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https://www.readbyqxmd.com/read/29424039/organising-nursing-practice-into-care-models-that-catalyse-quality-a-clinical-nurse-leader-case-study
#1
Miriam Bender, LeeAnna Spiva, Wei Su, Lisle Hites
AIMS: To determine the power of a conceptual clinical nurse leader practice model to explain the care model's enactment and trajectory in real world settings. BACKGROUND: How nursing, organised into specific models of care, functions as an organisational strategy for quality is not well specified. Clinical nurse leader integrated care delivery is one emerging model with growing adoption. A recently validated clinical nurse leader practice model conceptualizes the care model's characteristics and hypothesizes their mechanisms of action...
February 9, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29419625/use-of-a-standardized-care-communication-checklist-during-multidisciplinary-rounds-in-pediatric-cardiac-intensive-care-a-best-practice-implementation-project
#2
Julianna Boydston
OBJECTIVES: This project aimed to improve thoroughness and continuity of care of patients in a pediatric cardiac intensive care unit. Specific objectives were to increase support of clinical nurse and family participation in multidisciplinary rounds (MDR), as well as full use of a multi-component Complex Care Checklist (CCC) by all nurses in this unit. INTRODUCTION: Communication and collaboration are paramount for safe care and positive outcomes of critically ill patients hospitalized in intensive care units...
February 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29402313/the-improve-gap-trial-aiming-to-improve-evidence-based-management-of-community-acquired-pneumonia-study-protocol-for-a-stepped-wedge-randomised-controlled-trial
#3
Elizabeth H Skinner, Melanie Lloyd, Edward Janus, May Lea Ong, Amalia Karahalios, Terry P Haines, Anne-Maree Kelly, Melina Shackell, Harin Karunajeewa
BACKGROUND: Community-acquired pneumonia is a leading worldwide cause of hospital admissions and healthcare resource consumption. The largest proportion of hospitalisations now occurs in older patients, with high rates of multimorbidity and complex care needs. In Australia, this population is usually managed by hospital inpatient general internal medicine units. Adherence to consensus best-practice guidelines is poor. Ensuring evidence-based care and reducing length of stay may improve patient outcomes and reduce organisational costs...
February 5, 2018: Trials
https://www.readbyqxmd.com/read/29402306/sustainable-reduction-of-antibiotic-induced-antimicrobial-resistance-arena-in-german-ambulatory-care-study-protocol-of-a-cluster-randomised-trial
#4
Martina Kamradt, Petra Kaufmann-Kolle, Edith Andres, Tonia Brand, Anja Klingenberg, Katharina Glassen, Regina Poß-Doering, Lorenz Uhlmann, Katharina Hees, Dorothea Weber, Andreas Gutscher, Veit Wambach, Joachim Szecsenyi, Michel Wensing
BACKGROUND: Despite many initiatives to enhance the rational use of antibiotics, there remains substantial room for improvement. The overall aim of this study is to optimise the appropriate use of antibiotics in German ambulatory care in patients with acute non-complicated infections (respiratory tract infections, such as bronchitis, sinusitis, tonsillitis and otitis media), community-acquired pneumonia and non-complicated cystitis, in order to counter the advancing antimicrobial resistance development...
February 5, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29392791/a-transfusion-prescription-template-and-other-human-factor-interventions-to-improve-balanced-transfusion-delivery-in-major-haemorrhage-due-to-trauma
#5
J Swieton, R Hawes, S Avery, H Watson, Y Scott, M Lannon, J P Wallis
OBJECTIVES: The aim of this study is to improve practice in the management of major haemorrhage, particularly in red cell to plasma transfusion ratios. BACKGROUND: A review of the management of major haemorrhage in trauma in Newcastle Hospitals Trust in 2012-2013 showed good mortality outcomes but found that red cell : plasma transfusion ratios could be improved. Human factors techniques transferable from industry and the military were identified, and a package of interventions was implemented, including an intensive multidisciplinary team training programme and a new major haemorrhage prescription template...
February 2, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29382343/evidence-to-service-gap-cardiac-rehabilitation-and-secondary-prevention-in-rural-and-remote-western-australia
#6
Sandra Hamilton, Belynda Mills, Shelley McRae, Sandra Thompson
BACKGROUND: Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations...
January 30, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29374478/operation-and-challenges-of-home-based-medical-practices-in-the-us-findings-from-six-aggregated-case-studies
#7
Gregory J Norman, Kristann Orton, Amy Wade, Andrea M Morris, Jill C Slaboda
BACKGROUND: Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC...
January 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29368967/endo-echo-improves-primary-care-provider-and-community-health-worker-self-efficacy-in-complex-diabetes-management-in-medically-underserved-communities
#8
Matthew F Bouchonville, Brant W Hager, Jessica B Kirk, Clifford R Qualls, Sanjeev Arora
OBJECTIVE: To determine whether participation in a multidisciplinary telementorship model of healthcare delivery improves primary care provider (PCP) and community health worker (CHW) confidence in managing patients with complex diabetes in medically underserved regions. METHODS: We applied a well-established healthcare delivery model, Project ECHO (Extension for Community Healthcare Outcomes), to the management of complex diabetes (Endo ECHO) in medically underserved communities...
January 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29356078/diabetes-and-technology-in-2030-a-utopian-or-dystopian-future
#9
D Kerr, C Axelrod, C Hoppe, D C Klonoff
The ability of an individual living with diabetes to have human-to-human contact with their healthcare provider is not keeping pace with the number of people developing diabetes. From a futurist perspective, however, this dichotomy of diabetes care represents an opportunity for digital healthcare. The focus of technological innovation is unlikely to be the replacement of the multidisciplinary diabetes team but rather the provision of meaningful individual and family support between clinic visits and, on a larger scale, the facilitation of population health management for diabetes...
January 22, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29344338/current-best-practice-in-the-management-of-turner-syndrome
#10
REVIEW
Roopa Kanakatti Shankar, Philippe F Backeljauw
Turner syndrome (TS) is characterized by partial or complete loss of the second X-chromosome in phenotypic females resulting in a constellation of clinical findings that may include lymphedema, cardiac anomalies, short stature, primary ovarian failure and neurocognitive difficulties. Optimizing health care delivery is important to enable these individuals achieve their full potential. We review the current best practice management recommendations for individuals with TS focusing on the latest consensus opinion in regard to genetic diagnosis, treatment of short stature, estrogen supplementation, addressing psychosocial issues, as well screening for other comorbidities...
January 2018: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#11
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29325808/dutch-breast-reconstruction-guideline
#12
REVIEW
Marc A M Mureau
Treatment of breast cancer is complex and multidisciplinary by nature, with protocols that are updated continuously. During preoperative multidisciplinary team meetings, regularly there is discussion between team members regarding optimal timing and type of breast reconstruction, due to conflicting interests of oncological and reconstructive treatments. Therefore, a multidisciplinary, evidence-based guideline for breast reconstruction in women undergoing breast conserving therapy or mastectomy for breast cancer, or following prophylactic mastectomy was developed by a multidisciplinary working group...
December 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29325571/development-of-a-hospital-based-patient-reported-outcome-framework-for-lung-cancer-patients-a-study-protocol
#13
Natasha Moloczij, Karla Gough, Benjamin Solomon, David Ball, Linda Mileshkin, Mary Duffy, Mei Krishnasamy
BACKGROUND: Patient-reported outcome (PRO) data is central to the delivery of quality health care. Establishing sustainable, reliable and cost-efficient methods for routine collection and integration of PRO data into health information systems is challenging. This protocol paper describes the design and structure of a study to develop and pilot test a PRO framework to systematically and longitudinally collect PRO data from a cohort of lung cancer patients at a comprehensive cancer centre in Australia...
January 11, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29290407/expanding-access-to-clinical-services-for-toddlers-with-autism-spectrum-disorders
#14
Therese L Mathews, Ashley M Lugo, Melissa L King, Laura L Needelman, Paige E McArdle, Natalie Romer, Megan Terry, Kathryn Menousek, Joseph H Evans, William J Higgins
Autism spectrum disorder (ASD) is a neurodevelopmental disorder typically diagnosed in the toddler and preschool years. Intensive early intervention (EI) using applied behavior analytic procedures is the evidenced-based intervention most effective in improving developmental outcomes. Unfortunately, there are numerous barriers to accessing EI services for toddlers with ASD. This article addresses (a) the process of developing an EI program using primarily applied behavior analytic services with multidisciplinary health care providers, (b) a description of the service delivery provided, (c) educational and training programs to increase qualified staff, and (d) advocacy efforts to improve community capacity...
December 28, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29280778/perceptions-of-integration-of-the-clinical-pharmacist-into-the-pcmh-model-by-the-pcmh-team
#15
M Shawn McFarland, Kristen Lamb, Jonathan Hughes, Ashley Thomas, Justin Gatwood, Jacob Hathaway
INTRODUCTION: The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. The Veterans Health Administration (VA), while desiring to be a national leader in the delivery of primary care services, used the principles of the PCMH model to design the patient-aligned care team (PACT). The purpose of this study, was to explore the perception of the PACT members after integration of a clinical pharmacist to the PACT...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29223212/how-to-engage-your-team-to-implement-delayed-cord-clamping
#16
Rebecca L Gams, Kimberly K Popp, Julianne Cramer, Thomas N George, Phillip N Rauk, Samantha A Sommerness, Jane A Sublette
This article describes how a health care team changed practice by implementing delayed cord clamping as standard practice. After administration of a survey to assess clinicians' knowledge and to discover barriers to this proposed practice change, members of a multidisciplinary committee used the results to create a guideline for delayed cord clamping and a plan for successful implementation. Integral to embedding and sustaining changes in practice was development of the Delivery Room Brief and Debrief Tool and inclusion of the process into nursing guidelines and the electronic health record...
December 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/29218966/building-compassion-literacy-enabling-care-in-primary-health-care-nursing
#17
Letitia Helen Burridge, Sarah Winch, Margaret Kay, Amanda Henderson
This paper introduces the concept of compassion literacy and discusses its place in nursing within the general practice setting. Compassion literacy is a valuable competency for sustaining the delivery of high quality care. Being compassion literate enables practice nurses to provide compassionate care to their patients and to recognise factors that may constrain this. A compassion literate practice nurse may be more protected from compassion fatigue and its negative consequences. Understanding how to enable self-compassion and how to support the delivery of compassionate care within the primary care team can enhance the care experienced by the patient while improving the positive engagement and satisfaction of the health professionals...
2017: Collegian: Journal of the Royal College of Nursing, Australia
https://www.readbyqxmd.com/read/29214975/home-based-health-promotion-for-older-people-with-mild-frailty-the-homehealth-intervention-development-and-feasibility-rct
#18
Kate Walters, Rachael Frost, Kalpa Kharicha, Christina Avgerinou, Benjamin Gardner, Federico Ricciardi, Rachael Hunter, Ann Liljas, Jill Manthorpe, Vari Drennan, John Wood, Claire Goodman, Ana Jovicic, Steve Iliffe
BACKGROUND: Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. OBJECTIVES: (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT)...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29204014/mental-healthcare-delivery-in-rural-greece-a-10-year-account-of-a-mobile-mental-health-unit
#19
Vaios Peritogiannis, Thiresia Manthopoulou, Afroditi Gogou, Venetsanos Mavreas
Introduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29200059/a-perioperative-medicine-model-for-population-health-an-integrated-approach-for-an-evolving-clinical-science
#20
Solomon Aronson, Julie Westover, Nicole Guinn, Tracy Setji, Paul Wischmeyer, Padma Gulur, Thomas Hopkins, Thorsten M Seyler, Sandhya Lagoo-Deendayalan, Mitchell T Heflin, Annemarie Thompson, Madhav Swaminathan, Ellen Flanagan
Health care delivery in the United States continues to balance on the tight rope that connects its transition from volume to value. Value in economic terms can be defined as the amount something exceeds its commodity price and is determined by extraordinary reputation, quality, and/or service, whereas its destruction can be a consequence of poor management, unfavorable policy, decreased demand, and/or increased competition. Going forward, payment for health care delivery will increasingly be based on services that contribute to improvements in individual and/or population health value, and funds to pay for health care delivery will become increasingly vulnerable to competitive market forces...
February 2018: Anesthesia and Analgesia
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