scholarly journals Use of a Team-Based Video Simulation to Complement a Lecture in Motivational Interviewing to Develop Students’ Initial Attitudes and Skills

2021 ◽  
Vol 12 (3) ◽  
pp. 23
Author(s):  
David F Malewski ◽  
Shane P Desselle ◽  
Ranjit Kali-Rai
Keyword(s):  
Motivational Interviewing ◽  
Standardized Patients ◽  
Case Description ◽  
Post Intervention ◽  
Patient Centered ◽  
Student Knowledge ◽  
Before And After ◽  
Good Internal Consistency ◽  
Student Reflections ◽  
Student’S Attitude

Background: Motivational interviewing (MI) is increasingly recognized for its patient-centered approach to clinician-patient communication and often effective in evoking appropriate changes in patient behavior.  Doctor of Pharmacy (PharmD) programs are increasingly incorporating MI education; however, doing so represents a challenge regarding availability of both time and labor capital. Case Description: This study reports on the use of a 90-minute software-based simulation and tutorial coupled with a 90-minute lecture in a 3-hour course session. In a subsequent session consisting of several brief interactions with standardized patients (SPs), students reflected upon their strengths and challenges as a result of attempting to apply the MI principles they learned during the educational intervention. Case Themes: Students’ responses to a questionnaire delivered both before and after the simulation and lecture, showed improvements in several attitudinal components related to use of MI, as well as developing self-efficacies in deploying patient-centered communication strategies. A post-intervention survey without students’ opportunity to study/prepare saw gains in student knowledge about MI. Case Impact: The measurements employed to determine student’s attitude and knowledge showed good to very good internal consistency reliably based on calculated Cronbach’s alpha and KR-20. Student reflections indicated their understanding of MI principles, even though they fell short of implementing them in large part during their encounters with SPs. Conclusion: Use of a video simulation undergone by teams of PharmD students coupled with a brief lecture might be an effective and efficient way of building a foundation for MI competency among PharmD students where instructors might lack labor capital and significant space in the curriculum.

Oncology boot camp: A preparatory curriculum for advanced pharmacy practice experience students

2021 ◽  
pp. 107815522110191
Author(s):  
Bethannee Horn ◽  
Lyn Wells ◽  
Zachery Halford
Keyword(s):  
Student Perceptions ◽  
Pharmacy Practice ◽  
Boot Camp ◽  
Primary Objective ◽  
Comfort Level ◽  
Post Intervention ◽  
Student Knowledge ◽  
Survey Tool ◽  
Practice Experience ◽  
Drug Knowledge

Introduction The primary objective of this study was to evaluate the effectiveness of an autonomous oncology boot camp on Advanced Pharmacy Practice Experience (APPE) student knowledge. Secondary objectives included assessing student perception of the virtual learning experience and overall comfort level with the material. Methods APPE students rotating through our institution between November 2019 and March 2020 were voluntarily enrolled in a 4-hour oncology-focused boot camp, which included five PlayPosit (Denver, CO, USA) interactive video lectures embedded with case-based application questions followed by one comprehensive web-based Quandary (Victoria, BC, Canada) action-maze case. Student learning was measured by a pre- and post-intervention exam. A web survey tool (Qualtrics, Provo, UT, USA) collected student perceptions evaluating their comfort with oncology-specific drug knowledge and APPE rotations tasks. Results Fifty students enrolled in the oncology boot camp, with 100% completing the pre- and post-intervention assessments. Overall, pre-intervention exam scores (mean: 55.4%, SD: 21.8%) improved by 23.2% following the boot camp (mean: 78.6%, SD: 19.2%; p < 0.001). Students performed better on all 10 exam questions, with 6 questions showing a statistically significant improvement (p < 0.05). Forty-five students (90%) completed the perception surveys. Of those, 93% agreed that it effectively reinforced important oncology knowledge, 91% supported the autonomous design, and 82% would recommend the oncology boot camp for future students. Conclusion The boot camp proved to be a beneficial educational tool that enhanced student knowledge and confidence in navigating common oncology concepts. Students valued the ability to independently complete the activities and supported its continuation.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p&lt; 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals Daily Bathing with Chlorhexidine-Based Soap and the Prevention of Staphylococcus aureus Transmission and Infection

2014 ◽  
Vol 35 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Melissa A. Viray ◽  
James C. Morley ◽  
Craig M. Coopersmith ◽  
Marin H. Kollef ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
At Risk ◽  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Control Unit ◽  
Post Intervention ◽  
Icu Patients ◽  
Chlorhexidine Bathing ◽  
Before And After ◽  
Surgical Icu ◽  
Time Series Methodology

Objective.Determine whether daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and intensive care unit (ICU)-acquired S. aureus infection among ICU patients.Design.Prospective pre-post-intervention study with control unit.Setting.A 1,250-bed tertiary care teaching hospital.Patients.Medical and surgical ICU patients.Methods.Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology.Results.The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol (12.64 cases per 1,000 patient-days at risk before the intervention vs 10.03 cases per 1,000 patient-days at risk after the intervention; β, −2.62 [95% confidence interval (CI), −5.19 to −0.04]; P = .046). There was no significant change in MRSA acquisition in the control ICU during the study period (10.97 cases per 1,000 patient-days at risk before June 2005 vs 11.33 cases per 1,000 patient-days at risk after June 2005; β, −11.10 [95% CI, −37.40 to 15.19]; P = .40). There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002 through 2007 (19.73 cases per 1,000 patient-days at risk before the intervention to 15.63 cases per 1,000 patient-days at risk after the intervention [95% CI, −7.25 to −0.95]; P = .012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 infections per 1,000 patient-days at risk before the intervention vs 1.15 infections per 1,000 patient-days at risk after the intervention; P = .001).Conclusions.Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infection.

Needle-free connectors to prevent central venous catheter occlusion at a tertiary cardiac center: A prospective before and after intervention study

2021 ◽  
pp. 112972982110396
Author(s):  
Andrea Sansalone ◽  
Raffaello Vicari ◽  
Fabio Orlando ◽  
Alessandro Dell’Avo ◽  
Silvia Giuffrida ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Intervention Study ◽  
Absolute Risk ◽  
Phase 1 ◽  
Venous Catheter ◽  
Care Staff ◽  
Infusion Therapy ◽  
Central Venous ◽  
Post Intervention ◽  
Before And After

Objectives: To evaluate the effectiveness of needle-free connectors to maintain Central Venous Catheter—CVC patency. Background: Loss of patency is a common complication associated with CVC. For patients, this can be stressful and painful, and can result in a delay in infusion therapy. Pressure-activated anti-reflux needle-free connectors are one of the most modern devices; however, no studies have compared this connector with the open-system three-way stopcock in terms of the incidence of CVC occlusion. Methods: This study is a prospective before and after intervention study. From March to August 2018, an observation phase was conducted with the three-way stopcock as the standard central venous catheter hub and closure system (phase 1). After implementation of needle-free connectors (phase 2), post-intervention observations were made from September 2019 to January 2020 (phase 3). Results: Of 199 CVCs analyzed, 41.2% (40/97) occluded in at least one lumen in the first phase, and 13.7% (14/102) occluded after introducing the technological device, absolute risk reduction 27.5% (95% confidence interval 15.6%–39.4%). The lumens supported by needle-free connectors showed a higher probability of maintaining patency compared with three-way stopcocks. No differences were observed in the rate of infection. Conclusions: Pressure-activated anti-reflux needle-free connectors are effective and safe devices suitable for the management of vascular access in cardiac patient care. Staff training, even on apparently simple devices, is essential to avoid the risk of infection.

scholarly journals Rhetorical, Metacognitive, and Cognitive Strategies in Teacher Candidates’ Essay Writing

2017 ◽  
Vol 19 (2) ◽  
pp. 87-100
Author(s):  
Claudio Díaz Larenas ◽  
Lucía Ramos Leiva ◽  
Mabel Ortiz Navarrete
Keyword(s):  
Foreign Language ◽  
Teacher Candidates ◽  
Cognitive Strategies ◽  
Think Aloud ◽  
Writing Intervention ◽  
Writing Program ◽  
Post Intervention ◽  
Essay Writing ◽  
Think Aloud Protocols ◽  
Before And After

This paper reports on a study about the rhetoric, metacognitive, and cognitive strategies pre-service teachers use before and after a process-based writing intervention when completing an argumentative essay. The data were collected through two think-aloud protocols while 21 Chilean English as a foreign language pre-service teachers completed an essay task. The findings show that strategies such as summarizing, reaffirming, and selecting ideas were only evidenced during the post intervention essay, without the use of communication and socio-affective strategies in either of the two essays. All in all, a process-based writing intervention does not only influence the number of times a strategy is used, but also the number of students who employs strategies when writing an essay—two key considerations for the devising of any writing program.

scholarly journals Impact of educational intervention regarding anaemia and its preventive measures among pregnant women: an interventional study

2017 ◽  
Vol 6 (12) ◽  
pp. 5317 ◽  
Author(s):  
Pankajkumar B. Nimbalkar ◽  
Jaldhara N. Patel ◽  
Nilesh Thakor ◽  
Mansi Patni
Keyword(s):  
Pregnant Women ◽  
Preventive Measures ◽  
Signs And Symptoms ◽  
Contributory Factor ◽  
Interventional Study ◽  
Post Intervention ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Before And After ◽  
Baseline Knowledge

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to assess knowledge of pregnant women regarding anaemia and its preventive measures before and after educational interventional training.Methods: The present study was an interventional study undertaken in purposively selected pregnant women attending the out patient Department of Obstetrics and Gynecology Department of GMERS Medical College, Gandhinagar During the month of October 2017. Total 100 pregnant women were included after written informed consent. Baseline knowledge of pregnant women regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Single educational interventional training for 45 minutes was given to selected pregnant women. Post– intervention knowledge of pregnant women for the same was assessed after training. Thus, collected data was analyzed /using Epi info 7.Results: Baseline knowledge of the pregnant women regarding causes, signs and symptoms of anemia and dietary sources of iron was 21%, 23% and 40% respectively which was significantly increased to 64%, 66% and 72% respectively after the intervention. Baseline knowledge of the pregnant women regarding factors which inhibit and increase iron absorption was 25% and 4% respectively which was significantly increased to 55% and 41 % respectively after the intervention. Baseline knowledge of the pregnant women regarding treatment of anaemia was 30% which was significantly increased to 79 % after the intervention.Conclusions: There was significant improvement in the knowledge regarding anaemia and its preventive measures among pregnant women after our single educational session.

Change in perception of sclerotherapy results after exposure to pre–post intervention photographs

2017 ◽  
Vol 33 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Fabricio R Santiago ◽  
Mario Piscoya ◽  
Yung-Wei Chi
Keyword(s):  
Varicose Veins ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Clinical Severity ◽  
Post Intervention ◽  
Chi Square ◽  
Severity Scores ◽  
Venous Clinical Severity Score ◽  
Before And After ◽  
Chi Square Test

Objective To evaluate patients’ self-perception of cosmetic improvement before and after they were presented with pre- and postprocedure photographs after sclerotherapy with 75% dextrose. Methods Treatments included sclerotherapy of reticular and varicose veins using 75% dextrose. All treated limbs were photographed and classified according to Clinical, Etiology, Anatomy, and Pathology classification and Venous Clinical Severity Score pre- and posttreatment. The patients were queried before and after viewing the photos during these visits and indicated if they were very unsatisfied, dissatisfied, satisfied, or very satisfied. Nonparametric kappa correlation coefficient and a Chi square test were used to measure associations among agreement (p < 0.05 indicated statistical significance). The paired Wilcoxon test was used to compare statistical differences in mean Venous Clinical Severity Scores measured at different times (p < 0.05 indicated statistical significance). Data were analyzed using STATA software (version 12). Results Individuals were more satisfied with the results of sclerotherapy after exposure to images portraying their limbs two months after the procedure (p = 0.0028). This effect was maintained six months after sclerotherapy (p = 0.0027). Conclusion Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy.

Disseminating a patient-centered education bundle to reduce missed doses of pharmacologic venous thromboembolism (VTE) prophylaxis to a community hospital

2020 ◽  
pp. 251604352096932
Author(s):  
Oluwafemi P Owodunni ◽  
Brandyn D Lau ◽  
Dauryne L Shaffer ◽  
Danielle McQuigg ◽  
Deborah Samuel ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Real Time ◽  
Community Hospital ◽  
Post Intervention ◽  
Patient Centered ◽  
Record System ◽  
Vte Prophylaxis ◽  
Patient Refusal ◽  
Preventable Harm ◽  
Frequent Reason

Background Venous thromboembolism (VTE) is a leading cause of preventable harm in hospitalized patients. However, many doses of prescribed pharmacologic VTE prophylaxis are frequently missed. We investigated the effect of a patient-centered education bundle on missed doses of VTE prophylaxis in a community hospital. Methods We performed a pre-post analysis examining missed doses of VTE prophylaxis in a community hospital. A real-time alert from the electronic health record system facilitated the delivery of a patient education bundle intervention. We included all patient visits on a single floor where at least 1 dose of VTE prophylaxis was prescribed during pre- (January 1, 2018, - November 31, 2018) and post- (January 1 - June 31, 2019) intervention periods. Outcomes included any missed dose (primary) and reasons for missed doses (refusal, other [secondary]) and were compared between both periods. Results 1,614 patient visits were included. The proportion of any missed dose significantly decreased (13.8% vs. 8.2% [OR, 0.56; 95% CI, 0.48, 0.64]) between the pre-post intervention periods. Patient refusal was the most frequent reason for missed doses. In the post-intervention period, patient refusal significantly decreased from 8.8% to 5.0% (OR, 0.54; 95% CI, 0.46, 0.64). Similarly, other reasons for missed doses significantly decreased from 5.0% to 3.2% (OR, 0.62; 95% CI, 0.51, 0.77). Conclusions A real-time alert-triggered patient-centered education bundle developed and tested in an academic hospital, significantly reduced missed doses of prescribed pharmacologic VTE prophylaxis when disseminated to a community hospital.

scholarly journals Promotion of Early and Exclusive Breastfeeding in Neonatal Care Units in Rural Rwanda: a Quasi-experimental Study

2020 ◽  
Author(s):  
Saidath Gato ◽  
Francois Biziyaremye ◽  
Catherine M. Kirk ◽  
Chiquita Palha De Sousa ◽  
Alain Mukuralinda ◽  
...  
Keyword(s):  
Experimental Study ◽  
Exclusive Breastfeeding ◽  
Child Survival ◽  
Neonatal Care ◽  
Post Intervention ◽  
Factors Associated ◽  
Before And After ◽  
Quasi Experimental ◽  
Evidenced Based ◽  
Additional Support

Abstract Background: Early initiation of breastfeeding after birth and ongoing exclusive breastfeeding for the first 6 months improves child survival, nutrition and health outcomes. However, only 42% of newborns worldwide are breastfed within the first hour of life. Small and sick newborns are at greater risk of not receiving breastmilk and often require additional support for feeding. This study compares breastfeeding practices in Rwandan neonatal care units (NCUs) before and after the implementation of a package of interventions aimed to improve breastfeeding, aligned with the Baby Friendly Hospital Initiative for small and sick newborns.Methods: A pre-post quasi experimental study was conducted at two District hospital NCUs in rural Rwanda from October 2017–December 2017 (pre-intervention) and September 2018–March 2019 (post-intervention). Only newborns admitted before their second day of life (DOL) were included. Data was extracted from patient charts for clinical and demographic characteristics, feeding throughout admission, and patient outcomes. Bivariate analyses were conducted using Fisher’s exact and Wilcoxon rank sum tests. Logistic regression was used to evaluate factors associated with exclusive breastfeeding at discharge following a backwards stepwise procedure.Results: Pre-intervention, 255 newborns were admitted in the NCUs and 793 were admitted in the post-intervention period. The percentage of infants who were exclusively breastfed on their day of birth, or day-of-life zero (DOL0) increased from 5.4% to 35.9% (p<0.001). For newborns discharged alive, the proportion exclusively breastfeeding increased from 69.6% to 87.0% (p<0.001). The mortality rate for all admitted newborns decreased from 16.1% to 10.5% (p<0.019). Factors associated with greater odds of exclusive breastfeeding at discharge included post-intervention time point (Odds Ratio (OR): 4.91, 95% Confidence Interval (CI) 1.99-12.11, p<0.001), and admission for infection (OR 2.99, 95%CI 1.13-7.93, p=0.027). Home deliveries (OR 0.15, 95%CI 0.05-0.47, p=0.001), preterm delivery (OR 0.36, 95%CI 0.15-0.87, p=0.0260 and delayed first breastmilk feed (OR=0.04 for DOL3 vs. DOL0, 95%CI 0.01, 0.35, p=0.004) reduced odds of exclusive breastfeeding at discharge. Conclusion: Expansion and adoption of evidenced-based guidelines, using innovative approaches, aimed at the unique needs of small and sick newborns should be expanded and adapted in similar settings to improve outcomes for these infants.

scholarly journals A Cohort Study: Evaluating Self-Efficacy in Adolescents Attending a Tailored Youth-Informed Breastfeeding Program

2020 ◽  
Author(s):  
Christina M. Cantin ◽  
Wendy E. Peterson ◽  
Amisha Agarwal ◽  
Jemila S. Hamid ◽  
Bianca Stortini ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peer Support ◽  
Adolescent Mothers ◽  
Low Income ◽  
Self Efficacy ◽  
Short Form ◽  
Post Intervention ◽  
Non Profit ◽  
Before And After ◽  
Support Housing

ABSTRACTAdolescents (≤19 years of age) have lower rates of breastfeeding (BF) compared to older mothers. BF self-efficacy (SE), defined as a mother’s confidence in her ability to breastfeed her infant, has been identified as an important factor influencing BF outcomes. An innovative youth-informed BF program for young women was designed and implemented, which included staff training, a prenatal BF class and BF peer support. The objective of this cohort study was to evaluate the effectiveness of the program in improving young mother’s BF SE.Participants were pregnant adolescents recruited from a large urban non-profit social service outreach centre. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to participants before and after participating in the BF program. BSES-SF scores were summed to determine a composite score and compared descriptively using mean score. Un-aggregated, item-by-item, comparison of pre-vs post-BF program scores were also compared to examine improvements in SE. A total of 20 adolescent mothers (mean age = 16.6) attended the BF program. An increase in the total BSES-SF score was observed based on descriptively comparing the mean pre vs post intervention.Prenatal education and peer support adapted to the needs of adolescent mothers was associated with increased BSES-SF. These results are promising given that clients attending programs at this agency have low-income, low educational attainment, variable family support, housing instability, and are at-risk for not breastfeeding. Future studies with larger cohort are required to further validate and establish generalizability, as well as to determine the effect on BF duration rates.

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