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Direct observation of medical residents

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https://www.readbyqxmd.com/read/27914750/-medical-prescription-and-informed-consent-for-the-use-of-physical-restraints-in-nursing-homes-in-the-canary-islands-spain
#1
Gabriel J Estévez-Guerra, Emilio Fariña-López, Eva Penelo
OBJECTIVE: To identify the frequency of completion of informed consent and medical prescription in the clinical records of older patients subject to physical restraint, and to analyse the association between patient characteristics and the absence of such documentation. METHODS: A cross-sectional and descriptive multicentre study with direct observation and review of clinical records was conducted in nine public nursing homes, comprising 1,058 beds. RESULTS: 274 residents were physically restrained...
November 30, 2016: Gaceta Sanitaria
https://www.readbyqxmd.com/read/27903252/shifting-tides-in-the-emigration-patterns-of-canadian-physicians-to-the-united-states-a-cross-sectional-secondary-data-analysis
#2
Thomas R Freeman, Stephen Petterson, Sean Finnegan, Andrew Bazemore
BACKGROUND: The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a 'brain drain' and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources...
December 1, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#3
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27825345/reconfiguring-health-workforce-a-case-based-comparative-study-explaining-the-increasingly-diverse-professional-roles-in-europe
#4
Antoinette de Bont, Job van Exel, Silvia Coretti, Zeynep Güldem Ökem, Maarten Janssen, Kristin Lofthus Hope, Tomasz Ludwicki, Britta Zander, Marie Zvonickova, Christine Bond, Iris Wallenburg
BACKGROUND: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change...
November 8, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27777666/internal-medicine-residents-retention-of-knowledge-and-skills-in-bedside-ultrasound
#5
James A Town, Paul A Bergl, Akhil Narang, John F McConville
BACKGROUND : The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. OBJECTIVE : We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. METHODS : We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice...
October 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27749720/patient-centered-handovers-ethnographic-observations-of-attending-and-resident-physicians-ethnographic-observations-of-attending-and-resident-physicians
#6
Austin F Mount-Campbell, Michael F Rayo, James J OʼBrien, Theodore T Allen, Emily S Patterson
Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and resident physicians in 2 medical intensive care units at one institution. Digitally audiotaped data were manually analyzed for content using codes and time spent using box plots for emergent categories...
October 2016: Quality Management in Health Care
https://www.readbyqxmd.com/read/27721664/is-adherence-to-imatinib-mesylate-treatment-among-patients-with-chronic-myeloid-leukemia-associated-with-better-clinical-outcomes-in-qatar
#7
Nader I Al-Dewik, Hisham M Morsi, Muthanna M Samara, Rola S Ghasoub, Cinquea C Gnanam, Subi K Bhaskaran, Abdulqadir J Nashwan, Rana M Al-Jurf, Mohamed A Ismail, Mohammed M AlSharshani, Ali A AlSayab, Tawfeg I Ben-Omran, Rani B Khatib, Mohamed A Yassin
BACKGROUND: Despite the revolutionary success of introducing tyrosine kinase inhibitors (TKIs), such as imatinib mesylate (IM), for treating chronic myeloid leukemia (CML), a substantial proportion of patients' treatments fail. AIM: This study investigates the correlation between patient adherence and failure of TKIs' treatment in a follow-up study. METHODS: This is a follow-up study of a new cohort of CML patients. Adherence to IM is assessed using the Medication Event Monitoring System (MEMS 6 TrackCap, AARDEX Ltd)...
2016: Clinical Medicine Insights. Oncology
https://www.readbyqxmd.com/read/27638987/joint-sogc-ccmg-opinion-for-reproductive-genetic-carrier-screening-an-update-for-all-canadian-providers-of-maternity-and-reproductive-healthcare-in-the-era-of-direct-to-consumer-testing
#8
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27628722/-sometimes-the-work-just-needs-to-be-done-socio-cultural-influences-on-direct-observation-in-medical%C3%A2-training
#9
Christopher Watling, Kori A LaDonna, Lorelei Lingard, Stephane Voyer, Rose Hatala
CONTEXT: Direct observation promises to strengthen both coaching and assessment, and calls for its increased use in medical training abound. Despite its apparent potential, the uptake of direct observation in medical training remains surprisingly limited outside the formal assessment setting. The limited uptake of observation raises questions about cultural barriers to its use. In this study, we explore the influence of professional culture on the use of direct observation within medical training...
October 2016: Medical Education
https://www.readbyqxmd.com/read/27605458/influence-of-cognitive-impairment-on-fall-risk-among-elderly-nursing-home-residents
#10
M Seijo-Martinez, J M Cancela, C Ayán, S Varela, H Vila
BACKGROUND: Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents. METHODS: A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20-24) "MCI", moderate (14-19) "MOCI", and severe (≤14) "SCI"...
September 8, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27604332/prevalence-goals-of-care-and-long-term-outcomes-of-patients-with-life-limiting-illness-referred-to-a-tertiary-icu
#11
Neil R Orford, Sharyn L Milnes, Nigel Lambert, Laura Berkeley, Stephen E Lane, Nicholas Simpson, Tania Elderkin, Allison Bone, Peter Martin, Charlie Corke, Rinaldo Bellomo, Michael Bailey
OBJECTIVE: To describe the prevalence, characteristics, long-term outcomes and goals-of-care discussions of patients with objective indicators of life-limiting illnesses (LLIs) referred to the intensive care unit. DESIGN, SETTING AND PATIENTS: A prospective, observational, cohort study of all adult inpatients referred to the ICU by the medical emergency team or by direct referral, during the period 30 August 2012 to 1 February 2013, at a tertiary teaching hospital in Australia...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27544939/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2017-rates-quality-reporting-requirements-for-specific-providers-graduate
#12
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation...
August 22, 2016: Federal Register
https://www.readbyqxmd.com/read/27503793/adverse-child-experiences-and-health-in-adulthood-in-a-rural-population-based-sample
#13
Kristen C Iniguez, Rachel V Stankowski
BACKGROUND: Adverse childhood experiences (ACEs), including emotional abuse, substance abuse in the household, separation or divorce, physical abuse, violence between adults, mental illness in the household, sexual abuse, or incarceration of a household member, have the potential to profoundly impact health and well-being in adulthood. To assess whether previously reported relationships between ACEs and health outcomes withstand validation, we conducted a community-based ACE study with the unique capacity to link self-reported ACEs and other survey results to validated health data in an electronic medical record (EMR)...
August 8, 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/27496242/effect-of-warning-symbols-in-combination-with-education-on-the-frequency-of-erroneously-crushing-medication-in-nursing-homes-an-uncontrolled-before-and-after-study
#14
Steven van Welie, Linda Wijma, Tim Beerden, Jasperien van Doormaal, Katja Taxis
OBJECTIVES: Residents of nursing homes often have difficulty swallowing (dysphagia), which complicates the administration of solid oral dosage formulations. Erroneously crushing medication is common, but few interventions have been tested to improve medication safety. Therefore, we evaluated the effect of warning symbols in combination with education on the frequency of erroneously crushing medication in nursing homes. SETTING: This was a prospective uncontrolled intervention study with a preintervention and postintervention measurement...
2016: BMJ Open
https://www.readbyqxmd.com/read/27488489/teaching-leadership-in-trauma-resuscitation-immediate-feedback-from-a-real-time-competency-based-evaluation-tool-shows-long-term-improvement-in-resident-performance
#15
Shea C Gregg, Daithi S Heffernan, Michael D Connolly, Andrew H Stephen, Stephanie N Leuckel, David T Harrington, Jason T Machan, Charles A Adams, William G Cioffi
BACKGROUND: Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. METHODS: An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards...
October 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27479831/direct-observation-assessing-orthopaedic-trainee-competence-in-the-ambulatory-setting
#16
Donna P Phillips, Joseph D Zuckerman, Adina Kalet, Kenneth A Egol
The Accreditation Council of Graduate Medical Education requires that residency programs teach and assess trainees in six core competencies. Assessments are imperative to determine trainee competence and to ensure that excellent care is provided to all patients. A structured, direct observation program is feasible for assessing nontechnical core competencies and providing trainees with immediate constructive feedback. Direct observation of residents in the outpatient setting by trained faculty allows assessment of each core competency...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27450068/impact-of-rheumatoid-arthritis-in-the-public-health-system-in-santa-catarina-brazil-a-descriptive-and-temporal-trend-analysis-from-1996-to-2009
#17
Rafael Kmiliauskis Santos Gomes, Fabio Antero Pires, Moacyr Roberto Cuce Nobre, Mauricio Felippi de Sá Marchi, Jennifer Cristina Kozechen Rickli
INTRODUCTION: There are few studies that carried out a descriptive and trend analysis based on available data from the Unified Health System (SUS) between pre- and post-free dispensing of pharmacological treatment of rheumatoid arthritis (RA) from the perspective of the public health system, in terms of the direct cost of the disease among adults and elderly residents of the state of Santa Catarina, Brazil. This study aims to characterize the direct cost of medical and surgical procedures before and after the dispensing of drugs in this state...
July 2, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27331148/video-observation-of-procedural-skills-for-assessment-of-trabeculectomy-performed-by-residents
#18
Narges Hassanpour, Rebecca Chen, Masoud Baikpour, Sasan Moghimi
PURPOSE: The efficacy and sufficiency of a healthcare system is directly related to the knowledge and skills of graduates working in the system. In this regard, many different assessment methods have been proposed to evaluate various skills of the learners. Video Observation of Procedural Skills (VOPS) is one newly-proposed method. In this study we aimed to compare the results of the VOPS method with the more commonly used Direct Observation of Procedural Skills (DOPS). METHODS: In this prospective study conducted in 2012, all 10 ophthalmology residents of post graduate year 4 were selected for participation...
June 2016: Journal of Current Ophthalmology
https://www.readbyqxmd.com/read/27303094/utilization-of-pharmacy-technicians-to-increase-the-accuracy-of-patient-medication-histories-obtained-in-the-emergency-department
#19
Ellen C Rubin, Radhika Pisupati, Steven F Nerenberg
PURPOSE: The purpose of this study is to determine the accuracy of a pharmacy technician-collected medication history pilot program in the emergency department. This was completed by reviewing all elements of the technician activity by direct observation and by verifying the technician-collected medication list through a second phone call by a pharmacist to the outpatient pharmacy. METHODS: This was a retrospective, single-center study conducted from March to April 2015...
May 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27285377/direct-observation-of-clinical-skills-feedback-scale-development-and-validity-evidence
#20
Samantha Halman, Nancy Dudek, Timothy Wood, Debra Pugh, Claire Touchie, Sean McAleer, Susan Humphrey-Murto
: Construct: This article describes the development and validity evidence behind a new rating scale to assess feedback quality in the clinical workplace. BACKGROUND: Competency-based medical education has mandated a shift to learner-centeredness, authentic observation, and frequent formative assessments with a focus on the delivery of effective feedback. Because feedback has been shown to be of variable quality and effectiveness, an assessment of feedback quality in the workplace is important to ensure we are providing trainees with optimal learning opportunities...
October 2016: Teaching and Learning in Medicine
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