Hernandez, Maria de los Angeles Ortega

In 2018, 50 million people were living with dementia worldwide, and this number is expected to increase to 82 million by 2030 (Novotny et al., 2018).
The aim of this quality improvement project was to assess Certified Nursing Assistants’ (CNAs) dementia knowledge, self-efficacy in establishing caring relationships, and attitudes toward people living with dementia. In addition to sociodemographic data, measures used to guide development of the education intervention included questions from three measures; the Dementia Knowledge Assessment Scale (DKAS), Dementia Attitudes Scale (DAS), and Caring Efficacy Scale (CES).
The results of the project demonstrated a need for further education of CNAs regarding health promotion strategies to reduce the risk of developing dementia and strategies for those already experiencing dementia. There was also an identified need for education regarding best techniques for communicating with people experiencing dementia, and ways in which those experiencing dementia communicate with those in their environment, including manifested behaviors. These survey results are intended to be used to build a web-based asynchronized and on-demand course to meet these educational gaps. and further improve the understanding and care of those experiencing dementia within the workplace of the CNA.

Dementia, Alzheimer’s disease, and other neurocognitive disorders causing memory loss in the older adult population has substantial implications on one’s physical, mental, social, and economic well-being. This quality improvement project aimed to evaluate the perceptions of current resources in place and what educational needs exist for police officers when providing care to older adults with dementia. The project intervention included an evidence-based online survey intended to assess police officers’ sociodemographic information, previous exposure to dementia training, participants’ baseline dementia knowledge, general caring beliefs, and attitudes toward individuals with dementia. Most (97%; n = 28 of 29) respondents completed the surveys. Over half (64%) of respondents admitted to never receiving specialized training for dementia and 61% of respondents admitted to knowing someone in a professional setting with dementia. The overall average score of the Dementia Knowledge Assessment Scale (DKAS) questions was 76%, but there were 5 total questions that were answered correctly by less than 60% of respondents. The lowest scoring domains of questions from the DKAS included the “Communication and Behavior” domain and the “Risks and Health Promotion” domain. The data was interpreted and recommendations were made to inform the development of a 20-hour continuing education certificate course for first responders entitled, “Compassionate Care of Older Adults at Risk for Dementia.” The project results demonstrated the lack of formal training in dementia among police officers and emphasized areas of strength and areas of opportunity to learn more about caring for those with dementia. This project holds future application for learning about dementia among other first responder disciplines, such as firefighters or paramedics, including the administration of a post survey following the pilot program of the first responder continuing education certificate course.

Open-heart surgery is one of the most frequently performed surgeries in the United Sates. Despite advances in techniques, there is still a significant number of complications leading to readmission. As of 2021, the national pooled 30-day readmission rate was 12.9% (95% CI: 11.3-14.4%). Various studies report rates of 30-day readmission from 8% to 21%, thus making open-heart surgery a target to achieve value-oriented health care milestones by policymakers. A program evaluation was conducted via chart review to compare the rate of readmission of a local cardiothoracic program to the national average. The program focuses on early follow-up post discharge and direct communication and access to the team (surgeon and advanced practice providers). A total of 98 patient charts were reviewed and the rate of readmission was calculated to be 6.1%. There was also a 3.1% rate of emergency room visit without readmission noted. Due to the significant different between these percentages, it is recommended that the team shares their processes to develop a clear protocol for other teams in the area to adopt into their practice.

Low health literacy can lead to a lack of disease perception or understanding of one’s disease process, treatment plan, and state of health, which could potentially lead to nonadherence, further health disparities, and poor health outcomes (Hugtenburg et al., 2013). The purpose of this project was to evaluate whether an online platform that provides Hispanic patients with evidence based and culturally sensitive diabetic education and support in the form of a video, would improve adherence and health outcomes. Upon the completion of the 3-month program that consisted of bi-weekly check-ins, results showed that there were overall improvements in the participants’ fasting blood glucose, systolic and diastolic blood pressure, body mass index, Diabetes Self-Management Questionnaire (DSMQ) scores, and A1C.