Impact of a Standardized Handoff Tool between Gastroenterology and PACU Nurses’ Communication and Satisfaction

Impact of a Standardized Handoff Tool between Gastroenterology and PACU Nurses’ Communication and Satisfaction Abstract Problem: Patient handoff between nurses is a critical moment where it is imperative that complete and accurate information is exchanged. Handoff of patient information can be complex, and the use of unstructured, non-standardized handoffs could result in poor communication leading to the omission of pertinent information and a decrease in patient safety and staff satisfaction. Several studies have found the use of standardized handoff tools improve communication, decrease omission of critical information, and improve staff satisfaction. While the use of standardized handoff tools is best for patient handoff and safety, there still appears to be a gap in utilization in some areas of nursing. Methods: This quality improvement project utilized a descriptive observational design. Development of a new GI specific handoff tool was designed after obtaining feedback from both GI and PACU staff and reviewing the current handoff tool. Pre-implementation and post-implementation staff survey data were compared to determine if perceived communication and nursing satisfaction improved in relation to the application of the new handoff tool. Completion rates for items on the new GI handoff tool were also calculated. Results: Descriptive statistics, Fisher Exact tests, and two-tailed Mann-Whitney tests were utilized to determine statistical significance between staff surveys. No statistical significance was determined in the GI responses for either communication or satisfaction surveys. Two questions were found to be statistically significant in the PACU responses from the communication survey and one question was found to be statistically significant from the satisfaction survey. There was one question that was statistically significant in the combined staff surveys. The documentation completion rates for the most part either met or exceeded the 90% completion rate. One documentation item did not met the 90% completion rate. Implications for Practice: The implementation of the new standardized handoff tool did show improvement in the perceived communication and satisfaction with PACU nurses. No statistical improvement was shown with GI nurses, but there should be continued education on the use of the new standardized handoff tool. Almost all of the documentation items were identified correctly indicating a beneficial aspect of the new handoff tool

Threats Posed by the Fungal Kingdom to Humans, Wildlife, and Agriculture.

The fungal kingdom includes at least 6 million eukaryotic species and is remarkable with respect to its profound impact on global health, biodiversity, ecology, agriculture, manufacturing, and biomedical research. Approximately 625 fungal species have been reported to infect vertebrates, 200 of which can be human associated, either as commensals and members of our microbiome or as pathogens that cause infectious diseases. These organisms pose a growing threat to human health with the global increase in the incidence of invasive fungal infections, prevalence of fungal allergy, and the evolution of fungal pathogens resistant to some or all current classes of antifungals. More broadly, there has been an unprecedented and worldwide emergence of fungal pathogens affecting animal and plant biodiversity. Approximately 8,000 species of fungi and Oomycetes are associated with plant disease. Indeed, across agriculture, such fungal diseases of plants include new devastating epidemics of trees and jeopardize food security worldwide by causing epidemics in staple and commodity crops that feed billions. Further, ingestion of mycotoxins contributes to ill health and causes cancer. Coordinated international research efforts, enhanced technology translation, and greater policy outreach by scientists are needed to more fully understand the biology and drivers that underlie the emergence of fungal diseases and to mitigate against their impacts. Here, we focus on poignant examples of emerging fungal threats in each of three areas: human health, wildlife biodiversity, and food security

Threats Posed by the Fungal Kingdom to Humans, Wildlife, and Agriculture

The fungal kingdom includes at least 6 million eukaryotic species and is remarkable with respect to its profound impact on global health, biodiversity, ecology, agriculture, manufacturing, and biomedical research. Approximately 625 fungal species have been reported to infect vertebrates, 200 of which can be human associated, either as commensals and members of our microbiome or as pathogens that cause infectious diseases. These organisms pose a growing threat to human health with the global increase in the incidence of invasive fungal infections, prevalence of fungal allergy, and the evolution of fungal pathogens resistant to some or all current classes of antifungals. More broadly, there has been an unprecedented and worldwide emergence of fungal pathogens affecting animal and plant biodiversity. Approximately 8,000 species of fungi and Oomycetes are associated with plant disease. Indeed, across agriculture, such fungal diseases of plants include new devastating epidemics of trees and jeopardize food security worldwide by causing epidemics in staple and commodity crops that feed billions. Further, ingestion of mycotoxins contributes to ill health and causes cancer. Coordinated international research efforts, enhanced technology translation, and greater policy outreach by scientists are needed to more fully understand the biology and drivers that underlie the emergence of fungal diseases and to mitigate against their impacts. Here, we focus on poignant examples of emerging fungal threats in each of three areas: human health, wildlife biodiversity, and food security.</p