Advancing Nursing Practice in Vietnam: An International Collaboration to Improve Quality

abstract: International partnerships offer opportunities for healthcare professionals to promote evidence-based nursing in underdeveloped countries. When international collaboration is utilized among nurses in developing countries the clinical outcomes may be improved. This project focused on collaboration with nurse colleagues in Hanoi, Vietnam to support an internally identified quality improvement process and leadership development. Collaboration occurred in a large inpatient medical center between the author and nursing shared governance team members representing the General Surgical, Neuro Surgical, and Intensive Care Units. The nursing collaboration over 9 months concluded with an onsite visit by 5 members of a diverse group from the United States. The shared governance team reported an overall increase in nursing knowledge and skill regarding urinary catheter maintenance and care

Implementing Change: The use of Minocycline-Rifampin Impregnated Central Venous Catheters in Central Line Associated Blood Stream Infection Prevention in Critically Ill Patients

Introduction: At a large academic healthcare facility in the northeast a Gap Analysis was conducted finding quality improvement opportunities for central line associated blood stream (CLABSI) prevention in critically ill patients. Review of literature reveals the use of minocycline-rifampin impregnated (MNRI) central venous catheters (CVCs) as being an effective intervention in CLABSI prevention. Methods: Several assessments were conducted regarding the implications of updating the facilities practice to reflect this evidence including AHRQ Gap Analysis Tool, a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, Stakeholder Feedback, and Resource Allocation. Results: Facilitators and barriers were identified in implementing this practice change as the facility. Themes were identified based on stakeholder feedback, and important multidisciplinary team members were identified in being required to assist in practice change. Discussion: Implementation of this practice change is feasible at this facility and engagement of more key stakeholders will be necessary to progress. The Gap Analysis provided useful data in planning this practice change and is recommended to be used as a tool when implementing change

Midline Catheter Use in the Newborn Intensive Care Unit

Ongoing evaluation of current practice and incorporation of evidence based research into guidelines and protocols is a requirement for the provision of high quality, cost efficient care. Despite some literature describing observational data, midline catheters (MCs) are not an appropriate vascular access device for Newborn Intensive Care Unit (NICU) patients due to insufficient high level evidence demonstrating safety and efficacy. In addition, national guidelines for MC use in neonatal and infant patients lacks sufficient information for safe and effective use of MCs. The results of this small, online survey indicate that while some neonatal nurses and Nurse Practitioners report the use of MC use in the NICU, there is a wide range of practice pertaining to MC unit-specific protocols, competencies, success with placement, and clinician agreement of appropriate use for this vascular access device (VAD). Multicenter, randomized control trials are needed to evaluate current MC practice in the NICU, and institutions must incorporates current, evidence based practice into policies, procedures, and guidelines

GraphCombEx: A Software Tool for Exploration of Combinatorial Optimisation Properties of Large Graphs

We present a prototype of a software tool for exploration of multiple combinatorial optimisation problems in large real-world and synthetic complex networks. Our tool, called GraphCombEx (an acronym of Graph Combinatorial Explorer), provides a unified framework for scalable computation and presentation of high-quality suboptimal solutions and bounds for a number of widely studied combinatorial optimisation problems. Efficient representation and applicability to large-scale graphs and complex networks are particularly considered in its design. The problems currently supported include maximum clique, graph colouring, maximum independent set, minimum vertex clique covering, minimum dominating set, as well as the longest simple cycle problem. Suboptimal solutions and intervals for optimal objective values are estimated using scalable heuristics. The tool is designed with extensibility in mind, with the view of further problems and both new fast and high-performance heuristics to be added in the future. GraphCombEx has already been successfully used as a support tool in a number of recent research studies using combinatorial optimisation to analyse complex networks, indicating its promise as a research software tool

Nurse-Driven Protocol to Reduce Catheter Associated Urinary Tract Infections

Background: Catheter-associated urinary tract infections (CAUTIs) are a major source of avoidable hospital-acquired infections. The scientific evidence supports utilization of nurse-driven protocols to reduce CAUTIs. Purpose: The purpose of this quality improvement project was to update and implement an evidence-based CAUTI prevention protocol for the nursing staff on a medical-surgical unit in an adult acute care hospital to decrease the utilization of indwelling urinary catheters and CAUTIs. Theoretical Framework: Donabedian’s structures, processes, and outcomes (SPO) model was utilized as the framework for this project. Donabedian’s SPO model focuses on strong healthcare structures and processes to improve nurse, patient, and organizational outcomes. Methods: This project utilized a quantitative design. A convenience sample of 28 nurses from the medical-surgical unit of a South Florida hospital participated in the project. An educational intervention was delivered on CAUTI prevention based on guidelines from regulatory agencies, and the hospital existing protocol was updated and revised to reflect the guidelines. The sample was administered a short demographic survey, and 10-item pretests and posttests on CAUTI prevention before and after implementation of the standardized evidence-based protocol. To determine possible differences in nurses’ knowledge and perceptions of indwelling urinary catheters before and after the implementation, paired t tests were conducted. To determine if the proportions of days with urinary catheters were statistically significantly different 30 days before and after implementation of the standardized evidence-based guideline, a 2-proportion z-test was conducted. Results: On analysis of the pretests and posttests, a statistically significant difference was found in 6 of the 10 questions, indicating that nurses’ knowledge and perceptions of CAUTIs improved after the intervention (p \u3c .001 to p \u3c .043). After the intervention, urinary catheter days relative to patient days also decreased significantly (z = 5.562, p \u3c 0.001). Conclusion: Implementation of an evidence-based nurse-driven protocol in a hospital in South Florida improved nurses’ knowledge and perceptions of CAUTI prevention. Nursing practice and healthcare delivery can benefit from development of such guidelines and educational interventions to empower nurses to better manage patients’ indwelling urinary catheters, and decrease the incidence of CAUTIs in hospitals

An Organizational Change Perspective for the Curriculum Internationalization Process:Bridging the Gap between Strategy and Implementation

Following a rapidly changing external environment, internationalization has become an institutional phenomenon with strategic relevance for universities worldwide. However, the frequently reported gap between theory and practice remains. Engaging staff and achieving successful organizational implementation appears increasingly problematic with more stakeholders and disciplines involved. This study explores the long-time gap between strategy and implementation with Pettigrew's organizational change framework (1987). We conducted a systematic scoping literature review of articles about curriculum internationalization (N = 325) published in English in peer-reviewed journals between 2000 and 2022. Our study demonstrates that the organizational change perspective provides guidelines to improve and facilitate the process. Based on an organizational change perspective we developed a comprehensive framework that may contribute to more effective strategies for staff engagement and meaningful implementation outcomes for curriculum internationalization in higher education.<br/

First-Principles Calculations On Solgel Zinc Oxide Nanoparticles Optoelectronic Properties

An efficient diagnostic between experimental and theoretical calculation is essential to ensure the synergy between these two approaches. This study made attempt to use structural input from experimental in the theoretical framework. Initially, ZnO nanoparticles were synthesized by sol-gel method at different aging time. The phase and structural analyses confirmed the formation of hexagonal wurtzite ZnO structure at which sample aged at 36 h showed highest crystallinity and gave the best visual fit in Rietveld analysis. Morphological observation revealed spherical nanoparticles were formed at aging time higher than 6 h while only small variation in energy band gap recorded between 3.08 – 3.12 eV. The photoluminescence spectra revealed a green emission due to oxygen vacany. In firstprinciples calculation, the ZnO unit cell was built based on structural parameter from Rietveld analysis in order to provide a bridge with experimental study. Several exchange-correlation functional including LDA, GGA-PBE, GGA-PBESol, LDA+U, GGA-PBE+U and GGA-PBESol+U were tested. The GGA-PBE+U (Ud,Zn = 10 eV and Up,O = 6.1 eV) showed lowest lattice deviation and successfully reproduced the experimental band gap. ZnO supercell structure with oxygen vacancy showed that defect state were more delocalized and appeared at 1.90 eV from top of conduction band. This position was close to the photon energy released due to recombination of electron (2.06 eV) as observed in luminescence spectra. The results are beneficial in designing photoanode material in solar cell that will enhance visible light absorption