Group Of Champions Research Articles

Mechanical Circulatory Support Driveline Infection Reduction through Nursing Quality Improvement

Introduction Infection in patients with left ventricular assist device is a leading cause of morbidity and mortality resulting in increased risk for additional complications such as bleeding, thrombosis and stroke. The purpose of this quality improvement project was to reduce driveline infections through implementation of an evidence-based bundled dressing kit and education to nursing staff. Hypothesis Education of nurses and implementation of a standardized kit for driveline dressing changes will reduce driveline infection rates and improve nurse knowledge, satisfaction and confidence with infection prevention practices. Methods A multifocal intervention to improve standardization of care related to LVAD driveline care practices was initiated in 2018 on 5 nursing units. A multidisciplinary group contributed to creation of a driveline dressing kit. Nursing unit champions were identified and educated regarding driveline care knowledge and dressing change techniques. The institutional policy was updated to reflect new practices. In-person teaching and online educational videos were used to deliver education to nursing staff from the 5 units. A knowledge survey was used to test nursing knowledge immediately following the initial education and was repeated after 6 months to assess knowledge retention. Nurses were additionally asked to respond to questions regarding satisfaction and confidence with practice changes at the 6-month follow-up. Results An overall reduction in driveline infection rate from 35.7% in the 8 months prior to implementation of the DL dressing kit to 12.5% in the 8 months post implementation. Of the champion group, 26 nurses received 100% on their knowledge assessment. After in-servicing, 50% of floor nurses scored higher than 90% on their knowledge assessment. After 6 months, 57% of floor nurses scored greater than 90%. Of respondents, 93.6% agreed or strongly agreed that they “feel confident to expertly provide driveline dressing changes to LVAD patients using the new kit,” and 89.4% agreed or strongly agreed that they “feel confident that I can teach patients and their caregivers on how to use the new driveline dressing kit.” Conclusions While we have seen a great improvement in the rate of DLI, there are continued needs to reinforce nursing knowledge and skills related to driveline care and dressing change practices. Ongoing monitoring of driveline infection rates and further efforts to establish best practices are needed.

EcoEd: Cohesive training and skill development for digital ecoscience tools

Digital research infrastructures such as data portals and virtual laboratories enable easier access to data and analytical tools. Such infrastructures are essential to deliver research excellence that drives innovation, but we also need to ensure that we have a skilled workforce that can use these infrastructures. Therefore, training and skill development of students, researchers, government practitioners and industry professionals is key to the long-term success of this investment. In Australia, a suite of digital infrastructures has been developed for environmental sciences to enhance our understanding of the natural world and making forward projections into novel conditions (e.g. Atlas of Living Australia, Biodiversity and Climate Change Virtual Laboratory, ecocloud, Terrestrial Ecosystem Research Network). To provide users with a holistic approach to environmental spatial data discovery and analysis, these infrastructures have joined forces to deliver an exciting and innovative new training program. This program, called ecoEd, provides cohesive training and skill development to university lecturers, researchers and industry professionals enabling them to combine theoretical concepts with real-world applications. In this presentation, I will present how ecoEd was developed and the outcomes of the training sessions in which a group of ecoEd Champions absorbed ready-to-use lecture and workshop modules along with tools and knowledge on how to use the platforms. These resources can immediately be used in undergraduate courses that focus on topics such as ecology, biogeography, conservation biology, environmental management and spatial analysis as well as in stand alone workshops for researchers and practitioners. The training program aims to provide the Champions with the resources and knowledge required so that they can confidently re-deliver the lectures and workshops in their own institutions. As such, ecoEd is increasing the capacity of Australia’s environmental science community to advance science and deliver outcomes that underpin the sustainable use of our ecosystems using the latest advances in digital technologies. Moreover, it is enabling first-rate science education in Australia by supporting and nurturing our future scientists.

The Role of Women in the Management of Flood Disasters in Bima District, Nusa Tenggara Barat

Indonesia is located on the equatorial line result has a tropical climate so prone to hydrometeorological disasters such as landslides, floods,droughts.Disaster must be balanced with a good disaster management so that the Indonesian people are ready to face the incident when a disaster occurs. Disaster management must be implemented by all Indonesian people both women and men without having to distinguish gender. Bima, West Nusa Tenggara is one of the areas that have implemented gender responsive responses. Area of Bima Regency mostly (70%) is a highland textured mountains so prone to landslides and flash floods because it is in the hills. Disasters require sensitivity and involvement of all sections of society, including women. This research method is descriptive qualitative with CVA gender analysis (Capacities and Vulnerabilities Analysis). The purpose of this study is to examine the participation of women in disaster management such as women participation in Kelompok Siaga Bencana (KSB) and Women Champion Groups in their participation in the event of a disaster. The involvement has not been comprehensive and there are still many women who have not participated due to gender inequality. Women participation is at least sufficient to demonstrate that women have a capacity for disaster management.

Implementing quiet hours on a medical telemetry unit

Implementing quiet hours on a medical telemetry unit

Development of a toolkit to enhance care processes for people with a long-term neurological condition: a qualitative descriptive study

ObjectiveTo (A) explore perspectives of people with a long-term neurological condition, and of their family, clinicians and other stakeholders on three key processes: two-way communication, self-management and coordination of long-term...

Improving Asthma Control through Asthma Action Plans: A Quality Improvement Project at a Midwest Community Clinic

ABSTRACTThis urban community clinic had poor asthma outcomes compared to the state of Minnesota. The standard of care supports an annual Asthma Action Plan (AAP). However, the majority of patients at this clinic had not received one. This quality improvement project aimed to improve asthma control, measured by an asthma control test of at least 20, through AAP implementation supported by all team members. The clinic’s interdisciplinary champion group implemented workflow changes via practice facilitation and Plan-Do-Study-Act cycles. Asthma control rates increased from 23% to 58% in adults and 45% to 63% in children over one year, a statistically significant change.

Knowledge for effective action to improve the health of women, children and adolescents in the sustainable development era.

January 2016 marked the beginning of a new era for health and development. It was the start of Transforming our world: the 2030 agenda for sustainable development and its accompanying sustainable development goals (SDGs).1 All governments have committed to this ambitious sustainable agenda and its goals. The Global strategy for women’s, children’s and adolescents’ health (2016–2030)2 and its operational framework are aligned with the SDGs and provide an evidence-based roadmap for ending preventable deaths of women, children and adolescents by 2030. The global strategy can guide collective action so that every woman, child and adolescent – even those living in the most challenging settings – can achieve their full potential and rights to health and well-being. Governments are aligning their work with the SDGs and the global strategy’s three objectives – survive, thrive and transform – in ways that meet their countries’ priorities and unique contexts. The survival, health and well-being of women, children and adolescents are essential to achieving the SDGs. Analysis of lessons from the millennium development goal (MDG) implementation process – what has worked and what hasn’t – is needed to effectively implement the agenda set by the SDGs and the global strategy. Achieving the global strategy and the SDGs will require the use of the best available knowledge for action, as well as investment in new research and innovation. This month’s Bulletin theme issue seeks to broaden the evidence on effective country implementation and lessons learnt from the MDGs. Kuruvilla et al.3 summarize the current global strategy, show how the objectives of the strategy are aligned with the SDGs and how selected countries are already making progress. Several papers in this issue deal with progress on the survival objective of the global strategy; Negandhi et al.4 present a surveillance-based maternal and infant death review system in India; Murguia-Peniche et al.5 and McKinnon et al.6 address under-researched topics, such as the factors associated with stillbirths in Mexico and the high prevalence of suicidal behaviours among adolescents in low- and middle-income countries, respectively. The strategy’s thrive objective addresses the overall health and well-being of mothers, children and adolescents. Chai et al.7 determine how exposure to violence hinders child development and can affect health across the life-course and subsequent generations. Askew et al.8 describe the importance of ensuring sexual and reproductive health and rights in humanitarian settings. The transform objective of the strategy focuses on expanding enabling environments and aims to transform societies so that women, children and adolescents everywhere can realize their rights to the highest attainable standards of health and well-being. Several papers address the global strategy’s transform objective. Newberry et al.9 present a formal emergency response infrastructure developed in India for gender-based violence. This special issue also includes papers on approaches that have helped countries achieve improved health outcomes for women, children and adolescents. Marston et al.10 discuss the importance of community engagement in achieving results. Ahmed et al.11 describe policies and programmes that contributed to reductions in child and maternal mortality. Frost et al.12 explain how multistakeholder dialogues are used to clarify what works and does not work in policy-making and implementation. To drive the global strategy forward, governments, civil society, the private sector and other partners have mobilized under the banner of Every Woman Every Child and a group of political champions has been formed. A global financing facility has been established as a country-led partnership that combines domestic, external, and innovative financing for health and development. An independent accountability panel has been appointed by the United Nations Secretary-General to report on results, resources and rights for women’s children’s and adolescents’ health. This month, the World Health Assembly will consider a resolution on implementing the global strategy, giving delegations an opportunity to discuss its content and shape their own commitments. In addition, this theme issue illustrates the importance of continued investments in research and learning to support country implementation. The generation and sharing of knowledge for action is essential to achieve the global strategy’s objectives, to secure a healthy and transformative future for women, children and adolescents, their families and communities in the SDG era.

Taenia solium Taeniasis and Cysticercosis in Southeast Asia.

Human taeniasis/cysticercosis caused by the pork tapeworm Taenia solium has been identified as a potentially eradicable disease by the International Task Force for Disease Eradication of the World Health Organization. In southeast Asia, T. solium taeniasis/cysticercosis is considered one of the major neglected tropical diseases afflicting the region. In the last few decades, a considerable effort has been invested toward establishing the epidemiology and burden of disease in several southeast Asian countries. Moreover, further evidence is emerging as to understanding the dynamics of disease transmission and cultural, political, and socioeconomic factors influencing the success of control and eradication efforts within the region. However, despite major collaborations by several champion groups, advances have been slow and little remains known about the complete epidemiology of taeniasis/cysticercosis and the barriers to programmatic success. This review article aims to address the above issues with a further focus on the challenges to control and eradicate taeniasis/cysticercosis within the southeast Asia region.

Advancing Pharmacogenomics as a Component of Precision Medicine: How, Where, and Who?

Pharmacogenomics is an important element of precision medicine. Advances in pharmacogenomics implementation have been made but significant barriers remain, including evidence, reimbursement, and clinician knowledge, among others. Widespread adoption of pharmacogenomics requires overcoming these barriers, a clinician champion group, which we propose will be pharmacists, and an easily accessible setting, which may be the community pharmacy. Whatever the path, it must be evidence-driven and pharmacogenomics must improve drug-related outcomes to become a standard of care.

Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia. More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. INCLUSION CRITERIA Types of participants This review will consider studies that include residents with a formal diagnosis of dementia currently residing in permanent care in Residential Aged Care Facilities. This review will exclude participants that have not received a formal diagnosis of dementia as well as those who are not living as a permanent admission in Residential Aged Care Facilities. Studies conducted on community dwelling individuals with a formal diagnosis of dementia will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the efficacy of professional oral health care performed by a dental hygienist. These studies involve professional oral health care performed by a dental hygienist using a toothbrush, interdental brushes, floss and hand scalers if necessary to remove plaque and food debris and in some instances hardened calculus or tartar. If there are studies involving the professional oral health care being performed by dentists or a combination of dentists and dental hygienists they will be included in the analysis. This review will exclude interventions involving staff training interventions and interventions performed by nurses/assistant nurses. TRUNCATED AT 250 WORDS

G575(P) Promoting quality in a community paediatric department

Context Work was done within a busy community paediatric department. The work looked at how we assess and promote quality. Problem A lack of focus and evidence of quality. Assessment of problem and analysis of its causes Within the department we had completed audits over the years on an adhoc basis, there were guidelines and pathways which were used but they were not always up to date. There was no universal way documentation could be accessed to see what had been done when, or when it needed repeating/updating. This meant that there was variability in the service we provided. Intervention Initially we spent 2 days collecting data about the quality work being done already. Next we planned four interventions. We created a database of audits, who was responsible for them and when they needed repeating. The database also noted if there were protocols and audit tools and if the audit had been presented. We formed a centralised set of online files based on the current CQC standards. Supporting evidence was filed making it accessible to everyone in the department. Audit reports, pathways, patient information sheets, induction material and department protocols can be easily found. We asked each member of the department to join a “champions” group focused on different areas of change. New trainees in the department are allocated to a group. These included:- Staff Wellbeing ASD ADHD Patient Voice Expectations We organised a monthly “quality” meeting. This is an opportunity for the department to present any work so that we can all learn and share. Changes can be ratified quickly so consistent high quality care can be provided. Strategy for change The most important strategy was encouraging each team member to feel responsibilty for quality. An away day allowed us to develop a shared vision and the champion groups will feed back on their progress at the monthly meetings to encourage action and momentum. Measurement of improvement We have now completed departmental audits that are up to date and shared with the team. Our monthly meeting has a full agenda promoting and sharing best practice. Effects of changes These changes have allowed the department to move to a more cohesive and coherent view of their work around quality. We have helped to standardise care, share good practice and maintain a quality service for the future. The staff wellbeing group has started a free fruit and lunchtime walking initiative. While the patient voice group have raised the profile of recoding this in clinic letters and meetings. Lessons learnt One of the greatest challenges was getting colleagues to prioritise “quality” work above their clinical case load. In a busy department it can be hard find time to implement change. The quality day provided a different environment away from clinical duties to allow people to think about what we could do better. Message for others Identifying “quality” and the evidence required to show this is the first step. Forming a central easily accessed folder containing all the information along with an index or database to assess progress is the next. Using the CQC standards as a template for our files helped us to organise our thinking in line with national standards. Engaging colleagues and encouraging personal responsibility to support ongoing improvement is also essential.

Dementia friendly, dementia capable, and dementia positive: concepts to prepare for the future.

With an aging global population, the number of dementia cases is growing exponentially. To address the upcoming dementia crisis, the World Health Organization and Alzheimer's Disease International (2012) collaborated on an extensive report, Dementia: A Public Health Priority. In the United Kingdom, Prime Minster David Cameron initiated a national challenge on dementia, forming 3 dementia challenge champion groups aimed at improving health and care, creating dementia-friendly communities, and promoting dementia research. In the U.S., President Obama signed the National Alzheimer's Project Act, which led to the formation of the Advisory Council on Alzheimer's Research, Care, and Services and the launch of the first National Plan to Address Alzheimer's Disease. The term "dementia capable" was introduced in the 2012 Recommendations of the Public Members of the Advisory Council and has since been adopted in both the recommendations and annual updates of the national plan. This paper will first compare and contrast government usage of the concepts dementia friendly and dementia capable, along with another valuable concept, dementia positive, that was added after reviewing the literature. Finally, a new vision statement for the U.S.' national plan will be proposed and recommendations incorporating these 3 concepts in policy, research, and practice will be made.

Moving Toward Collective Impact in Climate Change Literacy: The Climate Literacy and Energy Awareness Network (CLEAN)

ABSTRACT In recent years, various climate change education efforts have been launched, including federally (National Oceanic and Atmospheric Administration, National Aeronautics and Space Administration, National Science Foundation, etc.) and privately funded projects. In addition, climate literacy and energy literacy frameworks have been developed and deployed, and both have been reviewed and endorsed by the U.S. Global Change Research Program. This paper describes a community-based effort to promote climate and energy literacy: the CLEAN Network (originally the Climate Literacy Network). We describe results from a member survey about the importance of the network to the members' professional lives and review the development and position of the network within the larger community of climate and energy literacy stakeholders. The CLEAN Network was first formed in 2008 to support climate literacy efforts, largely through voluntary efforts. It serves as a champion and rudimentary and unfunded backbone support organization, enabling first steps toward establishing the elements necessary for successful collective impact in achieving climate literacy. Among the elements that have been described to be essential for a collective impact, the CLEAN Network most effectively provides continuous communication for the broad community of climate literacy stakeholders. The network enables its professionally diverse members to learn of one another's needs and to begin identifying mutually reinforcing activities that will address the common agenda and shared system of measures (two other key elements of collective impact) once they are established. The CLEAN Network serves as a small champion group that continues to seek input from the larger climate literacy stakeholder community on how a backbone support organization might support and extend their efforts. The next steps in a collective impact approach to climate and energy literacy include defining and forming a backbone support organization to facilitate the development of a shared agenda and a shared system of measures, which has the support of all stakeholders, that is sufficiently funded and can help mobilize funding to scale what works in climate and energy literacy. Such an organization would have collective impact that is commensurate to the challenges and opportunities climate change present to the nation.

Barriers and Facilitators to Implementing the Baby-Friendly Hospital Initiative in Neonatal Intensive Care Units

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation.

Starting out - Joining a dementia champion group helped me overcome my trepidation

Student experiences in the real world of nursing

Changing Unit Culture and Fostering Well-being of Staff

Introduction:The key role of healthcare leaders is to create and sustain an environment that optimizes high-quality, safe, and effective patient-centered care. The leader's role is to ensure the best possible physical environment and provide a culture that supports healthcare team members in the stressful work of providing direct care. A positive approach is to empower nurses and other health team members with effective skills and techniques to help them transform stressful situations into more therapeutic scenarios.Methods:The nursing leadership team decided to test an approach to positive coping and resiliency designed to teach individuals on the oncology unit to recognize their stress symptoms and to use learned skills to counteract the negative impact of stress. Sixty-three participants voluntarily participated in the HeartMath educational class where they were taught techniques that could be used “in the moment” and throughout the day. A champions group was then identified to develop tools that would be used on the oncology unit to keep these techniques at the forefront of the staff's mind throughout each day. Staff members were encouraged to use the tools every day.Results:Staff members were surveyed using the Personal and Organizational Quality Assessment survey pre-intervention, post-intervention, and again at 7 months post-intervention. Results at the 7-month post-intervention showed statistically significant differences for each of the personal indicators (positive outlook, gratitude, motivation, calmness, fatigue, anxiety, depression, anger management, resentfulness, and stress symptoms). The organizational indicators at the 7 month post-intervention all trended in the expected direction, but only statistically significant differences were found in the indicators of goal clarity, productively, communication effectiveness, and time pressure. Other areas of improvement noted were decreased turnover on the oncology unit, improved employee satisfaction scores, and patient satisfaction scores with nursing care.Conclusion:Changing unit culture and fostering well-being of staff begins with nursing leadership. Recognizing that nurses and health team members are stressed, we implemented HeartMath as a team approach with staff taking an active role as champions to bring out ideas to keep the techniques at the forefront of everyone's mind everyday. By encouraging use of these tools at work, personal and organizational gains were found that were beneficial for the staff as well as the organization.

Identifying and Recruiting Recovery Champions: Exploratory Action Research in Barnsley, South Yorkshire

The UK Drug Strategy has embraced the philosophy of recovery as an “individual, person-centered journey” (Her Majesty's [HM] Government, 2010, p. 19) and is supported by a local network of recovery champions. The purpose of this article is to examine proactive attempts at establishing such networks based on training and working with a mixture of people in recovery and professionals, supported by a local recovery leader. What is presented in this article is a case study of an initiative attempting to access and link recovery champions. The early stages of the initiative were planned in advance, but the later stages were evolutionary and were based on the decisions of the emerging recovery champions group. The initiative started with a series of workshops to raise awareness about recovery, and from this, to recruit an initial group of candidate champions. Small groups were successfully recruited to participate in subsequent champions workshops, and they have since translated that commitment to a range of actions and directions, which have attempted to generate a visible recovery community and to challenge stereotypes and stigma perceptions. The final section of the article will review the utility of the label of “recovery champion” and will examine the role of such networks in enabling and supporting the emergence of a local culture of recovery.

Improving the lives of people with dementia and their carers: The Prime Minister's challenge and a challenge for us all

The profile of adult social care has probably never been higher and one of the biggest questions is how to manage demographic pressures on services as resources reduce, while aiming to improve outcomes and maintain quality. One group which brings these issues into sharp focus is the rising number of people with dementia and their carers. In this particular instance we have the additional focus given by the launch of the Prime Minister's dementia challenge. The challenge seeks to move further and faster in achieving the aims of the national dementia strategy focusing particularly on creating dementia-friendly communities, improving care and health and better research. This article sets out the context for the challenge, the logic behind extending the particular objectives set out in the challenge to better encompass social care and describes the action plan put together by the champion group for improving health and care. The article goes on to suggest that while the objectives of the Prime Minister's chal...

Role of a hospice education unit in leading the development of an end of life care model of service

Key conceptsThis innovation has been developed and led by a palliative care education centre supported by two hospices. It illustrates how hospices can lead, innovate and influence the quality and...

Sustained Hand Hygiene Improvement in a Pediatric Teaching Hospital During and After the H1N1 Influenza Pandemic

accurately measure HH compliance improvement. A group of IP Champions was formed that included nursing & ancillary representatives as advocates and this was a key component in our success. They were energized and took it back to their units. Champions made posters to bring awareness of the importance of HH. IP taught them the WIPES Campaign to measure HH performance as both before and afterpatient contact counting as one episode of HH compliance. With a newly-designed patient care pavilion with single patient rooms with large windows made observing compliance easy. The patient’s room is broken down into three sections: the nurse’s work area which includes a wash station, the patient section and the family area. At each nurse server, a sink is available for HH. The IP took individual pictures of hospital staff taking the pledge to commit to the campaign. Pictures were posted throughout the hospital. Computer screen savers were made to promote the campaign and pictures of workers taking the pledge were flashed across the screen. The group purchased a trophy to be given to the nursing unit with the most improved compliance rate for the month. A celebration including treats was given to the unit.