Implementation of a Standardized Universal Protocol Process at a Large Academic Medical Center

Background: Decreasing the risk of wrong site, wrong procedure and wrong patient surgery is an essential healthcare safety initiative. The Joint Commission’s Universal Protocol along with the World Health Organization (WHO) Safe Surgery Checklist were designed to aid in this patient safety effort and have been implemented in hospitals worldwide. Local Problem: Perioperative and procedural areas at the project hospital areas have adopted the Universal Protocol and Safe Surgery Checklist. Despite agreement in their importance, there is a lack of uniform application of all components. This leads to variation in practice which may impact team compliance with the protocol and patient safety if critical components of the process are missed. METHODS: A review of the literature revealed standardization of the universal protocol process as an evidence-based, promising intervention to decrease variability across perioperative and procedural areas. The overarching aim was to evaluate current practice of the universal protocol process in procedural and perioperative areas, identify gaps, and design a hospital-wide, standardized approach to universal protocol. INTERVENTION: The intervention was executed in 3 phases. Phase 1 evaluated current universal protocol tools and practice in procedural and perioperative areas and identified gaps. Phase 2 convened a working group of nursing experts from each project area to design a standardized process consisting of critical elements for each phase of the universal protocol. Phase 3 obtained consensus agreement and approval for the hospital wide dissemination of the recommended standardized process and tool from all area stakeholders. RESULTS: Analysis of universal protocol tools and direct observation of practice illustrated wide variation in the universal protocol process across 12 perioperative and procedural areas at the project hospital. These findings supported project approval by perioperative and procedural stakeholders for the development and implementation of the standardized universal protocol process and tool. CONCLUSION: This project demonstrated that it is feasible to standardize universal protocol practice across 12 complex and diverse perioperative and procedural settings. The effective use of the Kotter change theory engaged essential stakeholders and provided the foundation for the acceptance and completion of the project aims

Does the Production of Isoprene Affect the Productivity of Poplars?

Poplar trees are known to produce a chemical called isoprene that plays a complex, and not fully understood, role in the chemical process of photosynthesis. Understanding why plants produce isoprene and under what conditions will help scientists make more accurate predictions about poplars’ photosynthetic capabilities in future climates. What benefit could isoprene provide a plant? The literature suggests its production could help plants tolerate heat stress. We studied two genetic lines of trees in a common garden of Populus, one line with the gene for producing isoprene and a second line without that gene. We subjected some trees of each line to low water conditions to investigate if isoprene played a role in allowing plants to cope with water stress. We then compared the ability of these 4 treatment groups of poplars to photosynthesize over a range of temperatures. Poplars with and without isoprene showed similar rates of photosynthesis over the range of temperatures measured. Poplars subjected to low water conditions and poplars with normal water conditions also recorded similar rates of photosynthesis. This suggests that isoprene does not offer a photosynthetic benefit, and also that the low water conditions may not have triggered a water stressed state in the poplars. However, the poplars’ rate of photosynthesis differed between morning and afternoon, suggesting that time of day could play a role in photosynthesis. Future work is needed to understand how the influence of time of day on photosynthesis may overshadow any differences due to isoprene production

Teaching Learners with Visual Impairment

This book, Teaching Learners with Visual Impairment, focuses on holistic support to learners with visual impairment in and beyond the classroom and school context. Special attention is given to classroom practice, learning support, curriculum differentiation and assessment practices, to mention but a few areas of focus covered in the book. In this manner, this book makes a significant contribution to the existing body of knowledge on the implementation of inclusive education policy with learners affected by visual impairment

Understanding Education for the Visually Impaired

The contribution that this book makes to scholarship is regarded as ground-breaking, as it is based on recent research conducted with teachers on the ground-level, as well as on research and experiences of practitioners, gained over many years. In this volume, Understanding education for the visually impaired, the focus falls on understanding visual impairment within the South African context, more specifically on what the education of these learners entails. In addition to the contribution to existing literature in the fields of inclusive education and visual impairment, the publication has practical application value for teachers and practitioners who work with and support such learners

Teaching Learners with Visual Impairment

This book, Teaching Learners with Visual Impairment, focuses on holistic support to learners with visual impairment in and beyond the classroom and school context. Special attention is given to classroom practice, learning support, curriculum differentiation and assessment practices, to mention but a few areas of focus covered in the book. In this manner, this book makes a significant contribution to the existing body of knowledge on the implementation of inclusive education policy with learners affected by visual impairment

Understanding Education for the Visually Impaired

The contribution that this book makes to scholarship is regarded as ground-breaking, as it is based on recent research conducted with teachers on the ground-level, as well as on research and experiences of practitioners, gained over many years. In this volume, Understanding education for the visually impaired, the focus falls on understanding visual impairment within the South African context, more specifically on what the education of these learners entails. In addition to the contribution to existing literature in the fields of inclusive education and visual impairment, the publication has practical application value for teachers and practitioners who work with and support such learners

Effect of a Multidisciplinary Team Approach to Eradicate Central Line Associated Blood-Stream Infections (CLABSI)

Introduction: CLABSI remains a significant problem in the intensive care unit. Hypothesis: A multimodal approach for the insertion and care of CVC will prevent CLABSI. Methods: A Critical Care Operations Committee was formed to transform care in 8 intensive care units (ICU) in an academic medical center in 9/2004. One goal was to reduce CLABSI. Using evidence based medicine, a clinical practice guideline was developed that incorporated the use of maximum barrier precautions, chlorhexidine skin preparation, avoidance of the femoral insertion site, dedicated catheter cart, a check list, the tracking of high risk CVC, anti-septic or antimicrobial impregnated catheters, a recommendation to use ultrasound guidance when inserting CVC in the internal jugular vein, daily determination of the need for the CVC and treatment of CLABSI as a critical event.CLABSI were adjudicated by the hospital epidemiologist and CVC days were tracked. Rates of CLABSI were followed from 9/2004 through 7/2011. The Spearman correlation coefficient was used for statistical evaluation. A p Results: CLABSI rates (per 1000 catheter-days) declined dramatically from 2004 to 2011 (p Conclusions: A multimodal approach to CVC insertion and care reduces CLABSI by over 90%. Our ultimate goal is the complete eradication of CRBSI in our institution

Insights Gained into Marginalized Students Access Challenges During the COVID-19 Academic Response

The American Chemical Society (ACS) Committee on Minority Affairs (CMA) endeavors to support all chemistry faculty and staff as they educate all of our students during this pandemic. While the chemistry education community and the ACS have both provided resources as most institutions transitioned to virtual platforms, this pandemic disproportionally affects our students of color, lower socio-economic and rural backgrounds, and students with disabilities. Specifically, these students must overcome hurdles of technology access, environmental disruptions, and cultural pressures in order to be successful. Therefore, CMA has formulated partnerships with both academic and industrial institutions to highlight some best practices to improve future virtual learning experiences of these oftentimes marginalized students. Specifically, the work presented here examines programs and policies at three academic institutions with very different student body demographics and surrounding learning environments (Indiana University Purdue University Indianapolis (IUPUI), The College of New Jersey (TCNJ), and Los Angeles Community College District (LACCD)) with an attempt to identify variables that enhance marginalized student success in chemistry courses. The combination of their results suggests elements such as access to technology, home responsibility, and impostor syndrome, that other learning programs should consider to increase virtual learning success. Furthermore, other stopgap measures implemented at industrial partners give insight as to how these considerations can be implemented during virtual internship programs to meet their learning objectives associated with entering their institutional pipeline

Pathways into living alone in mid-life: diversity and policy implications

This paper adopts a life course approach to investigate the pathways into living alone in mid-life in Britain and how these vary by gender and socio-economic status. The rise in the proportion of people living alone over the past three decades has been well documented. However, much of the focus of the existing literature has been on either people living solo in young adulthood or in later life. Mid-life has received surprising little scholarly attention, despite the fact that living arrangements in mid-life are changing rapidly, and that household composition and socio-economic circumstances in the period immediately prior to retirement are strongly associated with living arrangements and associated sources of support in later life. This paper therefore aims to fill this gap. We begin with a review of previous research on living alone and present a conceptual framework of the pathways into living alone in mid-life. Data from the United Kingdom Household Longitudinal Survey (UKHLS) are used to analyse the partnership and parenthood histories and socio-economic characteristics of those currently living alone in mid-life. The findings indicate that the dissolution of a marriage with children is the dominant pathway into mid-life solo-living, but that there is also a substantial group of never partnered men living alone. These never partnered men are split between those with low and high socio-economic status. Distinguishing between different groups of individuals living alone in mid-life is important for policy as these groups of men and women will have different social and financial resources as they enter later life. Mid-life men living alone who have not had children, have no educational qualifications, are not economically active and who live in rented housing are likely to be most at risk of needing a social and economic ‘safety net’ in old age