The development of a self-directed learning module for rural emergency nurses on pediatric diabetic ketoacidosis

Background: Newfoundland and Labrador has a high incidence of type 1 diabetes and diabetic ketoacidosis (DKA) is a complication of type 1 diabetes. A clinical practice guideline was developed for the treatment of pediatric diabetic ketoacidosis (DKA) to standardize care in all Emergency Departments and improve patient outcomes. Rural emergency nurses are requires to maintain their competency and acquire new knowledge as stated by the Association of Registered Nurses of Newfoundland and Labrador (ARNNL). Purpose: The purpose of this practicum was to develop a self-learning module for rural emergency nurses to increase their knowledge and understanding of the clinical practise guideline to assess, treat, and prevent pediatric ketoacidosis. Methods: Two methodologies were used in this practicum. A review of the literature and consultations with key stakeholders were completed. Results: The self-learning module created was composed of three units and focused on the learning needs of rural emergency nurses in the areas of assessment, treatment, and prevention of pediatric DKA. Conclusion: The goal of the practicum was to increase rural emergency nurses’ knowledge and implementation of the clinical practice guideline when assessing and treating children and families experiencing DKA to improve patient outcomes. A planned evaluation of the self-learning module will be conducted following dissemination of the module throughout the rural Emergency Departments.

Development of calix[4]arene-functionalized microcantilever array sensing system for the rapid, sensitive and simultaneous detection of metal ions in aqueous solutions

The work described in this thesis was conducted with the aim of: 1) investigating the binding capabilities of calix[4]arene-functionalized microcantilevers towards specific metal ions and 2) developing a new16-microcantilever array sensing system for the rapid, and simultaneous detection of metal ions in fresh water. Part I of this thesis reports on the use of three new bimodal calix[4]arenes (methoxy, ethoxy and crown) as potential host/guest sensing layers for detecting selected ions in dilute aqueous solutions using single microcantilever experimental system. In this work it was shown that modifying the upper rim of the calix[4]arenes with a thioacetate end group allow calix[4]arenes to self-assemble on Au(111) forming complete highly ordered monolayers. It was also found that incubating the microcantilevers coated with 5 nm of Inconel and 40 nm of Au for 1 h in a 1.0 M solution of calix[4]arene produced the highest sensitivity. Methoxy-functionalized microcantilevers showed a definite preference for Ca²⁺ ions over other cationic guests and were able to detect trace concentration as low as 10⁻¹² M in aqueous solutions. Microcantilevers modified with ethoxy calix[4]arene displayed their highest sensitivity towards Sr²⁺ and to a lesser extent Ca²⁺ ions. Crown calix[4]arene-modified microcantilevers were however found to bind selectively towards Cs⁺ ions. In addition, the counter anion was also found to contribute to the deflection. For example methoxy calix[4]arene-modified microcantilever was found to be more sensitive to CaCl₂ over other water-soluble calcium salts such as Ca(NO₃)₂ , CaBr₂ and CaI₂. These findings suggest that the response of calix[4]arene-modified microcantilevers should be attributed to the target ionic species as a whole instead of only considering the specific cation and/or anion. Part II presents the development of a 16-microcantilever sensor setup. The implementation of this system involved the creation of data analysis software that incorporates data from the motorized actuator and a two-axis photosensitive detector to obtain the deflection signal originating from each individual microcantilever in the array. The system was shown to be capable of simultaneous measurements of multiple microcantilevers with different coatings. A functionalization unit was also developed that allows four microcantilevers in the array to be coated with an individual sensing layer one at the time. Because of the variability of the spring constants of different cantilevers within the array, results presented were quoted in units of surface stress unit in order to compare values between the microcantilevers in the array.