Peripheral Intravenous Infiltrates: Engaging Staff to Increase Reporting

A large free standing children’s academic hospital aimed to improve patient safety and outcomes by decreasing the overall severity of peripheral intravenous infiltration and extravasations (PIVIEs). A care bundle was developed by creating a PIVIE measurement tool within the electronic medical record (EMR) and integrating the tool into standardized daily practice for nurses. The care bundle included creating a team of clinical leaders consisting of empowered bedside nurses acting as mobilized resources embedded into each unit. The initiative resulted in a large scale increase in reported PIVIEs system-wide within 1 month of education dissemination to bedside RN staff. The QI interventions captured a realistic interpretation allowing for a more global and accurate reflection of the number and severity of PIVIE events system-wide, while creating documentation for the PIVIE tool in the EMR and a clinical leader model. The results reflected a dramatic rise in the number of reported PIVIE events, increase in staff awareness of PIVIEs, increased peripheral intravenous line assessments, and decreased severity of PIVIEs that do occur

Integrating interprofessional electronic medical record teaching in preregistration healthcare degrees : A case study

Background Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments. Objective To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings. Methods A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university. Results In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated. Discussion The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project. Conclusion The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management

An overview of the nature of the preparation of practice educators in five health care disciplines

Practice education is a core element of all educational programmes that prepare health care professionals for academic award and registration to practice. Ensuring quality and effectiveness involves partnership working between Higher Education Institutions (HEI’s) and health care providers, social care communities, voluntary and independent sectors offering client care throughout the United Kingdom and Republic of Ireland. Clearly practitioners who support, supervise and assess learners for entry to their respective professions need to be well prepared and supported in their roles as practice educators. However it would appear that the nature of this support and preparation varies across disciplines and that good practice is not easily shared. With this in mind, the Making Practice Based Learning Work (MPBLW) project aims to make practitioners more effective at supporting and supervising students in the workplace across a range of health care disciplines namely Dietetics, Nursing, Occupational Therapy, Physiotherapy and Radiology. The Department of Employment and Learning (Northern Ireland) and the Higher Education Funding Council for England has funded this collaborative project involving staff from Ulster, Northumbria and Bournemouth Universities. The outcomes for each phase of the project are: Phase One: • Identify and document good practice on how practitioners are prepared for their educational role. Phase Two: • Develop and evaluate learning materials for use by practitioners across five health care disciplines. • Make learning materials available in a number of efficient media, e.g. paper, electronic, CD-ROM and web-based. • Develop a programme applicable to interprofessional and uniprofessional contexts. • Widen access for a multicultural workforce. Phase Three: • Embed best educational practice through the establishment of an academicpractitioner network. • Disseminate a range of materials and processes across the wider academic and health and social care communities

A virtual practice community for student learning and staff development in health and social work inter-professional education. Mini-project evaluation report.

Interprofessional education (IPE) has been widely advocated and developed as a means to encourage effective collaboration in order to improve public sector services. An IPE curriculum was introduced at Bournemouth University from 2005 for all nursing branches, midwifery, occupational therapy, physiotherapy, operating department practice and social work students (n=600). Challenges of this ambitious and large scale project included facilitating meaningful interprofessional learning while balancing structural complexities of professional body requirements and the logistics of large student numbers and multi-site teaching. A web-based simulated community was created, known as Wessex Bay, as a learning resource to facilitate interprofessional learning around case scenarios. An evaluation of student and staff experiences of IPE over two years, focusing principally on the use of technology in the education process was implemented. Student and staff data were collected via e-surveys, focus groups and open-ended questionnaires with additional feedback from external reviewers specifically on Wessex Bay. Qualitative data were subjected to thematic analysis. Whilst the findings are not claimed to be representative, they provide a rich insight into student and staff experiences of technology enhanced learning in IPE. The richness and complexity of data has led to a number of project outcomes with wide-ranging implications for interprofessional education. This research has led to the identification of three major territories of praxis in which individuals, both students and tutors, are operating in IPE, namely professional differences and identity, curriculum design and learning and teaching strategies, and technology enhanced learning. For the purposes of this report, we will discuss the findings related to student and staff experiences of technology enhanced learning in IPE. The evaluation of the findings highlighted three issues; the level of student and staff knowledge and skill in using learning technologies impacted significantly on learning; there was a need to capitalise on the use of web-based learning resources by increasing interactivity within the scenarios; and finally student and staff experiences of the learning resources was enhanced by a positive learning culture to facilitate creative use of materials. All project aims and objectives were met, and whilst more focused staff and student development in using learning technology is required, a culture of working interprofessionally among students and academic staff has begun to develop, leading to the sharing of ideas about content and learning processes. Recommendations resulting from the project include the introduction of assessed development of student and staff learning technology skills; development of more interactive web-based learning embedded within the case scenarios; and streamlining of the scenarios to provide fewer, but more developed, cases

A Virtual Practice Community for Student Learning and Staff Development in Health and Social Work Inter-Professional Education; Changing Practice Through Collaboration

This Mini Project has been funded by the Health Sciences and Practice Subject Centre of the Higher Education Academy Available on-line at HEA website: http://www.health.heacademy.ac.uk/publications/miniproject/scammell08.pd

A Primer on Quality Assurance and Performance Improvement for Interprofessional Chronic Kidney Disease Care: A Path to Joint Commission Certification.

Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity to hospital administration and enhances visibility to patients and referring providers. This is a single-center, retrospective study describing quality assurance and performance improvement in chronic kidney disease, Joint Commission certification and quality outcomes. A total of 440 patients were included in the analysis. Thirteen quality indicators consisting of clinical and process of care indicators were developed and measured for a period of two years from 2009-2017. Significant improvements or at least persistently high performance were noted for key quality indicators such as blood pressure control (85%), estimation of cardiovascular risk (100%), measurement of hemoglobin A1c (98%), vaccination (93%), referrals for vascular access and transplantation (100%), placement of permanent dialysis access (61%), discussion of advanced directives (94%), online patient education (71%) and completion of office visit documentation (100%). High patient satisfaction scores (94-96%) are consistent with excellent quality of care provided

Email for clinical communication between healthcare professionals

Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals