Engaging Patients to Improve Documentation of Oral Intake on a Cardiac Telemetry Unit: A Quality Improvement Initiative

Background InformationIt is important for patients with heart failure to have awareness of their intake & output to effectively manage their disease. There is evidence that tracking intake & output is a component of missed nursing care resulting in discrepancies between the actual patient intake and what is documented in the patient’s electronic health record (EHR). Aim The aim of this quality improvement project was to engage patients in monitoring their intake by using teach-back and patient engagement techniques to track their own oral fluid intake throughout the day. MethodsThe Plan-Do-Study-Act (PDSA) model was used as the framework for this initiative. Patients meeting inclusion criteria were given a teach-back quiz to evaluate baseline knowledge. If patients were able to pass the teach-back quiz, they were given a tracking sheet with instructions on how to use it. After a period of eight hours, the sheet was collected and fluid intake volumes were compared with those documented in the EHR. ResultsUsing the Wilcox on non-parametric test, the mean difference between volume tracked by patient and volume documented by clinician was significant at pConclusion & Implications for CNL PracticeVariation between oral fluid intake volume documented in the EHR and patient stated volumes indicates that EHR documentation is less reliable than records kept by adequately educated and engaged patients. Implications for CNL practice include identification of opportunities to increase patient engagement and to utilize evidence-based techniques for this purpose. The CNL should explore barriers that contribute to inaccuracy of documentation. The CNL may explore more reliable methods for determining accurate patient fluid balance for at-risk populations

Where there is a wind, there is a way

A shift in USA energy policy from oil or natural gases to thermonuclear fission and solar energy is predicted. A massive diversified energy research and development effort to productively harness the energy in the winds is outlined to develop commercially feasible wind energy conversion systems - considered a form of solar energy - in the near future

Michigan\u27s Cooperative Forest Pest Management Program, A Team Approach to Improving Forest Management

A forest management team was organized in the late 1970\u27s by cooperative efforts of Michigan\u27s universities. the Michigan Department of Natural Resources, and the USDA Forest Service.The goals were to devise new technologies, transfer available technology, and service and management alternatives to forest land managers in Michigan. The program throughout has emphasized forest management rather than pest management for prevention and control of pests. Dissemination of pest management information has been of importance and new research results have gone directly to land managers for immediate use. The team participates in forest compartmental reviews and helps prescribe management plans for land parcels, thus providing for preventative pest management. Services and management recommendations are provided mostly through forest pest specialists located in the field. They feed back results and problems to researchers and extension specialists of the team for further input. Preventive management information used by by local managers in recent years has nearly paid the cost of the program. Plans are to broaden the team effort by cooperating with organizations and in adjacent states through a computer network system and by other means

Macroinvertebrate Assemblage in the littoral Zone of Green Lake, Fayetteville, NY ; in Comparison with Three Nearby Lakes

Macroinvertebrates were collected and identified to the genus level from ten sites at Green Lake, Fayetteville, NY. Green Lake is a meromictic plunge pool formed 11,000 years ago by a glacial waterfall. Due to the nature of its creation it has a very unique benthic habitat for macro invertebrates. The data collected were compared to three local lakes of varying human disturbance, Onondaga lake (most disturbed), Otisco Lake (mildly disturbed) and Cazenovia Lake (least disturbed). The comparison of Green Lake to Onondaga Lake is especially appropriate because they both have very high specific conductance levels (2,470 μS/cm and ~1,600 μS/cm, respectively). Genera richness did not differ between Green and Onondaga Lakes or between Green and Otisco Lakes. Green Lake had greater COTE (Coleoptera, Odonata, Trichoptera and Ephemeroptera) richness and number of intolerant taxa than Onondaga Lake according to the nonparametric Kruskal-Wallis test and post hoc Dunn\u27s test. The differences could be caused by differing lake morphology or habitat types in each lake. Both Onondaga Lake and Green Lake have high conductivity levels relative to Cazenovia and Otisco Lakes, but the conductivity in each lake is driven by different ions (Green lake: Ca2• and So/ · Onondaga Lake: Cl ). The difference in ions in each lake may cause the changes observed

Enhancing Team-Based Senior Capstone Projects: Opportunities and Challenges

Generally, capstone courses focus on the integration and application of technical knowledge and skills acquired in previous coursework along with a consideration of multiple realistic constraints. However, capstone courses also require students to focus on a variety of professional skills, including teamwork, unstructured task completion, and project management. Because students are often new at these skills, they may find it difficult to resolve issues as they arise, particularly when working with an actual industrial client. Capstone courses also pose challenges to faculty. Finding a consistent stream of projects that are at the appropriate level for senior level students can be difficult for faculty given the limited time frame of most courses. A fair and consistent method to evaluate student work on an individual and group level is also a challenge for instructors. This paper will outline the challenges and best practices learned in the development and implementation of a senior-level capstone course in engineering technology, based on qualitative data gathered over several years. Specifically, strategies for sourcing student projects, student team formation and management, and options for ensuring accountability among student teams will also be discussed. Ideas on fair and consistent assessment methods for group and individual work will also be emphasized

Curriculum Redesign with an Emphasis on Mathematical Literacy in an 8th Grade Function Unit

Most teachers in the United States are going through a paradigm shift. Teachers have to switch from using the National Council of Teachers of Mathematics (NCTM) Standards or State Standards to the Common Core State Standards. With this shift in standards, teachers are now creating new curriculum that follow the CCSS. This thesis provides a unit on function that is aligned with CCSS. This unit has an emphasis on mathematical literacy to help students have a deeper understanding of the concepts they are learning

Disk resolved studies of the optical properties and physical nature of the surfaces of the outer planet satellites

The spatially resolved albedo, color, compaction state, roughness, and constituent particle sizes of the surfaces of the satellites of Saturn, Uranus, and Jupiter provide important constraints in understanding the geologic evolution and relevant exogenic processes operating in these satellite systems. Some details of observations are given