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https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#1
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28424027/the-value-of-european-exchange-programs-for-early-career-family-doctors
#2
Bernadeta Bridgwood, Hannah Willoughby, Madeleine Attridge, Eugene Tang
The Hippokrates Exchange programme (HEP) is designed to give early career General Practitioners (Associates in Training (AITs)/First5s) first-hand experience into concepts of a primary healthcare system outside of their host country. The aim is to improve GP knowledge and skills, inspire professional development and promote a global approach to primary care. Although an increasing number are taking up this opportunity, their views and experiences of international exchanges are not well described. The aim of the study was to explore the experiences of AITs/First5s following their HEP exchanges...
April 20, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28422296/keeping-out-and-getting-in-reframing-emergency-department-gatekeeping-as-structural-competence
#3
Mara Buchbinder
Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28421425/the-role-of-alaska-s-tribal-health-workers-in-supporting-families
#4
Miriam Chernoff, Katie Cueva
Alaska's Community Health Aides/Practitioners (CHA/Ps) are often the sole medical workers in their communities in rural Alaska, and are instrumental in providing healthcare services and education to otherwise underserved individuals. This qualitative study explored how CHA/Ps support healthy families. Six CHA/Ps from two rural communities in western Alaska were interviewed about their scope of practice, interactions with mothers, infants, families, and teens, relationship to other medical providers, and perceptions of their work...
April 18, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28420688/can-a-partnership-between-general-practitioners-and-ambulance-services-reduce-conveyance-to-emergency-care
#5
Manuel Villarreal, Jonathan Leach, Kandala Ngianga-Bakwin, Jeremy Dale
BACKGROUND: Emergency services are facing increasing workload pressures, and new models of care are needed. We evaluate the impact of a service development involving a partnership between emergency ambulance crews and general practitioners (GPs) on reducing conveyance rates to the Hospital Emergency Department (ED). METHODS: The service model was implemented in the West Midlands of England. Call handlers identified patients with needs that could be addressed by a GP using locally agreed criteria...
April 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#6
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28413420/overcrowding-in-emergency-departments-a-review-of-strategies-to-decrease-future-challenges
#7
REVIEW
Mohammad H Yarmohammadian, Fatemeh Rezaei, Abbas Haghshenas, Nahid Tavakoli
Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28409062/improved-availability-and-quality-of-care-with-epilepsy-nurse-practitioners
#8
Chloe E Hill, Bethany Thomas, Kimberly Sansalone, Kathryn A Davis, Judy A Shea, Brian Litt, Nabila Dahodwala
BACKGROUND: This study investigated the quality of care delivered by nurse practitioner (NP)-physician teams employed to expand clinic appointment availability for patients with epilepsy. METHODS: We performed a retrospective observational cohort study of patients with epilepsy presenting to the Penn Epilepsy Center for a new patient appointment in 2014. During this time, patients were seen either by an NP-physician team care model or a more traditional physician-only care model...
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28403719/setting-the-bar
#9
Erin Dean
Amy Cawthorne, an advanced clinical practitioner in emergency care in Leeds, is one of the first emergency nurses in the country to reach a national standard for her role.
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28403655/prevalence-mortality-and-health-care-use-among-patients-with-cluster-b-personality-disorders-clinically-diagnosed-in-quebec
#10
Lionel Cailhol, Éric Pelletier, Louis Rochette, Lise Laporte, Pierre David, Évens Villeneuve, Joel Paris, Alain Lesage
BACKGROUND: Cluster B personality disorders (PDs) are prevalent mental health conditions in the general population (1%-6% depending on the subtype and study). Affected patients are known to be heavier users of both mental and medical health care systems than patients with other clinical conditions such as depression. METHODS: Several rates were estimated using data from the integrated monitoring system for chronic diseases in the province of Quebec, Canada. It provides a profile of annual and period prevalence rates, mortality rates, and years of lost life as well as health care utilisation rates for Quebec residents...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28399716/the-lgbtqi-health-forum-an-innovative-interprofessional-initiative-to-support-curriculum-reform
#11
Hannan M Braun, David Ramirez, Greg J Zahner, Eva Mae Gillis-Buck, Heather Sheriff, Marcus Ferrone
Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals continue to face barriers to accessing appropriate and comprehensive healthcare. Compounding this problem, healthcare trainees report few training opportunities and low levels of preparedness to care for LGBTQI patients. In 2009, an interprofessional group of students and a faculty advisor at the University of California, San Francisco, developed a novel student-organized LGBTQI Health Forum for medical, dental, pharmacy, nursing, and physical therapy students to deliver LGBTQI health content that was otherwise absent from the formal curriculum...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28388372/protein-delivery-in-the-intensive-care-unit-optimal-or-suboptimal
#12
Daren K Heyland, Peter J M Weijs, Jorge A Coss-Bu, Beth Taylor, Arnold S Kristof, Grant E O'Keefe, Robert G Martindale
Emerging evidence suggests that exogenous protein/amino acid supplementation has the potential to improve the recovery of critically ill patients. After a careful review of the published evidence, experts have concluded that critically ill patients should receive up to 2.0-2.5 g/kg/d of protein. Despite this, however, recent review of current International Nutrition Survey data suggests that protein in critically ill patients is underprescribed and grossly underdelivered. Furthermore, the survey suggests that most of protein administration comes from enteral nutrition (EN) despite the availability of products and protocols that enhance the delivery of protein/amino acids in the intensive care unit (ICU) setting...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28384433/self-management-of-health-care-multimethod-study-of-using-integrated-health-care-and-supportive-housing-to-address-systematic-barriers-for-people-experiencing-homelessness
#13
Cameron Parsell, Charlotte Ten Have, Michelle Denton, Zoe Walter
Objectives The aims of the present study were to examine tenants' experiences of a model of integrated health care and supportive housing and to identify whether integrated health care and supportive housing improved self-reported health and healthcare access.Methods The present study used a mixed-method survey design (n=75) and qualitative interviews (n=20) performed between September 2015 and August 2016. Participants were tenants of permanent supportive housing in Brisbane (Qld, Australia). Qualitative data were analysed thematically...
April 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28384077/american-telemedicine-association-telestroke-guidelines
#14
Bart M Demaerschalk, Jill Berg, Brian W Chong, Hartmut Gross, Karin Nystrom, Opeolu Adeoye, Lee Schwamm, Lawrence Wechsler, Sallie Whitchurch
The following telestroke guidelines were developed to assist practitioners in providing assessment, diagnosis, management, and/or remote consultative support to patients exhibiting symptoms and signs consistent with an acute stroke syndrome, using telemedicine communication technologies. Although telestroke practices may include the more broad utilization of telemedicine across the entire continuum of stroke care, with some even consulting on all neurologic emergencies, this document focuses on the acute phase of stroke, including both pre- and in-hospital encounters for cerebrovascular neurological emergencies...
April 6, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28376886/is-the-co-location-of-gps-in-primary-care-centres-associated-with-a-higher-patient-satisfaction-evidence-from-a-population-survey-in-italy
#15
Manila Bonciani, Sara Barsanti, Anna Maria Murante
BACKGROUND: Several countries have co-located General Practitioners (GPs) in Primary Care Centres (PCCs) with other health and social care professionals in order to improve integrated care. It is not clear whether the co-location of a multidisciplinary team actually facilitates a positive patient experience concerning GP care. The aim of this study was to verify whether the co-location of GPs in PCCs is associated positively with patient satisfaction with their GP when patients have experience of a multidisciplinary team...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28372709/tachyarrhythmias-and-bradyarrhythmias-differential-diagnosis-and-initial-management-in%C3%A2-the-primary-care-office
#16
REVIEW
Timothy Joseph Byrnes, Otto Costantini
Tachyarrhythmias and bradyarrhythmias are often seen in the outpatient setting. Patients can present minimally symptomatic or in extremis. Accurate diagnosis of the rhythm, plus a detailed clinical history, are critical for best management and optimal outcome. A 12-lead electrocardiogram is the cornerstone for diagnosis. Practitioners must identify patients who need immediate transport to an emergency department versus those who can safely wait for an outpatient specialty referral. This article reviews how to accurately diagnose and differentiate the most common tachyarrhythmias and bradyarrhythmias, the associated symptoms, and important concepts for the initial steps in the office management of such arrhythmias...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28371888/tobacco-nicotine-education-and-training-for-health-care-professional-students-and-practitioners-a-systematic-review
#17
Lisa Ye, Catherine Goldie, Tanvi Sharma, Sheila John, Megan Bamford, Patricia M Smith, Peter Selby, Annette Sh Schultz
Introduction: The objective of this systematic review was to investigate what education and training characteristics prepares and supports health-care professionals (HCPs) in the delivery of competent and effective care to clients who use tobacco-nicotine. Methods: A search of eight bibliographic databases for English-language peer-reviewed publications from January 2006 to March 2015. Studies were included if they met the a priori inclusion criteria, which consisted of: 1) quantitative study design, and 2) focus on tobacco-nicotine education or training for HCP students and practitioners...
March 29, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28367789/the-emergence-of-enterovirus-d68-in-england-in-autumn-2014-and-the-necessity-for-reinforcing-enterovirus-respiratory-screening
#18
A I Carrion Martin, R G Pebody, K Danis, J Ellis, S Niazi, S DE Lusignan, K E Brown, M Zambon, D J Allen
In autumn 2014, enterovirus D68 (EV-D68) cases presenting with severe respiratory or neurological disease were described in countries worldwide. To describe the epidemiology and virological characteristics of EV-D68 in England, we collected clinical information on laboratory-confirmed EV-D68 cases detected in secondary care (hospitals), between September 2014 and January 2015. In primary care (general practitioners), respiratory swabs collected (September 2013-January 2015) from patients presenting with influenza-like illness were tested for EV-D68...
April 3, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28363384/dedicated-educational-nursing-unit-clinical-instructors-role-perceptions-and-learning-needs
#19
Donna M Glynn, Cecilia McVey, Judith Wendt, Bonnie Russell
Over the past decade, health care leaders have called for a radical transformation in health care and nursing education. Patient care has become complex, demanding succinct interprofessional communication and collaboration to optimize the care of the patient, and the nurse at the bedside is the optimal leader at the point of care. Assistance with the clinical reasoning and critical thinking with nursing students is pivotal for successful patient outcomes. The expert clinical nurse at the bedside is the premier faculty to guide the young practitioner in the care of the patient...
March 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28359713/child-passenger-safety-an-assessment-of-emergency-nurses-knowledge-and-provision-of-information-in-the-emergency-department
#20
Thelma C Kuska, Mark R Zonfrillo
Each year, more than 130,000 children younger than 13 years are treated in the emergency department after evaluation of injuries sustained from motor vehicle crashes (MVCs). Many of these injuries can be prevented with use of child restraints. In this study we sought to assess emergency nurses' knowledge of child passenger safety (CPS) and its use to keep children safe while traveling in motor vehicles. METHODS: A cross-sectional anonymous study was distributed electronically to 530 emergency nurses who were asked to forward the survey link to other emergency nurses through snowball sampling...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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