Development and Implementation of a Game-Based Neonatal Resuscitation Refresher Training: Effect on Registered Nurse Knowledge, Skills, Motivation, Engagement.

Game-based learning theory and Google Docs Editors suite were used to develop an online, self-directed neonatal resuscitation refresher training for registered nurses to improve their resuscitation knowledge and skills and enhance their learning motivation and engagement. Results indicated that a self-directed, online game-based refresher training was motivating, engaging, and improved nurses' resuscitation knowledge and skill performance. Nurse professional development practitioners can use similar game-based online materials to enhance learning.

The Show Must Go On: Using Technology for Rapid Onboarding and Orientation During COVID-19 and Beyond.

The global pandemic presented an opportunity for using technology in expanded ways to meet mandated restrictions posed by the crisis. Nursing professional development practitioners redesigned onboarding structures and curriculum to accommodate the surge of new hires, taking into consideration restrictions set forth by regulatory institutions. Mobile technology and virtual learning were the platform used for this innovative approach. [J Contin Educ Nurs. 2021;52(3):115-117.].

A Study of the Psychometric Properties of the "Stanford Proxy Test for Delirium" (S-PTD): A New Screening Tool for the Detection of Delirium.

BACKGROUND: Delirium is a prevalent neuropsychiatric disorder associated with increased morbidity and mortality. Half the cases remain misdiagnosed. OBJECTIVE: Assess the effectiveness of the Stanford Proxy Test for Delirium (S-PTD) in detecting delirium in an inpatient setting. METHODS: This is a comparison study. Daily assessment with S-PTD, by the patient's nurse, and a neuropsychiatric assessment by a psychiatrist. Assessments were blinded. Inclusion criteria included 18 years or older. Exclusion criteria included patient's or surrogate's unwillingness to participate, inability to consent if a surrogate was not available, and inability to communicate in English or Spanish. A total of 309 patients were approached: 27 declined participation, 4 were excluded, and 278 subjects were followed up throughout their hospital stay. In the end, 78 were excluded for lack of neuropsychiatric assessment, S-PTD, or both. One was excluded for lack of demographic data. The sensitivity and specificity of the S-PTD in detecting delirium when compared with a neuropsychiatric assessment. RESULTS: Participants were on average 60.8 years old and 54.3% were male. Patients who developed delirium were, on average, older (15.12 y, confidence interval: 8.94-21.32). A total of 199 patients were analyzed; 43 patients (21.6%) met criteria for delirium. S-PTD detected 67 days with delirium (16.5%) of 405 hospital days, while neuropsychiatric evaluation identified 83 (20.5%). S-PTD had a sensitivity of 80.72% and a specificity of 90.37%. CONCLUSION: S-PTD is an effective, comprehensive, and simple screening tool for delirium, which is robust despite fluctuating symptoms and lack of cooperation. The use of S-PTD may enhance early diagnosis of delirium.

Skin to Skin Contact: Newborn Temperature Stability in the Operating Room.

PURPOSE: The purpose of this project was to assess temperature stability in newborns undergoing early intraoperative skin-to-skin contact (SSC) after elective cesarean birth. METHOD: This feasibility study examined electronic medical record data of 91 mother-baby dyads who participated in early intraoperative SSC after an elective cesarean birth. Infant axillary temperatures were obtained just before initiation and upon completion of intraoperative SSC. RESULTS: The mean age of women in this sample was 35 (SD, 4.2) years. They were an average of 39 4/7 weeks gestation, and largely Caucasian 55% (n = 50) and Asian 30 (33%). Fifty-eight percent (n = 53) of infants were male, weighing an average of 3,566 g (SD, 401.83). Nineteen (21%) of infants demonstrated no temperature change pre to post SSC, with an increase noted in 32 (35%) infants, and a decrease in 40 (44%). CLINICAL IMPLICATIONS: Findings provide support for continued intraoperative SSC. Areas for improvement were also identified, for example, missing medical record data.

Psychiatric Disorders and Suicidality in the Intensive Care Unit.

Suicidality is a general term that describes the continuum of suicidal ideation, intent, self-injurious behavior, attempts, and completed suicide. Suicidality across the entire spectrum is a public health concern with significant impact, including billions in work loss and medical costs. There are many challenges to managing suicidality in an intensive care unit setting, which will be reviewed here. Additionally, this article will review the prevalence of suicide attempts in different psychiatric diagnoses, conducting a suicide assessment, role of involuntary psychiatric holds, and most common challenges encountered in the ICU setting.

Direct visualization of cystic fibrosis transmembrane regulator mutations in the clinical laboratory setting.

BACKGROUND: The recommendation for population- based cystic fibrosis (CF) carrier screening by the American College of Medical Genetics for the 25 most prevalent mutations and 6 polymorphisms in the CF transmembrane regulatory gene has greatly increased clinical laboratory test volumes. We describe the development and technical validation of a DNA chip in a 96-well format to allow for high-throughput genotype analysis. METHODS: The CF Portrait chip contains an 8 x 8 array of capture probes and controls to detect all requisite alleles. Single-tube multiplex PCR with 15 biotin-labeled primer pairs was used to amplify sequences containing all single-nucleotide polymorphisms to be interrogated. Detection of a thin-film signal created by hybridization of multiplex PCR-amplified DNA to complementary capture probes was performed with an automated image analysis instrument, NucleoSight. Allele classification, data formatting, and uploading to a laboratory information system were fully automated. RESULTS: The described platform correctly classified all mutations and polymorphisms and can screen approximately 1300 patient samples in a 10-h shift. Final validation was performed by two separate 1000-sample comparisons with Roche CF Gold line probe strips and the Applera CF OLA, Ver 3.0. The CF Portrait Biochip made no errors during this validation, whereas the Applera assay made seven miscalls of the IVS-8 5T/7T/9T polymorphism CONCLUSIONS: The CF Portrait platform is an automated, high-throughput, DNA chip-based assay capable of accurately classifying all CF mutations in the recommended screening panel, including the IVS-8 5T/7T/9T polymorphism.