An Updated Rounds Checklist to Increase Appropriate Use of Telemetry Monitoring

Background: Telemetry monitoring is an essential tool to monitor cardiac electrical activity. Its overuse is costly in time and resources and leads to subsequent testing and treatments that are not necessary for the patient and, in addition, healthcare staff is burdened with work that is potentially not clinically useful. Aim: The global aim of increasing efficiency in telemetry use starts with the local improvement to facilitate nurse-physician communication of telemetry patients during Methods: This study with pre and post data collection looked at the results of quantitative data, collected in May-July 2015, on the number of patients with telemetry and the corresponding clinical indication before and after implementation of a modified rounds checklist which included telemetry as a discussion point. The new checklist was initiated on June 22, 2015 and post intervention data was gathered to determine if there was a decrease in the overuse of and increase in the appropriate use of telemetry. Results: With the implementation of the checklist the use of telemetry decreased, however the clinical indication for use did not improve. Conclusion and implications for CNL practice: After the implementation of the checklist criteria there has been a consistent decrease in telemetry use. This may attributable to improve nurse-physician communication, however, there is still a lack of appropriate clinical indication of use and the CNL, as lateral integrator, in future improvement projects, should support further modifications to the clinical indication set to improve appropriateness of telemetry use

What works best in education: the politics of collaborative expertise

This report presents a series of tasks designed to reduce the problem of within-school variability by seeking out and scaling up teacher expertise. Introduction In a previous paper, What Doesn’t Work in Education: The Politics of Distraction, I argued that the aim of schooling is for every student to gain at least a year’s worth of learning for a year’s input. I further argued that many policy-makers and systems are persistently drawn to the wrong kind of education interventions – distractors that will not help us realise this ambitious aim. From new types of schools to getting more adults into them, we need to declare these ‘fixes’ distractors and move to more fertile territory. What we need instead is a defensible and compelling narrative that leads to long-term, coherent and focused system-wide attention on student learning. I call this territory ‘the politics of collaborative expertise’. Its premise is that there is differential expertise across our schooling system and that there can be wide variation within schools. At the same time, there is a remarkable spread of expertise that can be identified, nurtured, esteemed and brought together to reduce this variance. The aim of this paper is to begin describing what a model of collaborative expertise would look like and what we need to get done to make it a reality

My Chilly Baby

https://digitalcommons.library.umaine.edu/mmb-vp/4008/thumbnail.jp

Little Alabama Coon

https://digitalcommons.library.umaine.edu/mmb-vp/1993/thumbnail.jp

Grandma\u27s Last Amen

https://digitalcommons.library.umaine.edu/mmb-vp/3133/thumbnail.jp

The Baleful Tale of Hale and Gale

Whenever I see a palindrome I am touched by sadness, for it reminds me of the tragic fate of my former colleague, Mr. Gale, and his boss, Mr. Hale. From the first, their behavior in each other\u27s company struck me as most unnatural. Like an electron and a positron, they lived peaceably enough in different universes, but as soon as they came together each threatened to annihilate the other

Palindrome Pairs

In Cat\u27s Cradle, by Kurt Vonnegut Jr., persons whose lives are tangled up for no very logical reasons are said to belong to the same \u27karass\u27. The table on the following two pages consists of pairs of words which also have this property: although not logically (semantically) related, they are inextricably linked to each other by the fact that together they form a palindrome

Solar Panel Recycling in The United States

The last decade has seen enormous growth in the solar industry across the globe. According to the International Renewable Energy Agency (IREnA) in 2015 solar energy produced about 222 gigawatts worldwide with expected growth to top 4500 gigawatts by 2050. By comparison the United States is expected to see an additional 10.6 gigawatts in 2018. The Midwest has seen similar growth in the solar industry within the past decade. The problem is the technology used to convert the sun’s rays into electrical energy does not last forever. On average the industry rates a solar panel\u27s life span around 25-30 years. Up to now limited quantities from early installations have been retired. The forecast for such systems will continue to grow. The once small quantities of glass and photovoltaic components will begin to grow from hundreds to thousands to millions of tons of material waste. This research provide a roadmap to the potential growth and opportunity to recycling solar technologies. It also illustrates some of the possible economic barriers including policy, transportation, value, and cost effective processes

Alien Registration- Akerly, Hattie (Cape Elizabeth, Cumberland County)

https://digitalmaine.com/alien_docs/32962/thumbnail.jp