A guide to armchair education. How to pursue a bachelor's degree without leaving home (almost).
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Education↗
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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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An educational intervention to prevent catheter-associated bloodstream infections in a nonteaching, community medical center.
OBJECTIVE: To evaluate the effectiveness of an evidence-based intervention to prevent catheter-associated bloodstream infections among intensive care unit patients at a nonteaching, community hospital. DESIGN: Nonrandomized pre/post observational trial. SETTING: Two intensive care units at Missouri Baptist Medical Center, Saint Louis, MO. PARTICIPANTS: Nurses and critical care physicians. INTERVENTION: A ten-page, self-study module on the prevention of catheter-associated bloodstream infections, lectures, and posters given between July and September 1999. MEASUREMENTS: The incidence of nosocomial catheter-associated bloodstream infection and patient demographics were measured for patients admitted between March 1998 and July 2000. MAIN RESULTS: Thirty cases of catheter-associated bloodstream infections during 6110 catheter-days were noted in the preintervention period (4.9 cases/1000 catheter-days) vs. 11 cases during the 5210 catheter-days in the postintervention period (2.1 cases/1000 catheter-days). The relative risk for catheter-associated infection in the postintervention period was 0.43 (95% confidence interval, 0.22-0.84). Among catheterized patients, Acute Physiology and Chronic Health Evaluation II score (25.2 preintervention vs. 25.1 postintervention; p =.86), hemodialysis (91 of 647 [14%] patients vs. 69 of 541 [13%]; p =.70), and the mean number of catheter days per patient (9.1 vs. 9.6 days; p =.46) did not differ between the pre- and postintervention periods. CONCLUSIONS: A focused, educational intervention among nurses and physicians in a nonteaching community hospital resulted in a significant, sustained reduction in the incidence of catheter-associated bloodstream infection.
Aged↗
Effect of standardized orders and provider education on head-of-bed positioning in mechanically ventilated patients.
OBJECTIVE: Semirecumbent head-of-bed positioning in mechanically ventilated patients decreases the risk of developing ventilator-associated pneumonia (VAP). The purpose of this study was to determine whether the addition of a standardized order followed by the initiation of a provider education program would increase the frequency with which our patients were maintained in the semirecumbent position. DESIGN: Prospective, pre-, and postintervention observational study. SETTING: A tertiary care, U.S. Army teaching hospital. PATIENTS: Mechanically ventilated medical and surgical intensive care unit patients. INTERVENTIONS: The first intervention involved the addition of an order for semirecumbent head-of-bed positioning to our intensive care unit order sets. This was followed 2 months later with a second intervention, which was a nurse and physician education program emphasizing semirecumbent positioning. MEASUREMENTS AND MAIN RESULTS: Data regarding head-of-bed positioning were collected on 100 patient observations at baseline and at 1 and 2 months after each of our interventions. The mean angle of head of bed increased from 24 +/- 9 degrees at baseline to 35 +/- 9 degrees (p <.05) 2 months after the addition of the standard order. The percentage of observations with head of bed >45 degrees increased from 3% to 16% 2 months after the standardized order (p <.05). Two months after our provider education program, the mean angle of the head of bed was 34 +/- 11 degrees and the percentage of patients with head of bed >45 degrees was 29% (p = NS compared with values after the first intervention). Data collected 6 months after completion of our education programs showed that these improvements were maintained. CONCLUSIONS: Standardizing the process of care via the addition of an order specifying head-of-bed position significantly increased the number of patients who were placed in the semirecumbent position. In an era of cost-conscious medicine, interventions that utilize protocols and education programs should be emphasized.
Female↗
A nontraditional method of providing radiation protection instruction at a large health science center.
In the 4 quarter of 2001 the University of Alabama at Birmingham (UAB) converted its traditional classroom radiation safety course, taught exclusively in a classroom setting four times each year, to a combined online-classroom format in which the majority of the course is taught online. This change was instituted in an effort to minimize the time spent in the classroom for UAB research personnel. This format should provide the additional benefit of self-paced instruction for course participants. The hypothesis that the combined online/lecture format was as effective as the lecture-only format was tested. A statistical analysis was performed on the average first-attempt test scores of the tests (number of tests = 334) taken during a 2-y period before the online transition (average score = 75.5), and the average first-attempt test scores of the tests (number of tests = 359) taken during a 2-y period after the online transition (average score = 74.1.) A two-tailed Student's t-test was performed on the data. The t-value was 1.73, and P (T< or = t) was 0.083. At alpha = 0.05, the null hypothesis that the two averages are equal cannot be rejected. Thus the online course format appears to be as effective a method of radiation safety instruction as the more traditional, exclusively-classroom method of instruction. This article also reviews steps under consideration to improve the current online course to make it a more effective tool in radiation safety instruction.
Academic Medical Centers↗
Evaluating self-managed learning--Part 2: Accelerating management development in an NHS region.
Evaluates the use of self-managed learning (SML) in management development processes in health-care settings. Focuses on the application of SML to region-wide management development initiatives in the South West Thames Region of the UK National Health Service (NHS) from the late 1980s onwards.
England↗
Automatic physiotherapy instruction.
An automatic tape-recorder system constructed to provide intermittent physiotherapy instruction for postoperative patients is described. Eighty patients, who had been given nitrous oxide and relaxant anaesthesia, were observed during the first 4 postoperative hours. Those who had received pre-operative physiotherapy instruction, responded well. They followed the programme and blood-gas analysis demonstrated elevations of arterial blood oxygen tensions after they had followed the instructions. The system can be recommended as a supplement to physiotherapy in a busy post-operative ward. It also protects the patient from unpleasant noises in the environment.
Blood Gas Analysis↗
Distance learning materials in cancer prevention: a European project.
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Education, Nursing, Continuing↗
Open learning in palliative care.
Open learning is increasing in importance in nurse education. In this article the author considers open learning and discusses its use in palliative care education. Advantages and disadvantages of this learning method are considered and guidelines are offered to the teacher to assist them to evaluate existing learning packages or to produce their own open learning materials.
Humans↗
Re-inventing the wheel: a case study of nursing curriculum innovation.
This paper reviews the literature concerned with active learning methods in British nurse education. A case study is presented describing the introduction of assisted independent learning to a cohort of student nurses in a district general hospital school of nursing in England. The implications, advantages and problems associated with such curriculum innovation are discussed and some areas for further study are identified.
Curriculum↗
Implementing contract learning in a senior nursing practicum.
The use of learning contracts with undergraduates and graduate nursing students, as well as in staff inservice and continuing nursing education, has been promoted in North America as a teaching/learning strategy to individualize learning, promote independence, promote habits of lifelong learning and teach nurses how to cope with change. The purpose of this article is to describe the implementation of contract learning in a required clinical nursing course at the undergraduate level in a Canadian university and to describe retrospectively perceived benefits and difficulties. The process of peer consultation and student evaluation used in modifying contract learning is described. Recommendations for nurse educators considering implementing contract learning are presented.
Alberta↗
Factors related to progress towards completion of correspondence courses in a baccalaureate nursing programme.
This study focuses on the instructional technique of correspondence instruction--the learner, the setting, and the problem of course non-completion. The purpose of this study was to develop a model of completion of correspondence courses which identifies factors related to progress towards course completion. The objectives were to estimate the model and identify factors associated with course completion. The causal model for this study was adapted from Bean's synthetic model of student attrition from institutions of higher education. Data to test the model were obtained from a questionnaire, transcripts, and progress records of students enrolled in independent study programme courses and declaring a nursing major. Eleven variables in the model estimated in this study accounted for 44% of variance in course progress. Students making progress intended completing the course in 3 months, submitted the first lesson within 40 days, had high SAT scores and GPAs, completed (and did not drop) other correspondence courses, perceived family support but not employer support, had high goals for completing the programme and obtaining the BSN, lived closer to the instructor, and entered the nursing programme with college preparation (as a registered nurse). The model can be used for understanding and explaining progress toward course completion as well as the distance education setting of correspondence instruction. The intent variable explains most variance and can be measured while students are enrolled in the course. The lesson submission variable is theoretically justified.
Education, Nursing, Baccalaureate↗
A practical approach to creative teaching: an experiment.
The purpose of this experiment was to see if creative teaching methods would prove effective when included in a school of nursing teaching programme. This would be demonstrated by significant differences in levels of achievement in assessments and a demonstration that the knowledge gained was applied to the clinical situation. Didactic teaching methods were exchanged for a more creative approach without alteration of the course structure. The quasi experimental method was used, with four introductory courses of 20 nursing students at two separate district schools as the sample, two groups acting as the control groups and two as the experimental groups. The teaching sessions introduced medical problems associated with poor oxygenation, particularly those consequent to heart disease. The teaching was supported by appropriate care planning within the Roper et al. (1981) theoretical framework. Three distinct areas were identified; fact learning, e.g. anatomy and physiology, problem identifications and planning for nursing, intervention and skill learning. Students in the experimental groups were given work sheets and facilities for self learning whilst those in the control groups continued with a traditional lecture/demonstration format. The results of the experiment were evaluated by testing all four groups using multiple choice objective tests, essays, problem solving and nursing intervention exercises and practical assessments. The findings showed that the experimental groups did no better in the multiple choice objective tests or in the essays than the control groups but they did do significantly better in the problem identification and planning for nursing intervention exercise. In the assessment of practical skills there was no difference between the groups in skill performance but the experimental groups were able to apply the theory significantly better than the control groups.
Creativity↗
Women and distance education: a nursing perspective.
It is only very recently that studies of distance learners have begun to consider gender as a variable. Given the rapid growth of distance education programmes for nurses, it is appropriate to consider at this time how educators can best meet the needs of these (mostly) women students. Distance education tends to mean different things in different institutions, ranging from the 'industrial model' self-study course package with limited teacher student interaction to the fully interactive audio and video conferencing of the 'virtual classroom'. Each of these teaching/learning situations poses a different set of challenges, and each requires different solutions. Using illustrations drawn from experiences with a BN programme for registered nurses in Atlantic Canada, and from the limited literature, this paper explores both women's participation in distance education and the barriers that sometimes prevent this, as well as the kind of support women distance learners need most in order to learn effectively.
Attitude↗
Nurses' experiences of distance education programmes.
AIM: This paper reports on a study exploring the experiences of nurses undertaking distance education (DE) programmes. BACKGROUND: While DE has many advantages in terms of the flexibility, autonomy and freedom that it affords to learners, the literature reports that students undertaking these programmes can also experience feelings of being disconnected and isolated. METHODS: A convenience sample of 15 participants was selected, and data were collected using in-depth interviews. Data were analysed using a qualitative design that drew most heavily on the methodological procedures of grounded theory. FINDINGS: Habermas' theory of communicative action was found to be relevant to the interpretation of data and four categories were constructed to explain participants' experiences in relation to DE, namely: lifeworld lamented; lifeworld experienced; lifeworld ceded and learning within a bounded system. These categories reflect the manner in which participants experienced the lifeworld component (the interactive and subjective dimensions) and the system component (objective and outcome oriented dimensions) of the educational realm. While data indicated diversity in how the boundedness of the programmes was experienced, overall such standardized, instrumental courses were viewed favourably by participants within the limitations of their own personal circumstances. CONCLUSION: Distance education as a means of disseminating nursing knowledge should be strengthened. The challenge for nurse educators is to develop DE programmes that minimize their limitations and maximize their potential.
Adult↗
A computer-aided programme for promoting unsupervized activities for multihandicapped adolescents.
The present study was aimed at developing a computer-aided programme for promoting performance of unsupervized activities with two multihandicapped adolescents. Simple household and occupational tasks already familiar to the subjects were selected as activities. Both subjects discriminated the pictorial representations of those activities. In order to control for the effects of the computer-aided programme, the subjects were also exposed to a card programme. Data indicate that the computer-aided programme was successful with both subjects. Advantages and limitations of this programme are discussed.
Activities of Daily Living↗
Professional updating through open learning as a method of reducing errors in the administration of medicines.
Errors in administration of medicines can have repercussions for the patient, the nurse and the organization. Reducing the incidence of drug administration errors must be a constant endeavour on the part of nurses and the organization as a whole. The organization can be proactive in providing support for the nurse before errors occur through refresher courses, however, the cost-effectiveness of such courses should be considered. Traditional teacher-centred approaches may not encourage nurses to reflect upon their own practice, and may only entail attendance rather than participation at a study session. An approach to drugs administration update is proposed which employs an open learning format. Consideration of the mechanisms for preparing, disseminating and evaluating such programmes are provided. Quantitative data to support positive evaluation of the update programme is not yet available. Qualitative evaluation by staff who have undertaken the module is very favourable. Staff have indicated that they have been enabled to reflect on their own performance, at their own pace, and that they have enjoyed active participation in the learning process. The possible future, and potential benefits, of such programmes in a time of scarce resources is discussed.
Curriculum↗
Individual study and educational technology.
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Audiovisual Aids↗