Implementation of the Provider Bull\u27s-eye: A Tool to Guide Clinical Reasoning and Communication for Nurse Practitioners

Problem In a large urban pediatric hospital in the southeastern region of the United States, Pediatric Intensive Care Unit nurse practitioners (NPs) had difficulty transitioning to practice. Identified NP transition to practice barriers were arduous clinical reasoning and ineffective communication. Transition to practice barriers impact patient outcomes and healthcare cost due to patient care errors, delays in care, and NP turnover from poor practice perceptions. The goal of the Doctor of Nursing Practice project was to examine whether the Provider Bull’s-Eye Tool (PBT), a tool to guide clinical reasoning and communication for NPs, would decrease time to diagnosis and intervention selection, while simultaneously improving communication and perceptions of practice confidence in new NPs. Methods The PBT was evaluated using a two-group comparison. All pilot participants were volunteers, actively enrolled in a NP program or had less than or equal to two years NP experience. Project participants, N=17, were randomly divided into those who completed simulation in medicine education (SIM) evaluation prior to PBT education, and those who completed SIM evaluation post PBT education. During SIM, project participant time to diagnosis and interventions were documented using a validated checklist. After SIM, each participant verbalized a recorded handoff report to a transferring facility. Recorded handoff reports of both groups were analyzed for communication enhancements from PBT training. Once both groups concluded all project components, a Likert survey evaluating perception of practice confidence after PBT training was completed. Results The PBT trained group was observed to be marginally slower during SIMS due to increased cognitive processing; however, they were more likely than the non-PBT group to diagnose and intervene appropriately in several areas. The PBT group also had more effective communication patterns during handoff reports than the non-PBT group. Further, PBT training increased perception of practice confidence in both groups. Conclusion Based on findings, the PBT is a promising tool that has the capacity to enhance NP clinical reasoning while simultaneously promoting effective handoff communication. Improving these skills increased perceptions of practice confidence. Combined, these improvements could result in decreased healthcare cost by reducing patient errors, delays, and NP turnover

Maintaining Agriculture\u27s Public Image: An Opinion Survey of Agricultural Communications Leaders

Most officers of professional agricultural communications organizations believe their organizations have a responsibility to promote favorable public attitudes toward agriculture. That is one result from a recent survey of the leaders of eight of these organizations

Construction Time of Three Wall Types Made of Locally Sourced Materials: A Comparative Study

Similarly to any other industry, the construction sector puts emphasis on innovativeness, unconventional thinking, and alternative ideas. At present, when sustainable development, ecology, and awareness of people’s impact on the environment grow in importance, low impact buildings can become an innovative alternative construction technology for the highly industrialized construction sector. The paper presents a comparative study of three walls made of available materials used locally, which can be classified as biosourced materials, in terms of construction time. The comparison of times necessary to make 1 m2 of the wall allows us to decide which building technology is more advantageous in terms of the construction duration. A shorter construction time means lower labour costs and lower expenses for construction machines. In order to obtain answers to the questions posed, the authors made extensive searches of source data on the time-consuming building works which used locally sourced materials. Reference is made to “Temporary principles of erecting clay buildings” issued by the Institute of Housing Construction in Warsaw (Poland). Three types of walls made of locally sourced materials were studied: a wall made of clay blocks insulated with mineral wool boards, a wall made of clay compacted in formwork, and one insulated with mineral wool boards and wooden frame structure filled with straw bales and cladded with fibreboards. The layers have been chosen in such a manner that heat transfer coefficient values for the studied variants are as equal as possible (0.2 W/m2 K), thus allowing a reliable comparative study

Diets enriched in fish and rapeseed oils, carnosic acid, and different chemical forms of selenium affect fatty acid profile in the periintestinal fat and indices of nutritional properties of selected tissues of lambs

The aim of our study was to investigate the impact of carnosic acid (CA), selenate (VISe) or selenized yeast (YSe) on concentrations of fatty acids (FA), tocopherols, cholesterol and malondialdehyde in the periintestinal fat (PIF) and muscles of lambs. Male lambs were fed the control diet containing rapeseed (RO) and fish (FO) oils, the CA diet containing RO, FO and CA, the YSe-CA diet with RO, FO, CA and YSe, and the VISe-CA diet with RO, FO, CA and VISe. The experimental diets with CA, irrespective of the presence of YSe or VISe, decreased sums of saturated FA (SFA) and the thrombogenic SFA in the PIF compared to the control. The experimental diets increased the Δ9-desaturation capacity in the PIF compared to the control. The experimental diets with YSe or VISe reduced sums of long-chain polyunsaturated FA in the PIF compared to the control and CA diets. The PIF and muscles of lambs fed the VISe-CA diet were characterised by the highest hypocholesterolemic/hypercholesterolemic-FA ratio, and lower modified atherogenic index compared to the control

Plant disease diagnosis trivia: The old, the new and the ugly

Every year the plant and insect diagnostic clinic receives many samples of crop disease and insect problems. Some problems can be readily diagnosed in the field or clinic, but there are always those difficult look-a-like diseases, unique disease symptoms on some hybrids and environmental stressors that can be vexing to us all and make accurate diagnosis more difficult. This presentation will help you identify some of these issues in the field and know when it is best to submit a sample to ISU. A majority of the presentation will consist of clicker question activities followed by discussion. We will also discuss how to use the Plant and Insect Diagnostic Clinic to your advantage