The effect of Touchpoints™ Model training on staff and reliablity of instrument tool

The purpose of this study is to determine if the Touchpoints™ training provided in a large, tertiary medical center in the Southwest region of the United States will result in more effective pediatric care and will increase nurse job satisfaction and intention rate. Informed consent for the survey was implied when the study participants voluntarily completed the survey and submitted it. The demographic and pre-training survey tools were given to consenting participants for completion. The immediate posttraining survey tools were then given to the participants on the same day as the training was completed. At Six months and one year follow-up survey tools were mailed to the participants. In data analyses for Touchpoints™ and subscales training effects; two-way ANOVA were performed, ICC applied to evaluate for Touchpoints™, subscales, and item reliabilities. McNemar’s test was applied for job satisfaction and intention rates. Kappa statistics applied for job satisfaction and intention reliabilities. Paired t test was applied for ethnicity and education level compared by pre and after training surveys. Results are, Touchpoints™ and recognizing the parent as expert for their child training effects may be retained up to six months after training but understanding of parent-child relationship was retained only for short term. The reliabilities for Touchpoints™, understanding of parent-child relationship were substantially consistent and recognizing parent as expert for their child was moderately consistent. The changes in job satisfaction and intention rates were not significant and these reliabilities were substantially consistent. Training effects were not significantly different between ethnic groups. “White” and “Other minority” ethnic groups demonstrated a significant training effect based on before and after training. Similarly, the training effects were not significantly different between education levels. “Associate degree/diploma”,”BSN/BS” and “Other Education” the participants displayed a significant Touchpoints™ training effect based on before and after training. Each item’s reliabilities exhibit between substantial or moderate agreement based on pre and immediate post training surveys except question 18, 30, 31 and these items show poor reliabilities

Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative

BACKGROUND: Despite cardiac rehabilitation (CR) being shown to improve health outcomes among patients with heart disease, its use has been suboptimal. In response, the Million Hearts Cardiac Rehabilitation Collaborative developed a road map to improve CR use, including increasing participation rates to ≥70% by 2022. This observational study provides current estimates to measure progress and identifies the populations and regions most at risk for CR service underutilization. METHODS AND RESULTS: We identified Medicare fee-for-service beneficiaries who were CR eligible in 2016, and assessed CR participation (≥1 CR session attended), timely initiation (participation within 21 days of event), and completion (≥36 sessions attended) through 2017. Measures were assessed overall, by beneficiary characteristics and geography, and by primary CR-qualifying event type (acute myocardial infarction hospitalization; coronary artery bypass surgery; heart valve repair/replacement; percutaneous coronary intervention; or heart/heart-lung transplant). Among 366 103 CR-eligible beneficiaries, 89 327 (24.4%) participated in CR, of whom 24.3% initiated within 21 days and 26.9% completed CR. Eligibility was highest in the East South Central Census Division (14.8 per 1000). Participation decreased with increasing age, was lower among women (18.9%) compared with men (28.6%; adjusted prevalence ratio: 0.91 [95% CI, 0.90-0.93]) was lower among Hispanics (13.2%) and non-Hispanic blacks (13.6%) compared with non-Hispanic whites (25.8%; adjusted prevalence ratio: 0.63 [0.61-0.66] and 0.70 [0.67-0.72], respectively), and varied by hospital referral region and Census Division (range: 18.6% [East South Central] to 39.1% [West North Central]) and by qualifying event type (range: 7.1% [acute myocardial infarction without procedure] to 55.3% [coronary artery bypass surgery only]). Timely initiation varied by geography and qualifying event type; completion varied by geography. CONCLUSIONS: Only 1 in 4 CR-eligible Medicare beneficiaries participated in CR and marked disparities were observed. Reinforcement of current effective strategies and development of new strategies will be critical to address the noted disparities and achieve the 70% participation goal