The influence of experience and credential status on perceptions of agency competency in delivery of the 10 essential environmental public health services.

Contributions made by the environmental health (EH) workforce in reducing human disease are some of the most significant to public health. A shrinking workforce and increased work complexity have called for workforce training in the 10 essential public health services. The preliminary study discussed here assesses perceived competency of the Kansas EH workforce in the 10 essential public health services and evaluates credentialing influence on perceptions.

Conspicuous vs customary location of hand hygiene agent dispensers on alcohol-based hand hygiene product usage in an intensive care unit.

Context: Hand washing is considered the single most important nosocomial infection-control strategy, yet compliance rarely meets levels recommended by infection control authorities.

Objectives: To determine whether placement of hand hygiene foam dispensers in more conspicuous positions and closer proximity to patients would increase use of infection control agents as measured by volume of product used. Further, to ascertain the influence of dispenser placement vs the number of dispensers available on usage by volume.

Effects of therapeutic massage on the quality of life among patients with breast cancer during treatment.

Objective: Therapeutic massage has demonstrated positive physical and emotional benefits to offset the effects of treatments associated with breast cancer. The goal of this study was to assess the impact of therapeutic massage on the quality of life of patients undergoing treatment for breast cancer.

Design: Using a pre/post intervention assessment design, this prospective, convenience sample pilot study measured anxiety, pain, nausea, sleep quality, and quality of life.

An assessment of a pilot asthma education program for childcare workers in a high-prevalence county.

Objective: To assess changes in knowledge, attitudes, and intentions among childcare workers before and after an asthma-management-education session.

Methods: Between May and August 2004 five asthma-education sessions were provided for childcare workers from Sonoma County, California. A total of 71 childcare workers came to the sessions.

Knowing who your partners are: terrorism-preparedness training for nurses.

Continuing education events addressing terrorism preparedness must be evaluated to measure their impact on knowledge acquisition and to assess changes in perceptions, attitudes, and beliefs. The purpose of this focus group study was to evaluate the effectiveness of a terrorism-preparedness training program. The majority of participants thought the training content was extensive, detailed, informative, and practical.

Outcomes of tube thoracostomies performed by advanced practice providers vs trauma surgeons.

Background: The role of advanced registered nurse practitioners and physician assistants in emergency departments, trauma centers, and critical care is becoming more widely accepted. These personnel, collectively known as advanced practice providers, expand physicians' capabilities and are being increasingly recruited to provide care and perform invasive procedures that were previously performed exclusively by physicians.

Objectives: To determine whether the quality of tube thoracostomies performed by advanced practice providers is comparable to that performed by trauma surgeons and to ascertain whether the complication rates attributable to tube thoracostomies differ on the basis of who performed the procedure.

Evaluating program effectiveness: creating a reliable and valid tool.

This study was done to assess the reliability of a pretest/ posttest design for a mass-casualty burn disaster continuing education (CE) program. Based on program objectives, an instrument to assess knowledge, skills, confidence, and competence in burn assessment and management was designed. The instrument's internal consistency, split-half reliability, and individual items were analyzed.

Preparing for burn disasters: predictors of improved perceptions of competency after mass burn care training.

Introduction: Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants' work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills.

Impact of a collaborative community case management program on a low-income uninsured population in Sedgwick County, KS.

This cross-sectional study assessed the impact of a collaborative nursing/social worker case management (CM) intervention on emergency department (ED) use, health status, and health locus of control (HLOC) in a low-income uninsured population. Using a pre-post intervention design, key outcomes were assessed using paired t test. A statistically significant (48%) reduction in total ED visits resulted in an estimated charge avoidance of US$1,446,280.

Regionalization: collateral benefits of emergency preparedness activities.

Introduction: To assess the impact of regionalization of Kansas counties associated with emergency preparedness since 2002 via local health departments (LHDs).

Methods: Three focus groups were conducted in May 2005 with 31 Kansas health department employees. Most participants were public health administrators, women, and 40 years or older.

Evaluation of interdisciplinary terrorism preparedness programs: a pilot focus group study.

Many terrorism preparedness trainings occur throughout the United States, yet few qualitatively examine trainees' needs and interests, reactions to training, or suggestions for training improvement. Eleven posttraining focus groups were conducted with 31 training participants at six sites. Participants were stratified by health profession discipline, and discipline-specific moderators conducted each session to better understand and probe for feedback.

Preparing for burn disasters: evaluation of a continuing education training course for pre-hospital and hospital professionals in Kansas.

"Preparing for Burn Disasters: A Training Course for Pre-Hospital and Hospital Professionals in Kansas," a continuing education program designed to provide licensed health care practitioners a training opportunity for multiple burn victim incidents, emphasized the challenges that the community-wide multidisciplinary team faces when responding to burn disasters. A pre-post survey design was used to assess changes in participants' knowledge and self-rated ability, confidence, and competence to perform in a burn disaster before and after training. Participants (N = 383) were predominantly female (71.

Influence of semi-recumbent position on intra-abdominal pressure as measured by bladder pressure.

Background: Intra-abdominal pressure (IAP) obtained by bladder pressure measurement is used to detect impending abdominal compartment syndrome (ACS), but, while it is recommended to use a supine position, the literature describes IAP measurement in varying positions. This study evaluated the impact of body position at differing head-of-bed (HOB) elevations on bladder pressure when planned to be used as a surrogate IAP measurement.

Materials And Methods: Forty-five trauma patients admitted to a surgical intensive care unit underwent bladder pressure measurements at 0, 15, 30, 45 degrees HOB position and 30 degrees HOB position plus 15 degrees of reverse Trendelenburg tilt; these measurements were performed in counterbalanced fashion and assessed by built-in angle indicators on the bed rails of each bed.

Help on the line: telephone-triage use, outcomes, and satisfaction within an uninsured population.

Telephone triage programs have been shown to be cost-effective and favorably utilized by insured populations. However, there are 45 million Americans who are uninsured and who do not have access to telephone nursing. A telephone triage service was piloted for local uninsured residents.

Quantitative evaluation of "Can It Happen in Kansas: Response to Terrorism and Emerging Infections".

Purpose: This study describes the evaluation of a 2-year plan to train 10 percent of Kansas' multidisciplinary health professionals for response to terrorism and emerging infections. This project was part of a national effort covering 19 states funded by the Health Resources and Services Administration in 2003.

Methods: The initial training occurred in six 2-day workshops.

Community case management: a strategy to improve access to medical care in uninsured populations.

Case management is a rapidly growing strategy to help vulnerable populations access the health care they need in a fragmented U.S. service delivery system.

Stigma and safe havens: a medical sociological perspective on African-American female epilepsy patients.

Purpose: Very little is known about the attitudes and behaviors of minorities with epilepsy. This pilot study explored access to health care, help-seeking behaviors, and adherence to treatment among African-American females with epilepsy.

Methods: Ethnographic interviews were conducted with 10 African-American female adults.

Strategies for community-based organization capacity building: planning on a shoestring budget.

Community-based organizations often capacity build to successfully enable themselves to be adaptable and responsive to constantly changing environments. However, community-based organizations are stretched for time, staffing, and funding, and the added obligation of regularly performing management planning tools, such as strategic planning, needs assessments, program evaluations, or market demand forecasting, strain limited resources. Through case studies, this article illustrates how collaborations between universities and community-based organizations can result in the development of successful management planning tools through the use of geographic information systems and secondary resources.

Assessment of patient and provider satisfaction scales for project access.

Objective: This study examined the underlying variables that contribute to patient and provider satisfaction with Project Access, a physician-driven program that connects low-income, uninsured adults (aged 18-64) to denoted specialty care and hospital services.

Subjects And Methods: Of the 550 physicians and 1400 patients participating per year, 125 physicians and 164 patients completed and returned the 14- and 15-item satisfaction questionnaires, respectively. The data from both surveys were factor analyzed.

Kansas office-based nurses' evaluation of patient tobacco cessation activities.

In this study, we examined the tobacco cessation efforts of nurses working in primary care settings. A 43-item questionnaire was mailed to 1,036 office-based nurses located throughout Kansas. With a response rate of 50.