Purposeful Nurse Hourly Rounding: Plan to Decrease Patient Falls During a Pandemic

Problem: Patient falls remain a critical and persistent safety problem in healthcare today. The prolonged impact of the COVID-19 pandemic raises leadership concerns regarding the safe care of high-risk COVID patients and mitigating the increased stress and potential risks of infection to clinical staff. Context: This Doctor of Nursing Practice (DNP) scholarly project details implementation of an evidence-based purposeful nurse hourly rounding (PNHR) pilot project designed to decrease the incidence of patient falls on a designated COVID-19 unit. Measure: A modified PNHR rounding tool was implemented to guide focused elements for key nurse/patient interactions. Interventions: PNHR strategies were further augmented by innovative quantum caring healthcare leadership (QCHL) principles intended to support team engagement and enhance a culture of safety. The transformational leadership approach and theoretical foundations of QCHL were viewed as pivotal enculturation tactics and were aligned to sustainability goals. The project aim was to decrease the incidence of adult patient falls by 10% over baseline data during a four-month pilot on a designated COVID-19 nursing unit. Results: The post-implementation outcomes highlight a 58% reduction in patient falls from 4.29 to 1.79 falls per 1,000 patient days. Conclusions: Quantitative and qualitative findings support a proactive leadership approach to patient safety and staff engagement that utilizes an evidence-based, structured, timely, and sustainable nurse hourly rounding strategy. Dissemination: Low costs, improved clinical outcomes, and positive impact on patient safety and employee engagement increase the potential for spread of this scholarly project to non-COVID care units across the organization and to other systems

Purposeful Nurse Hourly Rounding: A Plan To Decrease Patient Falls During a Pandemic

Aims: This paper describes the design of a purposeful nurse hourly rounding pilot to decrease the incidence of patient falls on a COVID-19 designated unit in an acute hospital setting. Background: Falls in acute care hospitals are a persistent patient safety problem. The COVID-19 pandemic has added to concerns to safely care for high-risk COVID patients while mitigating the risk of infection for frontline staff. Methods: A PNHR pilot project was designed for implementation in a 28-bed COVID-19 designated unit in a not-for-profit acute hospital in California. A modified PNHR rounding tool guides focus points for every nurse/patient interaction. Pre- and post-implementation surveys are used to obtain feedback from the frontline staff. Results: The pilot is in an early stage of implementation with data not yet available. Pre-implementation survey data indicate increased stress and anxiety from frontline staff. Conclusion: It is anticipated that an active focus on patient safety and a united approach by the entire care team will decrease the incidence of patient falls on a COVID-19 acute nursing unit. Implications for Nursing Management: This paper describes how the psychological and safety needs of the frontline staff are addressed in the design of a protocol to reduce patient falls

We Were War Surplus, Too: Nick Joaquin and the Impossibilities of Filipino Historical Becoming

This article reads Nick Joaquin’s 1983 novel Cave and Shadows alongside his persistent engagement with Filipino identity and history to argue that an investigation of Philippine historiography reveals the colonial entrapments of Filipino subjectivity. A mystery novel set in the period immediately preceding Ferdinand Marcos’s 1972 declaration of martial law, it contextualizes Marcos authoritarianism within the scope of post-World War II concerns about national politics in the wake of independence. It also simultaneously grapples with overarching ideas about the legacies of colonial conquest and their effects on the Filipino common sense. Jack Henson’s traversals through Manila find him grappling with the quandary of “true Filipinoness,” a literary dilemma that reveals Joaquin’s investment in wrestling with claims to any inherent Filipino identity as a discursive exploration of the arc of Philippine history. Rather than adhere to Filipino subjectivity as a coherent, unproblematic social formation; the novel explores it as an episteme for locating and interrogating broader systems of governance and power. Such a paradigm offers modalities for contesting Marcos’s revisionist history projects. Such projects sought to recuperate Filipino identity from the dregs of a colonial past in order to celebrate its universal humanity in ways that aligned with the modernizing tactics of global development.

The Role of HDAC6 in Cancer

Histone deacetylase 6 (HDAC6), a member of the HDAC family whose major substrate is α-tubulin, has become a target for drug development to treat cancer due to its major contribution in oncogenic cell transformation. Overexpression of HDAC6 correlates with tumorigenesis and improved survival; therefore, HDAC6 may be used as a marker for prognosis. Previous work demonstrated that in multiple myeloma cells, inhibition of HDAC6 results in apoptosis. Furthermore, HDAC6 is required for the activation of heat-shock factor 1 (HSF1), an activator of heat-shock protein encoding genes (HSPs) and CYLD, a cylindromatosis tumor suppressor gene. HDAC6 contributes to cancer metastasis since its upregulation increases cell motility in breast cancer MCF-7 cells and its interaction with cortactin regulates motility. HDAC6 also affects transcription and translation by regulating the heat-shock protein 90 (Hsp90) and stress granules (SGs), respectively. This review will discuss the role of HDAC6 in the pathogenesis and treatment of cancer

How do individuals with Williams syndrome learn a route in a real-world environment?

Individuals with Williams syndrome (WS) show a specific deficit in visuo-spatial abilities. This finding, however, is mainly based on performance on small-scale laboratory-based tasks. This study investigated large-scale route learning in individuals with WS and two matched control groups (moderate learning difficulty group [MLD], typically developing group [TD]). In a non-labelling and a labelling (verbal information provided along the route) condition, participants were guided along one of two unfamiliar 1 km routes with 20 junctions, and then retraced the route themselves (two trials). The WS participants performed less well than the other groups, but given verbal information and repeated experience they learnt nearly all of the turns along the route. The extent of improvement in route knowledge (correct turns) in WS was comparable to that of the control groups. Relational knowledge (correctly identifying spatial relationships between landmarks), compared to the TD group, remained poor for both the WS and MLD groups. Assessment of the relationship between performance on the large-scale route learning task to that on three small-scale tasks (maze learning, perspective taking, map use) showed no relationship for the TD controls, and only a few non-specific associations in the MLD and WS groups

Izdvajanje bakterije Escherichia coli O157:H7 i njezin dokaz lančanom reakcijom polimerazom u crijevima filipinskih šišmiša.

It is currently reported that bats in the Philippines harbor bacterial organism (Salmonella spp.) with pathogenic potential. The paper describes the conventional isolation and polymerase chain reaction (PCR) assay for the detection of another bacterium, Escherichia coli, from a sample population of 56 apparently healthy bats collected from Laguna and Quezon City, Philippines. Nineteen of the samples were positive for E. coli using the conventional method of isolation, while PCR molecularly detected the bacteria in 15 samples. The presence of hemolysin among the isolates was not observed. The isolates were subjected to E. coli O157:H7 serotype detection using the latex agglutination test and another PCR assay specific for this serotype. The data revealed that none of the isolates was positive for E. coli O157:H7 using serological and molecular diagnostic methods, which indicates that bats from Laguna and Quezon City, Philippines were not carriers of the pathogenic strain, E. coli O157:H7. The study also presents the first local report of conventional isolation and molecular detection of E. coli from Philippine bats.Poznato je da šišmiši na Filipinima mogu biti nositelji potencijalno patogenih bakterija, npr. salmonela. U radu je opisano izdvajanje i dokaz lančanom reakcijom polimerazom bakterije Escherichia coli iz 56 naizgled zdravih šišmiša uhvaćenih na području Laguna i Quezon City na Filipinima. E. coli bila je izdvojena iz 19 uzoraka, dok je lančanom reakcijom polimerazom ona bila dokazana u 15 uzoraka. Izolati nisu tvorili hemolizu, a lateks aglutinacija i specifični PCR rabljeni su za dokaz serovara O157:H7 bakterije E. coli. Nijedan izolat nije pripadao serovaru O157:H7, na osnovi čega se može zaključiti da šišmiši na području Laguna i Quezon City na Filipinima nisu nositelji patogenog soja E. coli O157:H7. Istraživanje je ujedno prvi dokaz o izdvajanju i molekularnoj identifikaciji bakterije E. coli u šišmiša na Filipinima

Izdvajanje bakterije Escherichia coli O157:H7 i njezin dokaz lančanom reakcijom polimerazom u crijevima filipinskih šišmiša.

It is currently reported that bats in the Philippines harbor bacterial organism (Salmonella spp.) with pathogenic potential. The paper describes the conventional isolation and polymerase chain reaction (PCR) assay for the detection of another bacterium, Escherichia coli, from a sample population of 56 apparently healthy bats collected from Laguna and Quezon City, Philippines. Nineteen of the samples were positive for E. coli using the conventional method of isolation, while PCR molecularly detected the bacteria in 15 samples. The presence of hemolysin among the isolates was not observed. The isolates were subjected to E. coli O157:H7 serotype detection using the latex agglutination test and another PCR assay specific for this serotype. The data revealed that none of the isolates was positive for E. coli O157:H7 using serological and molecular diagnostic methods, which indicates that bats from Laguna and Quezon City, Philippines were not carriers of the pathogenic strain, E. coli O157:H7. The study also presents the first local report of conventional isolation and molecular detection of E. coli from Philippine bats.Poznato je da šišmiši na Filipinima mogu biti nositelji potencijalno patogenih bakterija, npr. salmonela. U radu je opisano izdvajanje i dokaz lančanom reakcijom polimerazom bakterije Escherichia coli iz 56 naizgled zdravih šišmiša uhvaćenih na području Laguna i Quezon City na Filipinima. E. coli bila je izdvojena iz 19 uzoraka, dok je lančanom reakcijom polimerazom ona bila dokazana u 15 uzoraka. Izolati nisu tvorili hemolizu, a lateks aglutinacija i specifični PCR rabljeni su za dokaz serovara O157:H7 bakterije E. coli. Nijedan izolat nije pripadao serovaru O157:H7, na osnovi čega se može zaključiti da šišmiši na području Laguna i Quezon City na Filipinima nisu nositelji patogenog soja E. coli O157:H7. Istraživanje je ujedno prvi dokaz o izdvajanju i molekularnoj identifikaciji bakterije E. coli u šišmiša na Filipinima

First report of Cryptosporidium hominis in a freshwater sponge

Identification of Cryptosporidium oocyst is essential in ensuring water quality fit for human use, consumption, and recreation.This communication proposes the supplemental analysis of substrateassociated biofilms, in particular, freshwater sponges in improving case finding of waterborne-protozoan pathogens (WBPP) in environmental aquatic samples. In this study, a small portion of a mature freshwater sponge under the Genus Radiospongilla was subjected to microscopic and molecular analysis to identify the presence of Cryptosporidium. Microscopic screening with modified Kinyoun's staining (MK) and microscopic confirmation using direct antibody fluorescent testing (IFT) returned with Cryptosporidium spp. positive findings. Molecular investigation resulted in the confirmation of Cryptosporidium hominis upon sequencing of PCR products and phylogenetic analysis. This is the first report of a pathogenic protozoan, C. hominis isolated from a freshwater sponge. The results of this study provide evidence of the value of expanding water quality assessment strategies to the analysis of substrate-associated biofilms and sponges in improving case finding of WBPP in natural aquatic environments

Waterborne protozoan pathogens in environmental aquatic biofilms: implications for water quality assessment strategies

Biofilms containing pathogenic organisms from the water supply are a potential source of protozoan parasite outbreaks and a general public health concern. The aim of the present study was to demonstrate the simultaneous and multispatial occurrence of waterborne protozoan pathogens (WBPP) in substrate-associated biofilms (SAB) and compare it to surface water (SW) and sediments with bottom water (BW) counterparts using manual filtration and elution from low-volume samples. For scenario purposes, simulated environmental biofilm contamination was created from in-situ grown one-month-old SAB (OM-SAB) that were spiked with Cryptosporidium parvum oocysts. Samples were collected from the largest freshwater reservoirs in Luzon, Philippines and a University Lake in Thailand. A total of 69 samples (23 SAB, 23 SW, and 23 BW) were evaluated using traditional staining techniques for Cryptosporidium, and immunofluorescence staining for the simultaneous detection of Cryptosporidium and Giardia. In the present study, WBPP was found in 43% SAB, 39% SW, and 39% BW samples tested with SAB results reflecting SW and BW results. Further, the potential and advantages of using low-volume sampling for the detection of parasite (oo)cysts in aquatic matrices were also demonstrated. Scanning electron microscopy of OM-SAB revealed a naturally-associated testate amoeba shell, while Cryptosporidium oocysts spiked samples provided a visual profile of what can be expected from naturally contaminated biofilms. This study provides the first evidence for the simultaneous and multi-spatial occurrence of waterborne protozoan pathogens in low-volume environmental aquatic matrices and warrants SAB testing along with SW and BW matrices for improved water quality assessment strategies (iWQAS)