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https://www.readbyqxmd.com/read/28339685/information-needs-of-generalists-and-specialists-using-online-best-practice-algorithms-to-answer-clinical-questions
#1
David A Cook, Kristi J Sorensen, Jane A Linderbaum, Laurie J Pencille, Deborah J Rhodes
Objective: : To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. Methods: : We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#2
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28339374/basics-of-compounding-clinical-pharmaceutics-part-1
#3
Loyd V Allen
Pharmaceutics is relevant far beyond the pharmaceutical industry, compounding, and the laboratory. Pharmaceutics can be used to solve many clinical problems in medication therapy. A pharmacists' knowledge of the physicochemical aspects of drugs and drug products should help the patient, physician, and healthcare professionals resolve issues in the increasingly complex world of modern medicine. Pharmacy is unique as it contains a knowledge base significantly different from that of physicians, nurses, and other health-related practitioners...
September 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28335444/hiv-education-and-welfare-services-in-primary-care-an-empirical-model-of-integration-in-brazil-s-unified-health-system
#4
Rahbel Rahman, Rogério M Pinto, Melanie M Wall
Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#5
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333785/improving-decision-making-for-advanced-heart-failure-patients-and-caregivers
#6
Colleen K McIlvennan
In this month's Magnet® Perspectives column, Colleen K. McIlvennan, DNP, ANP, lead nurse practitioner, Advanced Heart Failure and Transplantation at the University of Colorado, discusses her groundbreaking research encompassing patients' and caregivers' emotional, rational, and fundamental beliefs when considering a left ventricular assist device (LVAD). Results have led to the development of 2 innovative decision aids that are currently in use by LVAD programs across the United States and Canada. Dr McIlvennan's efforts led to a $2 million grant from the Patient-Centered Outcomes Research Institute, as well as national recognition from the American Heart Association and the Heart Failure Society of America...
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28332289/the-lived-experience-of-nurse-practitioners-practicing-within-the-transformational-advanced-professional-practice-model-a-phenomenological-study
#7
Elizabeth C Elliott, Marlene Walden, Anne Young, Lene Symes, Nina Fredland
PURPOSE: The purpose of this study was to describe the lived experiences of nurse practitioners (NPs) practicing within the Transformational Advanced Professional Practice (TAPP) Model, a professional practice model (PPM). DATA SOURCES: A descriptive phenomenological analysis using semistructured interviews of 11 NPs across multiple inpatient and outpatient clinical areas at Texas Children's Hospital. Member checking and theming data occurred using Colaizzi's Method concurrently with Mind Mapping technique...
March 23, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28331972/safe-sleeping-positions-practice-and-policy-for-babies-with-cleft-palate
#8
Karen Davies, Iain A Bruce, Patricia Bannister, Peter Callery
Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate...
March 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28329388/healthcare-claims-data-an-underutilized-tool-for-pediatric-outpatient-antimicrobial-stewardship
#9
Joshua R Watson, Ling Wang, Jennifer Klima, Melissa Moore-Clingenpeel, Sean Gleeson, Kelly Kelleher, Preeti Jaggi
Background: Healthcare claims are under-utilized to identify factors associated with high outpatient antibiotic use. Methods: We evaluated ambulatory encounter claims of Medicaid-insured children in 34 Ohio counties in 2014. 1) Rates of total antibiotic and azithromycin prescriptions dispensed were determined by county of patient residence. 2) Standardized treatment rates by county were estimated for uncomplicated upper respiratory tract encounters (acute otitis media, pharyngitis, sinusitis, presumed viral infection) after adjusting for patient age and encounter provider type...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328684/eastern-association-for-the-surgery-of-trauma-society-of-trauma-nurses-advanced-practitioner-position-paper-optimizing-the-integration-of-advanced-practitioners-in-trauma-and-critical-care
#10
Jonathan Messing, Jasmine Garces-King, Dennis Taylor, Jonathan Van Horn, Babak Sarani, A Britton Christmas
Nurse Practitioners and Physician Assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma (EAST), the Society of Trauma Nurses (STN), and the American Association of Surgical Physicians Assistants (AASPA) acknowledge the value of APs and support their utilization in the management of injured and critically ill patients...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#11
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328312/adolescent-substance-use-assessing-the-knowledge-attitudes-and-practices-of-a-school-based-health-center-workforce
#12
Mary M Ramos, Rachel A Sebastian, Mary Murphy, Kristin Oreskovich, Timothy P Condon
BACKGROUND: Recent attention has focused on the potential for school-based health centers (SBHCs) to provide access points for adolescent substance use care. In 2015, the University of New Mexico began screening, brief intervention, and referral to treatment (SBIRT) training for providers at New Mexico Department of Health (NMDOH)-funded SBHCs across the state. This study assesses baseline knowledge, attitudes, and practices of the New Mexico SBHC provider workforce regarding adolescent substance use and provision of services...
February 8, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#13
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#14
Thomas J Caruso, Ellen Wang, Hayden T Schwenk, David Scheinker, Calida Yeverino, Mary Tweedy, Manjit Maheru, Paul J Sharek
BACKGROUND: The risk of surgical site infections is reduced with appropriate timing and dosing of preoperative antimicrobials. Based on evolving national guidelines, we increased the preoperative dose of cefazolin from 25 to 30 mg·kg(-1) . This quality improvement project describes an improvement initiative to develop standard work processes to ensure appropriate dosing. AIMS: The primary aim was to deliver cefazolin 30 mg·kg(-1) to at least 90% of indicated patients...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321968/practitioners-experiences-of-adolescent-suicidal-behaviour-in-peer-groups
#15
Stephen Briggs, Thomas Slater, Julia Bowley
INTRODUCTION: Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. AIM: To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/ needs, and how these insights inform understanding about these groups. METHOD: 10 practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England...
March 21, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28316784/characteristics-of-an-optimized-patient-information-material-for-elderly-patients-with-obstructive-pulmonary-diseases-based-on-patients-and-experts-assessment
#16
Gábor Tomisa, Alpár Horváth, Brigitta Dombai, Lilla Tamási
BACKGROUND: Life-long regular use of drugs is necessary in chronic diseases like asthma and COPD. There are several methods to improve adherence including patient information and education; however, their effectiveness on the basis of practical experience is often lower than originally planned and expected. Our objective is to develop a patient information material based on the recommendations of patients and their treating healthcare professionals to fulfill their needs. METHODS: A survey was conducted among pulmonologists (N = 262), asthma nurses (N = 102), general practitioners (N = 321) and patients with obstructive pulmonary disease (N = 978) using on line questionnaires...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28316554/does-telecare-improve-interorganisational-collaboration
#17
Jannie Kristine Bang Christensen
INTRODUCTION: Previous studies have suggested that telecare can improve interorganisational collaboration within fragmented health care systems, yet this outcome has not been examined in a large-scale setting. This study explores the effects of a large-scale interorganisational telecare programme in Denmark based on home-monitoring on collaboration in a telecare network between municipalities, hospitals, and general practitioners. METHODOLOGY: Semi-structured interviews and observations of collaborating health professionals from the municipalities, hospitals, and general practitioners were undertaken and then repeated a year later...
November 24, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28316553/community-hospitals-in-selected-high-income-countries-a-scoping-review-of-approaches-and-models
#18
Eleanor M Winpenny, Jennie Corbett, Celine Miani, Sarah King, Emma Pitchforth, Tom Ling, Edwin van Teijlingen, Ellen Nolte
BACKGROUND: There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. METHODS: We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis...
November 24, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28316266/differing-perspectives-on-parent-access-to-their-child-s-electronic-medical-record-during-neonatal-intensive-care-hospitalization-a-pilot-study
#19
Rebecca K Chung, Una Olivia Kim, Mir Abdul Basir
OBJECTIVE: To improve informed medical decision-making, principles for family-centered neonatal care recommends that parents have access to their child's medical record on an ongoing basis during neonatal intensive unit care (NICU) hospitalization. Currently many NICUs do not allow independent parent access to their child's electronic medical record (EMR) during hospitalization. We undertook a cross-sectional survey pilot study of medical professionals and parents to explore opinions regarding this practice...
March 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28315545/oral-anticancer-agents-an-intervention-to-promote-medication-adherence-and-symptom-management%C3%A2
#20
Sandra L Spoelstra, Alla Sikorskii, Atreyee Majumder, Peggy S Burhenn, Monica Schueller, Barbara Given
Symptom burden and poor adherence to oral anticancer agents remain significant clinical problems. This study examined feasibility, preliminary efficacy, and satisfaction with ADHERE, a nurse practitioner intervention that promotes symptom management and adherence among patients prescribed oral agents. The intervention group (which received one semistructured, face-to-face session followed by three weekly telephone sessions using motivational interviewing, brief cognitive-behavioral therapy, and a toolkit to promote self-management) had significantly lower symptom severity postintervention...
April 1, 2017: Clinical Journal of Oncology Nursing
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