Deliberate Practice of IV Medication Procedures by Student Nurses: Feasibility, Acceptability, and Preliminary Outcomes: A Dissertation

Background: Medication errors continue to be one of the most prevalent problems in healthcare related to patient safety, often resulting in injury or death, with higher incidences of error occurring with intravenous medications. The purpose of this study was to explore the use of deliberate practice (DP) with second-degree nursing students in developing and maintaining fundamental intravenous medication management practices required for safe practice. Method: This was a feasibility study using a two-arm, single-blind, randomized controlled trial design. Vygotsky’s Zone of Proximal Development model was used to explore the use of a DP teaching intervention to achieve competency in skills associated with safe IV medication management. A convenience sample of first-year, first-semester nursing students enrolled in an accelerated graduate program (N = 32) were invited to participate; 19 enrolled, and 12 completed the study. Students (n = 12) received three 30- minute one-on-one practice sessions at 2-week intervals with an expert nurse (the intervention group focused on IV skills and the control group on skills unrelated to IVs). Pre- and post-intervention instruments tested participants’ confidence with IV management and safety skills. The primary outcome was their ability to safely administer and monitor IV medications during a 20-minute videotaped medication administration scenario. Results: Low recruitment (19 of 32) and high attrition (37%) were observed. Participants completing the study (5 in the intervention group and 7 in the control group) reported that the time required to attend the sessions was not burdensome (91.7%); time allotted was adequate (100%); 100% reported positive experience; 91.7% found the DP sessions essential to learning. Change in confidence scores for IV skills were not significant (P = 0.210), but were higher in the intervention group (2.97–4.14 = 1.50 change) compared to the control group (2.71–3.77 = 1.04 change). Significant differences were found in overall medication administration skills between the control and intervention groups (t [-2.302], p = 0.044) in favor of the intervention group, particularly with medication preparation skills (p = 0.039). Overall raw scores were low in both groups; only 16–42 (26%–70%) of the total 60 steps required for safe practice were completed. Participants scored lowest in the evaluation phase, with all participants performing less than 50% of the 14 steps. Conclusion: Even though participant satisfaction was high, significant attrition occurred. Students reported the DP sessions to be beneficial and they felt more confident in performing skills, but three 30-minute sessions (90 minutes) were not adequate to develop, maintain, or refine all the IV-management skills associated with safe medication practices. Determining the length and duration of DP sessions as well as comparing the efficacy of DP sessions between individual and group sessions with varying doses and frequencies is needed to advance our understanding of using DP within nursing education

We decide what art means: Revitalizing audiences’ authority

Facing stagnant average audience attendance and inequality in governmental support, how can British Columbian arts organizations survive and thrive? Research has shown that audiences have become increasingly disconnected from their meaning-making processes during arts and culture experiences (Brown, 2013; Scollen, 2008; Sedgman, 2017). The literature has also demonstrated that meaning-making experiences could increase the audience’s desire to attend and advocate for others to attend arts and culture events (Brown, 2013; Gwillim et al., 2019; Prendergast, 2004). My research focused on my participants’ experiences at a suite of outreach activities (talkbacks, lectures, digital content, workshops, etc.) which I call information sessions. I was interested in their descriptions of the relationship between attending an information session and their decisions to attend and encourage others to attend arts and culture events. I was also interested in their suggestions for improving information sessions and their perceptions of the barriers to attendance faced by their communities. Using a social constructivist framework, I conducted a thematic analysis drawing on guided journal entries and semi-structured interviews. My findings showed that meaning-making value was a motivational factor in my participants\u27 decisions to attend arts and culture events, share their experiences with others, and encourage others to attend. In addition, participants articulated how improvements to the physical, financial, and content availability of information sessions and arts and culture events could overcome attendance barriers. These findings are useful because revitalizing audiences\u27 authority as meaning makers can recentre their importance in the development of arts programming that provides value and overcomes barriers to attendance. This potential for revitalization could position information sessions as a crucial contributor to the long-term success of the British Columbian arts and culture sector

Commentary: is digital health technology empowering patients?

This brief commentary explores how Web 2.0 technology is leading to a new kind of digital health technology. It considers what this might mean for the patient–practitioner encounter; whether practitioners are signed up to the notion of shared decision-making, and whether patients feel empowered and confident to make decisions about their car

Helping Elders Living with Pain (HELP)

The HELP study, which is a two-year study supported by a R21 grant from National Institute on Aging, is a direct extension of our previous work examining attentional demands of chronic pain in the older population. The HELP study is designed to compare two different exercise programs - simple body exercise and mind-body exercise, in their effects on pain symptoms, cognitive function, dual-task walking ability, and levels of pain-related biomarkers in community-dwelling older adults with multisite pain who are at risk of falling

Effective charges and expansion parameters in QCD

The momentum subtraction scheme MOM has been empirically successful in producing small QCD corrections to physical quantities at one loop order. By explicit calculations, we show that with a suitable shift in the renormalization scale, the minimal subtraction scheme coupling constant αMS coincides with typical momentum scheme coupling constants at both one and two loop order.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87888/2/107_1.pd

Prevalence of Vaginitis in Children and Adolescents of Les Cayes, Haiti

Data on the prevalence of vaginitis in children from the third largest city in Haiti indicate that nurses and other health care professionals, especially those providing care in Haiti, need to accurately diagnose, prevent, and treat vaginitis in children.  Vaginitis can have serious complications yet there are no national data regarding the prevalence of vaginitis in Haitian children and probably not in other countries with similar problems.  This paper provides data from Les Cayes, Haiti.  Signs, symptoms, risk factors, methods for diagnoses, and possible complications of vaginitis are reviewed.  Recommendations for prevention and treatment are provided. To successfully prevent and treat vaginitis, a holistic call to action includes the involvement of nurses and other health care professionals, the media, and government officials that encompasses education, appropriate medications, maintenance of follow up appointments, and continuity of treatment.Â

A Quasi-Experimental Study of a Health Patterning Modality about Childhood Vaginitis and Power in Haitian Primary Caregivers

The purpose of the study was to appraise the power as knowing participation in change of primary caregivers of Haitian children aged 6 to 13 years old before and after participation in an education and resource health patterning modality related to risk factors and prevention of childhood vaginitis. The study was framed within the realm of Rogers’ Science of Unitary Human Beings and the conceptual framework of Barrett’s Power as Knowing Participation in Change. A pretest-posttest quasi- experimental study was conducted. Descriptive statistics were used to answer the first research question “What are the power profiles of Haitian caregivers before and after the health patterning modality about childhood vaginitis?” and a t-test supported by a Wilcoxon Signed ranked test was done to answer the second question “To what extent does Haitian caregivers’ power profile change after the health patterning modality about childhood vaginitis?” A purposive sample of 92 Haitian primary caregivers of female children aged 6 to 13 years old was recruited. The sample was delimited to primary caregivers of girls who attended five selected schools. Participants completed the Haitian Creole translated Power as Knowing Participation in Change Tool Version II before and after their participation in the health patterning modality. The Power of Haitian primary care givers was statistically significantly enhanced following participation in the health patterning modality that included education and resources. The findings of this study though limited have many implications for nursing research and nursing practice. They support the unitary nature of power and reinforced the belief that power is an innate attribute that exists independent of contexts. Furthermore, statistically significant increase in power at posttest relates the importance of health patterning modalities in enhancing power