Subject(s)
Communication , Equipment Design/standards , Outcome Assessment, Health Care/statistics & numerical data , Equipment Design/statistics & numerical data , Humans , Outcome Assessment, Health Care/methods , Surveys and Questionnaires , Wireless Technology/standards , Wireless Technology/statistics & numerical dataABSTRACT
Although septic shock is rare in pregnancy, it is an important contributor to maternal mortality. A woman in the perinatal period can appear deceptively well before rapidly deteriorating to septic shock. We evaluated compliance with early goal-directed therapy before, during, and after the implementation of a standardized physician order set and interprofessional education. A retrospective study included 97 women with positive screening results for sepsis from April 2014 to January 2015. When comparing preintervention and postintervention results in women with sepsis, statistical significance was achieved for blood lactate level testing (p = .029), administering a broad-spectrum antibiotic (p = .006), repeat lactate level testing (p = .034), and administering a broad-spectrum antibiotic in women with severe sepsis and septic shock (p = .010). Education and a sepsis protocol using a multidisciplinary approach improves compliance with sepsis bundles, which are a group of interventions that, when used together, are intended to improve health outcomes.
Subject(s)
Early Diagnosis , Pregnancy Complications, Infectious/diagnosis , Sepsis/diagnosis , Sepsis/therapy , Shock, Septic/diagnosis , Shock, Septic/therapy , Evidence-Based Medicine , Female , Guideline Adherence , Hospitals, Community , Humans , Patient Care Team/organization & administration , Perinatal Care/organization & administration , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious/mortality , Pregnancy Complications, Infectious/therapy , Prognosis , Retrospective Studies , Risk Assessment , Sepsis/mortality , Severity of Illness Index , Shock, Septic/mortality , Survival Rate , Treatment OutcomeABSTRACT
Heart failure (HF) is the heart's inability to meet the body's need for blood and oxygen. According to the American Heart Association 2013 update, approximately 5.1 million people are diagnosed with HF in the United States in 2006. Heart failure is the most common diagnosis for hospitalization. In the United States, the HF direct and indirect costs are estimated to be US $39.2 billion in 2010. To address this issue, nursing educators designed innovative teaching frameworks on HF management both in academia and in clinical settings. The model was based on 2 resources: the American Association of Heart Failure Nurses (2012) national nursing certification and the award-winning Pierce County Responsive Care Coordination Program. The HF educational program is divided into 4 modules. The initial modules offer foundational levels of Bloom's Taxonomy then progress to incorporate higher-levels of learning when modules 3 and 4 are reached. The applicability of the key components within each module allows formatting to enhance learning in all areas of nursing, from the emergency department to intensive care units to the medical-surgical step-down units. Also applicable would be to provide specific aspects of the modules to nurses who care for HF patients in skilled nursing facility, rehabilitation centers, and in the home-health care setting.
Subject(s)
Critical Care Nursing/education , Education, Nursing , Heart Failure/nursing , Inservice Training , Curriculum , Educational Measurement , Heart Failure/physiopathology , Humans , Models, Educational , Nurse-Patient Relations , Nursing Assessment , Patient Education as Topic , Professional-Family RelationsABSTRACT
BACKGROUND: The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. METHODS: Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. RESULTS: The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). CONCLUSION: Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.
