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

How Service-Learning Can Support the Practice of, and Education About, Collaborative Natural Resource Management

Many researchers agree that contemporary natural resource management requires successful collaboration between diverse stakeholder groups. However, achieving successful collaboration can be challenging. So what makes stakeholder collaborations work and what models exist for educating the next generation of natural resource professionals about successful stakeholder collaboration? The Harwood Union Forest Project, a community-based forestry initiative in Vermont, provides such a model. By forming service-learning partnerships between a public high school and natural resources students at the University of Vermont, the Harwood Union Forest Project has successfully supported community-based forestry activities at the high school’s 180 acre forest, and educated both high school and university students about collaborative natural resource management. This presentation will described the Harwood Union Forest Project and present preliminary findings from a qualitative research study about the impacts of the project’s service-learning partnerships. Service-learning offers a means for academia to support communities in making difficult decisions about complex environmental issues while also educating students about those issues and providing them with hands on experience in the field. The Harwood Union Forest Project offers one model for accomplishing those goals

Optimal Conditions to Support School Climate and Increase Teacher Retention in Middle School Classrooms

This study addressed the increasing attrition and migration of teachers from middle school classrooms. The study also sought to determine to what extent specific research-based factors motivated teachers to remain in the middle school classroom. An explanatory sequential mixed-methods design was used in this study. The first portion of the study included quantitative and qualitative data collection through the administration of an online survey instrument. Survey data results were utilized to create and modify questions used to gather additional qualitative data during the administration of two focus groups. This study found a positive school climate, administrative support, and collegiality to be essential factors to increase teacher retention in middle school classrooms. Additional factors motivating teachers to remain in middle school classrooms gathered from qualitative data were the ability to have a positive impact on student lives and receiving professional development to address the unique needs of individual teachers. The study noted the impact administrative support, collegiality, and family/community support had on the creation of a positive school climate as well as the effect these factors have on a teacher’s ability to positively impact student lives. The study also noted the need for professional development designed to address the needs of individual teachers. Recommendations to increase teacher retention in middle school classrooms are provided along with the study’s implications for future research

Achieving Competence: Clinical Instructors\u27 Perspective

Purpose: The profession of physical therapy uses physical therapist clinical instructors to educate students in the clinical education portion of the curriculum. The requirements to become a clinical instructor are minimal and non- specific regarding formal training and development. A variety of educational opportunities is available to clinical instructors, but the evidence in the physical therapy literature is conflicting regarding the effectiveness of these programs. Additionally, no previous research regarding the meaning of competence, nor the pathway to achieving competence as a clinical instructor was found. Therefore, the purpose of this study was to describe the experience of achieving competence as perceived by clinical instructors who have chosen different paths toward becoming effective CIs. Methods: This study utilized phenomenological methodology to explore the meaning of clinical instructor competence and the experience of achieving competence from the perspectives of the clinical instructors themselves. Data was collected through the use of focus groups, semi-structured interviews and written statements. Data was analyzed for themes using thematic analysis. Participants: A purposive sample of twenty-nine physical therapist clinical instructors was recruited to participate in five focus groups, each group consisted of 5-7 participants. Results: An overarching theme of “Empowerment” emerged from the data analysis of the transcriptions and field notes. This overarching theme was supported by eight themes which resonated across the five focus groups. These themes were 1: The meaning of competence, 2: “My first student”, 3: Finding the way, 4: Feeling supported, 5: A fork in the road, 6: Barriers to achieving competence, 7: The “ah-ha” moment, 8: “Ongoing road”. Conclusion: The results of this study provide a description and interpretation of the meaning of clinical instructor competence and the journey of achieving competence. These findings can inform and empower clinical instructors on their own journey to competence. CCCEs may also find a deeper awareness of the meaning of competence and the importance of providing support for CIs. The physical therapy education community and it’s professional bodies can also be informed by these findings in establishing a definition of clinical instructor competence. As well as give direction to future efforts and programs designed to prepare clinicians to effectively educate students in the clinic setting

Neighborhood Typology and Cardiometabolic Pregnancy Outcomes in the Maternal Adiposity Metabolism and Stress Study.

ObjectiveThis study aimed to assess associations between neighborhood typologies classified across multiple neighborhood domains and cardiometabolic pregnancy outcomes and determine variation in effectiveness of a mindfulness-based stress-reduction intervention on outcomes across neighborhood types.MethodsNeighborhoods of participants in the Maternal Adiposity Metabolism and Stress (MAMAS) intervention (n = 208) were classified across dimensions of socioeconomic, food, safety, and service/resource environments using latent class analysis. The study estimated associations between neighborhood type and three cardiometabolic pregnancy outcomes-glucose tolerance (GT) during pregnancy, excessive gestational weight gain, and 6-month postpartum weight retention (PPWR)-using marginal regression models. Interaction between neighborhood type and intervention was assessed.ResultsFive neighborhood types differing across socioeconomic, food, and resource environments were identified. Compared with poor, well-resourced neighborhoods, middle-income neighborhoods with low resources had higher risk of impaired GT (relative risk [RR]: 4.1; 95% confidence Interval [CI]: 1.1, 15.5), and wealthy, well-resourced neighborhoods had higher PPWR (beta: 3.9 kg; 95% CI: 0.3, 7.5). Intervention effectiveness varied across neighborhood type with wealthy, well-resourced and poor, moderately resourced neighborhoods showing improvements in GT scores. PPWR was higher in intervention compared with control groups within wealthy, well-resourced neighborhoods.ConclusionsConsideration of multidimensional neighborhood typologies revealed important nuances in intervention effectiveness on cardiometabolic pregnancy outcomes

Recruitment and retention of pregnant women for a behavioral intervention: lessons from the maternal adiposity, metabolism, and stress (MAMAS) study.

IntroductionRecruiting participants for research studies can be challenging. Many studies fall short of their target or must prolong recruitment to reach it. We examined recruitment and retention strategies and report lessons learned in a behavioral intervention developmental trial to encourage healthy pregnancy weight gain and stress reduction in low-income overweight pregnant women.MethodsIn the San Francisco Bay area from February 2010 through March 2011, we used direct and indirect strategies to recruit English-speaking overweight and obese pregnant women who were aged 18 to 45, were in the early stages of pregnancy, and who had an annual household income less than 500% of the federal poverty guidelines. Eligible women who consented participated in focus groups or an 8-week behavioral intervention. We identified successful recruiting strategies and sites and calculated the percentage of women who were enrolled and retained.ResultsOf 127 women screened for focus group participation, 69 were eligible and enrolled. A total of 57 women participated in 9 focus groups and 3 women completed individual interviews for a completion rate of 87%. During recruitment for the intervention, we made contact with 204 women; 135 were screened, 33% were eligible, and 69.1% of eligible women enrolled. At 1 month postpartum, 82.6% of eligible women completed an assessment. Recruiting at hospital-based prenatal clinics was the highest-yielding strategy.ConclusionThe narrow window of eligibility for enrolling early stage pregnant women in a group intervention presents obstacles. In-person recruitment was the most successful strategy; establishing close relationships with providers, clinic staff, social service providers, and study participants was essential to successful recruitment and retention

Cultural ecosystem services and the well-being of refugee communities

The growing field of research into cultural ecosystem services (CES) explores nonmaterial benefits that people receive from ecosystems. These studies have, however, largely overlooked refugee communities. To reduce this gap, we systematically review academic literature on refugee interactions with ecosystems to understand what cultural ecosystem services refugees may experience, and how these services affect their well-being. The results identify a broad range of CES that refugees experience, even though studies do not use CES terminology. Benefits include social relations, mental health, cultural heritage, education, recreation, identity, sense of place, aesthetic, spirituality, perspective, and existence value. Results also show that the majority of studies of refugee—ecosystem interactions occur in agricultural ecosystems. Findings suggest that interactions with ecosystems may ease the resettlement process and overall well-being, including mental health, in many ways. These findings enrich understanding of CES experienced by people of diverse (and in this case traumatic) backgrounds and provide practical implications for those who work in the field of refugee resettlement