Effect of the Specific Training Course for Competency in Doing Arterial Blood Gas Sampling in the Intensive Care Unit: Developing a Standardized Learning Curve according to the Procedure's Time and Socioprofessional Predictors

Effect of specific training course for competency in professional oral hygiene care in the intensive care unit: a quasi-experimental study for developing a standardized learning curve

Background

The development of evidence-based training standards can help improve the quality of educational programs for novice intensive care unit (ICU) nurses. This study was conducted to assess the application of a training course on competency development of nurses in relation to oral hygiene care in ICU patients and to develop a checklist for evaluating the competence performance. In addition, to achieve a certain level of oral hygiene competence, as well as to assess the relative importance of predicting factors and learning competency patterns in oral hygiene care, we used standard learning curve.

Methods

This quasi-experimental study with time series design was conducted on newly registered ICU nurses of a teaching hospital affiliated with Tehran University of Medical Sciences, Iran, between 2016 and 2018. In the first phase of this study, we designed a checklist to assess nurses' professional competence in oral hygiene care in three stages: before, during, and after care. Then, in the second phase, the level of competence of nurses in repeated times of oral hygiene care was determined based on checklist items and recorded in the learning curve.

Results

The greatest increase of oral hygiene care competency due to repetition was observed in the first and fourth times of repetition in comparison to the subsequent and previous steps. In the linear regression model, demographic variables predicted 12–19% of changes related to skill scores in repetitions.

Conclusion

According to the learning curve, newly registered ICU nurses can reach an acceptable competency after 6 repetitions of oral hygiene care.

A Bimodal Pattern and Age-Related Growth of Intra-Annual Wood Cell Development of Chinese Fir in Subtropical China

Age plays an important role in regulating the intra-annual changes in wood cell development. Investigating the effect of age on intra-annual wood cell development would help to understand cambial phenology and xylem formation dynamics of trees and predict the growth of trees accurately. Five intermediate trees in each stand (total of 5 stands) in five age groupings of Chinese fir (Cunninghamia lanceolata Hook.) plantations in subtropical China were monitored on micro-cores collected weekly or biweekly from January to December in 2019. We modeled the dynamics of wood cell development with a mixed effects model, analyzed the age effect on intra-annual wood cell development, and explored the contribution of rate and duration of wood cell development on intra-annual wood cell development. We found a bimodal pattern of wood cell development in all age classes, and no matter the date of peak or the maximal number of cells the bimodal patterns were similar in all age classes. In addition, compared with the older trees, the younger trees had the longest duration of wood cell development because of the later end of wood cell development and a larger number of wood cells. The younger trees had the faster growth rate than the older trees, but the date of the maximal growth rate in older trees was earlier than younger trees, which led to the production of more wood cells in the younger trees. Moreover, we found that the number of cells in wood cell formation was mostly affected by the rate (92%) rather than the duration (8%) of wood cell formation.