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Emergency care practitioner

Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Tara Follett, Sara Calderon-Crossman, Denise Clarke, Marcia Ergezinger, Christene Evanochko, Krystal Johnson, Natalie Mercy, Barbara Taylor
BACKGROUND: A level 1 community hospital with a labor, delivery, recovery, and postpartum (LDRP) unit delivering over 2800 babies per year was operating without dedicated neonatal resuscitation and stabilization support. PURPOSE: With lack of funding and space to provide an onsite level 2 neonatal intensive care unit (NICU), a position was created to provide neonatal nurse practitioner (NNP) coverage to support the LDRP unit. METHOD: The article describes the innovative solution of having an NNP team rotate from a regional neonatal intensive care program to a busy community LDRP unit...
October 4, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Annelies Colliers, Roy Remmen, Marie-Luise Streffer, Barbara Michiels, Stefaan Bartholomeeusen, Koenraad G Monsieurs, Jef Goris, Samuel Coenen, Veronique Verhoeven, Hilde Philips
BACKGROUND: The implementation of general practitioner cooperatives (GPC) for out-of-hours (OOH) primary care, raises the question if the location of a GPC adjacent to a hospital reduces the OOH caseload of the emergency department (ED). METHODS: Two natural experiments were used in this before-after study, the effect of the implementation of two GPCs in two different regions on the out-of-hours caseload of the local EDs was compared. One GPC was located adjacent to the ED of a general hospital, the other was not...
October 17, 2016: Acta Clinica Belgica
Catherine Shaw, Brendan McCormack, Carmel M Hughes
BACKGROUND: There is increasing interest in how culture may affect the quality of healthcare services, and previous research has shown that 'treatment culture'-of which there are three categories (resident centred, ambiguous and traditional)-in a nursing home may influence prescribing of psychoactive medications. OBJECTIVE: The objective of this study was to explore and understand treatment culture in prescribing of psychoactive medications for older people with dementia in nursing homes...
March 2016: Drugs—Real World Outcomes
G Iakimova, S Dimitrova, T Burté
OBJECTIVES: Computer-delivered Cognitive Behavioral Therapies (C-CBT) are emerging as therapeutic techniques which contribute to overcome the barriers of health care access in adult populations with depression. The C-CBTs provide CBT techniques in a highly structured format comprising a number of educational lessons, homework, multimedia illustrations and supplementary materials via interactive computer interfaces. Programs are often administrated with a minimal or regular support provided by a clinician or a technician via email, telephone, online forums, or during face-to-face consultations...
October 10, 2016: L'Encéphale
Matteo Lippi Bruni, Irene Mammi, Cristina Ugolini
Overcrowding in emergency departments generates potential inefficiencies. Using regional administrative data, we investigate the impact that an increase in the accessibility of primary care has on emergency visits in Italy. We consider two measures of avoidable emergency visits recorded at list level for each General Practitioner. We test whether extending practices' opening hours to up to 12 hours/day reduces the inappropriate utilization of emergency services. Since subscribing to the extension program is voluntary, we account for the potential endogeneity of participation in a count model for emergency admissions in two ways: first, we use a two-stage residual inclusion approach...
October 8, 2016: Journal of Health Economics
Barbara Stetson, Karl E Minges, Caroline R Richardson
Accelerating diabetes rates have resulted in a global public health epidemic. Lifestyle change is a cornerstone of care, yet regimen demands may result in adherence difficulties. Distress, depression, and other psychosocial concerns are higher in those with diabetes. While interventions, such as the Diabetes Prevention Program appear to be effective, further research is needed to support the translation of interventions to prevent diabetes. Studies assessing optimal approaches to promoting effective decision making, coping and adherence are needed...
October 14, 2016: Journal of Behavioral Medicine
Megan E Harrison, Chantalle Clarkin, Kristina Rohde, Kerry Worth, Nathalie Fleming
STUDY OBJECTIVE: To share pregnant and parenting youth's experiences with health care in order to inform recommendations for promoting youth-friendly medical encounters. DESIGN: This exploratory study used a qualitative descriptive approach. SETTING: Three urban centers that service pregnant youth and young parents in a large Canadian city. PARTICIPANTS: Convenience sample of 26 participants (mean age of 18.7 years) was recruited across sites...
October 11, 2016: Journal of Pediatric and Adolescent Gynecology
M Kamrul Islam, Egil Kjerstad
In the theoretical literature on general practitioner (GP) behaviour, one prediction is that intensified competition induces GPs to provide more services resulting in fewer hospital admissions. This potential substitution effect has drawn political attention in countries looking for measures to reduce the growth in demand for hospital care. However, intensified competition may induce GPs to secure hospital admissions a signal to attract new patients and to keep the already enlisted ones satisfied, resulting in higher admission rates at hospitals...
October 14, 2016: Health Economics
Tia Renouf, Megan Pollard
Rural and remote places like Sable Island (Nova Scotia) or François (Newfoundland) pose a challenge in delivering both health care and appropriate education that today's learners need to practice in a rural setting. This education can be difficult to deliver to students far from academic centers. This is especially true for learners and practitioners at offshore locations like ships, oil installations, or in the air when patients are transported via fixed wing aircraft or helicopter. The following editorial provides a snapshot of the setting and the challenges faced while working as a physician on a ship, in remote regions...
September 9, 2016: Curēus
Tom Blakeman, Kathryn Griffith, Dan Lasserson, Berenice Lopez, Jung Y Tsang, Stephen Campbell, Charles Tomson
OBJECTIVES: Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN: An appropriateness ratings evaluation using the RAND/UCLA Appropriateness Method. SETTING: Clinical scenarios were developed to test the timeliness in (1) communication of AKI warning stage test results from clinical pathology services to primary care, and (2) primary care clinician response to an AKI warning stage test result...
October 11, 2016: BMJ Open
(no author information available yet)
This book is an informative reference guide to pathologies, illnesses and some minor injuries that nurse practitioners, paramedics, doctors and allied health professionals are likely to deal with in their daily practice. Laid out in a logical way, its outlines red flags, risk factors, causes, assessment, diagnostics, and management of various conditions.
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Régine Goemaes, Dimitri Beeckman, Joline Goossens, Jill Shawe, Sofie Verhaeghe, Ann Van Hecke
AIM: the concept of 'advanced midwifery practice' is explored to a limited extent in the international literature. However, a clear conception of advanced midwifery practice is vital to advance the discipline and to achieve both internal and external legitimacy. This concept analysis aims to clarify advanced midwifery practice and identify its components. METHODS: a review of the literature was executed using Rodgers' evolutionary method of concept analysis to analyze the attributes, references, related terms, antecedents and consequences of advanced midwifery practice...
September 13, 2016: Midwifery
Renata Villoro, María Merino, Alvaro Hidalgo-Vega
PURPOSE: This study estimates the health-related quality of life and the health care resource utilization of patients diagnosed with chronic depression (CD) in Spain. PATIENTS AND METHODS: We used the Spanish National Health Survey 2011-2012, a cross-sectional survey representative at the national level, that selects people aged between 18 and 64 years (n=14,691). We estimated utility indices through the EuroQol five-dimensional descriptive system questionnaire included in the survey...
2016: Patient related Outcome Measures
Stacey E Walker, Ashley B Thrasher, Stephanie M Mazerolle
CONTEXT:  Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition. OBJECTIVE:  To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner. DESIGN:  Qualitative study. SETTING:  Individual phone interviews...
October 6, 2016: Journal of Athletic Training
Louise E Curley, Janice Moody, Rukshar Gobarani, Trudi Aspden, Maree Jensen, Maureen McDonald, John Shaw, Janie Sheridan
BACKGROUND: Worldwide the demands on emergency and primary health care services are increasing. General practitioners and accident and emergency departments are often used unnecessarily for the treatment of minor ailments. Community pharmacy is often the first port of call for patients in the provision of advice on minor ailments, advising the patient on treatment or referring the patient to an appropriate health professional when necessary. The potential for community pharmacists to act as providers of triage services has started to be recognised, and community pharmacy triage services (CPTS) are emerging in a number of countries...
2016: Journal of Pharmaceutical Policy and Practice
Linda L Coventry, Johanna W van Schalkwyk, Peter Thompson, Scott Hawkins, Desley Hegney
AIMS AND OBJECTIVES: To explore patient decision delay, the symptom experience, and factors that motivated the patient experiencing myocardial infarction (MI) to go to the emergency department (ED). BACKGROUND: Reperfusion for MI is more effective if performed as soon as possible after the onset of symptoms. Multiple studies show that prehospital delay is long and can average several hours. DESIGN: A qualitative descriptive design using semi-structured interviews...
October 5, 2016: Journal of Clinical Nursing
Alexis Descatha, Alice Huynh Tuong, Pierre Coninx, Michel Baer, Thomas Loeb, Thomas Despréaux
In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans...
2016: Frontiers in Public Health
Paul Grimshaw, Linda McGowan, Elaine McNichol
Purpose For leadership and management of Western health systems, good quality relationships are a fundamental cornerstone of organising health and social care (H&SC) delivery, delivering benefits across organisations and communities. The purpose of this paper is to explore the extant management, H&SC literature, grounded in older people care, reveal behaviours, processes and practices that if readily identified across a context will support healthy relationships across the "whole system" of stakeholders. Design/methodology/approach An academic/practitioner group designed and guided a scoping literature review of the H&SC and broader management literature to identify and extract important behaviours, processes and practices underlying the support of high-quality relationships...
October 10, 2016: Journal of Health Organization and Management
M Kennedy Hall, Jane Hall, Cary P Gross, Nir J Harish, Rachel Liu, Sean Maroongroge, Christopher L Moore, Christopher C Raio, R Andrew Taylor
OBJECTIVES: Point-of-care ultrasound is a valuable tool with potential to expedite diagnoses and improve patient outcomes in the emergency department. However, little is known about national patterns of adoption. This study examined nationwide point-of-care ultrasound reimbursement among emergency medicine (EM) practitioners and examined regional and practitioner level variations. METHODS: Data from the 2012 Center for Medicare and Medicaid Services Fee-for-Service Provider Utilization and Payment Data include all practitioners who received more than 10 Medicare Part B fee-for-service reimbursements for any Healthcare Common Procedure Coding System code in 2012...
October 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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