Factors Influencing Implementation of Blood Transfusion Recommendations in Pediatric Critical Care Units

Purpose: Risks of red blood cell transfusion may outweigh benefits for many patients in Pediatric Intensive Care Units (PICUs). The Transfusion and Anemia eXpertise Initiative (TAXI) recommendations seek to limit unnecessary and potentially harmful transfusions, but use has been variable. We sought to identify barriers and facilitators to using the TAXI recommendations to inform implementation efforts.Materials and Methods: The integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework guided semi-structured interviews conducted in 8 U.S. ICUs; 50 providers in multiple ICU roles completed interviews. Adapted Framework analysis, a form of content analysis, used the iPARIHS innovation, recipient, context and facilitation constructs and subconstructs to categorize data and identify patterns as well as unique informative statements.Results: Providers perceived that the TAXI recommendations would reduce transfusion rates and practice variability, but adoption faced challenges posed by attitudes around transfusion and care in busy and complex units. Development of widespread buy-in and inclusion in implementation, integration into workflow, designating committed champions, and monitoring outcomes data were expected to enhance implementation.Conclusions: Targeted activities to create buy-in, educate, and plan for use are necessary for TAXI implementation. Recognition of contextual challenges posed by the PICU environment and an approach that adjusts for barriers may optimize adoption.

Stakeholder-Based Methods to Develop a Toolkit to Promote Engagement in Assisted Living Safety

This presentation provides and overview of a mixed-methods stakeholder engaged study to develop a toolkit to encourage resident and family engagement in the safety of assisted living (AL). This study uses stakeholder-based data and stakeholder engaged processes to adapt existing tools and strategies from other settings to encourage resident and family engagement in the safety of AL. We will improve resident safety in AL by developing an evidence-based tool to implement these engagement tools/strategies in AL. The presentation will outline the theoretical base, the approach for this study, including efforts to recruit and retain stakeholders throughout the study, and stakeholder engaged process to develop the toolkit. The presentation will include challenges and strategies to encourage participation of AL staff, residents, and family caregivers in the study. The presentation will conclude with a discussion of implications for future design and research efforts aiming to impact AL care, policy, and research implementation.

Defining Telehealth for Research, Implementation, and Equity (Preprint)

UNSTRUCTURED When the COVID-19 pandemic spurred a disruption in healthcare delivery, the role of telehealth shifted from an option to a near necessity to maintain access when in-person care was deemed too risky. Each state and many organizations developed temporary telehealth COVID-19 emergency policies, each with its definitions, coverage, government cases, and regulations. As the pandemic era policies are now being replaced with more permanent definitions, we are presented with an opportunity to re-evaluate how telehealth is integrated into routine healthcare delivery. We believe in the critical timing and nature of the sequential steps to re-define telehealth after these events and the importance of developing a clear and agreed upon definition of telehealth and its components. We further suggest it is a necessary preliminary step to support clear communication and interoperability throughout the development. Precise and standard definitions could create an unambiguous environment for clinical care for both patients and providers while also enabling researchers more precise control on their investigations of telehealth. A consensus when defining telehealth and its derivatives at this critical stage could create a consistent expectation of care for all patients and those who set the standards of care, as it has for other clinical scenarios with clinical guidelines.

Implementation of Digital Literacy in Elementary Schools

Digital literacy is one form of development in the 4.0 revolution era where we can access various desired information quickly. Of course, the digital literacy school environment impacts the learning process significantly. This study aims to analyze how the implementation of digital literacy in elementary schools. This type of research is qualitative with a research design in 4 stages: first, research focus. Second, research implementation (Observation, Interview). Third, data analysis. Fourth, the study results, the research subjects were 1 principal, 6 teachers and 6 students. Data collection techniques and research instruments include observation sheets and interview guidelines—data analysis using an interactive analysis model from Miles and Huberman. The study results show that the application of digital literacy in elementary schools is still not optimal. It is proven when conducting interviews and observations that the learning process is still teacher-centred and generally uses what app group digital literacy media is. In addition, the breakthrough about digital literacy in the school environment is still lacking, so that the implementation of digital literacy is only limited to understanding. Barriers experienced include students having difficulty understanding the material and limited internet quota. Therefore, to maximize the implementation of digital literacy in elementary schools, programs such as conducting training, manuals and digital literacy infrastructure are needed.

Blog Development as A Resource for Geographic Learning in SMAN Kecamatan Percut Sei Tuan

An effective learning process is a learning process that uses various forms of learning resources. This study aims to determine blogs' feasibility as a source of learning geography for material management of Indonesia's natural resources at SMAN Percut Sei Tuan District. This research was conducted in the odd semester of the 2019/2020 school year, with a population of all class XI IPS students at SMAN 1 Percut Sei Tuan consisting of 4 classes with a total of 139 students and class XI IPS at SMAN 2 Percut Sei Tuan which consisted of 2 courses with the number of 69 students. The study sample was class XI IPS 1 at SMAN 1 Percut Sei Tuan, totaling 35 students, and class XI IPS 1 at SMAN 2 Percut Sei Tuan amounted to 33 students. This research is development research using the Borg and Gall model with ten steps of research implementation. The data collection technique used was a questionnaire. The data analysis technique used is descriptive. The results showed that the validation of the feasibility of blogs as a source of learning geography carried out in 2 stages showed that in the first stage of verification, the acquisition of the feasibility of a blog as a source of learning geography was (87.27%) with criteria worthy of revision as needed. After making improvements according to the assessors' input, the results of the stage 2 validation obtained the feasibility of a blog as a source of learning geography (93.89%) with very feasible criteria without revision.

Plant Conservation Practitioners Can Benefit from Neutral Genetic Diversity

Several papers deal with a conservation genetics gap in which plant conservation and restoration managers or practitioners do not soundly integrate population genetics information into conservation management. Authors concerned about this issue point out that practitioners perceive genetic research results to be impractical or unnecessary in the short term due to time and financial constraints. In addition, researchers often fail to translate research findings into comprehensive, jargon-free recommendations effectively. If possible, conservation-related or conservation-oriented articles should be easily written to bridge the research–implementation gap. Finally, based on a previously published prioritization framework for conservation genetics scenarios, we introduce four simple genetic categories by exemplifying each case. We hope that conservation practitioners could employ these suggested guidelines for the prioritization of population- and species-level management.

Using an implementation science approach to build leader facilitation capability in healthcare: a novel approach for enhancing action learning set facilitation

PurposeThe study describes the implementation of a novel strategy, entitled the Action Learning Set Facilitation Model, to develop internal facilitation capability to lead change. The Model incorporated the Novice-Experienced-Expert pathway, a facilitation development approach underpinning the integrated-Promoting Action on Research Implementation in Health Services Implementation Framework, with action learning methodology.Design/methodology/approachA mixed-methods descriptive approach reports the results of 22 interviews, 182 Action Learning Sets and 159 post program survey data sets to explore facilitator experiences, strengths and potential application of the Model.FindingsAt program completion, five novice (of 174) and one experienced (of 27) facilitator transitioned to the next facilitation level. The three groups of facilitators described positive change in confidence and facilitation skill, and experience of action learning sets. Inconsistencies between self-report competence and observed practice amongst novices was reported. Novices had decreasing exposure to the Model due to factors related to ongoing organisational change. Internal facilitators were considered trusted and credible facilitators.Research limitations/implicationsThere are practical and resource implications in investing in internal facilitation capability, noting proposed and real benefits of similar development programs may be compromised during, or as a consequence of organisational change. Further research describing application of the facilitation model, strategies to enhance multisystemic support for programs and evaluation support are suggested.Practical implicationsThe Action Learning Set Facilitation Model offers promise in developing internal facilitation capability supporting change in organisations. Critical success factors include building broad scale internal capability, stable leadership and longitudinal support to embed practice.Originality/valueThis is the first application of the facilitation component of the integrated-Promoting Action on Research Implementation in Health Services implementation framework embedded to action learning sets as an implementation science strategy for leader development supporting organisational change.

Enhancing the application of therapeutic group therapy (TKT) for school-age children in Delima, Pekanbaru

Children are highly prone to certain psychological challenges, particularly at elementary level. These problems are predominantly influenced by environmental and academic conditions. Therefore, this research aims to stimulate the growth and development of school-age children from various perspectives. This activity was conducted at Al-Qur'an Education Park, Baitul Arsy Mosque, Hamlet 008, Delima village, Tampan sub-district, Pekanbaru, between September-December 2020. Additionally, the class II-VI students were selected as the participants during the seven TKT sessions. The research implementation incorporated description, modeling, role-playing, feedback and transfer techniques. Session 1 comprised of a comprehensive analysis on the growth and developmental characteristics of the school-age children. Meanwhile, sessions 2, 3, 4, 5 and 6 involved the stimulations of motor, cognitive and language, emotional and personality, moral and spiritual as well as the psycho-social perspectives. However, session 7 encompassed the overall stimulation from 1-6. The students are more knowledgeable about self-responsibility and psychological changes. This phenomenon tends to boost confidence as well as the ability to establish friendships and improve academic learning.

Guarantee for the Protection of Human Rights Against Witnesses Criminal Reporters of Corruption According to the Laws of Witnesses and Victims

The type of research used in this research is normative legal research. Implementation of the protection process for reporting witnesses in the corruption court based on Law of the Republic of Indonesia Number 13 of 2006 concerning Protection of Witnesses and Victims as amended by Law of the Republic of Indonesia Number 31 of 2014 concerning Protection of Witnesses and Victims, the process mechanism hasn’t been regulated in detail and completely in practice, it cannot be done optimally.

Effectiveness of an Academic-Practice Team Approach on Research Capacity Building of Nurses and Public Health Professionals

The purpose of this study was to determine the need for research training among nurses and health professionals in a rural province of Thailand and to evaluate the effectiveness of the interventions designed to address the identified factors. This two-phase study used a cross-sectional design with one-group pre- and post-tests. In phase I, 149 subjects from 16 subdistrict health promoting hospitals and one district hospital were sampled. As an intervention, an academic-practice team approach to research capacity building was designed. Twenty-four volunteers completed a three-time point assessment of intervention in phase II. Data were collected using self-report questionnaires and analyzed using bivariate and multivariate statistics. Phase-I results indicated that 33.6% of subjects were involved in the research implementation. They had a moderate perception of research barriers and capacity. The research experiences, capacity, and barriers associated with the research implementation were described in detail (p < 0.05). The only positive predictor of research implementation was research training (p < 0.001). The intervention improved 24 participants’ competency (p < 0.05). Most of their research proposals had received ethics approval and a small grant. These findings highlight the efforts of innovative research capacity development and its impact on research and health practices among nurses and health professionals.