Post-project Surveys Research Articles

Using Social Indicators to Evaluate the Effectiveness of Outreach in Two Indiana Watersheds

Nonpoint source pollution is recognized as one of the greatest threats to water quality in the United States. Outreach is one tool that can be used to help increase public awareness and motivate action towards addressing water issues. In order to create effective outreach, we must understand public perceptions of water quality, perceived barriers to implementing environmental solutions, and what types of outreach best connect with target audiences. In 2010, social indicator surveys were distributed in two watersheds in Indiana to gather baseline data on urban and agricultural residents' attitudes towards and usage of water quality conservation practices. Local watershed organizations then used various outreach methods to encourage residents to implement specific practices. In 2014, post-project surveys were conducted in both watersheds to assess whether the outreach efforts had been effective. Even with outreach efforts, many residents still were unaware that specific water pollutants were problems in their watershed. There were, however, positive changes in overall water quality attitudes. Changes in awareness and adoption of conservation practices varied by watershed and resident type, yet generally moved in a positive direction or were unchanged. The primary barrier to practice adoption for all respondents was cost. Outreach events were generally not well attended and did little to change attendee behavior. Some outreach activities seem to be more useful than others in terms of self-reported effectiveness while others are clearly visible to the community and may be a helpful way to raise awareness.

International Framework for Cancer Patient Advocacy: Empowering Organizations and Patients to Create a National Call to Action on Cancer.

PurposeWith the rate of cancer and other noncommunicable diseases (NCDs) growing globally, cancer prevention and control efforts are critical internationally. Moreover, since the 2011 United Nations High-Level Meeting on NCDs, the international health and development community has shifted its awareness to include NCDs as a global health priority, especially in developing countries where mortality rates are disproportionately high. Simultaneously, with the dissemination of the World Cancer Declaration and the evolution of cancer control policies, the international cancer community has recognized the value of engaging patients in reducing the global cancer burden. Cancer advocacy programs that involve patients, survivors, and nongovernmental organizations (NGOs) have increasing opportunities for global impact.MethodsWe developed a framework over 4 years through implementation of two pilot projects. We created a series of trainings and tools to build the capacity of local NGOs and patients to plan and implement a forum for patients with cancer and to create and disseminate a national call to action. The framework was piloted in South Africa from 2009 to 2011 and Japan from 2012 to 2014, and results were measured through postproject surveys completed by members of the collaborative working group and interviews with the in-country partner.ResultsThe framework is globally relevant and could be adapted and implemented in low- and middle-income countries to amplify patient voices in the policymaking process, increase grassroots mobilization, and improve health systems and infrastructure through addressing patient needs.ConclusionWith the dominant paradigm of global health in developing countries—which has previously focused on HIV/AIDS, maternal and child health, tuberculosis, and malaria—shifting to adapt to the burgeoning NCD burden, effective patient-centered advocacy frameworks are critical to the success of NCD control.

Clinical Decision Support and Perioperative Peripheral Nerve Injury: A Quality Improvement Project.

Decision support at the point of care has been demonstrated to be an effective tool in providing a safe environment and improving patient outcomes. The operating room is typically an area where advanced technology is introduced to nurses on a regular basis. This quality improvement project focused on preventing a peripheral nerve injury, which is an example of a postoperative adverse event that is considered preventable. Injury of a peripheral nerve is the result of compression, hyperextension, flexion, or ischemia surrounding the nerve. The goals for this project were to improve the knowledge of peripheral nerve injury of the operating room nurses, design and implement a peripheral nerve injury assessment screen that could provide decision support within the operating room record, improve the nursing documentation of peripheral nerve injury interventions, and (long term) decrease the incidence of peripheral nerve injury. A decision support screen within the operating room record was designed to supplement the operating room nurse's risk assessment for peripheral nerve injury. The components of this project involved a preliminary and postproject surveys on peripheral nerve injury knowledge, an educational presentation, and a retrospective random review of nursing documentation in the operating room electronic health records. Project results demonstrated a significant increase in nursing documentation of peripheral nerve injury interventions (63%-92%) and a positive attitude toward their exposure to basic decision support (P = .046). Recommendations for future studies and establishing a standardized coding system for peripheral nerve injury identification were identified.

The long-term impacts of resettlement programmes resulting from dam construction projects in Indonesia, Japan, Laos, Sri Lanka and Turkey: a comparison of land-for-land and cash compensation schemes

Post-project household surveys were conducted regarding 10 resettlement programmes resulting from dam construction projects in Indonesia, Japan, Laos, Sri Lanka and Turkey. In all cases the resettlement was completed at least 20 years ago, except for one case in Laos. Six of the programmes adopted a cash compensation scheme and the other four were based on a land-for-land compensation scheme. While the World Bank and the Organisation for Economic Co-operation and Development prefer land-for-land compensation, there was no significant difference observed concerning the effectiveness of the two compensation schemes. Cash compensation demonstrated a small advantage for farmers who wanted to change their occupation; for those who hope to move into an urban area to secure a better livelihood, cash compensation could be a better option.

PLANNING, PRELIMINARY DESIGN, AND INITIAL PERFORMANCE OF THE NAGS HEAD BEACH NOURISHMENT PROJECT

A 3.5 million cubic meter beach nourishment project was completed along 16 kilometers of shoreline at Nags Head, North Carolina, 32 kilometers south of the US Army Corps of Engineers Field Research Facility at Duck. The project is the largest locally-funded nourishment accomplished to date in the United States. Three ocean-certified hopper dredges and one cutterhead suction dredge constructed the project between May and October 2011. This paper discusses the planning, design, and initial performance of the project. Nags Head is exposed to high waves from the northeast which generate net southerly transport over the long term. A key design issue for the project was the large gradient in erosion rates from north to south. Fill sections were varied accordingly based on documented volume erosion rates and model simulations for the area. Permitting involved over five years of environ¬mental reviews because of the need to work during fair-weather summer months in the relatively high-energy setting. The design also built on prior work in connection with a federal nourishment project scheduled for the area if and when funds become available. Two offshore areas strategically located close to south Nags Head were utilized for construction which proceeded efficiently under summer waves until late August when Hurricane Irene impacted the area. The hurricane and fall northeast storms produced rapid adjustment of the construction profile but no net loss of sand from the project area. Post-project surveys show initial profile equilibration was largely confined to the inshore zone inside the 3.7 meter (m) [âˆ'12 foot (ft) NAVD] contour. Depth of closure at decadal scales is estimated to be âˆ'7.3 m (âˆ'24 ft NAVD).

Academic-service collaboration in evidence-based practice

Through this academic-service collaboration, undergraduate students engaged with a service partner to complete evidence-based practice projects. This case report describes the process and the outcomes of the three year experience. Project outcomes were evaluated through student and staff surveys. Students completed pre- and post-project surveys that revealed increased knowledge of evidence-based practice (EBP) and increased confidence in finding evidence for practice. Student responses also indicated high satisfaction with the process. The service partner staff post-project surveys indicated a high level of satisfaction with the process, increased learning and that targeted agency outcomes had been achieved.

Collaborative learning among undergraduate students in community health nursing

Teamwork can benefit students, enhancing their ability to think critically, solve problems creatively, and collaborate effectively. We piloted a collaborative learning project with undergraduate community health nursing students (N = 83) that entailed working in teams to explore epidemiologic data, synthesize the literature, and develop an evidence-based plan for nursing intervention and evaluation pertaining to a public health issue. Project evaluation consisted of pre- and post-project surveys by students, peer evaluation, and formative and summative evaluation by faculty. Having students work in teams, while challenging both for faculty and students, may be a viable strategy for preparing the next generation of nurses for inter- and intraprofessional collaboration. Our experience suggests that instituting a collaborative learning experience as part of an undergraduate course in community health nursing can be an effective way to expose students to constructive approaches to teamwork and prepare them for evidence-based nursing practice in the future.

Clinical Scenarios: Enhancing the Skill Set of the Nurse as a Vigilant Guardian

Patient safety is enhanced when nursing staff recognize and respond to subtle changes in a patient's condition. In this quality improvement project, simulated clinical scenarios were conducted with staff nurses on a multi-specialty surgical unit. Scenarios were developed from actual patient situations as well as from calls to the rapid response team. Nurses were given the opportunity to practice assessment, critical thinking, and communication skills. Pre- and post-project surveys were used to assess nurses' perceived level of confidence and skill in handling emergency situations. Post-project survey data showed that nurses perceived that the scenario exercises improved their confidence and skill in managing critical patient situations. In addition, the findings supported the continued use of the scenarios as a teaching strategy. The scenarios have increased nurses' awareness of early signs of patients' conditions deteriorating and have the potential to decrease the number of patient situations that escalate to emergencies.

Clinical Scenarios: Enhancing the Skill Set of the Nurse as a Vigilant Guardian

Patient safety is enhanced when nursing staff recognize and respond to subtle changes in a patient’s condition. I n this quality improvement project, simulated clinical scenarios were conducted with staff nurses on a multi-specialty surgical unit. Scenarios were developed from actual patient situations as well as from calls to the rapid response team. Nurses were given the opportunity to practice assessment, critical thinking, and communication skills. Pre- and post-project surveys were used to assess nurses’ perceived level of confidence and skill in handling emergency situations. Post-project survey data showed that nurses perceived that the scenario exercises improved their confidence and skill in managing critical patient situations. In addition, the findings supported the continued use of the scenarios as a teaching strategy. The scenarios have increased nurses’ awareness of early signs of patients’ conditions deteriorating and have the potential to decrease the number of patient situations that escalate to emergencies.

Assessment of the Effectiveness of a Constructed Compound Channel River Restoration Project on an Incised Stream

Compound channels are often constructed in restoration projects on rivers and streams that have been channelized or are deeply incised. This design allows for flow over a wider cross-sectional area during high flows and is expected to reduce both flow velocities and bed-shear stresses in the channel during high flows. Using a compound channel restoration project on Tassajara Creek as a case study, the effectiveness of a constructed compound channel in reducing channel velocities and bed-shear stresses during high flow events was tested in two ways. First, since this is an a posteriori analysis, postproject surveys and assessments of the project are used to demonstrate the geomorphic and ecological benefits of the constructed compound channel for reducing further channel incision, improving channel stability, and enhancing native riparian vegetation, while still providing conveyance capacity for design flood flows. Second, the effectiveness of a constructed compound channel in reducing channel velocities a...

Connecting Congregations

This descriptive pilot study evaluated the influence of health resource information education and the use of Web-based communication technology on the professional practice of the parish nurse in the congregational setting. Five parish nurse participants from varied denominations in rural and nonrural Virginia received a laptop computer, printer, video projector, and webcam along with high-speed Internet access in each congregational setting. The nurses attended two group education sessions that incorporated computer applications and training in accessing and using quality health information resources and communication applications such as a group "chat" software and webcam to communicate with others through high-speed Internet access. Qualitative analysis from semistructured interviews of nurses confirmed that participants found the project to be beneficial in terms of awareness, education, and applicability of technology use in parish nurse practice. Quantitative data from preproject and postproject surveys found significant differences in nurses' abilities and confidence with technology use and application. Findings showed that the knowledge and experience gained from this study enhanced parish nurse practice and confidence in using technology for communication, health education, and counseling.

An innovative partnership in service.

Stimulated by the need for better alignment of educational content and goals with evolving societal needs, practice patterns, and scientific developments, many medical schools are implementing new and creative educational experiences for students. Tulane University School of Medicine and Apple Computers have established an innovative partnership in which Apple laptop computers support and enhance students' service learning projects. The partnership also provides a unique opportunity to meet the Medical School Objectives Project (MSOP) objectives in Medical Informatics and Population Health, as outlined in Report II.(1) Apple Computers has a commitment to the New Orleans community as part of its corporate strategic plan to support educational programs at all levels; Tulane has a longstanding commitment to and experience with student-led service learning as part of the Foundations in Medicine Course.(2) Senior administrative personnel from Tulane and Apple discussed these common interests, resulting in a partnership to enhance the potential impact on the community served. Apple agreed to donate 20 G3 Powerbooks and a complete set of the Apple Learning series of software to support new and ongoing service-learning projects. A committee of Tulane faculty and students, information technology staff, and an Apple representative developed the project. To maximize students' access to the laptops while managing the administration's liability, the laptops were identically configured with standardized software packages (database development and maintenance, Web access, word processing, presentation development and execution, automated backup, and individual project access to protected server space). To maximize the use of the laptops, students from the service-learning organizations can check out the laptops on a just-in-time basis, because the projects have different needs over time. Student-service leaders are currently defining and developing the exact uses for the laptops. We anticipate that this project will enhance the administrative management of service-learning programs (e.g., schedules, directions to sites), the presentation of educational programs (e.g., teaching in schools), the creation of new media to support programs (e.g., our restaurant choking program has a partnership with the American Heart Association to create a video and training manual to be used nationwide), and data tracking (e.g., sites and clients served, outcomes achieved). Students' use of the laptops should support the achievement of several of the MSOP Report II Medical Informatics objectives. To assess that, all first-year medical students are completing a pre- and post-project survey based on those objectives. The availability of laptops and software should significantly enhance the service-learning programs. The students participating should gain important skills in the use of computer technology related to their roles as lifelong learners, educators and communicators, researchers, and managers.(1) We plan to report the results of the pre- and post-project surveys once they have been completed. Students' feedback on the project has been very positive, and we hope it can serve as a model for other medical school, corporate, and community partnerships.