576 Striving for Excellence: Beacon Application Submission and Achievement

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S139-S140
Author(s):  
Aemilio W Ha ◽  
Mini Thomas ◽  
Tammy L Henderson
Keyword(s):  
Continuous Process ◽  
Community Outreach ◽  
Evidence Based ◽  
Application Process ◽  
Award Recipient ◽  
Burn Care ◽  
Unit Management ◽  
Gold Silver ◽  
Burn Unit ◽  
Staff Engagement

Abstract Introduction The American Association of Critical-Care Nurses (AACN) Beacon Award (BA) recognizes individual nursing units with Gold, Silver, or Bronze level for excellence. The BA signifies an effective and systematic approach to policies, procedures and processes that include engagement of staff and key stakeholders; fact-based evaluation strategies for continuous process improvement; and performance measures that meet or exceed relevant benchmarks. Units designated with BA show an overall higher morale and lower turnover rate. Being a verified burn unit and Magnet designated facility, the unit practice council (upc) began the application process for Beacon. Methods The application process started in 2017 through a core group of UPC members. Different sections of the application were written through the guidance of the team leader and with support of the unit management. Data was gathered from various hospital departments and dashboards which included: leadership structures and systems, appropriate staffing and staff engagement, effective communication, knowledge management and learning development, evidence-based practice and processes, and outcome measurements. After data collection/synthesis, small group meetings were conducted to complete the application. The application was reviewed and edited by the unit management prior to submission. Highlights included: low infection rates in the unit exceeding national benchmarks, peer supporter events for burn survivors, team bonding, community outreach, multiple abstract submission/presentations from nursing at local/national conferences, high patient satisfaction scores, implementing new burn care practices based on evidence, and interdisciplinary rounds. Results Burn unit was designated as a Beacon Gold Award Recipient in 2019. This designation lasts for three years. Our burn unit became one of seven units in the nation with BA and is the second one to achieve Gold designation. During and after this process, there was an increase in staff engagement, teamwork, and exceptional quality metrics. Conclusions Persistent effort combined with teamwork and leadership can help a unit achieve Gold BA designation. This award requires ongoing work to refine processes and promote evidence-based practices.

602 Managing Hypothermia in the Surgical Burn Patient

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
Patricia Regojo ◽  
Molly Mohan
Keyword(s):  
Quality Assurance ◽  
Operating Room ◽  
Core Body Temperature ◽  
Temperature Management ◽  
Evidence Based ◽  
Burn Patients ◽  
Estimated Blood Loss ◽  
Increased Risk ◽  
Burn Unit ◽  
Burn Patient

Abstract Introduction It is known, hypothermia, core body temperature at or below 36oC/96.8oF, can lead to dangerous complications for burn patients. Due to loss of their protective thermoregulation, burn patients are at an increased risk of hypothermia during surgery. Findings from a Quality Assurance audit revealed burn patients were returning from surgery hypothermic and hemodynamically unstable. There was little evidence of intra-operative temperature management in the electronic medical record (EMR) or reported to the nurse upon the patients’ return from the operating room (OR). Only 73% of patients had temperatures recorded during their surgery and of those, 40% had a drop of temperature >2 degrees from their baseline. The purpose of this collaborative evidence-based quality assurance project was to improve temperature management in the operating room and prevent hypothermia in the intra and post operative periods. Our aim was to develop warming methods pre-operatively that would establish a goal for keeping the patients’s temperature within 2 degrees of their baseline preoperative temperature during surgery. Methods A literature search obtained from CINAHL, Cochrane, EMBASE, and MEDLINE from 2010–2018, provided current surgical guidelines and evidence-based practices for managing surgical hypothermia in burn patients (levels of evidence I, III, V, & VI). Recommendations from the burn unit staff for preoperative warming initiatives were listed and shared with the OR staff. Hemodynamic documentation, including core temperature, estimated blood loss, and intra-operative warming methods were monitored for twelve months after the Burn Unit Warming Protocol was implemented. Progress was reported quarterly in our Burn and Trauma Quality Committees. Results After implementing the Burn Unit Warming Protocol, temperature management of the burn patient improved. Intra-operative warming methods were initiated. Patients began returning from surgery warmer with improved hemodynamics. 96% of the patients had their temperatures recorded and managed intra-operatively. Of those patients, only 2.6% had a drop in temperature > 2 degrees from their pre-operative baseline. Conclusions Implementing a nurse-driven warming protocol from the pre-operative stage through surgery can aid in reducing post-operative hypothermia in burn patients. Applicability of Research to Practice Managing hypothermia will help reduce complications that can lead to increase morbidity and mortality in burn patients.

Gender Disparities Among Burn Surgery Leadership

2020 ◽  
Vol 41 (3) ◽  
pp. 674-680 ◽  
Author(s):  
Anisha Konanur ◽  
Francesco M Egro ◽  
Caroline E Kettering ◽  
Brandon T Smith ◽  
Alain C Corcos ◽  
...  
Keyword(s):  
Gender Diversity ◽  
Junior Faculty ◽  
Fellowship Training ◽  
Cross Sectional Study ◽  
Gender Disparities ◽  
Cross Sectional ◽  
Burn Care ◽  
Burn Unit ◽  
Burn Surgery

Abstract Gender disparities have been described in the plastic surgery and general surgery literature, but no data have been reported in burn surgery. The aim of this study is to determine gender disparities among burn surgery leadership. A cross-sectional study was performed. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers, past presidents of the ABA, and International Society for Burn Injuries (ISBI), and editors of the Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma. Training, age, H-index, and academic level and leadership position were compared among surgeons identified. Among the 69 ABA and ISBI past presidents, 203 burn journals’ editorial board members, and 71 burn unit directors, females represented only 2.9%, 10.5%, and 17%, respectively. Among burn unit directors, females completed fellowship training more recently than males (female = 2006, male = 1999, P < .02), have lower H-indexes (female = 8.6, male = 17.3, P = .03), and are less represented as full professors (female = 8.3%, male = 42.4%, P = .026). There were no differences in age, residency, research fellowship, or number of fellowships. Gender disparities exist in burn surgery and are highlighted at the leadership level, even though female surgeons have a similar age, residency training, and other background factors. However, gender diversity in burn surgery may improve as females in junior faculty positions advance in their careers.

Using Community Engagement and Navigators to Increase Colon Cancer Screening and Patient Outcomes

2018 ◽  
Vol 20 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Paul G. Devereux ◽  
John Gray ◽  
Susan Robinson ◽  
Janie Galvin ◽  
Jesse Gutierrez
Keyword(s):  
Colon Cancer ◽  
Patient Outcomes ◽  
Bowel Preparation ◽  
Ethnically Diverse ◽  
Community Outreach ◽  
Patient Navigator ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Patient Navigators ◽  
Gender And Age

A theory-driven tailored intervention developed in partnership with the community used evidence-based practices to (a) increase knowledge about colon cancer and screening and (b) assist patients in completing screenings. During the 16 months of delivery screening, patient navigators integrated into gastroenterology clinics met all goals, which included (a) enrolling an ethnically diverse group of participants ( N = 415) through inreach (clinic-referred patients who did not schedule appointments) and community outreach, (b) facilitating screening completions for 217 of the 358 (61%) patients identified as needing screening, and (c) obtaining satisfaction ratings from 89% of participants. A random sample ( N = 214) of nonnavigated patients matched on gender and age revealed no differences between navigated and nonnavigated patients on polyps detected. Navigated males (but not females) were significantly less likely than nonnavigated males to have either poor or only fair bowel preparation quality (odds ratio = .418, p = .020, 95% confidence interval [.197, .885]). Low-quality bowel preparation can lead to incomplete readings of the colon or cancelling a colonoscopy. This intervention demonstrates that evidence-based patient navigator programs are effective in increasing screening among a hard-to-reach population and improving bowel preparation quality for males.

scholarly journals The Effect of Caregiver Key Opinion Leaders on Increasing Caregiver Demand for Evidence-Based Practices to Treat Youth Anxiety: Protocol for a Randomized Control Trial

2021 ◽  
Author(s):  
Margaret Crane ◽  
Marc S. Atkins ◽  
Sara J. Becker ◽  
Jonathan Purtle ◽  
Thomas M. Olino ◽  
...  
Keyword(s):  
Unmet Need ◽  
Community Outreach ◽  
Opinion Leader ◽  
Opinion Leaders ◽  
Evidence Based ◽  
Direct To Consumer ◽  
Youth Anxiety ◽  
Caregiver Demand ◽  
Key Opinion Leaders ◽  
Key Opinion Leader

Abstract Background:Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments.Method:Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees (N = 180) will be cluster-randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at three-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT.Discussion:This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments.Trial registration:This trial was registered on clinicaltrials.gov (NCT04929262) on June 18, 2021. At the time of trial registration, pre/post presentation data had been collected from 17 participants; thus, it was retrospectively registered.

Hospice

2013 ◽  
Author(s):  
Mary Raymer ◽  
Dona J. Reese
Keyword(s):  
Social Workers ◽  
Spiritual Care ◽  
Symptom Control ◽  
Community Outreach ◽  
Interdisciplinary Team ◽  
Self Determination ◽  
Evidence Based ◽  
Culturally Competent ◽  
Death With Dignity

Hospice social workers are essential members of the interdisciplinary team that provide biopsychosocial and spiritual care to terminally ill patients and their significant others during the last 6 months of life. Hospice philosophy emphasizes symptom control, quality of life, patient self-determination, and death with dignity. Hospice social workers must be skilled in providing evidence-based interventions including direct client services; collaboration with the interdisciplinary team; community outreach; developing culturally competent services; and advocating for policy change on the organizational, local, and national levels.

Training

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Staff Training ◽  
Community Outreach ◽  
Comprehensive Care ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Supporting Evidence ◽  
Key Skills ◽  
Information Governance

This chapter sets out training frameworks and key skills and competencies that underpin comprehensive care in community outreach in mental health. A framework of core and advanced competencies for multidisciplinary teams is presented capable of supporting evidence-based clinical practice. Safe non-clinical operations are also supported by a schedule of mandatory staff training in areas such as equality, diversity, and information governance.

Digital Platform for Evidence-Based Medicine in Hematology (non-malignant and malignant conditions) in a Developing Country

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 31-31
Author(s):  
Juliana Rocha ◽  
Renata L Stanzione ◽  
Gabriela Fernandes Aranha ◽  
Dida Capobianco ◽  
Jose Claudio Cyrineu Terra ◽  
...  
Keyword(s):  
Medical Education ◽  
Developing Country ◽  
Medical Practice ◽  
Evidence Based Medicine ◽  
Continuous Process ◽  
Digital Transformation ◽  
Evidence Based ◽  
Access To Information ◽  
Digital Platform ◽  
Based Medicine

Introduction: The SARS-COV2 pandemic has transformed several aspects of our daily lives, we have already experienced profound changes in our society and behavior, and it was only possible to keep part of the gear of life functioning thanks to technology. But it is not possible to talk about technology without talking about digital transformation. The technology applied to medicine provides health professionals with greater access to information and tools that convey evidence-based medicine are essential. Among them we can mention databases such as Medline, PubMed, Embase, Cochrane and UpToDate platform. The COVID 19 pandemic has further accelerated this digital transformation process, instituting changes that are here to stay. Objectives: Today in Brazil, we have an average of 7,000 oncologists and 3,000 hematologists. We know that access to information in a foreign language, even English, is still a problem. The excess of information, and the difficulty of reading scientific publications critically, are another obstacle in medical education in a developing country. The objective of this project is to expand access to information, in continues medical education model, to improve public and private health in the area of hematology. Methods: The hematology team at Hospital Israelita Albert Einstein (HIAE), associated with the HIAE digital transformation laboratory, developed a healthtech platform, called hematolog.app, aiming to make available several updated technical content in different formats: podcasts, videos , discussion of clinical cases, analysis of scientific articles in the form of visual abstracts, reviews of relevant topics in text format. The initiative is supported by the most important national hematology Societies. Discussion: We know that healthtech platforms have transformed medical practice. An online survey of clinicians at the Massachusetts General Hospital and Brigham and Women's Hospital described the following effects among UpToDate users: 95% reported that UpToDate was integral for making decisions, 94% reported that they had changed diagnosis, 95% reported that UpToDate led to a change in patient management, 97% said UpToDate helps them provide the best care for their patients, 90% reported that UpToDate makes them a better doctor, 96% reported made them more comfortable with their decisions. PubMed makes it possible to identify references and summaries of articles from the Medline database, maintained by the National Library of Medicine. PubMed provides several tools to make the search more efficient, unknown to most doctors. Conclusion: The development of hematolog.app aims to create a digital platform that integrates specialists in the area, creating a continuous process of education, and integrating professionals in a developing country, seeking to standardize medical practice in different regions and health services in Brazil, creating an interconnected social network and practicing evidence-based medicine. Disclosures No relevant conflicts of interest to declare.

Compassion Fatigue in the Burn Unit: A Review of Quantitative Evidence

2021 ◽  
Author(s):  
Jonathan Bayuo ◽  
Pius Agbenorku
Keyword(s):  
Compassion Fatigue ◽  
Traumatic Stress ◽  
Psychosocial Support ◽  
Grey Literature ◽  
Working Environment ◽  
Care Staff ◽  
Contributing Factors ◽  
Screening Process ◽  
Burn Care ◽  
Burn Unit

Abstract Healthcare staff across varied clinical settings are faced with varied stressors that can lead to compassion fatigue. However, there is currently no review examining the phenomenon in-depth in the burn unit. Thus, the current study sought to scope existing studies to ascertain the prevalence, contributing factors, and effects of compassion fatigue in the burn unit. Compassion fatigue was conceptualised as comprising of burnout and secondary traumatic stress. Arksey and O’Malley scoping review approach was used and reported according to the PRISMA extension guidelines. Searches were undertaken across peer-reviewed databases and grey literature sources for quantitative studies. Following the search and screening process, nine studies were retained. Codes were formulated across studies following which narrative synthesis was undertaken. Majority of the studies (n=5) focused on burn care nurses. High levels of emotional exhaustion and depersonalization and comparatively low level of personal achievement were reported among burn care staff which is indicative of burnout. Compassion fatigue was also observed to be high among burn care staff. Contributing factors are varied albeit some variables such as age, staffing levels, remuneration, nature of the work environment, and number of years worked were consistent across some studies. In conclusion, working in the burn unit is challenging with significant stressors that can lead to burnout, traumatic stress, and subsequently, compassion fatigue. Interventions to promote resilience, hardiness, optimal working environment, peer, and psychosocial support are greatly needed.

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