Reducing Nursing Documentation Burden: Evaluation of an Electronic Health Record Optimization Plan

Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR. Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a nursing documentation optimization effort, implemented at UK HealthCare. Evaluation variables included nursing documentation burden and timeliness of documentation, particularly on time spent documenting in the inpatient EHR Basic Assessment Flowsheet and time from assessment to documentation. Methods: This study employed a pre and post data design where data were obtained prior to and after an optimization phase in the Epic Nurse Well-Being Project at UK HealthCare. Epic efficiency data were collected from the Nursing Efficiency Assessment Tool (NEAT) on nursing documentation time spent in the Basic Assessment Flowsheet and time from assessment to documentation in the EHR. Data were also collected using pre and post surveys to assess the self-reported timeliness of documentation and nursing satisfaction surrounding EHR documentation. Results: Satisfaction with the Basic Assessment documentation time in the flowsheet, satisfaction with amount of time between assessment and documentation, agreement that 3 documentation did not interfere with ability to provide patient care, and overall satisfaction with documenting in the flowsheet increased. The average time participants self-reported a delay of their Basic Assessment documentation decreased by 12.2 minutes. Epic efficiency data showed the average number of minutes spent per user per day in the Basic Assessment Flowsheet increased by 0.86 minutes, and the average number of minutes between assessment and documentation increased by 0.2 minutes after the intervention but was not statistically significant. Conclusions: The results showed an overall positive response from participants to the intervention, although there was not a notable difference in Epic efficiency data. This project contributes valuable insights into the importance of EHR optimization for both nursing staff and patient outcomes, emphasizing the need for ongoing optimization efforts

A study of religiosity and conservatismin relation to social value orientation and philanthropy

The purpose of this study was to examine the potential interdependent relationships between religiosity, conservatism, social value orientation and philanthropy. Participants included members of four religious institutions. A non-experimental survey design was used gather information. Subjects were given a hypothetical task related to social value orientation, two scales of measurement related to religiosity and philanthropy and asked to self-identify their political orientation. Chi Square analysis identified a significant relationship between political orientation and social value orientation. A correlation was found between religiosity and philanthropy within the liberal sample, rather than in the suspected conservative sample. Additionally, a one-way analysis of variance revealed that there were no significant differences in attitudes towards philanthropy. Results provide support for models suggesting that religion promotes competing psychological stances: conservatism and a prosocial value orientation

Treatment Accessibility for Co-Infected IDUs in China: A Likelihood for HIV, an Improbability for Hepatitis C

In a country which provides free medicine and care for patients living with HIV/AIDS, China has not included a crucial piece of the problem in its health care scheme. In Yunnan Province alone, 77.7 % of intravenous drug users are co-infected with HIV and hepatitis C. While these patients can obtain treatment for HIV with ease, they cannot do so to treat their hepatitis C infection, a viral disease that leads to liver failure. Recent trends indicate that more co-infected patients are dying of HCV rather than HIV due to treatment inaccessibility. This study investigates theseverity of HCV in China, the barriers to obtaining treatment, and what alternatives exist for patients infected by HCV. Over the course of one month, formal interviews were conducted with 18 intravenous drug users, two medical doctors specializing in infectious disease, and one Traditional Chinese Medicine doctor. The answers were analyzed to compare the experience of patients to the experiences of doctors and how this correlated with the shortfalls in HCV treatment distribution. There are four findings which point to the underlying causes. First, there is a gap between what medical doctors assume to what patients experience. While doctors claimed that HCV treatment is highly successful, not a single IDU who was interviewed had successfully completed the regimen. Second, finances and stigma serve as the largest barriers to obtaining treatment. Third, in order to cope with these barriers, patients find emotional reprieve in community support and treatment alternatives in Traditional Chinese Medicine. Fourth, the solution requires changes from both the Chinese health care system and foreign pharmaceutical companies. The goal of this research is to raise awareness about the gaps in knowledge and efforts surrounding hepatitis C to create a sense of urgency to fill them. This study will assist nongovernmental organizations and public health entities in understanding the problem of HCV in China so that they can implement improved and sustainable solutions

Protecting their land

Environmentalists, the Sioux tribe, and rural farmers. Three groups that may not always have a lot in common have been coming together to protest the Dakota Access Pipeline, also known as the Bakken Pipeline

Comparing Food Thought Suppression and Cognitive Restraint on Eating Behaviors

Research has suggested that assessing an individual’s thoughts and concerns about their caloric intake should be considered as equally important as an individual’s actual engagement in caloric restriction (Allison, Kalinsky, & Gorman, 1992). The construct of cognitive restraint has primarily been used to further understand the influence of these cognitive processes on eating behaviors. However, by definition, cognitive restraint includes both thoughts and actual engagement in behavioral restraint (Allison, et al., 1992). Food thought suppression, defined as the tendency to avoid thoughts regarding food, (Barnes & Tanteleff-Dunn, 2010), may be a more accurate representation of the cognitive processes that influence consumption. The current study aimed to compare the suppression of food- and eating-related thoughts on consumption and those factors known to influence eating behaviors (i.e., disinhibition, cravings and susceptibility to the food environment) in a sample of 68 female University students. When compared to cognitive restraint, food thought suppression was consistently found to be a stronger predictor of self-reported disinhibition, cravings and susceptibility to the food environment. Although results demonstrated that neither food thought suppression nor cognitive restraint were significantly associated with, nor significant predictors of consumption, interestingly, participant self-identified ethnicity was demonstrated to be a significant predictor of consumption. Taken together, the findings highlight the need for future studies to examine the ways in which one’s tendency to avoid food and eating related thoughts influence consumption and those factors known to influence eating behaviors

The investigation of the self-efficacy of special education teachers who teach mathematics to English language learners with disabilities

Of the English Language Learners (ELLs) in USA K-12 schools, 665,000 are identified as having a disability. In mathematics, ELLs with disabilities have significantly lower outcomes than English dominant, and non-disabled peers. Numerous studies over four decades have linked student outcomes to teacher self-efficacy (i.e. belief in ability to perform a task for expected outcomes). Considering many ELLs with disabilities receive mathematics instruction from special education teachers, there are questions about the self-efficacy of these teachers to provide quality instruction, since there are few studies focused specifically on preparing or supporting special education teachers to teach mathematics to ELLs with disabilities. The purpose of this dissertation is to examine in-service special education teachers' overall self-efficacy in teaching mathematics in teaching any student with a disability and in teaching ELLs with disabilities in culturally and linguistically responsive ways. One hundred seventeen special education teachers from 9 states were recruited for this study which utilized surveys and follow up interviews. Six participants, chosen for having low or high self efficacy in teaching mathematics to any student with a disability or in teaching mathematics to ELLs with disabilities, were interviewed about factors which were helpful or harmful to their self-efficacy. Themes from the data included (a) teacher preparedness, (b) student characteristics, (c) teaching pedagogy, (d) building culture, (e) overall teacher disposition and (f) culturally responsive pedagogy.Includes bibliographical reference

Periurethral Smooth Muscle Tumor of Undetermined Malignant Potential

Smooth muscle tumors of undermined malignant potential (STUMP) are atypical smooth muscle tumors. The majority of these tumors are of uterine origin. We report the first known periurethral STUMP. Complete surgical resection is recommended for all cases of STUMP. They can recur in the form of STUMP or leiomyosarcoma

Reproductive Healthcare Success Guide: A Resource for Practitioners and Funders

The Reproductive Healthcare Success Guide aims to advance equitable reproductive healthcare in New Mexico. In this guide we share and elevate what we have learned through collaborative work with our communities, and offer guidance directly to providers and funders who are seeking to offer and support reproductive healthcare in New Mexico. This guidance extends to organizational leaders, health and wellness practitioners and specialists, caregivers, clinics and clinicians, and those in a range of roles who fund efforts to provide care in New Mexico.This resource was developed in close collaboration with community partners, clinicians, and birth workers in Doña Ana, McKinley, and Santa Fe Counties. The guide outlines some of the critical aspects future providers, funders, and other institutions must consider as they begin the process to serve New Mexico communities with respect and dignity