.2 (p < 0.05) among APPs. APPs reported improved comfort level in rapidly assessing a stroke patient for thrombolytics (3.1–4.2; p < 0.05), making the decision to give thrombolytics (2.8 vs 4.2; p < 0.05), and assessing a patient for embolectomy (2.4–4.0; p < 0.05). There was no difference in the improvement observed in all the survey questions as compared to neurology residents.ConclusionSimulation training is a beneficial part of medical education for APPs and should be considered in addition to traditional didactics and clinical training. Further research is needed to determine whether simulation education of APPs results in improved treatment times and outcomes of acute stroke patients.

Abstract TP298: Code Stroke Simulation Training Benefits Junior Neurology Residents

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Linda C Wendell ◽  
Bradford B Thompson ◽  
Mahesh Jayaraman ◽  
Muhib Khan ◽  
David Lindquist ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Ischemic Stroke ◽  
Stroke Patient ◽  
Clinical Training ◽  
Simulation Training ◽  
Comfort Level ◽  
Ischemic Stroke Patient ◽  
Comfort Levels ◽  
Before And After ◽  
Perceived Preparedness

Introduction: Junior neurology residents frequently receive the first call for emergency neurological conditions, including acute ischemic stroke and intracerebral hemorrhage (ICH) (Code Stroke). Code Stroke simulations allow residents to gain experience in the evaluation and treatment of a potential stroke patient without compromising patient care. Simulations also give residents the opportunity to improve their skills through direct observation and feedback. We hypothesized that simulation training would increase junior neurology residents’ confidence, comfort level and preparedness in leading a Code Stroke. Methodology: Ten neurology residents in their first months of training each took turns leading a Code Stroke simulation – either assessment of an ischemic stroke patient for intravenous thrombolytics, coordination of an ischemic stroke patient for embolectomy, or management of an ICH patient. Standardized patients were used in each case. Emergency medicine, vascular neurology and neurointerventional radiology attendings were active participants in the cases and gave feedback. Residents completed a survey before and after the simulation. Results: On a 5-point Likert scale (1 – least true and 5 – most true), confidence in leading a Code Stroke significantly increased from 2.80 to 3.95 (p=0.01) and perceived preparedness for the next Code Stroke significantly improved from 2.80 to 4.30 (p<0.01). Residents reported significantly improved comfort levels in rapidly assessing the National Institutes of Health Stroke Scale score (3.35 vs. 4.25, p=0.03) and rapidly assessing a Code Stroke patient for thrombolytics (3.15 vs. 4.25, p=0.02), making the decision to give thrombolytics (2.80 vs. 4.00, p=0.02) and assessing a patient for embolectomy (3.33 vs. 4.67, p=0.03). There was a perception of enhanced mutli-disciplinary collaboration with emergency medicine providers (3.55 vs. 4.40, p=0.04) and neurointerventional radiologists (3.00 vs. 4.50, p=0.07). Conclusion: Simulation training is a beneficial part of medical education for junior neurology residents and should be considered in addition to traditional didactics and clinical training.

scholarly journals Using Simulation Training to Promote Nurses’ Effective Handling of Workplace Violence: A Quasi-Experimental Study

2019 ◽  
Vol 16 (19) ◽  
pp. 3648 ◽  
Author(s):  
Jin-Lain Ming ◽  
Hui-Mei Huang ◽  
Shiao-Pei Hung ◽  
Ching-I Chang ◽  
Yueh-Shuang Hsu ◽  
...  
Keyword(s):  
Workplace Violence ◽  
Simulation Training ◽  
Risk Group ◽  
High Risk Group ◽  
Focus Group Interviews ◽  
Self Confidence ◽  
Simulation Education ◽  
Quasi Experimental ◽  
Baseline Characteristics ◽  
Group Interviews

Background: Workplace violence in the health care sector has become a growing global problem. Research has shown that although caregivers comprise a high-risk group exposed to workplace violence, most of them lacked the skills and countermeasures against workplace violence. Therefore, through a quasi-experimental design, this study aimed to investigate the effectiveness of situational simulation training on the nursing staffs’ concept and self-confidence in coping with workplace violence. Methods: Workplace violence simulation trainings were applied based on the systematic literature review and the conclusions from focus group interviews with nursing staff. Data were obtained from structured questionnaires including: (1) baseline characteristics; (2) perception of aggression scale (POAS); and (3) confidence in coping with patient aggression. Results: The results revealed that training course intervention significantly improved the nursing staffs’ self-perception and confidence against workplace violence (p < 0.001). Conclusions: The “simulation education on workplace violence training” as the intervention significantly improved the workplace violence perception and confidence among nursing staffs in coping with aggression events.

scholarly journals PENGARUH ZIKIR TERHADAP PENURUNAN TEKANAN DARAH PADA PASIEN STROKE AKUT DI RSUP DR.M. DJAMIL PADANG

2021 ◽  
Vol 16 (1) ◽  
pp. 151-161
Author(s):  
Hendri Budi ◽  
Herwati Herwati
Keyword(s):  
Blood Pressure ◽  
Acute Stroke ◽  
Diastolic Blood Pressure ◽  
Intervention Group ◽  
Control Group ◽  
Stroke Patients ◽  
Before And After ◽  
Quasi Experimental ◽  
Experimental Group ◽  
Therapy Intervention

70-94% of acute stroke patients have an increase in blood pressure. Relaxation can be done to treat hypertension. Relaxation in Islam uses zikr (remembering Allah SWT). The purpose of this study was to determine the effect of zikr on reducing blood pressure in acute stroke patients. The research design was quasi-experimental, with two group pretest-posttest design with a control group. The experimental group was given the zikr therapy intervention. The sample of the study was acute stroke patients in the Nervous Room of RSUP Dr. M. Djamil Padang. There were 40 samples, 20 people in the experimental group and 20 people in the control group obtained by purposive sampling. Data collection is September to November 2020 by measuring the patient's blood pressure before and after the intervention. The data is processed manually. Analysis of data with non-parametric Mann Whitney test. The results showed that there was no difference between systolic blood pressure before treatment in the intervention group and the control group (p = 0.976), but there was a difference after treatment (p = 0.000). There was no difference between diastolic blood pressure before treatment in the intervention group and the control group, (p = 0.294), but there was a difference after treatment (p = 0.000). The study concludes that zikr therapy can reduce systolic and diastolic blood pressure in acute stroke patient. It is recommended to the head of the Nerve room to apply zikr therapy in acute stroke patients.

scholarly journals Effects of Passive Range Of Motion (ROM) Exercise On Increases Muscle Strength in Non-Hemorrhagic Stroke Patients in the Inpatient Room at RSUD Kota Tangerang

2020 ◽  
Vol 3 (2) ◽  
pp. 41
Author(s):  
Endah Sri Rahayu ◽  
Nuraini Nuraini
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Hemorrhagic Stroke ◽  
Wilcoxon Test ◽  
World Health ◽  
P Value ◽  
Stroke Patients ◽  
Before And After ◽  
Quasi Experimental ◽  
Health Organization

Stroke is one of the serious health problems in modern life today. According to the World Health Organization (WHO) explained that stroke is the leading cause of death globally. An estimated 17.7 million people die of strokes in 2015 representing 31% of all global deaths. This study aims to determine the effect of Passive Range of Motion (ROM) Exercise on Increasing Muscle Strength in Non-Hemorrhagic Stroke Patients in the Inpatient Room at Rsud Kota Tangerang. Quasi-experimental research design with a sample of 14 people. Univariate and bivariate data analysis using the Wilcoxon test. Samples are measured using Observation Sheets before and after Range Of Motion (ROM) Exercises. This Range Of Motion exercise is carried out for 1 week in 7 days, done 2 times in the morning and afternoon for 15 minutes. Based on the Paired Test, it was found that there was an effect of Passive Range Of Motion (ROM) Exercise on increasing muscle strength in non-hemorrhagic stroke patients with p-value = 0,01 <α 0,05. This proves that passive ROM has an effect on increasing the muscle strength of the respondent. Hospitals should set standard operating procedures for special handling using Passive ROM so that the results obtained can be maximal and uniform for all the problems of the word muscle strength.Keywords: Non-hemorrhagic; stroke; Passive ROM; Muscle Strength

scholarly journals Urinary retention: implications of low-fidelity simulation training on the self-confidence of nurses

2016 ◽  
Vol 50 (5) ◽  
pp. 831-837 ◽  
Author(s):  
Mateus Henrique Gonçalves Meska ◽  
Alessandra Mazzo ◽  
Beatriz Maria Jorge ◽  
Valtuir Duarte de Souza-Junior ◽  
Elaine Cristina Negri ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Nursing Care ◽  
Simulation Training ◽  
Objective Assessment ◽  
Pedagogical Workshop ◽  
Paulo State ◽  
Self Confidence ◽  
Before And After ◽  
Quasi Experimental ◽  
Simulated Training

Abstract OBJECTIVETo evaluate the confidence level of nurses in nursing care in urinary retention before and after low-fidelity simulation training. METHOD This was a quasi-experimental study carried out among nurses stationed in municipal care units in the interior of São Paulo State. Data were collected during the course of a pedagogical workshop that used low-fidelity simulation training. RESULTS The study included 42 nurses, mostly female with over 15 years of experience. After low-fidelity simulation training, nurses showed a significant increase (p<0.05) in confidence related to nursing care in urinary retention. The lowest self-attributed scores during the activity were related to the objective assessment of urinary retention. CONCLUSION Low-fidelity simulated training is an effective resource for the development of nurses with respect to nursing care in urinary retention.

scholarly journals Latihan Range of Motion Terhadap Rentang Gerak Sendi Ekstremitas Atas Pasien Stroke di RSUD M.Natsir

2021 ◽  
Vol 16 (2) ◽  
pp. 109-117
Author(s):  
Tintin - Sumarni ◽  
Yulastri Yulastri
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Upper Extremities ◽  
Distributed Data ◽  
Functional Disorders ◽  
Stroke Patients ◽  
Significant Difference ◽  
Before And After ◽  
Upper And Lower Extremities ◽  
Quasi Experimental

Stroke patients who experience hemiparese who do not receive proper treatment can cause complications of functional disorders, impaired mobilization, disruption of daily activities and incurable disabilities. The purpose of this study was to determine the effect of passive Range Of Motion (ROM) exercise on increasing the range of motion of stroke patients in the Neurology Room at RSUD M.Natsir.This research design is quasi experimental with the design used is one group pretest - postest design.In this study, passive Range Of Motion (ROM) was performed on the upper extremities of stroke patients for five days, twice a day.The number of respondents in 30 stroke patients who experienced hemiparese,The data was collected by direct measurement using a measuring instrument for the degree of motion of the joints, namely the goniometer, and data analysis was carried out using the t dependent test (normally distributed data).The results showed a significant difference in the range of motion of the upper limb joints before and after passive ROM exercises. The conclusion that ROM exercises affect the range of motion of the upper limb joints in stroke patients.Passive ROM can be an alternative to increase the range of motion of the joints in the upper and lower extremities in stroke patients.

School-Based Speech-Language Pathologists' Perceived Self-Efficacy in Conducting Multidimensional Treatment With Children Who Stutter

2020 ◽  
Vol 51 (4) ◽  
pp. 1172-1186
Author(s):  
Carolina Beita-Ell ◽  
Michael P. Boyle
Keyword(s):  
Self Efficacy ◽  
Clinical Training ◽  
Online Survey ◽  
The United States ◽  
Comfort Level ◽  
Social Emotional ◽  
Speech Language Pathologists ◽  
Fluency Disorders ◽  
Cognitive Components ◽  
School Based

Purpose The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method Three hundred twenty randomly selected school-based SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results Overall, SLPs reported moderate levels of self-efficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS. Supplemental Material https://doi.org/10.23641/asha.12978194

Brief psycho-education for caregivers of persons with first episode psychosis

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Praful Prabhuappa Kapse ◽  
Manisha Kiran
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Episode Psychosis ◽  
Study Results ◽  
Before And After ◽  
Quasi Experimental ◽  
Expressed Emotions ◽  
Experimental Group ◽  
Group Family

Caring for the persons with first episode psychosis is challenging and demanding. It may lead to the increased burden, expressed emotions among the caregivers. The numerous studies have shown that high burden and negative expressed emotions among caregivers can lead to early relapse in the patients with first episode psychosis. To evaluate the effects of the brief psychoeducation on the caregivers burden and expressed emotions. A quasi experimental - before and after with control group research design was adopted for the study. A total of 60 caregivers have participated in the study, of which 30 caregivers in experimental group and 30 caregivers in the control group. Family Burden Interview Schedule (Pai and Kapoor, 1981) and Attitude Questionnaire (Sethi et al., 1981) was used to assess caregiver's burden and expressed emotions. At end of the psychoeducation intervention, burden among caregivers and negative expressed emotions of the caregivers have significantly reduced. The positive expressed emotions have been increased. Study results demonstrates the importance of psychoeducation intervention in reducing the burden and negative expressed emotions.

The Effect of Using Flipped Classroom Model to Improve Iraqi EFL Learners’ Pronunciation in English at University Level

2020 ◽  
Vol 1 (40) ◽  
pp. 631-654
Author(s):  
Khaldoon Waleed Husam Al-Mofti
Keyword(s):  
Language Learning ◽  
Flipped Classroom ◽  
Efl Learners ◽  
English Pronunciation ◽  
Before And After ◽  
Quasi Experimental ◽  
University Level ◽  
The University ◽  
And Control ◽  
Experimental Group

For Iraqi EFL learners who are studying English pronunciation in a traditional instruction method often requires more effort and hard work. Thus, using new methods of teaching such as the flipped classroom model (FCM) is necessary to facilitate learning and improve performance. Hence, this study reports on explanatory research that investigates the effect of using the FCM in the teaching of English pronunciation for Iraqi EFL learners at the university level. The study implemented mixed research methods for data collection in a quasi-experimental analysis. Therefore, two tests were conducted on the assigned groups to measure the effect of the FCM before and after the intervention. Besides, a questionnaire and interviews were used on the experiment group students to collect data about their perceptions of the FCM. The study length (lasted)  was 15 weeks and is comprised of 60 students from the department of English, College of Arts at the University of Anbar. The students were divided into two groups, experimental, and control with 30 students in each group. The findings revealed that there was a significant statistical difference between the two groups in favour of the experimental group with better performance, indicating that the FCM has considerably assisted the Iraqi EFL learners to improve their English pronunciation. Moreover, the students expressed their positive feedback and satisfaction on the use of the FCM in their responses to the questionnaire and the interviews. As such, the current study recommends further research to study the effect of applying the FCM in areas and disciplines other than language learning.

Effect of Neuromuscular Electrical Stimulation on Swallowing Process in Stroke Patient with Neurogenic Dysphagia

1970 ◽  
Vol 1 (1) ◽  
pp. 44-53
Author(s):  
Ruth Ariyani ◽  
Widjajalaksmi ◽  
Luh K Wahyuni ◽  
Susyana Tamin ◽  
Saptawati Bardosono
Keyword(s):  
Electrical Stimulation ◽  
Voice Quality ◽  
Neuromuscular Electrical Stimulation ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Cough Reflex ◽  
Voluntary Cough ◽  
Pharyngeal Phase ◽  
Significant Difference ◽  
Quasi Experimental

Objective: The aim of this study to determine the therapeutic effect of Neuromuscular Electrical Stimulation (NMES) on pharyngeal phase of swallowing for stroke patients with neurogenic dysphagia,and to see the effect of NMES in reducing the incidence of standing secretion, residue, penetration and aspiration.Methods: It is a quasi-­experimental study design. 10 stroke patients with neurogenic dysphagia in Cipto Mangunkusumo hospital, Jakarta, 40-­80 years old with hemodynamically stable, cooperative and will be get NMES therapy for 4 weeks. Pre and Post treatment assessment caompared using a modified MASA test (The Mann Assessment of Swallowing Ability) and FEES examination (Flexible Endoscophic Evaluation of Swallowing). Analysis of change scores using Wilcoxon test.Results:The obtain average age of patients 59.80+9.705 years. Significant difference seen in the pharyngeal phase of swallowing increased score of gag reflex, velum elevation, cough reflex, voluntary cough, voice quality, pharynx response, pharyngeal constrictor contraction and vocal cord adduction (p<0.005).Also seen significant reduction in the incidence of standing secretion, residue and penetration (p<0.005), but not significantly in the incidence of aspiration (p=0083).Conclusions: NMES increased the pharyngeal phase of swallowing, reduced the incidence of standing secretion, residue and penetration of stroke patients with neurogenic dysphagia, but have not able to reduced aspiration.Keywords :Neuromuscular Electrical Stimulation (NEMS), neurogenic dysphagia, MASA test (The Mann Assessment of Swallow ing Ability), FEES examination (Flexible Endoscophic Evaluation of Swallowing), swallowing process.

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