2,893 research outputs found

    Gravestone Carvers of Early Ontario

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    B_s Mixing Via ψ K*

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    The decay mode Bs à ψ K*is suggested as a very good way to measure the Bs mixing parameter xs. These decays can be gathered using a ψ → ℓ+ℓ− trigger. This final state has a well resolved four track decay vertex, useful for good time resolution and background rejection

    Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

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    BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. PURPOSE: The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). METHODOLOGY/APPROACH: A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. FINDINGS: Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. PRACTICE IMPLICATIONS: Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality

    Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study.

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    Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program characteristics (ie, frequency of infection control committee meetings and the presence of 7 antibiotic stewardship policies). Responses were linked to concurrent Certification and Survey Provider Enhanced Reporting data, which contain information about NH facility characteristics and citations. Descriptive statistics and multivariable regression analyses were conducted to account for NH characteristics. Surveys were received from 990 NHs; 922 had complete data. One-third of NHs in this sample received an infection control deficiency citation. The NHs that received deficiency citations were more likely to have committees that met weekly/monthly versus quarterly ( P \u3c .01). The IPs in 39% of facilities had received specialized training. Less than 3% of trained IPs were certified in infection control. The NHs with trained IPs were more likely to have 5 of the 7 components of antibiotic stewardship in place (all P \u3c .05). The IP training, although infrequent, was associated with the presence of antibiotic stewardship policies. Receiving an infection control citation was associated with more frequent infection control committee meetings. Training and support of IPs is needed to ensure infection control and antibiotic stewardship in NHs. As the CMS rule becomes implemented, more research is warranted. There is a need for increase in trained IPs in US NHs. These data can be used to evaluate the effectiveness of the CMS final rule on infection management processes in US NHs

    Increasing Nurse Manager Knowledge of Authentic Leadership

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    AbstractResearch has demonstrated a positive correlation between authentic leadership and positive patient and organizational outcomes. Given that nurses can be educated in authentic leadership, providing nurse leaders with training opportunities will help them develop authentic leadership skills which will benefit patients and the organization. At the project site, there is little opportunity for leadership development among nurse leaders. Thus, the purpose of this DNP project was to determine if an educational intervention focused on authentic leadership increase knowledge and awareness among nurse managers. Authentic leadership theory grounded the DNP project. Twenty-three nurse managers were invited to participate in an educational intervention, and 20 individuals participated for an 87% response rate. The mean pretest score for knowledge was 7.45 (SD = 1.76); the mean posttest score was 8.75 (SD = 1.29). Using a Wilcoxon signed rank test to estimate the data, there was a statistically significant difference in pretest and posttest scores (z = –3.14, p \u3c 0.01), indicating an increase in knowledge. Participants were also asked to assess their awareness of authentic leadership using a Likert scale between 1 and 7, with 1 = No awareness at all and 7 = Full awareness. The mean pretest self-assessment score was 3.65 (SD = 1.50), and the mean posttest self-awareness score was 5.85 (SD = 1.09). Using a Wilcoxon signed rank test to estimate the data, there was a statistically significant difference in pretest awareness and posttest awareness (z = –3.78, p \u3c 0.001), indicating an increase in awareness. This project contributes to positive social change by improving leadership skills among nurse managers, which can lead to improved patient and organizational outcomes

    A method to implement fine-grained access control for personal health records through standard relational database queries

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    AbstractOnline personal health records (PHRs) enable patients to access, manage, and share certain of their own health information electronically. This capability creates the need for precise access-controls mechanisms that restrict the sharing of data to that intended by the patient. The authors describe the design and implementation of an access-control mechanism for PHR repositories that is modeled on the eXtensible Access Control Markup Language (XACML) standard, but intended to reduce the cognitive and computational complexity of XACML. The authors implemented the mechanism entirely in a relational database system using ANSI-standard SQL statements. Based on a set of access-control rules encoded as relational table rows, the mechanism determines via a single SQL query whether a user who accesses patient data from a specific application is authorized to perform a requested operation on a specified data object. Testing of this query on a moderately large database has demonstrated execution times consistently below 100ms. The authors include the details of the implementation, including algorithms, examples, and a test database as Supplementary materials
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