A Contemporary Shared Governance Structure and Its Role in Managing Nurse Turnover

Practice Problem: Nurse turnover can adversely impact any health system\u27s financial performance and the clinical practice environment, and it is detrimental to patient safety and quality of care. PICOT: The PICOT question that guided this project was for nurses on a Labor and Delivery and Antepartum unit at a 382-bed community hospital in Austell, GA(P), does the utility of a contemporary shared governance structure in everyday practice (I) compared to the current shared governance structure (C) decrease nurse turnover rates (O) within four weeks (T)? Evidence: Shared governance permits the reduction of turnover and the intent to leave for nurses by promoting nursing autonomy and engagement, directly linked to decreasing turnover rates. Intervention: The contemporary shared governance structure facilitated nurse decision-making at the point of care in real-time and interprofessional team collaboration to effect change. Outcome: Nurse turnover rates compared four weeks prior and post-implementation showed a decrease from 68.26% to 63.08%, translating into a 5.11% drop-in turnover rates. Conclusion: The contemporary shared governance structure facilitated the direct care nurse\u27s ability to make changes at the point of care in collaboration with the interprofessional team using a rolling idea-generating process integrated into everyday practice. The project was clinically significant as it transformed the direct care nurse\u27s autonomy in their practice fostering a positive practice environment in four weeks. This project showed how nurse engagement could be improved when on-demand decision-making in the clinical area was facilitated, resulting in reduced turnover to yield better patient outcomes and overall organization performance

An exploration of participation in physical activities on the wellbeing of adults with acquired and congenital disabilities

Social workers are advocates for social justice to reduce the inequality gaps that exist in our society. It explores the experiences of adults with disabilities in participating in physical activities through small scale interviews in collaboration with a community-based organisation working with people with disabilities in Cork City. This study is a community-based participatory CARL research project in collaboration with Irish Wheelchair-Sport. IWA-Sport sought the ways to increase participation in their services. Therefore, the research looked at the facilitators to participation from the seven adults with acquired and congenital disabilities that participated in the interviews. This research explores some of the benefits of participating in physical activities on the wellbeing of adults with acquired and congenital disabilities. The research set to answer whether adults with disabilities were aware of the relationship between physical activity and wellbeing. What were the limitations in their participation in physical activities and finally, to what extent was society facilitating and enabling them to participate in physical activities. This study set out to answer these questions by carrying out small-scale, qualitative research through semi-structured interviews with seven adults (male and female) with both acquired and congenital disabilities. The data from the interviews were analysed thematically and several emerging themes from the findings about the multi-layered barriers facing people who use wheel-chairs in the participation in physical activities were established. Four main themes are discussed in the study - accessibility, financial, mind-set, and environment that prohibit people with disabilities from participating in physical activities. The study discusses the conclusions of the lack of participation by females with disabilities, and the role of family. It identifies inaccessible facilities, lack of funding, expensive equipment, as main barriers to participation in physical activities. It recommends taking a social approach to all-inclusive physical activities, increasing awareness, increasing individualised funding, embracing new pathways such as schools and local sport partnerships and increased campaigns for women participation as the main recommendations of the stud

Achievements and lessons learned from the Uganda self-supply pilot project 2006-2008

This document provides the achievements and lessons learned from the Uganda selfsupply pilot Project (20062008). The pilot project followed a research study undertaken in 2005 that indicated that selfsupply initiatives existed in the Uganda rural water sector. Following the study a pilot project was launched in September 2006 and involved engagement of two local NGOs with support from Government. The pilot brought about a cost effective up grading of 41 water sources serving approximately 600 households. More importantly it enhanced understanding of selfsupply in Uganda, and a number of emerging lessons emerged. These provide a better focused definition of self supply, and of the appropriate ways and means for future scaling up

Actinomyces pyogenes in Embryonic Loss in Cattle

Actinomyces pyogenes is one of the bacteria commonly found in the bovine reproductive tract and it has been considered not to be a primary pathogen. The bacteria has also been isolated from foetuses and pus after abortion but its role as a primary or secondary pathogen in bovine abortion has remained an area of controversy and as yet little experimental work has been carried out to determine its role. In this thesis the potential role of A. pyogenes in bovine embryonic loss is examined

Postintensive care syndrome-family in Intensive Care Units: “What is it in the name?” A Scoping Definitive Review

Aim: In this review, we sought to succinctly review what Postintensive care syndrome is, it’s risk factors, consequences, assessment, diagnosis, prevention and treatment among family members of intensive care patients. Background: The proportion of family members caring for a patient in intensive care units is expected to proportionally increase with increase in utilization of intensive care units due to various reasons. Subsequently, unfavorable physical, psychosocial responses due to exposure to complications following admission of a family member in intensive care due to critical illness will consequently increase among family members. These unfavorable family responses to critical illness have been termed “Postintensive care syndrome-family (PICS-F).” Postintensive care syndrome-family encompasses: anxiety, acute stress disorder, post-traumatic stress, depression and complicated grief. Healthcare providers as well as family members need to be knowledgeable on the extent, diagnosis, prevention and outcomes of these sequelae. Relationship to the patient, younger patients, prior experience of ICU, low economic status, length of ICU stay, unmet self-care, communication needs and distance from the hospital seem to predispose family members to PICS-F. Longer distance from hospital and higher resilience seem to protect family members from PICS-F. Prevention of PICS-F includes: effective family-ICU staff communication, enhancing resilience and coping, post discharge planning and follow-up interventions. Conclusion: results highlight the importance of acknowledging experiences of family members having a patient admitted in intensive care unit. Healthcare professionals need to have insights into this phenomenon and optimally intervene to prevent these physiological and psychosocial sequelae.Peer reviewe

Caregiver Perceptions and Motivation for Disclosing or Concealing the Diagnosis of HIV Infection to Children Receiving HIV Care in Mbarara, Uganda: A Qualitative Study

Background: Disclosure of the diagnosis of HIV to HIV-infected children is challenging for caregivers. Despite current recommendations, data suggest that levels of disclosure of HIV status to HIV-infected children receiving care in resource-limited settings are very low. Few studies describe the disclosure process for children in these settings, particularly the motivators, antecedent goals, and immediate outcomes of disclosure to HIV-infected children. This study examined caregivers' perception of the disclosure concept prior to disclosure, their motivation towards or away from disclosure, and their short- and long-term intentions for disclosure to their HIV-infected children. Methods: In-depth interviews were conducted with primary caregivers of 40 HIV-infected children (ages 5–15 years) who were receiving HIV care but did not know their HIV status. Results: Caregivers of HIV-infected children mainly perceived disclosure as a single event rather than a process of gradual delivery of information about the child's illness. They viewed disclosure as potentially beneficial both to children and themselves, as well as an opportunity to explain the parents' role in the transmission of HIV to the children. Caregivers desired to personally conduct the disclosure; however, most reported being over-whelmed with fear of negative outcomes and revealed a lack of self-efficacy towards managing the disclosure process. Consequently, most cope by deception to avoid or delay disclosure until they perceive their own readiness to disclose. Conclusions: Interventions for HIV disclosure should consider that caregivers may desire to be directly responsible for disclosure to children under their care. They, however, need to be empowered with practical skills to recognize opportunities to initiate the disclosure process early, as well as supported to manage it in a phased, developmentally appropriate manner. The potential role for peer counselors in the disclosure process deserves further study

Effects of sewage sludge biosolid amendments on the potential of maize (Zea mays L.) in phytoremediation of trace metals in chromated copper arsenate contaminated soils

The effect of sewage sludge amendment (5-25% w/w) on the potential of maize (MM3 variety) to phytoextract trace metals from chromated copper arsenate (CCA) contaminated soils was investigated. The metal content of fresh soils, and soils, maize roots and shoots after 80 days of planting were determined by atomic absorption spectroscopy. The concentrations of chromium, copper and arsenic in fresh CCA soils were 365.8 ± 6.18, 109.72 ± 14.04 and 28.22 ± 3.8 mg/kg respectively. The MM3 maize variety could be used to phytoextract or phytostabilize the trace metals in the CCA contaminated soils without or with 5-25% sewage sludge amendment