Multilingual Postpartum Depression Screening in Pediatric Community Health Clinics.

INTRODUCTION: This evidence-based practice project established postpartum depression (PPD) screening and followed maternal use of mental health services in a multilingual low socioeconomic status urban population. METHOD: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was used to establish a screening protocol for mothers at their infants' well-child checks. For mothers with positive screens, providers referred them to mental health care and updated their child's electronic health record diagnosis to prompt reassessment for future visits. RESULTS: Over 6 months, 273 mothers were screened at 523 eligible office visits (83.5% screening rate), 26 (9.5%) screened positive, 19 (73.1%) were referred to mental health services, and 12 (63.2%) attended the referral. Thirteen (50%) mothers with PPD had the appropriate electronic health record flag in their infant's record. DISCUSSION: This project successfully implemented the American Academy of Pediatrics PPD screening guidelines and could be applicable to other pediatric outpatient settings.

Effectiveness of a collaborative, student-run campaign to increase safety belt use among adolescents.

BACKGROUND: MVCs are the leading cause of death among adolescents. Seat belts have been shown to decrease MVC-related death. The purpose of this retrospective cohort study was to evaluate the effectiveness of a community-supported, student-run campaign to increase safety belt use among adolescents in Southwest Florida. METHODS: We reviewed results of campaigns at 14 high schools from 2012 to 2018. The primary outcome was change in rates of student-driver seat belt use over the course of each campaign. Secondary outcomes included trends in seat belt use and MVC-related fatalities over the study period. Wilcoxon signed-rank test was used to compare rates of seat belt use before and after each intervention and over the course of the study period. Multivariate logistic regression was used to estimate the independent effects of demographic covariates on outcomes. RESULTS: Altogether, 85 campaigns were reviewed. A total of 8500 preintervention and 8500 postintervention observations of student seat belt use were assessed. The median rate of seat belt use increased from 82% prior to the intervention to 87% following the intervention (p<0.001). We did not detect a sustained trend in seat belt use or MVC-related fatalities over the study period. On multivariate analysis, schools with a higher proportion of minority students were less likely to experience a substantial increase in seat belt use following the intervention (OR=0.17, 95% CI 0.03 to 0.84, p=0.030). CONCLUSION: This collaborative campaign resulted in a modest, short-term increase in seat belt use among high school students. Future studies should evaluate which interventions are most effective and how short-term increases in seat belt use can be sustained.

Does Gender Matter in Septic Patient Outcomes?

PURPOSE: The purpose of this study was to examine potential gender disparities in relation to factors associated with sepsis management among a cohort of patients admitted through an emergency department with a discharge diagnosis of severe sepsis or septic shock. Sepsis is one of the leading causes of death globally, with significant associated costs. Predictors of survival for those with sepsis-related diagnoses are complex. DESIGN AND METHODS: The study had a retrospective, descriptive cross-sectional design. The sample (N = 482) included patients 18 years of age or older who presented to the emergency department of a nonprofit, Magnet-recognized, acute care hospital located in southern California. Subjects included those who subsequently met the criteria for a discharge diagnosis of severe sepsis or septic shock as defined by the Surviving Sepsis Campaign. Patient characteristics, clinical variables, care management processes, and outcomes were extracted from the electronic health record. A multivariate model was analyzed. FINDINGS: The sample included 234 women (48.5%) and 248 men (51.5%). Logistic regression with eight independent variables (discharge diagnosis, age, comorbidities, length of hospital stay, source of infection, first serum lactate level measured, recommended fluids administered, and gender) reliably predicted odds for patient survival, Ï°2 (12) = 118.38, p < .001, and correctly classified 77.3% of cases. All eight independent variables significantly contributed to the model. Men had a higher likelihood of hospital survival than women (odds ratio 1.68; 95% confidence interval 1.01-2.79; p = .045). CONCLUSIONS: The Surviving Sepsis Campaign has provided a clear pathway for care of patients with sepsis-related diagnoses. Therapeutic strategies should be developed to address differences in outcome by gender. The adoption of more aggressive applications of evidence-based interventions for these patients may result in better patient outcomes. CLINICAL RELEVANCE: Providers should understand the importance of adhering to sepsis protocols, minimizing treatment disparities, and recognizing gender differences.

360-Degree Feedback Model to Enhance Interprofessional Learning.

This article was migrated. The article was marked as recommended. Background: Providing meaningful feedback in interprofessional education (IPE) requires knowledge of discipline specific responsibilities and a method for measuring team dynamics while capturing individual performance. Methods: We implemented a 360-degree performance feedback model for a large-scale IPE simulation with standardized patients (SP) who transitioned from primary care to the emergency department. 293 medical, nursing, and pharmacy students were divided into 72 teams. We conducted a retrospective study evaluating feedback from 108 facilitators on individual and team based competencies, 12 SP patient satisfaction surveys and 293 student self-appraisals. We analyzed data using descriptive statistics and ANOVA for multiple group comparisons. Results: More than 94% of SP indicated they would return to the same student team to seek care. However, SP reported that the students did not summarize or clarify information, adapt to their level of understanding or encourage questions. Facilitators noted all disciplines were involved in formulating and implementing treatment plans. Student teams performed highest in mutual support and situational monitoring, and lowest in leadership and team structure. Students across all disciplines rated their teams as requiring light to no supervision. Conclusion: Applying the 360-degree performance model is feasible in IPE and provides multidimensional, qualitative feedback to enhance student learning.

Assessing Learning Styles of Graduate Entry Nursing Students as a Classroom Research Activity: A quantitative research study.

BACKGROUND: A number of studies across different disciplines have investigated students' learning styles. Differences are known to exist between graduate and baccalaureate nursing students. However, few studies have investigated the learning styles of students in graduate entry nursing programs. . OBJECTIVES: Study objective was to describe graduate entry nursing students' learning styles. DESIGN/SETTING/PARTICIPANTS/METHODS: A descriptive design was used for this study. The Index of Learning Styles (ILS) was administered to 202 graduate entry nursing student volunteers at a southwestern university. Descriptive statistics, tests of association, reliability, and validity were performed. Graduate nursing students and faculty participated in data collection, analysis, and dissemination of the results. RESULTS: Predominant learning styles were: sensing - 82.7%, visual - 78.7%, sequential - 65.8%, and active - 59.9%. Inter-item reliabilities for the postulated subscales were: sensing/intuitive (α=0.70), visual/verbal (α=0.694), sequential/global (α=0.599), and active/reflective (α=0.572). Confirmatory factor analysis for results of validity were: χ2(896)=1110.25, p<0.001, CFI=0.779, TLI=0.766, WRMR=1.14, and RMSEA =0.034. CONCLUSIONS: Predominant learning styles described students as being concrete thinkers oriented toward facts (sensing); preferring pictures, diagrams, flow charts, demonstrations (visual); being linear thinkers (sequencing); and enjoying working in groups and trying things out (active),. The predominant learning styles suggest educators teach concepts through simulation, discussion, and application of knowledge. Multiple studies, including this one, provided similar psychometric results. Similar reliability and validity results for the ILS have been noted in previous studies and therefore provide sufficient evidence to use the ILS with graduate entry nursing students. This study provided faculty with numerous opportunities for actively engaging students in data collection, analysis, and dissemination of results.