E-Dates: Enhancing Competency of Novice/Advanced Beginner RNs

Abstract Category: Practice Innovation / Performance Improvement (PI) Purpose: The purpose of the implemented initiative was to improve communication, critical thinking and decision making of novice/advanced beginner nurses on the medical/surgical areas. Methods: The bedside Clinical Nurse Educator’s (CNE’s) identified Novice/Advance Beginner Nurses in their departments. Meetings were planned on a 1:1 basis with the CNE’s and the identified nurses on the respective units. They called the sessions “Educational Dates,” or” E-Dates”. A tool for documentation during the E-dates was developed. During these E-dates the CNE shadowed the identified nurses for intervals of two to three hours in two separate occasions. During these E-dates the CNE would assessed on the areas of hand off report, patient assessment, documentation, medication administration and communication; looking for opportunities of improvement. Upon the E-date completion the CNE’s compared and discussed observations with the observed nurses and used reflection to promote learning and understanding of identified areas for improvement Findings: Improving the competency of nurses reflects on a delivery of safer patient care. As nurses develop and advance in their roles it is important to address their skills in all levels of practice. Enhancing nurses’ communication skills and assisting with their critical thinking will not only elevate nurses’ competency but also improve nursing practice. Discussion: With the current nursing shortage it is found experienced nurses are limited in number, healthcare systems use new graduates to help fill the gap (Blevins & Millen, 2016). Recently an increased in novice/advanced beginner nurses have being identified in the medical/surgical areas. However our institution is committed to the successful transition of these novice advance/beginner nurses. Leadership is aware that a successful transition influences patient safety and outcomes, financial cost and nurses’ longevity in the profession. The transition from advanced beginner to competent-proficient nurse includes experience within the clinical environment. Nurses at this level have showed mastered technical skills and the ability to provide patient care with competence and confidence. The interprofessional relations with physicians and nurses it’s greatly valued in our organization. Novice/advanced beginners nurses must feel comfortable and confident when communicating with physician, reporting findings, and documenting. Recent physician satisfaction survey scores showed that the physician’s perception of nurse’s competency decreased. Therefore, an initiative aimed to improve communication, critical thinking and decision making of novice nurses was started. Consequently with the expectation of improvement on the physicians’ perception of nurses’ competency. Implications for Practice: Improving the competency of nurses reflects on a delivery of safer patient care. As nurses develop and advance in their roles it is important to address their skills in all levels of practice. Enhancing nurses’ communication skills and assisting with their critical thinking will not only elevate nurses’ competency but also improve nursing practice

E-Dates: Enhancing Competency of Novice/Advanced Beginner RNs

Discussion: With the current nursing shortage it is found that experienced nurses are limited in number, and healthcare systems use new graduates to help fill the gap (Blevins & Millen, 2016). In 2015, an increase in novice/advanced beginner nurses was identified in the medical/surgical areas. The 2015 physician satisfaction survey scores showed that the physicians’ perception of nurses’ competency decreased. An initiative for improvement aimed to improve communication, critical thinking and decision making of novice nurses was implemented. Purpose: The purpose of the implemented initiative was to improve physician and peer satisfaction of working with clinically competent nurses by improving communication, critical thinking and decision making of novice advanced/beginner nurses in the acute med-ical surgical area. Methods: Clinical Nurse Educator’s (CNE’s) identified Novice/Advance Beginner Nurses in their departments. Meetings were planned on a 1:1 basis with the CNE’s and the identi-fied nurses on the respective units. They called the sessions Educational Dates, or “E-Dates”. A tool for documentation during the E-dates was developed. During these E-dates the CNE shadowed the identified nurses for intervals of two to three hours in two separate occa-sions. During these E-dates the CNE would assessed on the areas of hand off report, patient assessment, documentation, medication administration and communication. As opportuni-ties for improving critical thinking were identified the CNE addressed findings with the nurses and encouraged nurses to reflect on the experience. Findings: The implementation of the E-Dates by the CNE in the acute med-surg areas im-proved the communication, critical thinking and decision making of the novice advanced/beginner nurses. The result was an increase in physician and peer satisfaction improving the interprofessional relationships valued by our organization

Antimutagenicity of Methanolic Extracts from Anemopsis californica

Anemopsis californica has been used empirically to treat infectious diseases. However, there are no antimutagenic evaluation reports on this plant. The present study evaluated the antioxidant activity in relation to the mutagenic and antimutagenic activity properties of leaf (LME) and stem (SME) methanolic extracts of A. californica collected in the central Mexican state of Querétaro. Antioxidant properties and total phenols of extracts were evaluated using DPPH (1,1-diphenyl-2-picrylhydrazyl) and Folin-Ciocalteu methods, respectively. Mutagenicity was evaluated using the Ames test employing Salmonella enterica serovar Typhimurium strains (TA98, TA100, and TA102), with and without an aroclor 1254 (S9 mixture). Antimutagenesis was performed against mutations induced on the Ames test with MNNG, 2AA, or 4NQO. SME presented the highest antioxidant capacity and total phenolic content. None of the extracts exhibited mutagenicity in the Ames test. The extracts produced a significant reduction in 2AA-induced mutations in S. typhimurium TA98. In both extracts, mutagenesis induced by 4NQO or methyl-N′-nitro-N-nitrosoguanidine (MNNG) was reduced only if the exposure of strains was <10 μg/Petri dish. A. californca antioxidant properties and its capacity to reduce point mutations render it suitable to enhance medical cancer treatments. The significant effect against antimutagenic 2AA suggests that their consumption would provide protection against carcinogenic polycyclic aromatic compounds

Is there a link between wealth and cardiovascular disease risk factors among Hispanic/Latinos? : Results from the HCHS/SOL sociocultural ancillary study

OBJECTIVE: To examine the relationship between wealth and cardiovascular disease risk factors among Hispanic/Latinos of diverse backgrounds. DESIGN: This cross-sectional study used data from 4971 Hispanic/Latinos, 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline exam and the HCHS/SOL Sociocultural Ancillary Study. Three objectively measured cardiovascular disease risk factors (hypertension, hypercholesterolemia, and obesity) were included. Wealth was measured using an adapted version of the Home Affluence Scale, which included questions regarding the ownership of a home, cars, computers, and recent vacations. RESULTS: After adjusting for traditional socioeconomic indicators (income, employment, education), and other covariates, we found that wealth was not associated with hypertension, hypercholesterolemia or obesity. Analyses by sex showed that middle-wealth women were less likely to have hypercholesterolemia or obesity. Analyses by Hispanic/Latino background groups showed that while wealthier Central Americans were less likely to have obesity, wealthier Puerto Ricans were more likely to have obesity. CONCLUSION: This is the first study to explore the relationship between wealth and health among Hispanic/Latinos of diverse backgrounds, finding only partial evidence of this association. Future studies should utilize more robust measures of wealth, and address mechanisms by which wealth may impact health status among Hispanic/Latinos of diverse backgrounds in longitudinal designs

Is there a link between wealth and cardiovascular disease risk factors among Hispanic/Latinos? Results from the HCHS/SOL sociocultural ancillary study

Objective: To examine the relationship between wealth and cardiovascular disease risk factors among Hispanic/Latinos of diverse backgrounds. Design: This cross-sectional study used data from 4971 Hispanic/Latinos, 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline exam and the HCHS/SOL Sociocultural Ancillary Study. Three objectively measured cardiovascular disease risk factors (hypertension, hypercholesterolemia, and obesity) were included. Wealth was measured using an adapted version of the Home Affluence Scale, which included questions regarding the ownership of a home, cars, computers, and recent vacations. Results: After adjusting for traditional socioeconomic indicators (income, employment, education), and other covariates, we found that wealth was not associated with hypertension, hypercholesterolemia or obesity. Analyses by sex showed that middle-wealth women were less likely to have hypercholesterolemia or obesity. Analyses by Hispanic/Latino background groups showed that while wealthier Central Americans were less likely to have obesity, wealthier Puerto Ricans were more likely to have obesity. Conclusion: This is the first study to explore the relationship between wealth and health among Hispanic/Latinos of diverse backgrounds, finding only partial evidence of this association. Future studies should utilize more robust measures of wealth, and address mechanisms by which wealth may impact health status among Hispanic/Latinos of diverse backgrounds in longitudinal designs