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https://www.readbyqxmd.com/read/29457869/assessment-of-the-spectrum-of-hepatic-encephalopathy-a-multi-center-study
#1
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29457258/quality-of-prescribing-by-physicians-nurse-practitioners-and-physician-assistants-in-the-united-states
#2
Shiyin Jiao, Irene B Murimi, Randall S Stafford, Ramin Mojtabai, G Caleb Alexander
OBJECTIVE: Nurse practitioners (NPs) and physician assistants (PAs) have increasingly broad prescribing authority in the United States, yet little is known regarding how the quality of their prescribing practices compares to that of physicians. The objective of this study was to compare the quality of prescribing practices of physicians and non-physician providers. METHODS: A serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) was performed...
February 19, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29444208/death-on-demand-an-analysis-of-physician-administered-euthanasia-in-the-netherlands
#3
Robert Preston
Background: Physician-administered euthanasia (PAE) was legalized, along with physician-assisted suicide (PAS), in The Netherlands in 2001. Sources of data: Annual reports of the Dutch Regional Euthanasia Review Committees, the committees' 2015 published Code of Practice and research studies. Areas of agreement: There is a general openness about the practice of PAE/PAS in The Netherlands and an avoidance of misleading euphemisms. The 2001 law also includes arrangements for post-event review of PAE/PAS decisions...
February 12, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29443434/expanding-the-abortion-provider-workforce-a-qualitative-study-of-organizations-implementing-a-new-california-policy
#4
Molly Frances Battistelli, Sara Magnusson, M Antonia Biggs, Lori Freedman
CONTEXT: Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. METHODS: Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions...
February 14, 2018: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/29438143/identifying-pain-and-effects-on-quality-of-life-from-chronic-wounds-secondary-to-lower-extremity-vascular-disease-an-integrative-review
#5
Stacy Newbern
GENERAL PURPOSE: To provide information to enable better assessment and management of patients with lower extremity vascular disease (LEVD) chronic wound pain. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you will be able to: ABSTRACT: A lack of wound pain validation and provider understanding about the effect of pain on quality of life are the biggest barriers to pain management for patients with chronic wound pain...
March 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29435834/physician-assistants-and-nurse-practitioners-in-head-and-neck-surgery
#6
Chrysanta Patio, Nabilah Ali, Jill Ketner, Candy Young, Esther Chou, Carrie Chong, Wanchi Su
This chapter explores the role of advanced practice clinicians (APCs) and patient care coordinators in the head and neck cancer setting. APCs, which include physician assistants (PAs) and nurse practitioners (NPs), are licensed professional healthcare providers who diagnose and treat illnesses, order and interpret diagnostic tests, and prescribe pharmaceutical and non-pharmaceutical therapies. Although the training, education, and licensure differ between PAs and NPs, their roles are quite similar in head and neck surgery...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29429145/impact-of-an-interprofessional-primary-care-training-on-fear-of-cancer-recurrence-on-clinicians-knowledge-self-efficacy-anticipated-practice-behaviors-and-attitudes-toward-survivorship-care
#7
Julie Berrett-Abebe, Tamara Cadet, Larissa Nekhlyudov, Joan Vitello, Peter Maramaldi
There are an estimated 15.5 million cancer survivors in the United States, with numbers projected to increase. Many cancer survivors are receiving survivorship care in primary care settings, yet primary care providers report a need for additional training on addressing medical and psychosocial concerns of cancer survivors. This paper presents findings from a pilot study on the effectiveness of a novel training for interprofessional primary care providers on the clinically significant issue of fear of cancer recurrence...
February 10, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29421014/use-of-echocardiography-in-outpatients-with-chest-pain-and-normal-resting-electrocardiograms-referred-to-mayo-clinic-rochester
#8
Raymond J Gibbons, Damita Carryer, Hongfang Liu, Peter A Brady, John Wells Askew, David Hodge, Naser Ammash, Jon O Ebbert, Veronique L Roger
OBJECTIVES: To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). BACKGROUND: There are scant data to indicate how often Class III recommendations are ignored in clinical practice. PATIENTS AND METHODS: We searched electronically all medical records of referral outpatients seen at Mayo Clinic Rochester from January 1, 2010, through December 31, 2013, to identify patients with stable chest pain and known or suspected coronary artery disease who underwent resting echocardiography and had normal resting ECGs and no other indication for echocardiography...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29420414/the-comprehensive-addiction-and-recovery-act-opioid-use-disorder-and-midwifery-practice
#9
Jeanne Murphy, Daisy Goodman, M Christina Johnson, Mishka Terplan
The federal response to the opioid use disorder crisis has included a mobilization of resources to encourage office-based pharmacotherapy with buprenorphine, an effort culminating in the 2016 Comprehensive Addiction and Recovery Act, signed into law as Public Law 114-198. The Comprehensive Addiction and Recovery Act was designed to increase access to treatment with special emphasis on services for pregnant women and follow-up for infants affected by prenatal substance exposure. In this effort, the Comprehensive Addiction and Recovery Act laudably expands eligibility for obtaining a waiver to prescribe buprenorphine to nurse practitioners and physician assistants...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29420330/promoting-interprofessional-collaborative-practice-through-simulation
#10
Celeste M Alfes, Tonya Rutherford-Hemming, Casey M Schroeder-Jenkinson, Cynthia Booth Lord, Elizabeth Zimmermann
A 12-week program was developed to educate nursing, medicine, and physician assistant faculty on the principles and best practices of simulation. The goal was to facilitate team building and collaborative practice through the implementation of an interprofessional (IP) simulation experience for students. Workshops focused on IP communication involving seminar-based instruction, discussion, and the progressive development of an IP simulation based on a National League for Nursing Advancing Care Excellence for Seniors scenario...
February 7, 2018: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29417395/islamic-considerations-on-the-application-of-patient-s-autonomy-in-end-of-life-decision
#11
Mohammad Mustaqim Malek, Noor Naemah Abdul Rahman, Mohd Shahnaz Hasan, Luqman Haji Abdullah
In end-of-life situation, the need for patient's preference comes into the picture with the intention of guiding physicians in the direction of patient care. Preference in medical directive is made by a person with full mental capacity outlining what actions should be taken for his health should he loses his competency. This is based on the reality of universal paradigm in medical practice that emphasises patient's autonomy. A specific directive is produced according to a patient's wish that might include some ethically and religiously controversial directives such as mercy killing, physician-assisted suicide, forgoing life-supporting treatments and do-not-resuscitate...
February 7, 2018: Journal of Religion and Health
https://www.readbyqxmd.com/read/29409553/diagnostic-errors-in-paediatric-cardiac-intensive-care
#12
Priya N Bhat, John M Costello, Ranjit Aiyagari, Paul J Sharek, Claudia A Algaze, Mjaye L Mazwi, Stephen J Roth, Andrew Y Shin
Introduction Diagnostic errors cause significant patient harm and increase costs. Data characterising such errors in the paediatric cardiac intensive care population are limited. We sought to understand the perceived frequency and types of diagnostic errors in the paediatric cardiac ICU. METHODS: Paediatric cardiac ICU practitioners including attending and trainee physicians, nurse practitioners, physician assistants, and registered nurses at three North American tertiary cardiac centres were surveyed between October 2014 and January 2015...
February 7, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29404948/a-randomized-trial-on-the-efficacy-of-mastery-learning-for-primary-care-provider-melanoma-opportunistic-screening-skills-and-practice
#13
June K Robinson, Namita Jain, Ashfaq A Marghoob, William McGaghie, Michael MacLean, Pedram Gerami, Brittney Hultgren, Rob Turrisi, Kimberly Mallett, Gary J Martin
BACKGROUND: Early detection of melanoma represents an opportunity to reduce the burden of disease among people at increased risk for melanoma. OBJECTIVE: To develop and demonstrate the efficacy of online training. DESIGN: Randomized educational trial. PARTICIPANTS: Primary care providers (PCPs). INTERVENTION: Mastery learning course with visual and dermoscopic assessment, diagnosis and management, and deliberate practice with feedback to reach a minimum passing standard...
February 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29404881/appointment-scheduling-in-multi-stage-outpatient-clinics
#14
Kenneth J Klassen, Reena Yoogalingam
Healthcare providers can benefit from adding less costly capacity to their existing resources in order to satisfy demand while maintaining the quality of patient care. The addition of mid-level service providers (MLSPs) such as physician assistants or nurse practitioners that carry out portions of patient care provides a viable alternative for adding physician capacity. This research considers the circumstances under which adding an MLSP to a single-physician outpatient office becomes the best strategy for the clinic, and determines how scheduling policies from the widely-researched single-stage environment should be adjusted for a multi-stage environment...
February 5, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29403604/factors-affecting-public-dissatisfaction-with-urban-family-physician-plan-a-general-population-based-study-in-fars-province
#15
Mohammad Hadi Imanieh, Alireza Mirahmadizadeh, Bahareh Imani
Background: Understanding the level of public satisfaction with a family physician plan as well as the relevant factors in this respect, can be employed as valuable tools in identifying quality of services. Objective: To determine the factors affecting public dissatisfaction with an urban family physician plan in Iran. Methods: This cross-sectional study was conducted from January 2014 through June 2015 on Fars Province residents in Iran, selected based on cluster sampling method...
November 2017: Electronic Physician
https://www.readbyqxmd.com/read/29394430/development-and-implementation-of-an-inpatient-otolaryngology-consultation-service-at-an-academic-medical-center
#16
Matthew G Huddle, Nyall R London, C Matthew Stewart
OBJECTIVES: To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. METHODS: This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward)...
February 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29394421/on-improving-mental-health-services-through-physician-assistants-legislation-in-several-southern-states
#17
Keisha L Pitts, Stephanie Radix
No abstract text is available yet for this article.
February 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29388276/involvement-of-nurses-in-end-of-life-discussions-for-severely-disabled-children
#18
I H Zaal-Schuller, D I Willems, F Ewals, J B van Goudoever, M A de Vos
BACKGROUND: In children with profound intellectual and multiple disabilities (PIMD), discussions about end-of-life decisions (EoLDs) are comparatively common. Nurses play a crucial role in the care for these children, yet their involvement in EoLD discussions is largely unknown. The objective of this research was to investigate the involvement in the hospital of nurses in discussions with parents and physicians about EoLDs for children with PIMD. METHOD: In a retrospective, qualitative study, we conducted semi-structured interviews with the nurses of 12 children with PIMD for whom an EoLD was made within the past 2 years...
January 31, 2018: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29385203/practice-variation-and-practice-guidelines-attitudes-of-generalist-and-specialist-physicians-nurse-practitioners-and-physician-assistants
#19
David A Cook, Laurie J Pencille, Denise M Dupras, Jane A Linderbaum, V Shane Pankratz, John M Wilkinson
OBJECTIVE: To understand clinicians' beliefs about practice variation and how variation might be reduced. METHODS: We surveyed board-certified physicians (N = 178), nurse practitioners (N = 60), and physician assistants (N = 12) at an academic medical center and two community clinics, representing family medicine, general internal medicine, and cardiology, from February-April 2016. The Internet-based questionnaire ascertained clinicians' beliefs regarding practice variation, clinical practice guidelines, and costs...
2018: PloS One
https://www.readbyqxmd.com/read/29384775/implementation-of-an-asthma-self-management-education-guideline-in-the-emergency-department-a-feasibility-study
#20
Eric Roberts, Barbara Velsor-Friedrich, Vicki Keough
Patients often present to emergency departments (EDs) for the management of chronic asthma. Because of the nature of ED care, national guideline recommendations for asthma education are generally not initiated in the ED. There is evidence that asthma education can have a positive effect on patient outcomes (; ). This study examines the feasibility of implementing an asthma self-management guideline in a tertiary care center ED. Despite protocol utilization by physicians (87%), nurse practitioners and physician assistants (66...
January 2018: Advanced Emergency Nursing Journal
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