Identifying Obstructive Sleep Apnea Risk Using the STOP-BANG Questionnaire in a Cardiology Clinic.

ABSTRACT: Untreated obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality, warranting enhanced awareness, screening, and action among healthcare providers to optimize patient outcomes. Attempting to address the potential under detection of OSA, this quality improvement project implemented the STOP-Bang Sleep Apnea Questionnaire at a cardiology clinic, with the goals to stratify risk for OSA in 100% of patients and increase provider referral of high risk patients for sleep studies. The setting was an outpatient cardiology clinic in Pensacola, Florida. The sample included new and existing patients 18 years or older who had one or more of the following diagnoses: hypertension, heart failure, coronary artery disease, atrial fibrillation, or arrhythmia. Methods involved collecting and comparing preintervention sleep study referral rate data with 6-week STOP-Bang questionnaire implementation data. Results demonstrated a 65% (279 of 428 patients seen) screening implementation rate and a modest but statistically significant increase in the overall referral rate from 2.6% preintervention to 5.1% postintervention ( p = .040). Overall, standard use of the STOP-Bang questionnaire may enable higher detection and referral of OSA.

Assessing Student Performance in a Dedicated Education Unit: Validity of the Creighton Competency Evaluation Instrument.

ABSTRACT: In dedicated education units (DEUs), nurses serving as clinical teaching partners (CTPs) provide formative feedback about student performance. The Creighton Competency Evaluation Instrument (C-CEI) has demonstrated validity and reliability by faculty in both the simulated and clinical environments. The purpose of this pilot study was to determine the content validity of the C-CEI in the direct patient care environment when used by staff nurses functioning as CTPs in the DEU setting. Results indicate that the items of the C-CEI demonstrated necessity, fittingness, and understanding. CTPs reported the C-CEI is a valid instrument for use in the DEU setting.

Sepsis Screening: Combining Early Warning Scores and SIRS Criteria.

Providing effective screening tools to nurses is necessary to improve patient outcomes and health care quality. This research examines if the modification of two electronic health record sepsis screening tools using a combined systemic inflammatory response syndrome (SIRS), modified early warning score (MEWS), and national early warning score (NEWS) criteria improves the recognition of sepsis by nurses. Medical-surgical/telemetry units at a medical center in the Midwest were examined using a quasiexperimental design. Modifications of tool 1 captured 18% more correct classifications of sepsis (odds ratio [OR] = .82, 95% CI = [0.68, 0.98]), triggering for 10% fewer patients, t(1033) = 9.31, p < .001. 95% CI = [0.078, 0.119]. Modifications of tool 2 captured 3 times more correct alerts (OR = .29, 95% CI = [0.24, 0.35]), triggering for 46% fewer patients, t(1033) = 24.38, p < .001. 95% CI = [0.420, 0.493]. The updated criteria showed significant improvement toward correctly identifying sepsis and presents the opportunity to develop an effective tool that balances sensitivity with specificity.

A Synchronous Interprofessional Patient Safety Simulation Integrating Distance Health Professions Students.

BACKGROUND: Increasing rates of medical errors necessitate incorporation of patient safety education for health professions students. Institutions must address the needs of both campus- and distance-based learners to meet interprofessional education (IPE) accreditation requirements. The purpose of this project was to evaluate a synchronous interprofessional patient safety simulation to train students on interprofessional teamwork and communication through recognition of patient safety and medical hazards. METHOD: Students from health care professions participated in a Haunted Hospital/Heartbreak Hospital patient hazard/medical error simulation. A total of 201 students in 41 teams, both campus and distance, participated over three semesters. RESULTS: Mean Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R) scores significantly improved from 44.81 ± 3.59 to 47.08 ± 3.31 (p < .0001). Qualitative responses indicated that students appreciated working with other health care students through collaborative practice and recognized the importance of discipline-specific expertise. CONCLUSION: This simulation provided campus and distance learners with a collaboration opportunity that improved their perceptions of IPE. [J Nurs Educ. 2019;58(10):577-582.].

Development and Assessment of an Interprofessional Education Simulation to Promote Collaborative Learning and Practice.

BACKGROUND: We designed an interprofessional education (IPE) clinical simulation that paired nurse practitioner and pharmacy students. The objective was to evaluate the effect on attitudes of interprofessional collaborative learning and practice. METHOD: Perceptions were assessed using the Student Perceptions of Interprofessional Clinical Education-Revised instrument and reflection questions that assessed the simulation's effectiveness in requiring team knowledge and experience from each profession whether the experience improved individual student clinical performance, and how this team approach influenced patient outcomes. RESULTS: Students believed that working with another health profession was educationally beneficial and should be a required experience; they also believed that this collaboration improved patient outcomes and satisfaction. Responses also indicated student ambiguity about their role in interprofessional care, and that clinical rotations were not the ideal setting for first professional interactions with others. CONCLUSION: Students expressed satisfaction and increased awareness of the importance of collaboration to ensure patient safety. Increasing interprofessional education experiences prior to clinical rotations should be considered. [J Nurs Educ. 2018;57(7):426-429.].

The development of an instrument to evaluate interprofessional student team competency.

Healthcare institutions, accreditation agencies for higher learning, and organizations such as the National Academy of Medicine in the United States, support interprofessional education (IPE) opportunities. However, incorporating IPE opportunities into academic settings remains difficult. One challenge is assessing IPE learning and practice outcomes, especially at the level of student performance to ensure graduates are "collaboration-ready". The Creighton-Interprofessional Collaborative Evaluation (C-ICE) instrument was developed to address the need for a measurement tool for interprofessional student team performance. Four interprofessional competency domains provide the framework for the C-ICE instrument. Twenty-six items were identified as essential to include in the C-ICE instrument. This instrument was found to be both a reliable and a valid instrument to measure interprofessional interactions of student teams. Inter-rater reliability as measured by Krippendorff's nominal alpha (nKALPHA) ranged from .558 to .887; with four of the five independent assessments achieving nKALPHA greater than or equal to 0.796. The findings indicated that the instrument is understandable (Gwet's alpha coefficient (gAC) 0.63), comprehensive (gAC = 0.62), useful and applicable (gAC = 0.54) in a variety of educational settings. The C-ICE instrument provides educators a comprehensive evaluation tool for assessing student team behaviors, skills, and performance.

Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment.

A cancer diagnosis, along with accompanying chemotherapy treatments and new medication regimens, can significantly affect patients' overall health, well-being, and quality of life. Chemotherapy and medication teaching that meets patients' learning needs enhances knowledge and supports adherence to instructions. These interventions promote optimal patient outcomes, satisfaction, and overall safety.