Elder Abuse Screening Education for Emergency Department Nurses: An education intervention

Executive Summary Elder Abuse Screening and Identification for Emergency Department Nurses The Elder Abuse Screening and Identification for Emergency Department Nurses was an educational intervention. The education and training module was intended to improve the, skills and attitudes of emergency department nurses. The goal was to improve future screening and identification of elder patients presenting to the department for a healthcare encounter who may be victims of elder abuse. Problem The problem being addressed is a clinical practice issue that has multi-faceted contributing factors. Clinical practitioners receive little to no education and training on the topic of elder abuse, with exception of the fact that as licensed professionals mandated reporting is a known requirement. A knowledge deficit of emergency room nurses’ knowledge on elder abuse identification, screening, reporting and referral had been identified as an area for advancing education. Elder abuse is identified in one out of fourteen cases annually. The nursing and clinical literature is severely lacking in information of the clinical manifestations of elder abuse that can clearly be differentiated from age related changes and co-morbidities. The underreporting of elder abuse cases identified in healthcare settings, can be improved with by advancing knowledge, skills and attitudes of healthcare professionals. Emergency department nurses are key to improving identification and improved care and discharge planning as they are first responders, first line triage and are instrumental to establishing the care plan and process for patients presenting for a care encounter. Purpose The purpose of this evidence-based practice project was to improve the clinical identification by emergency department nurses in elder abuse identification by increasing the knowledge, skills and attitudes through the completion of an educational program authored by this forensic nurse specialist, DNP candidate. This project was a quality improvement initiative. Goal The goal was to design an educational intervention that focused and emphasized the clinical manifestations of elder abuse to improve the care of seniors presenting to the emergency department. The construct of the curriculum presented in the intervention addressed the three themes critical to understanding the scope, physiologic manifestations and the procedural aspects of care for a victim of elder abuse. increasing the knowledge and skill of the nurses in the identification and screening for elder abuse that may present as a symptom of a medical diagnosis, a co-morbid condition or as symptoms commonly associated with the aging process. Objectives The objectives of this project included: 1) Identify the demographics and descriptive profile of the emergency department nurses participating in the study. 2) Identify the emergency department nurses’ knowledge on clinical identification of elder abuse and associated response, referral, reporting and documentation and 3) Evaluate the effectiveness of the elder abuse educational module used in the project. Plan Identifying the change in knowledge of emergency department nurses on the topic of clinical identification of elder abuse prior to and immediately following completion of an educational intervention was planned. The content development and delivery of the education was disseminated via the on-line learning technology platform used by the hospital where the intervention took place. The project consisted of collecting demographic (descriptive of the project participants), followed by a pre-test on knowledge of elder abuse. The one-hour educational program to emergency department nurses aimed at increasing their knowledge on clinical identification of elder abuse was given and followed by a post-test survey. The effectiveness of the educational intervention was measured by using a pre-and post-test survey score difference analysis. Outcomes and Results The objectives of the project were met. Objective one achieved a descriptive profile of the nurses that participated in the intervention. Objective two and three were met and showed at the pretest that the knowledge level to be below the benchmark of 80% or 12 correct responses. The aggregate mean score of the pretest (M= 9.11, SD= 2.21) were below the 80% benchmark. The post- test aggregate mean scores met and slightly exceeded the benchmark (M= 12.53, SD 1.59). The mean scores on the post-test showed improved knowledge of the content as the result of the intervention. A statistically significant improvement in mean knowledge scores was noted in the post-intervention assessment, suggesting that the educational intervention was successful in increasing nurses’ knowledge on the topic

Metal Oxide Semiconductors for Solar Energy Harvesting

The correlation between energy consumption and human development illustrates the importance of this societal resource. We will consume more energy in the future. In light of issues with the status quo, such as climate change, long-term supply and security, solar energy is an attractive source. It is plentiful, virtually inexhaustible, and can provide more than enough energy to power society. However, the issue with producing electricity and fuels from solar energy is that it is expensive, primarily from the materials: silicon) used in building the cells. Metal oxide semiconductors are an attractive class of materials that are extremely low cost and can be produced at the scale needed to meet widespread demand. An industrially attractive thin film synthesis process based on aerosol deposition was developed that relies on self-assembly to afford rational control over critical materials parameters such as film morphology and nanostructure. The film morphology and nanostructure were found to have dramatic effects on the performance of TiO2-based photovoltaic dye-sensitized solar cells. Taking a cue from nature, to overcome the spatial and temporal mismatch between the supply of sunlight and demand for energy consumption, it is desirable to produce solar fuels such as hydrogen from photoelectrochemical water splitting. The source of water is important -- seawater is attractive. The fundamental reaction mechanism for TiO2-based cells is discussed in the context of seawater splitting. There are two primary issues with producing hydrogen by photoelectrochemical water splitting using metal-oxide semiconductors: visible light activity and spontaneous activity. To address the light absorption issue, a combined theory-experiment approach was taken to understand the fundamental role of chemical composition in determining the visible light absorption properties of mixed metal-oxide semiconductors. To address the spontaneous activity issue, self-biasing all oxide p/n bulk-heterojunctions were synthesized and the nanostructure was systematically varied to understand the fundamental role of various characteristic length scales in the nanostructured region of the device on performance. The conclusion of this work is that solar energy harvesting by metal oxide semiconductors is highly promising. All of the scientific concepts have been proven, and steady gains in efficiency are being achieved as researchers continue to tackle the problem

Visualizing current flow at the mesoscale in disordered assemblies of touching semiconductor nanocrystals

The transport of electrons through assemblies of nanocrystals is important for the performance of these materials in optoelectronic applications. The transport of electrons has primarily been studied by focusing on single nanocrystals or transitions between pairs of nanocrystals. There is a gap in knowledge of how large numbers of nanocrystals in an assembly behave collectively, and how this collective behavior manifests at the mesoscale. In this work, the transport of electrons in assemblies of touching, heavily doped ZnO nanocrystals was visualized as a function of temperature at the mesoscale theoretically using the model of Skinner, Chen and Shklovskii (SCS); and experimentally by conductive atomic force microscopy on ultrathin films only a few particle layers thick. Agreement was obtained between the model and experiments, with a few notable exceptions. The SCS model predicts that a single network within the nanocrystal assembly, comprised of sites connected by small resistances, dominates conduction - namely the well-known optimum band from variable range hopping theory. However, our experiments revealed that in addition to the optimum band, there are subnetworks that appear as additional peaks in the resistance histogram; which were not observed in the model calculations. Furthermore, the connections of these subnetworks to the optimum band changes in time. As time proceeds, some isolated subnetworks become connected to the optimum band; while some of the connected subnetworks become disconnected and then isolated from the optimum band. The subset of nanocrystals comprising the optimum band is dynamic

Corporations are Not People: Dissensual Democracy and the Movement Against Corporate Rights

This dissertation describes the way that the movement against corporate rights employs democratic ideals and media technologies to present itself as "the people" who have a more legitimate claim to sovereignty than corporations. The movement's use of rhetoric and technology demonstrate that democratic ideals do not necessarily represent actual democratic processes, but enacting them is still an effective way to produce a sense that a democratic event is occurring. Although different branches of the movement advocate different goals and use different rhetorical and technological strategies, they use similar techniques to demonstrate shared participation in the overall movement. These core shared techniques indicate that scholarship on democratic movements and their political issues has the opportunity to increase its effectiveness and relevance by integrating insights about how to produce dissensus based on studying movement techniques. Additionally, the history of the legal theoretical rhetoric of corporate rights relies on a sharp distinction between organic and technological collectives that shapes how the movement is able to selectively critique and enact democratic doxai.Doctor of Philosoph

Alternate Fuels Demonstration Project

This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu

Evidence Collection for the Unconscious and Unconsented Patient

Forensic nurses are faced with making an ethical decision when an unconscious patient presents with signs of sexual assault. If the patient is unable to consent, the nurses need to decide whether or not to perform a forensic exam. Hospitals have policies in place regarding consent for emergency care, but not all of them consider the collection of forensic evidence. The window of opportunity for forensic collection may disappear before contacts are made or proper consent is established.\ud Ethical, legal, and policy considerations that complicate this scenario are discussed