Podcasts about clinical nursing

This ASPEN podcast series is based on the Nutrition in Clinical Practice Supplement titled ‘Unmet Needs in Short Bowel Syndrome' published in 2023. This episode features Marion Winkler, PhD, RD, and Swapna Kakani, MPH, focusing on quality of life in adult patients with short bowel syndrome. This podcast series aims to educate clinicians on the current state of evidence in the management of SBS, stimulate ideas and questions for future research, and provide information in patient-friendly language to better educate and improve the health of patients with SBS. This podcast is supported by Ironwood. QOL Resources: HPN-PRQOL: hpn_proq_.pdf The Gutsy Perspective: project news | the gutsy perspective Oley Foundation: www.oley.org Short Bowel Syndrome: Where to find support, information, and community Let's Talk SBS Conversation Guide PDF Let's Talk SBS Appointment Checklist PDF QOL References: Fu M, Shi M, Li M, He G. The experience and needs of living with home parenteral nutrition in adult patients: A meta-synthesis of qualitative studies. Journal of Clinical Nursing. 2024;33:4468-4483. Winkler MF, Machan JT, Xue Z, Compher C. Home parenteral nutrition patient-reported outcome questionnaire: sensitive to quality of life differences among chronic and prolonged acute intestinal failure patients. J Parenter Enteral Nutr. 2021;45(7):1475-1483. Business Corporate by Alex Menco | alexmenco.net Music promoted by www.free-stock-music.com Creative Commons Attribution 3.0 Unported License creativecommons.org/licenses/by/3.0/deed.en_US February 2025

Support for Authentic Parenting comes from listeners like you. Since 2015, this podcast has been fully listener-supported, and we rely on your donations to continue bringing you valuable content. You can make a one-time or monthly donation at authenticparenting.com/support, or join us on Patreon at patreon.com/authenticparenting Returning guest, Associate Professor of Clinical Nursing, and family nurse practitioner at The Ohio State University Kate Gawlik on 3 ways to prevent parental burnout. We talked about adjusting our expectations, lowering demands, simplifying, the importance of free play, the downside of over scheduled lives, and more. May 2022 Report on Working Parental Burnout  May 2024 Report on Working Parental Burnout  CNN's article, “Parents Are Not OK Right Now. Here's What They Can Do LINKS AND RESOURCES Support the podcast by making a donation (suggested amount $15) 732-763-2576 call to leave a voicemail.  info@authenticparenting.com Send audio messages using Speakpipe. Join the Authentic Parenting Community on Facebook. Work w/Anna. Listeners get 10% off her services.  OTHER EPISODES YOU MAY LIKE Parental Burnout: Causes, Signs and How to Cope With It with Kate Gawlik The Consequences of Parental Burnout with Moïra Mikolajczak, PhD Mommy Burnout: How To Reclaim Your Life and Raise Healthier Children in The Process with Sheryl Ziegler Living Well with Stress with Elissa Epel, PhD Mind-Body Tools to Develop Stress Resilience

CNSA resources: Vessel health and Preservation - CNSA - Cancer Nurses Society of AustraliaPosition statement- https://www.cnsa.org.au/documents/item/1767Microcredential course Principles and Practice for Difficult Venous Access | University of Wollongong - Australia (openlearning.com)ReferencesUllman, A. J., Larsen, E., Gibson, V., Binnewies, S., Ohira, R., Marsh, N., ... & Kleidon, T. M. (2024). An mHealth application for chronic vascular access: A multi‐method evaluation. Journal of Clinical Nursing, 33(5), 1762-1776.An mHealth application for chronic vascular access: A multi‐method evaluation - Ullman - 2024 - Journal of Clinical Nursing - Wiley Online LibraryUllman, A. J., Gibson, V., Kleidon, T. M., Binnewies, S., Ohira, R., Marsh, N., ... & Larsen, E. (2024). An mHealth application for chronic vascular access: Consumer led co-creation. Journal of Pediatric Nursing, 76, 68-75.An mHealth application for chronic vascular access: Consumer led co-creation - ScienceDirectIvziku, D., Gualandi, R., Pesce, F., De Benedictis, A., & Tartaglini, D. (2022). Adult oncology patients' experiences of living with a central venous catheter: a systematic review and meta-synthesis. Supportive Care in Cancer, 30(5), 3773-3791.Ullman, A. J., Marsh, N., Mihala, G., Cooke, M., & Rickard, C. M. (2015). Complications of central venous access devices: a systematic review. Pediatrics, 136(5), e1331-e1344.PEDS20151507 1331..1344 (silverchair.com)The PISCES Trial (avatargroup.org.au)

“One of the big misconceptions is that this is just a quick shot. And this is a patient's treatment regimen. So, it is not just a quick shot. It is treatment, and we need to get it where it is supposed to go so that the patient's, cancer treatment is not impacted,” Caroline Clark, MSN, APRN, OCN®, AG-CNS, EBP-C, director of evidence-based practice and inquiry at ONS, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering intramuscular (IM) injections in oncology. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by August 23, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the administration of antineoplastic medications by IM injection. Episode Notes Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episodes on administration topics Episode 324: Pharmacology 101: LHRH Antagonists and Agonists Episode 316: Pharmacology 101: Estrogen-Targeting Therapies ONS Voice article:  Oncology Drug Reference Sheet: Asparaginase Erwinia Chrysanthemi (Recombinant)–Rywn ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) ONS course: Introduction to Evidence-Based Practice ONS Huddle Card: Hormone Therapy American Journal of Therapeutics article: Body Mass Index: A Reliable Predictor of Subcutaneous Fat Thickness and Needle Length for Ventral Gluteal Intramuscular Injections Centers for Disease Control and Prevention resources: Administering Vaccines: Dose, Route, Site, and Needle Size Vaccine Administration: General Best Practices for Immunization Concordia University Ann Arbor School of Nursing video:  Ventrogluteal identification Elsevier Clinical Skills: Medication Administration: Intramuscular Injections—Acute Care Healthline article: Z-Track Injections Overview Journal of Advanced Nursing article: Does Obesity Prevent the Needle From Reaching Muscle in Intramuscular Injections? Journal of Clinical Nursing article: Dorsogluteal Intramuscular Injection Depth Needed to Reach Muscle Tissue According to Body Mass Index and Gender: A Systematic Review Journal of Nursing Research article: Gluteal Muscle and Subcutaneous Tissue Thicknesses in Adults: A Systematic Review and Meta-Analysis National Institute of Occupational Safety and Health: Hazardous Drug Exposures in Health Care Novartis education sheet: Additional Considerations for Dorsogluteal and Ventrogluteal Intramuscular Injections Oncology Nurse Advisor article: Large-Volume IM Injections: A Review of Best Practices To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “More frequently oncology nurses are using intramuscular injection techniques when giving certain hormonal therapies for cancer treatment and for cancer symptom management. Some examples of those are fulvestrant for treatment of hormone receptor–positive, HER2-negative breast cancer, leuprolide as androgen deprivation therapy in prostate cancer. This is also used off label for breast cancer management. It's used for premenopausal ovarian suppression and also in noncancerous conditions like endometriosis and uterine fibroids.” TS 2:04 “Inadvertent injection into the sciatic nerve is one of the most common causes of sciatic injury. It has significant morbidity associated with it. And even for drugs like fulvestrant, the prescribing information notes reports of sciatica, neuropathic pain, neuralgia, peripheral neuropathy—all related to dorsogluteal injection.” TS 6:09 “When administering an IM injection to someone who is cachectic, you don't want the subcutaneous tissue to bunch up. So you can kind of stretch this over with your nondominant hand, as in the Z-track method, and then grasp the muscle between your thumb and index finger. That's going to help you ensure that you're getting that muscular injection.” TS 11:47  “Z-track is a way that you inject so that there's no leakage back out into the subcutaneous space. Clean your area as usual. You displace the skin and the subcutaneous tissue that's over that muscle, and then you inject slowly into the muscle. Once you remove the needle, then you release that tissue. And it kind of seals it over and prevents that leakage back up into the subcutaneous space.” TS 14:19 “I think ventrogluteal injection is less commonly done. There are documented issues with confidence in landmarking and giving it to that site, so practice is necessary. A great way to identify the ventrogluteal site on yourself to start is to stand up and put your hand at your side. You feel for the top of that iliac crest. Place your hand right below the iliac crest and then just start marching in place. You're going to feel that muscle contraction right away. This also works when you abduct your leg. Abducting the leg is helpful when a patient is at a side-lying position to give a ventrogluteal injection—you feel that muscle contraction.” TS 17:06 “I wish it would be front of mind to encourage adverse event reporting related to any injection you're giving. These types of reports—they drive improvement measures and monitoring. And then when things are underreported, it leads us to anecdotal reports. So really monitoring any change, trying to get some baseline data on adverse events with injection is really important.” TS 26:32 

Send us a Text Message.Dr. William Padula, PhD, MS, MSc, is Assistant Professor, Pharmaceutical & Health Economics and Fellow, Schaeffer Center for Health Policy & Economics, at the Alfred E. Mann School of Pharmacy & Pharmaceutical Sciences, University of Southern California ( https://healthpolicy.usc.edu/author/william-padula-phd/ ). His research explores the theoretical foundations of medical cost-effectiveness analysis, especially pertaining to issues around the value of vaccines, healthcare delivery and patient safety in hospitals for acquired conditions such as pressure injuries. He has received grant funding in the form of a Career Development Award from the National Institutes of Health (NIH), the Bill & Melinda Gates Foundation, and the PhRMA Foundation Frontier Award. He has authored 100+ scientific papers, letters and book chapters that have been published in leading medical, economic, and health policy journals. Dr. Padula is also Co-Founder & Principal of Stage Analytics ( https://stageanalytics.com/william-v-padula-phd/ ), a consulting firm that is committed to providing the highest quality of scientific solutions to advance health care. Dr. Padula is an Associate Editor of Value in Health, and serves on the editorial boards of Applied Health Economics and Health Policy and Journal of Clinical Nursing. His work has been featured in the New York Times, The Atlantic, The Hill, Forbes and other media. He is a past recipient of the Award for Excellence in Health Economics and Outcomes Research from the International Society of Pharmacoeconomics and Outcomes Research (ISPOR); the Academy Health Outstanding Dissertation Award; and the Society for Advancement in Wound Care (SAWC) Young Investigator Award. He served as President for the U.S. National Pressure Injury Advisory Panel (NPIAP) from 2021-2022. He was also Commissioner for the American Nurses Credentialing Center (ANCC) Magnet® Recognition Program from 2016-2019. Dr. Padula has previously held appointments as an Assistant Professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, USA, and as a postdoctoral fellow at The University of Chicago. He was a visiting scholar at the University of York Centre for Health Economics in York, UK, the Oxford Institute for Nursing, Midwifery and Allied Health in Oxford, UK, and the University of Technology Sydney in Sydney, Australia. He received his B.S. in Chemical Engineering from Northwestern University, M.S. in Evaluative Clinical Science from Dartmouth College, M.S. in Data Analytics from University of Chicago, and Ph.D. in Pharmaceutical Economics from University of Colorado. #HealthEconomics #USC #WoundCare #Pharmacy #PressureSores #Pharmaceuticals #WilliamPadula #HealthcareValue #Outcomes #WastefulSpending #Medicare #Medicaid #progresspotentialandpossibilities #IraPastor #podcast #podcaster #viralpodcast #STEM #Innovation #Technology #Science #Research Support the Show.

Clinical elective courses provide additional specialty knowledge for prelicensure nursing students; however, it is unknown how these courses impact nurses' clinical practice after graduation. Drs. Lisa Lewis and Michelle Hartman describe their study on the impact of these electives on new graduates' clinical practice. Half of the new graduates worked in clinical  areas that were the same, or related to, the elective they took. Graduates felt that taking the elective improved their confidence in the clinical setting and provided increased knowledge that put them at an advantage over their peers. Practice partners also reported benefits for their agency. Learn more about these clinical elective courses in their article.

Before we dive in, please note that this episode contains mature content intended for listeners aged 18 and above. We'll be discussing intimate topics related to queer sex, including kinks, sex toys, and explicit language. If you're under 18 or uncomfortable with such content, we recommend checking out our other episodes. For our adult listeners, get ready for an enlightening and candid conversation with Kendall Buckley, a seasoned sexologist and sapphic relationship therapist. Let's get started!  This week on “Turn's Out We're Gay” we sit down with Kendall Buckley, a seasoned sexologist and sapphic relationship therapist, for spicy conversation about all things queer sex. With a background in Clinical Nursing, a Bachelor of Science in Nursing, and a Masters in Sexology, Kendall brings a unique blend of medical expertise and sexual wellness advocacy to the table. In this episode, we engage Kendall in a frank discussion about queer sex, debunking misconceptions while highlighting the importance of sex health within LGBTQ+ relationships. We explore the realm of kinks, emphasising the crucial role of openness and communication when it comes to intimacy. Kendall shares insights on ethical pornography, the benefits of incorporating sex toys, and discusses the diversity of sexual experiences within queer communities.  Throughout their conversation, Kendall talks about the transformative power of a healthy sex life, and its impact on overall well-being and relationship satisfaction. Listeners will gain practical advice on embracing their sexual identities authentically and nurturing fulfilling connections with partners and themselves. We also share some personal insights into our own sex lives... Get ready for some juicy details! For more insights from Kendall, visit her website at www.kendallbuckley.com and connect with her on Instagram @kendall.buckley.sexologist. Kendall has generously shared her masturbation exercises, available on her website via this link: https://www.kendallbuckley.com/resources/p/masturbation-exercises As a special treat for all "Turn's Out We're Gay" podcast listeners, you can try this out for free using the code “TOWG” – don't miss out! We loved having Kendall on so get used to seeing her here on the “Turn's Out We're Gay” Podcast!

Have you jumped on the barefoot shoe trend yet? For those who have and for those who haven't, there are some important things you need to know about the world of modern day shoes vs. going barefoot and both's impact on our health. From ancient civilizations to modern-day trends - the shoes we put on our feet are drastically different.  That's why in this bonus episode of the Darin Olien show, I'll peel back the layers, exploring the science behind barefoot shoes, their potential benefits, and their effect on our overall well-being. We'll also dive into why foot health is more important than you think, the big issues with modern-day shoes, and the best solutions for going barefoot.  Don't forget… You can order now by heading to https://darinolien.com/fatal-conveniences-book or order now on Amazon.   Thank you to our sponsors: Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off   Find more from Darin: Website: https://darinolien.com/ Instagram: https://www.instagram.com/Darinolien/ Book: https://darinolien.com/fatal-conveniences-book/ Down to Earth: https://darinolien.com/down-to-earth/    Use code OLIEN20 for a Viome discount   Candiani Denim: https://www.candianidenim.com/    References:  Goel, S. (2024). The Shoes You Wear Everyday Are Destroying Your Feet — Read This To Restore Your Foot  Health. Retrieved from Medium. Gray, A. (2017). A strong base: the importance of foot health. Retrieved from The Pharmaceutical Journal Rodríguez-Sanz, D., Barbeito-Fernández, D., Losa-Iglesias, M. E., Saleta-Canosa, J. L., López-López, D., Tovaruela Carrión, N., & Becerro-de-Bengoa-Vallejo, R.. (2018). Foot health and quality of life among university students:  cross-sectional study. Sao Paulo Medical Journal, 136(2), 123–128.  Stolt, M., Suhonen, R., Puukka, P., Viitanen, M., Voutilainen, P., & Leino-Kilpi, H. (2012). Foot health and self-care  activities of older people in home care. Journal of Clinical Nursing, 21(21-22), 3082- 3095.  Tweney, D. (2000). Your Shoes Are Killing Your Feet. Retrieved from Wired    

This week on T.H.A.T.I'll be in conversation with Jamie Whitehouse, @jphysiologist who is Head of Partnerships for CP+R that operates out of the UK providing in-person and virtual Cardiac Rehab.  Jamie has an extensive background in Cardiac Rehab working in the field since 2013. Jamie manages the Clinical Nursing team, the assessment centre and leads their client onboarding process working directly with the Cardiologists, Surgeons and Cardiac Nurses on a daily basis helping patients who recently suffered a cardiac event or procedure.A typical day for Jamie involves speaking to patients 1:1 to help reassure them and explain what the treatment plan is and what to expect.CP+R on Instagram:   @cpandrWebsite: www.cpandr.co.ukJamie Whitehouse:  referrals@cpandr.co.uk#heartattack #cardiacrehab #heartattacksurvivor #gofromsurvivingtothriving #heartattackthriver #haveaplanworkyourplan #establishyournewnormal #itsoknotobeok #fearstressanxietyarereal #seekinghelp #cardiovasculardisease #cardiologistcare #knowthesigns #knowthesymptoms #knowyourfamilyhistory #numberonekillerofmenandwomen #nhs #theheartattackthriver #theheartattackthriverpodcastPodcast Disclaimer:The information and opinions presented in the Heart Attack Thriver Podcast is not intended as, and shall not be understood or construed as, medical advice. While the information provided on this Podcast relates to medical issues, and health and wellness, the information is not a substitute for medical advice from a Medical Professional who is aware of the facts and circumstances of your individual situation.Thank you for listening and please be sure to hit “SUBSCRIBE”, and “SHARE” this podcast with anyone that you feel could benefit from it.If you'd like to reach me for support or to leave a comment or feedback, please send an email to:: brian@thekindfulnesscoach.com

Steve Harper Interviews Dr Vivian C Wolf Wilets Clinical Nursing Educator -- VWOLFWILETS79@COMCAST.NET Listen to us live on mytuner-radio, onlineradiobox and streema.com (the simpleradio app) https://onlineradiobox.com/search?cs=us.pbnnetwork1&q=podcast%20business%20news%20network&c=us https://mytuner-radio.com/search/?q=business+news+network https://streema.com/radios/search/?q=podcast+business+news+network

Steve Harper Interviews Dr Vivian C Wolf Wilets Clinical Nursing Educator -- VWOLFWILETS79@COMCAST.NEThttps://onlineradiobox.com/search?cs=us.pbnnetwork1&q=podcast%20business%20news%20network&c=ushttps://mytuner-radio.com/search/?q=business+news+networkhttps://streema.com/radios/search/?q=podcast+business+news+network  Listen to us live on mytuner-radio, onlineradiobox and streema.com (the simpleradio app)https://onlineradiobox.com/search?cs=us.pbnnetwork1&q=podcast%20business%20news%20network&c=ushttps://mytuner-radio.com/search/?q=business+news+networkhttps://streema.com/radios/search/?q=podcast+business+news+network

https://www.nihr.ac.uk/people/endacott-ruth/27906 Bates S & Endacott R (2023) 'Building critical care nursing research capacity' Intensive and Critical Care Nursing 79, 103531-103531 , DOI Ede J, Clarete M, Taylor I, Taylor C, Kent B, Watkinson P & Endacott R (2023) 'Patient and public involvement and engagement (PPIE) in research: The Golden Thread' Nursing in Critical Care , DOI Endacott R & Blot S (2022) 'Fundamental drivers of nurses' experiences of ICU surging during the coronavirus disease 2019 (COVID-19) pandemic' Current Opinion in Critical Care 28, (6) 645-651 , DOI Hambridge K, Endacott R & Nichols A (2022) 'An audit of sharps injuries in clinical skills simulation wards at a UK university' British Journal of Healthcare Management 28, (9) 253-259 , DOI Open access Wong P, Gamble A, Jaspers R, Pope N & Endacott R (2022) 'Experiences of health care professionals in intensive care when families participate in clinician handovers: a qualitative systematic review protocol' JBI Evidence Synthesis 20, (8) 2048-2054 , DOI Elliott M & Endacott R (2022) 'The clinical neglect of vital signs' assessment: an emerging patient safety issue?' Contemporary Nurse 58, (4) 249-252 , DOI Endacott R, Pattison N, Dall'Ora C, Griffiths P, Richardson A & Pearce S (2022) 'The organisation of nurse staffing in intensive care units: A qualitative study' Journal of Nursing Management , DOI Open access Endacott R, Scholes J, Jones C, Boulanger C, Egerod I, Blot S, Iliopoulou K, Francois G & Latour J (2022) 'Development of competencies for advanced nursing practice in adult intensive care units across Europe: a modified e-Delphi study' Intensive and Critical Care Nursing , DOI Open access Fiori M, Coombs M, Endacott R, Cutello CA & Latour JM (2022) 'What the curtains do not shield: A phenomenological exploration of patient‐witnessed resuscitation in hospital. Part 2: Healthcare professionals' experiences' Journal of Advanced Nursing , DOI Open access Shepherd M, Endacott R & Quinn H (2022) 'Bridging the gap between research and clinical care: strategies to increase staff awareness and engagement in clinical research' Journal of Research in Nursing 27, (1-2) 168-181 , DOI Fiori M, Latour JM, Endacott R, Cutello CA & Coombs M (2022) 'What the curtains do not shield: A phenomenological exploration of patient‐witnessed resuscitation in hospital. Part 1: patients' experiences' Journal of Advanced Nursing , DOI Open access Madhuvu A, Endacott R, Plummer V & Morphet J (2022) 'Healthcare professional views on barriers to implementation of evidence-based practice in prevention of ventilator-associated events: A qualitative descriptive study' Intensive and Critical Care Nursing 68, 103133-103133 , DOI Ilangakoon C, Ajjawi R, Endacott R & Rees CE (2022) 'The relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education: An integrative review' Nurse Education in Practice 58, 103255-103255 , DOI Endacott R, Pearce S, Rae P, Richardson A, Bench S & Pattison N (2021) 'How COVID-19 has affected staffing models in intensive care: a qualitative study examining alternative staffing models (SEISMIC)' Journal of Advanced Nursing , DOI Open access Hambridge K, Endacott R & Nichols A (2021) 'Investigating the incidence and type of sharps injuries within the nursing student population in the UK' British Journal of Nursing 30, (17) 998-1006 , DOI Open access Coppola A, Black S & Endacott R (2021) 'How senior paramedics decide to cease resuscitation in pulseless electrical activity out of hospital cardiac arrest: a mixed methods study' Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 29, (1) , DOI Connell CJ, Cooper S & Endacott R (2021) 'Measuring the safety climate in an Australian emergency department' International Emergency Nursing 58, 101048-101048 , DOI Hambridge K, Endacott R & Nichols A (2021) 'The experience and psychological impact of a sharps injury on a nursing student population in the UK' British Journal of Nursing 30, (15) 910-918 , DOI Open access Rae P, Pearce S, Greaves J, Dall'Ora C, Griffiths P & Endacott R (2021) 'Outcomes sensitive to critical care nurse staffing levels: A systematic review' Intensive and Critical Care Nursing , DOI Open access Egerod I, Kaldan G, Nordentoft S, Larsen A, Herling SF, Thomsen T & Endacott R (2021) 'Skills, competencies, and policies for advanced practice critical care nursing in Europe: A scoping review' Nurse Education in Practice 54, 103142-103142 , DOI Madhuvu A, Endacott R, Plummer V & Morphet J (2021) 'Ventilation bundle compliance in two Australian intensive care units: An observational study' Australian Critical Care 34, (4) 327-332 , DOI Harris J, Tibby SM, Endacott R & Latour J (2021) 'Neurally adjusted ventilator assist (NAVA) in infants with acute respiratory failure: a literature scoping review' Pediatric Critical Care Medicine Publisher Site , DOI Open access Eustice S, James A, Endacott R & Kent B (2021) 'Identifying the health care–initiated and self-initiated interventions used by women for the management of rectal emptying difficulty secondary to obstructive defecation: a scoping review protocol' JBI Evidence Synthesis 19, (2) 491-498 , DOI Open access Ede J, Petrinic T, Westgate V, Darbyshire J, Endacott R & Watkinson PJ (2021) 'Human factors in escalating acute ward care: a qualitative evidence synthesis' BMJ Open Quality 10, (1) e001145-e001145 , DOI Coppola A, Smyth M, Black S, Johnston S & Endacott R (2021) 'The Regional Resuscitation Guidelines for Pulseless Electrical Activity in Emergency Medical Services in the United Kingdom: A Systematic Review' Australasian Journal of Paramedicine 18, 1-11 , DOI Hambridge K, Endacott R & Nichols A (2020) 'The financial cost of sharps injuries' British Journal of Healthcare Management 26, (11) 270-274 , DOI Open access Endacott R, Coombs M, Statton S & Endacott C (2020) 'Factors influencing family member perspectives on safety in the intensive care unit: a systematic review' International Journal for Quality in Health Care , DOI Open access Connell CJ, Endacott R & Cooper S (2020) 'The prevalence and management of deteriorating patients in an Australian emergency department' Australasian Emergency Care , DOI Open access Rance S, Westlake D, Brant H, Holme I, Endacott R, Pinkney J & Byng R (2020) 'Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person' Global Qualitative Nursing Research 7, 233339362093002-233339362093002 , DOI Open access Kidgell D, Hills D, Griffiths D & Endacott R (2020) 'Trade agreements and the risks for the nursing workforce, nursing practice and public health: A scoping review' International Journal of Nursing Studies 109, 103676-103676 , DOI Open access Nayna Schwerdtle P, Connell CJ, Lee S, Plummer V, Russo PL, Endacott R & Kuhn L (2020) 'Nurse Expertise: A Critical Resource in the COVID-19 Pandemic Response' Annals of Global Health 86, (1) , DOI Open access Connell CJ, Plummer V, Crawford K, Endacott R, Foley P, Griffiths DL, Innes K, Nayna Schwerdtle P, Walker LE & Morphet J (2020) 'Practice priorities for acute care nursing: A Delphi study' Journal of Clinical Nursing 29, (13-14) 2615-2625 , DOI Open access Madhuvu A, Endacott R, Plummer V & Morphet J (2020) 'Nurses' knowledge, experience and self-reported adherence to evidence-based guidelines for prevention of ventilator-associated events: A national online survey' Intensive and Critical Care Nursing 59, 102827-102827 , DOI Open access

In this episode, Riccardo Cosentino sits down with fellow Oxford alumni, Rachael Patel, to discuss integrated project delivery (IPD). With a background as a registered nurse, Rachael brings her unique expertise to her current role in the health sector specializing in strategic planning and execution of health services, research and infrastructure projects in North America. The pair discuss the impediments and challenges of adoption of the IPD model, specifically how it relates to private and public healthcare major infrastructure projects and the procurement process.“You add an integrated project delivery, where the idea is risk sharing and then you use that same methodology to calculate value for money, IPD will never win because IPDs base core base is sharing risk. It's two issues in our procurement, it's the idea of what value for money is and how we calculate money.”– Rachael Patel Key Takeaways: The origin of IPD and how its optimizing project design and construction Why value for money is problematic for IPDFinding a better way to allocate risk, relational over transactional  The policy associated in procurement and how it is hindering the marketplace shift to alternative models Links Mentioned: A critical perspective on Integrated Project Delivery (IPD) applied in a Norwegian public hospital projectBenefits and challenges to applying IPD: experiences from a Norwegian mega-project If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. The conversation doesn't stop here—connect and converse with our LinkedIn community: Navigating Major Programmes PodcastRiccardo CosentinoRachael Patel Transcript:Riccardo Cosentino  00:00If you're listening to Navigating Major Programmes, the podcast that aims to elevate the conversations happening in the infrastructure industry and inspire you to have a more efficient approach within it. I'm your host Riccardo Cosentino. I bring over 20 years of major programme management experience. Most recently, I graduated from Oxford Universities they business group, which shook my belief when it comes to navigating major problems. Now it's time to shake yours. Join me in each episode as a press the industry experts about the complexity of major program management, emerging digital trends and the critical leadership required to approach these multibillion dollar projects. Let's see where the conversation takes us.  Racheal Patel is an Associate Vice President and senior project manager at a global architecture and engineering firm. She's a registered nurse, and also the Master of Science in major program management from the University of Oxford, and a Master of nursing from the University of Toronto. Racheal is a skilled leader in the health sector specializing in strategic planning and execution of health services, research and infrastructure projects in Canada and the United States. Her expertise includes guiding organization for the initial strategic planning phase, through detailed planning and design to the implementation of transformative and innovative capital projects. Hello, everyone.  Welcome to another episode of navigating major programs. I'm here today with Richard Patel. I met Racheal at Oxford University when we were completing together our mastering major program management. And I asked Racheal today to join us on the podcast to discuss her dissertation, which is quite interesting and very relevant to the topics that we've been discussing on navigating major programs. How're you doing, Racheal? Racheal Patel  02:00I'm good Ricardo. And thanks for having me here. I'm excited to have a platform to talk about my dissertation and you providing that platform to talk about major programs. So thank you very much for having me.   Riccardo Cosentino  02:14It's my pleasure. So maybe since I've tucked up your dissertation a little bit, well, what was the topic of your dissertation?  Yeah, so my topic was actually looking at the challenges of adopting integrated project delivery in health infrastructure here specifically in Ontario. And I kind of was interested in this because here in Ontario, as you know, we've been in a transactional type of model for some time, and I wanted to see could we push the boundary and look at other project delivery models that would achieve the the goals of infrastructure for healthcare in a different manner? Interesting. And you talk about transactional contracting, and you talk about IPD, can you maybe explain for some of our listeners the difference or what was in the context of your, your research, what those terms mean? Racheal Patel  03:20So when we when I say transactional, it's more of a contractual obligation. So it's what we see today, like a p3, you know, alternative delivery model where you have a relationship based on some terms and conditions. Relational, it's a similar idea in that more, they're not similar, but it's a similar idea, in that it's a relationship based model where you're working together as a team, there's no one, you know, a buyer and a seller you are, I guess, in a way, a group or collaborative, all working towards the same goal and you have incentives and so forth, in a nutshell, that it's different. We in transactional, as you know, you have contractual requirements, you're obligated to meet certain things, whereas in relational, it's really about the relationships and the collaboration and the people and people organizations that come together to deliver. So it's, it's harder, sorry, relational is more softer compared to transactional in my non legal way of trying to explain. Riccardo Cosentino  04:41So another way of putting that is an is one that of an example that I use in the past is that transactional contracting or is more of a zero sum game where there is a party, a winning party in the losing party. We're in relational contracting. We're all on the same table, we all have one common goal, one common incentive. And all of the incentives are aligned providing a more collaborative environment.   Racheal Patel  05:11Yeah, yeah, that's probably more eloquent and articulate in the way I'm trying to explain it. That yeah, like, with relational, and specifically with IPD, you have everyone coming together with a common goal objective, and you're all measured on that same group of objectives or metrics metrics. And I would say transactional is a very much risk transfer moving risk to one party to hold that and your obligation to meet those risks, that transfer of that risk. But yes, I would say what you what you said is more eloquent than how I'm trying to explain it. Riccardo Cosentino  05:54No, yours is more is more detailed and more accurate by this very broad strokes. But maybe maybe for again, for our listeners, I know, in your research, you know, part of your literature review you you actually had a bit of a dive into IPD, which means integrated project delivery. And I actually cover some of that in my dissertation. So in a previous podcast, where I talked about IPD, Alliance and collaborative contracting, maybe just for those listeners that didn't listen to that podcast. Can you talk a little bit about the origin of IPD?  Yeah, no problem. So IPD, which is integrated project delivery is the definition. It's kind of vetted by the American Institute of Architects, or specifically the California Council that came up with this notion of IPD. Being that it's a project delivery model that integrates people, businesses, and legal structures into a process that drives collaboration, while it optimizes efficiencies in the design and the construction phases of a project. So what that really means is that your you know, you're kind of like a temporary project organization, or a temporary organization all set to one vision, a shared vision, purpose, and a goal. And you're all working together, in, in what we work in organizations to achieve that. And each part like, you know, you have a joint management decision making where you come together. It's not one party oversight on one, you have key party members within your organization that sit together make decisions, for the best project outcome, you agree on the targets and goals. So what what are we trying to like? What is our project mission values, but what are we trying to achieve with this, you bring everyone to the table. So it's early engagement of parties, like in our current models, or in some of the models, we're all used to, you know, you have owner, you know, their designers are the design team, and then they work together, then you bring in somebody else later in the game, whereas in this one, everyone's sitting at the table on day one, working together to achieve the vision. The other thing with integrated project delivery is that you're sharing the risks and rewards. So it's not self interest driven. It's more we work together, and we share the risk of the solutions we put together or the rewards of the solutions like we work together to do that. So it's a pain share gain kind of model, where if we all do it together, and we're successful, we profit in it together. If we made some bad judgments, we all suffer together in a nutshell. And then the other thing that's different than probably an alliance model, is that our life, reduce liability exposure. So there's no blame game, you know, you're waiving claim and liability between each other. I mean, I'm sure there are legal mechanisms that if it's willful, or negligent, like in that way, that it's purposeful, there's repercussions. But basically, what you're trying to do is create an environment that has trust or respect. And in order to do that, you don't have legal mechanisms that will point to someone and say, Well, you did this, now you're a blame because you all are all on the same page or sharing that reward or the risk or making the decisions.  Yeah, that's why I was That's why I was talking about a zero sum game, because I think what you described it, you know, I think the legal recourse creates a situation where there's going to be a winner and a loser in case things go wrong. I mean, at the end of the day, I mean, my my experience is that yeah, a contract. If a project goes well a contrast is on the shelves and nobody looks at it, but is when things start to go wrong, that you take out the contract. Look what the contract says and you pursue your legal remedies. I think what what you did ascribe to the IPD. And to a certain extent, even the Alliance model, or any relational contract allows for that. You know, if the project starts going badly, you don't reach for the contract to start appointing blame, but you actually have to sit at the table and come up with with a solution from the project team, rather than from the contract. Racheal Patel  10:25Yeah, like it's very much in this type of model. It's working together, you know, and in my experience, too, on the other types of contracts, if a project goes well, right, yeah, you're never gonna, you're never going to open it up and blame game. But I think, as the complexities of health infrastructure continues, and I'm talking health infrastructure, like continues to grow, I think we're more heading down the line. And I've seen it going down the line where that contract is open, and that blame game starts. Whereas an IP D, and what I like what I've seen in the industry, and those that have used it, you don't see those levels of escalation, or you don't hear about yourself as an escalation, because everyone that's in this delivery in this project are working together to achieve the same thing. So if, you know if blame is shared, everyone shares I mean, if blame is to be shared, everyone shares that blame. And so that that's the difference in this model, for sure.   Riccardo Cosentino  11:28Okay, so I think I think we've set the scene and we talked about IPD. So hopefully, people listening who are not familiar with a Marvel getting a sense. So like to take you back to your dissertation. And, you know, ask, I'd like to ask you, what were the key findings of your, of your, of your research. Racheal Patel  11:52So my, just to kind of give your listeners a little bit of context. So what I was trying to understand in this in this research is, what are the impediments or the challenges of adoption of this model? And so when I looked at, when I looked at, you know, how, how I would identify them, I interviewed individuals in Ontario, both in the public and the private end of health infrastructure, that are decision makers in the process and have been involved. And, you know, we looked at different categories. So is our market even ready to accept a model? Right? Like, are we are we in Ontario, even willing to say, hey, let's look at different project delivery models? You know, what's the impact of culture and environment? The legal ramifications, financial procurement, because we work through a different procurement body? And is there any impact of our regulatory authorities on how we go through it? And so I think, overarching, like one of the biggest findings, and the resounding is, the individuals that I interviewed, were all were like, We need a different model. So it was a resounding yes. The marketplace is saying we need to look at different ways to deliver these infrastructure projects. Because the complexities, the cost they're increasing. And the current models we have, while they deliver an amount saying that P3 are not good, but they do deliver. But for what we're delivering, it's not the best solution. And from a culture and environment, I think, you know, with integrated project delivery, it's about trust and collaboration. And our environment has a huge impact on trust, how we work together and so forth. So I think, I don't think are the culture we work in or in the environment. Everyone's like, it's going to be difficult to apply this model. And I think from a procurement perspective, one of the biggest, you know, ideas that came out was, you know, our procurement, the way we procure projects, that whole process, not necessarily, the broader procurement of the BPS has to change but we have to look at it in a different way to apply this type of model. I think those were some of the key big findings. Riccardo Cosentino  14:22Okay, so I think in your, your dissertation, you you talk about some of the challenges and some of the findings and I think procurement challenges is the one that I found quite interesting. And you talk about how the how the the process to secure funding for the developing new or new health infrastructure. creates challenges in adopting IPD. And also you look at the the value for money analysis used when procuring new infrastructure now that could be a barrier for the for the deployment of integrated project delivery. And so I'm very curious to draw upon your knowledge of what the MO Ministry of Health process is, and why is it detrimental? Racheal Patel  15:18So, I mean, it comes back to so the Ministry of Health process, if we look at, you know, how hospitals kind of work within our system, the hospitals are within, you know, the Ministry of Health. And it's not that they're regulated by the Ministry of Health, because each hospitals, independent corporations, they have their own board of directors, but they're tied to a lot of the operational funding the capital funding come through the Ministry of Health, so you have to work with them in order to get funding for whether it's a renovation or a new build. And so the capital, the health capital planning process, and I know they've changed it in in the last year, or they've added some different nomenclature of stages. But basically, it's separated into two different stages, in that you have your early planning, that talks about, you know, what is the infrastructure proposal how you're going to address it. And that then is requires approval to proceed further into the actual development of the health infrastructure structure project you want to actually implement. And so there's two different approval process within the government through the Treasury Board that your project has to go through. And then during that those approval processes, set dollar amount, whatever that is, whatever is established for that project, and that includes, you know, transaction fees. And so all the other fees that are held, that number is carried across the process. And that kind of is you're upset value or your total value of the project. But when you look at the process, the duration of this process is so long, and you know, healthcare projects can take 10, to, you know, 13 years to get through this process, where you actually go to a part where you go to RFP and start to bid and build, that there's such an evolution, the way we deliver healthcare, because it's rapidly changing with technology operations, and so forth, and different models of care, that what you first envisioned in your project, maybe you're one and where you ended up, when you're about to go to bed could change, but that number doesn't change. And so it's not agile enough to respond to the market. Riccardo Cosentino  17:36I guess another challenge is that when you know, because of the planning process, you develop a design and a solution. And you develop it to probably award 5% design completion. And so you lock in in certain certain things with your, with your master planning, you block schematic as you go through the approval process. And obviously, you wouldn't be able to have an IPD contractor on board, that early on to start that collaboration is that one of the findings, one of the challenges, Racheal Patel  18:11it is a challenge, but I think if you look at the way the US where IPDS is predominantly used for healthcare, you can have your business case written and your idea written, but then you know, when you get into blocks, or schematics, you engage that contractor into the process, right. And then together with the designer, the owner, the and the contractor in some of their sub trades, you start to build or design and plan for that future facility. So in the US, they do do that. Here in Ontario, we have a very process driven stream that contractors are not engaged and their value is not added until they get the bid documents. And so could the contractor come in earlier in the process? I believe it could. But that means you're procuring certain things earlier in order to have those conversations at the table. And they would have to be integrated into this. I don't see it being a barrier. I think it's a shift in mindset and how we approach it. And if this is the what we have to do with the ministry's process and Treasury board's approval for release of funding, then I think we have to look at, you know, when does a contract or when does the sub trades When did those key individuals get involved? Riccardo Cosentino  19:33Well, yeah, because what we have is a very linear process, you know, you have all these stages and you know, you can only is a Stage Gate approach. Well, I think without with IBD, you want a more fluid, more fluid approach that creates collaboration and interaction as early as possible because that's where that's where the value is created. And that's where optimization has appearance is it's at the early stages of the project. Racheal Patel  20:02Right. And it's also where the innovation happens, right? Like with the optimization, but it's innovation and maybe how we address mechanical I mean, you look at healthcare, mechanical, maybe 45, to, if not 50, but close to 50% of the value of our healthcare project is the engineering systems that run, not a name, excluding the equipment that you know, that it's put into the organization. But when you have such a heavy value of your costs sitting, like and you don't have those players that are going to build it at the table, it's a huge detriment, right. And we ended up having issues going down. And I think that's the benefit of this process of IPD. Everyone comes to the table early in design, so you can work out those solutions and the problems, say, you know, what's the best approach for, you know, air handling? What's the best approach for, you know, feature flexibility of data and so forth? I mean, I'm not an engineering to talk technical, but, you know, I've worked in situations where you have everyone at the table, and you can create something more efficient in its operation, but also in the price. Riccardo Cosentino  21:11Yes. Yeah. You know, enough to be dangerous. That's the mean. So, touched upon value for money. So let's, let's jump on to that. Because I think that's the other that, you know, and I worked for infrastructure, Ontario, and I know the value for money methodology. But, again, I think in your findings, you describe it beautifully. Why is problematic, so I won't steal your thunder. I leave, I leave you to explain why the VFM methodology is problematic. Racheal Patel  21:52Yeah, so So you, I get in trouble and not you. Alright. So I do believe that the value for money calculation that we use in Ontario is problematic, because the way we calculate value for money is that, and, again, I've listened and not at Infrastructure Ontario. So I can't say that with certainty. But my understanding of it is that when so let me take a step back when the idea of I think it's the idea of value for money first is problematic. When we think of value for money, we think of lowest price in Ontario. But when you look at what really value for money, it's the best, it's the best solution based on financial and non financial objectives. That's what value for money is value for money is not finding the cheapest bid. And I think, in Ontario, and I'm not just talking p3, but in Ontario, whether it's through supply chain procurement, so if we always look for this lowest price, because we believe that that is value for money, that itself is problematic for IPD. Because in IPD, its value for money is based on a number of other things, right? Value for money is on the team, it's on. It's not on a fixed price, it's how the team works together, right? Like, that's, you know, when you procure IPD, you're not procuring a fixed price, what you're procuring is the team that comes to the table that will work with you to develop the solution for what you're coming together for, you know, their qualifications, their experience, how they work together, their behaviors, that is what you're evaluating how you choose a team. It's not like, here's my lowest bid. And so I think that's one of the biggest challenges in Ontario is that we had this idea of low bid is the right solution. And then sorry, go   Riccardo Cosentino  21:52yeah, I was gonna I was gonna, you seem reluctant to come to the punch line. So I was gonna I was for you, in case you're too scared. Racheal Patel  24:00Scared, so but I just wanted to say, you know, like, so when you get to value for money calculation, and the way we do it is that it's about transferring the risk, right? So when you look at the value for money calculation, and how, you know, how one thing is, like one procurement model, p3 is better. It's because they're seeing the risk allocation, the transfers of the risk to the private sector is value for money for the public sector, because they're not burdened by that risk. And so that's kind of the premise. And I don't think that's correct, because you're measuring, you know, p3, the risk transference and against a traditional model where there isn't a risk transfer. So that's kind of the issue with the value for money calculation. Now you add an integrated project delivery, where the idea is risk sharing, and then you use that same methodology to calculate value for money IPD will never win because it's IPDs base core base is sharing risk. Because, you know, the definition is if you share a risk, you share solutions, right? Like you're working together to problem solve, as opposed to transferring that problem to somebody else doesn't get to the punch. Thank you. I'm not afraid to say it. But I just wanted to kind of, you know, I think it's two issues in our procurement, it's the idea of what value for money is and how we calculate money.   Riccardo Cosentino  25:26Okay, so I think I think that paints a pretty good picture of what what are the, in my mind, I mean, I'm your research talks about other challenges. And I think there's there's most the softer type challenges, which is, you know, resources, availability of resources, and culture and environment, which you talked at the beginning, but I'm a commercial person. So I always gravitate toward the heard liabilities and the heard numbers. So not that's not the sort of stuff but you know, the soft stuff is important. And yeah, I agree with you, I mean, value for money as to be and it to be to give credit to Infrastructure Ontario for for new projects. Now, on the civil side, they are starting to use more collaborative model, the studying to assess cognitive they do cognitive behavioral assessments for all the people that work on those project, because at the end of the day, there needs to be a culture of fit of everybody's at the table, because otherwise, you're not going to achieve the collaboration that you need. Racheal Patel  26:29100%. And, you know, I, I've spoken to people at Metrolinx, as well about the different ways they're trying to approach project delivery, civil projects are so complex, I would say probably even more so than a hospital delivery. You know, I think the hospital itself is a complex, but what Civil Works does, that's even more complex, but they're willing to try different models. And so if our partners here at Metrolinx, or other organizations are looking at different models, why can't we apply that? That's kind of also why I'm driving this idea. Like, let's look outside the box of what we've traditionally done here, Ontario. Riccardo Cosentino  27:06Yeah, I couldn't agree more. Okay. So jumping on, I wanted to maybe ask you more of a broader question, which, if you have actually had the chance to look at some case studies when you were doing your research, and if there's anything that that jumped out, you might you might have not actually looked at case study, because I know your literature literature review was a bit broader than that. But any, any anything that jumped out and key successes that jumped out,   Racheal Patel  27:34you know, IPD, in general, is permanently used in the US, but I think other countries are looking at it. So when I was doing this study, specifically, I was trying to find public hospitals or public systems that have applied integrated project delivery. The one organization I found was an I'm going to pronounce this wrong, because there is a lot over one of the letters, but it's in Norway, is the Songa project. And so the Norwegian government decided they've had enough with cost overruns, scheduled delays, adversarial relationships. And they actually implemented integrated project delivery in the redevelopment of hospitals, specifically one in this specific region and can't remember the name, but I can get you the reference or anybody that wants to know it after. And so they applied integrated project delivery, because they wanted more of a collaboration and a different approach to public infrastructure, it's probably the closest thing that you would see to a true definition of integrated project delivery, with the exception is that there is no multi party contract. So in integrated project delivery, all the individuals are under a multi party contracts, you all signed together. And so in this public project, that was the only key characteristics of a true IPD. That wasn't in there. But all of the risk sharing the reduced liability, not waiver of liability was there, you know, the the key concepts were there, with the exception of the multi party agreement. So that was probably the only one. There's still in the middle of the build stages. And if you do look it up. It's multi phase project. It's very complex redevelopment in this system. But they've just started issuing case studies or publishing case studies are starting to talk to the public or the global public about this specific example. And it's successful because they have delivered and they've achieved what they've wanted to they've had innovations through the process. But it's the first example of public system using integrated project delivery for health infrastructure. Riccardo Cosentino  29:43Interesting. Okay, I'll try. I'll try to get the details. We'll put in the shownotes. Search it up. Okay, so I guess, as maybe as a final question, probably quite a challenging question but are going to have Is there any way? What will be your recommendation to Ontario policymakers? entities like MOH, or Infrastructure Ontario? To what what would they have to do to embrace IPD for future projects? How can they navigate these challenges? Effectively?   does. I think, I think if I can paraphrase. I mean, there's a there's a need for a shift for a fundamental shift in the policy, because as you describe the fact that hospitals are risk averse, and they can't really absorb too much or cost overruns, or, you know, as lower risk. But that's a funding issue. Right? That's a policy issue there. I mean, at the end of the day, hospital are a creature of the Ministry of Health, right. So ultimately, the governance could allow could be put in place to allow a hospital to to have a different approach a different commercial approach. So it is it is within the gift of the policymaker and the politicians. Racheal Patel  33:45Yeah. And 100%. And I think, you know, when you're paraphrasing it better than I wrote it, I think, but I'm trying to put, you know, 60 pages into small answer. But if you look at you know, just even the allocation of how hospitals have funding for resources to do infrastructure. In the study, a lot of individuals brought up that thing that goes, there's not even enough money to do the current projects that we have with the lack of funding, you know, because they get a certain percentage of ancillary funding in order to pay their staff. But in this situation, when we do IPD, you're going to have a plethora of individuals and experts and stuff that have to sit in the hospital organization to do this. And a hospital isn't an infrastructure professional, right? They bring in the resources to do what they need to but they're they're there to deliver service and care to their community. And so they need to bring all these specialists in but if our if our ancillary costs are how until your cost is given and or funding is given to the hospitals to have the resources doesn't meet the need of these comp, this type of project delivery, you're never going to be able to add execute it. Right now, it supports more of the transactional. So yeah, to your point that also has to be done from a ministry level saying we need to look at how money is given the allocation of funding for these types. Riccardo Cosentino  35:15Okay, so I mean, if I gonna, I'm going to try to summarize I mean, I think my three takeaways is having the there needs to be a change in changing culture, and environment. In order to bring a different type of behaviors to the table, there needs to be a change in the way that risk is allocated, or better, we need to find a better way to share risk. We need to we will need to change some of the policies associated with procurement and project development. And if all this was to happen, then potentially we could have a rich IPD market in Ontario.  Yeah, I think you separated and I think maybe IPD, just in its and probably negate everything I just said about why I'm passionate about IPD. But I, I, I think this would be true for any relational type of contracting like Alliance, Alliance, as well as IPD. They have similarities as we talked about earlier. But what you've summarize are critical for our marketplace to allow for different models. And I think that's kind of the crux of the issue is that we have a marketplace that's set up for one specific type of delivery model. And if we need to look outside the box, we need to look at these issues. Okay, now, you said it better than me, well, Racheal Patel  36:44play off of you. Riccardo Cosentino  36:47Okay, I think I think that's all we have time for today. Thank you very much for joining me today. Racheal. This was a fascinating conversation about our own province, our own in our own country. So thank you for joining me and all the best for your future endeavors. Racheal Patel  37:02Thanks, Riccardo and thank you for the platform to talk about this right now. Riccardo Cosentino  37:08That's it for this episode on navigating major problems. I hope you found today's conversation as informative and thought provoking as I did. If you enjoyed this conversation, please consider subscribing and leaving a review. I would also like to personally invite you to continue the conversation by joining me on my personal LinkedIn at Riccardo Cosentino. Listening to the next episode, we will continue to explore the latest trends and challenges in major program management. Our next in depth conversation promises to continue to dive into topics such as leadership risk management, and the impact of emerging technology in infrastructure. It's a conversation you're not going to want to miss. Thanks for listening to Navigating Major Programmes and I look forward to keeping the conversation going  Music: "A New Tomorrow" by Chordial Music. Licensed through PremiumBeat.DISCLAIMER: The opinions, beliefs, and viewpoints expressed by the hosts and guests on this podcast do not necessarily represent or reflect the official policy, opinions, beliefs, and viewpoints of Disenyo.co LLC and its employees.

If you are looking for strategies for teaching clinical judgment, listen to this podcast with Dr. Laura Calcagni. She discusses an active learning strategy she developed for clinical teaching and shares the research findings on its outcomes. This strategy works.

Expand your horizons in nursing fields. Guests include Curry Bordelon, DNP, MBA, CRNP and Tedra Smith, DNP, CRNP, CPNP-PC, CNE, CHSEYoutube version available to watch here: https://www.youtube.com/watch?v=6kf-jSU-vNM

Michael Ackerman is currently the director of the Master in Healthcare Innovation Program and Professor of Clinical Nursing and the director of the Center for Healthcare Innovation and Leadership at the Ohio State University College of Nursing. He also maintains a clinical practice as an acute care nurse practitioner at St. Joseph's Neighborhood Hospital in Rochester, New York. Today, we talk about nursing, healthcare innovation, and opportunities for designers in the healthcare industry. Listen to learn about: The role of nurses in nursing/healthcare innovation The unique challenges of innovation in healthcare Improving the healthcare innovation cycle OSU's Center for Healthcare Innovation and Leadership Our Guest Michael Ackerman is currently the Director of the Master in Healthcare Innovation Program and Professor of Clinical Nursing, and the Director of the Center for Healthcare Innovation and Leadership at the Ohio State University College of Nursing. He also maintains a clinical practice as an acute care nurse practitioner at St Joseph's Neighborhood in Rochester, NY.  He is also the Owner of Ackerman Consultants. Dr. Ackerman has held just about every position a nurse could hold in academia and clinical practice from candy striper to senior director. His entire career has been dedicated to critical care with numerous publications as well as invitations to speak nationally and internationally. His research and writing has focused on a variety of clinical topics including sepsis, airway management, hemodynamics, innovation and leadership. His innovation work has led to many disruptions in clinical practice and health system change. He has been recognized for his various contributions with various fellowships including; Fellow in Critical Care Medicine, Fellow in the National Academy of Practice, and Fellow in American Academy of Nurse Practitioners. Dr. Ackerman completed his BSN from Niagara University, his MSN and DNS from The State University of New York at Buffalo, a post-masters certificate as an Acute Care Nurse Practitioner from the University of Rochester and is currently enrolled in a Design Thinking certificate program at Rochester Institute of Technology.   Show Highlights [01:18] Michael talks about his love of nursing, and starting his career in the ICU. [01:46] Finding his way into the healthcare innovation space. [03:27] What people, and especially designers, should understand about bedside nursing. [04:33] The three “P's” of nursing and design. [07:22] Co-creating with nurses via the Center for Healthcare. [09:52] Nurses are moving into the innovation space. [11:59] Michael's wishlist of things designers should do when working in the healthcare innovation space. [12:37] The healthcare industry is risk-averse. [14:46] A look at the different viewpoints of healthcare executives. [16:41] Michael talks about one project – a new feeding tube device. [19:07] The healthcare innovation cycle is often slow. [20:20} How the COVID-19 pandemic sped up the innovation cycle. [22:18] How designers and healthcare leadership can help improve the healthcare innovation cycle. [23:27] Democratizing innovation and inviting healthcare staff to the table. [26:00] Ohio State's innovation studios for healthcare and nursing. [27:42] Working with the architecture school on creating healthier work environments. [28:48] OSU's Masters in Healthcare Innovation program. [30:12] OSU's Center for Healthcare Innovation and Leadership. [32:42] The importance of creativity, and logic-brain versus creative-brain. [34:21] Designers need to help people find ways to turn off their logic-brain to allow their creative-brain to turn on. [35:43] Giving people permission to experiment and create. [38:37] The patient harm threshold for rapid healthcare innovation. [39:49] The need for innovation leadership roles in hospitals and healthcare. [43:01] All leaders would benefit from being familiar with design thinking and being able to lead teams using a design mindset and methods. [44:51] A culture of innovation and creativity starts at the top. [47:22] Hospitals and healthcare are complex adaptive systems. [49:59] Michael's and Dawan's advice for innovators.   Links Michael on LinkedIn Michael on Twitter Ackerman Consulting Michael on ResearchGate The Handoff: Nurse Burnout with Michael Ackerman Google Scholar list of articles where Michael is an author/co-author The #HCBIZ Show: The Novation Dynamic: 3 Pillars for Healthcare Innovation Success with Michael Ackerman SONSEIL   Other Design Thinking 101 Episodes You Might Like Healthcare Design Teams + Wellness + ScienceXDesign with Chris McCarthy — DT101 E24 Nursing + Service Design + Healthcare Innovation with Brittany Merkle — DT101 E38 Seeing, Reframing, and Pursuing Problems with Thomas Wedell-Wedellsborg — DT101 E86

Michael Ackerman is currently the director of the Master in Healthcare Innovation Program and Professor of Clinical Nursing and the director of the Center for Healthcare Innovation and Leadership at the Ohio State University College of Nursing. He also maintains a clinical practice as an acute care nurse practitioner at St. Joseph's Neighborhood Hospital in Rochester, New York. Today, we talk about nursing, healthcare innovation, and opportunities for designers in the healthcare industry. Listen to learn about: The role of nurses in nursing/healthcare innovation The unique challenges of innovation in healthcare Improving the healthcare innovation cycle OSU's Center for Healthcare Innovation and Leadership Our Guest Michael Ackerman is currently the Director of the Master in Healthcare Innovation Program and Professor of Clinical Nursing, and the Director of the Center for Healthcare Innovation and Leadership at the Ohio State University College of Nursing. He also maintains a clinical practice as an acute care nurse practitioner at St Joseph's Neighborhood in Rochester, NY.  He is also the Owner of Ackerman Consultants. Dr. Ackerman has held just about every position a nurse could hold in academia and clinical practice from candy striper to senior director. His entire career has been dedicated to critical care with numerous publications as well as invitations to speak nationally and internationally. His research and writing has focused on a variety of clinical topics including sepsis, airway management, hemodynamics, innovation and leadership. His innovation work has led to many disruptions in clinical practice and health system change. He has been recognized for his various contributions with various fellowships including; Fellow in Critical Care Medicine, Fellow in the National Academy of Practice, and Fellow in American Academy of Nurse Practitioners. Dr. Ackerman completed his BSN from Niagara University, his MSN and DNS from The State University of New York at Buffalo, a post-masters certificate as an Acute Care Nurse Practitioner from the University of Rochester and is currently enrolled in a Design Thinking certificate program at Rochester Institute of Technology.   Show Highlights [01:18] Michael talks about his love of nursing, and starting his career in the ICU. [01:46] Finding his way into the healthcare innovation space. [03:27] What people, and especially designers, should understand about bedside nursing. [04:33] The three “P's” of nursing and design. [07:22] Co-creating with nurses via the Center for Healthcare. [09:52] Nurses are moving into the innovation space. [11:59] Michael's wishlist of things designers should do when working in the healthcare innovation space. [12:37] The healthcare industry is risk-averse. [14:46] A look at the different viewpoints of healthcare executives. [16:41] Michael talks about one project – a new feeding tube device. [19:07] The healthcare innovation cycle is often slow. [20:20} How the COVID-19 pandemic sped up the innovation cycle. [22:18] How designers and healthcare leadership can help improve the healthcare innovation cycle. [23:27] Democratizing innovation and inviting healthcare staff to the table. [26:00] Ohio State's innovation studios for healthcare and nursing. [27:42] Working with the architecture school on creating healthier work environments. [28:48] OSU's Masters in Healthcare Innovation program. [30:12] OSU's Center for Healthcare Innovation and Leadership. [32:42] The importance of creativity, and logic-brain versus creative-brain. [34:21] Designers need to help people find ways to turn off their logic-brain to allow their creative-brain to turn on. [35:43] Giving people permission to experiment and create. [38:37] The patient harm threshold for rapid healthcare innovation. [39:49] The need for innovation leadership roles in hospitals and healthcare. [43:01] All leaders would benefit from being familiar with design thinking and being able to lead teams using a design mindset and methods. [44:51] A culture of innovation and creativity starts at the top. [47:22] Hospitals and healthcare are complex adaptive systems. [49:59] Michael's and Dawan's advice for innovators.   Links Michael on LinkedIn Michael on Twitter Ackerman Consulting Michael on ResearchGate The Handoff: Nurse Burnout with Michael Ackerman Google Scholar list of articles where Michael is an author/co-author The #HCBIZ Show: The Novation Dynamic: 3 Pillars for Healthcare Innovation Success with Michael Ackerman SONSEIL   Other Design Thinking 101 Episodes You Might Like Healthcare Design Teams + Wellness + ScienceXDesign with Chris McCarthy — DT101 E24 Nursing + Service Design + Healthcare Innovation with Brittany Merkle — DT101 E38 Seeing, Reframing, and Pursuing Problems with Thomas Wedell-Wedellsborg — DT101 E86

“Cultural competence is about being able to deliver care while respecting and valuing the differences people bring with them to the table. Did we consider their uniqueness? Have we done our best to care for them in a way that's individualized?” Erica Fischer-Cartlidge, DNP, RN, AOCNS®, EBP-CH, chief clinical officer at ONS, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about cultural considerations that can arise in cancer care and how oncology nurses can deliver culturally competent care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by January 20, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to delivering culturally competent care. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast episodes: Episode 235: Self-Advocacy Skills for Patients Episode 75: LGBTQ+ Patients Face Significant Barriers to Successful Cancer Care Episode 63: Why Your Words Matter to Patients With Cancer ONS Voice articles: Religious Fasting During Cancer Treatment Prevent Implicit Bias in Patient Care With These Cultural Conversation Starters Cultural Humility Is a Nursing Clinical Competency Cultivate Cultural Humility in Yourself and Your Practice Clinical Journal of Oncology Nursing articles: Addressing Cultural Competency: Lesbian, Gay, Bisexual, Transgender, and Queer Cancer Care Cultural Humility: Retraining and Retooling Nurses to Provide Equitable Cancer Care Providing Culturally Appropriate Care to American Muslims With Cancer Oncology Nursing Forum article: Cultural Competency in Nursing Research National Center on Disability and Journalism Disability Language Style Guide Journal of Clinical Nursing article: Nurse Bias and Nursing Care Disparities Related to Patient Characteristics: A Scoping Review of the Quantitative and Qualitative Evidence Lancet Oncology series: Disabilities and Cancer Video: Inequality in Cancer Care for People With a Disability To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Most specifically, cultural competence is about being able to deliver care while respecting and valuing the differences people bring with them to the table.” Timestamp (TS) 02:00 “We can never be fully culturally competent because people are always evolving and changing based on new experiences in their life. We should always be questioning and asking and seeking to learn, not just going to obtain a set information of knowledge and then applying that to all the people in that group.” TS 04:00 “Every situation is different, but it always starts with having an open dialogue with your patients. It's important to not make assumptions about their life or their behaviors. No one is ever expected to know everything, but taking the time to ask is the first step. I think then the next thing is to read about different groups so you're more aware of differences and know what types of questions to ask.” TS 06:08 “You have a patient who wants to fast for Yom Kippur but they're on chemotherapy. Do you automatically say no? If a patient is active in their church and requesting to have a prayer group hold their weekly meeting in his room while he's admitted but the visitor policy is only two people at a time, do you say no? The answer to these situations isn't always that we say yes and the rule changes, but it's more about reflecting on if we actively tried to meet their needs the best way we can. Did we consider their uniqueness? Have we done our best to care for them in a way that's individualized?” TS 10:37

Dr. Mary Tantillo is a Professor of Clinical Nursing at the University of Rochester School of Nursing and a Clinical Professor in the Department of Psychiatry at the University of Rochester School of Medicine and Dentistry. Dr. Tantillo is a fellow and previous board member of the Academy for Eating Disorders (AED). She served as chairperson for the AED Credentialing Task Force and as co-chairperson for the AED Patient/Carer Committee and was awarded the Meehan-Hartley Award for Public Service and Advocacy by the AED in 2010. Since 2005 Dr. Tantillo has been the Director of the Western New York Comprehensive Care Center for Eating Disorders (WNYCCCED), one of three NY State Office of Mental Health-funded CCCED's. As part of this work she and the WNYCCCED team initiated Project ECHO® Eating Disorders in January 2017 and School-Based Project  ECHO® Eating Disorders in 2018. Project ECHO® provides primary care, behavioral health care, and college health care practitioners, and school personnel with case-based telementoring and tele education related to best practices for early identification, assessment, prevention, and treatment of eating disorders. Additionally, in 2010 Dr. Tantillo founded The Healing Connection (THC), a free-standing, non-profit 501(c) 3 NY State Office of Mental Health-licensed Eating Disorders Facility for adults and adolescents. THC offers partial hospitalization, intensive outpatient treatment, and outpatient treatment. She is currently assisting THC with the foundation of a new adolescent eating disorders residential program scheduled to launch in Spring 2022. Over the past 10 years Dr. Tantillo partnered with patients and families to develop a new and innovative relationally and motivationally-informed multifamily therapy group approach to treating Anorexia Nervosa in young adults called “Reconnecting for Recovery.” Dr. Tantillo obtained grant-funding from the Hilda and Preston Davis Foundation to conduct a pilot study of this intervention and the results, along with a decade of research, clinical observation, theory, and patient and family lived experience, informed her recently published treatment manual, "Multifamily Therapy Group for Young Adults with Anorexia Nervosa: Reconnecting for Recovery."   We discuss topics including: How to empower and enfoster the young adult How to know when you are speaking to the young adult vs. the eating disorder voice Empower and foster autonomy Challenging “we” Differentiate from the family of origin   SHOW NOTES: www.thehealingconnectioninc.org www.nyeatingdisorders.org (book) Multifamily Therapy Group for Young Adults with Anorexia Nervosa   ____________________________________________ If you have any questions regarding the topics discussed on this podcast, please reach out to Robyn directly via email: rlgrd@askaboutfood.com You can also connect with Robyn on social media by following her on Facebook, Instagram, Twitter, and LinkedIn. If you enjoyed this podcast, please leave a review on iTunes and subscribe. Visit Robyn's private practice website where you can subscribe to her free monthly insight newsletter, and receive your FREE GUIDE “Maximizing Your Time with Those Struggling with an Eating Disorder”. Your Recovery Resource, Robyn's new online course for navigating your loved one's eating disorder, is available now! For more information on Robyn's book “The Eating Disorder Trap”, please visit the Official "The Eating Disorder Trap" Website. “The Eating Disorder Trap” is also available for purchase on Amazon.

If parenting was stressful before the pandemic, during the COVID-19 global crisis, ⅔ of parents experienced some level of burnout. The pandemic is not over and stress on parents is not going to magically go away and it is critical that we recognize and find ways to prevent burnout in parents.  Kate Gawlik, an Associate Professor of Clinical Nursing at The Ohio State University on how to recognize the signs of parental burnout and how to cope with it.  Parental burnout builds in stages, slowly. Phase one -overwhelming exhaustion. Next phase, burned-out parents tend to distance themselves from their kids to preserve their energy. And the third phase is loss of fulfillment.  You can take the self-assessment tool provided by Kate to learn more about yourself. Burnout runs on a continuum.  A report by The Ohio State University Office of the Chief Wellness Officer and College of Nursing found the stress was simply too much for many working parents to handle,  revealing that two-thirds of working parents experienced some level of burnout. The study found an association between burnout and depression, anxiety, alcohol consumption and The research, conducted in 2021 found stress on parents also had consequences for children, as parental burnout was associated with punitive behavior towards their kids – including screaming, criticizing and even physical harm – and increased acting out by their children. MENTIONED IN THIS EPSIODE Ep. 143: How to Be a Happier Parent with KJ De'll Antonia  Ep. 144: Mommy Burnout: How to Reclaim Your Life and Raise Healthier Kids Ep. 281: The Power of Self-Regulation with Sarah MacLaughlin  Ep. 289: Mind-Body Tools to Develop Stress Resilience with Rebekkah LaDyne  Ep. 270: Simple Tools to Feel Great with Rangan Chatterjee, MD SUPPORT THE SHOW, SHOW YOUR LOVE Become a patron on Patreon.com and join 18 exisiting memebers who contribute $92 towards our monthly goal of $500.  Make a one-time donation in any amount to say “Thank you!” Rate or write a review FULL SHOW NOTES www.authenticparenting.com/podcast HOW TO WORK WITH ANNA I would be thrilled to support you in your parenting journey! All listeners get 10% off on my services. Private Coaching Online courses and classes GET IN TOUCH Comments, questions, feedback, and love notes  USA listeners call 732-763-2576 and leave a voicemail. International listeners use the FREE Speak Pipe tool on my website Email: info@authenticparenting.com STAY CONNECTED Instagram Facebook Group-Authentic Parenting Community Thank you for listening!  With gratitude, Anna Seewald Parent Educator, Keynote Speaker, Author www.authenticparenting.com      

In this week's gestational age episode, we talk about late preterm babies…you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:·       Betamethasone for mom and how recommendations have changed·       Cold stress and bathing·       How to use your resources (like this podcast!)·       Why these babies are never a “sure thing” as far as their NICU stay is concerned.BibliographyBlackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmChamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#aboutGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004 Notes:ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It's here.Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

In this week's gestational age episode, we talk about late preterm babies…you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:·       Betamethasone for mom and how recommendations have changed·       Cold stress and bathing·       How to use your resources (like this podcast!)·       Why these babies are never a “sure thing” as far as their NICU stay is concerned.BibliographyBlackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmChamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#aboutGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004 Notes:ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It's here.Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

In this week's gestational age episode, we talk about late preterm babies…you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:·       Betamethasone for mom and how recommendations have changed·       Cold stress and bathing·       How to use your resources (like this podcast!)·       Why these babies are never a “sure thing” as far as their NICU stay is concerned.BibliographyBlackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmChamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#aboutGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004 Notes:ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It's here.Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

In this week's gestational age episode, we talk about late preterm babies…you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:·       Betamethasone for mom and how recommendations have changed·       Cold stress and bathing·       How to use your resources (like this podcast!)·       Why these babies are never a “sure thing” as far as their NICU stay is concerned.BibliographyBlackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmChamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#aboutGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004 Notes:ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It's here.Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

It's no secret that the healthcare industry is facing a crisis. For the past few weeks, we've been interviewing professionals on the burnout that is present for nurses globally. In this episode, we had Dr. Jacqueline Hoying. Dr. Hoying is an Assistant Professor of Clinical Nursing and serves as the Director of the MINDSTRONG/MINDBODYSTRONG program and Community Core at the Helene Fuld Health Trust National Institute at The Ohio State University.  In today's episode, Dr. Hoying gives us insight into the MINDSTRONG/MINDBODYSTRONG program and how it helps to foster stress reduction among clinicians. She gives details into how the program can support nurses facing burnout and improve clinicians' overall mental health, behaviors and job satisfaction. She also shares impactful wisdom on cultivating self-compassion, prioritizing self-care and treating yourself the same way you would treat a dear friend and loved one. What's in this episode: How Dr. Hoying got to this place in her career What evidence-based practice is What the MINDSTRONG/MINDBODYSTRONG program is How you can implement the MINDSTRONG/MINDBODYSTRONG program into your facility or organization How the program helps support you in nursing What nurse burnout is and how their program can support those in burnout Her advice on self-care and supporting yourself How to get programs like MINDSTRONG/MINDBODYSTRONG in hospitals How Dr. Hoying achieves personal wellness   For more resources, head to www.wellnesswarriors.healthcare. If you are an RN, you can receive Nursing Professional Development (NCPD) credits by going to www.wellnesswarriors.healthcare and click “Receive NCPD credit”. The Mentor-Facilitated Training Award Dissemination Project was funded by NIDA CTN DI in partnership with the National Institute on Drug Abuse and the American Association of Colleges of Nursing (AACN).

A health care visionary and CEO of a recruiting healthcare company, Praveen Ponnuru has a Bachelor's Degree in Nursing, with certifications in Nursing Administration, Nursing Research, and Clinical Nursing. He is a visionary and change leader who has served several healthcare companies providing innovative solutions in HR. He has been working closely with the Ontario government to bring positive change to the healthcare industry. One of his most exciting goals is to facilitate the training and credentialing of global immigrant health care professionals to solve the challenging shortage the American and Canadian markets face. If you are a healthcare professional considering moving abroad, you need to listen to his interview! #internationaljobs #recruiting #relocation #immigrants #expats #healthcare #jobs #jobsearchtips  

In this episode, Martin Kiernan talks to Prof Heather Loveday, Director of the Richard Wells Research Centre at the University of West London about an lecture recently given at the 2021 IPS Conference. The topic discussed centres on the role that fundamental care has in the prevention of healthcare-associated infections and the impact of 'missed' care. Papers for futher reading on these topics are listed below. Journal of Clinical Nursing special issue on fundamental care: https://onlinelibrary.wiley.com/toc/13652702/2018/27/11-12 Richards, DA, Hilli, A, Pentecost, C, Goodwin, VA, Frost, J. Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene. J Clin Nurs. 2018; 27: 2179– 2188. https://doi.org/10.1111/jocn.14150   Vollman KM. Interventional patient hygiene: discussion of the issues and a proposed model for implementation of the nursing care basics. Intensive Crit Care Nurs. 2013 Oct;29(5):250-5. doi: 10.1016/j.iccn.2013.04.004. Epub 2013 Jun 6. PMID: 23746440. https://www.sciencedirect.com/science/article/abs/pii/S0964339713000414?via%3Dihub   Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety Maryanne McGuckin, Dr. ScEd, MT(ASCP), Arlene Shubin, Marianne Hujcs, RN, MSN DOI:https://doi.org/10.1016/j.ajic.2007.01.010   Recio-Saucedo A, Dall'Ora C, Maruotti A, Ball J, Briggs J, Meredith P, Redfern OC, Kovacs C, Prytherch D, Smith GB, Griffiths P. What impact does nursing care left undone have on patient outcomes? Review of the literature. J Clin Nurs. 2018 Jun;27(11-12):2248-2259. doi: 10.1111/jocn.14058. Epub 2017 Oct 16. PMID: 28859254; PMCID: PMC6001747. https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.14058

In this episode, Martin Kiernan talks to Prof Heather Loveday, Director of the Richard Wells Research Centre at the University of West London about an lecture recently given at the 2021 IPS Conference. The topic discussed centres on the role that fundamental care has in the prevention of healthcare-associated infections and the impact of 'missed' care. Papers for futher reading on these topics are listed below. Journal of Clinical Nursing special issue on fundamental care: https://onlinelibrary.wiley.com/toc/13652702/2018/27/11-12 Richards, DA, Hilli, A, Pentecost, C, Goodwin, VA, Frost, J. Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene. J Clin Nurs. 2018; 27: 2179– 2188. https://doi.org/10.1111/jocn.14150   Vollman KM. Interventional patient hygiene: discussion of the issues and a proposed model for implementation of the nursing care basics. Intensive Crit Care Nurs. 2013 Oct;29(5):250-5. doi: 10.1016/j.iccn.2013.04.004. Epub 2013 Jun 6. PMID: 23746440. https://www.sciencedirect.com/science/article/abs/pii/S0964339713000414?via%3Dihub   Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety Maryanne McGuckin, Dr. ScEd, MT(ASCP), Arlene Shubin, Marianne Hujcs, RN, MSN DOI:https://doi.org/10.1016/j.ajic.2007.01.010   Recio-Saucedo A, Dall'Ora C, Maruotti A, Ball J, Briggs J, Meredith P, Redfern OC, Kovacs C, Prytherch D, Smith GB, Griffiths P. What impact does nursing care left undone have on patient outcomes? Review of the literature. J Clin Nurs. 2018 Jun;27(11-12):2248-2259. doi: 10.1111/jocn.14058. Epub 2017 Oct 16. PMID: 28859254; PMCID: PMC6001747. https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.14058

Summary by author Charlotte: I believe that most of the female audiences of this podcast would remember when we hide ourselves in a narrow space to change our pads or tampons, to flush the evidence of menstruation away carefully and secretly like we are concealing some evidence of a crime. It is true that menstruation has always played a negative role in human history. Putting on a dialectical and contrastive lens, we are going to find what is menstruation in Chinese and American culture, which represent both Eastern and Western civilizations and what is people's attitude towards it in these two countries from two ends of the globe. Works Cited Coutinho, Elsimar M., and Sheldon J. Segal. Is menstruation obsolete?. Oxford University Press, 1999. Wong, Wing Chi, et al. "A cross‐sectional study of the beliefs and attitudes towards menstruation of C hinese undergraduate males and females in H ong K ong." Journal of Clinical Nursing 22.23-24 (2013): 3320-3327. Liu, H-L., K-H. Chen, and N-H. Peng. "Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan—Qualitative investigation." Journal of pediatric and adolescent gynecology 25.1 (2012): 43-47. Johnston-Robledo, Ingrid, and Margaret L. Stubbs. "Positioning periods: Menstruation in social context: An introduction to a special issue." (2013): 1-8. Merskin, Debra. "Adolescence, advertising, and the ideology of menstruation." Sex Roles 40.11 (1999): 941-957. Mandziuk, Roseann M. "" Ending Women's Greatest Hygienic Mistake": Modernity and the Mortification of Menstruation in Kotex Advertising, 1921—1926." Women's Studies Quarterly38.3/4 (2010): 42-62.

Please reach out if you ever feel overwhelmed and in need of support by emailing me directly at info@stephaniedekker.orgAll additional contact information can be found at www.stephaniedekker.org or Instagram @stephaniedekker.counsellingThe content of this podcast is for information and entertainment purposes only. If you feel triggered by any information shared, please reach out to a health care professional. ReferencesBrooks, J. & Jackson, D. (2020). Older people and COVID-19: Isolation, risk and ageism. Journal of Clinical Nursing, 29(13-14), 2044-2046.Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., and Greenberg, N. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet, 395, 912–920. doi: 10.1016/S0140-6736(20)30460-8Bzdok, D., and Dunbar, R. I. M. (2020). The neurobiology of social distance. Trends in Cognitive Science. doi: 10.1016/j.tics.2020.05.016Denham, J. (2020, May 2). For introverts, lockdown is a chance to play to our strengths. The Guardian, Retrieved from https://www.theguardian.com/lifeandstyle/2020/may/02/for-introverts-lockdown-is-a-chance-to-play-to-our-strengthsMatia, T., Dominski, F. H. & Marks, D. F. (2020). Human needs in COVID-19 isolation. Journal of Health Psychology, 25(7), 871-882.Novotney, A. (2019). The risks of social isolation. Monitor on Psychology, 50(5), 32.Pancani, L., Marinucci, M., Aureli, N., & Riva, P. (2020, April 5). Forced social isolation and mental health: A study on 1006 Italians under COVID-19 lockdown. https://doi.org/10.31234/osf.io/uacfjPietrabissa, G. & Simpson, S. G. (2020) Psychological Consequences of Social Isolation During COVID-19 Outbreak. Frontiers in Psychology, 11, 2201. Provenzi, L. & Tronick, E. (2020). The power of disconnection during the COVID-19 emergency: From isolation to reparation, Psychological Trauma: Theory, Research, Practice, and Policy, 12(1), S252-S254. Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., et al. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry, 7, 611–627. doi: 10.1016/S2215-0366(20)30203-0Saltzman, L. Y., Hansel, T. C., & Bordnick, P. S. (2020). Loneliness, isolation, and social support factors in psot-COVID-19 mental health, Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), 55-57. Sandford, A (2020) Coronavirus: Half of humanity now on lockdown as 90 countries call for confinement. Available at: https: //www.euronews.com/2020/04/02/coronavirus-in-europe-spain-s-death-toll-hits-10-000-after-record-950-new-deaths-in-24-hou

Professor Calvin Moorley RN, PhD is a Professor in Nursing Research and Diversity in Care, Adult Nursing Department at London South Bank University, with a background in public health and diversity in care. His research focuses on the interplay of gender, culture ethnicity and health. Since graduating from the University of Essex as an adult registered nurse, Calvin has followed a clinical/academic career, remaining close to clinical nursing, particularly in the critical care environment, and currently works one shift a week in an inner-city hospital in central London. He supports clinical nursing at the point-of-care through his role as a link lecturer for Barts Health NHS Trust. Calvin has a keen interest in how health is theorized using social media platforms. He has published widely in nursing and social media and is developing an area on the use of social media to enhance research literacy of nurses. His most recent works include Knowledge, attitude and beliefs on sex among Black Africans; Psychosexual Experiences of FGM survivors and Experience of Stroke among Caribbean populations in the UK. Calvin is well recognised in the field and this can be seen in his esteem factors which include: Guest Editor for a special issue of Journal of Clinical Nursing on LGBTI Health 2017; the Mary Seacole Prize for Leadership in Nursing 2013/14 by the Royal College of Nursing, and various editorships including Evidence Based Nursing Journal and Journal of Transcultural Nursing. Calvin collaborates nationally and internationally including working with teams in Trinidad, Jamaica and Australia. He publishes widely in various nursing journals, and has a current H-index of 6 (Google Scholar 2019). Calvin further serves the nursing community on various panels such as the Nursing Times Student Nurses awards; Edith Cavell Awards and Health Service Journal awards. A key objective of Calvin's programme of work is to reduce the gap in health inequalities through developing and improving cultural competence and health literacy. Support this podcast

Welcome back to another episode of The ACN Podcast with Ben Jenkins MACN. Today I speak with Professor Debra Jackson AO FACN.  For the last 6.5 years, Professor Jackson has been the Editor in Chief of the prestigious, Journal of Clinical Nursing. Professor Jackson currently works at the University of Technology Sydney (UTS); and is a Visiting Professor, and Adjunct Professor at multiple universities throughout Australia, New Zealand and the United Kingdom.  Professor Jackson has a wealth of clinical, research and leadership experience. In today's episode, we talk about Professor Jackson's journey into nursing; her career pathway; her motivation for entering research; time management; and Professor Jackson share's some tips for maximising your chance of getting your research published.  Social Media: LinkedIn - https://www.linkedin.com/in/debra-jackson-ao-2b017156/ Twitter: https://twitter.com/debraejackson

On this episode of The Handoff, Dan speaks with Mike Ackerman, the Director of the Master in Healthcare Innovation Program and a Professor of Clinical Nursing at The Ohio State University. One of Mike's passions is promoting mental health and wellness among nurses, and they discussed a variety of different topics related to nurse burnout. Mike shared what Ohio State is doing to help its nursing students maintain their mental health, and how they integrate the concept of “live well” into their courses. He highlighted the role that the EMR has had in clinician burnout and his thoughts on the bill that's working its way through the Ohio state legislature to end mandatory overtime for nurses. Mike also discussed why he doesn't like the word “burnout,” how the healthcare industry needs to look more at systems than individuals when seeking to find solutions, and how he thinks the current COVID-19 crisis will impact nurses.

On this episode of The Handoff, Dan speaks with Mike Ackerman, the Director of the Master in Healthcare Innovation Program and a Professor of Clinical Nursing at The Ohio State University. One of Mike's passions is promoting mental health and wellness among nurses, and they discussed a variety of different topics related to nurse burnout. Mike shared what Ohio State is doing to help its nursing students maintain their mental health, and how they integrate the concept of “live well” into their courses. He highlighted the role that the EMR has had in clinician burnout and his thoughts on the bill that's working its way through the Ohio state legislature to end mandatory overtime for nurses. Mike also discussed why he doesn't like the word “burnout,” how the healthcare industry needs to look more at systems than individuals when seeking to find solutions, and how he thinks the current COVID-19 crisis will impact nurses.

# Episode Notes

Sepsis is not an infection. Rather, it's your body's overwhelming reaction to an infection and can lead to some serious health issues. In fact, sepsis is the #1 cause of death for patients in hospitals. Sepsis definitions and protocols have been around for some time, but have been undergoing major changes. Additionally, sepsis is under scrutiny from CMS at the federal level and is subject to public reporting in many states. All of this, plus the importance of quickly diagnosing and treating the condition puts clinicians in a difficult spot. Many times they'll find themselves treating to the protocol, even when their clinical instincts suggest something else. In that regard, sepsis proves to be a very instructive topic in our never-ending quest to unravel the business of healthcare. On this episode, we'll talk with Michael Ackerman who's Director of the Master in Healthcare Innovation Program and Professor of Clinical Nursing at The Ohio State University. Michael is an expert on the topic who speaks on it across the country. He'll help us understand what we're up against and why it's so complicated from both a clinical and administrative standpoint. We discuss: What is sepsis? How is sepsis diagnosed? Why it's so important to diagnose and treat quickly. Why protocols and definitions continue to change. How new definitions of sepsis seem to be at odds with public reporting. How this impacts the clinicians and their ability to treat. How public reporting and media impact the approach. How proper identification and treatment impact healthcare costs. Why we need to focus on quality, but can't ignore the patient experience, the costs of care or the value that you bring to that care. What it all means to the patient and how we can protect ourselves. Why hospital administrators need to take the long-view. How a Sepsis-team can drive tremendous value to the hospital. The importance of incorporating new technology.   This episode originally aired on The #HCBiz Show! on May 3rd, 2017.   For more details visit DeepDive.tips

Interested in transitioning into a non-clinical nursing career?  Renee, RN compares clinical nursing vs non clinical nursing.  She also provides advice on how to make the switch.

In this episode, Devin chats with Rachael Harding, a Registered Nurse, about her journey from a new grad to living out her dream job.