Purpose/Objectives The purpose of this article is to provide the clinical nurse specialist with an interactive, creative, and fun approach using an escape room to increase the retention and application of knowledge about caring for patients with sepsis and improve patient care outcomes. Description of the Project This project involved the design of a healthcare-based escape room, where clinical nurses and interprofessional learners engaged in a series of puzzles and problem-solving experiences to apply clinical judgment and critical thinking about patient care. Theory and Frameworks Knowles' theory of adult learning guided the development of this gamified learning. Outcome The clinical nurse specialist was critical to the success of the escape room. The escape room created an innovative learning environment, expanding opportunities to engage staff and promote high-quality care for best patient outcomes. Conclusion The benefits of incorporating adult learning principles with gamification-based education as a teaching strategy are evident in the feedback and overwhelmingly positive responses received from participants. The successes of the sepsis escape room have presented opportunities to continue supporting progressive, fun, and evidence-based learning environments and positively impact both nursing education and patient care outcomes.
Este estudo buscou identificar conhecimentos e práticas de pais de crianças de 6 a 12 meses de idade, sobre alimentação complementar e fatores que influenciam seu comportamento. Adotou-se o referencial teórico-metodológico da Teoria do Comportamento Planejado e optou-se por uma abordagem qualitativa e exploratória através de duas técnicas: grupo focal com mães e entrevistas em profundidade com pais, frequentadores de um serviço público de saúde e de uma clínica de pediatria privada. Do material empírico advindo dos relatos gravados e transcritos, por meio da análise de conteúdo, identificaram-se as categorias: Crenças, opiniões e atitudes, reorganizadas de acordo com suas relações com as recomendações do Ministério da Saúde incluídas no Guia Alimentar Para Crianças Menores de 2 anos; Influências formais e informais sobre as práticas de alimentação complementar; e Papel dos fatores socioeconômicos. Concluiu-se que os comportamentos dos pais são resultado da interação complexa entre suas crenças, pressões sociais e a percepção sobre sua competência para alimentar seus filhos, e que os dilemas e dúvidas são de toda ordem e independem da realidade sociocultural. O pediatra e outros profissionais da saúde perdem espaço para as influências informais que afetam diretamente as práticas de alimentação das crianças. Apontou-se a necessidade de prover orientações sobre alimentação complementar contextualizadas à realidade dos pais e que a internet seja utilizada por fontes confiáveis para disseminação do conhecimento. DOI: 10.12957/demetra.2019.43550
The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences.
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