Characteristics of nursing professionals and the practice of ecologically sustainable actions in the medication processes

ABSTRACT Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument. The processes analyzed involved 99 professionals in the pre-intervention phase and 97 in the post-intervention phase. Data were analyzed quantitatively and the association of variables was accomplished by means of statistical inference, according to the nature of the related variables. Results: the education level was the only characteristic that showed to be relevant to an increase in sustainable practices, with a statistically significant difference (p = 0.002). When comparing before and after the intervention, there was an increase in environmentally friendly actions with statistically significant differences (p = 0.001). Conclusions: the results suggest that institutions should encourage and invest in formal education, as well as training of health professionals to promote sustainable practices in the hospital.

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Abstract 17595: The Value of Continuous ST-Segment Monitoring in the Emergency Department: a Quasi-Experimental Pre-Post Study

Circulation ◽

10.1161/circ.130.suppl_2.17595 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Leonie L Rose Bovino ◽

Michele M Pelter ◽

Mayur M Desai ◽

Vanessa Jefferson ◽

Laura K Andrews ◽

...

Keyword(s):

Emergency Department ◽

Diagnostic Accuracy ◽

Intermediate Risk ◽

Intervention Phase ◽

Coronary Syndrome ◽

St Segment ◽

Significant Difference ◽

Time To Diagnosis ◽

Before And After ◽

Risk Patients

Purpose: The AHA Practice Standards for ECG Monitoring recommend continuous ST-segment monitoring (C-STM) in patients presenting to the emergency department (ED) with signs and/or symptoms suggestive of acute coronary syndrome (ACS), but few studies have evaluated its use in the ED. Our aims were to compare the time to diagnosis and 30-day adverse events (return to the ED with signs and/or symptoms of ACS, hospital admission, acute myocardial infarction, use of reperfusion therapy, or mortality) before and after implementation of C-STM. We also evaluated the diagnostic accuracy of C-STM in detecting ischemia or infarction, using stress test and troponin I results as reference standards. Methods: We prospectively studied 163 adults (pre-intervention phase: n=78; intervention phase: n=85) in the ED at a single hospital. We stratified patients into low (n=51), intermediate (n=100), or high (n=12) risk using HEART scores. The principal investigator monitored participants, activating C-STM on bedside monitors in the intervention phase. We used likelihood ratios (LRs) as the measure of diagnostic accuracy. By convention, a positive (+) LR is diagnostic at >10 and a negative (-) LR at <0.1. Results: Overall, 9% of patients were diagnosed with ACS. There was no significant difference in median time to ACS diagnosis before and after implementation of C-STM (5.55 vs. 5.98 hours; p=0.43 for Mann-Whitney U test). In risk-stratified analyses, no significant pre-post difference in time to ACS diagnosis was found in low-, intermediate-, or high-risk patients. There was no difference in the rate of any 30-day adverse event before vs. after C-STM implementation (11.5% vs. 10.6%; p=0.85 Chi-squared test). None of 3 episodes of ST-segment changes on C-STM represented ACS. The +LR and -LR of C-STM for ischemia were 24.0 (95% CI 1.4 - 412.0) and 0.3 (95% CI 0.02 - 2.9), respectively; and for infarction were 13.7 (95% CI 1.7 - 112.3) and 0.7 (95% CI 0.3 - 1.5), respectively. Conclusion: In this sample of mainly low- to intermediate-risk patients, use of C-STM did not improve time to diagnosis or 30-day adverse outcomes, nor provide much benefit in detecting myocardial ischemia or infarction. Use of C-STM may need to be re-evaluated for patients with low to intermediate risk for ACS in the ED.

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Effects of Single versus Multiple Bouts of Resistance Training on Maximal Strength and Anaerobic Performance

Journal of Human Kinetics ◽

10.1515/hukin-2017-0122 ◽

2018 ◽

Vol 62 (1) ◽

pp. 231-240 ◽

Cited By ~ 1

Author(s):

Kai Shiau ◽

Te Hung Tsao ◽

Chang Bin Yang

Keyword(s):

Resistance Training ◽

Resistance Exercise ◽

Bench Press ◽

Upper Body ◽

Anaerobic Performance ◽

Maximal Strength ◽

Post Intervention ◽

Significant Difference ◽

Single Bout ◽

Before And After

Abstract This study examined the effects of one single bout daily versus triple bouts of resistance exercise for 12 weeks on muscular strength and anaerobic performance of the upper body. Twenty young male adults (age: 22.0 ± 1.0 years, bench press: 44.0 ± 10.3 kg) were randomly assigned to a single bout (SB) or triple bouts (TB) of resistance exercise group. Maximal strength and anaerobic performance of the upper body using the bench press (one-repetition maximum) and the modified 30 s Wingate test were determined before and after the intervention. Additionally, changes in lactate levels before and after the Wingate test were measured. Although the SB and TB groups showed a significant increase in maximal strength (post-intervention, SB: 67.2 ± 9.2 and TB: 67.6 ± 7.6 kg, respectively) compared with the values at pre-intervention (SB: 44.6 ± 11.4 and TB: 43.9 ± 8.7 kg, respectively), there was no significant difference for this variable between the two groups post-intervention (p > 0.05). The anaerobic performance of the upper body in the SB and TB groups also displayed improvements without significant difference between the two groups after the completion of different training regimes. On the basis of the same training volume, multiple bouts of resistance training showed similar improvements in maximal strength and anaerobic performance to one bout of resistance training in young adult men without prior experience in resistance training

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Use of digital game therapy among elderly persons undergoing dialytic treatment: cognitive aspects and depressive symptoms

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562018021.170184 ◽

2018 ◽

Vol 21 (4) ◽

pp. 447-455

Author(s):

Sirlei Ricarte Bento ◽

Ana Carolina Ottaviani ◽

Allan Gustavo Brigola ◽

Vânia Paula de Almeida Neris ◽

Fabiana de Souza Orlandi ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Intervention Program ◽

Depression Scale ◽

Elderly Persons ◽

Post Intervention ◽

Therapeutic Game ◽

Significant Difference ◽

Before And After ◽

The Mean

Abstract Objective :to evaluate the presence of depressive symptoms and cognitive disorders before and after an intervention program with a digital therapeutic game among elderly persons undergoing hemodialysis. Method: a quasi-experimental study was carried out with 26 elderly patients on hemodialysis. For the data collection, a questionnaire relating to sociodemographic and health conditions, the Geriatric Depression Scale - 15 items and Addenbrooke’s Cognitive Examination Revised were used. The intervention with the digital therapeutic game was performed over 5 sessions. Results: of the participants, 80.8% were male, with a mean age of 66.7 (± 5.8) years. The mean pre-intervention depressive symptom score was 3.9 (± 3.0) while post-intervention it was 2.8 (± 2.9), representing a statistically significant difference (p = 0.005). Regarding cognitive function, there was no statistically significant difference before and after the intervention. There was a statistically significant difference in the mean of the depressive symptom scores, which were lower after the intervention. In addition, there was no statistically significant difference in the mean of the cognitive assessments. Conclusion: intervention studies with patients undergoing hemodialysis treatment are still scarce and this study describes the positive results of an intervention with a digital therapeutic game, demonstrating improvement in the depressive symptoms of the participants.

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Assessment of knowledge, attitude and perception among mothers towards immunization in a tertiary care teaching hospital

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20173857 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3429

Author(s):

Sarfaraz Md. ◽

Athira A. ◽

Lakshmi Mani Deepa Thotamsetty ◽

Sree Anoohya Ravilla ◽

Naresh Nadikudi ◽

...

Keyword(s):

Teaching Hospital ◽

Tertiary Care ◽

Immunization Coverage ◽

Counseling Session ◽

Childhood Immunization ◽

Post Intervention ◽

Intervention Phase ◽

Tertiary Care Teaching Hospital ◽

Care Teaching ◽

Significant Difference

Background: The knowledge, attitude and perception (KAP) of parents is an important factor for better immunization coverage. Previous studies showed misconceptions on parent’s knowledge towards childhood immunization. This study aimed at promoting the childhood immunization by providing information and knowledge to mothers regarding immunization.Methods: A prospective interventional study was conducted on 103 mothers for a period of six months in a tertiary care teaching hospital, Karnataka. The study was divided into Pre-intervention and post-intervention phases and was performed using a KAP questionnaire.Results: 103 mothers were enrolled in the study, of which 77 (74.75%) mothers were uneducated which was the main reason for lack of knowledge on immunization. Most of the mothers in pre-intervention phase got score in the range of 2-4 and in post-intervention phase they got score in the range of 10-12. A significant difference was observed in the Pre and Post-intervention scores which indicated that level of knowledge among mothers was improved after counseling session. Chi-square test was used to analyse the pre and post- intervention scores and was found to be significant (p<0.01). Out of 103 mothers who had attended counseling session on immunization 80 (77.66%) children were immunized, 23 (22.66%) were partially immunized and no one was unimmunized.Conclusions:It was therefore suggested that proper health education and health promotion interventions be taken as measures to improve knowledge, attitude and perception of mothers towards immunization as a disease prevention tool.

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46. Antimicrobial Stewardship’s Selective Antibiotic Suppression Does Not Lead to Adverse Outcomes in Neutropenic Patients with Gram-Negative Bacteremia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.091 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S46-S46

Author(s):

Anna Witt ◽

Mason G Harper ◽

Juan Carlos Rico Crescencio ◽

Ryan K Dare ◽

Mary Burgess

Keyword(s):

Intervention Group ◽

Adverse Outcomes ◽

Post Intervention ◽

Gram Negative ◽

Narrow Spectrum ◽

Stewardship Program ◽

Significant Difference ◽

Before And After ◽

Gram Negative Bacteremia ◽

Post Intervention Group

Abstract Background An antimicrobial stewardship program (ASP) strategy to minimize the use of overly broad antimicrobials is to suppress specific antimicrobial susceptibility results when isolates are sensitive to narrow antibiotics. There is limited data on possible adverse outcomes of this method. Patients with febrile neutropenia (FN) and gram-negative bacteremia (GNB) whose culture is sensitive to non-pseudomonal antibiotics still require broader pseudomonal coverage to treat the syndrome of FN. We evaluated if ASP suppression of anti-pseudomonal antibiotics adversely affects patients with FN and GNB. Methods In February 2018, our institution’s ASP began suppressing cefepime and meropenem susceptibility results from E. coli, Klebsiella spp, and Proteus spp when sensitive to cefepime (MIC ≤ 2), ceftriaxone and ceftazidime. We performed a retrospective analysis of patients with FN and GNB from 2016 – 2020 to evaluate the appropriateness of antibiotic regimens before and after the ASP intervention. Antibiotic regimens were deemed inappropriate if the patient was de-escalated to a narrow-spectrum, non-pseudomonal agent while neutropenic. Of 338 inpatient encounters identified with any bacteremia and FN, 49 were due to non-Pseudomonas, non-ESBL GNB, 20 before and 29 after the intervention. Sixteen of the 29 post-intervention patients were excluded, as their isolates did not meet suppression criteria. This resulted in a total of 13 patients in the post-intervention group. Results After culture susceptibility reports were released, 3 out of 20 patients in the pre-intervention group (15%) and 4 out of 13 patients in the post-intervention group (30.8%) were inappropriately tailored to narrow-spectrum antibiotics (p=0.39). There was no significant difference in 30-day mortality, 10.0% pre- and 0% post-intervention (p=0.50), or amount of meropenem prescribed, 45% pre- and 38.5% post-intervention (p=0.74). Conclusion These data show no significant difference in inappropriate antibiotic regimens prescribed for patients with FN and GNB after ASP antibiotic suppression was implemented. 30-day mortality was also not affected. The ASP intervention did not decrease meropenem prescriptions in this patient group, which may be appropriate. Larger studies are needed to verify these findings. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support) Mary Burgess, MD, Pfizer Inc (Grant/Research Support)

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Teaching Cardiac Arrhythmias Using Educational Videos and Simulator Software in Nurses: An Educational Interventional Study

Shiraz E-Medical Journal ◽

10.5812/semj.97984 ◽

2020 ◽

Vol 21 (9) ◽

Author(s):

Hamed Tavan ◽

Siros Norouzi ◽

Masoumeh Shohani

Keyword(s):

Cardiac Arrhythmias ◽

Heart Diseases ◽

Educational Interventions ◽

P Value ◽

Post Intervention ◽

Significant Difference ◽

Before And After ◽

Quasi Experimental ◽

The Mean ◽

Educational Videos

Background: Cardiac arrhythmias are among the most prominent causes of mortality in patients with heart diseases. By timely diagnosis of arrhythmias, nurses can provide necessary therapeutic measures to these patients. Objectives: The purpose of this study was to determine the effects of teaching cardiac arrhythmias using educational videos and simulator software in nurses. Methods: In this quasi-experimental study, 22 novice nurses were selected based on the census method. Evaluations were performed before and after educational interventions for cardiac arrhythmia. The interventions included using simulator software and face-to-face education. A questionnaire with 20 questions regarding cardiac arrhythmias organized in 4 parts of sinus arrhythmias, atrial arrhythmias, ventricular arrhythmias, and blocks and junctional rhythm, and each with 5 questions was used to collect data. Each question was scored 1 point, and the final score ranged from 0 to 20. The scores were categorized into poor (< 10), moderate (11 - 15), and good (16 - 20) levels. Data were analyzed using SPSS V.20 software. Results: There was a significant difference in the mean of total score regarding the diagnosis of arrhythmias before (9.9) and after (15.68) the education (P value = 0.022). This indicated an increase of about 6 scores at post-intervention. The classification of the scores showed that 9 (40.9%) and 13 (59.1%) nurses had poor and moderate diagnostic abilities before training. However, following education, 10 nurses (50%) acquired moderate and 10 (50%) nurses obtained good scores. Conclusions: Arrhythmia scores varied before and after training, with the mean scores after training increased, and arrhythmia detection rate was increased after the intervention. It is advisable to use modern educational methods as good alternatives for reviewing educational content and concepts.

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Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study

Investigación y Educación en Enfermería ◽

10.17533/udea.iee.v38n1e04 ◽

2020 ◽

Vol 38 (1) ◽

Author(s):

Nahid Zarifsanaiey ◽

Alireza Bagheri ◽

Faezeh Jahanpour ◽

Samaneh Nematollahi ◽

Parviz Azodi

Keyword(s):

Pregnant Women ◽

Vaginal Delivery ◽

Delivery Method ◽

Interventional Study ◽

Post Intervention ◽

Delivery Methods ◽

Interactive Training ◽

Significant Difference ◽

Before And After ◽

Quasi Experimental

Objective. To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women. Methods. Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information. Results. The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p <0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p<0.001). Conclusion. Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.How to cite this article: Zarifsanaiey N, Bagheri A, Jahanpour F, Nematollahi S, Azodi P. Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study. Invest. Educ. Enferm. 2020; 38(1):e04.

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Referrals to a Pediatric Emergency Department of a Tertiary Care Teaching Hospital Before and After Introduction of a Referral Education Module - a Quality Improvement Study

10.21203/rs.3.rs-53721/v2 ◽

2020 ◽

Author(s):

Gopalakrishnan Ezhumalai ◽

Muralidharan Jayashree ◽

Karthi Nallasamy ◽

Arun Bansal ◽

Bhavneet Bharti

Keyword(s):

Emergency Department ◽

Health Care Providers ◽

Critically Ill Children ◽

Referral Letter ◽

Care Providers ◽

Post Intervention ◽

Intervention Phase ◽

Before And After ◽

Referral Letters

Abstract Background: Provision of timely care to critically ill children is essential for good outcome. Referral from smaller peripheral hospitals to higher centers for intensive care is common. However, lack of an organized referral and feedback system compromises optimal care. We studied the quality of referral letters coming to our Emergency Department (ED) with respect to their demography, association with severity of illness and mortality before and after referral education. Methods: Our study was completed in three phases in the Pediatric ED; Pre-intervention, Intervention and Post intervention phases. Quality of referral letter was matched with a quality checklist proforma and graded as ‘good’, ‘fair’ and ‘poor’ if it scored >7, 5 –7 and < 5 points respectively. A peer reviewed referral education module was prepared using case studies, expert opinions, and lacunae observed in the first phase and administered to health care providers (HCP’s) of referring hospitals. Quality of referral letter was compared between pre and post intervention phases. Results: Most referrals belonged to the neighboring states of Punjab (48.2%) and Haryana (22.4%). Major referring hospitals were from public sector (80.9%), of which the teaching hospitals topped the list (53.6%). Government run ambulance services (85.5%) was commonest mode of transport used and need for a PICU bed and/or mechanical ventilation (50.4%) was the commonest reason for referral. The post intervention phase saw a significant decline in the proportion of poor (93.2 vs.78.2%; p=0.001) and a significant increase in the proportion of fair (6.1 vs 18%; p=0.001) and good referral letters (0.7 vs 18%; p=0.001). The proportion of children with physiological decompensation at triage had reduced significantly in the post intervention phase [513 out of 1403 (36.5%) vs. 310 out of 957 (32.3%); p= 0.001]. Conclusion: Referral education had significantly improved the quality of referral letters. Proportion of children with physiological decompensation at triage had decreased significantly after referral module. This change suggests sensitization of the peripheral hospitals towards a better referral process. Continued multifaceted approach will be required for sustained and increased benefits

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Improving retention in care of HIV+ women through behavioural change interventions aimed at their male partners: A prospective, controlled before-and-after study protocol (WeMen) (Preprint)

10.2196/preprints.19384 ◽

2020 ◽

Author(s):

Stefano Orlando ◽

Ilaria Palla ◽

Fausto Ciccacci ◽

Isotta Triulzi ◽

Darlington Thole ◽

...

Keyword(s):

Adult Population ◽

Retention In Care ◽

Hiv Positive ◽

Male Partners ◽

Post Intervention ◽

Intervention Phase ◽

The World ◽

Before And After ◽

Living With Hiv ◽

Before And After Study

BACKGROUND According to the World Health Organization (WHO), in 2018, 37.9 million people were living with HIV (PLWHIV) worldwide. More than two-thirds of PLWHIV reside in Sub-Saharan Africa (SSA), where the HIV prevalence in the adult population (aged 15-49) is 3.9%. This includes 1.3 million pregnant women living with HIV, of whom 82% received Antiretroviral Therapy (ART) for Prevention of HIV Mother-To-Child Transmission (PMTCT). In these countries, one of the main challenges is an insufficient level of treatment adherence, particularly in HIV positive pregnant women. Among the causes, the lack of male partner involvement represents a significant contributor to the problem. This issue emerges strongly in Malawi, one of the countries with the highest HIV prevalence in the world: 9.2% of its adult population lived with HIV in 2018. OBJECTIVE The objective of the study is to assess three different interventions aimed at improving ART adherence and retention among HIV positive women through engagement with their male partners in four Malawian healthcare centres. METHODS The prospective, controlled before-and-after study is articulated in three phases (total duration of 24 months): pre-intervention, intervention and post-intervention analyses. The number of selected clusters (clinical centres) is limited to four, one for each intervention plus a cluster where no intervention will be performed (control arm). The interventions are 1) opening the facility on one Saturday per month, only for men, defined as a "special day"; 2) testing peer-to-peer counselling among men, "male champions"; 3) providing a non-economic incentive to all women who are accompanied by their partners to the facility, "nudge". The primary outcome of the study is to evaluate differences in retention in care and adherence among women to therapeutic protocols; the intermediate outcome is the assessment of differences in Male Involvement (MI). The level of MI in the health of their female partners (intermediate outcome) will be evaluated through a dedicated questionnaire administered at baseline and in the post-intervention phase. Data will be collected at the clinical centres and stored in two electronic databases managed through two different types of software. RESULTS Analysis of data collected in the four centres during the pre-intervention phase is ongoing as enrolment ceased on March 31, 2020. The total number of patients enrolled was 452 (Namandanje: 133, Kapeni: 78, Kapire: 75, Balaka: 166). Meanwhile several meetings have taken placeat the centres to organize the intervention phase. CONCLUSIONS The study will identify the best intervention which enhances involvement of male partners in womens health, using an approach that takes into consideration a broad spectrum of behaviours. An important aspect will the use of educational tools focused on messages initiating a reflective discussion of stereotypes and false beliefs related to the idea of masculinity present in Malawian culture. CLINICALTRIAL Clinicaltrials.gov NCT04356157 https://clinicaltrials.gov/show/NCT04356157

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EFFECT OF LEVENTIS FOUNDATION YOUTH AGRICULTURAL EMPOWERMENT PROGRAMME ON TRAINEES’ FOOD OUTPUT IN OSUN STATE, NIGERIA

Cercetari Agronomice in Moldova ◽

10.46909/cerce-2020-018 ◽

2020 ◽

Vol 53 (2) ◽

pp. 207-216

Author(s):

K. A. ADELOYE ◽

A. O. AJAYI ◽

A. O. SOTOMI

Keyword(s):

Formal Education ◽

Sampling Technique ◽

Community Leaders ◽

Systematic Random Sampling ◽

Significant Difference ◽

Before And After ◽

High Knowledge ◽

Quality Of Food ◽

The Mean

The study assessed the effect of Leventis Foundation Youth Agricultural Empowerment Programme (LFYAEP) on trainees’ food output in Osun State, Nigeria. A total of 248 ex-trainees of LFYAEP were selected and interviewed in the study area through a systematic random sampling technique using list of Leventis Foundation Agricultural School, Ilesa ex-trainees between the year 2010 and 2017 as sample frame. Data collected were presented using appropriate descriptive and inferential statistics. The mean age of the respondents was 30.0±6.2 and their farming experience was 7.2±4.4. About 74.7 and 77.6% got information about the empowerment through their community leaders and media respectively; also, they all participated to better their lot in life. In addition, there were high knowledge and skill proficiency in all the farm enterprises engaged in after the empowerment. Furthermore, the respondents recorded increased food output in all the farm enterprises engaged in after the empowerment. The findings revealed that at p< 0.05, respondents’ reasons for participation (χ2 = 31.612) had significant association with their food output. Furthermore, at p< 0.05, farming experience (r = 0.483), age (r = 0.322), years of formal education (r = 0.153), knowledge possessed (r = 0.148) and skill proficiency (r = 0.221) of respondents had significant relationship with their food output. Finally, there was significant difference between food output before and after the empowerment (F = 65.59). The study concludes that there was a significant improvement in the quantity and quality of food produced by the ex-trainees after the empowerment programme. It was recommended that similar empowerment should be put in place for all youth to enhance productivity.

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