Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed. Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care outcomes. Methods: Patient perceptions of care and staff perceptions of teamwork were assessed pre-and post-intervention for the effects of implementing structured team communication in a nurse practitioner (NP) medical management model. Responses were collected with the NRC Health Patient Experience Survey and the AHRQ TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ). Patient experience scores for the NP-led unit, a resident-led unit, and a physician-assistant led unit were compared. Interventions: Implementation of an NP-Led Care Pod model was evaluated over three months. An education session on structured communication tools prepared NP-Led Care Pod teams in role-based purposeful rounds, bedside shift reports, structured bedside interdisciplinary team rounds, and TeamSTEPPScommunication strategies. Results: Teamwork perception scores post-education and post-implementation fell short of the aim for a 10% increase from baseline. Patient experience survey scores increased 71.6% from baseline at two months for care team explanations, 128% for listening carefully, and 71.6% for perceived staff communication. Although not sustained, all scores were 14% higher than baseline. Team members reported increased team support, inclusion, and role satisfaction. Patients asked fewer questions about their care plans. Conclusion: The NP-Led Care Pods contributed to evidence on the effectiveness of NP-led, team-based care, with implications for nursing leadership and team communication. The NP-Led Care Pod environment improved workflow, team dynamics, and staff communication. Further studies may benefit from using measures to capture improvement in patient safety and patient experience domains that were not addressed in this project. Keywords: acute care nursing, bedside handoff, collaboration, communication, interprofessional, patient-centered care, purposeful rounding, team perceptions, TeamSTEPPS

U.S.-CANADIAN DAIRY TRADE TENSIONS: THE NATURE AND EFFECTS OF CANADIAN DAIRY POLICY

Agricultural and Food Policy, International Relations/Trade,

The Conflict Between Trade Policy and Environmental Policy in Agriculture

Environmental Economics and Policy, International Relations/Trade,

Le surgissement du terme « africain » pendant la révolution de Saint-Domingue

Deux constats sont à l’origine de cet article : le sens attribué dans la vie courante en Haïti aux termes « nègre », « africain » et « citoyen », ensuite la distinction entre citoyens et Africains observée dans certains textes relatifs à l’abolition de l’esclavage en 1793 et 1794. L’auteur relève l’usage du vocable africain par les acteurs qui ont dominé la scène politique sous la révolution haïtienne. Il démontre que leur emploi de ce terme soulève un problème important, relatif au statut social, à l’identité et à la nationalité, pas seulement des anciens esclaves, mais de tous les indigènes. Les chefs mulâtres ne revendiquent aucune origine africaine et désignent les cultivateurs sous le vocable « africain », considéré comme infamant. Les leaders noirs se taisent sur leur origine africaine et sont aussi impitoyables que les chefs mulâtres envers les cultivateurs. Ces dirigeants perpétuent une image négative de l’Africain. Le courant indigéniste a essayé, au début du XXe siècle, de réhabiliter l’image de l’Africain aux yeux de l’Haïtien, mais sa reconstruction de l’histoire n’est pas scientifique, car il est impossible de faire des leaders noirs de la révolution des représentants des cultivateurs.Two moments lie at the genesis of this article: the sense in the current Haitian vernacular attributed to the terms “Negro,” “African,” and “Citizen,” as well as the distinction between “Citizens” and “Africans” observed in certain texts relevant to the abolition of slavery in 1793 and 1794. The author reviews the use of the word African by the actors dominating the political scene during the Haitian Revolution. He shows how their use of this term raises an important issue of identity and nationality, relevant for social status not only for former slaves but for all the native-born. Mulatto chiefs claimed no African origins and relegated the term “African” for farmers, meant in a defamatory way. Black leaders kept their African origin quiet and were as ruthless as the mulatto chiefs against the farmers. These elites perpetuated a negative image of the African. Current nativist thought has tried, since the beginning of the twentieth century, to rehabilitate the image of the African in the eyes of the Haitian, but its revision of history is not scientific, as it is impossible to make the black leaders of the revolution the representatives of the farmers

NAACP Sends Bid to Both Candidates

https://egrove.olemiss.edu/citizens_clip/1017/thumbnail.jp

Development of Motor Networks in Zebrafish Embryos

General mechanisms of motor network development have often been examined in the spinal cord because of its relative simplicity when compared to higher parts of the brain. Indeed, most of our current understanding of motor pattern generation comes from work in the lower vertebrate spinal cord. Nevertheless, very little is known about the initial stages of motor network formation and the interplay between genes and electrical activity. Recent research has led to the establishment of the zebrafish as a key model system to study the genetics of neural development. The spinal cord of zebrafish is amenable to optical and electrophysiological analysis of neuronal activity even at the earliest embryonic stages when the network is immature. The combination of physiology and genetics in the same animal model should lead to insights into the basic mechanisms of motor circuit formation. This paper reviews recent work on the development of zebrafish motor activity and discusses them in the context of the current knowledge of embryonic and larval zebrafish spinal cord morphology and physiology.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63184/1/zeb.2006.3.173.pd

NAACP Sends Bid to Both Candidates

https://egrove.olemiss.edu/citizens_clip/1095/thumbnail.jp

Teacher Perceptions of Social Emotional Learning Supports in Freshman Academy

Ninth grade year is the most important challenging year of high school. Many students struggle adjusting to the transition to high school. If supports are not in place, many ninth-grade students are at-risk of dropping out of school. The purpose of this study was to identify and examine the social emotional learning supports in Freshman Academy that assist in the transition to High School. A qualitative investigation was conducted to explore these social emotional supports. This study used a phenomenological methodology, enabling the researcher to gather information from a purposeful selection of educators directly identified by their Academy Principals. This study employed processes of data collection that included the use of individual interviews found in qualitative design. Analysis of data happened in several steps: (a) transcribing all interviews that were recorded, (b) coding, (c) examining the themes of the codes, and (d) relating the themes to the research questions. The credibility of the analysis was supported by triangulation, member checks, and thick descriptions. The results revealed that seven themes emerged as identified supports which included: (a) Freshman Seminar programming, (b) personnel supports to include Dean of Students and the School Counselor, (c) Restorative Practices programming, (d) building relationships with students, (e)advisory, (f) informal SEL practices, and (g) teaming. Based on the research the following conclusions were presented: (a) schools use restorative practices as a means to provide SEL, (b) relationship building is a central focus, (c) and the Freshman Seminar course and content provide meaningful social emotional learning experiences

Evidence for Forcing-Dependent Steady States in a Turbulent Swirling Flow

We study the influence on steady turbulent states of the forcing in a von Karman flow, at constant impeller speed, or at constant torque. We find that the different forcing conditions change the nature of the stability of the steady states and reveal dynamical regimes that bear similarities to low-dimensional systems. We suggest that this forcing dependence may be applicable to other turbulent systems