Evidence Based Approach to Novice Nurse Orientation in Perianesthesia Units

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Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (135 download)

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Book Synopsis Evidence Based Approach to Novice Nurse Orientation in Perianesthesia Units by : Seun O. Ross

Download or read book Evidence Based Approach to Novice Nurse Orientation in Perianesthesia Units written by Seun O. Ross and published by . This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Purpose: To implement evidence-based practice that demonstrates inadequate orientations (equal or less than 4 weeks) often result in increased stress, burnout and attrition among novice nurses in specialized units. Design: Quality Improvement project Methods: 20 nurses who work in the PACU of a military hospital participated in the project by completing the 6 week CBO standardized orientation program; 2 weeks post orientation they completed the MBI-HSS, ENSS and MJS self-report surveys. Relationships among the variables were examined using Pearson's correlation coefficient. Findings: This project supported prior research demonstrating a relationship between length of orientation, job satisfaction and intent to leave employment; indicating that adequate orientations increases job satisfaction and decreases attrition. Conclusion: New graduates benefit from a structured, but customizable orientation program. The appropriate quality and length of orientation has the potential to increase novice nurse sense of belonging, work satisfaction and decreases work-related stress. Keywords: novice nurse, orientation, stress, turnover " -- Abstract.

Drain’s PeriAnesthesia Nursing – E-Book

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Publisher : Elsevier Health Sciences
ISBN 13 : 0323832687
Total Pages : 770 pages
Book Rating : 4.3/5 (238 download)

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Book Synopsis Drain’s PeriAnesthesia Nursing – E-Book by : Jan Odom-Forren

Download or read book Drain’s PeriAnesthesia Nursing – E-Book written by Jan Odom-Forren and published by Elsevier Health Sciences. This book was released on 2022-12-27 with total page 770 pages. Available in PDF, EPUB and Kindle. Book excerpt: UPDATED! Revised content throughout provides the most up-to-date information for effective perianesthesia nursing practice. NEW! Full-color layout makes content more visually appealing and highlights important information. NEW! Information on SARS/COVID-19 is now included in the Pathogens chapter. NEW! Chapter on International Care of the Perianesthesia Patient offers complete coverage on this key topic. UPDATED! Coverage of pain management for the perianesthesia patient features the latest guidelines. UPDATED! Patient with Chronic Disorders chapter provides current information on caring for these patients. UPDATED! Evidence-Based Research boxes provide the latest standards of care.

The Doctor of Nursing Practice and the Nurse Executive Role

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Publisher : Lippincott Williams & Wilkins
ISBN 13 : 1496303717
Total Pages : 311 pages
Book Rating : 4.4/5 (963 download)

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Book Synopsis The Doctor of Nursing Practice and the Nurse Executive Role by : Albert Rundio

Download or read book The Doctor of Nursing Practice and the Nurse Executive Role written by Albert Rundio and published by Lippincott Williams & Wilkins. This book was released on 2014-10-07 with total page 311 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering real-world guidance and seasoned insight, The Doctor of Nursing Practice and the Nurse Executive Role is the first book to offer DNP-trained nurse executives the tools needed to create and manage successful nursing care systems. Crucial topics in leadership and personal and organizational success are addressed, using current concrete examples in nursing management. This is a unique, indispensable tool for nursing educators, current nurse executives, and those planning on taking up the nurse executive role. Suitable as a reference for both clinical and classroom use, The Doctor of Nursing Practice and the Nurse Executive Role will take seasoned nursing professionals and future leaders of the profession on a an educational journey where they’ll learn . . . · Why evidence-based practice is critical to the delivery of quality patient care · Tough questions, such as: How can nursing faculty inspire, educate, and empower nurse-executive DNP students? · Essential pearls to help you on your journey to successful leadership and management · Why implementing the Magnet model makes sense even if your organization does not intend to pursue Magnet status · Why healthcare organizations must continually focus on improvement · The necessity of organizational transformation to ensure optimal ethical climates · How to become an effective delegator · How personal self-awareness leads to success · How to create an environment that fosters professional sustainability · How to use succession planning and management to develop and maintain strong leadership

Perianesthesia Nursing Care

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Publisher : Jones & Bartlett Learning
ISBN 13 : 1284127095
Total Pages : 432 pages
Book Rating : 4.2/5 (841 download)

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Book Synopsis Perianesthesia Nursing Care by : Daphne Stannard

Download or read book Perianesthesia Nursing Care written by Daphne Stannard and published by Jones & Bartlett Learning. This book was released on 2016-09-01 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: Perianesthesia Nursing Care: A Bedside Guide for Safe Recovery, Second Edition is an essential reference for clinicians caring for perianesthesia patients in a variety of situations, such as in a preop and postanesthesia care unit (PACU), an intensive care unit (ICU), a procedural recovery area, or on a labor and delivery unit. Ideal for perianesthesia nursing orientation and perioperative cross-training programs, it is also a valuable tool for nursing students preparing to sit for the Certified Post Anesthesia Nursing (CPAN) and Certified Ambulatory Perianesthesia Nurse (CAPA) certification examinations. With contributions from leading experts, this reference addresses common clinical issues, population specific knowledge, and surgery specific knowledge. The Second Edition includes a new chapter on trauma, an increased emphasis on non-OR areas, and an extended focus on pediatric patients.

A Competency-based Orientation for the Registered Nurse and Pain Management in the Perianesthesia Setting

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Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (145 download)

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Book Synopsis A Competency-based Orientation for the Registered Nurse and Pain Management in the Perianesthesia Setting by :

Download or read book A Competency-based Orientation for the Registered Nurse and Pain Management in the Perianesthesia Setting written by and published by . This book was released on 2024 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This publication addressing the complexity of pain and comfort management, is the result of the collaborative work contributed by many perianesthesia nurse experts. The purpose of this competency-based manual (CBO) derives from ASPAN’s clinical inquiry priority to provide the best evidence upon which perianesthesia nurses practice. ASPAN studies have shown that perianesthesia nurses frequently request access to new knowledge and resources related to the management of pain during the perianesthesia patient experience. This CBO outlines essential performance criteria to be utilized in the orientation process of the nurse new to perianesthesia care, provides a reference of best practices for the veteran nurse, and serves as a source of annual clinical updates for the entire perianesthesia nursing staff related to pain and comfort in the perianesthesia setting [Publisher's summary].

Orientation Programs for Novice School Nurses

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Publisher :
ISBN 13 : 9781392260210
Total Pages : 350 pages
Book Rating : 4.2/5 (62 download)

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Book Synopsis Orientation Programs for Novice School Nurses by : Stephanie G. Knutson (Ed.D. candidate at the University of Hartford)

Download or read book Orientation Programs for Novice School Nurses written by Stephanie G. Knutson (Ed.D. candidate at the University of Hartford) and published by . This book was released on 2019 with total page 350 pages. Available in PDF, EPUB and Kindle. Book excerpt: Research has shown that there exists an increase in the amount and complexities of students with health care needs and the need for school nurses to safely and effectively support these students. Notably, research also revealed that the majority of nurses who enter this specialty practice lack the comprehensive knowledge base and are underprepared to practice in educational environments. The purpose of the qualitative, action research study was to provide school nurses an opportunity to reflect on and voice their novice school nursing experiences in order to examine the contents that should be included in new school nurse orientation programs. The researcher used a qualitative, action research design to develop the methodology for this study. The research questions that guided this study were: 1. What do practicing school nurses report regarding orientation programs for novice school nurses? 2. What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in the key principles (Maughan, Bobo, Butler & Schantz, 2016) of school nursing practice? 2.1 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in the standards of practice? 2.2 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in care coordination practices? 2.3 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in quality improvement practices? 2.4 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in leadership practices? 2.5 What do practicing school nurses report regarding ways in which an orientation program prepares novice school nurses in community/public health practices? Select parts of the NASN Framework (Maughan et al., 2016), and Benner’s (1984) definition of novice nurses, together, formed the conceptual framework that examined school nurses’ reflection regarding the content that should be included in new school nurses’ orientation programs. A purposeful sampling (Maxwell, 2012) was used to recruit practicing school nurses from across a Northeastern state in rural, urban and suburban school district settings. Efforts to include school nurses from all regions resulted in 27 participants. Participants engaged in semi-structured interviews and shared about the experiences they had as novice school nurses. A two-step process was used to analyze the data: first, open coding was performed to identify underlying themes and, second, a crosswalk of the resulting matrices against the already defined components in the NASN Framework (Maughan et al., 2016). The researcher found that institutional culture and organizational sensemaking were central to the perceptions and experiences described by participants during their transition to school nursing practice. Findings of the study culminated in four major themes that were identified as critical to school nursing practice and that must be included in orientation programs for novice school nurses: 1) mentoring and supervising; 2) communicating; 3) developing specialized skills; and 4) identifying resources.

Nursing Orientation Program Builder

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Publisher : HC Pro, Inc.
ISBN 13 : 1601467087
Total Pages : 275 pages
Book Rating : 4.6/5 (14 download)

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Book Synopsis Nursing Orientation Program Builder by : Adrianne E. Avillion

Download or read book Nursing Orientation Program Builder written by Adrianne E. Avillion and published by HC Pro, Inc.. This book was released on 2010-03-23 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: This binder and CD-ROM walk you through each step of a well-run orientation program so you can incorporate field-tested, evidence-based practices at your facility. Use this resource to evaluate your program outcomes, fulfill Joint Commission orientation requirements, train new graduates, and meet the needs of a diverse workforce.

Standards of Perianesthesia Nursing Practice

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Publisher :
ISBN 13 :
Total Pages : 92 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Standards of Perianesthesia Nursing Practice by : American Society of PeriAnesthesia Nurses

Download or read book Standards of Perianesthesia Nursing Practice written by American Society of PeriAnesthesia Nurses and published by . This book was released on 2000 with total page 92 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Enhancing Orientation Strategies for Rural Novice Nurses Entering the Medical-surgical Nursing Arena

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Publisher :
ISBN 13 :
Total Pages : 152 pages
Book Rating : 4.:/5 (987 download)

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Book Synopsis Enhancing Orientation Strategies for Rural Novice Nurses Entering the Medical-surgical Nursing Arena by : Meaghan Lynne Nesti

Download or read book Enhancing Orientation Strategies for Rural Novice Nurses Entering the Medical-surgical Nursing Arena written by Meaghan Lynne Nesti and published by . This book was released on 2016 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: " ... Especially in the rural settings, new graduate nurses are expected to perform with a higher degree of independence and limited access to resources than their metropolitan counterparts. Developing and implementing innovative orientation strategies can promote a seamless transition into practice, reduce the reality shock experienced by new graduate nurses, and adequately prepare novice nurses with the clinical competency to succeed in their new role. New graduate nurses entering the medical-surgical arena should undergo extensive orientation to acquire and maintain a diverse and comprehensive set of skills and knowledge base to function competently. It is essential for healthcare organizations to provide support that goes beyond basic orientation, and is sensitive to the unique learning needs of each new graduate nurse. An 18-week interactive, competency-based program was developed to focus on the transition into practice and to facilitate higher levels of clinical performance in new graduate nurses ..."--Abstract.

Perianesthesia Nursing

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Publisher :
ISBN 13 : 9780017688125
Total Pages : 148 pages
Book Rating : 4.6/5 (881 download)

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Book Synopsis Perianesthesia Nursing by : Aspan

Download or read book Perianesthesia Nursing written by Aspan and published by . This book was released on 2010-01-01 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since its inception in 1984, the American Society of Perianesthesia Nurses (ASPAN) Standards of Perianesthesia Nursing Practice provides a framework for the care of a diverse patient population across all perianesthesia settings. The Standards are reviewed and updated biennially, incorporating current evidence-based practice and regulatory requirements and reflecting changing technology and nursing practice. The 2010-2012 edition of the ASPAN Standards will reveal a new title: Perianesthesia Nursing Standards and Practice Recommendations. This change reflects re-titling traditional elements of the Standards. This updated text contains standards of perianesthesia nursing practice, practice recommendations, (formerly titled resources), evidenced-based clinical practice guidelines, position statements, and resources from partnering organizations. New content in this publication includes a practice recommendation for fast tracking the ambulatory surgery patient, a practice recommendation for family visitation in perianesthesia care unit, a position statement on workplace violence in the perianesthesia setting and a position statement on the pediatric patient. We know that you will find this edition of the ASPAN Standards to be an invaluable resource to support perianesthesia nursing practice across the care continuum. The 2010-2012 Standards go into effect 90 days after the official publication date. The 2008-2010 Standards remain in effect until that date.

Reduce Failure to Rescue and Increase Competence and Confidence in Novice Nurses Through Simulation

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Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (135 download)

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Book Synopsis Reduce Failure to Rescue and Increase Competence and Confidence in Novice Nurses Through Simulation by : Lisa Knudsen

Download or read book Reduce Failure to Rescue and Increase Competence and Confidence in Novice Nurses Through Simulation written by Lisa Knudsen and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: " Failure to rescue (FTR) a patient from clinical deterioration is a multi-faceted issue that has dire consequences on patients and their families. Novice nurses placed in intense situations without prior experience can negatively affect patient outcomes. Novice nurses themselves question their abilities and feel unprepared. Medium-fidelity simulation of patient decline during nursing orientation provides a safe venue for novice nurses to practice their assessment and intervention skills related to FTR. Implementation of this evidence-based practice change exposed 11 newly-licensed nurses to an FTR simulation where nurses were required to discern the patient problem and intervene appropriately. Pre- and post- self-assessments of confidence and competence demonstrated a 22.5% increase in global mean scores post-intervention (p = 0.001). The highest improvement post-implementation related to self-assessment of ability to recognize signs and symptoms of clinical change, with a 25% increase in mean scores (p = 0.001). Implications for nursing practice include utilization of simulation for other skill related gaps in both novice and experienced practitioners. Key words: novice nurse; newly licensed nurse; clinical deterioration; failure to rescue; simulation; transition to practice; critical thinking " -- Abstract

Preparing the New Graduate Nurse Entering Critical Or Progressive Care Practice Areas

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ISBN 13 :
Total Pages : 90 pages
Book Rating : 4.:/5 (776 download)

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Book Synopsis Preparing the New Graduate Nurse Entering Critical Or Progressive Care Practice Areas by : Jennifer L. Forbes

Download or read book Preparing the New Graduate Nurse Entering Critical Or Progressive Care Practice Areas written by Jennifer L. Forbes and published by . This book was released on 2011 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: The transition from student nurse to professional nurse is often difficult for the new graduate especially if transitioning into critical or progressive care areas of practice. It is imperative for new graduates to receive a clinical orientation that meets their educational and transitional needs. The orientation process should provide them with a strong foundation in critical or progressive care practices. Educators are challenged to provide educational opportunities while accommodating diverse learning needs and continuing to maintain competency that ensures the highest quality of patient care and improved patient care outcomes. New graduate nurses hired into the critical or progressive care areas were asked to participate in a study evaluating the effect of blended orientation approaches on their level of self-confidence and satisfaction with current orientation methods. Their level of self-confidence and satisfaction were evaluated and measured using a pretest and posttest questionnaire. New graduates entering critical or progressive care areas of practice were evaluated following nursing school (prior to hospital orientation) and following a two-month hospital orientation model. The results did not reveal any significant difference between pre and post orientation. The review of literature suggests that the use of a more blended learning approach to teaching and learning can be beneficial. Blended learning can include online learning, case studies, human simulation, clinical time with a preceptor, service-based classroom lectures, quizzes, games, videos, mock events, review of pertinent evidence-based articles, and demonstration with return demonstration (p. 10), and is a growing area in education requiring more evaluation and research.

2023-2024 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements

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Publisher :
ISBN 13 : 9780017688422
Total Pages : 0 pages
Book Rating : 4.6/5 (884 download)

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Book Synopsis 2023-2024 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements by : American Society of PeriAnesthesia Nurses. Standards and Guidelines Committee

Download or read book 2023-2024 Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements written by American Society of PeriAnesthesia Nurses. Standards and Guidelines Committee and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Since the first publication of the American Society of PeriAnesthesia Nurses (ASPAN) Standards of Perianesthesia Nursing Practice in 1984, this publication has provided a framework for the expanding scope of care for a diverse patient population across all perianesthesia settings inclusive of all ages and all phases of care. The Standards are reviewed and updated on an ongoing basis by a team of clinical practice experts and are republished biennially. Each revised edition incorporates current evidence-based practice, emerging regulatory requirements, and reflects changing technology and nursing practice. The 2023-2024 edition of the ASPAN Standards contains principles of safety and ethics in perianesthesia practice, perianesthesia practice standards, practice recommendations, position statements, resources from partnering organizations, and interpretive statements which provide clarity and definition to key elements of the standards. The promotion of normothermia in the adult patient is an updated practice recommendation incorporating current evidence-based practice knowledge. New position statements include a position statement on electronic nicotine delivery systems and vaping products, a position statement on human trafficking, and a timely position statement on emergency preparedness. Each edition of the ASPAN Standards serves perianesthesia nurses as an invaluable resource and provides guidance and support for the expanding scope of perianesthesia nursing practice across the care continuum.--Taken from publisher web site

Sheehy's Emergency Nursing

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Publisher : Elsevier Health Sciences
ISBN 13 : 0323485456
Total Pages : 688 pages
Book Rating : 4.3/5 (234 download)

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Book Synopsis Sheehy's Emergency Nursing by : Emergency Nurses Association

Download or read book Sheehy's Emergency Nursing written by Emergency Nurses Association and published by Elsevier Health Sciences. This book was released on 2019-08-15 with total page 688 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by emergency nurses for emergency nurses, Sheehy's Emergency Nursing: Principles and Practice, 7th Edition covers the issues and procedures unique to the emergency department. This comprehensive, evidence-based resource is written by the Emergency Nurses Association and includes developments and changes in clinical practice that are incorporated throughout the text. Considered the go-to guide for issues and procedures unique to the emergency department, the user-friendly format features more than 150 high-quality illustrations and tables that highlight essential concepts and offer quick access to vital information. New to this edition is updated key coverage including clinical fundamentals, treatment for trauma and medical-surgical emergencies, the foundations of emergency nursing practice, special populations, and more! Written by the Emergency Nurses Association, ensuring this is the most accurate information on the market. Most comprehensive and authoritative text available on emergency nursing. Logically organized, chapters are grouped into six sections for quick access to important content: Foundations of Emergency Nursing, Professional Practice, Clinical Foundations of Emergency Nursing, Major Trauma Emergencies, Medical and Surgical Emergencies, and Special Patient Populations. Tables and boxes highlight and summarize critical and essential information, while 150 illustrations help you to quickly identify and treat frequently encountered conditions. A separate unit on special patient populations covers topics such as child abuse, elder abuse, intimate partner violence, sexual assault, substance abuse and behavioral/pediatric/obstetrical emergencies. NEW! Coverage includes the latest on topical issues such as ethics, workplace violence, and geriatric trauma. UPDATED pain guidelines feature the latest pain indicators. UPDATED sepsis guidelines provide essential information on pathophysiology and diagnosis, with valuable guidelines for managing these patients. NEW! Fully revised information on communicable diseases. UPDATED Information on non-narcotic use for treatment of pain and increasing rates of addiction. NEW! Discussion of transgender patients covers how to work with this unique population. NEW! Full color photo insert

From Novice to Expert

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Publisher : Pearson
ISBN 13 :
Total Pages : 340 pages
Book Rating : 4.4/5 (91 download)

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Book Synopsis From Novice to Expert by : Patricia E. Benner

Download or read book From Novice to Expert written by Patricia E. Benner and published by Pearson. This book was released on 2001 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: This coherent presentation of clinical judgement, caring practices and collaborative practice provides ideas and images that readers can draw upon in their interactions with others and in their interpretation of what nurses do. It includes many clear, colorful examples and describes the five stages of skill acquisition, the nature of clinical judgement and experiential learning and the seven major domains of nursing practice. The narrative method captures content and contextual issues that are often missed by formal models of nursing knowledge. The book uncovers the knowledge embedded in clinical nursing practice and provides the Dreyfus model of skill acquisition applied to nursing, an interpretive approach to identifying and describing clinical knowledge, nursing functions, effective management, research and clinical practice, career development and education, plus practical applications. For nurses and healthcare professionals.

Nurse as Educator

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Publisher : Jones & Bartlett Learning
ISBN 13 : 0763746436
Total Pages : 689 pages
Book Rating : 4.7/5 (637 download)

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Book Synopsis Nurse as Educator by : Susan Bacorn Bastable

Download or read book Nurse as Educator written by Susan Bacorn Bastable and published by Jones & Bartlett Learning. This book was released on 2008 with total page 689 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designed to teach nurses about the development, motivational, and sociocultural differences that affect teaching and learning, this text combines theoretical and pragmatic content in a balanced, complete style. --from publisher description.

Transitions Theory

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Publisher : Springer Publishing Company
ISBN 13 : 0826105351
Total Pages : 664 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Transitions Theory by : Afaf I. Meleis, PhD, DrPS (hon), FAAN

Download or read book Transitions Theory written by Afaf I. Meleis, PhD, DrPS (hon), FAAN and published by Springer Publishing Company. This book was released on 2010-02-17 with total page 664 pages. Available in PDF, EPUB and Kindle. Book excerpt: "It is very exciting to see all of these studies compiled in one book. It can be read sequentially or just for certain transitions. It also can be used as a template for compilation of other concepts central to nursing and can serve as a resource for further studies in transitions. It is an excellent addition to the nursing literature." Score: 95, 4 Stars. --Doody's "Understanding and recognizing transitions are at the heart of health care reform and this current edition, with its numerous clinical examples and descriptions of nursing interventions, provides important lessons that can and should be incorporated into health policy. It is a brilliant book and an important contribution to nursing theory." Kathleen Dracup, RN, DNSc Dean and Professor, School of Nursing University of California San Francisco Afaf Meleis, the dean of the University of Pennsylvania School of Nursing, presents for the first time in a single volume her original "transitions theory" that integrates middle-range theory to assist nurses in facilitating positive transitions for patients, families, and communities. Nurses are consistently relied on to coach and support patients going through major life transitions, such as illness, recovery, pregnancy, old age, and many more. A collection of over 50 articles published from 1975 through 2007 and five newly commissioned articles, Transitions Theory covers developmental, situational, health and illness, organizational, and therapeutic transitions. Each section includes an introduction written by Dr. Meleis in which she offers her historical and practical perspective on transitions. Many of the articles consider the transitional experiences of ethnically diverse patients, women, the elderly, and other minority populations. Key Topics Discussed: Situational transitions, including discharge and relocation transitions (hospital to home, stroke recovery) and immigration transitions (psychological adaptation and impact of migration on family health) Educational transitions, including professional transitions (from RN to BSN and student to professional) Health and illness transitions, including self-care post heart failure, living with chronic illness, living with early dementia, and accepting palliative care Organization transitions, including role transitions from acute care to collaborative practice, and hospital to community practice Nursing therapeutics models of transition, including role supplementation models and debriefing models