Evaluation of a Human Trafficking Educational Intervention at Thomas Jefferson University for Public Health Students

The evaluation of educational programs serves as a mechanism to enhance student learning and professional success. Effective evaluation provides value to educators invested in improving their interventions, students invested in receiving high-quality education, future employers searching for well-trained team members. One critical public health topic for students to understand well so it can be better addressed by future public health professionals is human trafficking. Human trafficking not only affects individuals but society in significant ways. Educating public health students on the significant and increasing problem is key to victim identification and intervention. Estimates indicate over 80% of trafficked victims interact with health care professionals at some point in their experience, and these workers need an understanding of the issues involved. This capstone integrative learning experience involved evaluation of a Human Trafficking Self-Guided Education Module (HTSGEM) developed by a Jefferson College of Population Health (JCPH) alumni to educate public health students on human trafficking. The evaluation of this educational intervention involved a pre-test and post-test of student knowledge on human trafficking. Public health students (N=12) had 10 minutes to answer a paper questionnaire with sixteen (16) printed questions for the pre-test. After the pre-test, students watched a thirty (30) minute Human Trafficking Self-Guided Education Module (HTSGEM) and then had 10 minutes for the post-test. Individual scores were analyzed and compared. Pre-test awareness was low, with significant improvement post-test. Described in this report is a comparison of both pre and post-test results and a statement on findings to aid decisions on future evaluations and curriculum implementation

What You Need to Know about Bar-Code Medication Administration

Medication errors are the most common type of preventable error. Bar-code medication administration (BCMA) technology was designed to reduce medication administration errors. Poor system design, implementation and workarounds remain a cause of errors. This paper reviews the literature on BCMA, identifies a gap in the findings and identifies three evidence based practices that could be used to improve system implementation and reduce error. The literature review identified that Bar-code medication administration and system workarounds are well documented and affect patient safety. Based on the critical analysis of 10 studies, we identified gaps in the standardization of BCMA planning, implementation, and sustainability. The themes that emerged from the literature were poor BCMA design and implementation that resulted in workarounds.The three evidence based strategies proposed to address this gap are, evidence based standardization in planning and implementation, the identification and elimination of workarounds and hard wiring. An evidence based checklist evaluates compliance with standard procedures. The LEAN model of Jodoka is used to assure adaptation of the machine to human workflow. Direct observation provides valuable workflow assessment. An effective BCMA implementation involves careful system design, identification of workflow issues which cause workarounds, and adapting the machine to nursing needs

Utilization of Care by Infants with Neonatal Abstinence Syndrome in Delaware

From 1999-2013, the nationwide incidence of neonatal abstinence syndrome (NAS) due to maternal drug use rose from 1.5/1000 to 6/1000 hospital births. There is a dearth of information regarding what happens to these children when they are discharged. The purpose of this Practice Inquiry Project is to utilize existing Delaware Medicaid data to retrospectively explore the utilization of services and gaps in care for the infant with NAS in the first year of life. Key findings include less than expected well child visits and immunizations along with higher hospital re-admission rates. This represents missed opportunities for care, also demonstrating the need for more robust social supports. Potential for prospective outpatient management and avenues for future research are outlined. Presented at Jefferson Accelerator Zone as completion of doctoral work. Note: Poster available at bottom of pag

Treatment-Related Decisional Conflict, Quality of Life, and Comorbid Illness in Older Adults with Cancer

As the aging population in the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults are confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. In their current research agenda, the Oncology Nursing Society identified the need for research related to multiple comorbidities in older adults with cancer. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Oncology nurses recruited a sample size of 200 for this study from outpatient medical oncology, radiation oncology, and palliative care practices. Using an anonymous survey method, participants completed three psychometrically-sound instruments, including the Decisional Conflict Scale, Self-Administered Comorbidity Questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Bivariate relationships existed between increased levels of decisional conflict and increased quality of life (p = .009) and quality of life and comorbidity (p = .001). All six regression models achieved significance (p \u3c .001). Statistically significant relationships were identified in each of the six regression models. Positive relationships existed between decisional conflict and financial problems, physical function, and global health status/quality of life. Increased emotional function may be predictive of decreased decisional conflict in all of the regression models. Other negative relationships existed between decisional conflict and cognitive function, diarrhea, spiritual support, insomnia, year diagnosed, fatigue, and nausea/vomiting. With their focus on patient-centered care, oncology nurses are a crucial component of the multidisciplinary cancer team that can empower older cancer patients to communicate their values and preferences regarding cancer treatment. Additionally, this study underscores the importance of oncology nurses being prepared to provide high-quality care to geriatric patients with multiple comorbidities. Given the paucity of research on the impact of cancer and its treatment on older adults, there are no published studies that address all of these variables. In light of the regression analyses, further research is needed with regard to emotional function, spiritual support, and symptom management in the setting of decision making in older adults with cancer. Poster presented at: Oncology Nursing Society 42nd Annual Congress in Denver, COhttps://jdc.jefferson.edu/nursingposters/1007/thumbnail.jp

Prevalence of Oral Cancer in Adolescents Related to Areca (Betel) Nut Chewing, Using Tobacco and Other Additives in Saipan, Northern Marianas Islands: A Review of Literature

Oral cancer can involve the lip, tongue, mouth and pharynx. It is the sixth most prevalent cancer worldwide. One of the leading causes of Oral Cancerin the Commonwealth of the Northern Mariana Islands (CNMI) is chewing betel nut with tobacco and other additives. The International Agency for Research on Cancer (IARC) linked areca nut, betel quid with tobacco and betel quid without tobacco as carcinogenic to humans. Areca nut, also known as betel nut comes from the areca palm tree. The use of areca nut is common throughout the Pacific, and is widespread in Papua New Guinea, Solomon Islands, Guam, the Federated States of Micronesia, Palau, CNMI and the Marshall Islands. The objective of this review is to gather published data related to oral cancer in adolescents as a result of chewing betel nut, using tobacco and other additives; and whether these studies address prevalence in adolescents in Saipan, CNMI. The literature searches were done electronically on World Health Organization, Journal of Dental Research, Center for Pacific Islands Studies/University of Hawai\u27i, IARC websites and Google search using keywords. A cross-sectional survey study (Oakley at el 2005) of 169 students shows 63.4% use areca nut regularly. It was more prevalent among male (73%) than females (54%). The mean age in starting to chew areca nut was 12.0, while some starting at age 10 or younger. The betel quid mixture included powdered lime and pepper betel leaf. Tobacco use was also widely prevalent among schoolchildren. Oral pathological lesions were noted during screening examinations. Areca (betel) nut chewing with the use of tobacco and other additives is increasingly observed among adolescents in Saipan. Further studies are needed on the prevalence of oral cancer in adolescents related to areca nut chewing, using tobacco and other additives and how to decrease oral cancer risk in this age group

The Play and Learn Classroom

Providing a consistent curriculum to educate and train more than 2,000 members of a nursing department and over 1000 nursing students in a tertiary care hospital on a complex clinical documentation system can be a challenge to the educator. Training new employees on an ongoing basis and an entire department when periodic system upgrades occur requires that the curriculum and methodology be consistent and made available at any time – day or night. In order to maintain consistency of the curriculum and provide the learner with ample opportunity to “play and learn” we use computer – based training video tutorials that we have created in which an instructor’s voice guides the learner through the clinical documentation functionality. In this format, the learner, plays and views a series of video tutorials accessible from the hospital intranet and then uses the online training pathway to practice documentation exercises. This self – paced teaching format allows us to provide a standardized curriculum to a variety of learners including orientees during Nursing Central Orientation, nursing students throughout the year, and large numbers of incumbent staff 24/7 whenever system upgrades are implemented. The benefit to using this methodology of education and training includes: · Ease of access for self- paced and active learning at any time · Flexibility to use in either a classroom or as independent learning · Implementation of a standardized curriculum · More time for individual support by instructor during classroom session

Evidence-Based Skin Champion Program Reduces Pressure Injuries in a Pediatric Hospital

Prevention of pressure injuries (PIs) in pediatric patients is an important nurse-sensitive quality goal. The PI rate at a large urban pediatric hospital triggered a call to action by the Chief Nursing Officer to establish a Hospital Acquired PI (HAPI) Task Force which identified the Skin Champion program as a key improvement strategy. The goals of the Skin Champion program are to lower the rate of HAPIs, empower front line care providers to implement evidence-based care bundles, achieve consistency of practice, and provide resource availability at the point of care. The implementation of the Skin Champion quality improvement program achieved an 85% reduction in severe harm and “reportable HAPI incidence, which is lower than the HAPI national average in pediatric patients (Solutions for Patient Safety, 2018), and an increase in nurse compliance with the HAPI prevention bundle. The HAPI incidence rate has remained near 0.05 per 1000 patient days

Opioid Exposed Mothers and Infants in Delaware: Clinical and Legal Considerations

Drug use is on the rise in Delaware, as demonstrated by the continued increase in infants born with neonatal abstinence syndrome. Thoughful, evidence based, and coordinated approaches are necessary to impact this problem. There is solid evidence that mothers and infants who remain together have improved outcomes. Professional medical and nursing societies are unanimous in support of non-punitive approaches to care. Medical Professionals, legislators, and society in general would benefit from ongoing education on the addiction disease process in order to best care for the increasing number of mother/baby dyads with neonatal abstinence syndrome

A Translational Intervention for Reducing Infant Mortality in Mississippi: A Move to Eliminate Health Disparities

Therapeutic, technological, and medical advances have contributed to improve Infant Mortality Rates in the United States over the last 100 years. However, there are still geographical and racial disparities and challenges, and infant mortality remains higher in the Unites States than in many other developed countries. A formal death review process can identify causal, contributory and potentiating factors related to infant deaths. This article describes use of the PDSA Model for Improvement to develop a strategy for change that will result in reducing the Infant Mortality Rate within an organization