scholarly journals Creating and Implementing a Protocol for the Management of Patients in Skeletal Traction: A Quality Improvement Project

2021 ◽  
Vol 14 ◽  
pp. 240-242
Author(s):  
Justin Cline ◽  
Jack Nolte ◽  
Gregory Mendez ◽  
Jordan Willis ◽  
Andrew Bachinskas ◽  
...  
Keyword(s):  
Nursing Management ◽  
Hospital Policy ◽  
Skeletal Traction ◽  
Improvement Project ◽  
Fracture Stabilization ◽  
Management Protocol ◽  
Key Points ◽  
Post Test ◽  
Manual Traction ◽  
Hospital Protocol

Introduction.Skeletal traction use generally has decreased over generations and is used most often for temporary fracture stabilization. Proper nursing management of patients in skeletal traction is crucial. A hospital protocol was created and implemented to educate and direct registered nurses (RNs) in the care of patients requiring skeletal traction. Method.A skeletal traction management protocol was drafted and implemented as hospital policy. Twenty-nine RNs from an orthopaedic unit at a level 1 trauma center attended a financially compensated, 45-minute, in-person, off-shift educational session. An anonymous pre-test utilizing a 5-point Likert scale was completed to assess RN knowledge and comfort regarding the following topics of traction care: pin care, manual traction, frame assembly, weight application and removal, skin evaluation, neurovascular checks, and reporting issues. The RNs were provided with a copy of the new hospital policy and key points were highlighted and demonstrated. After the demonstration, the RNs were given a post-test to assess their perceived knowledge and comfort with traction care. Results.Statistically significant improvements in RN knowledge and comfort were seen in six of the seven evaluated topics. The greatest increase was seen in the manual traction topic. No significant change regarding neurovascular checks was observed with this topic having the highest pre-test scores. Conclusion. A hospital protocol was created successfully and implemented that significantly improved the level of RN knowledge and comfort with the management of patients requiring skeletal traction. Future studies should assess the effectiveness of annual education regarding the traction policy.

The Effect of Alarm Fatigue Nursing Management Protocol on Critical Care Nurses' Experience

2020 ◽  
Vol 11 (4) ◽  
pp. 224-241
Author(s):  
Amina Mohamed Abdel Fatah Sliman ◽  
Wafaa Wahdan Abd El-Aziz ◽  
Hend Elsayed Mansour
Keyword(s):  
Critical Care ◽  
Critical Care Nurses ◽  
Nursing Management ◽  
Alarm Fatigue ◽  
Management Protocol

scholarly journals Impact of a blended curriculum on nursing handover quality: a quality improvement project

2021 ◽  
Vol 10 (1) ◽  
pp. e001024
Author(s):  
Xavier Losfeld ◽  
Laure Istas ◽  
Quentin Schoonvaere ◽  
Michel Vergnion ◽  
Jochen Bergs
Keyword(s):  
Educational Intervention ◽  
Patient Information ◽  
Professional Communication ◽  
Fit Indices ◽  
Negative Consequences ◽  
Improvement Project ◽  
Face To Face ◽  
Before And After ◽  
Post Test ◽  
E Learning

Context and objectiveThe negative consequences of inadequate nursing handovers on patient safety are widely acknowledged, both within the literature as in practice. Evidence regarding strategies to improve nursing handover is, however, lacking. This study investigates the effect of a tailored, blended curriculum on nurses’ perception of handover quality.MethodsWe used a pre-test/post-test design within four units of a Belgian general hospital. Our educational intervention consisted of an e-learning module on professional communication and a face-to-face session on the use of a structured method for handovers. All nurses completed this blended curriculum (n=87). We used the Handover Evaluation Scale (HES) to evaluate nurses’ perception of handover quality before and after the intervention. The HES was answered by 87.4% of the nurses (n=76 of 87) before and 50.6% (n=44 of 87) after the intervention. Confirmatory factor analysis was used to assess the validity of the HES.ResultsThe original factor structure did not fit with our data. We identified a new HES structure with acceptable or good fit indices. The overall internal consistency of our HES structure was considered adequate. Perception of nurses on Relevance of information showed a significant improvement (M=53.19±4.33 vs M=61.03±6.01; p=0.04). Nurses also felt that the timely provision of patient information improved significantly (M=4.50±0.34 vs M=5.16±0.40; p=0.01).ConclusionThe applied intervention resulted in an improved awareness on the importance of Relevance of information during handovers. After our intervention, the nurses’ perception of the HES item ‘Patient information is provided in a timely manner’ also improved significantly. We are aware that the educational intervention is only the first step to achieve the long-term implementation of a culture of professional communication based on mutual support.

scholarly journals Pre and Post test Clinical study to evaluate the Immunomodulatory effect (IgE) of Virecana followed by Citrakaharitaki Leha in Allergic Asthma

2021 ◽  
Vol 12 (1) ◽  
pp. 53-61
Author(s):  
Jyotish S Jayandan ◽  
James Chacko ◽  
Devipriya Soman ◽  
Mahesh C Kundagol
Keyword(s):  
Clinical Study ◽  
Allergic Asthma ◽  
Rank Test ◽  
Drug Induced ◽  
Paired Samples ◽  
Management Protocol ◽  
Post Test ◽  
Signed Rank Test ◽  
Significant Change ◽  
The Difference

Allergic Asthma is one among the diseases which imposes a great burden on the subjects by hampering the quality of life of patients, reducing productivity, and causing work absence. The literary search hinted that there are no published works reporting both clinical and immunological(IgE) outcomes in Allergic Asthma. So the present study was a pre and post test clinical study to evaluate the effect of Ayurvedic line of management in inducing both immunological(IgE) and clinical outcomes in Allergic Asthma. In this study 30 patients were administered classical Virecana Karma (drug induced purgation) followed by Shamanoushadi (internal medicine) for 30 days. Statistical Analysis was done using SPSS VER. 20. Wilcoxon signed rank test was used to evaluate the Subjective parameters, in order to interpret the time of significant change. For objective parameters Paired Samples t- Test was used to evaluate the difference of significant change. The results showed improvement in the subjective criteria, objective criteria and the overall effect of the therapy with the exception of no statistically significant results in immunomodulatory (IgE) effect which proves that the particular management protocol adopted is found to be clinically efficant but not effective in inducing changes at the immune level.

Abstract WP356: Impact of a Designed Acute Stroke Nursing Management Protocol on Nurse’s Knowledge and Practices

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Samah Zidan ◽  
Hanaa Elfeky ◽  
Warda Yossif ◽  
Foad Abd Allah
Keyword(s):  
Acute Stroke ◽  
Nursing Management ◽  
Management Protocol

scholarly journals Effectiveness of Self Instructional Module (Sim) on Knowledge Regarding Alzheimer's Disease

2018 ◽  
Vol 4 (2) ◽  
pp. 25-29
Author(s):  
Nira Neupane ◽  
M. Vijaya lakshmi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Student Nurses ◽  
Knowledge Score ◽  
Nursing Management ◽  
Adequate Knowledge ◽  
Instructional Module ◽  
Post Test ◽  
Level Of Knowledge ◽  
Test Level

INTRODUCTION: Alzheimer's disease is a progressive neurodegenerative disease that causes severe deterioration of functional and cognitive abilities. As the leading cause of dementia in adults, it affects one in every 10 people who are more than 65 years of age. There is a vital need for student nurses with knowledge of Alzheimer's disease to provide high quality care for the growing number of patients. The use of effective nursing interventions for the management of Alzheimer's disease can help student nurses promote independence and quality of life for Alzheimer's disease patients. Thus this study is under taken to assess the effectiveness of the self instructional module (SIM) on nursing management of client with Alzheimer's disease among 4th year B. Sc. (N) students.MATERIALS AND METHODS: A quantitative evaluative research approach with pre experimental one group pre test and post test research design & non probability purposive sampling technique was used to select the 60 samples of B.Sc. (N) 4th year students. Self administered structured knowledge questionnaire were used to collect the information from the study samples. The prepared tool was validated by the experts and the reliability was established. The study was conducted in R.V. College of Nursing and Vidyakirana Institute of Nursing Sciences, Bangalore. The data was analyzed by descriptive and inferential statistics using SPSS version 19.RESULTS: Findings of the study shown that, the overall mean percentage pre test level of knowledge of B.Sc. Nursing 4th year studentswas 62.08%, and the pre test knowledge score was 35(58.33%) respondents were having moderately adequate knowledge, 13(21.67%) had inadequate knowledge and 12(20%) were having adequate knowledge regarding nursing management of clients with Alzheimer's disease. In the post test overall mean percentage post test level of knowledge was 84.37%. The post test knowledge score was 54(90%) respondents were having adequate knowledge and 06(10%) had moderately adequate knowledge after the administration of SIM. The overall obtained ''t'' value of knowledge 15.6 is highly significant at P< 0.01 level. The obtained chi-square value showed significant association between the pre test level of knowledge and certain socio demographical variables; gender (χ2 =5.12, df =1, p<0.05) and sources of information (χ2 =4.82, df=1, p<0.05). However, it did not show any significant association with other demographic variables of 4th Year B. Sc. (N) students.CONCLUSION: Findings of the study showed that majority of the student nurses were moderately adequate knowledge before administering the SIM. The SIM facilitated them to gain more knowledge regarding nursing management of client's with Alzheimer's disease which was evident in post test knowledge scores. Hence SIM was an effective strategy for providing information and to improve knowledge of students' nurses.Journal of Universal College of Medical Sciences (2016)Vol.04 No.02 Issue 14, page: 25-29 

scholarly journals Quality improvement project for improving inpatient glycaemic control in non-critically ill patients admitted on medical floor with type 2 diabetes mellitus

2020 ◽  
Vol 9 (3) ◽  
pp. e000982
Author(s):  
Adeel Ahmad Khan ◽  
Aamir Shahzad ◽  
Samman Rose ◽  
Dabia Hamad S H Al Mohanadi ◽  
Muhammad Zahid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Diabetes Management ◽  
Oral Intake ◽  
Improvement Project ◽  
Type 2 Dm ◽  
Management Protocol ◽  
Patients With Diabetes

A significant number of patients admitted to the medical floor have type 2 diabetes mellitus (DM). Lack of a standardised inpatient hyperglycaemia management protocol leads to improper glycaemic control adding to morbidity in such patients. American Diabetes Association, in its 2019 guidelines, recommends initiation of a regimen consisting of basal insulin (long-acting insulin) or basal plus correctional insulin for non-critically ill hospitalised patients with poor or no oral intake. A combination of basal insulin, bolus (short-acting premeal or prandial) insulin and correctional scale insulin is recommended for inpatient hyperglycaemia management in non-critical patients with type 2 DM who have proper oral intake. Baseline data of 100 patients with diabetes admitted to Hamad General Hospital Doha, Qatar, showed that although insulin was used in the majority of patients, there was lack of uniformity in the initiation of insulin regimen. Adequate glycaemic control (7.8–10 mmol/L) was achieved in 45% of patients. Using Plan–Do–Study–Act (PDSA) model of improvement, a quality improvement project was initiated with the introduction of a standardised inpatient hyperglycaemia management protocol aiming to achieve 50% compliance to protocol and improvement in inpatient glycaemic control from baseline of 45% to 70%. Interventions for change included development of a standardised inpatient hyperglycaemia management protocol and its provision to medical trainees, teaching sessions for trainees and nurses, active involvement of medical consultants for supervision of trainees to address the fear of hypoglycaemia, regular reminders/feedbacks to trainees and nurses about glycaemic control of their patients and education about goals of diabetes management during hospitalisation for patients with diabetes. Overall, glycaemic control improved significantly with target glycaemic control of 70% achieved in 4 of the 10 PDSA cycles without an increase in the number of hypoglycaemic episodes. We conclude that development of a standardised inpatient insulin prescribing protocol, educational sessions for medical trainees and nurses about goals of diabetes management during hospitalisation, regular reminders to healthcare professionals and patient education are some of the measures that can improve glycaemic control of patients with type 2 DM during inpatient stay.

Sepsis in adult leukemia patients.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 133-133
Author(s):  
Jan Garza
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Quality Improvement ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Hematologic Malignancies ◽  
Systemic Inflammatory Response ◽  
Improvement Project ◽  
Post Test ◽  
Sepsis And Septic Shock

133 Background: Sepsis is estimated to affect 16.8% of the cancer population with hematologic malignancies leading to significant mortality. The incidence may be higher in elderly leukemia patients with concurrent comorbidities. Results of case scenario questionnaires presented to leukemia nurses during a quality improvement project revealed a potential to increase recognition of systemic inflammatory response syndrome, commonly used to identify patients who are at high risk for sepsis, severe sepsis, and septic shock, by 20% among leukemia nurses. Earlier recognition of the systemic inflammatory response syndrome by clinicians is thought to possibly reduce the mortality among those with leukemia. The purpose of this poster is to present the pre-test/post-test results of an educational intervention aimed at increasing earlier recognition of SIRS and consequent sepsis, severe sepsis, and septic shock by 20% among 65 nurses on the leukemia units at a major cancer center. Methods: A multidisciplinary team Pharmacists from ICU and Leukemia and ICU MERIT Team-Leader, led by 2 APNs from ICU and Leukemia, developed and presented an educational program to nurses on the leukemia units to support proposed changes in practice. Pre-test and post-tests were used to determine nurses’ knowledge prior to and after the educational intervention. Results: Analysis of pre- and post-test scores revealed 61% increase in recognition of SIRS, sepsis, severe sepsis, and septic shock. There were no cases of systemic inflammatory response syndrome identified among the 29 leukemia patients by nurses prior to the intervention compared to 9 out of 16 post intervention. Conclusions: Education of nurses on leukemia units revealed an increase in their knowledge base and improvement in recognition of SIRS, sepsis, severe sepsis and septic shock. Implications for nursing include a need to incorporate this education to all nurses who are assigned to units caring for hematologic malignancies to include lymphoma, stem-cell transplant, and myeloma. Our quality improvement project showed the need for on-going healthcare provider education to recognize the symptoms early which may save lives and reduce costs of healthcare.

scholarly journals Enhancing Leadership, Management and Governance Competencies for Performance Improvements at Primary Health Care Entities in Ethiopia: A Quasi-Experimental Study Design

2020 ◽  
Author(s):  
Mesele Damte Argaw ◽  
Binyam Fekadu Desta ◽  
Sualiha Abdlkader Muktar ◽  
Nurhan Tewfik ◽  
Bekele Belayhun Tefera ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Performance Improvement ◽  
Health Workers ◽  
Management Systems ◽  
Improvement Project ◽  
Leadership Management ◽  
Primary Health ◽  
Post Test ◽  
Quasi Experimental

Abstract Background Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing work climate, and creating responsive health systems. The Federal Ministry of Health with the support of USAID Transform: Primary Health Care project, cascaded its basic LMG trainings and interventions to primary health care staff. The purpose of this evaluation was to measure the changes observed on performance improvement at primary health care entities after implementing the interventions for one year. The results of this research will help policy makers, program managers, and implementers to make informed decisions in the area of performance improvement. Methods The study used a quasi-experimental pre-post survey design to assess the changes observed as a result of LMG in performance management at primary health care entities. It was conducted from August 28, 2017 to September 30, 2018 in Amhara, Oromia, Tigray, and Southern Nations, Nationalities and Peoples Regions. The data was collected through document review and interviewer and self-administered questionnaires across 136 health facilities, in which there are 293 health workers who attended the LMG training; and 333 health workers who did not attend the training. In addition, training records were reviewed to capture change in knowledge and skill through pre-post training and, baseline and end-line performance improvement project achievements, respectively. The data were analyzed using SSPS IBM V 20. Results The response rates were 100% for staff who attended the training; and 87% for staff who did not attend the training. Of those who attended the training, 235 (80.9%) and 252 (86%) trainees scored above 70% on post-test, and 80% or more achieved the desired measurable results of their performance improvement projects. Using the above-mentioned criteria, composite scores were compiled from post-test and performance improvement project results. The result showed that 70% (205/293) of basic LMG trainees completed the course. As a result of the LMG trainings, management systems, work climate, and responsiveness of the health system to challenges significantly improved (p<0.001). Because of the leadership projects, an additional 2,290.3 units of health service coverage were gained. Conclusions The performance of the primary health care entities was significantly improved as a result of enhanced knowledge and skills through LMG trainings, and leadership projects implemented at primary health care entities. We recommend providing LMG trainings for more health workers and managers working at primary health care entities to accelerate implementation of prioritized health sector interventions helpful to achieving the Sustainable Development Goals as a global target. Evaluation of effectiveness and efficiency of the basic LMG training package is recommended.

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