The impact of an authentic, simulated learning activity on student preparedness for work-integrated learning

Student preparation for work-integrated learning using simulated learning experiences is an under researched field in occupational therapy. In 2013 the Deakin University occupational therapy degree introduced a simulated learning experience for students aimed at preparing them for work-integrated learning experiences. The session gave students an opportunity to practice fundamental skills of the discipline. A Likert scale survey was written and critically reviewed by the authors. Students rated the extent to which they felt that they could communicate effectively, build rapport, safely transfer clients, apply occupational health and safety principles and write case notes, prior to and after participation in the simulated learning experience. A statistically significant improvement was found for all outcomes measured. Students also reported improved confidence and valued opportunities to practice and receive feedback on skills. The results demonstrate that participation in a simulated learning activity improves confidence and skills in a range of areas that are relevant to work-integrated learning placement

The Vehicle, Fall 1994

Table of Contents Poetry Noah\u27s WifeJennifer Moropage 8-9 The Intensity of a BreathHeather Anne Winterspage 10-11 When I Was RainNicole Moonpage 11 Wreckage at Low Tide, After a Storm On Cape FearMatt Parkspage 12-14 two belowKeith Spearpage 16 HeatScott Langrenpage 17 Plastic Shard WordsMatthew J. Nelsonpage 18 Mr. Snowplow ManMartin Paul Brittpage 19 Carpe DiemMichael Lairpage 19 untitledWalt Howardpage 20 The GameKellie J. Olsenpage 21 AT PEACEJennifer Surmanpage 22 SawdustSue Songerpage 23 Photography Unbound RealitiesKris Quiriconipage 26 untitled Mark Porter page 27 untitled Mark Porter page 28 untitled Mark Porter page 29 Prose I am Here...RememberingJ. Dylan McNeillpage 32-34 RecognitionSue Songerpage 35-36 SACCADICSteve Beinpage 37-40 The BurnBryan Levekpage 41-45 Biographiespage 46-48https://thekeep.eiu.edu/vehicle/1063/thumbnail.jp

The Vehicle, Fall 1994

Table of Contents Poetry Noah\u27s WifeJennifer Moropage 8-9 The Intensity of a BreathHeather Anne Winterspage 10-11 When I Was RainNicole Moonpage 11 Wreckage at Low Tide, After a Storm On Cape FearMatt Parkspage 12-14 two belowKeith Spearpage 16 HeatScott Langrenpage 17 Plastic Shard WordsMatthew J. Nelsonpage 18 Mr. Snowplow ManMartin Paul Brittpage 19 Carpe DiemMichael Lairpage 19 untitledWalt Howardpage 20 The GameKellie J. Olsenpage 21 AT PEACEJennifer Surmanpage 22 SawdustSue Songerpage 23 Photography Unbound RealitiesKris Quiriconipage 26 untitled Mark Porter page 27 untitled Mark Porter page 28 untitled Mark Porter page 29 Prose I am Here...RememberingJ. Dylan McNeillpage 32-34 RecognitionSue Songerpage 35-36 SACCADICSteve Beinpage 37-40 The BurnBryan Levekpage 41-45 Biographiespage 46-48https://thekeep.eiu.edu/vehicle/1063/thumbnail.jp

Characterising the nature of primary care patient safety incident reports in the England and Wales National Reporting and Learning System: a mixed-methods agenda-setting study for general practice

Background There is an emerging interest in the inadvertent harm caused to patients by the provision of primary health-care services. To date (up to 2015), there has been limited research interest and few policy directives focused on patient safety in primary care. In 2003, a major investment was made in the National Reporting and Learning System to better understand patient safety incidents occurring in England and Wales. This is now the largest repository of patient safety incidents in the world. Over 40,000 safety incident reports have arisen from general practice. These have never been systematically analysed, and a key challenge to exploiting these data has been the largely unstructured, free-text data. Aims To characterise the nature and range of incidents reported from general practice in England and Wales (2005–13) in order to identify the most frequent and most harmful patient safety incidents, and relevant contributory issues, to inform recommendations for improving the safety of primary care provision in key strategic areas. Methods We undertook a cross-sectional mixed-methods evaluation of general practice patient safety incident reports. We developed our own classification (coding) system using an iterative approach to describe the incident, contributory factors and incident outcomes. Exploratory data analysis methods with subsequent thematic analysis was undertaken to identify the most harmful and most frequent incident types, and the underlying contributory themes. The study team discussed quantitative and qualitative analyses, and vignette examples, to propose recommendations for practice. Main findings We have identified considerable variation in reporting culture across England and Wales between organisations. Two-thirds of all reports did not describe explicit reasons about why an incident occurred. Diagnosis- and assessment-related incidents described the highest proportion of harm to patients; over three-quarters of these reports (79%) described a harmful outcome, and half of the total reports described serious harm or death (n = 366, 50%). Nine hundred and ninety-six reports described serious harm or death of a patient. Four main contributory themes underpinned serious harm- and death-related incidents: (1) communication errors in the referral and discharge of patients; (2) physician decision-making; (3) unfamiliar symptom presentation and inadequate administration delaying cancer diagnoses; and (4) delayed management or mismanagement following failures to recognise signs of clinical (medical, surgical and mental health) deterioration. Conclusions Although there are recognised limitations of safety-reporting system data, this study has generated hypotheses, through an inductive process, that now require development and testing through future research and improvement efforts in clinical practice. Cross-cutting priority recommendations include maximising opportunities to learn from patient safety incidents; building information technology infrastructure to enable details of all health-care encounters to be recorded in one system; developing and testing methods to identify and manage vulnerable patients at risk of deterioration, unscheduled hospital admission or readmission following discharge from hospital; and identifying ways patients, parents and carers can help prevent safety incidents. Further work must now involve a wider characterisation of reports contributed by the rest of the primary care disciplines (pharmacy, midwifery, health visiting, nursing and dentistry), include scoping reviews to identify interventions and improvement initiatives that address priority recommendations, and continue to advance the methods used to generate learning from safety reports

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat