The process of implementing a new baby-friendly hospital initiative for nurses: a grounded theory study

Maternity nursing practice is changing across Canada with the movement toward becoming “baby friendly.” The World Health Organization (WHO) recommends the Baby-Friendly Hospital Initiative (BFHI) as a standard of care in hospitals worldwide. Very little research has been conducted with nurses to explore the impact of the initiative on nursing practice. The purpose of this study, therefore, was to examine the process of implementing the BFHI for nurses. The study was carried out using Corbin and Strauss’s method of grounded theory. Theoretical sampling was employed, which resulted in recruiting and interviewing 13 registered nurses whose area of employment included neonatal intensive care, postpartum, and labour and delivery. The data analysis revealed a central category of resisting the BFHI. All of the nurses disagreed with some of the 10 steps to becoming a baby-friendly hospital as outlined by the WHO. Participants questioned the science and safety of aspects of the BFHI. Also, participants indicated that the implementation of this program did not substantially change their nursing practice. They empathized with new mothers and anticipated being collectively reprimanded by management should they not follow the initiative. Five conditions influenced their responses to the initiative, which were (a) an awareness of a pro-breastfeeding culture, (b) imposition of the BFHI, (c) knowledge of the health benefits of breastfeeding, (d) experiential knowledge of infant feeding, and (e) the belief in the autonomy of mothers to decide about infant feeding. The identified outcomes were moral distress and division between nurses. The study findings could guide decision making concerning the implementation of the BFHI.

Independent Projects Environmental Studies 2001: Environmental Auditing Strategy for Sir Wilfred Grenfell College

Overconsumption has caused environmental degradation, while creating a dependence on convenience commodities. It is the disposal of solid waste which will prove problematic in the future with growing world populations requiring resources and the use of the land. Universities, as institutions of higher learning, have an opportunity to reduce their environmental impact through its daily operations. Adopting an environmental management system and creating an environmental policy is the means by which these institutions become sustainable campuses. Stewardship policies are developed for universities, such as Sir Wilfred Grenfell College by analyzing current consumptive practices of the students, Faculty, and staff at the institution, often by way of an environmental audit

Student Independent Projects 2009: Embedding Sustainability: Hiking Trail Proposal to Steady Brook via Massey Drive

The construction and maintenance of a hiking trail to Steady Brook via Massey Drive would provide an opportunity for introducing proactive strategies toward sustainability. This will form a motive for further ecotourism development as Massey Drive becomes recognized as a tourist destination. For Massey Drive to embrace hiking trail development with the intention of developing further tourism initiatives, educating the community members about sustainability in tourism is essential to provide the community with the knowledge necessary to develop tourism through a long-term vision.

Student Independent Projects Environmental Studies 2007: Redesigning the Corner Brook Waterfront

In recent decades, urban planning has seen a rise in waterfront revitalization. This is important concerning Corner Brook, where the possible permanent closure of the Mill would have devastating consequences for the surrounding area. Corner Brook is located on the West Coast of Newfoundland, Canada, and has a population of 20,083 (WWW.statcan.ca, 2007). Corner Brook Pulp and Paper Ltd. (CBP&P) dominates the local economy and is located on the city's waterfront. With the realization that the heart of any city is the waterfront, if there is one present, many cities started revitalization trend in order to bring life back to the community and restore the local economy (Robertson, 1999). In the past, waterfronts were dominated with industry, shipping, and the navy. Today, the focus has shifted to leisure, recreation, tourism, and residential and commercial activity. Along with economic factors, the visual aspect of the waterfront is also Important (Albrecht, Bode, & Evers, 2003; Hoffman, 1999). Although this trend started out larger cities, such as Toronto, it has now spread to smaller centers, similar to the size of Corner Brook (Hoyle, 2000). What differs between the various sizes of the cities is what the main focus of the waterfront will be following the revitalization. With the tourism economy making a strong foothold in Newfoundland, the waterfront would provide the possibility to extend it even further. Yet, the most important aspects of the new waterfront will be to ensure environmentally safe measures (Slocombe, 1993) and making sure that as many jobs as possible will be generated. The generation of new jobs is especially important considering the loss of the Mill, which has provided the city and surrounding area with paying employment.

Student independent Projects Environmental Studies 2007: An Environmental Levy for Disposable Cups in NL: A preliminary Investigation

Human ability to impact Planet Earth appears to know no bounds. Adherence to polices of managed resource extraction combined with unbridled consumption, have fostered a disposable culture contributing to mass production of garbage. Eco-taxation may provide the economic tools required to reduce the amount of waste generated. Keys to eco-tax success are vision, education, and flexibility. Success must be measured in societal gains, not simply in monetary terms. Public opinion is initially opposed to consumer charges. Education and viable personal options are crucial to overcome resistance. With one coffee shop dispensing over 800,000 disposable cups annually, an eco-tax is an attractive option to simultaneously raise revenue to waste management programs and reduce one sector of waste production.

Student Independent Projects Environmental Studies: Energizing the Future: Meeting Future Power Needs of Grenfell College

In this paper I pose the Questions: Is it feasible to install a large wind turbine(S) at Grenfell College as a pilot project, and what will the benefits of the installation be to Grenfell if the project goes ahead? My answers are based on a literature review, data analysis from previous experiments, and a SWOT analysis. I will conclude by recommending a course of action for Grenfell that will move it toward using more renewable energy, and becoming a local resource for alternative energy solutions.

Patterns in personal experience narratives: storytelling at cod harbour - a Newfoundland fishing community

This study is concerned with storytelling as a part of the folk culture of a fishing community on the north east coast of Newfoundland. The study is based on field work done in the community throughout the summer of 1969 during which I tape recorded oral narratives along with other folklore and folklife material . The principal genre discussed is the personal experience narrative which is an account of the experiences of either the narrator, someone in his kin network, orhis friends. It was found that a large number of community residents communicate in narrative form and that the narratives function to substantiate conversation preceeding the narrativei have a didactic function; function as a means of entertainment~ and reflect the narrators' and the community's value system. The methods employed in collecting the material were the directive and the non-directive interview techniques and participant observation. Collecting was done mainly among fishermen between fifty and eighty years of age and who, on -the average, had not gone beyond the sixth grade in school. Since the narratives are so much a part of the environment, I give an account of the community culture. The principal things that I deal with are the community's history, economy, education, religion, and social life which includes rites of passage, calendar customs , social events, visiting patterns, and gossip. Information in each of these categories is based primarily on oral reports, narratives and documented materials. After a discussion of the storytelling process in the community, I deal specifically with four male narrators. For each I give biographical information, discuss his repertoire, telling situations, style, and give a sampling of his narratives. The fourth narrator is discussed in more detail than the first three. The narratives of the latter comprise the final chapter in the study, and have been analyzed to show what they tell us about the narrator's style, his value system, and the community culture.

The Ross's Gull (Rhodostethia rosea) in North America

The population, distribution and range of the Ross's gull in North America remain poorly understood, as does almost every aspect of its ecology and biology. It breeds at a few disparate locations in the Canadian Arctic and is an annual fall migrant in northern Alaska where tens of thousands occur in the nearshore waters of the Beaufort and Chukchi Seas, but little else is known about the distribution, habitat requirements, migratory routes and wintering areas used by this species. In order to clarify the status of the Ross's gull in North America I sought to discover new breeding sites in the Canadian High Arctic in order to characterize nesting habitat requirements, develop a predictive model with which to identify suitable nesting habitat for Ross's gulls, and refresh outdated estimates of the number of individuals migrating past Point Barrow, Alaska. Taken together, my findings provide a comprehensive account of the current status of the Ross's gull in North America.

Use of active power filter to reduce the effects of harmonics in solid oxide fuel cells

The Solid Oxide Fuel Cell (SOFC) is a class of fuel cells that is capable of generating very high levels of power at high temperatures. SOFCs are used for stationary power generation and as Combined Heat and Power (CHP) systems. In spite of all the beneficial features of the SOFC, the propagation of ripple currents, due to nonlinear loads, is a challenging problem, as it interferes with the physical operation of the fuel cell. The purpose of this thesis is to identify the cause of ripples and attempt to eliminate or reduce the ripple propagation through the use of Active Power Filters (APF). To this end, a systematic approach to modeling the fuel cell to account for its nonlinear behavior in the presence of current ripples is presented. A model of a small fuel cell power system which consists of a fuel cell, a DC-DC converter, a single-phase inverter and a nonlinear load is developed in MATLAB/Simulink environment. The extent of ripple propagation, due to variations in load magnitude and frequency, are identified using frequency spectrum analysis. In order to reduce the effects of ripple propagation, an APF is modeled to remove ripples from the DC fuel cell current. The emphasis of this thesis is based on the idea that small fuel cell systems cannot implement large passive filters to cancel the effects of ripple propagation and hence, the compact APF topology effectively protects the fuel cell from propagating ripples and improves its electrical performance.

Evaluation of a One-Day Meditech Magic Training Program for Registered Nurses and Licensed Practical Nurses in a long term care program

Background: An evaluation was completed on the One-Day Meditech Magic Training Program for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) developed for the Long Term Care (LTC) Program. Methods: Both a literature review and consultation with stakeholders were completed to determine possible evaluation methods, expected outcomes, and ways to measure the effectiveness of the education program. A pretest/posttest design and questionnaire were chosen as the evaluation tools for this project. Results: No significant difference was found between the pretest and posttest total scores indicating that learners retained information from the orientation session (Z = -1.820, p = 0.069). Additional Wilcoxon matched-pairs signed rank tests were performed on the individual sections of the tests and revealed a significant decrease in the posttest scores for entering a Diagnostic Imaging requisition (Z = -1.975, p = 0.048). No other significant findings were present. Questionnaires were also analyzed revealing that most participants were pleased with the Meditech documentation education they received and did not indicate barriers that would affect electronic documentation. Conclusions: Further testing is required to ensure reliability and validity of the evaluation tools. Finally, caution is needed due to a small sample size. However, problematic documentation tasks were identified during the evaluation, and as a result both the training session and support materials will be improved as a result of this project.

The impact of income and social status on population health: a scenario based simulation for nursing students

The development of critical thinking and communication skills is an essential part of Baccalaureate and Practical Nursing education. Scenario-based simulation, a form of experiential learning, directly engages students in the learning process. This teaching learning method has been shown to increase students’ understanding of the influence of their personal beliefs and values when working with clients and to improve therapeutic communication and critical thinking skills. Students in both the BN (Collaborative) and PN Programs at the Centre for Nursing Studies demonstrate a strong theoretical understanding of the impact of income and social status on population health but often experience difficulty applying this knowledge to the clinical situations involving clients and families. The purpose of the project was to develop a scenario-based simulation activity to provide nursing students with first-hand experiences of the impact of income and social status on health service accessibility. A literature review and stakeholder consultations were conducted to inform the project. The findings of these initiatives and Kolb’s Experiential Learning Theory were used to guide all aspects of the project. This report is an account of how the income and social status simulation and its accompanying materials were developed. This project provided an excellent learning opportunity that demonstrated the use of advanced nursing competencies.

Learning leadership: a resource for aspiring nurse leaders

Background/purpose – Nurse leaders play a key role in the growth of the nursing profession; hence the development of future leaders is essential. Despite its importance, opportunities for leadership development can be limited. The purpose of the practicum project was to develop a comprehensive, yet concise resource to assist aspiring nurse leaders in their journey towards effective leadership. Methods – The methods used to achieve the practicum objectives were: (a) explore the literature and complete a comprehensive review (b) conduct expert consultations with current nurse leaders, and (c) develop a learning resource for aspiring nurse leaders. Results – The literature review and expert consultations highlighted the importance of effectively developing aspiring nurse leaders. The information obtained allowed for the development of a comprehensive learning resource. A detailed background, leadership theory, leadership framework, leader competencies and learning activities are presented throughout the resource. Conclusion – In order to for the nursing profession to continue to advance, effective nurse leaders are of paramount importance. However, it is essential that aspiring leaders are given appropriate opportunities for development. The learning resource was developed to provide aspiring leaders with a comprehensive tool to enhance their leadership development.

The development of an online neonatal intensive care unit family education

Background: British Columbia’s Fraser Health Authority (FHA) neonatal intensive care units (NICUs) value family centered care (FCC). Nevertheless, there is limited evidence that FCC is actually incorporated into practice, as well as some concern that FHA NICU education is inaccessible, inconsistent, or disorganized. Purpose: The mission of this project is to support the principles of FCC throughout the development of an FHA online NICU family education guide by reflecting upon the needs of families throughout their NICU journey. Methods: A needs assessment was initially completed and included literature reviews, consultations, and an environmental scan. This data informed development of an online NICU family education guide which plots current education materials along key stages of the NICU journey: prenatal, admission, early days, growing and developing, discharge and at home. For the purposes of this practicum, only the prenatal stage was fully developed and will serve as a template for other stages following a formative evaluation. A pamphlet and revised FHA Neonatal Checkpoint will also be developed to augment teaching by health care professionals. Implementation and evaluation plans were adapted from the Center for Disease Control Framework for Program Evaluation in Public Health. Results: The needs assessment validates and directs the development, implementation, and evaluation of the online guide illustrating an FCC approach. The online guide centralizes and organizes education by selecting education topics that relate to each stage of the NICU journey. This family-directed design enables families’ access to consistent and reliable information and offers them an opportunity to learn at their own pace. Conclusion: The process of creating, implementing, and evaluating an online family education program for FHA NICUs elucidates the intricacies and the advantages of integrating FCC into NICU practice.

Development of an education resource for families and clients navigating through end-of-life care with at-home palliation

Background: Community health nurses (CHNs) play a pivotal role in providing end-of-life care to clients diagnosed with a life-threatening illness. Providing quality end-of-life care is an ethical obligation. Eastern Health’s palliative end-of-life care program (PEOLC) offers nursing care, equipment, services, and support. However, the caregiver’s need for practical information about end-of-life issues is not addressed. Purpose: To develop an educational resource to assist clients and families during end-of-life and to provide a framework for new CHNs in home palliation. Methods: An informal Needs Assessment, a literature review, an environmental scan, and consultations with four CHNs involved with home palliation. Results: An educational resource was developed to address the practical end-of-life issues identified in the literature review and consultations. Conclusion: An improved delivery of care for at-home palliation in the community for clients and families, and a framework for new CHNs.