Implementing Evidence-Based Vitamin D Protocol in the Dialysis Clinic: An Educational Approach.

Vitamin D deficiency is prevalent among patients with chronic kidney disease (CKD) and even more pronounced in patients with kidney failure who are undergoing peritoneal dialysis and hemodialysis. This project was a nurse practitioner-led quality improvement project conducted in an outpatient hemodialysis unit that focused on determining if educating providers and hemodialysis unit clinical staff on vitamin D guidelines increased the awareness and monitoring of patients on hemodialysis. The number of patients screened for vitamin D levels increased from 29% to 100%, and 70% of patients tested were deficient in vitamin D. While the follow-up monitoring yielded a result of only 32%, we recommend processes and structures for long-term sustainability, such as periodic re-education, reminders and prompts for conducting needed follow-up, continued outcome monitoring, and champions to support the ongoing processes and structures.

Initiation of Therapeutic Hypothermia in the Emergency Department: A Quality Improvement Project.

Therapeutic hypothermia (TH) postresuscitation has been recommended by the American Heart Association (AHA) since 2005. Early initiation of TH and fast achievement of goal temperatures have been associated with better neurological outcomes. The objective of this study was to evaluate the effectiveness of a specific TH protocol for the emergency department (ED) in increasing ED use of TH and decreasing the time from return of spontaneous circulation (ROSC) to initiation of cooling measures. An ED protocol for TH as recommended by the AHA was implemented. A random sample of 10 patients who received TH prior to the implementation of an ED protocol were analyzed and compared with the first 10 patients who received TH after the ED protocol was implemented. The time from ROSC to initiation of cooling measures and survival to discharge rates were analyzed. After implementation of the ED protocol, 7 of the 10 patients were treated with the ED protocol. The mean time to initiation of TH for the preimplementation group was 127.8 min (SD = 52.9) compared with 15.71 min (SD = 9.552) for the postimplementation group. The difference in initiation time between the pre- and postimplementation study groups was statistically significant, t(9.826) = 6.55, p < 0.05. Survival to discharge rates were 30% for the preimplementation group and 20% for the postimplementation group. The difference was not statistically significant, χ (1, N = 20) = 0.73, p = 0.78. Implementation of an ED protocol for TH reduced mean time to initiation of therapy. Additional study is warranted to determine whether differences in survival and functional recovery for ED patients receiving TH were influenced by age, comorbidities, and total resuscitation time.

Reflections of Evidence-Based Practice in Nurse Educators' Teaching Philosophy Statements.

AIM: This article focuses on the nature and importance of evidence-based practice (EBP) as described in the teaching philosophy statements of academic nurse educators (ANEs). BACKGROUND: EBP is a core competency identified by the Institute of Medicine. Its incorporation into teaching philosophies expresses ANEs' ideas, values, and practices. METHOD: A mixed-method design using an online survey was used to collect and analyze demographic data and teaching philosophy statements from 375 ANEs. Coding was done via direct correct analysis. Themes were identified to capture the essence of the coded statements. RESULTS: EBP and its components were mentioned 275 times collectively; 44 ANEs specifically mentioned EBP in their teaching philosophies. other components were mentioned more frequently. three themes emerged: keeping up-to-date, setting up student success with EBP, and EBP as a teaching approach. CONCLUSION: The incorporation of EBP and its components was not widely acknowledged by ANEs.

Student learning with concept mapping of care plans in community-based education.

Concept mapping, a learning strategy used to understand key concepts and relationships between concepts, has been suggested as a method to plan and evaluate nursing care. The purpose of this study was to empirically test the effectiveness of concept mapping for student learning and the students' satisfaction with the strategy. A quasi-experimental pre- and posttest design was used to examine the content of concept maps of care plans constructed by junior-level baccalaureate students (n = 23) at the beginning and end of a community-based mental health course. Additionally, students completed a questionnaire to self-evaluate their learning and report their satisfaction with concept mapping. Findings indicated that concept mapping significantly improved students' abilities to see patterns and relationships to plan and evaluate nursing care, and most students (21/23) expressed satisfaction in using the strategy. This study supported concept mapping as an additional learning strategy and has extended knowledge in community-based nursing education.