Redesigning Evidence-Based Initiatives for Nurses
- Author (aut): Vea, Davina; Espinosa, Gloria
- Thesis advisor (ths): Hagler, Debra
- Contributor (ctb): Arizona State University. College of Nursing & Healthcare Innovation
Hospitalized and chronically ill infants are at risk for motor, cognitive, and social developmental delays. Nurses have an important role in supporting infant and family development to mitigate these delays. A literature review was performed to identify nursing interventions that promote development in these three categories. After literature was selected, critical appraisals were performed to assess the quality of evidence. Breast feeding, early cognitive-motor intervention, and family centered care were found to be beneficial for promoting motor development. Maternal scaffolding, responsive-didactic caregiving, and skin-to-skin contact are recommended nursing interventions for cognitive development. Lastly, integration of music is the nursing intervention recommended to promote social development.
Knowledge of the False Claims Act is necessary for nurse practitioners. Education on the False Claims Act is a preventive measure to protect patients, taxpayers, and federal health care programs. To provide the necessary education, I conducted extensive research on the False Claims Act, examined the literature to determine the relevance of the False Claims Act to nurse practitioners, conducted interviews with members in charge of preparing students to become nurse practitioners, and evaluated the best means to present the information. My end product is infographics that provide an overview of the complexities of the False Claims Act. From a health care compliance perspective, the infographics are resources that promote compliance with the False Claims Act through education.
Background: Vaccine-preventable diseases significantly influence the health and academic success of college students. Despite the known negative impact of these diseases, vaccination rates routinely fall short of national goals and recommendations. Although vaccination decisions are complex, a recommendation from a health care provider is one of the key motivators for individuals receiving a vaccine. Motivational interviewing (MI), a counseling approach primarily used to address substance abuse, can be applied to other health-related behaviors.
Local Problem: Despite previous quality improvement efforts aimed at increasing vaccine rates for influenza, human papillomavirus (HPV), and meningitis B (MenB), vaccinations at large university health centers have been well below benchmarks set by Healthy People 2020.
Methods: This study was guided by the Theory of Planned Behavior and included MI training and regular reinforcement for health care providers to address vaccine hesitancy with college students.
Results: Influenza vaccination rates improved, but HPV vaccine rates remained stable and MenB vaccine rates decreased compared with the previous year. Clinicians demonstrated a significant increase in knowledge of MI techniques after a targeted educational intervention. Repeat measures indicate the potential for sustained improvement when ongoing reinforcement is provided.
Conclusion: MI can be an effective part of a strategy to increase vaccination rates.
Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death. ED HCPs frequently cite lack of knowledge or confidence in screening for and detecting child physical abuse.
The purpose of this evidence-based quality improvement project was to implement a comprehensive screening program that included ED HCP education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. After a 20-minute educational session, there was a significant increase in ED HCP knowledge and confidence scores for child physical abuse screening and recognition (p < .001). There was no difference in diagnostic coding of child physical abuse by ED HCPs when evaluating a 30-day period before and after implementation of the screening protocol.
In a follow-up survey, the Escape Instrument and educational session were the most reported screening facilitators, while transition to a new electronic health system was the most reported barrier. The results of this project support comprehensive ED screening programs as a method of improving HCP knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Efforts should also be made to standardize child abuse screening programs throughout all EDs, with the potential for spread to other settings.