Applying a Multidimensional Strategy to Mitigate Lateral Violence in a Small Rural Community Hospital in Western New York

Providing registered nurses with education and strategies to mitigate lateral violence is an evidenced-based method for creating a culture of civility. A descriptive pilot study with registered nurses was conducted on two medical/surgical units at a small rural community hospital. Strategies included a review of organizational policies, a one-day educational retreat for unit managers and registered nurse champions, and an online educational toolkit on lateral violence for the staff nurses on the pilot units

Initiating Kangaroo Care in the Neonatal Intensive Care Unit

Kangaroo care (KC) is a cost-efficient method to increase infant-parent bonding and neonatal health outcomes worldwide. Despite evidence supporting KC in critically ill infants, nursing perceptions regarding patient safety and interrupted work flow continued to impede practice in the local high-tech neonatal intensive care unit (NICU). Their current policy failed to address the 2-person transfer method recommended for safe practice. In addition, both staff and parents lacked training and education regarding the benefits and feasibility of KC. This doctoral project aimed to decrease practice barriers and promote earlier and more frequent KC by developing and integrating an evidence-based clinical pathway within a multifaceted champion-based simulated educational training program for NICU staff and parents. Published outcomes and generated organizational data for program synthesis connected the gap in practice. Kolcaba\u27s comfort theory served as the guiding framework to ensure a partnership in care. This quasi-experimental quantitative study used the generalized liner model for data analysis. Study findings indicated that KC occurred 2.4 more times after the intervention compared to before (p = 0.001). Descriptive data revealed that KC episodes for intubated patients nearly doubled after implementation (11.1% from 6.2%). Post-survey scores for nursing knowledge and comfort level also improved after the intervention. Although earlier KC practice was non-conclusive (p = 0.082), future trials should control groups for day of life since admission. Disseminating the KC pathway can have a positive social change on family-centered care by increasing NICU nurses\u27 knowledge, comfort, and adoption of this evidence-based practice as an expected routine standard of care

An Integrated Approach for Evaluating Students' Achievement of Clinical Objectives

During the clinical phase of undergraduate medical education (UME) students are often geographically dispersed and assigned to preceptors throughout the community. Monitoring, documenting, and evaluating their clinical experiences and achievement of clinical objectives in this venue becomes a challenge, especially for large UME programs. The purpose of this manuscript is to discuss a method for developing and implementing a school-wide evaluation system for the clinical phase of UME. This type of evaluation system links students' clinical experiential data with the objectives of a clerkship, using technological advances, such as the Personal Digital Assistant (PDA), Internet, and intranet. Clerkship directors are provided real-time reports on student's progress toward achieving clerkship objectives and are able to monitor the clinical activities of the clerkship. Students on the other hand, will be empowered to take more control of their educational experiences by monitoring their own progress

Business Models for e-Health: Evidence from Ten Case Studies

An increasingly aging population and spiraling healthcare costs have made the search for financially viable healthcare models an imperative of this century. The careful and creative application of information technology can play a significant role in meeting that challenge. Valuable lessons can be learned from an analysis of ten innovative telemedicine and e-health initiatives. Having proven their effectiveness in addressing a variety of medical needs, they have progressed beyond small-scale implementations to become an established part of healthcare delivery systems around the world

Developing Comprehensive Diabetes Education Materials for Structured Patient Education Programs in Primary Care Setting

Diabetes education is a key factor for a successful diabetes care. Comprehensive diabetes education materials for conducting structured diabetes education programs were rarely found in primary care setting in Indonesia. There was a need for developing new, comprehensive diabetes education materials for low-literate readers. Developing these education materials followed standard steps in developing print materials, and took account tips for writing low literacy materials for poor readers. The new diabetes education materials consisted of ten various leaflets, also printed as14 posters and 14 x-banners. The ten diabetes leaflets were pre-tested to 5 people with type 2 diabetes (T2D). After minor revisions, the leaflets were printed and distributed to 88 people with T2D attending two structured diabetes education programs in Yogyakarta City. These 88 people were requested to evaluate the leaflets using an evaluation form consisting of four items on language usage, font size, use of pictures, and diabetes information with a 1-10 rating scale; and an open-ended question for improvement. Descriptive statistics were used to analyze the results. Most participants thought that the leaflets were easy to understand and read, interesting, and simple. Majority of participants (79.7%) gave favorable comments without providing suggestions for improvement, such as: “The diabetes leaflets are already good and easy to understand” One third of the participants gave suggestions for improvement. The comprehensive diabetes leaflets developed were well received and highly appreciated by people with T2D attending diabetes education programs