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A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff.

ABSTRACT: Introduction:The American Society of Gastrointestinal Endoscopy recommends continuing aspirin prior to routine endoscopy. National data show that few endoscopists follow the current guidelines due to concern about?bleeding?and perceived minimal downside to stopping?aspirin. Utilizing the Kern model, we implemented an educational quality improvement initiative aimed at increasing knowledge of antithrombotic management periendoscopy and during acute gastrointestinal (GI) bleeding. Methods:We implemented an interactive lecture incorporating a large-group discussion to help residents learn to define low- versus high-risk procedures, distinguish thrombotic risk in medical conditions, present the procedural risks associated with use of antiplatelets, and list current practice guidelines. Nursing staff received a tailored lecture with the goal of learning proper management of current antiplatelets and holding parameters for anticoagulants prior to endoscopy. Both groups received pre-and posttest questionnaires evaluating their knowledge. Results:Eighteen nurses and 75 medical trainees received this intervention. Significant score improvement was noted in both groups. The greatest change was seen in aspirin management (30.5% vs. 95.0% for group 1, 43.7% vs. 91.9% for group 2; p < .0001). For management of antiplatelets after aspirin-induced GI bleed, the medical trainees improved from 50.7% to 93.3%. Chi-square analysis showed a statistically significant difference in knowledge across all areas among medical trainees pre-and posttest (p < .001). Discussion:This quality-based educational intervention significantly increased the knowledge of nurses and medical trainees in management guidelines that directly impact patient care. Similar educational programs may be very effective in improving quality and safety.

SUBMITTER: Fradkov E

PROVIDER: S-EPMC6338142 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff.

Fradkov Elena E Goldowsky Alexander A Quiles Kirsten K Williams Renee R

MedEdPORTAL : the journal of teaching and learning resources 20171016

<h4>Introduction</h4>The American Society of Gastrointestinal Endoscopy recommends continuing aspirin prior to routine endoscopy. National data show that few endoscopists follow the current guidelines due to concern about bleeding and perceived minimal downside to stopping aspirin. Utilizing the Kern model, we implemented an educational quality improvement initiative aimed at increasing knowledge of antithrombotic management periendoscopy and during acute gastrointestinal (GI) bleeding.<h4>Metho ...[more]

PMID: 30800843

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Project description:BACKGROUND:Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11-13?years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. METHODS:We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. RESULTS:A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent's awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p <?0.001). HPV vaccine's acceptability increased from 74.3 to 87.4% (p <?0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r?=?0.32 to 0.53, p <?0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI,1.05-1.63), respectively. CONCLUSIONS:A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents' knowledge, perceptions and HPV vaccine acceptability.

Project description:Introduction:Ventilator-associated pneumonia, a common cause of mortality and morbidity, is commonly seen among patients with endotracheal intubation due to unsafe suctioning practices by health professionals. Objective:A systematic review was conducted to explore the gaps in the existing practices of nurses and thus proposing comprehensive guidelines for safe practice. Materials and methods:A two-phase strategy was adopted to identify the studies through a comprehensive electronic search in PubMed, Google Scholar, ProQuest, Ovid, and Helinet Summon by using predefined keywords within a year limit of 2002-2016. The quality of studies was reviewed using tools endorsed by Joanna Briggs Institute. This review was conducted according to the guidelines described in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Qualitative data were described through the process of metasynthesis. Quantitative analysis was performed to combine the competent quantitative evidences to identify knowledge and practices of endotracheal suctioning (ETS). Results:Thirty studies had been subjected for metasynthesis, among which six provided relevant information for quantitative analysis. Quantitative analysis of the studies reported that only 36% of the nurses had assessed patients prior to suctioning and had knowledge about the size of the suction catheter while only 46% were aware of the appropriate suction pressure to be used for ETS. Handwashing compliance prior to suctioning was observed in only 62% of the nurses. It is reported that, despite the awareness on possible complications, nurses fail to adhere to the recommended practice guidelines. Conclusion:The current review would explore the best evidence-based practices (EBPs) among nurses related to ETS, which would ensure quality care to critically ill patients. How to cite this article:Pinto HJ, D'silva F, Sanil TS. Knowledge and Practices of Endotracheal Suctioning amongst Nursing Professionals: A Systematic Review. Indian J Crit Care Med 2020;24(1):23-32.

Project description:We undertook a needs assessment exercise using questionnaire survey of junior doctors' knowledge and beliefs concerning evidence-based medicine (EBM) and critical literature appraisal, as this is a core competence in postgraduate medical education.We surveyed 317 junior doctors in various specialities in the UK West Midlands Deanery. Using validated questionnaires we compared the needs of different trainee groups. Results overall were internally consistent (Cronbach's alpha 0.929).Respondents' generally felt that they had poor training in EBM (Mean score 2.2, possible range 1-6) and that they needed more education (Mean score 5.3, possible range 1-6). Male trainees felt more confident at evaluating statistical tests than females (p = 0.002). Female trainees considered patient choice above the evidence more often than males (p = 0.038). Trainees from surgical speciality felt more confident at assessing research evidence (p = 0.009) whereas those from medical speciality felt more confident at evaluating statistical tests (p = 0.038) than other specialities. However, non-surgical specialities tended to believe that EBM had little impact on practice (p = 0.029). Respondents who had been qualified for 11 years or over felt overall more confident in their knowledge relating to EBM than those who had been qualified less than 10 years. In particular, they felt more confident at being able to assess study designs (p = < 0.001) and the general worth of research papers (p = < 0.001). Trainees with prior research experience were less likely to find original work confusing (p = 0.003) and felt more confident that they can assess research evidence (p = < 0.001) compared to those without previous research experience. Trainees without previous research experience felt that clinical judgement was more important than evidence (p = < 0.001).There is a perceived deficit in postgraduate doctors' EBM knowledge and critical appraisal skills. Learning needs vary according to gender, place of basic medical qualification, time since graduation, prior research experience and speciality. EBM training curricular development should take into account the findings of our needs assessment study.

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A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff.

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A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff.

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