The Use of Clinical Decision Support to Improve Nursing Practice

Healthcare information technology is solidly entrenched in most acute care hospitals but the need to demonstrate its positive impact on patient outcomes persists. Clinical decision support (CDS) is an informatics tool that is highly customizable to promote patient improvement activities. Despite its high potential, studies have had mixed results regarding the impact of CDS and it has not been widely studied in the realm of nursing practice. One aim of this dissertation was to analyze the concept of CDS in order to inform the examination of the relationships between CDS implementation and nursing interventions. The determining factors of nurses use and acceptance of CDS was also described within the context of the CDS concept schematic developed. Data from 4718 pediatric hospital admissions were analyzed to examine if there was a relationship between the implementation of CDS and the implementation of sequential compression devices (SCD) for the purpose of preventing VTE and the placement of chart notifications of VTE risk. Admissions with patients who were identified as at risk for VTE had SCDs placed almost two and one-half times more often after the CDS was implemented (RR = 2.32; 95% CI (1.9 – 2.83)) and 33 times more likely to have chart notifications placed. In order to describe the determining factors of use, the unified theory of acceptance and use of technology (UTAUT) was adapted to create an electronic survey. Two multivariate regression models were built to describe the UTAUT model from previous literature. Results demonstrated that the model as described explains the majority of the data but also highlighted some weaknesses in the realm of the construct voluntary use. The results of this dissertation contribute to the limited literature regarding CDS use in nursing practice

UTILIDAD DE LA ESCALA PECARN EN TRAUMATISMO CRANEOENCEFALICO LEVE EN PACIENTES ATENDIDOS EN EL HOSPITAL PARA EL NIÑO.

El trauma craneoencefálico (TCE) se define como alteración física o funcional de cualquier magnitud, mecanismo o severidad que se inflige o sufre la cavidad craneana y su contenido, masa encefálica. Es una de las causas principales de consulta al servicio de urgencias tanto a nivel mundial como en el ámbito nacional se ha relacionado con la práctica de deportes y en sitios de alta incidencia de accidentalidad asociado a politraumatismo, de forma aislada o a maltrato físico a cualquier edad. Debido a que el traumatismo craneoencefálico leve representa el 81% es de suma importancia establecer los estudios necesarios para su correcto diagnóstico.UAEM-El autor

“Who minds the minders”: a mixed methods examination of Irish primary school teachers’ experiences of and perspectives on supporting pupils exposed

Background Adverse Childhood Experiences (ACEs) have the capacity to influence neurobiological processes, impacting upon children’s cognitive, social, emotional and behavioural wellbeing, which can impede their ability to function appropriately in the school environment. Accordingly, school constitutes an important microsystem in a child’s life, with the interactions a child experiences having the potential to mitigate, or conversely exacerbate, the impact of adversity. ACEs therefore confront schools, endowing teachers with considerable responsibility. Aims This study aimed to elucidate how the field of Educational and Child Psychology can assist teachers to optimally support their pupils who have experienced adversity. Based on previous research, it is possible that the consequences of ACEs are present in Irish classrooms on a daily basis. Resultantly, attention and assistance are required, and Educational Psychologists (EPs) are especially well suited for such support. However, in order for EPs to fulfil this need, an exploration of teachers’ experiences of and perspectives on this matter is warranted. Sample The sample comprised qualified primary school teachers practising in Ireland. A total of 492 participants partook in the online questionnaire within Phase One. A subsample of eight participants from Phase One partook in the Phase Two interviews. Method An explanatory sequential mixed-methods design was adopted, with two distinct yet interactive phases occurring. Quantitative data was collected in Phase One using an online questionnaire exploring multiple dimensions. The subsequent qualitative phase of the study was designed so that it followed on from the results of the quantitative phase, explaining and further expanding upon the findings. Results Path analysis indicated the potential presence of a conceptual model, comprising teachers’ understanding of behaviours related to ACEs, teachers’ self-efficacy in supporting ii pupils exposed to ACEs, and teachers’ reactions to working with pupils experiencing adversity. Hybrid thematic analysis elaborated upon the interrelationships between these variables. Conclusions The implications of the findings pertaining to the field of Educational and Child Psychology are presented, with recommendations for policy, practice and research delineated.N