Applying Principles of a Fair and Just Culture to a Student Scenario.

BACKGROUND: This article reviews national efforts toward promoting fair and just cultures in schools of nursing. A real-life vignette in which a nursing student made a medication error is presented, and the nursing program contacted the nursing regulatory body for advice on how to handle the situation. METHOD: A framework was used to analyze the causes of the error. Commentary is offered regarding how applying the principles of a fair and just culture could improve student performance and advance the school's culture to reflect one that was fair and just. RESULTS: A fair and just culture requires a commitment of all leaders and faculty within a school of nursing. Administrators and faculty must recognize that errors are part of the learning process, that errors can be minimized but not eliminated, and that learning can occur from each incident to prevent similar occurrences in the future. CONCLUSION: Academic leaders must engage faculty, staff, and students in a dialogue about the principles of a fair and just culture to develop a tailored plan of action. [J Nurs Educ. 2023;62(3):139-145.].

Reshaping wound care: Evaluation of an artificial intelligence app amid the COVID-19 pandemic...Wounds Australia Conference, 14-17 September 2022, Sydney, Australia

Objectives: To evaluate the usability and effectiveness of a digital application for wound care from a clinician-and-patient user perspective. Methods: A quasi-experimental design was conducted in four settings in an Australian health service from July to December 2019 to October 2020. Owing to the coronavirus disease pandemic, the study paused in March 2020 but then restarted immediately after 3 weeks. Data were collected from patients in the standard group (n = 166, 243 wounds), and intervention group (n = 124, 184 wounds). Clinicians participated in a survey (n = 10) and focus group interviews (n = 13) and patients were interviewed (n = 4). Wound documentation data were analysed descriptively. Interviews were thematically analysed. Results: Positive evaluations identified improvements such as instantaneous objective wound assessment, shared wound plans, increased patient adherence and enhanced efficiency in providing virtual care. Compared to the standard group, wound documentation in the intervention group improved significantly (more than two items documented 24% versus 70%, p < .001). During the intervention, 101 out of 132 wounds improved (mean wound size reduction = 53.99 %). The travel-related fuel cost saved for a patient living in a rural area was on average $72.90. Conclusions: The digital application provided real-time wound data with an interface for communication between the patient and clinician and clinicians in a hospital, community, and outpatient setting in a variety of settings. The use of the application facilitated remote patient monitoring, and reduced patient travel time, while maintaining optimal wound care.

The Florida Clinical Skills Collaborative: A New Regional Consortium for the Assessment of Clinical Skills.

Discontinuation of the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) exam and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2 Performance Evaluation (2-PE) raised questions about the ability of medical schools to ensure the clinical skills competence of graduating students. In February 2021, representatives from all Florida, United States, allopathic and osteopathic schools initiated a collaboration to address this critically important issue in the evolving landscape of medical education. A 5-point Likert scale survey of all members (n=18/20 individuals representing 10/10 institutions) reveals that initial interest in joining the collaboration was high among both individuals (mean 4.78, SD 0.43) and institutions (mean 4.69, SD 0.48). Most individuals (mean 4.78, SD 0.55) and institutions (mean 4.53, SD 0.72) are highly satisfied with their decision to join. Members most commonly cited a "desire to establish a shared assessment in place of Step 2 CS/2-PE" as their most important reason for joining. Experienced benefits of membership were ranked as the following: 1) Networking, 2) Shared resources for curriculum implementation, 3) Scholarship, and 4) Work towards a shared assessment in place of Step 2 CS/2-PE. Challenges of membership were ranked as the following: 1) Logistics such as scheduling and technology, 2) Agreement on common goals, 3) Total time commitment, and 4) Large group size. Members cited the "administration of a joint assessment pilot" as the highest priority for the coming year. Florida has successfully launched a regional consortium for the assessment of clinical skills competency with high levels of member satisfaction which may serve as a model for future regional consortia.

Insights and Innovation: How a Local Public-Private Partnership is Building Home Care.

Recent national reports asserted an urgent imperative for transforming working conditions for the direct care workforce in the US. These clarion reports identified key influencers in reform as federal and state governments, workers' unions and coalitions, individual and organizational employers. Equally essential and well-positioned local actors have been overlooked in the conversation-namely, municipalities, area agencies on aging, higher education, philanthropic entities, and community. Although deemed "essential," direct care workers have been disproportionately affected by the COVID-19 pandemic. This paper examines an early public-private partnership initiative designed to recruit and train PCAs in Virginia.

Nurturing Diverse Generations of the Medical Workforce for Success With Authenticity: An Association of Black Cardiologists' Roundtable.

The COVID-19 pandemic exposed the consequences of systemic racism in the United States with Black, Hispanic, and other racial and ethnic diverse populations dying at disproportionately higher rates than White Americans. Addressing the social and health disparities amplified by COVID-19 requires in part restructuring of the healthcare system, particularly the diversity of the healthcare workforce to better reflect that of the US population. In January 2021, the Association of Black Cardiologists hosted a virtual roundtable designed to discuss key issues pertaining to medical workforce diversity and to identify strategies aimed at improving racial and ethnic diversity in medical school, graduate medical education, faculty, and leadership positions. The Nurturing Diverse Generations of the Medical Workforce for Success with Authenticity roundtable brought together diverse stakeholders and champions of diversity and inclusion to discuss innovative ideas, solutions, and opportunities to address workforce diversification.

Growth and Gastrointestinal Tolerance in Healthy Term Infants Fed Milk-Based Infant Formula Supplemented with Five Human Milk Oligosaccharides (HMOs): A Randomized Multicenter Trial.

Background: Five of the most abundant human milk oligosaccharides (HMOs) in human milk are 2'-fucosyllactose (2'-FL), 3-fucosyllactose (3-FL), lacto-N-tetraose (LNT), 3'-sialyllactose (3'-SL) and 6'-sialyllactose (6'-SL). Methods: A randomized, double-blind, controlled parallel feeding trial evaluated growth in healthy term infants fed a control milk-based formula (CF; n = 129), experimental milk-based formula (EF; n = 130) containing five HMOs (5.75 g/L; 2'-FL, 3-FL, LNT, 3'-SL and 6'-SL) or human milk (HM; n = 104). Results: No significant differences (all p ≥ 0.337, protocol evaluable cohort) were observed among the three groups for weight gain per day from 14 to 119 days (D) of age, irrespective of COVID-19 or combined non-COVID-19 and COVID-19 periods. There were no differences (p ≥ 0.05) among the three groups for gains in weight and length from D14 to D119. Compared to the CF group, the EF group had more stools that were soft, frequent and yellow and were similar to the HM group. Serious and non-serious adverse events were not different among groups, but more CF-fed infants were seen by health care professionals for illness from study entry to D56 (p = 0.044) and D84 (p = 0.028) compared to EF-fed infants. Conclusions: The study demonstrated that the EF containing five HMOs supported normal growth, gastrointestinal (GI) tolerance and safe use in healthy term infants.

Not by trees alone: Centering community in urban forestry

Urban forestry and urban greening efforts are blossoming as cities and towns work to enhance their open spaces as green infrastructure that provides multiple benefits. This work has reached new urgency given the need for both high-performance landscapes that can mitigate the effects of climate change and accessible, safe greenspaces that can support community well-being during the COVID-19 pandemic. At the same time, activists, practitioners, scholars, and decision-makers--particularly those within Black, Indigenous, People of Color, and frontline communities who bear the brunt of negative impacts--are calling for the need to attend to environmental justice implications of greening efforts. Following a review of the literature, we draw upon our observations as researchers embedded in the field of urban and community forestry to offer three themes and related guiding questions that can help advance that work: 1) supporting human capacity and care (investments in people and organizations);2) community organizing beyond the green silo (intersectional and cross-sectoral approaches);and 3) re-envisioning the functions of the urban forest (productive systems and biocultural approaches). Our perspective is inspired by the work of residents, practitioners, and decision-makers who are engaging in reflection and innovation in pursuit of “just cities” that can enhance diversity, equity, and inclusion as critical to and inseparable from sustainability and resilience. We suggest that the field of urban forestry draw upon a community forestry ethos as we center the needs, capacities, and priorities of historically marginalized communities at the heart of the work of creating more just, sustainable cities.

K-8 eLearning during the covid-19 pandemic: "spreading" best practices

In March of 2020, schools were abruptly forced to close their doors for in-person learning due to the COVID-19 global pandemic. Schools quickly adjusted to online learning in order to continue educating students. This was a drastic change for both teachers and students, and hugely impacted all stakeholders. The purpose of this study is to identify key components of a K-8 eLearning program and offer best practices recommendations for implementing an effective eLearning program based on data collected from St. John the Evangelist School (SJE) and existing literature. It can be used as a guide for K-8 administrators in developing eLearning plans for schools. SJE is a private school in an affluent community in northwest Indiana. The student population is >80% White, and <10% of students are on free and reduced lunch. A triangulation approach was taken in collecting data from SJE through analyzing survey data, document reviews, and focus groups. Through examining the data collected and existing research, key components of eLearning were identified, including communication, engagement, technology, and supports. Based on these key components, the following recommendations were made. Communication among all stakeholders is important in an eLearning program. Communication should be frequent, simple, and familiar. Ongoing communication is recommended between home and school for the purpose of sharing updates, expectations, and feedback through written and video messages.Strong engagement is a key component in an effective eLearning program. This involves a balance of asynchronous and synchronous learning. Students should participate and engage with one another during online learning. Developing and nurturing strong relationships between home and school is recommended. Teachers should make learning fun through incorporating students' interests into lessons, and use engaging teaching practices and strategies.The effective use of technology is critical in eLearning. Adopting a universal learning platform for teaching and learning is recommended. The number of tools and resources should be limited, and utilizing familiar resources is ideal. Technology should be used as a driving force to engage students and enhance learning. Supporting teachers, students, and families is important in an effective eLearning program. Collaboration and communication are recommended. Teachers and administrators should promote healthy practices and check in on the wellbeing of the students and staff. Clear content and technology supports need to be provided. The school staff should meet with students synchronously on an individual and small group basis. Providing a manageable workload is a best practice recommendation in an eLearning program. The focus should be placed on assigning meaningful work rather than busy work. Utilizing creativity when developing school schedules and being open to making changes is key. Modifying school schedules can create a more manageable workload for students through the adoption of block scheduling. In identifying these key findings and offering best practices recommendations for eLearning, K-8 schools can develop and implement effective eLearning programs. Furthermore, this study can help guide schools in creating a plan for emergency online learning due to a public health crises or other disaster in order to preserve the health and safety of all and/or allow for continuous learning if school buildings are unavailable. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Reshaping wound care: Evaluation of an artificial intelligence app to improve wound assessment and management amid the COVID-19 pandemic.

Wound documentation is integral to effective wound care, health data coding and facilitating continuity of care. This study evaluated the usability and effectiveness of an artificial intelligence application for wound assessment and management from a clinician-and-patient user perspective. A quasi-experimental design was conducted in four settings in an Australian health service. Data were collected from patients in the standard group (n = 166, 243 wounds) and intervention group (n = 124, 184 wounds), at baseline and post-intervention. Clinicians participated in a survey (n = 10) and focus group interviews (n = 13) and patients were interviewed (n = 4). Wound documentation data were analysed descriptively, and bivariate statistics were used to determine between-group differences. Thematic analysis of interviews was conducted. Compared with the standard group, wound documentation in the intervention group improved significantly (more than two items documented 24% vs 70%, P < .001). During the intervention, 101 out of 132 wounds improved (mean wound size reduction = 53.99%). Positive evaluations identified improvements such as instantaneous objective wound assessment, shared wound plans, increased patient adherence and enhanced efficiency in providing virtual care. The use of the application facilitated remote patient monitoring and reduced patient travel time while maintaining optimal wound care.

Transitioning Speech-Language Assessment to a Virtual Environment: Lessons Learned From the ELLA Study.

Purpose The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is (a) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment and (b) to provide tips for optimizing virtual assessment procedures. Method We provide an overview of our decision making during the transition to virtual assessment. Additionally, we report on a pilot study that calculated test-retest reliability from in-person to virtual assessment for a subset of our preschool-age participants. Results Our pilot study revealed that most speech-language measures had high or adequate test-retest reliability when administered in a virtual environment. When low reliability occurred, generally the measures were timed. Conclusions Speech-language assessment can be conducted successfully in a virtual environment for preschool children with hearing loss. We provide suggestions for clinicians to consider when preparing for virtual assessment sessions. Supplemental Material https://doi.org/10.23641/asha.14787834.

Perceived Usefulness of a Social Robot Augmented Telehealth Platform by Therapists in the United States.

With the shortage of rehabilitation clinicians in rural areas and the ongoing COVID-19 pandemic, remote rehabilitation (telerehab) fills an important gap in access to rehabilitation, especially for the treatment of adults and children experiencing upper arm disability due to stroke and cerebral palsy. We propose the use of a socially assistive robot with arms, a torso, and a face to play games with and guide patients, coupled with a telepresence platform, to maintain the patient-clinician interaction, and a computer vision system, to aid in automated objective assessments, as a tool for achieving more effective telerehab. In this paper, we outline the design of such a system, Lil'Flo, and present a uniquely large perceived usefulness evaluation of the Lil'Flo platform with 351 practicing therapists in the United States. We analyzed responses to the question of general interest and 5 questions on Lil'Flo's perceived usefulness. Therapists believe that Lil'Flo would significantly improve communication, motivation, and compliance during telerehab interactions when compared to traditional telepresence. 27% of therapists reported that they were interested in using Lil'Flo. Therapists interested in using Lil'Flo perceived it as having significantly higher usefulness across all measured dimensions than those who were not interested in using it.

Protecting prone positioned patients from facial pressure ulcers using prophylactic dressings: A timely biomechanical analysis in the context of the COVID-19 pandemic.

Prone positioning is used for surgical access and recently in exponentially growing numbers of coronavirus disease 2019 patients who are ventilated prone. To reduce their facial pressure ulcer risk, prophylactic dressings can be used; however, the biomechanical efficacy of this intervention has not been studied yet. We, therefore, evaluated facial soft tissue exposures to sustained mechanical loads in a prone position, with versus without multi-layered silicone foam dressings applied as tissue protectors at the forehead and chin. We used an anatomically realistic validated finite element model of an adult male head to determine the contribution of the dressings to the alleviation of the sustained tissue loads. The application of the dressings considerably relieved the tissue exposures to loading. Specifically, with respect to the forehead, the application of a dressing resulted in 52% and 71% reductions in soft tissue exposures to effective stresses and strain energy densities, respectively. Likewise, a chin dressing lowered the soft tissue exposures to stresses and strain energy densities by 78% and 92%, respectively. While the surgical context is clear and there is a solid, relevant need for biomechanical information regarding prophylaxis for the prone positions, the projected consequences of the coronavirus pandemic make the present work more relevant than ever before.