Reducing Patient Handoff Inadequacies Using an Electronic Medical Record Based Standardized Handoff Tool in the Critical Care Unit

INTRODUCTION: Inadequate handoff communication is a contributing factor in sentinel events and adverse patient outcomes. Research has shown that the use of a standardized handoff tool can improve quality of handoff communication. This quality improvement (QI) project sought to standardize handoff and reduce the risk of adverse patient outcomes by utilizing the I-PASS handoff tool available in the electronic medical record (EMR). AIM: The aim of this quality improvement project was to improve the accuracy of nurse-to-nurse patient handoffs. METHODS: The outcomes measured by the post-intervention survey were the number of reported handoffs received with omissions, the percentage of staff using the standardized report tool regularly, and staff satisfaction with the standardized handoff tool. The primary measures were the percentage of handoffs with omissions as reported on the post-intervention surveys. A quantitative analysis of post-intervention survey responses was performed using descriptive statistical analyses. The frequency of reported handoffs with omissions and the associated method of handoff were obtained from the post-intervention survey responses using a tick and tally method. RESULTS: The I-PASS handoff tool post-educational feedback survey results were as follows (1) 100% of the nursing staff either strongly agreed or agreed that they were confident in their ability to give an organized and concise handoff report; (2) 84% of respondents agreed or strongly agreed that the I-PASS tool could be beneficial in increasing patient safety on the unit (3) 83% of nursing staff either agreed or strongly agreed that utilizing the handoff tool could be beneficial in keeping report on topic; (4) 100% of respondents either agreed or strongly agreed that they liked the idea of using an I-PASS tool that is linked to the patients EMR; and (5) 100% of respondents agreed that I-PASS could be a beneficial tool for relaying patient handoffs and that SBAR would be a good way to communicate patient status changes. DISCUSSION: The purpose of this QI project was to minimize the risk of adverse patient outcomes caused by inadequate communication. Due to conflicting priorities, the outcomes of this QI project deviated from the previously outlined aims. The updated aim of the final project was to provide staff education related to the I-PASS tool while obtaining feedback from the nursing staff on their perceptions of usefulness of integration into practice. The key finding of this project was that the staff nurses agree that I-PASS could be useful in several ways if integrated into practice

What does not happen: quantifying embodied engagement using NIMI and self-adaptors

Previous research into the quantification of embodied intellectual and emotional engagement using non-verbal movement parameters has not yielded consistent results across different studies. Our research introduces NIMI (Non-Instrumental Movement Inhibition) as an alternative parameter. We propose that the absence of certain types of possible movements can be a more holistic proxy for cognitive engagement with media (in seated persons) than searching for the presence of other movements. Rather than analyzing total movement as an indicator of engagement, our research team distinguishes between instrumental movements (i.e. physical movement serving a direct purpose in the given situation) and non-instrumental movements, and investigates them in the context of the narrative rhythm of the stimulus. We demonstrate that NIMI occurs by showing viewers’ movement levels entrained (i.e. synchronised) to the repeating narrative rhythm of a timed computer-presented quiz. Finally, we discuss the role of objective metrics of engagement in future context-aware analysis of human behaviour in audience research, interactive media and responsive system and interface design

A time series feature of variability to detect two types of boredom from motion capture of the head and shoulders

Boredom and disengagement metrics are crucial to the correctly timed implementation of adaptive interventions in interactive systems. psychological research suggests that boredom (which other HCI teams have been able to partially quantify with pressure-sensing chair mats) is actually a composite: lethargy and restlessness. Here we present an innovative approach to the measurement and recognition of these two kinds of boredom, based on motion capture and video analysis of changes in head and shoulder positions. Discrete, three-minute, computer-presented stimuli (games, quizzes, films and music) covering a spectrum from engaging to boring/disengaging were used to elicit changes in cognitive/emotional states in seated, healthy volunteers. Interaction with the stimuli occurred with a handheld trackball instead of a mouse, so movements were assumed to be non-instrumental. Our results include a feature (standard deviation of windowed ranges) that may be more specific to boredom than mean speed of head movement, and that could be implemented in computer vision algorithms for disengagement detection

Using a Class-Wide, Semester-Long Project to Teach Software Engineering Principles

A senior-level, project-based Software Engineeringcourse taught at the University of Central Arkansas serves asthe capstone course for the Computer Science Program andintroduces students to the theory, tools, and techniques used tobuild large-scale software systems in a project-driven setting.Foundational to the course is the use of a class-wide, semesterlongcourse project to emphasize the theoretical aspects of thesoftware process and the system used for scoring studentperformance on the project. One project is selected for theentire class with students divided into teams of four to sixstudents to support different functional requirement areas. Amilestone-driven approach is used following a modifiedversion of the Unified Process for project development.Student scores on the project are divided into a group score,assignable via a rubric-like grade sheet, and an individualscore which is determined by the individual’s effort asassigned using the task-management tool, Issue-Tracker.Experiences gained and lessons learned in teaching the courseare provided as a guide for those wishing to follow a similarapproach to teaching Software Engineering in the future

Historical reasons for the focus on broad monetary aggregates in post-World War II Britain and the ‘Seven Years War’ with the IMF

The British monetary authorities have traditionally focused on broader monetary aggregates than their counterparts elsewhere. The reasons include: the willingness of UK banks to allow customers to make payments by drawing on time deposits, the particularities of the UK approach to managing the national debt and the foreign exchange reserves, and the flow-of-funds system of national accounts developed after World War II. This article outlines these reasons, and explores the implications for the UK's often fractious relationship with the International Monetary Fund during the 1950s and 1960s. It explains why IMF conditionality on loans to the UK focused on broad aggregates

Relationship between performance competence and cardiorespiratory fitness in contemporary dance

This is an accepted manuscript of an article published by Science & Medicine, Inc. in Medical Problems of Performing Artists on 01/06/2019, available online: https://doi.org/10.21091/mppa.2019.2014 The accepted version of the publication may differ from the final published version.© 2019 Science & Medicine. Aims: While a foundation of basic cardiorespiratory fitness is beneficial for coping with the physiological demands of dance training and performance, the extent to which cardiorespiratory fitness levels are related to performance ability is not all-together clear. This study aimed to directly compare aerobic capacity (VO2peak) and anaerobic threshold (AT) to an aesthetic competence measure (ACM) in student contemporary dancers. Methods: Participants were 18 contemporary dance students and all undertook a one-off treadmill test to volitional exhaustion in the week leading up to a performance to determine VO2peak and AT. In the same week, a final rehearsal for the performance was filmed to allow retrospective analysis of specific performance competence. Results: Mean VO2peak values of 47.67 ± 5.84 ml/kg/min and AT values of 43.18 ± 7.72 ml/kg/min (90.68 ± 11.87 %VO2peak) were recorded, and the mean total ACM score was 52.67 ± 8.74. No significant correlations were found between cardiorespiratory fitness variables and ACM scores. Regression analyses revealed experience level to be the only significant predictor of total ACM score (p<0.05, R2=0.12, SEE=11.91). Conclusions: The range of choreography used for assessment may limit the present study; nevertheless, as level of experience did significantly predict ACM total score, it is suggested that vocational dance training may be developing the performance and technical skills of students but not sufficiently developing their physical conditioning.Published versio

The Respiratory Form of Pseudorabies in Pigs

Diagnosis of respiratory diseases among growing and finishing swine has become a challenge for food animal practitioners. The incidence and severity of respiratory disease has increased with confinement raising of hogs. Pseudorabies (Aujeszky\u27s Disease. mad itch) caused by Herpesvirus suis. can affect pigs. dogs. cats, cattle, sheep, and goats. There have been no confirmed cases of pseudorabies in horses. Although invariably fatal in other species, pseudorabies virus infection in swine can cause a variety of clinical syndromes characterized by respiratory signs, central nervous system (CNS) symptoms, and reproductive failure. These syndromes vary according to route of infection, viral strain, immune status of the animal and most importantly, age of the pig at the time of infection

Model-based spacecraft and mission design for the evaluation of technology

In order to meet the future vision of robotic missions, engineers will face intricate mission concepts, new operational approaches, and technologies that have yet to be developed. The concept of smaller, model driven projects helps this transition by including life-cycle cost as part of the decision making process. For example, since planetary exploration missions have cost ceilings and short development periods, heritage flight hardware is utilized. However, conceptual designs that rely solely on heritage technology will result in estimates that may not be truly representative of the actual mission being designed and built. The Laboratory for Spacecraft and Mission Design (LSMD) at the California Institute of Technology is developing integrated concurrent models for mass and cost estimations. The purpose of this project is to quantify the infusion of specific technologies where the data would be useful in guiding technology developments leading up to a mission. This paper introduces the design-to-cost model to determine the implications of various technologies on the spacecraft system in a collaborative engineering environment. In addition, comparisons of the benefits of new or advanced technologies for future deep space missions are examined