This study aimed to investigate the effect of a learning guideline on nurses' knowledge and performance regarding patient safety after cardiac catheterization. A quasi-experimental design was used with 51 nurses from cardiac units. Nurses' knowledge and performance were assessed before and after implementing a 4-week learning guideline program using questionnaires and checklists. The results showed that nurses had significantly higher knowledge scores after the learning guideline, with a positive correlation between qualification, experience, and post-guideline knowledge. Nurses' performance scores were satisfactory both before and after the guideline, but there was a strong positive correlation between qualification and post-guideline performance. In conclusion, the learning guideline improved nurses' knowledge regarding patient safety after cardiac catheterization.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
Injury Management should be included as "Must Know"Amit Agrawal
The document discusses trauma care in India. It provides information on several speakers who discussed various aspects of trauma care including situational analysis, pre-hospital care, injury biomarkers, and primary injury care. It notes that injury management should be included as essential knowledge. It highlights India's high injury and trauma mortality rates. There is a need to improve emergency and pre-hospital care services which are currently fragmented in India. The development of trauma care systems and guidelines on classification of injuries and roles in trauma management are needed.
The document discusses important considerations for anesthetic choice in elderly patients undergoing surgery. Older patients are at higher risk of complications and mortality compared to younger patients. Even minor physiologic disturbances during surgery can have serious consequences for frail elderly patients with limited reserve. The choice of anesthetic regimen and agents can help minimize risks. For example, etomidate is preferred over propofol for induction due to lower risk of hypotension in older patients. Careful preoperative evaluation and avoidance of complications is important for optimizing outcomes in elderly surgical patients.
This document discusses manual compression versus arterial puncture closing devices following femoral cardiac catheterization. It identifies coronary artery disease and cardiac catheterization as major health issues. The authors recommend a protocol where arterial puncture closing devices are used for hemostasis in non-high risk patients, while developing a high-risk checklist. They suggest alternative approaches to further study differences between manual compression and arterial puncture closing devices.
Impact of a designed nursing intervention protocol about preoperative liver t...Alexander Decker
This document summarizes a study that assessed the impact of a designed nursing intervention protocol on patient outcomes for liver transplantation. The study was conducted at a university hospital in Egypt and included 14 adult patients scheduled for liver transplantation. Patients who received the nursing intervention protocol were compared to a control group of 52 past patients from the previous 3 years. Outcomes measured included changes in patient knowledge and practice scores before and after the intervention, as well as post-operative complication rates. The results showed statistically significant improvements in knowledge and practice scores for patients who received the protocol, as well as lower rates of respiratory and rejection complications compared to the control group. The study concluded the nursing intervention protocol had a positive impact on patient outcomes.
The study evaluated practices around informed consent for surgery at a hospital in Pakistan. It found that consent was often taken by nurses for elective surgeries and residents for emergencies, rather than surgeons. Patients were usually not well informed about risks and complications. While most patients were told the type of anesthesia, very few were told about anesthesia risks. Consent was often signed by family rather than patients. Overall, current practices did not adequately inform patients or respect patient autonomy, indicating a need for improved informed consent procedures.
This study reviewed the management of 1432 grown-up congenital heart disease patients over 10 years at a tertiary hospital in India. It found a early morbidity rate of 5.2% and identified previous sternotomy, emergency procedures, cross-clamp time over 45 minutes, and cyanotic disease as significant risk factors. Outcomes were generally good with a mortality rate of 1.4% and 86% follow-up completeness. However, the study was limited by its single center retrospective design and loss to follow-up of simpler cases.
This study analyzed data from 1061 chronic heart failure patients in Australia to determine if distance is the main factor affecting access to healthcare. The results showed that 94.8% of patients lived in areas highly accessible to healthcare services. On average, it took patients 25.7 minutes by car to reach the hospital and 8.9 minutes to reach their general practitioner. The study concluded that distance was not the primary factor affecting access, and that other issues like socioeconomic status or health condition severity may play a bigger role.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
Injury Management should be included as "Must Know"Amit Agrawal
The document discusses trauma care in India. It provides information on several speakers who discussed various aspects of trauma care including situational analysis, pre-hospital care, injury biomarkers, and primary injury care. It notes that injury management should be included as essential knowledge. It highlights India's high injury and trauma mortality rates. There is a need to improve emergency and pre-hospital care services which are currently fragmented in India. The development of trauma care systems and guidelines on classification of injuries and roles in trauma management are needed.
The document discusses important considerations for anesthetic choice in elderly patients undergoing surgery. Older patients are at higher risk of complications and mortality compared to younger patients. Even minor physiologic disturbances during surgery can have serious consequences for frail elderly patients with limited reserve. The choice of anesthetic regimen and agents can help minimize risks. For example, etomidate is preferred over propofol for induction due to lower risk of hypotension in older patients. Careful preoperative evaluation and avoidance of complications is important for optimizing outcomes in elderly surgical patients.
This document discusses manual compression versus arterial puncture closing devices following femoral cardiac catheterization. It identifies coronary artery disease and cardiac catheterization as major health issues. The authors recommend a protocol where arterial puncture closing devices are used for hemostasis in non-high risk patients, while developing a high-risk checklist. They suggest alternative approaches to further study differences between manual compression and arterial puncture closing devices.
Impact of a designed nursing intervention protocol about preoperative liver t...Alexander Decker
This document summarizes a study that assessed the impact of a designed nursing intervention protocol on patient outcomes for liver transplantation. The study was conducted at a university hospital in Egypt and included 14 adult patients scheduled for liver transplantation. Patients who received the nursing intervention protocol were compared to a control group of 52 past patients from the previous 3 years. Outcomes measured included changes in patient knowledge and practice scores before and after the intervention, as well as post-operative complication rates. The results showed statistically significant improvements in knowledge and practice scores for patients who received the protocol, as well as lower rates of respiratory and rejection complications compared to the control group. The study concluded the nursing intervention protocol had a positive impact on patient outcomes.
The study evaluated practices around informed consent for surgery at a hospital in Pakistan. It found that consent was often taken by nurses for elective surgeries and residents for emergencies, rather than surgeons. Patients were usually not well informed about risks and complications. While most patients were told the type of anesthesia, very few were told about anesthesia risks. Consent was often signed by family rather than patients. Overall, current practices did not adequately inform patients or respect patient autonomy, indicating a need for improved informed consent procedures.
This study reviewed the management of 1432 grown-up congenital heart disease patients over 10 years at a tertiary hospital in India. It found a early morbidity rate of 5.2% and identified previous sternotomy, emergency procedures, cross-clamp time over 45 minutes, and cyanotic disease as significant risk factors. Outcomes were generally good with a mortality rate of 1.4% and 86% follow-up completeness. However, the study was limited by its single center retrospective design and loss to follow-up of simpler cases.
This study analyzed data from 1061 chronic heart failure patients in Australia to determine if distance is the main factor affecting access to healthcare. The results showed that 94.8% of patients lived in areas highly accessible to healthcare services. On average, it took patients 25.7 minutes by car to reach the hospital and 8.9 minutes to reach their general practitioner. The study concluded that distance was not the primary factor affecting access, and that other issues like socioeconomic status or health condition severity may play a bigger role.
1) This study investigated whether using 64-slice MDCT as part of the initial diagnostic strategy for patients presenting with acute chest pain could reduce emergency department and hospital length of stay, admissions, and 30-day major adverse cardiac events.
2) 267 patients were randomized to either a conventional diagnostic strategy or a MDCT-based strategy. The MDCT-based strategy reduced unnecessary admissions in patients at intermediate risk and decreased hospital length of stay overall and in high-risk patients specifically.
3) Emergency department length of stay was not different between the strategies. No patients in the MDCT group experienced events at the one-month follow-up.
This document summarizes the outcomes of an emerging pediatric cardiac surgery program's experience with surgical palliation of hypoplastic left heart syndrome (HLHS) and related anomalies between 2010-2014. The program achieved an overall hospital survival rate of 81% by utilizing different surgical strategies including the Norwood procedure, hybrid procedure, and salvage hybrid-bridge-to-Norwood procedure based on individual patient factors. Cardiac comorbidities such as obstructed pulmonary venous return influenced the choice to use a hybrid or salvage strategy. The program's flexible approach and matching of surgical strategy to patient characteristics helped achieve outcomes comparable to benchmark data, despite being a new program.
Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
The effect of clonidine on peri operative neuromuscular blockade and recoveryAhmad Ozair
Background: Alpha-2-agonists are as used adjunct for anaesthesia. We conducted this study with the aim to determine whether the addition of clonidine, an α-2-agonist, decreases the time to recovery from neuromuscular blockade caused by non-depolarising muscle relaxant. Secondary objectives were to know whether clonidine as an adjuvant improves hemodynamic stability, decreases stress hyperglycaemia, pain and time to discharge from Post-Anaesthesia Care Unit (PACU). Methods: This placebo-controlled clinical trial, enrolled 64 patients into clonidine (n = 32) or placebo (saline) group (n = 32). Study drug was given 1.5 mcg/kg IV bolus at the time of induction followed by infusion (1.5 mcg/kg/hour) intra-operatively. Extubation was started when train-of-four (TOF) count was ≥ 2. Primary outcome measure was time to achieve TOF ratio of ≥ 70% and ≥ 90%, assessed at 5, 15, 30- and 60-min intervals following extubation. Results: 2 patients in each group were excluded due to intra-operative requirement of additional supportive medications, hence in each group 30 were analysed. Significant difference was observed between clonidine and placebo groups in terms of time to achieve TOF ratio ≥ 70% and ≥ 90%, stress hyperglycemia, hemodynamic and pain profile, no statistical difference in the Ramsey sedation score and modified Aldrete score between groups. Patients given clonidine required repeat doses of non-depolarising muscle relaxant at longer intervals, with decrease in total amount administered. Clonidine group had a median time to achieve TOF ratio ≥ 70% at 15 min compared to 60 min in placebo group. Conclusion: Clonidine hastens the recovery from neuromuscular block with reduced stress hyperglycaemia and post-operative pain, along with unaffected Ramsey sedation score and modified Aldrete score.
This document discusses different types of triage. It begins by defining triage as a dynamic decision-making process that prioritizes patients' need for medical care when arriving at emergency departments. The document then discusses the history and origins of triage, developing from battlefield use to current emergency department applications. It describes key principles of triage in emergency settings and identifies several types of triage used in different contexts, including disaster triage, military triage, emergency department triage, ICU triage, and telephone triage.
This document summarizes a study comparing outcomes of general versus spinal anesthesia for total hip arthroplasty. The study found higher odds of adverse events, such as prolonged ventilation and unplanned intubation, with general anesthesia. While many studies have found improved outcomes with spinal anesthesia, it remains underutilized. The interpretation of such database studies is limited as they cannot prove causality. A large prospective randomized trial would be needed to definitively compare the techniques.
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after ab...Takehiko Ito
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after abdominal surgery: A questionnaire survey. The 1st International Nursing Research Conference of World Academy of Nursing Science, Kobe: Program & Abstracts, 235.
Geriatric Oncology
1. Relationship between aging and cancer
2. Constructs of frailty and multimorbidity
3. Evidence for geriatric assessment in older adults living with cancer
1) A study of 455 patients undergoing transradial cardiac catheterization found that the rate of radial artery occlusion (RAO) was significantly higher when a 6-French sheath was used (30.5%) compared to a 5-French sheath (13.7%).
2) Multivariate analysis identified female sex, younger age, presence of peripheral artery disease, and use of a 6-French sheath as independent predictors of RAO.
3) For patients who developed symptomatic RAO, treatment with low molecular weight heparin showed a higher rate of recanalization (55.6%) compared to patients who did not receive anticoagulation (13.5%).
1) Geriatric assessment is important for elderly cancer patients to evaluate multiple health domains beyond just cancer and avoid under or overtreatment.
2) Assessments can identify issues like frailty, nutrition, mood, functionality that require management to optimize outcomes and quality of life during cancer treatment.
3) A multidisciplinary approach including nutrition support, exercise interventions, and comprehensive management of geriatric conditions can improve survival and reduce complications in elderly cancer patients.
Classification and Regression Tree Analysis in Biomedical Research Salford Systems
This document discusses using classification and regression tree (CART) analysis to develop clinical decision rules for three clinical settings: 1) emergency department triage of HIV-infected patients, 2) survival prediction of patients with colon and rectal cancer, and 3) prediction of neurologic survival in patients following out-of-hospital cardiac arrest. For each setting, the document describes developing CART models using various clinical variables to classify patients into risk groups and reports validation results for predicting outcomes like medical urgency and survival.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
Management of pediatric blunt renal trauma a systematic reviewskrentz
This systematic review examines current practices in managing pediatric blunt renal trauma conservatively. 32 studies met the criteria of including cases of high-grade renal injuries in children. The literature supports applying conservative management protocols including observation, percutaneous drainage, stenting, and angioembolization to high-grade pediatric renal trauma, with short and long-term outcomes generally being favorable.
This document describes a study conducted at a children's heart center examining alternative surgical strategies for high-risk neonates and infants with congenital heart defects and significant co-morbidities. The study analyzed 442 cardiac surgeries performed between 2010-2013. It found that alternative bi-ventricular and uni-ventricular strategies minimized mortality but were associated with prolonged intubation, ICU stay, and hospitalization compared to standard strategies. Major pre-operative risk factors and lower weight significantly correlated with worse outcomes. The study concludes that flexible surgical approaches allowed survival of high-risk patients, though at the cost of increased resource utilization.
Australian Clinical Consensus Guideline: The diagnosis and acute management o...Carmenlahiffjenkins
This document presents guidelines for the diagnosis and acute management of childhood stroke in Australia. It was developed by an expert panel and is based on a systematic review of evidence from 2007-2017. The guidelines provide over 60 evidence-based recommendations to help clinicians rapidly identify, diagnose, determine the cause of, and treat childhood strokes. Key recommendations include rapid neuroimaging to confirm diagnosis, investigations to identify the cause, treatments like intravenous thrombolysis to restore blood flow to the brain, and management of conditions like raised intracranial pressure. Implementing the guidelines would help minimize delays in care, improve access to treatments, and allow for benchmarking outcomes of childhood strokes in Australia.
PSC_spasticity J of Stroke & Cerebrovascular Dx Oct 2013 Philp et alDon Buskirk
The document describes the development of a poststroke checklist (PSC) to help healthcare providers identify long-term problems in stroke survivors and facilitate appropriate referrals for treatment. An international group of stroke experts generated a list of long-term poststroke problems. Using a Delphi method, 11 key problem areas were identified and included in the PSC, including secondary prevention, activities of daily living, mobility, spasticity, pain, incontinence, communication, mood, cognition, life after stroke, and relationship with caregiver. The goal of the PSC is to standardize long-term care for stroke survivors and improve their quality of life.
The document summarizes new guidelines from the American College of Chest Physicians (ACCP) on antithrombotic and thrombolytic therapy. Key points include:
1) The guidelines provide comprehensive recommendations for preventing and treating thrombosis in pregnant women, children, and perioperative/postoperative patients.
2) For pregnant women, the guidelines recommend stopping vitamin K antagonists before 6 weeks of gestation but continuing them for some with mechanical heart valves. Low molecular weight heparin or unfractionated heparin should be substituted for others.
3) Recommendations for preventing and treating thrombosis in children have been expanded significantly.
This document discusses the management of the neck and cervical lymph nodes in thyroid cancer. It notes that surgery should aim to completely remove cancer while preserving important structures like the voice, airway, swallowing, and parathyroid function. For differentiated thyroid cancers, lymph node dissection generally includes lymph nodes in levels IIa, III, IV, and Vb of the neck. The risks and benefits of prophylactic central neck dissection for papillary thyroid carcinoma are debated, as it may provide prognostic information but also increase risks of temporary complications like hypocalcemia or nerve paralysis.
The document provides information about urinary tract infections and catheter-associated urinary tract infections (CAUTIs). It discusses APIC's mission to reduce infection risks and outlines strategies to prevent CAUTIs. CAUTIs are common in long-term care facility residents with indwelling catheters. Prevention efforts can reduce CAUTI rates and associated risks like bacteremia. Guidelines for CAUTI prevention in hospitals also generally apply to long-term care facilities. A facility's infection risk assessment should identify CAUTI as a priority for intervention strategies outlined in the guide.
Reducing Stroke Readmissions in Acute Care Setting.docxdanas19
This document discusses factors that contribute to readmissions of stroke patients and interventions to reduce readmissions. It notes that readmissions account for 20.5% of hospital admissions and reviews reasons for readmissions like medication issues, lack of follow-up care, and unhealthy lifestyles. The document outlines programs like TRACS, COMPASS and MISTT that provide post-discharge support through nurse coaching, medication management support and lifestyle counseling to reduce readmissions.
1) This study investigated whether using 64-slice MDCT as part of the initial diagnostic strategy for patients presenting with acute chest pain could reduce emergency department and hospital length of stay, admissions, and 30-day major adverse cardiac events.
2) 267 patients were randomized to either a conventional diagnostic strategy or a MDCT-based strategy. The MDCT-based strategy reduced unnecessary admissions in patients at intermediate risk and decreased hospital length of stay overall and in high-risk patients specifically.
3) Emergency department length of stay was not different between the strategies. No patients in the MDCT group experienced events at the one-month follow-up.
This document summarizes the outcomes of an emerging pediatric cardiac surgery program's experience with surgical palliation of hypoplastic left heart syndrome (HLHS) and related anomalies between 2010-2014. The program achieved an overall hospital survival rate of 81% by utilizing different surgical strategies including the Norwood procedure, hybrid procedure, and salvage hybrid-bridge-to-Norwood procedure based on individual patient factors. Cardiac comorbidities such as obstructed pulmonary venous return influenced the choice to use a hybrid or salvage strategy. The program's flexible approach and matching of surgical strategy to patient characteristics helped achieve outcomes comparable to benchmark data, despite being a new program.
Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
The effect of clonidine on peri operative neuromuscular blockade and recoveryAhmad Ozair
Background: Alpha-2-agonists are as used adjunct for anaesthesia. We conducted this study with the aim to determine whether the addition of clonidine, an α-2-agonist, decreases the time to recovery from neuromuscular blockade caused by non-depolarising muscle relaxant. Secondary objectives were to know whether clonidine as an adjuvant improves hemodynamic stability, decreases stress hyperglycaemia, pain and time to discharge from Post-Anaesthesia Care Unit (PACU). Methods: This placebo-controlled clinical trial, enrolled 64 patients into clonidine (n = 32) or placebo (saline) group (n = 32). Study drug was given 1.5 mcg/kg IV bolus at the time of induction followed by infusion (1.5 mcg/kg/hour) intra-operatively. Extubation was started when train-of-four (TOF) count was ≥ 2. Primary outcome measure was time to achieve TOF ratio of ≥ 70% and ≥ 90%, assessed at 5, 15, 30- and 60-min intervals following extubation. Results: 2 patients in each group were excluded due to intra-operative requirement of additional supportive medications, hence in each group 30 were analysed. Significant difference was observed between clonidine and placebo groups in terms of time to achieve TOF ratio ≥ 70% and ≥ 90%, stress hyperglycemia, hemodynamic and pain profile, no statistical difference in the Ramsey sedation score and modified Aldrete score between groups. Patients given clonidine required repeat doses of non-depolarising muscle relaxant at longer intervals, with decrease in total amount administered. Clonidine group had a median time to achieve TOF ratio ≥ 70% at 15 min compared to 60 min in placebo group. Conclusion: Clonidine hastens the recovery from neuromuscular block with reduced stress hyperglycaemia and post-operative pain, along with unaffected Ramsey sedation score and modified Aldrete score.
This document discusses different types of triage. It begins by defining triage as a dynamic decision-making process that prioritizes patients' need for medical care when arriving at emergency departments. The document then discusses the history and origins of triage, developing from battlefield use to current emergency department applications. It describes key principles of triage in emergency settings and identifies several types of triage used in different contexts, including disaster triage, military triage, emergency department triage, ICU triage, and telephone triage.
This document summarizes a study comparing outcomes of general versus spinal anesthesia for total hip arthroplasty. The study found higher odds of adverse events, such as prolonged ventilation and unplanned intubation, with general anesthesia. While many studies have found improved outcomes with spinal anesthesia, it remains underutilized. The interpretation of such database studies is limited as they cannot prove causality. A large prospective randomized trial would be needed to definitively compare the techniques.
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after ab...Takehiko Ito
G112 Ito & Shiromaru (2009). Patients’ coping strategies before and after abdominal surgery: A questionnaire survey. The 1st International Nursing Research Conference of World Academy of Nursing Science, Kobe: Program & Abstracts, 235.
Geriatric Oncology
1. Relationship between aging and cancer
2. Constructs of frailty and multimorbidity
3. Evidence for geriatric assessment in older adults living with cancer
1) A study of 455 patients undergoing transradial cardiac catheterization found that the rate of radial artery occlusion (RAO) was significantly higher when a 6-French sheath was used (30.5%) compared to a 5-French sheath (13.7%).
2) Multivariate analysis identified female sex, younger age, presence of peripheral artery disease, and use of a 6-French sheath as independent predictors of RAO.
3) For patients who developed symptomatic RAO, treatment with low molecular weight heparin showed a higher rate of recanalization (55.6%) compared to patients who did not receive anticoagulation (13.5%).
1) Geriatric assessment is important for elderly cancer patients to evaluate multiple health domains beyond just cancer and avoid under or overtreatment.
2) Assessments can identify issues like frailty, nutrition, mood, functionality that require management to optimize outcomes and quality of life during cancer treatment.
3) A multidisciplinary approach including nutrition support, exercise interventions, and comprehensive management of geriatric conditions can improve survival and reduce complications in elderly cancer patients.
Classification and Regression Tree Analysis in Biomedical Research Salford Systems
This document discusses using classification and regression tree (CART) analysis to develop clinical decision rules for three clinical settings: 1) emergency department triage of HIV-infected patients, 2) survival prediction of patients with colon and rectal cancer, and 3) prediction of neurologic survival in patients following out-of-hospital cardiac arrest. For each setting, the document describes developing CART models using various clinical variables to classify patients into risk groups and reports validation results for predicting outcomes like medical urgency and survival.
Nursesí practices and perception of delirium in the intensive care units of ...Alexander Decker
This document summarizes a study that assessed critical care nurses' practices and perceptions of delirium among critically ill patients in Egyptian intensive care units. The study found that nurses ranked delirium assessment as their fourth priority and that more than half of nurses never assessed for delirium in patients. All nurses reported never receiving training on assessing or managing delirium. While delirium is common in ICU patients and associated with poor outcomes, the study results indicate that it remains under-recognized and under-assessed among ICU patients in Egypt due to lack of protocols, tools, and education for nurses. The study highlights the need to incorporate delirium assessment and management into nursing education and daily ICU care to improve outcomes for critically ill patients.
Management of pediatric blunt renal trauma a systematic reviewskrentz
This systematic review examines current practices in managing pediatric blunt renal trauma conservatively. 32 studies met the criteria of including cases of high-grade renal injuries in children. The literature supports applying conservative management protocols including observation, percutaneous drainage, stenting, and angioembolization to high-grade pediatric renal trauma, with short and long-term outcomes generally being favorable.
This document describes a study conducted at a children's heart center examining alternative surgical strategies for high-risk neonates and infants with congenital heart defects and significant co-morbidities. The study analyzed 442 cardiac surgeries performed between 2010-2013. It found that alternative bi-ventricular and uni-ventricular strategies minimized mortality but were associated with prolonged intubation, ICU stay, and hospitalization compared to standard strategies. Major pre-operative risk factors and lower weight significantly correlated with worse outcomes. The study concludes that flexible surgical approaches allowed survival of high-risk patients, though at the cost of increased resource utilization.
Australian Clinical Consensus Guideline: The diagnosis and acute management o...Carmenlahiffjenkins
This document presents guidelines for the diagnosis and acute management of childhood stroke in Australia. It was developed by an expert panel and is based on a systematic review of evidence from 2007-2017. The guidelines provide over 60 evidence-based recommendations to help clinicians rapidly identify, diagnose, determine the cause of, and treat childhood strokes. Key recommendations include rapid neuroimaging to confirm diagnosis, investigations to identify the cause, treatments like intravenous thrombolysis to restore blood flow to the brain, and management of conditions like raised intracranial pressure. Implementing the guidelines would help minimize delays in care, improve access to treatments, and allow for benchmarking outcomes of childhood strokes in Australia.
PSC_spasticity J of Stroke & Cerebrovascular Dx Oct 2013 Philp et alDon Buskirk
The document describes the development of a poststroke checklist (PSC) to help healthcare providers identify long-term problems in stroke survivors and facilitate appropriate referrals for treatment. An international group of stroke experts generated a list of long-term poststroke problems. Using a Delphi method, 11 key problem areas were identified and included in the PSC, including secondary prevention, activities of daily living, mobility, spasticity, pain, incontinence, communication, mood, cognition, life after stroke, and relationship with caregiver. The goal of the PSC is to standardize long-term care for stroke survivors and improve their quality of life.
The document summarizes new guidelines from the American College of Chest Physicians (ACCP) on antithrombotic and thrombolytic therapy. Key points include:
1) The guidelines provide comprehensive recommendations for preventing and treating thrombosis in pregnant women, children, and perioperative/postoperative patients.
2) For pregnant women, the guidelines recommend stopping vitamin K antagonists before 6 weeks of gestation but continuing them for some with mechanical heart valves. Low molecular weight heparin or unfractionated heparin should be substituted for others.
3) Recommendations for preventing and treating thrombosis in children have been expanded significantly.
This document discusses the management of the neck and cervical lymph nodes in thyroid cancer. It notes that surgery should aim to completely remove cancer while preserving important structures like the voice, airway, swallowing, and parathyroid function. For differentiated thyroid cancers, lymph node dissection generally includes lymph nodes in levels IIa, III, IV, and Vb of the neck. The risks and benefits of prophylactic central neck dissection for papillary thyroid carcinoma are debated, as it may provide prognostic information but also increase risks of temporary complications like hypocalcemia or nerve paralysis.
The document provides information about urinary tract infections and catheter-associated urinary tract infections (CAUTIs). It discusses APIC's mission to reduce infection risks and outlines strategies to prevent CAUTIs. CAUTIs are common in long-term care facility residents with indwelling catheters. Prevention efforts can reduce CAUTI rates and associated risks like bacteremia. Guidelines for CAUTI prevention in hospitals also generally apply to long-term care facilities. A facility's infection risk assessment should identify CAUTI as a priority for intervention strategies outlined in the guide.
Reducing Stroke Readmissions in Acute Care Setting.docxdanas19
This document discusses factors that contribute to readmissions of stroke patients and interventions to reduce readmissions. It notes that readmissions account for 20.5% of hospital admissions and reviews reasons for readmissions like medication issues, lack of follow-up care, and unhealthy lifestyles. The document outlines programs like TRACS, COMPASS and MISTT that provide post-discharge support through nurse coaching, medication management support and lifestyle counseling to reduce readmissions.
Operartions research in US Healthcare IndustryPrasant Patro
1. This document describes how operations research (OR) models can help reduce delays in healthcare. It identifies three major sources of delays: emergency department delays, delays for medical appointments, and delays for nursing care.
2. Within emergency department delays, it notes long wait times to see physicians and delays in getting inpatient beds once admitted. For medical appointments, it describes waits of several weeks on average to see primary care physicians. Delays for nursing care can compromise patient safety due to insufficient staffing levels.
3. It argues that healthcare delays remain prevalent because they have not been well measured or reported, hospitals face cost pressures to maximize occupancy, and national shortages of healthcare professionals exacerbate delays. OR models have
2Running Head Nursing Informatics on Patient Outcomes 2Nurs.docxlorainedeserre
2
Running Head: Nursing Informatics on Patient Outcomes
2
Nursing Informatics on Patient Outcomes
The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies
Nicole L Rosser
Walden University
NURS 6051
June 16, 2019
The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies
According to Agha (2014) “Information technology has been linked to productivity growth in a wide variety of sectors, and health information technology (HIT) is a leading example of an innovation with the potential to transform industry-wide productivity.” Due to evidence-based practice research with informatics in the healthcare setting has proven to be a well-known, much needed entity. Studies have shown the efficiency of technology in healthcare improved documentation for healthcare providers and nurses. Healthcare technology also provides a means for organizations to communicate with each other without even picking up a phone. Another, aspect of technology in healthcare allows the healthcare team to monitor trends and changes in a patient’s status. For example, a critical patient on a cardiac monitor would alarm to quickly notify the nurse that a critical change has occurred for timely interventions to take place. With stroke being the fifth leading cause of death in the U.S. adopting Stroke Telemedicine into practice would be innovative for any organization. Much research has shown that healthcare facilities remain untrained and unprepared for stroke care and management.
Proposed Project
The project proposed to better equip my organization with treating stroke patients is Telestroke. According to the Mayo Clinic (2019) “In telestroke, also called stroke telemedicine, doctors who have advanced training in treating strokes can use technology to treat people who have had strokes in another location.” The use of this system is said to reduce wait time for an onsite neurologist and to increase one’s chances of receiving prompt treatment for a desirable outcome. This service will also save money by preventing Medicare and Medicaid from having to pay rehabilitation cost due to disabilities and long-term care. Telestroke will also provide efficient time for Tissue Plasminogen Activator (tPA). The drug tPA is an FDA-approved medication also known as a clot buster use in treating strokes to dissolve that which may be causing an ischemic stroke. However, it is contraindicated with a hemorrhagic stroke which may cause an excessive amount of bleeding if given due to the broken vessels that may have caused the stroke. This service has brought together neurologist and emergency physicians that feel using Telestroke will reduce geographical disparities and prevent increased cost from misuse of other medical facilities.
Stakeholder Impacted by This Project
One of the main stakeholdersthat would be affected in this project would be Dr. Buehler who is the regional director of all the Urgent Cares and Clinical Decision- ...
Nephrology Nursing Journal September-October 2014 Vol. 41, No. 5 447
Patient Safety and Patient Safety
Culture: Foundations of Excellent
Health Care Delivery
Primum non nocere. First do no harm.
Patient safety forms the founda-tion of healthcare delivery justas biological, physiological,and safety needs form the
foundation of Maslow’s hierarchy
(Maslow, 1954). Little else can be
accomplished if the patient does not
feel safe or is, in fact, not safe. But the
healthcare system is extremely com-
plex, and ensuring patient safety
requires the ongoing, focused efforts
of every member of the healthcare
team.
Patient safety moved to the fore-
front in health care with the release in
1999 of the Institute of Medicine (IOM)
landmark report, To Err is Human:
Building a Safer Health System, which
estimated that annually in the United
States, up to one million people were
injured and 98,000 died as a result of
medical errors (IOM, 2000). The re -
port caught the attention of the media,
and there were headlines across the
nation about the safety (or lack of safe-
ty) for patients in healthcare organiza-
tions. In 2013, James updated the esti-
mate of patient harms associated with
Beth Ulrich
Tamara Kear
Continuing Nursing
Education
Beth Ulrich, EdD, RN, FACHE, FAAN, is
Editor, the Nephrology Nursing Journal, and a
Professor, the University of Texas Health Science
Center at Houston School of Nursing. She is a Past
President of ANNA and a member of ANNA’s
Sand Dollar Chapter. She may be contacted direct-
ly via email at [email protected]
Tamara Kear, PhD, RN, CNS, CNN, is an
Assistant Professor of Nursing, Villanova
University, Villanova, PA, and a Nephrology
Nurse, Liberty Dialysis. She is on the Editorial
Board for the Nephrology Nursing Journal,
serves as the ANNA Research Committee chairper-
son, and is a member of ANNA’s Keystone Chapter.
Statements of Disclosure: Please refer to page
457.
Note: Additional statements of disclosure and
instructions for CNE evaluation can be found on
page 457.
This offering for 1.4 contact hours is provided by the American Nephrology Nurses’
Association (ANNA).
American Nephrology Nurses’ Association is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center Commission on Accreditation.
ANNA is a provider approved by the California Board of Registered Nursing, provider number
CEP 00910.
This CNE article meets the Nephrology Nursing Certification Commission’s (NNCC’s) continu-
ing nursing education requirements for certification and recertification.
Copyright 2014 American Nephrology Nurses’ Association
Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of ex -
cellent health care delivery. Nephrology Nursing Journal, 41(5), 447-456, 505.
In 1999, patient safety moved to the forefront of health care based upon astonishing sta-
tistics and a landmark report released by the Institute of Medicine (IOM). This report,
To Err.
This document is the introduction to the third edition of the Echocardiography Review Guide, which is intended to complement the fifth edition of the Textbook of Clinical Echocardiography. The review guide provides a concise review of echocardiography principles, a step-by-step guide to performing echocardiograms, and self-assessment questions for each chapter to help readers consolidate their knowledge. It is recommended that this review guide and the textbook be used together.
This document discusses an evidence-based quality improvement project aimed at evaluating the effectiveness of an educational intervention for nurses on reducing catheter-associated urinary tract infection (CAUTI) rates. The project would employ a pretest-posttest design to assess the impact of education on nurses' knowledge and facility CAUTI rates. Permission is being requested to conduct the project at a hospital where CAUTI rates are currently higher than the national benchmark according to published data. Potential benefits include cost savings from a reduction in CAUTI treatment and reimbursement risks, while there are no anticipated risks to patients. Nurses may have to work longer hours to care for patients with CAUTIs.
Nurses' Performance regarding Patients with Cardiac Arrhythmiasmohammed Abd el sayed
This study aimed to assess nurses' performance in caring for patients with cardiac arrhythmias in Egypt. The researchers surveyed 67 nurses working in cardiac care units using a questionnaire to evaluate their knowledge, a skills assessment to evaluate their practice in identifying different arrhythmias, and a scale to assess their attitudes. The results found that 62.7% of nurses had an unsatisfactory level of knowledge, while 64.2% and 77.6% had adequate practice levels and positive attitudes, respectively. A statistically significant correlation was found between nurses' knowledge and practice, practice and attitude, and knowledge and attitude. The researchers recommend providing nurses with periodic training programs to improve patient care for those with cardiac arrhythmias.
The document discusses the role of nurses in improving patient safety in colorectal surgery. It emphasizes that patient safety should be the top priority and is a shared responsibility. The Enhanced Recovery After Surgery (ERAS) program plays an important role in pre-operative patient safety, focusing on goals like reduced fasting and avoidance of unnecessary interventions. Proper pre-operative stoma site marking by nurses is also discussed as an important way to reduce postoperative complications. Overall, the document stresses the importance of multidisciplinary teamwork and a holistic, patient-centered approach to ensure high quality, safe care.
The document discusses the role of nurses in improving patient safety in colorectal surgery. It emphasizes that patient safety should be the top priority and is a shared responsibility. The Enhanced Recovery After Surgery (ERAS) program plays an important role in pre-operative patient safety, focusing on goals like reduced fasting and avoidance of unnecessary devices. Proper pre-operative stoma site marking by nurses is also discussed as an important way to reduce postoperative complications. Overall, the document stresses the importance of multidisciplinary teamwork and a holistic, patient-centered approach to ensure high quality, safe care.
This document discusses various aspects of mechanical ventilation and weaning patients off ventilators. It addresses the problems associated with prolonged intubation versus premature extubation. It emphasizes the nurse's responsibility to monitor patients' readiness for weaning and to gradually decrease mechanical support. The document also discusses definitions of weaning success and ensuring patients are weaned at the appropriate time.
Barriers to Health Care Access for Low Income Families.docxwrite31
Patient safety issues in healthcare can arise from errors such as misdiagnosis, poor communication between providers, and an overburdened healthcare system. The most common causes of safety lapses are preventable adverse events stemming from diagnostic errors, failures to consider patient context, and miscommunication. Implementing electronic health records and improving communication standards and leadership can help create a culture of safety to reduce errors and protect patients.
1) The study assessed nurses' knowledge and practice regarding care of patients with chest drains at Sudan Heart Center hospital.
2) It found that while nurses had average knowledge of basic drain functions and complications, over 60% lacked knowledge of specific aspects like underwater seal positioning and routine drain milking.
3) The study also found that most nurses demonstrated poor practice in preparing equipment for drain insertion and providing routine patient care.
Detection of myocardial infarction on recent dataset using machine learningIJICTJOURNAL
In developing countries such as India, with a large aging population and limited access to medical facilities, remote and timely diagnosis of myocardial infarction (MI) has the potential to save the life of many. An electrocardiogram is the primary clinical tool utilized in the onset or detection of a previous MI incident. Artificial intelligence has made a great impact on every area of research as well as in medical diagnosis. In medical diagnosis, the hypothesis might be doctors' experience which would be used as input to predict a disease that saves the life of mankind. It is been observed that a properly cleaned and pruned dataset provides far better accuracy than an unclean one with missing values. Selection of suitable techniques for data cleaning alongside proper classification algorithms will cause the event of prediction systems that give enhanced accuracy. In this proposal detection of myocardial infarction using new parameters is proposed with increased accuracy and efficiency of the existing model. Additional parameters are used to predict MI with more accuracy. The proposed model is used to predict an early diagnosis of MI with the help of expertise experiences and data gathered from hospitals.
Background: Cardiac catheterization (CC) is the inserting of a thin, hollow catheter into a chamber or vessel; it is done for diagnostic and intervention purposes. Death charges from coronary heart disease have decreased in recent decennium, however, coronary heart disease is still a major cause of morbidity and mortality worldwide especially in developed countries. Coronary heart disease refers to different conditions of failing circulation of the heart and includes myocardial infarction (MI). In this study, we assessed the patients’ knowledge regarding CC.
Materials and Methods: A descriptive study was conducted with a purposive sample of 250 patients were selected and included from Cardiac Specialty Hospital in Slemani City, Iraq. This study was carried out between November 2017 and October 2018. A self-conductive questionnaire was used for data collection.
Results: Totally 250 patients were included in this study. Among 250 patients, 176 (70.4%) were males and 74 (29.6%) females. The validity of the questionnaire was estimated through a panel of experts related to the field of the study, and its reliability was determined through a pilot study which was carried out on 105 patients who were selected purposively from the patient were admitted those who have undergone the procedure at Cardiac Specialty Hospital in Slemani city. Most 70.4% of the participants were male and the majority 212 (84.8%) were Kurdish and more than a quarter of the patient’s age was in group 60 years and above. Among 250 patients, 202 (80.8%) were married and 117 (46.8 %) of study participants were illiterate, 171 (68.4%) of them were unemployed, and 148 (59.2%) were lived in an urban area.
Conclusion: Our present study showed that the majority of participants had a low level of knowledge regarding CC as well as the level of knowledge from post-CC was higher than pre-CC procedure.
Key Words: patients’ Knowledge, cardiac catheterization, pre and post-cardiac catheterization, Slemani City, Iraq
This document describes a study protocol to evaluate the effectiveness of a planned teaching program for preventing pressure ulcers among fracture patients in a selected hospital in Bangalore. The study aims to provide patients and their family members with health education to improve knowledge on preventing pressure ulcers. A literature review found that pressure ulcer incidence is high for immobile patients like those with orthopedic fractures. Studies show prevention is better than treatment and nurses play a key role in educating patients and monitoring skin integrity. The planned teaching program aims to reduce pressure ulcer rates by empowering patients with knowledge on prevention.
Reflection Journal 10Assessment DescriptionStudents are requir.docxcargillfilberto
Reflection Journal 10
Assessment Description
Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.
In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:
Please focus on the topic: Fall Prevention in Outpatient Radiology Clinic
New practice approaches
Intra-professional collaboration
Healthcare delivery and clinical systems
Ethical considerations in health care
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities
Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
RN to BSN
1.3: Understand and value the processes of critical thinking, ethical reasoning, and decision making.
2.6: Promote interprofessional collaborative communication with health care teams to provide safe and effective care.
3.2: Utilize patient care technology and information management systems.
4.2: Preserve the integrity and human dignity in the care of all patients.
5.5: Provide culturally sensitive care.
20XXKRONA HOSPITAL OPERATING BUDGET FOR 20XXRevenuesInpatient $ 25,000,000Outpatient15,000,000Emergency Room10,000,000Laboratory5,000,000Pharmacy1,500,000Home Health and Hospice1,500,000Ambulance Services950,000Substance Abuse250,000Other850,000Subtotal$ 60,050,000Less Chartiy Care18,000,000Net Revenues$ 42,050,000ExpensesPayroll (including nursing salaries)$ 12,500,000Benefits3,000,000Contract Labor100,000Insurance300,000General Services (laundary, security, etc)3,000,000Depreciation 1,500,000Interest Expense300,000Professional Services10,000,000Total Operating Expenses$ 30,700,000Net Income$ 11,350,000
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Sheet3
Benchmark - Capstone Project Change Proposal
Mananita Gerochi-Caparas
Grand Canyon University
NRS-493-O503 Professional Capstone and Practicum
Davida Murphy Smith
October 23, 2022
Benchmark - Capstone Project Change Proposal
Background
Falling incidences are prevalent among older patients. In so.
The document discusses the nursing process and its role in developing clinical judgment and reasoning skills. It describes the nursing process as having five key steps - assessment, diagnosis, planning, implementation, and evaluation - which provide an organized framework to guide care. This framework allows nurses to build their knowledge, develop customized care plans for each client, and gain critical thinking abilities through evaluating the success of interventions.
Similar to Creating Learning Guideline for Nurses Caring for Patients Safety Undergoing Cardiac Catheterization (18)
The purpose of this study was to determine how parenting contributes to deviancy in school among students at Bokamoso Junior Secondary School. The study was a descriptive survey in which a questionnaire was administered to Form 2 and Form 3 students of Bokamoso Secondary School to collect data. The results were then presented using mean and standard deviation. The results showed that majority of students were male around the age of 16-20 years. The results further revealed that parental involvement has a significant influence on students being deviant, which was given by an average mean of 2.55 which is above the criterion mean of 2.50 and average standard deviation of 0.572. It was concluded that parenting is factor associated with a deviancy amongst students at Bokamoso Secondary School. It was therefore recommended that they should be a joint disciplinary council consisting of parents or guardian, teachers and school management which usually recommends on how to deal or act on certain offences depending on the gravity of offences.
This paper studies the pattern of students’ movement within and around the various classes of degrees in Modibbo Adama University of Technology, Yola, Nigeria. In this paper, a transition matrix was developed for the five classes of degrees using movement patterns in ten consecutive semesters (2011 – 2016). The probabilities of moving across the five different classes was obtained. Furthermore, a fundamental matrix was obtained to determine the expected number of students who stay within each particular class (stayers).
This study endeavoured to establish the characteristics of effective teachers and how these characteristics assisted teachers to improve learner performance. To address this aim, a case study design was employed as a methodology for the study, consisting of five rural schools. A literature study was conducted, alongside semi-structured individual interviews with five school principals and focus group interviews with twenty eight teachers from the same rural schools from where school principals were drawn. The collected data was analysed thematically, by establishing themes and their emerging categories. The established themes and their categories were interpreted and discussed to answer the research questions. The major findings of the study revealed that an effective teacher has a blend of three characteristics, namely, professional characteristics, personality characteristics and social characteristics. The blend of characteristics contribute to the quality of teaching and learning processes. The study recommended that educational practitioners in diversity should be cognisant of the characteristics of effective teachers and nurture them appropriately as these characteristics have a life-transforming effects on the lives of the learners.
This study endeavoured to establish the characteristics of effective teachers and how these characteristics assisted teachers to improve learner performance. To address this aim, a case study design was employed as a methodology for the study, consisting of five rural schools. A literature study was conducted, alongside semi-structured individual interviews with five school principals and focus group interviews with twenty eight teachers from the same rural schools from where school principals were drawn. The collected data was analysed thematically, by establishing themes and their emerging categories. The established themes and their categories were interpreted and discussed to answer the research questions. The major findings of the study revealed that an effective teacher has a blend of three characteristics, namely, professional characteristics, personality characteristics and social characteristics. The blend of characteristics contribute to the quality of teaching and learning processes. The study recommended that educational practitioners in diversity should be cognisant of the characteristics of effective teachers and nurture them appropriately as these characteristics have a life-transforming effects on the lives of the learners.
This research study examined the influence of self-regulation skills and social competence on the academic achievement of lower primary school pupils in Osun State, Nigeria. The study used a correlational research design and surveyed 418 primary 3 pupils across 9 local government areas using three instruments to measure self-regulation skills, social competence, and academic achievement. The results showed that pupils had low levels of behavioral and verbal self-regulation skills, average levels of emotional self-regulation skills, and overall low levels of self-regulation skills. Pupils showed high levels of social competence. Statistical analysis revealed a significant influence of self-regulation skills and social competence on pupils' academic achievement. The study concluded that social competence had a greater influence on academic achievement compared
With growth in enrollment in online courses at the university level, the quality of those courses is coming under increased scrutiny. This study surveyed faculty with experience in online, onsite, and blended courses to identify factors most likely to impede student success in online courses as well as strategies to improve online courses. The most common responses for why students might find online courses more challenging focus in the areas time management, student-teacher interaction, and motivation. The strategies for improving student success in online courses fall into the categories of assignments, teaching strategies, and training for both faculty and students. Steps for students to take before enrolling in an online course and tips for faculty who want to teach online courses for the first time are also included as appendices.
This paper focused on analysis of emergence of criminal groups in Dar es Salaam city and Zanzibar town. Data collection was based on in-depth interviews and focus group discussions. Content analysis was used in analysis of data collected from the study. The study findings revealed that youths are vulnerable and susceptible to criminal activities due to corruption, fake promises from politicians, education systems, laxity of parental or guardians’ care and inspiration of children to live luxurious life. In addition, the study recommended to take proper moves that police operation and other government authorities undertake on use of force that cannot end such societal challenges. Instead, the government should provide education system, which is skilled oriented to enable young people to employ themselves. In addition, more efforts are needed to fight corruption from low level to high level of government system.
Zambian communities are rich with voices of the value of adult education, albeit unsystematically documented. It is these insightful voices that this article unveils. Phenomenological research design was employed. Three research sites were targeted comprising two chiefdoms and covering four villages, two villages from each chief dom. Data was collected using interviews and focus group discussions. After coding the data, narrative and thematic methods of data analysis were used. Findings reveal that the value of adult education is measured informally by the number of the adult population able to access social amenities equitably and equally on one hand, and on the other, by their ability to read the ‘word and the world’ as purported by Freire and Macedo (1987).
Despite a healthy production of teachers, teacher attrition is a significant concern facing school administrators across the state of Texas. This study sought to determine the extent to which questions on the Exit and Principal Surveys reflect three sets of standards which guide educator preparation in Texas: Association of Teacher Educators (ATE) Standards for Teacher Educators, Texas Administrative Code (TAC) Educator Preparation Program Curriculum Standards, and Pedagogy and Professional Responsibilities (PPR) Exam Standards. This analysis provides important information about the validity of survey questions as a measure of standards compliance for educator preparation in Texas and also sought to determine if there is a difference between teacher candidates’ Exit Survey evaluation of preparation and principals’ Principal Survey evaluation of first-year teachers’ preparation. Findings indicated a clear disconnect. Recommendations are provided as contributions for future discussion on much needed educator preparation program standards reform.
This research study examined the effect of individual counseling on the academic performance of underachieving pupils at Maimusari Public Primary School in Borno State, Nigeria. The study found that common causes of underachievement among pupils included arriving late to school, not having complete learning materials, depression, anxiety, and negative teacher attitudes. The study also revealed that individual counseling helped pupils overcome learning barriers and significantly improved their academic performance. It is recommended that teachers be trained to identify underachieving pupils and refer them for counseling support.
The study contributes to the on-going debate regarding the significance of early childhood teachers’ instructional decision-making that take into consideration their theoretical knowledge (explicit theories) and practical experiences (implicit theories) and how they impact their instructional decision-making processes in diverse socio-cultural contexts of children. To address this gap in the literature, a qualitative multi-case study into the perceptions and classroom practices of four kindergarten teachers in two Ghanaian schools, Tata and Kariba, was carried out over a six-month period. One research question that sought to explore factors and beliefs influencing teachers’ instructional decision-making in a kindergarten classroom guided the study. Data sources used were semi-structured individual interviews and pair-based interviews and fieldnotes of classroom observations. Both within and across case interpretative analysis, as outlined. The study’s findings revealed that these teachers’ explicit theories and implicit theories of teaching influenced their instructional decision-making processes in kinder garten classrooms.
The study aimed to evaluate the “Human resource management for vocational schools at Bac Ninh province, Viet Nam: A model of faculty development program”. It concentrated on evaluating the existing Human resource management for vocational schools of the province, determining demographic profile of the respondents, profile of vocational schools. In order to come up with this analysis, a survey covering 50 specific vocational schools is implemented aiming to assess current status of the development of contingent of teachers and the factors affecting the development of teaching staff for vocational schools in Bac Ninh province such as Human resource planning; Recruitment and selection; Training and development Retention and maintenance; Promotion; Labor relations; and Transfer and retirement. Thereby, identifing the limitations in Human resource management of vocational schools. Based from all the findings of this study, the following conclusions were derived: The human resource management of vocational schools on Bac Ninh province still limited. Human resources in sufficient quantity, but the structure is not reasonable, lack of highly qualified and experienced faculty. Support policies are not sufficient to motivate faculty and attract highly qualified human resources. From the cited summary of findings and conclusions, the following are hereby recommended: Re-examining all the plans and programs for the Quality of Human Resource so that necessary updating and modification can be done; Strongly focusing on recruitment process and policies of training and retraining human resources, Specific strategies for implementing these plans must also be considered. Conducting regular evaluation of all the programs must be implemented.
The study investigated the differences in leadership styles exhibited by principals of public Colleges of Education in Ghana in relation to their sex, age, years of work experience, and academic qualification. The cross-sectional survey design was adopted for the study. The target population was made up of all 46 principals of public Colleges of Education in Ghana. The target population consisted of all 38 public Colleges of Education which were in existence before the absorption of eight private Colleges of Education by the government of Ghana into public system. The purposive sampling technique was used to select 38 principals for the study. The Multifactor Leadership Questionnaire developed by Bass and Avolio (2004) was adapted to collect data. Means, standard deviations, t-test and ANOVA were used to analyse the data. The findings revealed that there were no statistically significant differences in the leadership styles of the principals of public Colleges of Education in Ghana based on their sex, age, and academic qualification. However, there were statistically significant differences in the leadership styles adopted by the principals in relation to their years of work experience. It was therefore concluded that many years of experience of principals of public CoEs in Ghana is critical for good leadership in these colleges. Among the recommendations was that the National Council for Tertiary Education (NCTE) should consider years of work experience in the selection and appointment of principals for public Colleges of Education in Ghana. Additionally, in-service training and refresher courses should be organized regularly by NCTE for principals on the leadership styles suitable for achievement of objectives and goals of their colleges.
This document summarizes a research study on the challenges of teaching English to young learners in primary schools in Kuwait. The study collected data through surveys of 20 English teachers and interviews/observations of teachers in 5 educational areas of Kuwait. The main challenges identified were lack of teacher training, inadequate resources, large class sizes that make communicative language teaching difficult, exams that focus on grammar over skills, and limited use of English in and outside the classroom. The researchers concluded that teachers face significant obstacles in teaching English to young learners locally in Kuwait.
The study examines the effect of improvisation of teacher-made instructional media on students’ performance in some selected primary science concepts. Thus, a pre-test and post-test, non-randomized experimental design was adopted for the study. Three thousand, three hundred and sixty-eight (3,368) primary six pupils from 48 public primary schools in Akwa Ibom State formed the population while two hundred and nineteen primary six pupils from two schools formed the sample for the study. The two intact classes were exposed to standard and improvised science equipment. A Primary Science Performance Test (PSPT) instrument was used to collect data before and after each lesson. A t-test statistical analysis revealed that there is no significant difference of the post-test performance of intact classes exposed to improvised science equipment and those standard equipment indicating that pupils benefited equally from the standardized and improvised equipment with t-calculated score of 1.34 below the t-critical 2.92. It is recommended that the government should organize workshop on the use of improvised materials to change the orientation of the teacher centred instructional approach to teaching primary science.
Child and Youth Care (CYC) students have the right to be engaged in pedagogical practices that inspire and arouse their curiosity about their field of practice. Undergraduate course-based research in which students have an opportunity to conduct authentic research within a for-credit course is one such high-impact pedagogical practice with a growing body of evidence-based outcomes. This article presents an undergraduate course-based research project that examined child and youth care student’s beliefs about displaying love as a component of their practice. Located in the constructivist/interpretive research paradigm, this course-based research project collected data through the use of an expressive arts-based data method followed by a semi-structured questionnaire. Four overarching themes were identified during the thematic analysis: (a) authentic caring involves expressions of love, (b) expressions of love are an essential component of growth and development, (c) loving care as an ethic of relational practice, and (d) but…professionalism stands in the way. The results of this course-based study suggest that expressing love as a component of relational-centred CYC practice is not fully understood by CYC students and that much more research is needed to explore this issue.
This research describes an attempt to establish a pedagogically useful list of the most frequent semantically non-compositional multi-word combinations for English for Journalism learners in an EFL context, who need to read English news in their field of study. The list was compiled from the NOW (News on the Web) Corpus, the largest English news database by far. In consideration of opaque multi-word combinations in widespread use and pedagogical value, the researcher applied a set of selection criteria when using the corpus. Based on frequency, meaningfulness, and semantic non-compositionality, a total of 318 non-compositional multi-word combinations of 2 to 5 words with the exclusion of phrasal verbs were selected and they accounted for approximately 2% of the total words in the corpus. The list, not highly technical in nature, contains the most commonly-used multi-word units traversing various topic areas and news readers may encounter these phrasal expressions very often. As with other individual word lists, it is hoped that this opaque expressions list may serve as a reference for English for Journalism teaching.
The main objective of this study is to explore how podcasting can be implemented in teaching English as a Second Language as a supportive technological tool and thus contribute to the development of positive attitudes and beliefs of the learners. To this aim, the field experiment research was conducted. The study was carried out in a total of 28 pupils of the first grade of high school at an educational institution on Rhodes, Greece in February 2018. The students were assigned into the experimental group (15 students) and the control group (13 students). The results of the research have shown a positive change in students’ attitudes and beliefs, though no statistically significant difference has arisen regarding the students’ interest in the course, their self-confidence in English, the role of gender in learning English and the difficulties students come across when studying English. Similarly, no significant change has occurred regarding the usefulness of English, the importance of the English accent and the knowledge of another foreign language as a contributing factor to learning English more easily. Finally, a negative change was found regarding difficulties in oral communication in English.
One of the challenges of higher education focuses on the improvement of personal and professional skills of students, with the aim of strengthening strategies that include cutting-edge resources in the learning process. The appropriate use of Information and Communication Technologies (ICTs) in teaching work as support in face-to-face mode, has a significant impact on engineering professionals. With the correct handling of instruments, strategies, evaluations and educational materials mediated by technologies, which provide great advantages, where the student can work at their own pace and improve the synchronous and asynchronous communication channels with the teacher and their classmates to develop skills and acquire experiences. This work presents the incorporation of educational resources in virtual scenarios as support to the learning units taught in face-to-face modality in the Interdisciplinary Professional Unit of Engineering campus Guanajuato (UPIIG), with the purpose of reinforcing in the student self-management of knowledge to discover new teaching experiences and motivate them in the achievement of meaningful learning.
This study aims to recognize effectiveness methods of teaching skills in primary school in English , the researcher used the numbered heads together strategy as an effective method in education skills, the researcher used an experimental design with two groups (control group and experiment group), with a post-test for the achievement of Al-Khamaal Primary school , Fifth class , The sample of the study consisted of (60) pupils at Al-Khamaal Primary school in English, for the academic year (2018-2019). The researcher equaled the two research groups statistically by ( age by months, the marks of the last year, the achievement of the parents), so there were no statistical significance between the two groups in variables. The researcher used a test to collect data. The analysis of the data showed that the numbered heads together strategy has a great effect in teaching skills at primary schools. At the end of this study, the researcher presented some recommendations. These recommendations that focus on paying more attention to the learning strategies that used to improve educational process, moreover, teacher at primary schools should use effective strategies and effective methods in teaching skills.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
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Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
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Creating Learning Guideline for Nurses Caring for Patients Safety Undergoing Cardiac Catheterization
1. Research Journal of Education
ISSN(e): 2413-0540, ISSN(p): 2413-8886
Vol. 4, Issue. 7, pp: 101-109, 2018
URL: http://arpgweb.com/?ic=journal&journal=15&info=aims
Academic Research Publishing
Group
*Corresponding Author
101
Original Research Open Access
Creating Learning Guideline for Nurses Caring for Patients Safety Undergoing
Cardiac Catheterization
Lamiaa Ismail Keshk*
Assistant Professor in Nursing administration Department, Faculty of Nursing/Helwan University, Egypt
Samia Eaid Elgazzar
Lecturer at Medical Surgical Nursing Department, Faculty of Nursing, Port Said University, Egypt
Abstract
Background: Cardiac catheterization is considered as the gold standard practice for the recognition and diagnosis
coronary heart disease. The hazard physically and emotionally occurs from this procedure can disturb the patient’s
perception of their health. Nursing care is vital in survival and avoids the patients from post cardiac catheterization
problems. So the competence of nurses about knowledge and practice regarding patient care after cardiac
catheterization is very crucial. Aims: the aim of this study to investigate the effect of creating learning guideline for
nurses caring for patients safety undergoing cardiac catheterization. Methods: A quasi experimental research design
was conducted. The study was conducted at the Cardiac Catheterization intensive care, cardiac care and emergency
units at general Port Said hospital in Port Said city – Egypt. Subjects: A purposive sample of 51 nurses was working
in those departments. Tools: two tools were utilized. Tool I: consisted of the following: Part 1: Socio-demographic
data of the nurses. Part II: nurses’ knowledge about cardiac catheterization. Tool II: Nursing care after cardiac
catheterization to providing patient safety. Results: The study revealed that the majority of nurses have a highly
satisfactory level of knowledge and performance regarding patient safety on cardiac catheterization post
implementation the learning guideline than pre learning guideline. It was reflected positive correlation between nurses
qualification, experience and knowledge regarding patient's safety at post learning guideline with significant
difference regarding experience. While, there was a strong positive correlation between the performance of studied
nurses and their qualification regarding the post learning guideline implementation with significant. Finally, positive
correlation between performance and knowledge regarding patient safety at post learning guideline implementation.
Conclusion: it can be concluded that learning guideline considerably improved the nurses’ level of knowledge and
performance regarding Caring For Patients Safety Undergoing Cardiac Catheterization. Overall knowledge score
between pre learning guideline and post learning guideline was found to be significant. While, total performance
score between pre learning guideline and post learning guideline was found to be not significant. Therefore, the
learning guidelines are recommended for educating these nurses to promote knowledge and performance regarding
patient safety to decrease hazards following cardiac catheterization.
Keywords: Creating; learning guideline; Patients safety; Cardiac catheterization.
CC BY: Creative Commons Attribution License 4.0
1. Introduction
Coronary Artery Disease (CAD) is the leading cause of death in both men and women (CDC, 2010). CAD occurs
primarily due to a build-up of plaque inside the arteries of the heart which supply blood to the heart muscle. When the
arteries become narrowed from plaque, there is a lack of blood circulating to the heart muscle which can cause
irreversible damage. This in turn can lead to chest pain, myocardial infarction (MI) and possibly death Schiks et al.
(2008). According to the Centers for Disease Control (CDC), it was estimated that over 631,000 people died from
heart disease, and more than half of those individuals were women (2006). In the United States (US), someone has a
heart attack every 34 seconds, and every minute there is a death related to a heart disease related event CDC and
NCHS (2015). Cardiovascular diseases are known as the leading cause of death in the world Jamshidi et al. (2010).
According to World Health Organization, about 18 million deaths occurred due to cardiovascular diseases in 2008
and this value has been estimated to reach 23 million by 2030 World Health Organization (2013).
Cardiac catheterization (cardiac cath or heart cath) is a procedure to examine how well your heart is working. A
thin, hollow tube called a catheter is inserted into a large blood vessel that leads to your heart. View an illustration
of cardiac catheterization American (2018). Cardiac catheterization is an percutaneous treatment which is used in the
diagnosis and management of various cardiac heath problem. It may prime to some major and minor complications
which may lead to disease and death .Early identifying of complications and appropriate intervention is logically tight
to compelling action to have prompt management and thus diminishing additional complications. Nearly
complications happens during the transfer of patients later cardiac catheterization or late or inadequately provided
care. Patient safety is defined as being free from accidental harm as a result of a health care encounter. It is the
responsibility of the cardiac catheterization team to make that commitment to every patient and to each other. A well-
functioning unit with a culture of safety, demonstrated clinical quality outcomes, and high internal/external customer
satisfaction scores can avoid the risks associated with a less reliable unit Arathy (2011) and Michael et al. (2018)
2. Research Journal of Education
102
Complications are usually temporary and may include minor infections, bleeding, abnormal heartbeats, and
reaction to medications or dye. There is also a possibility that more serious but rare problems may develop during the
procedure. These major cardiac catheterization complications include heart or lung problems, stroke, heart attack, or
kidney failure. The frequency of haematoma was 1.3% (>10 cm) and 8.9% (>5 cm), which corresponds with reports
from similar studies and departments. The factors found to increase the risk of haematoma development can provide
background for procedural changes and increase the focus on patients at increased risk in order to minimize the
development of haematomas Anderson et al. (2005).
Cardiac nurse must assess and care for patients with cardiac problems as well as patients undergone cardiac
catheterizations procedures, patient for any negative signs of a change in condition, safe transport, administering
medication, help with basic personal care needs control of bleeding, maintenance of haemostatis. This will help in
minimizing the vascular complications in patient. Increased risk for vascular complications was found in patients who
were older than 70 years, were female, had renal failure, underwent percutaneous intervention. Dumont et al. (2006)
Cardiac nurses are responsible for providing patient’s safety and minimizing vascular complications after cardiac
catheterization procedures. They should be aware about the guidelines for providing safety for the patient. Each nurse
should know the high risk patient, safe practices for handling and maintenance of homeostasis. Patient safety in
minimizing complications is increasingly recognized as essential in practice of coronary care unit. Individual have
right to safe and effective quality health care. Cardiac nurses are responsible for providing patient’s safety and
minimizing vascular complications after cardiac catheterization procedures. They should be aware about the
guidelines for providing safety for the patient. Each nurse should know the high risk patient, safe practices for
handling and maintenance of homeostasis (Arathy, 2011).
1.1. Theoretical Framework
Knowles’ Adult Learning Theory was utilized in the development of this study. There are five principles of the
Adult Learning Theory: self-concept, experience, readiness to learn, orientation to learning and motivation to learn.
Knowles stated “adults should acquire a mature understanding of themselves. They should be able to understand their
needs, motivations, interests, capacities, and goals”. This theory supports the idea that the quality of experiences
people have in society will influence the skills and attitudes they will carry into the future Smith (2002).
Knowles’ Adult Learning Theory
1.2. Significance of the Study
Several studies have been conducted to determine the effectiveness of self learning modules. With the
increasingly rapid pace of society, many people do not have the time to participate in traditional education classes and
are more likely to participate when it is convenient for them. Self-learning modules include a complete education
package allowing learners to gain knowledge at their own pace. These provided a self directed learning opportunity
for the nurses participating in this study. It also allows individuals to gain the knowledge needed to perform tasks and
be successful at their jobs Stacy (2011).
1.3. Aim of the Study
Aim of the study was to investigate the effect of creating learning guideline for nurses caring for patients’ safety
undergoing cardiac catheterization.
1.4. Research Hypotheses Were As Follows
1. There are improvements of nurses’ knowledge regarding patients safety undergoing cardiac catheterization
post Learning guideline implementation
2. There are improvements of nurses’ performance regarding patients safety undergoing cardiac catheterization
post Learning guideline implementation
3. Research Journal of Education
103
2. Subjects and Methods
2.1. Research Design
A quasi experimental research design was used to conduct this study.
2.2. Setting
This study was conducted at cardiac catheterization, intensive care, cardiac care and emergency units at general
Port Said hospital in Port Said city – Egypt.
2.3. Subject
The researchers used a purposive sample to select nurse's participants; 51 nurses were worked in those departments
included in the study.
2.4. Tool of Data Collection
2.4.1. The Study Instruments
For the purpose of the present study, the questionnaire was used before and after conducting a special learning
guideline designed. Two tools were utilized by the researchers to collect the necessary data. These tools were as
following:
Tool I: It consists of two parts as the following:
Part I: Socio-demographic data of the nurses was comprised of items related to nurse age, sex, educational
qualification, place of work and total years’ experience.
Part II: Nurses’ knowledge regarding patients safety undergoing cardiac catheterization.
It was used to determine the nurse knowledge regarding cardiac catheterization patients complications that
composed of 10 questions multiple choice. It was adopted by Arathy (2011) and modified by the researchers. It
was concerned with items related knowledge about local complications occurring in patients, detect
pseudoaneurysm, check the serum creatine level of patients, identify the complication of delayed sheath removal,
development of contrast-induced nephropathy occurs, determine the risk for developing renal failure, determine
sign of thrombus formation, patient’s affected extremity to be kept immobilized, risk for developing pulmonary
edema and detect a hematoma at the puncture site after cardiac catheterization pre/post learning guideline. Scoring
system: - multiple choice (10 questions) were each right answer was given one score and the false answer code
was (0) this to assess nurses knowledge. While those who obtained score <60% were considered having
unsatisfactory nurse knowledge and satisfactory score of ≥60%.
Tool II: Nursing care after cardiac catheterization to providing patient safety
Observational checklist was designed to assess the nurse performance regarding patients’ safety after cardiac
catheterization. It was adopted by Arathy (2011) and modified by the researchers. It covered the following skills:
Mode of transport from Cath lab to CMICU/CMWR, Puncture site, transfer to bed, checking distal pulse,
frequency of checking pulse, assessing the puncture site, frequency of assessing the puncture site, communicated
to the patient, connected to cardiac monitor, checked for (ECG , heart rate , respiratory rate and temperature),
immobilizing the affected limb, administering intravenous( IV) fluids. compression given to puncture site after
sheath removal till bleeding stops, Immobilizing the affected limb after sheath removal, checked for untoward
symptoms, development of symptoms, Any episodes of vasovagal attacks, Intake output chart maintained, urine
output In 8 hours, If urine not passed, bladder Palpable, If urine not passed, intervention done, administered fluid
and soft diet, due medicines given, ambulation done in 8 hours and Seen by relatives. Scoring system: each item
right safe performance was given one score and the unsafe performance code was (0) this to assess nurses
performance regarding patient safety after cardiac catheterization. While, higher scores indicate greater
satisfaction with the procedure is ≥60% and the lower scores <60% indicate un-satisfaction with the procedure.
2.5. Pilot study
Pilot study was conducted on the month of August 2017 after obtaining permission from the authorities of
hospital management. The study was conducted in 5 cardiac nurses with a self-prepared questionnaire and
observation tool. After pilot study assessment has been done after making necessary corrections in the
questionnaire.
2.6. Learning Guideline Construction
The current study was carried out on three phases (preparatory, implementation and evaluation phase.
Phase I: Preparatory phase: Human rights and ethical permission were obtained to conduct the study. An official
permission was obtained from the Dean of nursing faculty in which the study was conducted and then the official
permission was obtained from director of hospital. Nurses were fully informed of the study aim. The voluntary
nature of participation was stressed as well as confidentiality. Consent was obtained from each nurse. The
Learning guideline (Nursing intervention) was designed by the researchers and based on the results obtained from
the study tools; also, it was revised and modified according the related literature, cultural and socio-demographic
aspects of the study sample.
Phase 2: Implementation phase: Data collection was carried out during the period from August 2017 to October
2017. The pre learning guidelines was done for nurses in order to have base line information. The implementation
phase of the learning guideline lasted for 3 months. The time taken to develop educational skills of learning
4. Research Journal of Education
104
guideline for nurses one month, and then the assess their performance. The learning guideline was designed by the
researchers and based on the result obtained from the study tools and findings of similar researches, also it was
revised and modified according the related literature. It consists of one session every week for 4 weeks to nurses.
Each session took 30-45 minute in addition to 15-20 minutes to discuss any questions for nurses. Nurses were
allocated into small groups (each group contained 3- 5 nurses) to ensure assembly of patients` care. After there,
the contents of the learning guideline was given to the nurses after assessment knowledge and observe their
performance and explain any queries with them through booklet. Then nurses` knowledge and performance were
assessed immediately after learning guideline implementation.
Phase 3: Evaluation phase: Evaluation was applied before and after the Learning guideline, in order to identify
differences, similarities and areas of improvement, as well as defects. This was done through pre and post
administration of the self-administered questionnaires and observation checklist performance for nurses. Also the
Learning guideline evaluated through measure the patients safety regarding Nursing care after cardiac
catheterization
2.7. Ethical Consideration
An officially letter from the faculty of nursing was send to accountable authorities of the hospital and approval
was attained to conduct this study after explanation of the aim of the study. Formal consent was taken from the nurses
to participate in the study. The researchers firstly introduced themselves to all potential subjects, then explaining the
purpose of the study and they were assured that all data collected would be very confidential and only will be used for
the study' aim. The researchers stressed that contribution in the study is entirely volunteer and anonymity of the nurse
was sure through coding data. Subjects were also knowledgeable that rejection to participate in the study would not
disturb their care
2.8. Data Analysis
Data were revised, coded, analyzed and tabulated using the number and percentage distribution and carried
out using SPSS version 20. The statistical tests used are chi-square test and correlation. A value of p<0.05 was
considered to be statistically significant.
3. Results
Figure (1) illustrated that the majority of the studied nurses were ranged between (30≤40) years.
Figure (2) showed that the majority of studied nurses had a diploma degree (88.5%).
Figure (3) indicated that the majority of studied nurses had experienced ≥ 10 years.
Table (1) Showed that the majority of studied nurses have a highly satisfactory level of knowledge and total score
regarding patient safety on cardiac catheterization post implementation the learning guideline than pre learning
guideline with a highly significant difference.
Table (2) indicated that all studied nurses have a satisfactory level of total performance score regarding patient safety
after implementation of the learning guidelines on cardiac catheterization.
Table (3) reflected that the positive correlation between the studied nurses qualification, experience and knowledge
regarding patient's safety at post learning guideline with statistically significant difference regarding experience. Also,
the table shows that the negative correlation between the studied nurses qualification, experience and knowledge
regarding patient's safety at pre learning guideline with no statistically significant difference.
Table (4) illustrated that the strong positive correlation between the performance of studied nurses and their
qualification regarding the post learning guideline implementation with a statistically significant difference. Also, the
table shows that the negative correlation between the performance of studied nurses regarding their qualification and
experience at the pre learning guideline implementation with no statistically significant difference.
Table (5) reflected that the positive correlation between the performance of studied nurses and their knowledge
regarding post learning guideline implementation with no statistical significant difference. Also, the table indicates
that negative correlation between the performance of studied nurses and their knowledge regarding pre learning
guideline implementation with no statistically significant difference.
Figure-1. Number and percent distribution of the studied nurses regarding age group (N=51)
Figure (1) Age (Years)
20≤30
43.10%
30≤40
45.10%
40≤50
11.80%
20≤30
30≤40
40≤50
5. Research Journal of Education
105
Figure-2. Percentage distribution of the studied nurses regarding professional qualifications (N=51)
Figure-3. Percentage distribution of the studied nurses regarding their experience
Table-1. Number and percent of satisfactory level of nurse's knowledge regarding patient's safety on cardiac catheterization at pre and post learning
guideline
Satisfactory Unsatisfactory 2X P
valueNo % No %
1. Identify the local complications
occurring in patients after
cardiac catheterization
pre learning guideline 0 0.0% 51 100.0% 2.040a
.153
post learning guideline 49 96.1% 2 3.9%
2. Detect pseudoaneurysm after
cardiac catheterization
pre learning guideline 0 0.0% 51 100.0% 12.330a
.000
post learning guideline 40 78.4% 11 21.6%
3. check the serum creatine level of
patients after cardiac
catheterization
pre learning guideline 0 0.0% 51 100.0% 33.117a
.000
post learning guideline 26 51.0% 25 49.0%
4. Identify the complication of
delayed sheath removal
pre learning guideline 0 0.0% 51 100.0% 11.087a
.001
post learning guideline 41 80.4% 10 19.6%
5. Development of contrast-
induced nephropathy occurs
pre learning guideline 0 0.0% 51 100.0% 21.857a
.000
post learning guideline 33 64.7% 18 35.3%
6. Identify the risk patient for
developing renal failure after
cardiac catheterization
pre learning guideline 0 0.0% 51 100.0% 21.857a
.000
post learning guideline 33 64.7% 18 35.3%
7. Identify the sign of thrombus
formation after cardiac
catheterization
pre learning guideline 0 0.0% 51 100.0% 9.871a
.002
post learning guideline 42 82.4% 9 17.6%
8. Identify the patient’s affected
extremity to be kept immobilized
after cardiac catheterization
pre learning guideline 0 0.0% 51 100.0% 7.516a
.006
post learning guideline 44 86.3% 7 13.7%
9. Identify the risk for developing
pulmonary edema after cardiac
catheterization
pre learning guideline 0 0.0% 51 100.0% 7.516a
.006
post learning guideline 44 86.3% 7 13.7%
10.detect a hematoma at the
puncture site after cardiac
catheterization
pre learning guideline 0 0.0% 51 100.0% 24.878a
.000
post learning guideline 31 60.8% 20 39.2%
Total scores of Knowledge pre learning guideline 22 43.1 29 56.9% 20.778a
.000
post learning guideline 44 86.3 7 13.7%
88.50%
17.67%
Figure (2) Qualifications
Diploma Bachelar
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
1≤5 5≤10 ≥10
Experience
Experience
6. Research Journal of Education
106
Table-2. Number and percent of satisfactory level of nurse's performance regarding patient's safety on cardiac catheterization at pre and post
learning guideline
Satisfactory Unsatisfactory 2X P value
No % No %
Total scores of
performance
pre learning guideline
3 5.9% 48 94.1%
3.091a
.079post learning guideline 51 100.0% 0 0.0%
Table-3. Correlation between the nurses knowledge regarding patient's safety and their qualification and experience at pre and post learning
guideline
Items Knowledge of studied nurses
pre learning guideline post learning guideline
R P R P
Qualification
-.145 .308 .776 .041
Experience
-.088 .541 .987 .002
Table-4. Correlation between the nurses performance regarding patient's safety and their qualification and experience at pre and post learning
guideline
Items Performance of studied nurses
pre learning guideline post learning guideline
R P R P
Qualification
-.140 .328 .441****
.001
Experience
-.198 .163 .056 .697
Table-5. Correlation between the performance of studied nurses and their knowledge regarding patient safety pre and post learning guideline
implementation
Items Performance of studied nurses
pre learning guideline post learning guideline
R P R P
Knowledge
-.017 .906 .216 .128
4. Discussion
Cardiac catheterization is a common interventional process useful for diagnosis the patients suffering from acute
coronary syndrome (ACS). It can source of various health problems that have to be recognized and treated following
the test. Taking into consideration probable dangerous complications so that the nurse plays a critical role in cardiac
catheterization unit in the provision great quality nursing care and increase patient safety to their patients. Creature
knowledgeable and existing on evidence based practice is the crucial to being an efficient and effective nurse. So
nurses should understand clearly information and optimal performance about patient safety to improve quality care.
The findings of the study regarding to age group the majority of the studied nurses were ranged between (30≤40)
years. This could be meaning the age group is considered a period of steadying in which the person creates job
decision and develops additional adjustable and reactive to tasks. Concerning this age behavior throughout delivery of
health care, they developed additional alert of the effect of medical intervention on the patients; sensitive to their
fears; honestly explain medical procedures and predictable outcomes. This result disagreement with Elfeky and Ali
(2013), Rushdy et al. (2016) Feroze et al. (2017) who revealed that almost of the studied nurses was young adults
from 26-30 year and more than two third them of had 1-4 years' experience an intensive care unit.
Concerning qualifications, the current study revealed that the majority of studied nurses had a diploma degree
(88.5%). This result disagreed with the findings of the study done by Abdel (2006), Zaki (2010); Hassan and
Aburaghif (2016) who indicated that most of the studied nurse were graduate of health technical institute. While this
result supported by Feroze et al. (2017).
As years of experience in cardiac catheterization highest percentage of the nurses had experience years for ten or
more years. These results disagree with the findings of many studies which were done by Abdel (2006), Zaki (2010) ;
Hassan and Aburaghif (2016) who reported that most of the studied nurse had years of experience between (1-10)
years.
In current the study revealed that the majority of nurses have a highly satisfactory level of knowledge and total
score regarding patient safety on cardiac catheterization post implementation the learning guideline than pre learning
guideline for the highly statistically significant difference. This could be connected to the fact that majority of nurses
hold diploma nursing. This study result in the same line Thapa and Neupane (2018) Who was conducted a study to
assess the impact of teaching programme (STP) on nurses knowledge concerning intra-aortic balloon pump (IABP)
implantation therapy for coronary artery bypass grafting (CABG) patient at selected hospitals in Dehradun and
7. Research Journal of Education
107
found that most of the studied nurses had reported adequate knowledge regarding IABP and the level of knowledge
increased after intervention. Also, Straight (2008) developed a self learning module to evaluate nurses knowledge of
safe medication delivery. Results showed an increase in use and awareness of resources available after the completion
of the self learning module. Participants strongly supported the study methods. All participants expressed a desire for
more training similar to that used in this study. In the same line Kang (2002) stated that the self learning module was
developed in a simple writing format and addressed the important learning needs of the nurses. A pre test and post test
consisting of 15 questions each were available on each pediatric unit for nurses to complete. Results of the study
revealed an increase in the score of the post test when compared to the pre test. A majority of the nurses gave a
positive evaluation of the self learning module. They thought the module was attractive, and agreed that topics were
comprehensive, and would help them to better care for their patients. Addition, Taha A. (2006), Sharma (2008), Shini
et al. (2018), Mahgoubn et al. (2017); Elsay et al. (2016) Who documented that knowledge of nurses were
significantly increased post program implementation in these study results.
Moreover, Self learning modules (SLMs) are used frequently for nurses in hospital settings and expand
knowledge needed to successfully perform tasks. Results of these studies showed that self learning modules have the
potential to increase knowledge of a particular topic, and were accepted by the participants. Use of SLMs is a low cost
way to provide information so nurses are better able to care for their patients Stacy (2011).
The present study showed that all studied nurses have a satisfactory level of total performance score regarding
patient safety after implementation of the learning guidelines on cardiac catheterization. This result agreement by
Thomas (2013) who implemented study to evaluate the effect of video assisted programme teaching on staff nurses
practice and knowledge regarding defibrillation and cardioversion as a cardiac unit in Bagalkot hospitals. He
illustrated that there were statistically significant difference between post and pretest practices score.
However other researcher is contradicted for the result of Hassan and Aburaghif (2016). Also, s Schiks et al.
(2007) reflected that the performance estimation of sheath removal arterial femoral by nurses post Percutaneous
Intervention PCI through training nurses to remove the sheath and throughout the sheath removal observed them
for elective non complicated PCI-patients. The result reported that there was greater than 90% for the total score
of the performance was not achieved for those nurses.
Also the current study revealed that the positive correlation between the studied nurse's qualification, experience
and knowledge regarding patient's safety at post learning guideline with statistically significant difference regarding
experience. This finding inconsistent with Shini et al. (2018) who conducted study to determine the effect of
protocol nursing care on staff nurses knowledge and practice related to the nursing management of patients during
coronary angioplasty He reported that no association was found between knowledge, professional qualification and
total professional experience among nurses regarding role of patients undergoing coronary angioplasty.
While the study indicated that a negative correlation between the performance of studied nurses and years of
experience at the pre learning guideline implementation with no statistically significant difference. This result
consistent with (Feroze et al., 2017) and Shini et al. (2018).
The current study revealed that a strong positive correlation between the performance of nurses and their
qualification regarding the post learning guideline implementation with a statistically significant difference. This
result is inconsistent with Taha N. M. A., Z. H. (2013) who implemented research a study regarding the effect of an
educational program on knowledge and practice for critical care nurses’ regarding physical restraints and illustrated
that nurses’ experience years had no effect on performance scores and job qualification. While other researchers
consistent with this study Thomas (2013) who implemented a study to assess the efficiency of video assisted teaching
program on practice and knowledge about cardioversion and defibrillation and reported that a strongly significant
result of planned nursing intervention on level of practice. On the other hand, Best et al. (2010) implemented a
follow up study of quickly ambulation 90 minutes following left cardiac catheterization via a retrospective contrast
group. Found that the nurse that performed early ambulation for patients within 90 minute of cardiac catheterization
lead to safe and has the potential to improve both patient quality of care and comfort.
Finally there was positive correlation between the performance of studied nurses and their knowledge regarding
post learning guideline implementation with no statistically significant difference. High level of nurses` knowledge
reflected on their practice; knowledgeable nurses provide more accurate care. This result is in the same line with Feroze
et al. (2017)who found a positive correlation between the skills and knowledge regarding patient’s safety following
cardiac catheterization in Pakistanis registered nurses and nurses that have adequate skills and knowledge lead to patient
safety.
5. Conclusion
Study findings revealed that there was significant increase knowledge in the post- learning guideline. Also, all
studied nurses have a satisfactory level of performance regarding patient safety after implementation of the learning
guidelines on cardiac catheterization. Therefore, it can be established learning guideline shows a vital role in
increasing nurse’s level of knowledge and performance.
6. Recommendation
The nurses are accountable to offer a humanized support to deal with a fast convalescence, minimize complication of
hospitalization and the procedure. So that the knowledge and performance of the safety and the strategies are fundamental
to prevent patient hazards undergoing cardiac catheterization. The study recommended that continuous staff development
regarding patients` safe with nursing care in every care settings.
8. Research Journal of Education
108
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