Teaching Students about Intravenous Therapy: Increased Competence and Confidence

2009 ◽  
Vol 14 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Rebecca Jensen
Keyword(s):  
Associate Degree ◽  
Relevant Literature ◽  
Central Line ◽  
Teaching Methodology ◽  
Complication Rates ◽  
Additional Information ◽  
Adequate Knowledge ◽  
Adn Students ◽  
Elective Course ◽  
Educational Offering

Abstract Aim/Purpose: Graduate nurses require competency in IV therapy. Associate Degree in Nursing (ADN) programs offer elective IV education to provide additional information for interested students. After instituting such a course, students' perceived comfort and knowledge of IV therapy were evaluated. Review of Relevant Literature: Studies demonstrated that IV education for nurses in practice helped reduce complication rates. Dated research also indicated that nursing programs were reluctant to provide IV instruction that included advanced skills, such as catheter insertions. More recent literature involved teaching methodology. Methods: A researcher-designed survey was distributed at the completion of an ADN program to evaluate perceived knowledge and comfort related to IV therapy, as well as information about IV education throughout the program. Results: Students who participated in the workshop perceived having a higher level of comfort and knowledge of several IV content areas than those who participated in the course or had no elective IV education. Conversely, participants in the workshop and course felt more comfortable with central line dressing changes and IV insertions than students who did not take either IV educational offering. Conclusions: The standard IV education appeared to provide adequate knowledge and comfort with IV therapy. However, optional IV education benefited students who wanted more in depth IV knowledge and skills. Implications for Practice: The best methods for teaching ADN students about IV therapy remains unknown. However, offering an elective course provides opportunities for interested students to increase their knowledge and comfort related to IV therapy prior to graduation.

Value Analysis of Central Line Simulation-Based Education

2021 ◽  
pp. 000313482110111
Author(s):  
Nicholas J. Iglesias ◽  
Taylor P. Williams ◽  
Clifford L. Snyder ◽  
Christian Sommerhalder ◽  
Alexander Perez
Keyword(s):  
Financial Burden ◽  
Bloodstream Infections ◽  
Central Line ◽  
Complication Rates ◽  
Qualitative Synthesis ◽  
Reporting Standard ◽  
Value Analysis ◽  
Learner Analysis ◽  
Simulation Based ◽  
Value Propositions

Background Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE. Methods A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning “Cost and CLABSI,” “Cost and Central line Associated Bloodstream Infections,” and “Cost and Central Line” in their abstract and article body. Articles chosen for qualitative synthesis mentioned “simulation” in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis. Results Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs. Conclusion Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists

2021 ◽  
Keyword(s):  
Lung Ultrasound ◽  
Central Line ◽  
Arterial Line ◽  
Ultrasound Guided ◽  
Pediatric Airway ◽  
Skill Sets ◽  
Additional Information ◽  
Line Placement ◽  
Extensive Training ◽  
Radiologic Imaging

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists is intended as a ready resource for both experts and novices. It will be useful to those with extensive training and experience as well as beginners and those with distant experience or training. A wealth of knowledge in the human factors of procedure design and use has been applied throughout to ensure that desired information can be easily located, that steps are clearly identified and comprehensible, and that additional information of high relevance to procedure completion is co-located and salient. This book begins with the basics but quickly progresses to advanced skill sets. It is divided into four parts. Part I starts with a primer on ultrasound machine functionality as well as procedural chapters on lung ultrasound to detect a mainstem intubation or pneumothorax and gastric ultrasound to assess gastric contents in incompletely fasted patients. Part II covers ultrasound guided peripheral intravenous line placement through the incremental advancement method, ultrasound guided arterial line placement, and ultrasound guided central line placement. Part III details several ultrasound guided regional anesthesia techniques. Part IV covers radiology of the pediatric airway and mediastinum, lungs, gastrointestinal, genitourinary, musculoskeletal, and neurologic systems.

New Product Decisions - The Process and Outcome for a Community Health System

2011 ◽  
Vol 16 (2) ◽  
pp. 74-84 ◽  
Author(s):  
Jose Delp ◽  
Lynn Hadaway
Keyword(s):  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Negative Impact ◽  
Relevant Literature ◽  
Outcome Data ◽  
Passive Safety ◽  
Radiology Department ◽  
Complication Rates ◽  
Safety Mechanism ◽  
Catheter System

Abstract Purpose: To compare patient outcomes and evaluate safety features and costs associated with a new catheter system and securement dressing. Background: The need to improve dwell times for short peripheral catheters and reduce complication rates, along with improvements in clinical practice in radiology and enhanced staff safety were driving factors leading to a change in peripheral catheters and securement systems. Review of Relevant Literature: Several reports of catheter stabilization devices have shown improved clinical outcomes with their use. Currently available studies on this new catheter system include one small evaluation and a randomized trial comparing a traditional round hub catheter coupled with a supplemental securement device and the new catheter system with an integrated stabilization platform combined with a securement dressing. Passive safety mechanisms on peripheral catheters may produce fewer needlestick injuries than mechanisms requiring the user to activate the device. Methods: After a learning period, the following seven months were designated the intervention period. Outcome data from the same seven-month period of the preceding year were used for comparison. The data were divided into scheduled and unscheduled restarts. Data from two hospitals are reported separately and in combination. Data from the two periods were analyzed for equivalence or noninferiority. Results: Clinical outcomes for both periods are virtually equivalent, demonstrating that one system is not inferior to the other regarding catheter complications. However the catheter system with the integrated stabilization platform was less costly and safer due to a passive safety mechanism. Problems with high pressure injection in the radiology department were also solved with the new catheter system. Conclusions: While any product change can be a challenging experience, we accomplished these changes in an orderly manner without negative impact on patient outcomes and reducing costs. Improvements in radiology were also attributed to these changes, along with enhanced staff safety. Implications for Practice: The catheter designed with an integrated stabilization platform, a pre-attached extension set, and a passive safety mechanism produced benefits for radiology staff without negatively affecting patient outcomes in other clinical areas. These product changes were implemented in an organized manner and involved all stakeholders in the process.

Early Identification of Transformation in the Proficiency Level of Critical Thinking

2017 ◽  
pp. 190-211
Author(s):  
Velmarie King Swing
Keyword(s):  
Critical Thinking ◽  
Nursing Students ◽  
Associate Degree ◽  
Thinking Skills ◽  
Critical Thinking Skills ◽  
Teaching Methodology ◽  
Associate Degree Nursing Students ◽  
Early Evaluation ◽  
First Semester ◽  
Proficiency Level

Critical Thinking (CT) in the nurse graduate continues to be a topic of concern in the academic and acute care settings. Few studies focus on early evaluation of Critical Thinking Skills (CTS). The purpose of this chapter is to show how the non-experimental, explanatory, quantitative study, the Kaplan CTIT, was employed to determine if a transformation in the level of CTS occurs within the first semester of associate degree nursing students. Participants completed the pretest in the first three weeks of classes. Posttests were given after course finals. A significant transformation in the level of CT occurred. The estimated change in CT test scores was 2.04, with 95% confidence. Implications for early measurement of CTS in nursing programs reveals if teaching methodology is providing the necessary input for developing CTS or if evaluation and changes are needed.

Inpatient Peripherally Inserted Central Venous Catheter Complications: Should Peripherally Inserted Central Catheter Lines be Placed in the Intensive Care Unit Setting?

2017 ◽  
Vol 83 (8) ◽  
pp. 925-927 ◽  
Author(s):  
Michael Martyak ◽  
Ishraq Kabir ◽  
Rebecca Britt
Keyword(s):  
Intensive Care Unit ◽  
Interventional Radiology ◽  
Intensive Care ◽  
Infection Rate ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Complication Rates ◽  
Central Venous ◽  
Icu Patients

Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients. Data regarding infectious and thrombotic complications were collected and evaluated. During the study period, 1209 PICC line placements met inclusion criteria and were evaluated; 1038 were placed by interventional radiology in non-ICU patients, and 171 were placed at the bedside in ICU patients. The combined thrombotic and central line associated blood stream infection rate was 6.17 per cent in the non-ICU group and 10.53 per cent in the ICU group (P = 0.035). The thrombotic complication rate was 5.88 per cent in the non-ICU group and 7.60 per cent in the ICU group (P = 0.38), whereas the central line associated blood stream infection rate was 0.29 per cent in the non-ICU group and 2.92 per cent in the ICU group (P = 0.002). This study seems to suggest that PICC lines placed at the bedside in the ICU setting are associated with higher complication rates, in particular infectious complications, than those placed by interventional radiology in non-ICU patients. The routine placement of PICC lines in the ICU settings needs to be reevaluated given these findings.

Clinical Utility of Pneumogastrography in Dogs

2005 ◽  
Vol 41 (3) ◽  
pp. 171-178 ◽  
Author(s):  
Rachel A. Bowlus ◽  
David S. Biller ◽  
Laura J. Armbrust ◽  
Todd D. Henrikson
Keyword(s):  
Contrast Media ◽  
Clinical Utility ◽  
Relevant Literature ◽  
Diagnostic Technique ◽  
Negative Contrast ◽  
Gastric Disease ◽  
Gastric Diseases ◽  
Case Examples ◽  
Additional Information ◽  
Mucosal Surfaces

Pneumogastrography utilizes negative contrast media such as air or carbonated beverages to improve visualization of luminal contents and mucosal surfaces within the stomach. Pneumogastrography as a diagnostic technique in cases of gastric disease has not been widely described in the veterinary literature and is a procedure that may yield additional information not obtained from survey radiographs. This technique is useful in the diagnosis of luminal and mucosal gastric diseases. In this article, the pneumogastrography technique and relevant literature are reviewed. Six case examples are included that demonstrate the utility of pneumogastrography in dogs with gastric disease.

scholarly journals Investigating Consumer Decision-Making Styles of Car Buyers in Croatia

2021 ◽  
Vol 11 (1) ◽  
pp. 65-78
Author(s):  
Ivana Tonković Pražić
Keyword(s):  
Decision Making ◽  
Representative Sample ◽  
Relevant Literature ◽  
Consumer Decision Making ◽  
Consumer Decision ◽  
Additional Information ◽  
Brand Quality ◽  
Car Market ◽  
Decision Making Styles ◽  
The Republic

This research sought to explore consumer decision-making styles of buyers in the car market in the Republic of Croatia. Additional aim of this research was also to add on the literature on consumer decision-making styles to further the understanding of the specificity of consumer behavior when buying a car. The research was conducted with in-depth interviews with car buyers using a non-probability purposive sample. Furthermore, interviews were conducted with car dealership employees who were consulted for additional information. The results indicate that car buyers in the Republic of Croatia make their car buying decisions based on specific consumer decision-making styles. Based on the relevant literature and empirical research, ten consumer decision-making styles specific to car buyers in the Republic of Croatia were identified: price sensitivity, susceptibility to the influence of others, interest in automobiles, involvement in car purchase, brand loyalty, and brand, quality, aesthetics, innovation and functionality consciousness. The research was conducted on a sample of respondents from the Croatian market, so the results cannot be applied to other markets. Also, the study was conducted on a smaller and a non-representative sample, so the results should be verified on a larger and representative sample.

scholarly journals Defining and tracking medical student self-monitoring using multiple-choice question item certainty

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mike Tweed ◽  
Gordon Purdie ◽  
Tim Wilkinson
Keyword(s):  
Multiple Choice ◽  
Multiple Choice Questions ◽  
Self Monitoring ◽  
Student Responses ◽  
Additional Information ◽  
Adequate Knowledge ◽  
Question Item ◽  
Time Patterns ◽  
Item Level ◽  
Definition Of

Abstract Background Self-monitoring is an important component of clinical practice. It is underpinned by the framework of self-efficacy which is concerned with judgments of how well one believes one can achieve or perform a task. This research aimed to develop criteria for adequate self-monitoring, then to measure patterns of self-monitoring, and to explore how these patterns relate to a student’s year in a medical course and to patterns of knowledge. Methods Analysis of individuals’ levels of correctness in answering assessment items and their certainty in correctness may be used to inform assessments of ability to self-monitor. Two criteria were proposed and applied to define adequate self-monitoring. Firstly, increasing proportions correct with increasing levels of certainty. Secondly, having a proportion correct for high certainty responses that was not lower than cohort levels. Student responses in progress tests comprising multiple-choice questions (MCQs) and associated certainty were analysed. Criteria for the presence of adequate self-monitoring and for adequate knowledge were applied to the results of each of four tests conducted over 2 years, and used to categorise patterns of self-monitoring and knowledge. Results Data from 3 year group cohorts totalling 737 students were analysed. The majority (58%) of students demonstrated adequate knowledge and met both criteria for adequate self-monitoring across all four tests. The most advanced year group cohort had the highest rates of adequate knowledge and the highest rates of meeting both self-monitoring criteria. The patterns of self-monitoring were the same as the patterns of knowledge across the four tests for 454 students, but for the remaining 283 the patterns of self-monitoring and knowledge differed. Conclusion Analysis of responses to item level certainty has informed development of a definition of adequate self-monitoring that may be applied to individual student’s responses from a single test, and to track the adequacy of a student’s self-monitoring over time. Patterns of self-monitoring tend to match patterns of knowledge, but not in all cases, suggesting the self-monitoring measure could provide additional information about student ability.

A National Survey of Pediatric Otolaryngologists and Early Hearing Detection and Intervention Programs

2006 ◽  
Vol 17 (10) ◽  
pp. 708-721 ◽  
Author(s):  
Jeffrey L. Danhauer ◽  
Carole E. Johnson ◽  
Dan Finnegan ◽  
Marilene Lamb ◽  
Ilian Priscilla Lopez ◽  
...  
Keyword(s):  
The United States ◽  
Vital Role ◽  
Postal Survey ◽  
Intervention Programs ◽  
National Study ◽  
Screening Programs ◽  
Additional Information ◽  
Adequate Knowledge ◽  
Newborn Hearing

Follow-up rates for babies identified for hearing loss from early hearing detection and intervention programs (EHDIPs) and newborn hearing screening programs (NHSPs) in the United States do not meet the goals posited by the Centers for Disease Control. Pediatric otolaryngologists (PED-ENTs) play a vital role in EHDIPs and can positively influence parents' compliance with professionals' recommendations for their babies. This national study used a 19-item questionnaire and postal survey to assess PED-ENTs' knowledge about, experience with, and attitudes toward NHSPs. Of 565 surveys mailed (36 were undeliverable), 233 were returned for a 44% response rate. Most of these PED-ENTs had adequate knowledge about, participated in, and expressed positive attitudes toward NHSPs; however, some could benefit from additional information about national EHDI benchmarks and poor follow-up rates. Audiologists should ally with PED-ENTs locally and nationally to strengthen EHDIPs and prevent loss of children with hearing impairment to follow-up.

Using Low-Fidelity Simulation to Maintain Competency in Central Line Care

2012 ◽  
Vol 17 (1) ◽  
pp. 31-37 ◽  
Author(s):  
John T. Taylor
Keyword(s):  
Health Care Providers ◽  
Relevant Literature ◽  
Central Line ◽  
Staff Nurses ◽  
Care Providers ◽  
Self Assessment ◽  
Healthcare Facilities ◽  
Significant Difference ◽  
Competency Evaluation ◽  
Almost All

Abstract Purpose: Many healthcare facilities require staff nurses to complete annual competency assessments on central line care. However, the question arises, could simulation provide a better assessment of competency and possibly help nurses retain competence longer? Review of Relevant Literature: A thorough review of the literature revealed that limited investigation has been done regarding the perception or effectiveness of simulation as a tool for competency evaluation. Multiple authors have identified simulation as an advantageous method for training health care providers in central line care. Several studies have linked simulation based training with decreased central line associated bacteremia rates. There is also evidence in the literature that simulation has great potential as a competency validation technique. Discussion: A sample of staff nurses participated in one of four central line care scenarios in a simulation environment. The participants were asked to complete a demographics survey as well as a self-assessment on central line competency prior to the simulation experience. Debriefing followed the simulation, offering the participant feedback on performance and verification of correct and incorrect actions. The self-assessment was then repeated to measure participant perception post-simulation. Implications for Clinical Practice: No significant difference of performance in the simulation was inferred from baccalaureate-prepared nurses versus diploma or associate-prepared nurses. Almost all participants rated their competence in caring for a central line as either “competent” or “highly competent.” However upon demonstration of central line skills in the simulation, all but two participants omitted a critical step. Omitting these steps places the patient at risk for infection or other complications.

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