The vast majority of adolescents do not achieve five or more bouts of moderate physical activity per week, and continue to fail to achieve this amount of activity into adulthood.
Heavy alcohol use is a serious health issue in the United States with consequences such as illness, injury, and death. College students are among the most vulnerable to problems associated with risky drinking. This demographic is known as the Net Generation because members have grown up with digital technologies such as smartphones and apps. Thus, mobile health (mHealth) applications, successful in the delivery of health information and interventions to tech-savvy individuals, are a promising means of reaching them. To that end, we developed a smartphone application (SmarTrek) that targets college students and aims to reduce risky alcohol use. SmarTrek features are easy to use and have interactive components including text messages that incorporate motivational interviewing and ecological momentary interventions. We conducted iterative theater testing, field testing, and focus groups to evaluate the acceptability of SmarTrek with college students. We identified salient issues that might arise from SmarTrek use and modified the app based on feedback from participants. Participants were assigned to 2 groups (Group 1 [n ϭ 4] and Group 2 [n ϭ 6]). At baseline, participants completed 2 standardized surveys. Following their field testing, each group of participants was then invited to a focus group session of the app in which they provided feedback. The majority of participants (90%) agreed that SmarTrek was easy to use and that the information provided was useful and had a positive effect on decreasing their drinking.
Poor education-related discharge preparedness for patients with heart failure is believed to be a major cause of avoidable rehospitalizations. Technology-based applications offer innovative educational approaches that may improve educational readiness for patients in both inpatient and outpatient settings; however, a number of challenges exist when implementing electronic devices in the clinical setting. Implementation challenges include processes for "on-boarding" staff, mediating risks of cross-contamination with patients' device use, and selling the value to staff and health system leaders to secure the investment in software, hardware, and system support infrastructure. Strategies to address these challenges are poorly described in the literature. The purpose of this article is to present a staff development program designed to overcome challenges in implementing an electronic, tablet-based education program for patients with heart failure. (Critical Care Nurse. 2016;36 A lthough many factors contribute to high rates of hospital readmission for patients with heart failure, inadequate educational preparation for discharge is one factor that is largely avoidable and predominantly managed by nurses.1,2 New electronic, tablet-based patient education platforms, designed to address predischarge gaps in education, are increasingly accessible and linked to electronic health records.3,4 Yet, integrating these tools into nursing workflow is challenging. Staff development initiatives to facilitate adoption of electronic tablet-based patient education in the acute care setting are needed.Louise Saladino, RN To illustrate the gravity of the prevalence and high cost of preventable readmissions, the Agency for Healthcare Research and Quality sponsored work to identify contributing factors. Of the 9 million Medicare hospitalizations yearly, 1 in 5 patients is readmitted within 1 month of discharge. 5 The cost of hospital readmissions is estimated to be $26 billion per year, of which $17 billion is considered preventable.5 Notably, inadequate educational preparation was identified as a common contributor to avoidable readmissions and was established as a target for care redesign. [6][7][8] In 2009, providing written instructions and educational materials at discharge became a critical performance measure in the heart failure clinical practice guidelines for the American College of Cardiology and American Heart Association. 9The Joint Commission and the Centers for Medicare and Medicaid Services also require that discharge instructions include information on medications, worsening symptoms, diet, activity, weight monitoring, and follow-up appointments. [10][11][12] Although clinical practice guidelines and regulatory requirements support the need for more effective education before discharge, the challenges of redesigning traditional paper-based educational content and patient education workflow processes in inpatient care settings are substantial.For nurses, classroom education is shifting to include more contemporary, peda...
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