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Journal of Clinical Nursing Nov 2020The role of professional doctorates is receiving increased attention internationally. As part of building the rigour and scholarship of these programmes, we assessed... (Review)
Review
AIMS AND OBJECTIVES
The role of professional doctorates is receiving increased attention internationally. As part of building the rigour and scholarship of these programmes, we assessed projects undertaken as part of a doctor of nursing practice (DNP) programme at Johns Hopkins University. Recommendations for programme development in professional doctorates are provided.
BACKGROUND
Past research has described the methodologic limitations and dissemination of DNP projects. However, few studies have provided recommendations for strengthening these projects and alternative strategies for achieving scale in larger student cohorts.
DESIGN
A descriptive study reported in accordance with STROBE guidelines.
METHODS
From 2009-2018, 191 final DNP project reports were obtained from the DNP programme administrator. Essential project characteristics from the papers were extracted, including use of theoretical framework, design, setting, sample and dissemination through publication. To determine whether the results of the projects had been published, the title and student's name were searched in Google Scholar and Google.
RESULTS
Of the 191 projects, 83% focused on adults and 61% were conducted in the hospital setting. Sample sizes ranged from 7 to 24,702. Eighty per cent of the projects employed a pretest/post-test design, including both single and independent groups. The projects spanned six overarching themes, including process improvement, clinician development, patient safety, patient outcome improvement, access to care and workplace environment. Twenty-one per cent of the project findings were published in scholarly journals.
CONCLUSIONS
Conducting a critical review of DNP projects has been useful in refining a strategy shifting from incremental to transformative changes in advanced practice.
RELEVANCE TO CLINICAL PRACTICE
Programme evaluation is critical in order to sufficiently prepare nurses in advanced nursing practice to influence healthcare outcomes at the individual or population level.
Topics: Adult; Advanced Practice Nursing; Education, Nursing, Graduate; Humans; Nurses; Program Development; Program Evaluation
PubMed: 33439493
DOI: 10.1111/jocn.15435 -
Maternal and Child Health Journal Aug 2022To describe an undergraduate pipeline training program (PTP) designed to guide underrepresented minorities (URM) trainees into MCH-related health professions, ultimately...
PURPOSE
To describe an undergraduate pipeline training program (PTP) designed to guide underrepresented minorities (URM) trainees into MCH-related health professions, ultimately contributing to a diverse maternal and child health (MCH) workforce that can improve health outcomes for all women/mothers, children, and their families, including fathers and children with special healthcare needs.
DESCRIPTION
Three cohorts with 35 total undergraduate trainees were recruited to participated in the 2 years USF MCH PTP program where they were mentored, trained, guided, and supported by program faculty/staff. Students were recruited early in their education track, and the program was individually tailored based on trainees' educational discovery stages. Key program components included seminars, summer institutes, public health courses, mentorship, internship, experiential learning opportunities, and professional networking opportunities.
ASSESSMENT
The majority of the undergraduate participants were diverse URMs including Hispanic/Latino (37.1%), Black/African American (31.4%), Asian (20%), and American Indian/Alaskan Native (5.7%) trainees. Out of all the cohorts, 51.4% were first-generation college students and 74.3% had economic hardships (i.e., PELL Grant, FAFSA). Resulting from the program, all cohorts increased in educational discovery stages, one-third enrolled in health-related graduate studies and half joined the MCH workforce.
CONCLUSION
Recruitment in pipeline programs should be intentional and meet students where they are in their education discovery stage. The use of educational discovery stages within a pipeline program are useful in both tailoring curriculum to individuals' needs and assessment of progression in career decision-making. Mentoring from program staff remains an important component for pipeline programs.
Topics: Animals; Cattle; Child; Female; Humans; Male; Mentoring; Mentors; Minority Groups; Program Development; Students
PubMed: 34982334
DOI: 10.1007/s10995-021-03332-y -
American Journal of Health-system... Aug 2017The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described.
PURPOSE
The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described.
SUMMARY
Maintaining a hospital formulary requires clear communication and coordination among multiple members of the pharmacy department. Using principles of lean methodology, pharmacy department personnel within a multihospital health system launched a multifaceted initiative to optimize formulary management systemwide. The ongoing initiative began with creation of a formulary maintenance redesign committee consisting of pharmacy department personnel with expertise in informatics, automation, purchasing, drug information, and clinical pharmacy services. The committee met regularly and used lean methodology to design a standardized process for management of formulary additions and deletions and changes to medications' formulary status. Through value stream analysis, opportunities for process and performance improvement were identified; staff suggestions on process streamlining were gathered during a series of departmental kaizen events. A standardized template for development and dissemination of monographs associated with formulary additions and status changes was created. In addition, a shared Web-based checklist was developed to facilitate information sharing and timely initiation and completion of tasks involved in formulary status changes, and a permanent formulary maintenance committee was established to monitor and refine the formulary management process.
CONCLUSION
A clearly defined, standardized process within the pharmacy department was developed for tracking necessary steps in enacting formulary changes to encourage safe and efficient workflow.
Topics: Formularies as Topic; Humans; Multi-Institutional Systems; Pharmacy Service, Hospital; Program Development
PubMed: 28790076
DOI: 10.2146/ajhp160193 -
Military Medicine Nov 2017Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac surgical procedure that has revolutionized the treatment of aortic stenosis. This is the...
BACKGROUND
Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac surgical procedure that has revolutionized the treatment of aortic stenosis. This is the most common valvular heart condition in developed countries, affecting 3.4% of those ages 75 and above. Because there is no medical therapy that can arrest progression of the disease, valve replacement forms the cornerstone of therapy.
METHODS
Naval Medical Center San Diego and the VA San Diego Healthcare System have developed a unique collaborative TAVR program-a first in the Department of Defense-to offer this revolutionary procedure to their beneficiaries. Herein, we review development of the program and outcome for patients referred during the first 9 months.
FINDINGS
Development of the program was a multiyear process made successful because of administrative support, facility upgrades, and collaboration within the crossfacility and multispecialty heart valve team. In the first 9 months, 29 patients were referred for evaluation. Twenty-two (average age 80 years) underwent TAVR, whereas others were deemed nonoperable or were pending disposition at the time of this report. Patients who underwent TAVR had a predicted risk of procedural mortality from surgical aortic valve replacement of 7.7%, similar to other trials and registry studies. After mean follow-up of 5.6 months (range 30-355 days), zero deaths were recorded in the patients who underwent TAVR. Compared to other nonfederal local institutions, the program also realized a cost savings of approximately 17%, or nearly $10,000, per patient.
DISCUSSION
In the first 9 months, results were positive and consistent with expectations from national and international registries. Our hope is that this program may serve as an example for other federal facilities looking to start their own combined programs to improve health care quality and patient experience while simultaneously achieving considerable cost containment within a constrained national health care budget.
Topics: Aged; Aged, 80 and over; Aortic Valve Stenosis; Female; Hospital Mortality; Humans; Male; Patient Care Team; Program Development; Transcatheter Aortic Valve Replacement; Treatment Outcome; United States; United States Department of Veterans Affairs
PubMed: 29087877
DOI: 10.7205/MILMED-D-16-00398 -
Journal of Nursing Management May 2020To appraise the quality of current nursing clinical practice guidelines (N-CPGs) in China and explore the methodology for N-CPGs development. (Review)
Review
AIM
To appraise the quality of current nursing clinical practice guidelines (N-CPGs) in China and explore the methodology for N-CPGs development.
BACKGROUND
Implementation of quality improvement projects based on N-CPGs has becoming an hot topic for nursing with proliferation in the number of N-CPGs in China in recent years. The methodology for developing N-CPGs is worthy of exploration.
METHODS
A systematic literature search was performed using PubMed, CINAHL, Web of Science, CNKI, Wanfang, VIP and CBM and relevant representative guidelines repositories from inception to July 31, 2019. Two authors independently selected eligible guidelines and performed data extraction. Four appraisers independently assessed the quality of the N-CPGs using the AGREE II tool.
RESULTS
20 N-CPGs were eventually included in this review. After AGREE II appraisal, the final domain scores ranged between 0.00 and 83.33%. When comparing the total domain scores, "Scope and purpose" and "Clarity of presentation" scored highest with a total of 63.89 (59.37-69.79) (%, median, interquartile range (IQR)), and 63.89 (58.33-75.70) (%), respectively. "Editorial independence" obtained the lowest ranking with a total score of 0 (0-81.25) (%). The total scores of "Stakeholder involvement", "Rigour of development", "applicability" and "editorial independence" were lower than 50%.
CONCLUSION
The quality of N-CPGs in China is not very high and the process of guideline development still needs to improve.
IMPLICATIONS FOR NURSING MANAGEMENT
N-CPGs are important documents used to guide nursing quality improvement. High quality N-CPGs are beneficial for nursing management.
Topics: China; Guidelines as Topic; Humans; Program Development; Program Evaluation; Quality Improvement
PubMed: 32173922
DOI: 10.1111/jonm.13007 -
Rehabilitation Nursing : the Official... 2020
Topics: Acupuncture Therapy; Adult; Feasibility Studies; Female; Geriatrics; Humans; Male; Middle Aged; Program Development
PubMed: 32604261
DOI: 10.1097/RNJ.0000000000000276 -
Health Expectations : An International... Dec 2018Engaging youth as partners in academic research projects offers many benefits for the youth and the research team. However, it is not always clear to researchers how to... (Review)
Review
CONTEXT
Engaging youth as partners in academic research projects offers many benefits for the youth and the research team. However, it is not always clear to researchers how to engage youth effectively to optimize the experience and maximize the impact.
OBJECTIVE
This article provides practical recommendations to help researchers engage youth in meaningful ways in academic research, from initial planning to project completion. These general recommendations can be applied to all types of research methodologies, from community action-based research to highly technical designs.
RESULTS
Youth can and do provide valuable input into academic research projects when their contributions are authentically valued, their roles are clearly defined, communication is clear, and their needs are taken into account. Researchers should be aware of the risk of tokenizing the youth they engage and work proactively to take their feedback into account in a genuine way. Some adaptations to regular research procedures are recommended to improve the success of the youth engagement initiative.
CONCLUSIONS
By following these guidelines, academic researchers can make youth engagement a key tenet of their youth-oriented research initiatives, increasing the feasibility, youth-friendliness and ecological validity of their work and ultimately improve the value and impact of the results their research produces.
Topics: Adolescent; Communication; Community-Based Participatory Research; Cooperative Behavior; Humans; Mental Health; Program Development; Research Design; Research Personnel
PubMed: 29858526
DOI: 10.1111/hex.12795 -
Nursing Administration Quarterly 2014
Topics: Fund Raising; Humans; Program Development
PubMed: 25208140
DOI: 10.1097/NAQ.0000000000000067 -
BMJ Open Quality Apr 2020To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital. (Review)
Review
OBJECTIVE
To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital.
METHODS
A scoping review of scientific and grey literature and community hospital stakeholder discussions were used to identify and design a conceptual framework for PFCC across five core pillars of leadership, engagement, service delivery, learning and environment.
RESULTS
107 publications were identified and 76 were included for data extraction. A draft framework was constructed and modified following consultation with hospital stakeholders across a small Australian Community Hospital. The 'Caring Together' framework outlines three core layers: (1) the focus of our care is the experiences of our consumers and staff; (2) concepts of leadership, environment, service delivery, engagement and learning; and (3) the overarching fundamental values of being heard, respected, valued and supported by staff and consumers at all levels in an organisation.
CONCLUSIONS
The conceptual Caring Together framework structures key PFCC concepts across organisational priority areas within an Australian healthcare setting and can be used to guide implementation of PFCC at other small hospital facilities. Changes to national and state healthcare funding may help facilitate improved hospital facility implementation of PFCC, and ultimately improve consumer healthcare satisfaction and clinical outcomes.
Topics: Australia; Family Nursing; Hospitals, Community; Humans; Leadership; Patient-Centered Care; Program Development
PubMed: 32354755
DOI: 10.1136/bmjoq-2019-000823 -
Journal of Cancer Survivorship :... Jun 2015This manuscript will describe institutional changes observed through goal analysis that occurred following a multidisciplinary education project, aimed at preparing...
PURPOSE
This manuscript will describe institutional changes observed through goal analysis that occurred following a multidisciplinary education project, aimed at preparing health care professionals to meet the needs of the growing numbers of cancer survivors.
METHOD
Postcourse evaluations consisted of quantitative questionnaires and follow-up on three goals created by each participating team, during the 3-day educational program. Evaluations were performed 6, 12, and 18 months postcourse for percent of goal achievement. Goals were a priori coded based on the Institute of Medicine's survivorship care components along with two additional codes related to program development and education.
RESULTS
Two hundred and four teams participated over the four yearly courses. A total of 51.6 % of goals were related to program development, 21 % to survivorship care interventions, 20.9 % on educational goals, and only 4.7 % related to coordination of care, 1.4 % on surveillance, and 0.4 % related to prevention-focused goals. Quantitative measures postcourse showed significant changes in comfort and effectiveness in survivorship care in the participating institutions.
CONCLUSION
During the period 2006-2009, health care institutions focused on developing survivorship care programs and educating staff, in an effort to prepare colleagues to provide and coordinate survivorship care, in cancer settings across the country.
IMPLICATIONS FOR CANCER SURVIVORS
Goal-directed education provided insight into survivorship activities occurring across the nation. Researchers were able to identify survivorship care programs and activities, as well as the barriers to developing these programs. This presented opportunities to discuss possible interventions to improve follow-up care and survivors' quality of life.
Topics: Continuity of Patient Care; Delivery of Health Care; Health Personnel; Health Services Needs and Demand; Humans; National Health Programs; Neoplasms; Patient Care Planning; Program Development; Quality of Life; Surveys and Questionnaires; Survival Rate; Survivors; United States
PubMed: 25216608
DOI: 10.1007/s11764-014-0397-8