Children's Health: Evaluating the Impact of Digital Technology. Final Report for Sunderland City Council.

EXECUTIVE SUMMARY The Children’s Health project sponsored by the City of Sunderland Digital Challenge project examined the impact of providing health-focused digital technologies to children aged 11-15 years, in terms of their usage and requirements of such technologies, and their subsequent behavioural changes. The empirical study ran with three groups of six children over a period of seven weeks for each group. A console-based exercise game and an exercise-focused social website were used in the study and the focus was on opportunistic (unstructured/unplanned) exercise. The emergent findings are: • Data collected about physical activity must be more extensive than simple step counts. • Data collection technologies for activities must be ubiquitous but invisible. • Social interaction via technology is expected; positive messages reinforcing attainments of goals are valued; negative feedback is seen as demotivating. • participants were very open to sharing information (privacy was not a concern). • Authority figures have a significant impact on restricting adolescents’ use of technologies. This document reports the how the study was conducted, analyses the findings and draws conclusions from these regarding how to use digital technologies to improve and/or maintain the physical activity levels of children throughout their adolescence and on into adulthood. The appendices provide the detailed (anonymised) data collected during the study and the background literature review

Eliminating Central Line Infections and Spreading Success at High-Performing Hospitals

Synthesizes lessons in preventing central line-associated bloodstream infections, including the importance of evidence-based protocols, dedicated teams to oversee central line insertions, participation in collaboratives, and monitoring of infection rates

Exercising Sovereignty and Expanding Economic Opportunity Through Tribal Land Management

While the United States faces one of the most significant housing crises in the nation's history, many forget that Indian housing has been in crisis for generations. This report seeks to take some important steps toward a future where safe, affordable, and decent housing is available to Native people in numbers sufficient to meet the housing needs that exist in Indian country today. This study provides first-of-its-kind analysis of a critical barrier to homeownership on Indian lands. It analyzes the success of tribes that have taken responsibility (in whole or in part) for administering the land title process on tribal lands. It also addresses the challenges those tribes have faced. Section 1 outlines the significant obstacles to homeownership strategies for Native communities. In Section 2, the report delves into the experiences of five tribes that are managing aspects of the land title process in their communities. In Section 3, the report details findings from a site visit and in-depth interview at the Bureau of Indian Affairs regional offices in Portland, Oregon and Aberdeen, South Dakota. Finally, Section 4 of the report draws conclusions and makes specific recommendations about the future of land title processing on Indian lands. This report is the culmination of two years of research funded by NeighborWorks America and Stewart Title Company

Park Nicollet Methodist Hospital: Aligning Goals to Achieve Efficiency

Describes strategies to integrate with outpatient clinics and post-discharge treatment programs to minimize hospitalizations, distribute performance data organization-wide, delegate staff, and meet quality and safety standards while controlling costs

Intermountain Healthcare's McKay-Dee Hospital Center: Driving Down Readmissions by Caring for Patients the "Right Way"

Outlines the hospital's strategies for low readmission rates for heart failure and pneumonia, including standardization of care, interdisciplinary care coordination and discharge planning, and integration with community providers, and lessons learned

Critical thinking: A two-phase framework

This article provides a comprehensive review of how a two-phase framework can promote and engage nurses in the concepts of critical thinking. Nurse education is required to integrate critical thinking in their teaching strategies, as it is widely recognised as an important part of student nurses becoming analytical qualified practitioners. The two-phase framework can be incorporated in the classroom using enquiry-based scenarios or used to investigate situations that arise from practice, for reflection, analysis, theorising or to explore issues. This paper proposes a two-phase framework for incorporation in the classroom and practice to promote critical thinking. Phase 1 attempts to make it easier for nurses to organise and expound often complex and abstract ideas that arise when using critical thinking, identify more than one solution to the problem by using a variety of cues to facilitate action. Phase 2 encourages nurses to be accountable and responsible, to justify a decision, be creative and innovative in implementing change

Achieving Efficiency: Lessons From Four Top-Performing Hospitals

Synthesizes lessons from case studies of how four hospitals achieved greater efficiency, including pursuing quality and access, customizing technology, emphasizing communications, standardizing processes, and integrating care, systems, and providers

Creating Opportunities for Personal Empowerment for Adolescent Students in a Rural High School

BACKGROUND: With the incidence of 3% of children and 6% of adolescents diagnosed with depression, treatment appropriate for this population is needed. Provision of mental health care is limited due to barriers of access such as transportation, parental consent, and availability of services in the adolescent’s environment such as the school setting. OBJECTIVES: To decrease the depressive symptoms and increase the self-confidence perceptions of adolescents in a high school setting utilizing a cognitive-behavioral skills enhancing, seven-session intervention called COPE (Creating Opportunities for Personal Empowerment). STUDY DESIGN: The project was an evidence-based nurse practitioner project utilizing pre- and post- intervention assessment tools (Beck Youth Inventory II and Healthy Lifestyle Beliefs Scale). The project intervention was based on Cognitive Behavior therapy (CBT) principles of the relationship between thinking, feeling, and behavior. A program (COPE TEEN) was the framework for the interventions implementing CBT principles for adolescents. RESULTS: A majority of the adolescent students reported positive outcomes from the study in reducing their depressive symptoms and increasing their perception of self-confidence. The project did not show a statistically significant difference but did demonstrate clinically significant improvement in behavior and perception of self-confidence by the adolescents. CONCLUSIONS: The COPE TEEN program provides tools for the adolescent to learn effective coping skills to demonstrate clinical improvement in depressive symptoms and effective coping skills

Simulation in a variety of settings using 'live' adult patient Service Users and moulage

This article shows how simulation can be modified and adapted to benefit Higher Education Institutes (HEIs) in a variety of situations. These situations include the engagement of Service Users and moulage to ensure skill enhancement so the very best student experience can be harnessed empowering and supporting students in learning, as a means to achieving their potential. This article describes a unique collaboration between one Higher Education Institute and Service Users (SUs), who have worked together in engaging in simulation activities in partnership. The development of simulation using Service Users is at the heart of developing student nurse education and recruitment. It has created communities of practice working across the traditional departmental boundaries to create innovative and creative learning opportunities for students. This collaboration links to the political imperative to improve the education of the health and social care sector, highlights the integration of skills development to theory, focuses on person-centred care and demonstrates how this HEI is producing a compassionate and caring workforce

The 10 ‘R’s of safe multidisciplinary drug administration

Nurses are responsible for medication administration, and, as with many other nursing interventions, some risk is involved. If an error occurs, a patient may suffer harm or injury, which may lead to a permanent disability or a fatality. To ensure safe drug administration, nurses are encouraged to follow the five rights (‘R’s; patient, drug, route, time and dose) of medication administration to prevent errors in administration. The five ‘R’s do not consider all causes of drug errors; instead, they focus on medication administration at the bedside so they relate only to this stage of a drug prescription. A drug’s journey is more than what happens at the bedside; therefore, the reduction of errors requires more than just the five ‘R’s. This article proposes a multi-professional, evidence-based approach to medicines management, which all clinicians can work towards, together. Clinicians can achieve this approach by considering the National Patients Safety Agency’s definition of a medication error and the values set out by the National Prescribing Centre. The approach utilizes 10 ‘R’s, which provide a benchmark for good practice. The 10 ‘Rs’ advocate the need for the knowledge of the causes of drug errors, how to implement strategies to reduce drug errors, how to ensure safe practice throughout the medication journey, from chemical preparation, to monitoring outcomes, to response