Can Empowered Nurses Decrease Catheter Associated Urinary Tract Infection (CAUTI) Rates?

Nurses lack knowledge about the use and importance of a nurse-driven urinary catheter removal protocol, an evidence-based tool empowering them to remove urinary catheters that are no longer needed or are inappropriate based on set criteria, without calling a physician. (Health Care Infection Control Practice Advisory Committee (HIPAC), 2009) Despite this autonomy, catheter-associated urinary tract infections (CAUTI) are one of the leading hospital-acquired infections in many institutions (Centers for Disease Control and Prevention [CDC], 2015). A quasi-experimental pre post intervention in a medical-surgical telemetry floor of an acute hospital in North Carolina showed a statistically significant increase in knowledge among nurses after an educational intervention on the importance and use of a nurse-driven urinary catheter removal protocol. Pretest. (N=27) mean score 8.41 (SD=. 797) and posttest (n=24) mean score 9.75 (SD=. 442). (T =7. 125, p =. 001) CI: -17.20, 9.462 with a p value set @ = 0.05. No direct link was noted between knowledge and CAUTI, However, the unit maintained a zero CAUTI rate three months after the intervention which is clinically meaningful. The main limitation of the study was the small sample size and the low CAUTI rates prior to the intervention. The main implication of the study, however, speaks volumes: Nurses, empowered with education and motivated with new awareness and guided by an evidence-based, nurse-driven protocol, may be the key in fighting high CAUTI rates, which makes them an asset in today’s value-based health care market

Sustaining School Colleagues’ Commitment to a Long-term Professional Experience Partnership

This paper presents findings from a qualitative study that investigated school participants’ perceptions of the benefits, challenges and supportive factors related to their involvement in a long-term school/university professional experience partnership. Data were collected through interviews with coordinators and a written survey completed by mentor teachers from 4 schools. The findings indicate that participants perceived the program to have a number of benefits for both staff and school students and that participation was supported by effective communication, flexible funding arrangements, local autonomy to interpret and adapt the program and the continuity arising from the long-term nature of the partnership. The benefits and supportive factors appear to have compensated for challenges such as organisational demands, negotiating university expectations and stresses on workload, time, space and resources. The discussion focuses on features that appear to have contributed to the sustainability of the partnership over many years

Are They Ready? Final Year Pre-service Teachers\u27 Learning about Managing Student Behaviour

This paper presents findings from a study addressing final year pre-service teachers’ perceptions of their confidence and competence in managing student behaviour. Data were collected by means of a written survey administered shortly after the end of their last professional experience. Themes derived from analysing survey responses are examined in relation to seven principles identified by the MCEETYA funded Student Behaviour Management Project as best practice in Australia (De Jong, 2005). The findings reveal that although the majority of participating pre-service teachers felt confident and competent to manage student behaviour, their reporting of strategies indicated a narrow ‘behaviourist’ conception of management that may limit their chances of successfully responding to more complex challenges as beginning teachers – challenges such as responding to the diversity of student backgrounds and behaviours, engaging all learners and working with a range of stake-holders

Telehealth Case Management Nursing Process and Technology Enhancements: Reflecting Practice and Outcomes

Accurate reflection of care practices in telehealth care management is the fore runner to the delivery of reportable beneficiary outcomes. Success in delivering Geriatric Care Services (GCS) resides in a partnership between clinician practice and technology tools utilized in telehealth practice. Through in home technologies, telehealth can provide ongoing care needs to underserved populations, and it can support independent aging of beneficiaries who live with chronic care conditions. Tele-health care management, performed through a health plan, presents a unique opportunity to capitalize on the abundance of health data collected on a patient, and maximize the use of that information for clinical decision support. Nursing informatics is the facilitator of telenursing. It is the specialty that integrates and applies nursing science, and respective theoretical models, in identifying, collecting, processing, and managing data. It furthers seeks to process that data to formulate knowledge based decisions and informed care plan actions. Maximizing technology and available data are primary tools a telehealth clinician uses in care management practice. It is imperative that the technology system utilized in practice supports the telehealth interaction by accurately and effectively reflecting the clinician’s practice through data inputs, collection methods, and interpretation logic. This Doctorate of Nursing Practice (DNP) systems change project examined existing telehealth care practice and available technology tools. The project explored options for practice and process improvements in identification and formulation of cases and the development of new clinical technology tools to support the practice. Further, this project implemented practice change to support the organization’s strategic plan to provide efficient and effective GCS case management to our client. In summary, this project produced new clinical technology tools to reflect telehealth practice, gave a voice to telehealth case managers in the technology development cycle, and established a measurement framework for organizational reporting on case management outcomes

Evaluating the Cephalonia method of library induction

This is a PDF version of an article published in SCONUL Focus© 2007. SCONUL Focus is available online at http://www.sconul.ac.uk/publications/newsletterThis article discusses the results of a survey carried out at the University of Chester library into student feedback of the Cephalonia method of library induction

Characterizing object- and position-dependent response profiles to uni- and bilateral stimulus configurations in human higher visual cortex:a 7T fMRI study

Visual scenes are initially processed via segregated neural pathways dedicated to either of the two visual hemifields. Although higher-order visual areas are generally believed to utilize invariant object representations (abstracted away from features such as stimulus position), recent findings suggest they retain more spatial information than previously thought. Here, we assessed the nature of such higher-order object representations in human cortex using high-resolution fMRI at 7T, supported by corroborative 3T data. We show that multi-voxel activation patterns in both the contra- and ipsilateral hemisphere can be exploited to successfully classify the object category of unilaterally presented stimuli. Moreover, robustly identified rank order-based response profiles demonstrated a strong contralateral bias which frequently outweighed object category preferences. Finally, we contrasted different combinatorial operations to predict the responses during bilateral stimulation conditions based on responses to their constituent unilateral elements. Results favored a max operation predominantly reflecting the contralateral stimuli. The current findings extend previous work by showing that configuration-dependent modulations in higher-order visual cortex responses as observed in single unit activity have a counterpart in human neural population coding. They furthermore corroborate the emerging view that position coding is a fundamental functional characteristic of ventral visual stream processing

Identification and characterisation of new interaction partners of the lysosomal integral membrane protein type-2 (LIMP-2/SCARB2)

Das lysosomale integrale Membranprotein Typ-2 (LIMP-2/SCARB2) ist wichtig für den Transport der lysosomalen Hydrolase beta-Glukocerebrosidase vom Endoplasmatischen Retikulum ins lysosomale Kompartiment. In dieser Arbeit konnten Interaktionspartner von LIMP-2 identifiziert und charakterisiert werden, die in Zukunft die noch unbekannte Funktion von LIMP-2 in Lysosomen identifizieren können.The lysosomal integral membrane protein type-2 (LIMP-2/ SCARB2) is important for the transport of the lysosomal hydrolase beta-glucocerebrosidase from the endoplasmic reticulum to the lysosomal compartment. In this work interaction partner of LIMP-2 could be identified and characterized that could next to others clarify still unknown functions of LIMP-2 in lysosomes in future

Accuracy of 1,2-o-Dilauryl-rac-glycero-3-glutaric Acid-(6'-methylresorufin) Ester (DGGR)-Lipase to Predict Canine Pancreas-Specific Lipase (cPL) and Diagnostic Accuracy of Both Tests for Canine Acute Pancreatitis.

Different lipase assays have variable reported diagnostic accuracies for acute pancreatitis (AP) in dogs. The aims of this retrospective study were to evaluate optimal cutoffs for 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR)-lipase to predict diagnostic cutoffs of canine pancreas-specific lipase (cPL; IDEXX). DGGR-lipase activity and cPL from the same blood draw in 301 dogs with a variety of diseases were compared using Spearman's rank correlation, Cohen's kappa agreement, and receiver operating characteristic (ROC) curves. Activity of DGGR-lipase (10-15,616 U/L) and cPL concentrations (8.1-≥2000 µg/L) were highly correlated (rs = 0.91). Areas under the ROC curves (AUCs) to predict cPL >200 and ≥400 µg/L with DGGR-lipase were 0.97 and 0.99, with optimal cutoffs of 143 U/L (sensitivity (Se) 91.7%; specificity (Sp) 95.3%) and 205 U/L (Se 97.5%; Sp 96.4%), and Cohen's kappa agreements of 0.87 and 0.92, respectively. AUCs for a clinical diagnosis of AP, assigned to 87/301 dogs, with DGGR-lipase (0.75) and cPL (0.76) did not differ significantly (p = 0.48); optimal cutoffs were 161 U/L for DGGR (Se 67%; Sp 81%) and 235 µg/L for cPL (Se 68%; Sp 84%). To conclude, DGGR-lipase is a highly accurate predictor of cPL with a comparable performance when used to diagnose AP in dogs