Distance graduate nursing education has been expanding. Although many didactic courses are taught through an online platform, there are often challenges to providing skill-based courses, such as advanced physical assessment, through an online format. To prepare and assess advanced practice nursing students on their clinical knowledge and physical assessment skills, an online course was developed using multisource feedback and videography. Students used videography to record themselves as they conducted physical assessments on a volunteer patient. Students then critiqued their own video, critiqued two of their colleagues' videos, and the final critiques of the videos were conducted by faculty. All students were expected to perform and pass a complete physical examination on a standardize patient as their final examination. The final scores of the students learning through the online course were equivalent to the scores achieved by the students in the traditional face-to-face physical assessment course.
Catheter-associated urinary tract infections account for 40% of healthcare-acquired infections. This study explored the addition of cloud-based software technology to an established nursing quality improvement program to reduce catheter-associated urinary tract infections. Unit-based nurse champions evaluated peers' evidence-based catheter-associated urinary tract infection prevention practices using manual, paper-based feedback. That process achieved reduced rates of catheter-associated urinary tract infection over 18 months. However, it was resource intensive. Cloud-based software technology was introduced to replace the paper. Nurse champions' satisfaction, catheter-associated urinary tract infection and indwelling urinary catheter utilization, and prevention practices were compared before and after the technology intervention. Compliance with the provision of a chlorhexidine bath demonstrated improvement (P = .003), while other practice measures did not significantly change. The indwelling urinary catheter utilization ratio was lower (P = .01), yet the intervention yielded no change in catheter-associated urinary tract infection rates. The short time interval of the intervention was potentially a contributing factor in no significant rate change. Nurse champions (N = 14) were more satisfied with the cloud-based technology (P = .004), the clarity of improvement targets (P = .004), and the speed of sharing data (P = .001). Their time to share data decreased from 4 days or more to 1 hour or less. Nurse champions readily adopted the cloud-based technology. These findings suggest additional research on technology innovations for nursing quality improvement is needed.
Introduction U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country’s most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention “cues-to-action” and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention perceptions, benefits, threats, barriers, and sun-protective behavior self-efficacy) and sun-protective behaviors (e.g., wearing long sleeve shirts and using sunscreen and not deliberately exposing skin for a tan) in a Navy population. Materials and Methods A cross-sectional, descriptive, correlational design was utilized, and the study approval was obtained by the Naval Medical Center Portsmouth Institutional Review Board. Two-hundred twenty-nine active duty Navy service members aged 18-30 years who presented to primary care for their periodic health assessment completed the Brief Skin Cancer Risk Assessment and the Skin Cancer Survey. Descriptive statistics were utilized to assess service members’ perceptions and knowledge regarding skin cancer prevention along with sociodemographic characteristics. The Spearman rank-order correlation and the Mann–Whitney U test were used to assess associations. P-values <.05 were used to determine statistical significance. Results Skin cancer prevention knowledge was significantly related to sun-protective behavior self-efficacy (r = 0.218, P = .001), benefits (r = 0.271, P ≤ .001), sun protection behaviors (r = 0.152, P = .024), skin cancer risk (r = 0.256, P = .001), current frequency of high-risk sun behavior (r = 0.183, P = .006), past frequency of high-risk sun behavior (r = 0.219, P = .001), sun exposure (U = 4,813.50, P = .005), tanning bed use (U = 3,154.50, P = .031), and training (U = 4,099.50, P = .005). Conclusions Integrating skin cancer education into primary care visits (i.e., periodic health assessments) may improve Navy service members’ modifiable sun-protective attitudes and behaviors and may contribute to lowering future skin cancer rates.
BackgroundChildhood obesity is a growing epidemic of great concern for our nation, including pediatric populations treated at military treatment facilities.ObjectiveThis study aims to retrospectively evaluate the effectiveness of a primary care–based structured weight management program in a sample of pediatric patients with obesity at a military treatment facility.MethodsThis study was a retrospective chart review of patients enrolled in the All About Me Program (AAMP) from August 1, 2011, through July 10, 2012. Baseline demographics, 5-2-1-0 behavioral targets, and anthropometric measures were obtained from 54 enrollees. Pre- and post-program weight, body mass index (BMI) percentile, and 5-2-1-0 behavioral targets were compared for 20 patients who completed the program which consisted of a total of five visits over 3 months.ResultsParticipants showed a significant reduction in their BMI, improvement in daily servings of fruits and vegetables, reduction in recreational screen time from baseline, improvement in daily physical activity, and reduction in consumption of sugary beverages.ConclusionsThese preliminary findings are a promising indicator that primary care–based obesity interventions may be effective for the management and treatment of pediatric obesity.Implications for NursingThis evidence-based toolkit provides a practical point-of-care guidance on the prevention, assessment, and treatment of childhood obesity and can be easily implemented in other primary care settings.
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