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Snyder, Eric C. "Implementation of Educational Program for Nurses to Improve Knowledge and Use of Discharge Planning Best Practices." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1429530002.
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Gardner, Lyndsay E. "Advanced Practitioner Provided Pre-Hospital Discharge Asthma Education." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2654.
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Asthma is a leading cause of pediatric hospital admissions. Parents of children under the age of 18 with asthma require education to recognize and manage the signs and symptoms of the disease. Parent education has shown to decrease their children's hospital admission and readmission rates. The purpose of this pilot project was to develop an asthma educational module for the parents of children with asthma and obtain parent feedback on the content. Families with children under the age of 18 who had been admitted to the hospital with a diagnosis of asthma, an asthma exacerbation, or status asthmaticus were invited to participate. A nurse practitioner provided three parents with information on the signs, symptoms, and medication management of asthma, as well as hands-on demonstration of inhaler use. Twenty-eight staff nurses provided verbal feedback on module content, including educational benefit and readability for parents. Parent and staff verbal feedback indicated the module was both a useful and effective tool for asthma education. Clinical leaders plan to expand the pilot study on two additional pediatric units using the same module used in the pilot program with intent to analyze readmission rates. The project promotes social change through parent empowerment to care for their child in the home environment.
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First-Williams, Julie. "Educating Staff Nurses for Successful Patient Discharge." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7473.
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The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and day shift of a rural hospital were interviewed using questions developed from the content from the literature review. Individual interviews were conducted with the volunteer participants and data from the interviews were examined using content analysis. Results included barriers to discharge education were related to inadequate nursing education, poor patient compliance, and inadequate discharge planning. Recommendations from the nurses' interviewed included the need for staff nurse education regarding their role in the educational needs of the patient and their family prior to discharge. The findings from this project may benefit nurses' practice by providing them with an understanding of the need for effective discharge education for patients. When patients are appropriately educated prior to discharge, their ability to self-manage their disease may improve, which can result in a decrease in health care costs and preventable readmissions. Educating nurses about their role in discharge planning promotes positive social change by improving the quality of the discharge education and patient outcomes.
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Naseri, Chiara. "Tailored education for older adult fall prevention after hospital discharge." Thesis, Curtin University, 2020. http://hdl.handle.net/20.500.11937/78789.
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The research in this thesis evaluated how tailored fall prevention education provided at hospital discharge affected older adults’ level of engagement in fall prevention strategies during the six months after hospital discharge. Secondary outcomes were levels of capability and motivation to engage in fall prevention activities after hospital discharge, and an exploration of the opportunity (barriers and enablers) experienced by older adults to engage in fall prevention activities during the six months after hospital discharge.
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Jensen, Gwenneth Anne. "Outcomes of heart failure discharge instructions." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/3318.
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Acute decompensation of chronic heart failure is common and results in many patients being re-hospitalized every year (Jancin 2008). One of four voluntary core measures deployed by the Joint Commission for evaluation of quality of heart failure care in hospitals is heart failure discharge instructions, also called core measure HF1. Although the core measure is a widely disseminated standardized measure related to discharge education, there is little evidence about its impact on patient or readmission outcomes. The purpose of this study was to determine the relationship between the completion of heart failure discharge instructions as defined by the Joint Commission core measure HF1 in a single site, 500 bed tertiary hospital population in the Upper Midwest and the primary endpoint of subsequent readmission to the hospital 30, 90, 180 and 365 days following an index discharge for primary diagnosis of heart failure. Secondary endpoints included hospital readmission charges and total hospital readmission days per year. Patient characteristics, clinical characteristics, unit factors and index visit utilization variables were controlled. This study also described the relationship between nursing unit factors and completion of HF1.
A retrospective, descriptive design, and analyses using primarily generalized linear models, were used to study the relationship of HF1 to utilization outcomes (readmission, hospital days and cost) and unit context (discharge unit and number of inter-unit transfers). Individual level retrospective demographic, clinical, administrative and performance improvement data were used (n = 1034). Results suggested a weak and non-significant association of completion of the core measure HF1 bundle and readmission within 30 days for all cause readmissions (p = .22; OR 1.32), and no association with HF to HF readmissions at 30 days. There was an inverse association
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after 6 months for all cause readmission, and after 90 days for HF to HF readmission. There was a non-significant trend toward a relationship to total hospital days, but no relationship of HF1 to total annual charges. The study did find a significant relationship between type of discharge nursing unit and HF1 completion, and type of discharge unit and readmission. The discharge nursing unit was quite consistently and strongly related to all cause readmissions in binary (p = .029: OR 1.58) and counts analyses (p = .001; OR 1.52), but was not related to the subset of HF to HF readmissions. The study concludes that there is limited relationship between HF1 and 30 day all cause hospital readmission and total readmission days, but a stronger relationship between HF1 and discharge from a cardiology specialty unit. There was also a relationship between cardiology discharge unit and reduction in all cause readmissions.
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Causey-Upton, Renee. "READINESS FOR DISCHARGE AFTER TOTAL KNEE REPLACEMENT: EXPLORING PATIENTS’ PERCEPTIONS OF DISCHARGE PREPARATION AND PROVIDERS’ DESCRIPTIONS OF PRE-OPERATIVE EDUCATION." UKnowledge, 2018. https://uknowledge.uky.edu/rehabsci_etds/47.
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Discharge readiness following total knee replacement (TKR) has often been defined using quantitative factors, such as knee range of motion or walking a specified distance. These measurements fail to include other features that could impact readiness for discharge, such as social support or patient perceptions. Most patients have positive results following TKR surgery, however others experience negative outcomes such as falls, reduced functional performance, and hospital readmission. Readiness for returning home after TKR begins with pre-operative education to prepare patients for surgery and the post-operative phase. Health care providers must have a clear understanding of patients’ perceptions of readiness to return home after surgery. It is also essential to describe the current structure of pre-operative education nationally as a mechanism for better preparing patients to return home following knee replacement.
This dissertation includes three studies that explore aspects of discharge readiness following TKR including patients’ perceptions of readiness for discharge as well as the structure of pre-operative education for TKR across the United States. The first study examined patients’ experiences preparing for discharge home from the acute care setting following TKR surgery. Results indicated that patients felt prepared overall for discharge and received appropriate supports for returning home after surgery, but some felt unprepared for certain aspects of recovery such as the amount of pain experienced in the post-operative phase. The second study surveyed health care providers who participated in pre-operative education before TKR to identify the current structure of education programs in the United States. This pilot study revealed that pre-operative education teams were commonly interprofessional with education being typically provided in a group format in a single session lasting between 1 and 1.5 hours. Verbal and written instruction were common delivery methods to provide education.
The final dissertation study used mixed-methods to explore the current structure of pre-operative education for TKR in the United States with a large, national sample. Orthopedic nurses completed an online survey to describe their pre-operative education program. The majority of participants provided pre-operative education as part of interprofessional teams in either a group format or a format that included both group and individual education. Verbal instruction was the most common educational delivery method followed by written instruction. Most pre-operative education classes lasted between 1 and 1.5 hours, were delivered in a single session, and included a variety of topics. Ten orthopedic nurses were then interviewed and interview transcripts were analyzed qualitatively for common themes among participants. Participants expressed that pre-operative education was a significant component impacting patient outcomes following surgery. Interprofessional pre-operative education was valued by participants, but pragmatic factors were identified as barriers to the inclusion of other disciplines within these programs. Education programs were constantly evolving based on current evidence-based practice and changes to orthopedic protocols. Descriptions of pre-operative programs nationally combined with providers’ perceptions provides a strong basis for determining best practice to support better post-operative patient outcomes. This dissertation research culminated in recommendations for best practice as well as the creation of a model, the ICF-I-EDUCATE, which combines the International Classification of Health, Functioning and Disability (ICF), interprofessional practice, and the EDUCATE model for providing patient and family education. Research is needed to examine the ICF-I-EDUCATE model in clinical practice for patients with planned TKR.
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Haire, Tracey Marie. "Alleviating Discharge Confusion for Older Patients Using the Teach-Back Method." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3684.
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Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the Always Use Teach-Back Toolkit for education and evaluation provided strategies and resources for the project. Five nurse practitioners and a physician assistant, who are responsible for discharge instructions, participated in the study by viewing an online teaching module and completing written surveys. The Conviction and Confidence Tool revealed 100% of the clinicians agreed that Teach-Back education was '10-Very Important' and were '10-Very Confident' in their abilities to apply the Teach-Back methods using a 1-10 Likert scale. Likewise, the practitioners showed significant improvements when comparing the pre-implementation and one-month, post-policy implementation, as indicated in the paired t test of the second part of the Conviction and Confidence Teach-Back Tool. Nursing plays a pivotal role in positive social change by using an evidence-based education method, which improves patient care through medication compliance and decreased readmission rates, thus showing significant transformation in chronic health management.
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Whicker, Mary Ann. "Bedside Nurses' Influence on Patients' Continuum of Care Through Effective Discharge Teaching." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/314.
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The evolution of person-centered healthcare reinforces the need for nursing to provide effective patient education. Literature suggests nurses desire to provide strong discharge education to patients, but are challenged by knowledge gaps and other barriers. This DNP project developed a plan for integrating teach-back on a 30-bed cardiac unit, focusing on heart failure patients. Following a logic model, the process improvement plan to implement teach-back includes education on teach-back, empowerment of unit champions to support the project and evaluation of effectiveness of the education plan and impact on heart failure patients. The sample size of 15 cardiac nurses provides a group representative of other cardiac units and allows for testing and data collection to support spread of the project. Collaboration with the unit leadership to sequence the implementation of the project will direct the timeline for execution and minimize competing priorities that could impede the success. Evaluation of the project takes into account the implementation processes that focus on resources such as education hours needed to implement and heart failure patient outcomes related to readmission rates. Pre- and post-implementation heart failure patient readmission rates as supplied by the site quality improvement team will be analyzed using ttest to correlate the education intervention on heart failure readmission rates. Nursing will drive improved patient outcomes and promote positive social change by using an evidence-based teaching methodology that allows for better patient understanding of how to manage their health. Empowered and better prepared heart failure patients enjoy autonomy with their health management and with reduced readmissions, decrease health care costs.
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Thomas, Lacy Rebaka. "Reducing Congestive Heart Failure Hospital Readmissions through Discharge Planning." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5138.
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Every year, thousands of congestive heart failure (CHF) patients are readmitted to the hospital within 30 days of discharge. There is a gap in practice in the care continuum of patients with CHF within the transition from hospital to home. One of the factors known to increase a patient's risk for readmission is the lack of patient engagement and self-efficacy regarding the treatment plan. The purpose of this project was to implement a transition of care practice guideline that consisted of the use of a risk identification tool, a customized care plan for patients at high risk for readmission, and a discharge checklist crafted specifically for CHF patients who are at risk for readmission. The practice initiative utilized the Iowa model of Evidence Based Practice as a framework and the teach-back method for discharge education. A sample of 193 patients admitted during a 1-month timeframe fit the inclusion criteria and was generated from the electronic health record. Descriptive statistics were used to analyze the data collected during implementation. In fact, of the 106 CHF patients who benefited from the CHF checklist only 2 required readmission within 30 days, a 1.8% 30 day readmission rate. As compared to the 22% readmission rate experienced in 2017, this represented a considerable improvement, albeit preliminary. Efforts to improve the lives of patients and their families will ultimately serve society well, making a significant contribution to positive social change. Providing comprehensive discharge education to patients using the teach-back method to assess the retention of knowledge will help close the gap in the transition of care between hospital and home, ultimately reducing CHF readmissions.
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Scarlett, Marjorie V. "Evidence-Based Diabetic Discharge Guideline: A Standardized Initiative to Promote Nurses' Adherence." NSUWorks, 2017. https://nsuworks.nova.edu/hpd_con_stuetd/51.
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Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present guideline to stakeholders; implement the guideline in fall of 2017; and evaluate nursing compliance with the guideline at a for-profit adult care hospital in South Florida. Theoretical Framework: The chronic care model was utilized as the framework. This model has been used for improving practice and preventing many chronic illnesses. Methods: Two quantitative nonparametric descriptive designs were used, the Wilcoxon signed- rank test and a paired t test. An online demographic survey and pre- and posttest surveys were administered to determine nurses’ knowledge of diabetes discharge guideline practices. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool evaluated the guideline, and data were analyzed with Wilcoxon and paired t tests. Results: A statistically significant difference was found in the pre-posttest survey responses for question 5 (p=0.046 Wilcoxon; p=0.041t test), and question 13 (p= 0.022 Wilcoxon; p=0.018 t test), indicating improvement. With the AGREE II tool, the multidisciplinary team evaluated the guideline at 100%, and 76% of Advanced Practice Registered Nurses (APRNs) and Registered Nurses (RNs) demonstrated compliance with guideline use. Conclusion: A standardized diabetic discharge guideline incorporated into the hospital’s discharge process provided APRNs and RNs with tools for educating and providing diabetic patients for increase in quality of life after discharge. The guideline was recommended by the administrative team for continued use throughout the hospital. Implementation of an evidence-based standardized diabetic discharge guideline to promote nurses’ adherence results in effective nursing practices and an informed patient population.
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Kang, Evelyn P. "The Development and Feasibility Testing of a Patient-Centred Discharge Education Intervention to Improve the Postoperative Recovery of General Surgery Patients." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/414251.
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Background. Postoperative complications resulting in unplanned hospital readmission are common and avoidable. Discharge education enables general surgery (GS) patients to manage their recovery and seek professional help when required, but evidence gaps in this education exist. Aims. The purpose of this thesis was 1) to develop an evidence-based discharge education program using web-based technology for GS patients to self-manage their postdischarge recovery and 2) to test the feasibility of implementing the web-based education program. Methods. This research was guided by the Knowledge-to-Action (KTA) framework and UK Medical Research Council (MRC) guidance for developing and evaluating complex interventions. Phase 1 was a systematic mixed studies review (MSR) to identify the who, what, when and how relevant to discharge education being given to GS patients. Phase 2 included a qualitative study using individual and focus group interviews with patients and health care providers. The aim was to gain an understanding of the problem and the barriers and enablers in delivering discharge education. Phase 3 described the comprehensive approach used to develop the web-based education intervention. Phase 4 involved a pilot randomised controlled trial (RCT) to assess the feasibility of implementing the web-based discharge education intervention. Results. In Phase 1, the MSR of seven studies identified four themes: 1) the quality of discharge education influences its uptake, 2) health care professionals’ perceptions of their role in the delivery of discharge education to patients, 3) patients’ preferences for education delivery, and 4) patients’ participation in their self-care. In Phase 2, telephone interviews with 13 patients uncovered four themes: 1) the quality of discharge information influences patients’ postdischarge experience, 2) the negative impact of contextual influences on delivery of discharge education, 3) patients actively participating in their surgical journey, and 4) patients’ preferences with the delivery of discharge education. Interviews with 21 nurses revealed four themes: 1) assuming responsibility for patient education in the absence of discharge communication; 2) supporting patients to participate in self-management after hospitalisation; 3) variability in the resources, content, and delivery of discharge education; and 4) meeting operational demands compromises the quality of patients’ discharge education. Five themes emerged from the individual interviews with 10 doctors: 1) challenges of delivering quality discharge education, 2) complexities of the discharge planning process, 3) production pressures imposed by the organisation impede delivery of discharge education, 4) anticipating patients’ needs and preferences, and 5) coordinating the discharge process requires a team effort. In Phase 3, a logic model was used in the co-design of the intervention, which was underpinned by the concept of patient activation and Knowles theory of andragogy. It included three components:1) warning signs of potential postoperative complications, 2) information on postdischarge care, and 3) video on surgical wound care and signs of wound complication. In Phase 4, 85 GS patients were recruited and randomised to receive the web-based education intervention or standard education. Feasibility criteria of recruitment, randomisation was met although participants’ loss to follow up was high (27%). Patients in the intervention arm accessed the education an average of three times (SD 3.14) with 4 minutes (SD 16) spent on the website. Most patients were satisfied with its content and found it useful and straightforward. Patient activation, self-care ability, and unplanned health care utilisations improved for patients in the intervention arm, although were only statistically significant for patient activation (F[1,60] = 9.347, p = .003). Conclusions. This web-based discharge education intervention is easily accessed and is an additional support for GS patients to support their recovery after hospital discharge.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing & Midwifery
Griffith Health
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Wang, Tongyao. "Pictographic Education Handout: Significant Impact on Patients and Family Caregivers' Self-Efficacy on Tracheostomy Care." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case161945406039485.
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Scarlett, Marjorie V. "Evidence-Based Diabetic Discharge Guideline| A Standardized Initiative to Promote Nurses' Adherence." Thesis, Nova Southeastern University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10685982.
Full textAbstract:
Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care.
Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present guideline to stakeholders; implement the guideline in fall of 2017; and evaluate nursing compliance with the guideline at a for-profit adult care hospital in South Florida.
Theoretical Framework: The chronic care model was utilized as the framework. This model has been used for improving practice and preventing many chronic illnesses.
Methods: Two quantitative nonparametric descriptive designs were used, the Wilcoxon signed- rank test and a paired t test. An online demographic survey and pre- and posttest surveys were administered to determine nurses’ knowledge of diabetes discharge guideline practices. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool evaluated the guideline, and data were analyzed with Wilcoxon and paired t tests.
Results: A statistically significant difference was found in the pre-posttest survey responses for question 5 (p = 0.046 Wilcoxon; p = 0.041t test), and question 13 (p = 0.022 Wilcoxon; p = 0.018 t test), indicating improvement. With the AGREE II tool, the multidisciplinary team evaluated the guideline at 100%, and 76% of Advanced Practice Registered Nurses (APRNs) and Registered Nurses (RNs) demonstrated compliance with guideline use.
Conclusion: A standardized diabetic discharge guideline incorporated into the hospital’s discharge process provided APRNs and RNs with tools for educating and providing diabetic patients for increase in quality of life after discharge. The guideline was recommended by the administrative team for continued use throughout the hospital. Implementation of an evidence-based standardized diabetic discharge guideline to promote nurses’ adherence results in effective nursing practices and an informed patient population.
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Bergerman, Mauro. "New grain discharge terminal at Santos Port, Brazil." Thesis, Kansas State University, 2012. http://hdl.handle.net/2097/14756.
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Master of AgribusinessDepartment of Agricultural Economics
Allen Featherstone
The thesis assesses the viability of investing in a new grain discharge terminal at the port of Santos, located in the Brazilian southern region, used mostly for wheat but also for malt and malting barley operations. ABC Intl suffered losses of more than USD 1.0 million in 2006 due to demurrage costs at berth 39, used by ABC Intl to export and import grains, sugar and soybean. Congestion tends to increase with the growth of Brazilian soybean and sugar cane production and exports (average 5.0% per year) and 2.0% growth of wheat imports. Demurrage losses are expected to amount to USD 3.0 million by the year 2011 if no investments are made. A brief summary of Brazilian wheat supply and demand for the last five years is presented. Brazil is a net importer between 6.0 and 8.0 million metric tons of wheat per year, to supply the 10.0 million metric ton internal demand. Brazilian wheat imports through the port of Santos average 1.6 million metric tons per year from 2000 to 2006. Sao Paulo is the most populated Brazilian city with more than 18.0 million inhabitants. Its wheat consumption amounts to a third of the total Brazilian consumption and represents around 3.0 million metric tons per year. The thesis analyzes data related to berth 39 activities in the past seven years. A 56-day lineup in 2006 represented more than USD 1.0 million demurrage costs. The thesis forecasts the activity of berth 39 for next five years with and without investment at the new terminal. The new terminal will result in an average of USD 1.8 million savings on demurrage costs over five years. Codesp, Companhia Docas de Sao Paulo, the governmental authority in the port of Santos, is offering a unique opportunity for ABC Intl to invest in a new terminal for grain imports granting the land at no cost. The new terminal would be located at the middle of the port (berth 13/14) close to the railroad and the main avenue in the port of Santos, allowing discharging, storing and loading grain to trucks and wagons. ABC Intl needs to invest USD 5.0 million in the new terminal. It comprises the dismantling and rebuilding of all the grain discharge equipment that will be moved from shed 39 to the new terminal, including two suckers and conveyor belts. The thesis analyzes four different wheat import scenarios for the next five years. In addition, the same scenarios are analyzed for a 10-year period for comparison purposes. The weighted average of the Net Present Value of the four different investment scenarios, considering the probability of each occurring, is a positive USD 78,908 with 13.1% Internal Rate of Return, compared to 9.0 % ABC Intl opportunity cost of capital. It must be considered that the Net Present Value is a conservative figure since it does not take into account the savings on demurrage at berth 39, forecasted to be more than USD 3.0 million in the year 2011 if the company does not invest in the new terminal construction. It is recommended the ABC Intl invest in the new terminal to improve the overall logistics of the port and the quality of the service. This will avoid unnecessary demurrage costs and improving shareholders wealth by investing in a project with positive Net Present Value.
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Sizer, Mary Elizabeth. "Staff Education for Registered Nurses Using the Teach-Back Method." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5656.
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This purpose of this quality improvement project was to develop an educational training curriculum designed for staff nurses to use the teach-back method with patients with low health literacy during discharge instructions. Health literacy is associated with the ability to read, comprehend, and make appropriate healthcare decisions; the teach-back method asks patients to restate or explain health information in their own words, aiding retention and literacy. Effective staff education plays a critical role in the education of patients during discharge teaching: Nurses must help to ensure that patients and their families understand healthcare information and apply this information in their daily lives. The program was planned in an ambulatory care setting and used conceptual frameworks including the Iowa model and the Plan-Do-Study-Act cycle for quality improvement. The program was informed by evidence in the peer-reviewed literature. The curriculum was contextualized by needs of the care setting. The evidence was organized and analyzed using a review matrix to identify common findings among major studies that were applicable to the context. As an aid to operationalization of the program, an implementation plan and an evaluation plan were developed for use by the institution to move the program forward without additional planning. This project may effect positive social change by addressing a health care need that exists throughout the population and is prevalent in those of lower socioeconomic status. Increasing health literacy among patients is likely to promote improved health outcomes among those who are most vulnerable to illness.
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French, Brian M. "Caregivers' perceptions of nurse-led discharge education interventions: Knowledge needed for adequate care of a technology-dependent infant in the home setting." Thesis, Boston College, 2018. http://hdl.handle.net/2345/bc-ir:108082.
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Thesis advisor: Pamela J. GraceBackground: Advances in clinical care over the past 40 years have saved the lives of many infants who previously would not have survived. However, a substantial proportion of these children need on-going technological support and are cared for at home by family caregivers with or without the assistance of home care services. Existing studies describe the experience of family caregivers of technology-dependent children post-discharge, but there is a gap in knowledge related to caregivers’ perceptions of nurse-led discharge teaching. Purpose: To describe caregivers’ perceptions of nurse-led discharge education designed to prepare them to care for their technology-dependent infant in the home setting and to uncover factors that facilitate or hinder its effectiveness. Method: A qualitative descriptive study design was employed to explore caregivers’ perceptions of nurse-led discharge education efforts. Demographic data was collected prior to conducting a semi-structured interview. Interview data were analyzed in an iterative fashion using qualitative content analysis. Sample Recruitment was via purposive sampling aimed to find caregivers of technology-dependent infants under the age of three. Nine participants completed the study. Results: An overarching theme, caregiver learning and self-advocacy is enhanced by positive nurse/caregiver relationships and team cohesion, especially during anxiety-producing transitions in care, emerged from the data. The overarching theme encompasses five major themes and several major themes. The five main themes are: the nurse/caregiver relationship enhances learning; the complexity of care presents challenges to the learning process; team performance affects caregivers’ level of anxiety/uncertainty; caregivers’ level of expertise improves self-advocacy; and transitions in care settings contribute to caregiver anxiety. Conclusion: Insights that contribute to nursing knowledge of the caregivers’ experience of nurse-led discharge education and their perceptions of factors that help or hinder their learning were gained. Implications for nursing include the importance of caregivers’ involvement in care team discussions, the necessity of basing teaching approaches and materials in knowledge of best practices, and improved care coordination and discharge planning. Further nursing research, that can generalize findings and generate interventions is also needed to improve the care of this population
Thesis (PhD) — Boston College, 2018
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Churley-Strom, Ruth Ann. "Post Hysterectomy Discharge Destination and Risk of Hospital Readmission in Elderly Women." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/574.
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In elderly women, discharge after gynecologic surgery is often associated with increased morbidity. Little information exists about elderly women's discharge destination after gynecologic surgery and the outcome of early hospital readmission. The purpose of this study, conceptualized using the quality health outcomes model, was to examine whether post hysterectomy discharge destination is an independent predictor of 30-day hospital readmission in women age 65 and older. Examination of covariates included patient age, race, medical comorbidity and complications of care, as well as surgical anatomic approach and operative technique. This study involved use of a retrospective cohort design and data from 10,598 cases contained in the Healthcare Cost and Utilization Project 2010 and 2011 California State Inpatient Databases. Results of the bivariate analysis showed a statistically significant association between discharge destination after hysterectomy and 30-day hospital readmission. Additionally, the results of multivariate logistic regression revealed the odds of readmission after discharge with home care were 2.99, p < .001, 95% CI [2.29, 3.67] times greater when compared with discharge home for self-care and 5.99, p < .001, 95% CI [4.68, 7.43] times greater with discharge to continuing inpatient care versus home for self-care. This study may lead to positive social change for elderly women by informing health care providers about the odds of early hospital readmission associated with discharge destination after hysterectomy. Further, this information may stimulate development of interventions to improve health care practices for elderly women preparing for hospital discharge after hysterectomy.
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Koshy, Rachel. "Impact of the Discharge Education Plan on 30-Day Heart Failure Hospital Readmission Rates of Elderly Patients." Thesis, The William Paterson University of New Jersey, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3629964.
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Purpose: The purpose of the study was to determine the impact of the discharge education plan on the 30 day heart failure (HF) hospital readmission rates of elderly patients.
Research Question: What was the impact of the discharge education plan including medication adherence, dietary discretion, daily exercise tolerance, daily weight recording, recognition of any early symptoms of worsening HF and early follow-up plan with the physician in reducing the 30 day HF hospital readmission rates of the elderly patients?
Research Hypothesis: The discharge education plan including medication adherence, dietary discretion, daily activity tolerance, daily weight monitoring, recognition of any early symptoms of worsening heart failure, and early follow–up with the physician will reduce the 30 day heart failure hospital readmission rates of elderly patients.
Background: HF is one of the most common diagnoses and indications for hospitalization among adults over 65 years in United States (Pang, Komajda, and Gheorghiade, 2010). HF admission results in 6.5 million hospital days annually. In 2010, the total cost of care for patients with HF was 39.2 billion dollars (Gheorghiade, Vaduganathan, Fonarow, and Bonow, 2013). About two million Medicare beneficiaries are readmitted within 30 days of release from the hospital each year, costing Medicare 17.5 billion dollars in additional hospital bills. It is reported that elderly patients with HF are at increased risk for early readmission as a result of behavioral factors such as medication non–adherence, dietary indiscretion, exercise intolerance, drug and alcohol abuse, inadequate access to follow-up care, and poor transition of care (Gheorghiade, et al., 2013).
Design and Methods: A retrospective, non–experimental, and descriptive chart review was used in this study. The quantitative data, using convenience sampling, selected charts of patients with a diagnosis and readmission of HF within 30 days of discharge from the hospital between May 2012 and June 2013, was reviewed.
Findings: A chi square statistic was used to investigate whether distributions of categorical variables differ and also compare the tallies or counts of categorical responses between the six independent variables. The significant results of the Chi square test for goodness of fit was found only for daily weight monitoring (p=0.0372) and with activity intolerance (p=0.0123). The test compared theoretical (expected) values to experimental (observed) values to determine whether the differences between these values are due to chance (sampling error) alone. The components of the discharge education plan that could not be tested were early recognition of worsening symptoms, early follow–up with the physician and medication non-compliance because of the low frequency counts of <5, and thus we cannot assume that the data follows a rough normal distribution. Therefore, the hypothesis was not supported.
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Moses, Mychal-Drew. "A Study on the Micro Electro-Discharge Machining of Aerospace Materials." TopSCHOLAR®, 2015. http://digitalcommons.wku.edu/theses/1448.
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Electrical Discharge Machining (EDM) is a non-traditional machining process that uses hundreds of thousands of minute electrical sparks per second to machine any electrically conductive material, no matter the hardness or how delicate it is. EDM allows a much greater range of design possibilities, unconstrained from the traditional machining processes, in which material is removed mechanically by either rotating the cutting tool or the work piece. Shapes that were impossible to machine by any other method, such as deep, precision, square holes and slots with sharp inside corners, are readily produced. It provides accurate geometries in high- aspect ratio holes and slots, blind undercuts, small holes adjacent to deep sidewalls, and complex cuts in thin, fragile parts. Micro-EDM is a growing form of manufacturing and will continue to expand within various production fields. Micro-EDM is especially attractive for the applications where the cutting time is minimal, but precision and accuracy are maximized. Micro- EDM is a non-traditional cutting process, which consistently produces ultra-precise holes with fine surface finishes and better roundness, while holding extremely close diameter tolerances. The process could be an excellent problem-solving tool for configurations that are difficult or impossible to produce using conventional machining processes. This study presents a comparative experimental investigation on the micro-EDM machinability of difficult-to-cut Ti-6Al-4V and soft brass materials. As both materials are electrically conductive, they were machinable using the micro-EDM process irrespective of their hardness. The machining performance of the two materials was evaluated based on the quality of the micro-features produced by the micro-EDM process. Both blind and through micro-holes and micro-slots were machined on brass and Ti-6Al-4V materials. The quality of micro-features was assessed based on the shape accuracy, surface finish and profile accuracy of the features. Finally, the arrays of micro-features were machined on both materials to compare the mass production capability of micro-EDM process on those materials.
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Harmon, Aaron. "Development of learning objectives for an undergraduate electrical discharge machining technology course using the Delphi technique /." View online, 2009. http://repository.eiu.edu/theses/docs/32211131566692.pdf.
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Martens, Karen Helen. "A description of medication discharge education in older adults with heart disease and its relationship to hospital readmission /." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487853913101242.
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Hayes, Karen S. "Geragogy-based medication instruction for the rural elderly patient discharged from the emergency department." free to MU campus, to others for purchase, 1996. http://wwwlib.umi.com/cr/mo/fullcit?p9812954.
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Henderson, Erica Vanessa. "Development and Evaluation of an Evidence-Based Educational Process to Reduce Post-Transplant Infections." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3997.
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The targeted transplant center's abdominal organ transplant unit had difficulty providing
adequate education to patients prior to discharge, which had resulted in a 24% readmission rate within 30 days due to infections. Patients and caregivers were unavailable to receive education despite multiple attempts, which made it challenging for health care providers to complete this aspect of their job, resulting in a negative impact on patients' long-term outcomes. A more structured educational environment was needed to provide appropriate and effective patient and caregiver education to increase adherence and positive outcomes. The health promotion model served as a foundation for the development of the evidence-based educational process and materials. A panel of 6 experts was invited to review the evidence-based, theory-supported educational materials along with the staff and caregiver educational process developed for the unit. Five experts participated in the formative and summative evaluation of the educational process, materials, and the evaluation tool. Results of the evaluations demonstrated that a majority (83%) of the experts found the educational materials and process were essential, accurate, and provided a more structured environment that afforded health care providers the ability to maintain compliance with the targeted transplant center's education policy. The materials, process, and evaluation tool will be implemented at the site. Social change will result from increased patient engagement and confidence in self-care; improved caregiver ability to assist the patient; and reduced risk of noncompliance, readmissions, and poor outcomes.
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Barton-Verdi, Michele A. "THE DEVELOPMENT OF A SYSTEMATIC DISCHARGE PLANNING PROCESS FOR THE CARE OF COPD PATIENTS IN A SMALL URBAN COMMUNITY HOSPITAL." Cleveland State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=csu1623883152504604.
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Eyegue-Sandy, Katherine. "Decreasing Thirty Days Hospital Readmission Rates of Adult Heart Failure Patients." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3767.
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Heart failure is a complex heart disease that incapacitates more than 5 million people, is associated with increasing healthcare cost, and remains the leading cause of admission in the United States. As the United States faces increasing financial burden related to readmission of heart failure patients within 30 days of discharge, many healthcare institutions are evaluating interventions to determine the most effective opportunities to improve systems, including nursing practice. The purpose of this doctoral project was to improve readmission rates within 30 days of discharge from an acute care facility through the development and implementation of a standardized, evidence-based, patient-centered discharge education toolkit using the Teach-Back method. Orem's self-care theory and the situation-specific theory of heart failure self-care were utilized as a theoretical framework to inform this doctoral project. The sources of evidence were obtained from the Get With The Guidelines-Heart Failure database and through a review of nursing and health-related databases. Descriptive statistics were used to compare the pre- and posteducation session readmission rates. The rate of readmissions occurring within thirty days of discharge pre- and post-educational session retrieved from the GWTG-Heart Failure database were 9.4% and 0.0% respectively. These results showed that this discharge toolkit reduced heart failure 30-days readmission rates. The limitations and strengths of this project will be used to guide further research on heart failure readmission and self-care management. This DNP project will promote positive social change for clinicians, who can use this discharge toolkit to improve self-management in adults with heart failure and thus decrease the costs related to readmission.
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Sanchez, Lynda M. "Using the Power of 3 with Total Joint Surgery Patients." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2057.
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The purpose of patient education is to provide patients and their families with the tools needed to care for themselves after discharge from the hospital, but shortened hospital stays, limited health literacy, language, and age can impede the patient's comprehension of the information provided. Researchers have found that the lack of effective patient education is related to 30-day hospital readmissions. The Power of 3 educational tool, designed by Sanchez and Cooknell, addressed the factors that impeded effective patient teaching by using the adult learning theory and low health literacy concepts. The Power of 3 was implemented as a quality improvement project in the Total Joint Center in October 2014. The purpose of this project was to assess the effect of an adult learning-based educational tool on the readmission rates for venous thrombus embolism and infection and on the effect on mobility in total joint surgery patients. This goal was accomplished by performing a retrospective chart review on 90 randomized patients, 45 before and 45 after implementation. The Power of 3 demonstrated a statistically significant change in the length of time a patient remained out of bed on the day of surgery after implementing the educational tool (0.75 hours vs. 1.514 hours, p = 0.0182, CI 95%). In addition, the number of patients that nursing staff documented who were out of bed was also statistically significant on the day of surgery (12 patients vs. 24, p = 0.0461, CI 95%). This educational tool can facilitate patient teaching by addressing language and educational barriers between patients and health care workers.
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Hansen, Aslak Balle, and Federico Sampognaro. "What patients want to learn after an AMI. Self-perceived learning needs of patients following an acute myocardial infarction – a literature review." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25754.
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Att överleva en hjärtinfarkt är en livsomvälvande händelse. Det leder ofta till ångest, stress och i vissa fall depression. Att få rätt information i de inledande stadierna efter behandlingen är avgörande. Dock är det så att på grund av snabba behandlingstider är patienternas utbildningstid före utskrivning ofta för kort. För att ge adekvat utbildning måste patientens självupplevda lärandebehov vara kända för utbildaren. Syftet med denna studie är att utforska de självupplevda inlärningsbehoven hos patienter som har genomgått behandling för en akut hjärtinfarkt under sin sjukhusvistelse. Metoden för denna studie är en litteraturstudie av kvantitativa studier där systematiska sökningar har utförts och relevanta studier har kvalitetsgranskats och analyserats. Resultaten är baserade på tio studier med olika inlärningsbehovsskalor. De högsta rankade inlärningsbehovskategorierna var "sårvård", "information om medicinering" samt "komplikationer och symtom” Den lägst rankade kategorin var "fysisk aktivitet". Betydande skillnader hittades i denna kategori i flera studier, vilket visade sig bland unga och yrkesverksamma patienter som rankade denna kategori högre.Generellt sett rankades alla inlärningsbehov högt, vilket gjorde skillnaden mellan de enskilda kategorierna mindre betydande. Skalorna var svåra att jämföra och mycket information om innehållet i kategorierna saknades. Slutsatsen är att sjuksköterskor ska fokusera på övergående praktiska och överlevnadsrelaterade utbildningsämnen i de inledande stadierna efter behandlingen, men att mer forskning, särskilt av, kvalitativ karaktär behövs.Surviving a myocardial infarction is a lifechanging event. It often causes anxiety, stress and in some cases depression. Receiving the right information in the initial stages after treatment is crucial, but due to fast treatment times the time for patient education before discharge is often short. To provide the right education the patient’s self-perceived learning needs to be assessed. The aim of this study is to explore the self-perceived learning needs of patients, who have undergone treatment for an AMI, during their hospital stay. The method is a literature review of quantitative studies in which systematic searches were performed and relevant studies were assessed for quality and analyzed. The results are based on ten studies employing different learning needs assessment scales. The top ranked learning needs categories were ‘wound care’, ‘medication information’ and ‘complications and symptoms’. The lowest ranked category was ‘physical activity’, but significant differences were found I regards to this category in several studies, which showed that it was ranked higher amongst young and employed patients. Generally, all learning needs were ranked highly, which made the disparity between the individual categories less substantial. The different scales were difficult to compare and a lot of information regarding the contents of the categories were lacking. The conclusion is that nurses should focus on imminent practical and survival related education topics in the initial stages after treatment, but that more research is needed especially of a qualitative nature.
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Dirksing, Douglas Michael. "Urban Stormwater Quality Management and Education with an Emphasis in Erosion and Sediment Control: An Internship with Butler Soil and Water Conservation District." Miami University / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=miami1185505303.
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Helgesson, Pernilla, and Benevides Berit Långström. "Patienters uppfattning av information vid utskrivningen från en urologisk vårdavdelning." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320224.
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The purpose of the study was to investigate the perception of given information at discharge from a urological ward at Akademiska sjukhuset, and to investigate whether the patients had searched for information themselves after discharge. The study is an empirical cross -sectional study with descriptive design. All the patients inscribed as urologic patients, discharged to their home during month of March 2009, were asked to participate in the study (in total 82 patients), which led to 57 participants. The data collection method was an interview over the phone, with 20 structured questions. The interview form was sent by mail to the patients after the discharge from the ward, the authors thereafter called the participants at home and performed the interview within 10-20 days after discharge. The most common concerns for surgical patients after discharge are wound care, pain management, daily activity, the detection of complications, handling symptoms, elimination and quality of life. This study shows that 72 % of the participants considered the given information as sufficient for handling their self-care at home. The lack of information experienced by the participants concerned daily activity, eventual complications that may occur and pain management. The majority of the discharge information was given in the patient room. Postoperative complications that occur after discharge can be expensive for the society and is a cause of unnecessary suffering for the patient, therefore the patient need to understand what to be observant of after discharge. This requires that both doctors and nurses provide relevant information for each individual patient.Syftet var att undersöka patienters uppfattning av information given vid utskrivning från en urologisk vårdavdelning på Akademiska sjukhuset samt att undersöka om patienterna själva sökt information efter utskrivningen. Studien är en empirisk tvärsnittstudie med deskriptiv design. Alla patienter inskrivna som urologpatienter, som skrevs ut till hemmet från en urologisk vårdavdelning under mars månad 2009 tillfrågades att delta (sammanlagt 82 patienter), 57 patienter deltog. Som datainsamlingsmetod användes en telefonintervju med 20 strukturerade frågor. Frågorna skickades hem till patienterna efter hemgång och författarna ringde sedan upp patienterna i hemmet och genomförde intervjun. De områden som kirurgiska patienter upplever störst bekymmer för efter utskrivning från sjukhuset är sårvård, smärthantering, daglig aktivitet, att upptäcka komplikationer, symtomhantering, elimination och livskvalitet. Studien visar att 72 % av deltagarna tyckte att den information de fått var tillräcklig för att sköta sin egenvård. Den information som saknats har varit inom områdena daglig aktivitet, eventuella komplikationer som kan uppstå och smärtlindring. Majoriteten av utskrivningssamtalen ägde rum på patientsalen. Postoperativa komplikationer som uppträder efter utskrivning kan bli kostsamma för samhället och är källa till onödigt lidande för patienten, patienten behöver därför förstå vad denne skall vara uppmärksam på efter hemgång. Detta ställer krav på både läkare och sjuksköterskor att ge information som är relevant för varje individuell patient.
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Harun, Nur Ainita. "Factors influencing discharge decisions in dermatology outpatients : checklist and educational methods to support appropriate discharge." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/97397/.
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The decision whether or not to discharge an outpatient is vital in determining outpatient clinic attendance numbers, directly affecting overall patient care efficiency. A review of the factors influencing discharge decisions revealed that there was limited evidence of these factors and a lack of understanding how clinicians take discharge decisions. This project’s objectives were to describe the influential factors on discharge decisions from the clinicians’ and patients’ perspectives, to demonstrate the development and clinical evaluation of a novel "Traffic-light” design dermatology outpatient discharge information checklist to improve appropriateness and consistency in discharge decision-making. Semi-structured interviews were carried out with 40 consultant dermatologists across England. 148 influences were generated and thematically analysed manually and using NVivo10 software. A wide array of nonclinical factors, clinician-based, patient-based, practice-based and policy-based, influence discharge decision-making. Observations of 64 consultations and 56 semi-structured interviews with dermatology outpatients were carried out to understand their experience concerning the decision for their discharge. Twelve of 31 patients (39%) who were discharged considered their discharge inappropriate. A three-round Delphi exercise with 17 dermatology consultants (100% response) was carried out to reach agreement on what a high quality discharge information checklist should contain. There was strong inter-rater reliability (ICC=0.958) and fair inter-rater agreement (Fleiss Kappa=0.269). Thirteen items were identified that formed the "Trafficlight" design checklist. Twelve (67%) dermatology clinicians who evaluated the checklist found it useful. This study has demonstrated the importance of approaching discharge decision taking in an informed, structured manner. The checklist provide the basis for making discharge decisions more systematic, auditable and transparent, improving patient safety and optimising healthcare costs. These methods are potentially useful in other clinical disciplines.
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Pinhão, Cláudia do Rosário Gião Risso Cavas. "Mapear o cuidado para regressar a casa: qualidade da intervenção educativa de enfermagem no planeamento da alta da pessoa submetida a transplante de progenitores hematopoiéticos." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2012. http://hdl.handle.net/10400.26/5475.
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Dissertação apresentada à Escola Superior de Saúde do
Instituto Politécnico de Setúbal, para cumprimento dos requisitos
necessários à obtenção do grau de Mestre em Enfermagem
Médico-CirúrgicaContexto e Objetivo: Visando melhorar a qualidade dos cuidados em Transplante de Progenitores Hematopoiéticos (TPH), foram implicadas competências de investigação científica, para promover a prática baseada na evidência, na área problemática da intervenção educativa de enfermagem no planeamento da alta da pessoa submetida a TPH. Metodologia: A primeiro tempo, foi implementada a metodologia investigativa centrada na resolução de problemas mediante projeto de intervenção no fenómeno problemático, cuja futura ampliação depende de actualização científica a segundo tempo, exequível mediante a revisão integrativa dos artigos disponíveis nas bases de dados, publicados entre 2000 e 2011. Foi concebido um protocolo de revisão circunscrevendo uma amostra de 21 artigos científicos, posteriormente sujeitos a análise descritiva. Os resultados foram sintetizados em matrizes, e classificada a evidência, refletindo sobre a confiabilidade deste procedimento. Por último, foram ponderados à luz do Modelo Qualidade - Cuidado © (2003). Resultados e Discussão: Sobressaem dados da estrutura inclusa ao fenómeno. Com relevância, as competências específicas do enfermeiro em TPH implicadas no processo educativo, as condicionantes do individuo e família, e particularidades físicas e organizacionais para a intervenção educativa em TPH. São expostas evidências relativas à relação de cuidados, específicas em enfermagem e colaboração multidisciplinar, salientando-se a variedade de modelos orientadores de práticas educativas, e promotores de resultados intermédios de adesão, aprendizagem, segurança e capacitação. São apresentados os potenciais resultados futuros, relacionados com os processos estudados, com relevância para: Qualidade de Vida e Satisfação. Conclusões e Implicações práticas: A amostra de evidências apresenta fraca a moderada confiabilidade, carecendo de dinamização de estudos com rigor científico. Todavia, verificam-se subsídios para o desenvolvimento do conhecimento respeitante ao fenómeno estudado, englobados na construção do mapa conceptual orientador da ação prática: O Cuidado para Regressar a Casa.
Abstract: Background and Purpose: Aiming to improve the quality of care in Hematopoietic Stem Cell Transplantations (HSTC), scientific research skills were involved to promote evidence-based practice. The nursing educational intervention for HSTC discharge planning sets up the problem area, supported by theory and projectbased learning. Methodological approach: First, the research approach adopted problem solving activities through an intervention project methodology, focusing on the problematic phenomenon; meanwhile, the need for scientific evidence update arose. An integrative review was developed covering available articles in databases published from 2000 to 2011; it was carried out according to a pre-defined protocol. The sample was composed of 21 articles, submitted to descriptive analysis and level of evidence classification. We’ve done a summary and reflect on the process reliability. The results that expose sensitive factors in the phenomenological field of study were discussed and matched to the Quality - Caring Model © (2003). Findings: Prominent structural features included the phenomenon with greater relevance: the specific HSTC skills of nurses involved in the educational process, the individual and family constraints, the specific physical possibilities and organizational educational interventions in HSTC; the relationship care evidence is exposed concerning to nursing discipline specificity and multidisciplinary collaboration, highlighting the variety of models guiding the educational intervention, promoters of intermediate results of compliance, learning, safety and empowerment. Furthermore, there is presented the potential future results, satisfaction and Quality of Life, related to the studied processes. Conclusions and implications for practice: The sample shows weak and moderate consistency of evidence, requiring encouragement of scientific accuracy; however, it supports the development of knowledge concerning to the studied phenomenon, including the construction of the concept map for practical action guiding: Caring to Back Home.
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Logee, Ashley Shannon. "How home-based clinicians assess and assist parent(s) who experience changes in family dynamics post discharge of their pre-latency/latency age child's first psychiatric hospitalization : a project based upon an independent investigation /." View online, 2008. http://hdl.handle.net/10090/5909.
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França, Adriana Ayres de Oliveira. "Alta hospitalar: práticas educativas em uma unidade de terapia intensiva neonatal." Pontifícia Universidade Católica de São Paulo, 2015. https://tede2.pucsp.br/handle/handle/9505.
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Previous issue date: 2015-03-24The hospital Discharge in a NITU must be planned and evaluated by all the staff evolved in the child and the mother care, who, after coming to the conclusion that they are prepared, determine the hospital discharge date. Professionals working in the NITU need to be prepared for dialogue with family, always looking for a horizontal dialogic practice between work and family. Health education appears as a tool to transform professional practice, giving the assistance and care characteristics of critical and creative activity. Therefore, this study aimed to describe how the multidisciplinary team working in direct care with preterm infants in the neonatal intensive care unit of Hospital Santa Lucinda, Sorocaba (SP) performs the hospital discharge guidelines. It is, then, an exploratory, descriptive study of qualitative-quantitative approach. The study included 36 professionals who answered a self-administered instrument developed by the researcher, with open and closed questions, composed of 22 items divided into three dimensions on educational activities for hospital discharge: characterization of professionals; educational actions and perceptions. In general, participants use dialogue and demonstration, the most used feature is the vaccination card and the most discussed topics are breastfeeding, hygiene, vaccination and follow-up. The most cited facilitating factors were: maternal presence in the NITU, maternal involvement, use of folder and booklets, bond with the family, the multidisciplinary team performance and personal improvement. The most frequently mentioned hindering aspects were not participatory mother, mother of cognitive difficulty, lack of staff training, standardization of guidelines and educational material the need for educational materials, the mother's resistance to participate in the care, the lack of preparation. Most of the team believes that mothers come prepared to care for the newborn in the household, and these are also satisfied with the guidelines they perform. The guidelines are performed mechanical way into the work process, are segmented and there is no consensus among professionals on the subject, content, strategy and evaluation. Although education is embedded in the daily activities within the NITU, this is reproduced as a service task without the questioning of those who do and those who receive it. Thus, there is the need of education for the multidisciplinary team, seeking the preparation and greater integration between professionals beyond the availability of funds for such practices
A alta do recém-nascidos pré-termo (RNPT) deve ser planejada e avaliada por toda a equipe envolvida no cuidado da criança e da mãe, que, após concluir que ambos estão preparados, determinar a data da saída do hospital. Os profissionais que atuam na UTIN precisam estar preparados para o diálogo com a família, buscando sempre uma prática dialógica horizontal entre profissionais e familiares. A educação em saúde aparece como um instrumento capaz de transformar a prática profissional, conferindo à assistência e ao cuidado características de uma atividade crítica e criativa. Para isto, este trabalho buscou descrever como a equipe multiprofissional que atua na assistência direta com o RNPT na UTI Neonatal do Hospital Santa Lucinda, Sorocaba (SP) realiza as orientações de alta hospitalar. Trata-se, então, de um estudo exploratório, descritivo, de abordagem qualiquantitativa. Participaram do estudo 36 profissionais que responderam um instrumento autoaplicável, desenvolvido pela pesquisadora, com perguntas abertas e fechadas, composto de 22 itens divididos em três dimensões sobre as ações educativas para alta hospitalar: caracterização dos profissionais; ações educativas e percepções. De forma geral, os participantes utilizam o diálogo e a demonstração, o recurso mais utilizado é a Carteira de Vacinação e os temas mais abordados são Aleitamento Materno, cuidados de higiene, vacinação e seguimento ambulatorial. Os aspectos facilitadores mais citados foram: a presença materna na UTIN, o comprometimento materno, uso de folder e cartilhas, vínculo com a família, atuação da equipe multiprofissional e o aprimoramento pessoal. Os aspectos dificultadores mais apontados foram: mãe não participativa, dificuldade cognitiva da mãe, falta de capacitação da equipe, padronização das orientações e material educativo a necessidade de materiais educativos, a resistência da mãe em participar do cuidado, a falta de preparo. A maior parte da equipe acredita que as mães saem preparadas para o cuidado com o RN no domicilio, e estes também estão satisfeitos com as orientações que realizam. As orientações são realizadas de maneira mecanizada dentro do processo de trabalho, são segmentadas e não há consenso entre os profissionais quanto ao tema, conteúdo, estratégia e avaliação. Embora a educação esteja incorporada no cotidiano das atividades dentro da UTIN, esta se reproduz como uma tarefa do serviço, sem a problematização daqueles que a fazem e para aqueles que a recebem. Assim, há a necessidade de intervenções educativas para a equipe multiprofissional, visando o preparo e maior integração entre os profissionais além da disponibilização de recursos para essas práticas
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Dansby, Benjamin W. "An Informed Emergency: Improving Patient Comfort And Comprehension In And After The Emergency Department." Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1276367591.
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Brunson, Tara Nicole. "Postmilitary Life Satisfaction and Social Support, Educational Attainment, and Length of Service." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5308.
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The U.S. military has downsized since the early 2000s and has plans to continue to decrease their forces. There are negative implications many veterans experience after discharge. Using the transition theory as the framework for this study, the purpose of this between-groups study was to explore the differences in life satisfaction scores between voluntarily- and involuntarily-discharged U.S. service members and the associations between educational attainment, social support, and length of service. The participants were honorable discharged U.S. service members. A total of 182 participants were included in this study; 141 were voluntarily discharged and 41 were involuntarily discharged. The participants were recruited through Walden's participant pool, flyers, and Facebook. The Satisfaction with Life Scale, the Multidimensional Scale of Perceived Social Support, and a demographic questionnaire were used to identify participants' life satisfaction scores, amount of perceived social support, and personal information. Based on the results of t tests and hierarchical linear regressions, there were no differences in life satisfaction scores between voluntarily and involuntarily discharged service members. Social support and educational attainment were statistically significant predictors of life satisfaction for discharged service members. The positive social change implications of this study include increasing mental health workers' awareness of U.S. service members and the factors that affect life satisfaction after discharge.
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Jamarik, Marissa Blair. "Development of a Teach-Back Educational Module for Heart Failure Discharge Teaching." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2291.
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Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement initiative was to develop a HF educational module to improve patients' readiness to learn in order to promote self-care and prevent readmission to the hospital within 30 days. The design of the educational program was supported by the evidence-based literature and incorporated best practices promoted by the Joint Commission, the Institute for Healthcare Improvement, and the Agency for Healthcare Research and Quality. Content evaluation of the newly developed HF educational program was conducted by 10 experts using a quantitative Likert-type scale and qualitative narrative feedback. Descriptive findings from the Likert scale showed a range of 3.9 to 4.0 in the content, process, and design of the program. Recommendations for improvement included more detail around pathophysiology, as well as how to initiate the process in the outpatient setting. Positive social change can result from the program which offers a relevant strategy to reduce readmissions for HF and has wide-application options for many chronic illnesses that can be better managed through effective discharge teaching.
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Ofoegbu, Lilian Chinyere. "Creating and Establishing Content Validity of a Tool Kit to Educate Mothers of Premature Babies." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3118.
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Abstract
Delivering a preterm baby who is admitted to a neonatal intensive care unit can be an enormous hardship for parents and families, and especially for mothers. The consequences of prematurity alter the parental role, affect their confidence in caring for the baby, and subsequently may impact infant outcomes. Adequately educating mothers of premature babies using an evidence-based practice approach may help them gain the confidence and skills needed to care for their infants. The purpose of this project was to create a tool kit to educate mothers of premature babies about the essential components of caring for their babies, establish content validity of the tool kit among clinical experts, and make recommendations about the use of the tool kit in the neonatal intensive care unit. Polit, Beck, and Owen’s framework was used to establish content validity. Neonatal intensive care nurses who were considered “experts” using Benner’s novice-to-expert theory (n = 7 reviewed the tools which were quantitatively computed and yielded an Item Content Validity Index value range of 0.86 to 1.00, and a Scale Content Validity Index of 0.97, reflecting that the content met the objectives of the toolbox. Positive social change can be realized through use of the tool kit in the neonatal intensive care unit to educate mothers in the care of their preterm babies, thus improving both maternal and infant outcomes.
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Johnson, Jessica. "Socio-Demographic and Financial Predictors of Discharged Chapter 12 Bankruptcies for Utah, Idaho, and Wyoming." DigitalCommons@USU, 2008. https://digitalcommons.usu.edu/etd/606.
Full textAbstract:
The purpose of this study was to examine the socio-demographic and financial characteristics that were associated with the likelihood of a discharge among Chapter 12 bankruptcy filers in Utah, Idaho, and Wyoming. Previous bankruptcy studies conducted in Utah have looked at the same associations in Chapter 7 and Chapter 13. This study contains individual filer-level data from 158 Chapter 12 bankruptcy cases filed in Utah, Idaho, and Wyoming between 1997 and 2005. These cases were accessed through the Web-PACER system, a database of imaged court documents filed in district bankruptcy courts. Free access to this system was given by the Utah, Idaho, and Wyoming bankruptcy trustees to the researcher. The principal finding in this study is that filers with longer repayment plans and those that live in the states of Idaho and Wyoming are more likely to attain a discharge. The local legal culture of Idaho and Wyoming may promote plans that are more feasible and the debtors are more likely to reach a discharge. However, debtors in Utah are more likely to reach a discharge in a shorter time than those living in Idaho or Wyoming. Studies have found that debtors who started making payments were more likely to assure that their plans were successful. Discharge is the most common outcome for cases open for a number of years. Debtors who have reached a Chapter 12 confirmation are more likely to continue on a payment schedule and receive a discharge.
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Corones, Watkins Katina Marlene. "A randomised controlled clinical trial of a post-discharge, nurse-led educational intervention to reduce anxiety and enhance self-efficacy in percutaneous coronary intervention (PCI) patients within the first week post-discharge: A pilot study." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/93369/1/Katina_Corones-Watkins_Thesis.pdf.
Full textAbstract:
This research investigated the efficacy of a post-discharge nurse-led clinic, for patients who underwent a cardiovascular interventional procedure in Australia. A randomised controlled clinical trial measured the effects of the clinic on patient confidence to self-manage and minimise psychological distress given the strong link between anxiety, depression and coronary heart disease. Hospitalisation for the procedure is short and stressful, and patients may wait up to 7-64 days for post-discharge review. This study provides preliminary quantitative and qualitative evidence that nurse-led clinics undertaken within the first week post-percutaneous coronary intervention may fill a much-needed gap for patients during a potentially vulnerable period.
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Miller, Lakisha Chitique. "Medical Resident Turnover and Its Association with Inpatient Mortality in Patient Discharges with a Primary Diagnosis in the Heart Disease, Cancer, or Stroke Diagnostic Groups at U.S. Teaching Hospitals, 2002." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1239044238.
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Delatorre, Patrocínia Gonçalves. "Elaboração e validação de tecnologia educacional como estratégia de cuidado de enfermagem ao idoso submetido à angioplastia coronariana transluminal percutânea." Universidade Federal Fluminense, 2013. https://app.uff.br/riuff/handle/1/1171.
Full textAbstract:
Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-16T13:50:27Z
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Conselho Regional de Enfermagem - Rio de Janeiro - COREN-RJ
Mestrado Profissional em Enfermagem Assistencial
As pessoas, que vivem mais, estão expostas a determinadas doenças crônicas não transmissíveis. Dentre essas, a Doença Arterial Coronariana. Tornando-se primordial, portanto, que os cuidados de enfermagem dispensados aos idosos submetidos à Angioplastia Coronariana Transluminal Percutânea (ACTP) estejam voltados para além do atendimento hospitalar. Objetivo: Elaborar e Validar uma Tecnologia Educacional em forma de manual visando o autocuidado do idoso submetido à ACTP. Metodologia: Pesquisa do tipo metodológica, sustentada nas teorias de Dorotéia Orem. Critérios de inclusão: pessoas a partir de 60 anos submetidas à ACTP. Critérios de exclusão: Idosos com distúrbios cognitivos ou psiquiátricos. A pesquisa desenvolveu-se na hemodinâmica do Hospital Universitário Antonio Pedro e no Programa de Enfermagem na Atenção a Saúde do Idoso e seu Cuidadores - UFF. Em atendimento à resolução 66 de 12 de dezembro de 201260, foi submetida ao Comitê de Ética em Pesquisa, aprovado pelo parecer de Nº 234.557, de 08 de março de 2013. 1º Etapa da pesquisa- realizou-se entrevista utilizando um questionário semiestruturado, para identificar e descrever as necessidades dos idosos submetidos à ACTP relacionado ao autocuidado. As entrevistas foram realizadas no período de maio a julho de 2013, com vinte idosos (20). A análise desta etapa subsidiou a elaboração da tecnologia educacional. 2º Etapa da pesquisa - Elaboração da Tecnologia Educacional - 3ª Validação da Tecnologia Educacional - foram utilizados dois instrumentos de validação da escala Likert. Um instrumento respondido por doze juízes especialistas e o outro instrumento pelo público alvo, nove idosos, da primeira etapa da pesquisa, os que concordaram participar da pesquisa, assinaram o termo de consentimento livre esclarecido e lhes foi entregue um kit contendo a tecnologia educacional e o instrumento para avaliação. Análise da 1ª Etapa da pesquisa - interpretação, transcrição dos dados e análise temática de conteúdo. Resultados: emergiram sete categorias relacionadas ao saber do idoso sobre a ACTP, apontando para déficit de autocuidado relacionado ao conhecimento acerca do procedimento. As categorias temáticas serviram de subsídio para a elaboração da Tecnologia educacional. Análise da 2ª Etapa da pesquisa - análise estatística dos questionários da Escala Likert: baseou-se na frequência simples do número de vezes em que os especialistas e os idosos optaram pelas diferentes valorações em cada bloco do instrumento, a saber: Totalmente Adequado (TA); Adequado (A); Parcialmente Adequado (PA) e para Inadequado (I). Resultados: A TE foi considerada validada os itens que obtiveram concordância maior ou igual a 70%, o manual foi considerado adequado quanto aos itens propostos para avaliação. Os itens que não alcançaram o índice de concordância de 70% foram corrigidos e modificados. 3ª Etapa: Adequação da Tecnologia Educacional - de posse de todas as avaliações realizadas, o manual recebeu o tratamento e os ajustes necessários. Conclusão: foi construído um manual educativo impresso, um vídeo com o mesmo conteúdo e um folder explicativo, tais produtos estão sendo compartilhados com as pessoas idosas que necessitam ser instrumentalizadas de maneira mais eficaz nos serviços de alta complexidade para executar o autocuidado. Este estudo servirá de modelo para outros cenários devido o seu caráter inovador de cuidar educando da pessoa idosa no setor de alta complexidade
People who live longer are exposed to certain chronic diseases. Among these, the Coronary Artery Disease. It becomes paramount, therefore, that nursing care dispensed to elderly undergoing Percutaneous Transluminal Coronary Angioplasty (PTCA) are facing beyond hospital care. Objective: To Develop and Validate an Educational Technology as a manual the self-care of the elderly undergoing PTCA. Methodology: Methodology type research, supported in the theories of Dorotéia Orem. Inclusion criteria: people aged over 60 years old undergoing PTCA. Exclusion criteria: Older adults with cognitive or psychiatric disorders. The research was developed on the hemodynamics of Antonio Pedro University Hospital and Nursing Program in Health Care of the Elderly and their Caregivers - UFF. In compliance with Resolution 66 of December 12, 201260, it was submitted to the Committee for Research Ethics approved by Opinion No. 234 557 of March 08, 2013. 1st Step of the research – it was carried out using a semi-structured interview questionnaire to identify and describe the needs of the elderly undergoing PTCA related to self-care. The interviews were conducted in the period of May to July 2013, with twenty (20) older adults. The analysis of this step subsidized the development of educational technology. 2nd Step of the research - Development of Educational Technology - 3rd Educational Technology Validation - validation of two instruments of Likert scale were used. An instrument responded by twelve expert judges and other instrument by the target audience, nine elderly, from the first stage of the research who agreed to participate in the study, they signed a consent form and was handed a kit containing educational technology and the instrument for review. Analysis of the 1st Step of the research - interpretation, data transcription and thematic content analysis. Results: Seven categories emerged related to knowing about the elderly PTCA, pointing to self-care deficit related to knowledge about the procedure. The themes categories were used as input for the development of educational technology. Analysis of the 2nd Stage of the research - statistical analysis of the questionnaires of Likert Scale: based on the simple frequency of the number of times that the experts and the elderly opted for different valuations on each block of the instrument, namely: Totally Adequate (TA) ; Adequate (A); Partially Adequate (PA) and Inadequate (I). Results: The TE was considered validated items that had greater than or equal to 70% agreement, the manual was considered adequate to the proposed items evaluation. Items that have not reached the level of agreement of 70% were corrected and modified. 3rd Step: Adequacy of Educational Technology - in possession of all the assessments, the manual received the necessary adjustments. Conclusion: it was built a printed teaching manual, a video with the same content and an explanatory brochure. Such products are being shared with the elderly that need to be manipulated more effectively in highly complex services to perform self-care. This study will be a model for other scenarios due to its innovative character of caring for the elderly in educating highly complex sector
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Chen, Yen-Lu, and 陳彥如. "A Study of Systematic Discharge Planning as In-Service Education Intervention on Discharge Planning Effectiveness by Nursing Staff." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/6j4zv2.
Full textAbstract:
碩士國立臺北護理健康大學
醫護教育研究所
105
This study aims to examine the effectiveness of systematic discharge planning as in-service education intervention on discharge planning knowledge and self-efficacy of nursing staff, completeness of the discharge planning checklist, course satisfaction level, and satisfaction level of patients with nursing care. An experimental design was used, and nursing staff from a teaching hospital in New Taipei City that implemented discharge planning were selected as study participants (135 in total). In the experimental group, 70 participants received systematic discharge planning as in-service courses while 65 in the control group received conventional courses. The study tools included a discharge planning knowledge scale, discharge planning self-efficacy scale, discharge planning checklist, course satisfaction questionnaire, and scale of patients’ satisfaction with nursing care as discharge planning. Before course intervention, both groups received pre-testing with a discharge planning knowledge scale, discharge planning self-efficacy scale, and discharge planning checklist. After course intervention was carried out, both groups received post-testing with a discharge planning knowledge scale, discharge planning self-efficacy scale, and course satisfaction questionnaire. Two weeks after intervention, post-testing with the discharge planning checklist and survey on patients’ satisfaction with nursing care as discharge planning was carried out. The SPSS 20.0 computer statistical software suite was used for data analysis, including descriptive statistics analysis (percentages, mean values, and standard deviation), paired t-test, Mann-Whitney U test, unpaired t-test, Wilcoxon signed-rank test, Spearman correlation test, and so on. The results of the study showed the following. (1) After different courses on discharge planning as in-service education, there were no significant differences between the pre- and post-testing scores on the discharge planning knowledge scale in the control and experimental groups. (2) After intervention with different courses on discharge planning as in-service education, there were significant differences between the pre- and post-testing scores in the discharge planning self-efficacy scale in the control and experimental groups with the experimental group showing higher scores than the control group. (3) After intervention with different courses on discharge planning as in-service education, the experimental group showed greater mean satisfaction scores than the control group, but this was not statistically significant. (4) After intervention with different courses on discharge planning as in-service education, the experimental group obtained higher mean satisfaction scores of patients towards nursing care as discharge planning compared with the control group, but this was not statistically significant. Conclusion: Systematic discharge planning as in-service education intervention can help improve discharge planning self-efficacy in nursing staff, completeness of discharge plan, and patients’ level of satisfaction towards nursing care as discharge planning. We suggest that future studies on systematic discharge planning as in-service education can be conducted with different teaching methods for as in-service education of nurses, and performance tracking can be carried out.
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Syu, Wei-Lin, and 許維麟. "The Study of Education Website regarding Animal Husbandry Wastewater Discharge." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/74031584599580512127.
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碩士國立雲林科技大學
環境與安全衛生工程系
103
The research takes the animal husbandry: pig farms in Yunlin County and promoting the community environment as research subjects. Most of the animal husbandry in Yunlin County is nearby the neighbor communities and coexist with the neighbor communities. Commonly, there are 3 to 4 stock farms in the community, and the waste water caused by raising livestock has the serious influence to the community environment and the river ecology.Although the establishment of the waste water processing facility of pig waste has been counseled and promoted extensively since 1990, and the the establishment rate of the waste water processing facility is above 95%. The government also put great emphasis on the animal husbandry, and request stock farm keepers to make use of the waste water processing facility properly to meet the environment laws and regulations through the permission and examination control related to water pollution; in order to reduced the influence of the waste water caused by raising livestock to the community environment and the river ecology. The statistical data in 2014 shows that the animal husbandry governed in Yunlin County altogether has 1,254 stock farms, raising about 1,332,689 pigs, and waste water generated by a pig is approximately equal to the quantity of 3 to 5 adults. The quantity of pig-raising in Yunlin County goes first in Taiwan, but stock farm keepers are primarily the middle-aged and the elder, whose understanding toward related laws and regulations, the operation porcedure of the facilities and ethical concepts are still insufficient. Therefore, how to reach the status of the harmony between the stock farm and the community, maintaining good environment at the same time is an important topic of this research. The research takes the stock farm as a memeber of the community; therefore, living environment and the quality should be maintained cooperatively. Compile guidance, work ethic principles and so on through educational platform of the correlative information of animal husbandry waste water emission, water pollution laws and regulations in the information platform, the introduction and the main point of the waste water facility, and the permission of the water pollution emission to assist farmer to obtain the permission of the animal husbandry water pollution emission. Provide related teaching material for the animal husbandry farmers to have a better understanding of the water pollution laws and regulations, and the waste water processing facility, and to enhance work security and ethical concepts. To reache the goal of maintaining good community environment and community integration, the research uses the Google cooperation platform and the related information system, which save the manpower cost, reduce waste of resources and rule out question instantly.
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Lin, Yu-Han, and 林昱翰. "Incorporating the Topic on Sewage Discharge into Primary Schools' Marine Education." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/25458157230820500673.
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碩士國立臺灣海洋大學
海洋環境資訊學系
99
Solving the issue of water pollution needs to rely on proper construction of sewer systems. The objective of this paper is to incorporate the issue of sewage discharge into marine education at primary school and to promote the importance of sewage treatment to the ocean through national education. Water resources recovery center at Hopin Island in Keelung City is used as an example. Questionnaires are issued to the parents of Hopin Elementary School students in order to understand their knowledge of and attitude towards this issue. Four courses of teaching experiments are conducted among fourth-grade students at Hopin Elementary School. Their learning results are analyzed. Lastly, questionnaires are distributed to teachers of five elementary schools nearby the sewage treatment plant in an attempt to understand the teaching status of and teachers’ attitude towards sewage discharge. The results suggest that parents hold different opinions about the establishment of sewage treatment plant at Hopin Island by the government. Although parents’ knowledge about sewage discharge is not enough, they generally agree the inclusion of the issue in the course. In teaching experiments, students are highly willing to learn and the effects are good. Parents are invited to participate in outdoor teaching, which increases the opportunity of promote the issue. Teachers’ questionnaires indicate that sewage discharge is not currently stressed. Mostly, integrated teaching is conducted. The major factors of not being included in the teaching are lack of related knowledge, not enough teaching hours, and no teaching materials. However, most teachers agree that the issue of sewage discharge should be incorporated into marine education. They are willing to teach if proper plan of teaching is provided. Concluded, this study argues that the feasibility of incorporating the issue of sewage discharge into marine education at primary school is high, and the issue is worth promoting.
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Rizkallah, Sawsan Girgus. "The health education needs of the patient and family upon discharge after a myocardial infarction." Thesis, 2002. http://hdl.handle.net/10413/4806.
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A knowledgeable person can deal with problems in a confident and flexible manner. This statement is certainly applicable in the area of health where an adequate knowledge helps clients to avoid complications. This study was conducted to explore the perceptions of ischemic heart disease patients and their families regarding the content and format of health education they need, before discharge from the hospital. A non-experimental survey study was conducted in the coronary care unit (ccu) of three governmental hospitals in Abu Dhabi, United Arab Emirates (UAE). A convenient sample of one hundred and twelve (112) participants consisting of eighty (80) patients and thirty two (32) relatives, were selected over a three month period. A self-report approach was used to collect data and a questionnaire in the form of five point Likert scale, was developed with appropriate content matching the study purpose. Reliability was tested by test- retest for nine (9) patients not participating in the sample. A panel of experts tested its validity. The confidentiality of the participants was carefully considered. The study has revealed that patients and their families indicate a strong need for health education. Most of the sample prefers health education during the hospital stay by the doctor, although nurses and different health service members were also seen as being important. The respondents perceived the health education function as increasing their confidence in dealing with the disease, while reducing their readmission and anxiety. They preferred a member of the family to attend the session. They wanted comprehensive health education addressing a wide range of topics. Since the study result agreed with other previous research results, it confirmed that people's perceptions about the need for information is similar in the UAE and everywhere else in the world.Thesis (M.Cur.)-University of Natal, Durban, 2002.
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"Evaluation of an educational video for mothers caring for their preterm infants following hospital discharge." 2005. http://library.cuhk.edu.hk/record=b5892432.
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Lee Chor To.Thesis (M.Phil.)--Chinese University of Hong Kong, 2005.
Includes bibliographical references (leaves 102-112).
Abstracts in English and Chinese.
List of appendices --- p.xi
List of tables --- p.xii
List of figures --- p.xii
Chapter CHAPTER 1. --- INTRODUCTION --- p.1
Chapter CHAPTER 2. --- LITERATURE REVIEW
Introduction --- p.3
Prematurity --- p.3
Parental feelings of a preterm birth --- p.5
Transition from hospital to home care --- p.11
Maternal information need --- p.13
Discharge education --- p.15
Use of video education --- p.18
Summary --- p.21
Chapter CHAPTER 3. --- OBJECTIVES AND METHODOLOGY
Aims and Objectives --- p.22
Operational definitions --- p.23
Research design --- p.23
Sample --- p.24
Inclusion criteria --- p.24
Sample size --- p.25
Sampling procedure --- p.26
Educational program of infant care --- p.27
Usual care --- p.27
Educational video --- p.27
Data collection methods --- p.30
Phase I:
Instruments --- p.31
Chinese version State Scale of the State-Trait Anxiety Inventory for Adults --- p.31
The Chinese version of the Maternal Confidence Questionnaire --- p.31
Knowledge Test Infant Care --- p.33
Social Support Questionnaire --- p.35
Demographic information --- p.35
Satisfaction Questionnaire of the Video Education --- p.36
Date Collection procedure in Phase I --- p.37
Phase II:
Instrument --- p.39
Interview guide --- p.39
Data collection procedure in Phase II --- p.39
Data analysis --- p.40
Phase I of the quantitative data --- p.40
Phase II of the qualitative data --- p.41
Pilot study --- p.42
Ethical considerations --- p.42
Chapter CHAPTER 4. --- FINDINGS
Introduction --- p.44
Phase I
Sample --- p.45
Sociodemographic and other characteristics of participating women --- p.45
Demographic characteristics of infants --- p.46
Comparison of sociodemographic data between groups --- p.47
"Maternal outcomes of knowledge, confidence and anxiety about infant care" --- p.52
Knowledge of infant care --- p.52
Confidence in infant care --- p.53
Anxiety concerning infant care --- p.55
Correlation between outcome measures and sociodemographic data --- p.56
Video group women perceived satisfaction of the study video --- p.58
Summary of major findings in Phase I --- p.61
Phase II
Characteristics of informants --- p.62
Six categories emerged from the content analysis --- p.63
Feelings about infant care at home --- p.64
Concerns about the infant --- p.65
Perceptions of the discharge process --- p.67
Sources of support --- p.69
Help-seeking activities --- p.70
Perceptions of the usefulness of video education --- p.74
Differences and similarities in the perceptions of the video group and non-video group women about the experience of caring for their infants at home --- p.77
Summary of major findings in Phase II --- p.78
Chapter CHAPTER 5. --- DISCUSSION
Introduction --- p.80
Sociodemographic characteristics of participants --- p.80
Effects of video education on knowledge of infant care --- p.83
Effects of video education on confidence about infant care --- p.85
Effects of video education on anxiety about infant care --- p.88
Women's feelings about caring for infants at home and their information need --- p.90
Preferred methods of learning about infant care --- p.92
Contributions of the study video --- p.93
Chapter CHAPTER 6. --- CONCLUSION
Limitations --- p.96
Implications for nursing practice --- p.98
Recommendations for farther research --- p.100
Conclusion --- p.101
REFERENCES --- p.102
APPENDICES
Appendix 1a State Scale of State-Trait Anxiety Inventory for Adults (English) --- p.113
Appendix 1b State Scale of State-Trait Anxiety Inventory for Adults (Chinese) --- p.114
Appendix 2a Maternal Confidence Questionnaire (English) --- p.115
Appendix 2b Maternal Confidence Questionnaire (Chinese) --- p.116
Appendix 3a Knowledge Test of Infant Care (English) --- p.117
Appendix 3b Knowledge Test of Infant Care (Chinese) --- p.120
Appendix 4a Social Support Questionnaire (English) --- p.123
Appendix 4b Social Support Questionnaire (Chinese) --- p.125
Appendix 5 Demographic information --- p.127
Appendix 6a Satisfaction Questionnaire of the Video Questionnaire (English) --- p.128
Appendix 6b Satisfaction Questionnaire of the Video Questionnaire (Chinese) --- p.129
Appendix 7a Interview guide (English) --- p.130
Appendix 7b Interview guide (Chinese) --- p.131
Appendix 8a Ethics approval 2001 --- p.132
Appendix 8b Ethics approval 2004 --- p.133
Appendix 9 Permission from Prince of Wales Hospital --- p.134
Appendix 10 Consent form --- p.135
Appendix 11 Comments about the video provided by video group women --- p.136
Appendix 12 Other topics of interest provided by video group women --- p.137
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Knight, Janet S. "A comparison of patients' perception of needs pre and post discharge : a study of laminectomy patients : a research report submitted in partial fulfillment ... /." 1988. http://catalog.hathitrust.org/api/volumes/oclc/68787893.html.
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Lopes, Tânia Alexandra Ferreira. "Um olhar sobre a preparação do regresso a casa." Master's thesis, 2015. http://hdl.handle.net/10400.14/20270.
Full textAbstract:
Este relatório retrata o percurso realizado ao longo do meu estágio, representando o culminar
do Curso de Mestrado em Enfermagem na área de Especialização em Enfermagem Médico-
Cirúrgica. O estágio estaria normalmente dividido em três Módulos: Módulo I Serviço de
Urgência; Módulo II Unidade de Cuidados Intensivos/Intermédios e Módulo III Opcional
Cuidados Paliativos. No entanto, como me foi creditado o estágio de cuidados
intermédios/intensivos, fiz apenas dois estágios: o de Cuidados Paliativos, num hospital privado
de Lisboa, e o de Urgência, num hospital da região centro. O que motivou a escolha dos locais
de estágio foram as características, valências e qualidade da assistência prestada pelos
mesmos, que primam pela excelência dos cuidados, permitindo o desenvolvimento de
competências que me habilitem a prestar cuidados de enfermagem especializados.
Neste relatório são descritas as atividades realizadas no sentido de concretizar os objetivos
definidos, relatando as competências e os comportamentos desenvolvidos. No decurso do
estágio desenvolvi competências relacionadas com o cuidar do doente crítico e da sua família.
Desta forma, mobilizei conhecimentos, habilidades e capacidades para prestar cuidados de
enfermagem com qualidade ao doente crítico inserido em ambientes tão distintos como a
unidade de cuidados paliativos e o serviço de urgência.
Esta variedade de ambientes permitiu-me desenvolver as competências humanas, técnicas e
científicas exigidas a um enfermeiro especialista, assim como a reflexão crítica e a tomada de
decisão.
Inserido no estágio de cuidados paliativos, torna-se fulcral mencionar o programa de melhoria
contínua dos Padrões de Qualidade da Ordem dos Enfermeiros que foi desenvolvido por mim,
em parceria com a equipa de enfermagem, sobre o impacto dos programas educativos
dirigidos a cuidadores de doentes dependentes aquando do regresso a casa, elaborado
através duma revisão integrativa da literatura.
Torna-se evidente que os profissionais de saúde são responsáveis pelo colmatar das
necessidades dos cuidadores através de uma comunicação clara e objetiva, proporcionando a
informação necessária aos mesmos para poderem cuidar do doente aquando do regresso a
casa. Acima de tudo deve ser facultado o apoio necessário a cada cuidador, assegurando a
presença do enfermeiro para auxiliar no que precisarem e também para o esclarecimento de
dúvidas.
Evidenciam-se várias necessidades de intervenções ao nível do cuidador informal do doente
dependente, nomeadamente no que diz respeito ao ensino, informação, apoio emocional e
encaminhamento, quer em contexto hospitalar, quer em contexto comunitário. Desta forma,
salienta-se a relevância da visibilidade da nossa prática, quer pela investigação em áreas dos
cuidados de enfermagem, quer pela sua comunicação, suportada por um referencial teórico,
que lhe confere credibilidade e qualidade. O presente relatório procura ser um testemunho da
análise e reflexão pessoais que faço sobre o estágio realizado.This report describes the course of action of my internship, representing the final step towards -Surgical Nursing. The internship would normally be divided in three Modules: Module I Emergency Service; Module II Intensive/Intermediate Care; and Module III Optional Palliative Care. However, I received credit for my previous work in Intensive/Intermediate Care and completed only two Modules: Palliative Care, at a private hospital in Lisbon, and Emergency, at a hospital in the centre region. What motivated my choice of internship locations were the characteristics, broad range and quality of the care provided at those locations, which are known for the excellence of their care, allowing for the development of competences that qualify me to provide specialized nursing care. In this report, I describe activities conducted towards fulfilling the defined objectives, describing the competences and behaviours developed. During the course of my internship, I developed competences related to caring for critical patients and their relatives. I employed knowledge, skills and capacities to provide care to critical patients in different environments such as the palliative care unit and the emergency room. This diversity of environments allowed me to develop the human, technical and scientific competences one should expect from a specialist nurse, as well as my critical thinking and decision making. In the scope of the palliative care internship, it is important to highlight the Nurses Council Quality Standards continuous improvement programme I developed together with the nursing team, focused on the impact of training programmes aimed at caregivers for dependent patients upon home return, developed through an integrative literature review. It became evident that healthcare professionals are responsible for fulfilling the needs of caregivers through clear and objective communication, providing the necessary information to allow them to care for the patient upon home return. Above all, the necessary support should be given to each caregiver, ensuring a reliable presence of the nurse to provide assistance and to clarify any doubts. Several areas in which the informal caregiver needs assistance were evident, namely training, information, emotional support and guidance, whether in a hospital or community setting. Therefore, the relevance of the nursing practice visibility should be highlighted, whether by research in nursing care or by its communication, supported by a theoretical framework that endows it with credibility and quality. This report aims at providing an account of my personal analysis on the internship I undertook.
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HOU, YA-PING, and 侯雅萍. "The Effects of Educational Program using Mobile Application(APP) on Pre-Discharge Knowledge, Skills and Anxiety of Wound Care." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/89173645209347458476.
Full textAbstract:
碩士輔英科技大學
護理系碩士班
105
Background: Wound care is a major stress to patients or their primary caregivers no matter what their size of wound may be. Knowledge and skills of wound care would affect their willing and determination to perform the wound care as well as affect their self-care ability on wound care after discharge. Many patients and their primary caregivers are afraid of performing wound care incorrectly and lead to developing anxiety which, in turn, affects the learning outcome of wound care. Thus, the purpose of this study was to explore the effects of patient education applications (APP) on self-care of wound before discharging from the hospital. Aims: This research used the self-regulation theory to design patient education on wound care with Mobile Applications in comparison of routine patient education on knowledge, skills and anxiety of on wound care. Research Methods: A single-blinded experimental research design was used. The study recruited patients from the Department of Plastic Surgery at a Medical Center Hospital in Southern Taiwan. A total of 70 participants were randomized to each group for 35 people, the control group receiving the oral patient education and the experimental group receiving patient education using mobile applications. Both groups collected data using “Wound Care Knowledge Scale,” “Wound Care Skills Scale,” “State Trait Anxiety Inventory,” “Visual Analogue Scale” and “Heart Rate Variability” at three phases, including before the intervention (T1), after 3 times of intervention (T2), and before discharge from hospital (T3). The SPSS 22.0 for Windows was used for statistics analyses. Results: The major findings indicated that the scores of knowledge and skills on wound care were improved after receiving patient education for both the experimental and control group. The findings revealed that both oral education and education Applications (APP) had a positive effect on the knowledge and skills of the Wound Care. The change degree of knowledge, skills and anxiety of wound care for experimental group was significantly improved than the control group (p < .05). Conclusion: The Mobile Applications (APP) for patient education has promoted the knowledge, skills on the Wound Care and reduced the anxiety of wound care which can not only serves as the individual nursing education but also provide as a reference for nurses when planning the patient education in clinical settings. In recent years, the popularity of smart healthcare and mobile devices has helped us develop and design the interactive healthcare platform to provide the quality and ability of a continuing care after discharging from the hospital for patients and reduce the numbers of return visits and rates of unexpected readmission.
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Williamson, Karen Martha. "An individualized telephone educational intervention for patients following coronary artery bypass graft surgery during the first three weeks after discharge." 2007. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=742518&T=F.
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