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Nursing Open Jan 2020A benchmark of 4 has been determined for the reduction of self-reported stress by nursing students' status post 5 weeks of holistic educational activities and...
AIM
A benchmark of 4 has been determined for the reduction of self-reported stress by nursing students' status post 5 weeks of holistic educational activities and interventions provided by a nurse educator.
DESIGN
Provision 5 in the American Nurses Association Code of Ethics for Nurses with Interpretive Statements emphasizes the duty of the nurse to not only promote the health and safety of others, but to self as well (ANA, 2015, Code of ethics with interpretive statements, http://Nursebooks.org). A self-care for nurses' pilot project was trialled with 25 accelerated nursing students over the course of 5 weeks. Holistic education programmes were facilitated by a nurse educator uninvolved in providing clinical or classroom education to the students.
METHODS
The Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines are used in this pilot project as a framework to explore standardization of education of nursing students about self-care in nursing programmes and to promote positive health behaviours and student nurses' insight into how nurses' self-care can have an impact on patient outcomes. The self-care pilot project introduced the importance of self-care for the pre-licensure nursing student by teaching healthy eating, physical exercise, the value of sleep, use of positive affirmations and aromatherapy to a cohort of accelerated nursing students over the course of 5 weeks. The Star Model of Knowledge Transformation was the theoretical framework for the pilot study. Two questionnaires were used by the principal investigator to obtain participant data, the Project Participant Questionnaire and the Final-Year Group Questionnaire.
RESULTS
On completion of the self-care for nurses' pilot, the nursing students reported a reduction in stress and an increased ability to cope with stress after exposure to different holistic stress reduction strategies. An average benchmark of 4.36 was achieved indicating that the nursing students' self-care had improved status post the interactive teaching intervention.Self-care taught to pre-licensure nursing students by nurse educators can enhance their self-awareness of the importance of stress reduction and care of themselves while enduring the academic rigour and simultaneous clinical practicum experiences in nursing programmes.Applying self-care behaviours to reduction of stress for nursing students may be of benefit to of students as they transition from the pre-licensure to graduate nurse roles. Hence, teaching health behaviours that are self-protective and contribute to maintaining safe clinical environments for nurses and the patients in their care.
Topics: Faculty, Nursing; Humans; Pilot Projects; Self Care; Students, Nursing
PubMed: 31871706
DOI: 10.1002/nop2.384 -
Canadian Journal of Surgery. Journal... 2022Given Canada's geographically dispersed population, initial trauma care may occur at rural sites that may not manage patients with trauma frequently; thus, telementoring...
BACKGROUND
Given Canada's geographically dispersed population, initial trauma care may occur at rural sites that may not manage patients with trauma frequently; thus, telementoring can play a life-saving role. In this article, we describe a rural trauma telementoring pilot program in British Columbia and report the results of an evaluation of its strengths and weaknesses.
METHODS
Trauma surgeons from a quaternary trauma centre in Vancouver helped facilitate 3 in situ trauma simulation sessions at a rural BC hospital between fall 2019 and summer 2020. The sessions involved 4 physician participants (a trauma surgeon telementor, a family physician with additional expertise in emergency medicine acting as trauma team leader, a family physician with additional expertise in anesthesia and a family physician with Enhanced Surgical Skills), an emergency department nurse, 2 operating room/trauma team nurses, and laboratory and radiology technicians. The sessions involved simulated damage-control procedures and lasted about 2 hours. The participants completed surveys assessing comfort and confidence regarding aspects of trauma care and use of the telehealth unit before and after each session, and the facilitators assessed team dynamics using the Modified Non-Technical Skills for Trauma (T-NOTECHS) tool. Focus groups were held to gather qualitative data, and costs were tracked.
RESULTS
The average presimulation confidence survey score was 19.6/30, and the average postsimulation score was 24.0/30. The mean score improved significantly after both the first and second sessions ( = 0.01 and = 0.004, respectively). Across the 3 sessions, the average T-NOTECHS score improved significantly, from 18.5/25 to 21.5/25 ( = 0.02). Qualitative analysis identified 3 dominant themes: telementoring increased provider confidence, telementoring increased order to the resuscitation procedure and the technical aspects of telementorship. The telementoring program was well received by all participants.
CONCLUSION
A significant improvement was seen across simulations in physician confidence and trauma team dynamics with telementorship support. Telementoring in trauma may provide a way to lessen the difference between rural and urban patient outcomes within Canada's geographically dispersed population, although further work investigating the impact of its use in real-life patients, as well as barriers to its implementation, is required.
Topics: Humans; Pilot Projects; Resuscitation; Emergency Medicine; Rural Population; Telemedicine
PubMed: 36302133
DOI: 10.1503/cjs.015020 -
International Journal of Environmental... Sep 2022This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate...
This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate nursing students were mentored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Program in the Application of Ethics through an exploration on the ethics of embodiment using an arts pedagogy across one academic year. Inspired by the intersection of nature and health, this project explores the impact of an arts-integrated pedagogy on the human body. The findings from this project provide a natural first step for nursing students to consider multiple interpretations of the human body and to facilitate the students' development of an embodied ethical practice that is perceptive, empathic, and attuned to themselves as natural beings as well as diverse individuals and populations. The findings from this pilot project presents a pivotal opportunity to guide future nursing curricular development toward holistic, nature-inspired, and mindful-based interventions in order to increase resilience, decrease risk factors of compassion fatigue and burnout, and support nursing students to develop strength-based skills to use in their professional nursing practice.
Topics: Education, Nursing, Baccalaureate; Faculty, Nursing; Human Body; Humans; Pilot Projects; Students, Nursing
PubMed: 36141876
DOI: 10.3390/ijerph191811603 -
Zeitschrift Fur Gerontologie Und... May 2022With the growing number of older and old patients as well as patients affected by multimorbidity, cognitive impairments and frailty in hospital and expansion of... (Review)
Review
BACKGROUND
With the growing number of older and old patients as well as patients affected by multimorbidity, cognitive impairments and frailty in hospital and expansion of long-term care, the challenges in the various geriatric and gerontological care settings are also increasing. Social networks and resources become fragile due to the changing family structures. A strong interprofessional team building and networking of the main actors in the nursing and healthcare systems become necessary.
OBJECTIVE
A qualification program for students of medicine, social work and relevant study courses for nursing was established. In this program participants should collectively learn to deal with the concerns and needs of geriatric patients in a case-related manner and to develop suitable plans for treatment and interventions.
METHOD
The qualification program for interprofessional team building was evaluated during the development phase as a pilot project and scientifically evaluated (n = 78) using the Freiburg questionnaire on interprofessional learning evaluation (FILE).
RESULTS
The program experienced a high level of approval by approximately 98% of the participants. The measurement of change showed an improvement in team skills and ability to work in a team.
CONCLUSION
Opening up a learning field for interprofessional learning and working to students of different disciplines and professions during their studies creates a good basis for successful interprofessional team building in the subsequent professional practice. The interuniversity and interprofessional teaching project presented is now firmly anchored in the curriculum at the participating universities with the teaching module "The geriatric patient". It is therefore a possible model for similar projects.
Topics: Aged; Curriculum; Delivery of Health Care; Geriatrics; Humans; Learning; Patient Care Team; Pilot Projects
PubMed: 35092455
DOI: 10.1007/s00391-022-02021-x -
Public Health Nursing (Boston, Mass.) Jan 2021A program evaluation to demonstrate the feasibility of a recuperative care pilot project to address the needs of unhoused individuals.
OBJECTIVE
A program evaluation to demonstrate the feasibility of a recuperative care pilot project to address the needs of unhoused individuals.
DESIGN
The study is a descriptive postprogram evaluation.
SAMPLE
A total of 73 referrals were made to the project with 23 admissions.
MEASURE
Data regarding number and type of referrals for admission, cost of respite care per guest and per day, hospital costs avoided, referrals to community services, and discharge destination were collected.
INTERVENTION
A case management care model was used. The project staff included a public health nurse and an outreach worker.
RESULTS
One local hospital accounted for 65% of all admissions. Admitting diagnoses were abscess/wound care (44%) followed by postsurgery recovery (17%). Housing resources (65%) was a common referral with 22% of guests discharged to stable housing. Actual length of stay exceeded the planned length by an average of 24 days. Total cost per guest per day was $157.45 which is an estimated savings to referring acute care facilities of between $18,000 and $48,000 per day.
CONCLUSIONS
The project demonstrated an ability to provide unhoused individuals a place to recuperate following hospitalization in a cost-effective manner. Challenges and recommendations of the program going forward were identified.
Topics: Aftercare; Cost-Benefit Analysis; Humans; Pilot Projects; Program Evaluation
PubMed: 33190328
DOI: 10.1111/phn.12834 -
Global Health, Science and Practice Feb 2022Gender disparities persist across the HIV care continuum in sub-Saharan Africa. Men are tested, linked, and retained at lower rates than women. Men experience more...
INTRODUCTION
Gender disparities persist across the HIV care continuum in sub-Saharan Africa. Men are tested, linked, and retained at lower rates than women. Men experience more treatment interruptions, resulting in higher rates of virological failure and increased mortality. Peer support is an approach to improving men's engagement and retention in HIV treatment. We assessed uptake and early retention in HIV care among men in the 'Coach Mpilo' peer support pilot project in South Africa.
METHODS
We conducted a pilot project from March 2020 to September 2020 in 3 districts: Ehlanzeni and Gert Sibande (Mpumalanga) and Ugu (KwaZulu-Natal). Men living with HIV were invited to receive one-on-one coaching from a peer supporter who was stable on treatment. We analyzed participants' self-reported data on demographics, uptake, and retention in HIV treatment. We described baseline characteristics using summary statistics and reported uptake and early retention proportions overall and by testing history (newly and previously diagnosed).
RESULTS
Among 4,182 men living with HIV, most were previously diagnosed (n=2,461, 64%) and uptake was high (92%, n=3,848). Short-term retention was 80% (n=1,979) among men previously diagnosed and 88% (n=1,213) among newly diagnosed. In September 2020, 95% (n=3,653/3,848) of all participants reported being active on HIV treatment, including those retained consistently and those who had interrupted and returned to care. Among participants experiencing treatment interruption after enrolling, the majority (82%, n=464) returned to treatment, largely within 2 months.
CONCLUSIONS
Improving linkage to and retention in HIV treatment among men is essential for their health and for treatment as prevention. This pilot project provided preliminary evidence that a peer-led support model was acceptable, retained a high proportion of men in the early stages of ART, and supported men returning to care after treatment interruption. These promising results require further investigation to assess impact, scalability, and cost-effectiveness.
Topics: Continuity of Patient Care; Counseling; Female; HIV Infections; Humans; Male; Pilot Projects; South Africa
PubMed: 35294387
DOI: 10.9745/GHSP-D-21-00498 -
International Journal of Environmental... Nov 2022This paper takes the second batch of low-carbon pilot cities in China as the research object and selects the Urban Health Ecological Index to measure the green...
This paper takes the second batch of low-carbon pilot cities in China as the research object and selects the Urban Health Ecological Index to measure the green development level of cities, aiming to explore and evaluate the theoretical mechanism and policy effect of low-carbon pilot projects to promote the coordinated development of urban economy, society and the environment. The research conclusions show that: ① The low-carbon city pilot project is conducive to support the pilot cities to build a low-carbon industrial system, advocate a low-carbon lifestyle, establish a low-carbon evaluation system, and then play a positive role in promoting the green development level of the city; ② By applying the Propensity Score Matching-Difference in Differences (PSM-DID) model, the empirical analysis finds that after the implementation of the pilot policy, the green development level of low-carbon pilot cities has been significantly improved, and this conclusion is still stable in the parallel trend test, counterfactual test and sample expansion test; ③ In terms of regional heterogeneity, the low-carbon pilot projects have a more significant policy effect on promoting the green development of provincial capitals and eastern cities. Strict administrative supervision in provincial capitals and good economic foundations in eastern cities have had a positive moderating effect on the policy effect of low-carbon pilot projects. Finally, this paper discusses how to realize the ecological effects of low-carbon city pilot projects and put forward some relevant policy suggestions.
Topics: Cities; Carbon; Pilot Projects; Industry; China; Economic Development
PubMed: 36361363
DOI: 10.3390/ijerph192114467 -
Orphanet Journal of Rare Diseases Mar 2019The Korean Undiagnosed Diseases Program (KUDP) was launched in January 2017 as a one-year pilot project to address the increasing global interest in patients with... (Review)
Review
BACKGROUND
The Korean Undiagnosed Diseases Program (KUDP) was launched in January 2017 as a one-year pilot project to address the increasing global interest in patients with undiagnosed rare diseases. The purpose of this paper is to summarize the project results and emphasize the unmet research needs among patients with undiagnosed rare diseases in Korea.
RESULTS
Patient enrollment, assessment, and diagnostic processes were determined by the KUDP clinical expert consortium. Patients followed a diagnostic workflow after being categorized into one of four groups: I) insufficient clinical information or lack of standard diagnostic processes; II) undiagnosed due to low disease awareness; III) clinically diagnosed but unconfirmed genetically due to genetic heterogeneities; or IV) unknown disease due to complex, atypical clinical presentations. After excluding two patients from group I, 97 patients were enrolled, including 10 in group II, 67 in group III, and 20 in group IV. Most of them (92 of 97, 94.8%) were pediatric patients (< 18 years old) and 59 (60.8%) were male. The primary symptoms for 80 patients (82.5%) were neurologic. During the one-year pilot study, 72 patients completed a diagnostic assessment including clinical and molecular genetic analyses; some patients also underwent pathological or biochemical analysis. Twenty-eight of these patients (28/72, 38.9%) achieved molecular genetic diagnosis. Thirteen patients were diagnosed based on traditional tests, including biochemical assay, single or targeted genetic analysis, and chromosomal microarray. We performed whole exome sequencing on 52 patients, among whom 15 (28.8%, 15/52) reached a final diagnosis. One new disorder was identified via international collaboration.
CONCLUSIONS
Using an efficient clinical diagnostic workflow, this KUDP pilot study resulted in a fair diagnostic success rate, improving the potential for additional diagnoses and new scientific discovery of complex and rare diseases. KUDP also satisfied unmet needs for rare diseases with multisystem involvement, highlighting the value of emerging genomic technologies for further research into rare and still-undiagnosed conditions.
Topics: Humans; National Health Programs; Pilot Projects; Rare Diseases; Republic of Korea
PubMed: 30894207
DOI: 10.1186/s13023-019-1041-5 -
Psychiatria Polska Feb 2023The authors, in their study, refer to the changes taking place in Polish psychiatry under the National Mental Health Program (NMHP). They present their thoughts on the... (Review)
Review
The authors, in their study, refer to the changes taking place in Polish psychiatry under the National Mental Health Program (NMHP). They present their thoughts on the restructuring of psychiatric health care for adults in Lower Silesia. They refer to the European experiences described in the book Better Mental Health Care by G. Thornicroft and M. Tansella, and in the practical and scientific dimension - to the substantive premises, derived from demographic analyzes, epidemiological indicators obtained in the EZOP study, from Maps of Health Needs and other official statistics. Lower Silesia is the fifth voivodeship in Poland in terms of population, with four psychiatric hospitals in need of restructuring, a lower than the national rate of beds per 100,000 population and a relatively high rate of the so-called common mental disorders should be included in a targeted pilot project under the NMHP. In conclusion, the authors strongly support the fastest possible implementation of the community model of psychiatric services in Lower Silesia, indicating the methodology that should accompany the transformation process, the risks that may occur, but most of all, making people aware of the benefits that society should achieve in a human and economic sense.
Topics: Humans; Adult; Pilot Projects; Awareness; Hospitals, Psychiatric; Mental Disorders; Delivery of Health Care
PubMed: 37350717
DOI: 10.12740/PP/OnlineFirst/139499 -
BMC Health Services Research Mar 2022The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo...
Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project.
BACKGROUND
The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization's Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training's impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement.
METHODS
Trainees (n = 13) completed a 43-item questionnaire before and after their 5-day training to assess perceptions of mental disorders and attitudes towards people with mental illness. These responses were analyzed using paired-sample t-tests for four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured key informant interviews (n = 11) with trainees, trainers, and local health officials who participated in or supported the HAPPINESS project were thematically analyzed to understand their experiences and perspectives of the project's barriers, facilitators, and opportunities.
RESULTS
Trainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. Key informant interviews revealed that the HAPPINESS project enhanced trainees' diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding, and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Respondents also suggested ways that the HAPPINESS project could be improved and expanded in the future.
CONCLUSIONS
This study adds to the limited evidence on the implementation of mhGAP-IG in Nigeria. Using mixed methods, it evaluates how mhGAP-IG can impact perceptions and knowledge of stigma among primary care trainees. It also highlights barriers, facilitators, and opportunities to consider for project growth. Future efforts should focus on clinical support, supervision, health outcomes, as well as scaling up and assessing the cost-effectiveness of the HAPPINESS project intervention.
Topics: Epilepsy; Humans; Mental Health; Nigeria; Pilot Projects; Primary Health Care
PubMed: 35279154
DOI: 10.1186/s12913-022-07703-1