Barriers and facilitators for the use of NURSING bedside handovers : implications for evidence‐based practice

BACKGROUND: Previous studies on bedside handovers have identified nurse-related barriers and facilitators for implementing bedside handovers, but have neglected the existing ward's nursing care system as an important influencing factor. AIMS: To determine the association between the existing nursing care system (i.e., decentralized, two-tier, or centralized) on a ward and the barriers and facilitators of the bedside handover. METHODS: Structured individual interviews (N = 106) on 14 nursing wards in eight hospitals were performed before implementation of bedside handovers. The structured interview guide was based on a narrative review. Direct content analysis was used to determine the nursing care system of a ward and the degree to which barriers and facilitators were present. Pearson's Chi-square analysis was used to determine whether there were associations between the nursing care systems concerning the presence of barriers and facilitators for implementing bedside handovers. RESULTS: Twelve barriers and facilitators were identified, of which three are new to literature: the possible loss of opportunities for socializing, collegiality, and overview; head nurse's role; and role of colleagues. The extent to which barriers and facilitators were present differed across nursing care systems, with the exception of breach of confidentiality (barrier), and an existing structured handover (facilitator). Overall, nurses working in decentralized nursing care systems report fewer barriers against and more facilitators in favor of using bedside handovers than nurses in two-tier or centralized systems. LINKING EVIDENCE TO ACTION: Before implementing bedside handovers, the context of the nursing care system may be considered to determine the most effective process to implement change. Based on these study findings, implementing bedside handovers could be more challenging on wards with a two-tier or centralized care system

Merging flexibility with superinsulation : machinable, nanofibrous pullulan-silica aerogel composites

Freeze-dried nanofibrous scaffolds are flexible, but typically have high thermal conductivities. Conversely, silica aerogel has an ultra-low thermal conductivity, but is brittle. Here, the impregnation of pullulan/PVA nanofiber scaffolds with hydrophobic silica aerogel decreased the thermal conductivity from 31.4 to 17.7 mW/(m·K). The compatibility between the silylated nanofibers and the silica aerogel promotes the overgrowth of silica particles onto the fiber surfaces and the fiber incorporation. The composites display improved compressive and tensile properties compared to the neat pullulan scaffold and silica aerogel. The composite's E-modulus is 234 kPa compared to 4 kPa for the pullulan scaffold and 102 kPa for the silica aerogel. The composite's tensile strength is five times higher than that of the silica aerogel. Because of its reduced brittleness, the pullulan-silica aerogel composites can be shaped using a sharp blade. The composites can sustain uniaxial compression up to 80% strain, but the decompressed composites display two times higher densities because the strain is partially irreversible. This densification reduces thermal conductivity to 16.3 mW/(m·K) and increases final compressive strength by a factor of seven. Both the as prepared and densified composites demonstrate unique material properties in terms of thermal conductivity, mechanical strength and machinability

Effect of aging on thermal conductivity of fiber-reinforced aerogel composites: An X-ray tomography study

Silica aerogels display an ultra-low thermal conductivity (λ) and are used as thermal superinsulators. Here, we study the influence of aging and drying processes on the microstructure and thermal conductivity of fiber-reinforced silica aerogel composites. Glass wool-silica gel composites were aged for variable times, hydrophobized, and dried either at ambient pressure or from supercritical CO2 (scCO2). The X-ray micro- tomographic data display three distinct phases: silica aerogel, glass fibers, and macroscopic pores and cracks. The silica aerogel appears as a continuous medium in the tomograms because the spatial resolution (6–11 μm) is insufficient to resolve the aerogel mesopores (∼0.02–0.10 μm). For the composites prepared by ambient pressure drying, insufficient aging led to prominent drying shrinkage and cracking, and a high macro-porosity, as quantified by 3D image analysis. Insufficient aging also led to an increase in λ from 15.7 to 21.5 mW m−1 K−1. On the contrary, composites that were nearly free of cracks and displayed a constant λ of 16.3 ± 0.8 mW m−1 K−1 could be prepared by scCO2, independent of aging time. The thermal conductivity was reproduced from the macro-porosity to within 0.7 mW m−1 K−1 using simple thermal transport models consisting of thermal elements connected in series or parallel. Our results illustrate the usefulness of X-ray micro-tomography to quantify the 3D microstructure and its effects on the bulk composite properties and the data highlight the importance of aging for the production of low λ aerogel-fiber composites by ambient pressure drying

Reinforced and superinsulating silica aerogel through in situ cross-linking with silane terminated prepolymers

Silica aerogels have only half the thermal conductivity of conventional insulation, but their application potential is limited by the poor mechanical properties. The fragility arises from the thin necks between the silica nanoparticle building blocks. Here, we produce strong silica aerogels through co-gelation of the polyethoxydisiloxane precursor with a variety of silane terminated prepolymers that reinforce the inter- particle necks, followed by hydrophobization and supercritical CO2 drying. All prepolymers enabled the synthesis of aerogels with excellent thermal and mechanical properties, but the shortest prepolymer (∼2–3 nm long) yielded the best results. The hybrid aerogels can sustain uniaxial compression without brittle rupture to at least 80% strain for all prepolymer concentrations (5–50 wt%), leading to a final strength of up to 21 MPa, an E modulus up to 3.4 MPa, and an up to 400 times lower dust release rate. In contrast to classical reinforcement strategies, the mechanical improvement does not come with a penalty in thermal conductivity, which remains between 14 and 17 mW m−1 K−1. The hybrid aerogels are a unique class of superinsulating materials with superior thermal and mechanical properties and a scalable production process

The Economics of Thermal Superinsulation in Buildings

In comparison to conventional thermal insulators, superinsulation materials (SIMs), such as silica aerogel or vacuum insulation panels, provide a similar insulation performance at half to a quarter of the material thickness but this superior thermal insulation performance typically comes at a significantly higher material cost. However, under certain conditions, the use of superinsulation materials in building walls allows for the creation of additional floor space. Here, we derive a simple equation to quantify the cost to create such additional space using superinsulation materials as opposed to conventional thermal insulators. The equation has six independent variables, namely the thermal conductivity and cost of the superinsulation and conventional insulation materials, as well as two building geometry parameters. Notably, the cost to create additional floor space is independent of the heat transfer coefficient (U-value) of the wall. The real estate price distributions within major cities around the world are presented in order to compare the cost to create additional space with the potential financial benefit. The analysis of typical construction types, combined with the real estate data, shows that, from a financial perspective, the use of superinsulation such as silica aerogel or vacuum insulation panels (VIPs) is already clearly profitable in several major cities globally. Improvements of the production processes of superinsulation materials and the associated reduction in costs will be key drivers to make superinsulation materials economically feasible for many other locations in the future

Superhydrophobicity of nanofibrillated cellulose materials through polysiloxane nanofilaments

The wetting behavior of nanofibrillated cellulose (NFC) was drastically changed from hydrophilic to superhydrophobic, achieving limited contact angle hysteresis. Remarkably, superhydrophobicity was attained for a variety of morphologies, namely dense and porous films, foams and powders, thus exploiting a wide spectrum of cellulose manifestations. The superhydrophobic behavior resulted from the combined action of hydrophobic polysiloxane nanofilaments, formed by controlled reaction of methyltrichlorosilane with water at the surface of NFC fibrils, and the NFC substrates surface morphology, established by various drying methods of the nanofibrils. In particular, the optimal conditions for polysiloxane nanofilaments growth, with identification of various regimes of coating versus nanofilaments growth, were identified. Depending on the morphology, we demonstrated that modified NFC materials can act multiple roles, such as superhydrophobic liquid-infused lubricating surfaces, filters for dodecane drops capture from a nebulized dodecane/water mixture, hydrocarbon absorption from an aqueous phase, with absorbance capacity as high as 50 gdodecane/gfoam, and beds to separate hydrocarbon/water mixture. As such, the versatile combination of two materials with nanoscale features (nanocellulose and nanofilaments), which provide multi-tier topography and unprecedented wetting characteristics, can serve for all those applications, in which liquid mixture behavior (e.g. water/hydrocarbon) needs to be controlled.ISSN:1572-882XISSN:0969-023

Biopolymer Aerogels and Foams: Chemistry, Properties, and Applications

ISSN:1433-7851ISSN:1521-3773ISSN:0570-083

Zr complexation in high pressure fluids and silicate melts and implications for the mobilization of HFSE in subduction zones

International audienc