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COMPETENCY-ORIENTED BLENDED LEARNING Training Technology Competencies Recognizes Communicates Training Technology

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COMPETENCY-ORIENTED BLENDED LEARNING Improving early location and reporting of status changes in NH occupants with CHF or DM Growing keenness and unpredictability of NH inhabitants, particularly those with heart disappointment or diabetes Early acknowledgment and correspondence of status changes basic to quality care TNH built up a DVD-based mixed educational programs , "Clinical Communication in the Nursing Home," to address archived competency holes Positive effect of educational programs: students and mentors like it, and it enhanced acknowledgment and correspondence of status changes

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ADDIE MODEL Curriculum Development System A nalysis – Identifying the preparation need and assembling data about the preparation program and its members D esign – Blueprinting what ought to be realized and how D evelopment – Producing preparing materials and their testing I mplementation – Delivering the preparation E valuation – Assessing the preparation's prosperity and viability

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GUIDE TO TNH CURRICULUM DESIGN Blend Technology with ADDIE Training Model Address center clinical components of competency showed by front-end examination Focus on competency-related information and expertise holes Demonstrate acknowledgment and correspondence procedures and competency Instruct and evaluate center information and aptitudes Encourage group preparing and fortification

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FRONT-END ANALYSIS OF TRAINING NEEDS Global disappointment with correspondence productivity and adequacy: Medical suppliers baffled by attendants' "insufficient and less than ideal" arrangement of signs and manifestations of status changes, particularly in occupants with CHF or DM Nurses baffled by inaccessibility and restlessness of doctors 40% of medical attendants couldn't precisely show a sign or indication of CHF compounding on the study. While the medical caretakers communicated trust in their association of data displayed to the doctor, the doctors deviated, expressing that the attendants' calls were not composed and that vital data was not generally accessible or introduced plainly. Doctors sought brief, clear, sorted out clinical data from a medical caretaker who had physically observed the occupant before calling. Needs: Implement an institutionalized reporting technique and give more instruction and preparing concerning acknowledgment and reporting of status changes in CHF and diabetic occupants.

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BLENDED (DVD-BASED) COMPETENCY-ORIENTED CURRICULUM Goal: Learners will enhance their insight into cardinal signs and indications of CHF worsening. LO: Nurses will list three key signs and manifestations of CHF status change (e.g., dyspnea, weariness, orthopnea, hack). LO: Nurses will distinguish key clinical examination markers of CHF compounding (e.g., expanded weight, fringe edema). Objective: Learners will enhance their capacity to recognize, arrange, and introduce data to the doctor for a non-new however noteworthy change in clinical status. LO: Nurses will expand their certainty and capacity for powerful and proficient correspondence of CHF-related data to the occupant's restorative supplier (doctor or ARNP).

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Competency-Oriented Blended (DVD-Based) Curriculum

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BLENDED-LEARNING CURRICULUM COMPONENTS and APPROACH DVD-Based Multimedia for data and demonstrating great and terrible abilities and demeanors Instructional Strategies to enhance acknowledgment and conveying changes in manifestations, signs, and useful status of occupants with CHF (and additionally DM) Emphasis: Disease signs and side effects and correspondence structure Facilitator's Guide to DVD, assessment, and learning practices Educational Handout with LOs and devices for learners (staff attendants)

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SNAPSHOT: DVD-Based Curriculum on Physician–Nurse Communication

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FACILITATOR'S GUIDE Implementation directions Tools and assets for actualizing educational programs - Role-playing practices for the attendants to practice "stray pieces" way to deal with correspondence with medicinal suppliers List of assets (counting showing Web locales) on the most proficient method to play out a lung exam and listen for irregular lung sounds Resources for drawing in doctors in QI handle - A specimen letter to advise doctors of preparing arrangements and expected changes in correspondence rehearses ("stray pieces" approach and device)

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EDUCATIONAL TOOL KIT FOR LEARNERS Nuts and Bolts for Clinical Communication Respiratory Rate Check Tips for Measuring Weight Signs and Symptoms of Disease Exacerbation Glossary of Terms

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TRAINER PREPARATION TIPS Before executing the preparation, educators ought to watch the DVD to recognize content that requires more clarification or alteration for their learners. Before actualizing this preparation, the teacher (i.e., clinical instructor, chief, hazard administrator) ought to audit the office's inner arrangements and methodology for clinical calls to doctors. To use this material in your office, it is essential to illuminate doctors of the adjustment in correspondence. Be set up amid the instructional meeting to talk about boundaries to legitimate clinical correspondence and strategies to enhance correspondence.

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MORE TRAINER TIPS The Lung Assessment Resources sheet gives Web locales and books that can invigorate nurture on appropriate physical examination strategies. ( Attachment A.) The example letter to the doctor or ARNP can be utilized to educate doctors and ARNPs about the stray pieces organized clinical correspondence that your medical caretakers will be prepared in. ( Attachment B.) The pretending activities should be possible with the medical caretakers to hone the stray pieces system. ( Attachment C.)

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OVERALL CURRICULUM EVALUATION BY NURSE PARTICIPANTS (n = 15) DVD Multimedia Enjoyable 1.3 (.46) Entertaining 1.5 (.74) Easy to comprehend 1.3 (.46) Length appropriate 1.3 (.49) Informative 1.2 (.41) Educational Handouts Usable daily 1.5 (.83) Understandable 1.4 (.83) Informative 1.4 (.83) Applicable to needs 1.6 (.83) ________________________________________________ 4-point Likert scale: 1 = fantastic to 4 = poor

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CURRICULUM EVALUATION PRE-VS POST-TRAINING KNOWLEDGE OF SIGNS & SYMPTOMS Pre- Post-Difference p % remedy % redress Respiratory rate 86.7 93.3 6.6 1.00 Orthopnea 46.7 100 53.3 0.004 Signs and symptoms 66.7 93.3 26.6 0.017 Information to impart 72.0 83.3 11.3 0.059 ACCURACY OF DATA COLLECTION AND CLINICAL COMMUNICATION Clinical Information Pre- Post- Diff p Related to CHF Mean (SD) Mean (SD) Mean Accurately gather 6.6(2.5) 8.9(1.3) 2.2 .011 Effectively convey 7.1(2.9) 8.8(1.3) 1.7 .063 + _______________________________________________________________________ 10-point Likert scale (1 = exceptionally questionable; 10 = extremely certain) REPORTED CAPABILITY TO ID AND COMMUNICATE INFORMATION TO PHYSICIANS Pre- Post % % Extremely skilled 8 93 Moderately or somewhat competent 92 7

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WHAT NEXT?? Assist research is expected to learn whether this preparation together with clinical bolster apparatuses will enhance "certifiable" practice and lessen intensifications and the high expenses of ER visits and hospitalizations of occupants with CHF and related conditions. Our experience up to this point shows that expansive spread of the TNH preparing will require some showcasing in industry and office gatherings and likely incorporation of a nearby "medical caretaker champion" to guarantee the preparation can be actualized and strengthened without issues identified with conceivable clash with individual nursing home approaches and systems. We are as of now testing this "medical caretaker champion" approach in our effort exercises alongside a PDA clinical choice bolster instrument.

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Behavior ( Apply ) Professional credibility Cognition ( Remember ) Competence Does Shows how Knows how Knows