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Infection Prevention and Control in Baccalaureate Nursing Education: Identifying Content, Teaching Strategies and Gaps
Mary Lou Manning, PhD, CRNP, CIC, FAAN and Monika Pogorzelska-Maziarz, PhD, MPH, CIC
Background
Healthcare-associated infections (HAI) are a major risk to patient safety. In the US, on any given day, 1 of every 25 inpatients has at least one HAI, resulting in significant health, social, and economic consequences.1 It is estimated that up to 70% of some types of HAIs are preventable through improved infection prevention and control (IPC) practices of health care providers.2
Additionally, antibiotic resistant infections and emerging and re-emerging infectious diseases represent ongoing threats to population health.
Integrating IPC concepts and content in baccalaureate nursing education is crucial to ensure that nurses have the essential knowledge, skills and abilities to recognize, prevent and manage simple to complex infections across a variety of situations and settings.
It is important to understand how nursing students are being prepared for contemporary IPC practice. We conducted a review of the literature to identify IPC curricular concepts and content in prelicensure baccalaureate nursing education programs.
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Utilization of care by infants with neonatal abstinence syndrome in Delaware
Michele K. Savin, DNP, APRN, NNP-BC
Introduction: There is little information regarding use of expected well care by infants diagnosed with neonatal abstinence syndrome (NAS) post initial discharge. We describe expected and unexpected utilization of care by infants with NAS in the first year of life.
Methods: A de-identified State of Delaware Medicaid data set was obtained. Included were all infants with an ICD-9 code for NAS from 01/01/2012-12/31/2014. All associated medical claims were extracted for one year after birth. Utilization rates of primary care, immunizations, urgent or emergency care, and re-hospitalization were quantified.
Results: 499 of 522 babies were able to be fully analyzed. The population reflected Delaware demographics. Fifteen percent were preterm. Attendance at expected well visits ranged from 65% at two months to 30% at nine months. This is less than published rates for Medicaid infants as a whole. Two percent had no well visit. Immunization rates were below national average at 92%. Urgent care use was 7%, Emergency Department 52% and inpatient re-admission 15%. General term re-admission rates have has described at less than 10%.
Conclusion: There is a decreased amount of well child visits and immunization rates in infants diagnosed with NAS. This represents a loss of preemptive care, developmental screening and early intervention. Engagement in primary care may decrease the need for urgent and emergency room care. Future research should include prospective analysis of utilization with case management focus, and collaboration with community partners. Real-time surveillance would inform planning and decision making for programming and allocation of resources.
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Promoting health and quality of life along the care continuum: Creating a nursing curriculum for today’s health care environment
Kathleen D. Black, Mary Bouchaud, and Denise Brown
Background
The focus on traditional acute, hospital-based health care is being replaced with a new paradigm aimed at providing primary care, care of populations, and care across transitions and providers. The Institute of Medicine’s report (2010), the “Future of Nursing” emphasized the need for nurses to lead health care change and called for nursing education focused on a community and population-based perspective, person centered care, and emerging roles for nurses across the care continuum. In response, the Jefferson College of Nursing embarked on the ambitious task of designing a new and innovative baccalaureate nursing curriculum over a 13 month period.
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The H.E.R.E.© Curricular Model…Educating Nursing Students for 21st Century Health Care
Susan Egger, MSN, RN; Mary Bouchaud, PhD, RN; Beth Ann Swan, PhD, CRNP, FAAN; and Ann Phalen, PhD, APRN, NNP-BC
Background
The focus on traditional acute, hospital-based health care is being replaced with a new paradigm aimed at providing primary care, care of populations, and care across transitions and providers. As changes unfold, nursing education is challenged to prepare graduates who can effectively function in new healthcare environments of the 21st century. In response, the Jefferson College of Nursing (JCN) embarked on the ambitious task of designing a new 21st century baccalaureate nursing curriculum over a 13-month period. Although a 13-month turnaround time for curriculum design is unprecedented, what is most unique about JCN’s initiative is that it began with a charge of developing an idealized curriculum from a blank slate. Advised by a curriculum consultant, a group of nine faculty and six key stakeholders (known as the Curriculum Navigators) created ‘The H.E.R.E© Curricular Model’ which provides a framework for a nursing curriculum that is forward thinking and contemporary.
The four major themes of the H.E.R.E© model, Interprofessional Collaboration, Innovation, Population Health and Practice Excellence, are the foundation for the curriculum model as well as the curriculum’s organizing framework statement, Promoting Health and Quality of Life along the Care Continuum. A concept-based approach based on Giddens book (2013) organizes the curriculum concepts. Traditional clinical experiences were replaced with “Immersions” that encompass objectives from concurrent courses and connect didactic concepts to patient care experiences across the health care continuum and settings.
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The H.E.R.E.© Curricular Model...Educating Nursing Students for 21st Century Health Care
Susan Egger, PhD, RN; Mary Bouchaud, PhD, RN; Beth Ann Swan, PhD, CRNP, FAAN; and Ann Phalen, PhD, APRN, NNP-BC
Background:
The focus on traditional acute, hospital-based health care is being replaced with a new paradigm aimed at providing primary care, care of populations, and care across transitions and providers. As changes unfold, nursing education is challenged to prepare graduates who can effectively function in new healthcare environments of the 21st century. In response, the Jefferson College of Nursing (JCN) embarked on the ambitious task of designing a new 21st century baccalaureate nursing curriculum over a 13-month period. Although a 13-month turnaround time for curriculum design is unprecedented, what is most unique about JCN’s initiative is that it began with a charge of developing an idealized curriculum from a blank slate. Advised by a curriculum consultant, a group of nine faculty and six key stakeholders (known as the Curriculum Navigators) created ‘The H.E.R.E© Curricular Model’ which provides a framework for a nursing curriculum that is forward thinking and contemporary.
The four major themes of the H.E.R.E© model, Interprofessional Collaboration, Innovation, Population Health and Practice Excellence, are the foundation for the curriculum model as well as the curriculum’s organizing framework statement, Promoting Health and Quality of Life along the Care Continuum. A concept-based approach based on Giddens book (2013) organizes the curriculum concepts. Traditional clinical experiences were replaced with “Immersions” that encompass objectives from concurrent courses and connect didactic concepts to patient care experiences across the health care continuum and settings.
Poster presented at:
American Association of Colleges of Nursing (AACN), 2016 Baccalaureate Education Conference: Innovating Nursing Education to Improve the Health of the Nation. Anaheim, California. November 17-November 19, 2016.
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The Jefferson Teamwork Observation Guide: Reliability and Validity for Use in Education and Practice
June Andrews Horowitz,; Elizabeth T. Speakman, EdD, RN, FNAP, ANEF; and Shoshana Sicks, MEd
Background & Purpose
- Interprofessional education (IPE) is fast becoming an integral part of the education of health professions students. To meet this aim, it is important to provide students with the skills needed for interprofessional success, but also to use reliable and valid measures to help students and clinicians to recognize characteristics of well-functioning teams.
- The Jefferson Teamwork Observation Guide (JTOG) was created for health professions students to evaluate teams in action by rating behaviors indicative of good team work.
- The JTOG, mapped to the 2011 Interprofessional Education Collaborative Expert Panel (IPEC) core competencies, was developed over two years to help health professions students understand the characteristics of high functioning teams and to fill a gap in the literature around validated, competency-based assessment tools. The tool contains 14 Likert scale items and three qualitative items.
- The purpose of this presentation is to describe the JTOG’s reliability and validity to support its use in education and practice.
Poster presented at NLN Education Summit in Orlando Florida.
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Accelerating Curriculum Design: "A Love It, Don't Leave It" Approach to Creative Process and Idealized Design
Mary Bouchaud, PhD, RN; Angela Gerolamo, PhD, APRN, BCPS; Beth Ann Swan, PhD, CRNP, FAAN; Kathleen Black, PhD, RNC; Karen Alexander, MSN, RN, CCRN; Jennifer L. Bellot, PhD, MHSA, CNE; Denise Brown, MSN, RNC; Susan Egger, PhD, RN; Rachel Scherzer, MSN, RN, CCRN; Kathy Shaffer, EdD, RN, CNE; Catherine Levonian, PhD, RN; and Dori Sullivan, PhD, RN, NE-BC, CPHQ, FAAN
Purpose and Background:
The Institute of Medicine’s (IOM) report (2010) on the “Future of Nursing” emphasized the need for nurses to lead health care change. One of the key messages in this report is a call to action for nursing schools to re-envision nursing education that focuses on a population-based perspective and emerging roles for nurses across the care continuum. With an evolving focus on primary and community-based care rather than acute care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses now and in the future will need to be prepared with a breadth of knowledge, skills, and competencies. In response, the Jefferson College of Nursing (JCN) embarked on the ambitious task of designing a new 21st century baccalaureate nursing curriculum over a 13-month period.
Nursing curriculum design varies widely and can span the course of two to five years. To reduce the lengthy process and ensure faculty commitment, JCN leadership selected a core team of nine faculty members to navigate the full faculty through the design of the curriculum. Each team member was assigned three teaching credits for curriculum development and design.
Although a 13-month turnaround time for curriculum design is unprecedented, what is most unique about JCN’s initiative is that it began with a charge of developing an idealized curriculum from a blank slate. To ensure that the curriculum reflected multiple perspectives, the team recruited six stakeholders including a nurse practice partner, health care consumer, community leader, alumnus, current student, and adjunct clinical faculty.
Poster presented at:
NLN Education Summit, 2015:Bridging Practice and Education, Las Vegas, Nevada, September 30, 2015-October 2, 2015.
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The Use of Narrative Pedagogy and Unfolding Case “Ivan” To Promote Interprofessional Collaboration and Education Among Nursing and Radiology Students
Mary Bouchaud, PhD, RN and Elizabeth Speakman, EdD, RN, ANEF, FNAP
Purpose:
Nursing students are unfamiliar with roles and responsibilities of their healthcare colleagues and how partnering with them can impact patient health outcomes. Many are unaware of how an interprofessional healthcare team contributes to preventing and resolving healthcare issues affecting care transition from tertiary settings back to the community. Case “Ivan” is a real lived experience that was shared to prepare nursing and allied health students for interprofessional, patient-centered care practice.
Poster presented at:
NLN Education Summit, 2015:Bridging Practice and Education, Las Vegas, Nevada, September 30, 2015-October 2, 2015.
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Fostering the Development of Emotional Intelligence among Health Science Students: Empowering Students to Impact Institutional Culture
Julia Ward, PhD, RN; Mary Hanson-Zalot, MSN, RN, AOCN; and Collleen Dempsey, MS, RT(R)
Objectives:
Identify challenges of navigating institutional culture for students interacting in a variety of clinical settings
Discuss the importance of integrating concepts of emotional intelligence throughout curricular plans of study
Consider contemporary research findings in the health science literature regarding emotional intelligence among students.
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The Effects of a Smart Phone App on Hospital Readmission Rates for Patients Diagnosed with Diabetes
Kevin Abercrombie and Mary Bouchaud
Abstract
Diabetes has been a growing concern in the United States due to the rapidly increasing incidence of this disease over the past decade. In their 2014 report, the CDC reported there were 29.1 million people diagnosed with diabetes in 2012, comprising 9.3% of the total US population. In addition, according to the CDC, 1.7 million people were newly diagnosed with type I and type II diabetes in 2012 with health care costs at an estimated $245 billion. Moving forward, the most effective approach is to empower and educate these patients to self-manage their own disease to decrease or prevent acute and chronic complications associated with diabetes. Many studies have been conducted examining the effectiveness of smart phone apps as an educational tool to engage patients in the self-management of their diabetes. These studies measured success based primarily on the subject's hemoglobin A1c. However, the literature was deplete of studies on the effect of smart phone apps on reducing hospital readmission rates for patients diagnosed with diabetes. The aim of this study is to determine if a smart phone app, CareSmarts, utilizing text alerts and educational alerts and educational material is effective in reducing hospital readmission rates related to acute diabetic complications within 30 days of hospital discharge for patients who are insulin-dependent diabetics, newly diagnosed diabetics, and those admitted for an acute diabetic exacerbation.
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Measuring the Effectiveness of Interactive Patient Education in Reducing Hospital Readmission Rates of Patients Diagnosed with Congestive Heart Failure
Melanie Colace, Carly Bongart, Kayla Walker, Alisha Droxler, Yuehhsia Chen, and Mary Bouchaud
Introduction •The leading cause of hospitalization in the United States is heart failure among adults 65 years of age. •One million patients are hospitalized every year with a primary diagnosis of heart failure, resulting in a Medicare expenditure exceeding $17 billion. •For every five patients admitted to a hospital with congestive heart failure (CHF), one patient will be readmitted within 30 days of discharge . •75 percent of early heart failure readmissions are preventable. •Medicare introduced the Hospital Readmission Reduction Program that became effective in 2012. • This program established financial penalties for greater than expected readmissions for primary diagnoses of heart failure, myocardial infarction, and pneumonia. •The Institute for Health Care Improvement (IHIC) believes these rates can be reduced with patient education and support for patient self-management. •The purpose of this study is to examine the effectiveness of an interactive patient education system (IPE), The GetWellNetwork, on reducing hospital readmission rates for patients diagnosed with CHF.
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