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https://www.readbyqxmd.com/read/29785757/a-nursing-solution-to-primary-care-delivery-shortfall
#1
Michael Carter, Phillip Moore, Nina Sublette
Many countries project that they will have difficulty to meet their demand for primary care based on an inadequate supply of primary care doctors. There are many reasons for this, and they tend to vary by country. The policy options available to these countries are to increase the number of local primary care doctors, recruit doctors from other countries, ration primary care, shift more primary care to specialists, or authorize other disciplines to provide primary care. This article examines lessons learned in the United States over the past 50 years and proposes that expanding the use of nurse practitioners is the best solution when measured by feasibility, costs, ethics, and scope of the care delivered...
May 21, 2018: Nursing Inquiry
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#2
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29781471/translational-research-unit-development-of-nursing-standards-and-practice-within-a-specialized-unit-for-participants-in-early-phase-clinical-trials
#3
Theresa Rudnitzki, Tina Curtis, Julie Griffie
BACKGROUND: A growing need exists to ensure safe and skilled oncology nursing care for an increasing number of patients enrolled in phases 1 and 1/2 clinical trials and to provide detailed adherence to protocol administration. This can be best accomplished in a dedicated area for patients in early phase clinical trials. OBJECTIVES: Nursing standards and practice within a newly established translational research unit at an academic medical center were developed. METHODS: A portion of an existing outpatient infusion room composed of 13 beds and a sub-waiting room with 2 chairs was designated for placement of patients enrolled in early phase clinical trials...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29776706/gaps-in-pain-agitation-and-delirium-management-in-intensive-care-outputs-from-a-nurse-workshop
#4
REVIEW
Carsten Hermes, Maria Acevedo-Nuevo, Andrea Berry, Thomas Kjellgren, Alessandra Negro, Paola Massarotto
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29767916/in-depth-knowledge-of-the-role-of-the-clinical-mentor
#5
Claudia Soto Núñez, Lissette Avilés Reinoso, Camila Lucchini Raies, Paz Soto Fuentes
OBJECTIVES: This work sought to unveil the meaning expressed by clinical nurses by being mentors for students from the nursing internship level. METHODS: Phenomenological research. In-depth interviews were conducted with nine clinical nurses from a hospital in Santiago de Chile, who participate as mentors of nursing students in their last stage of university formation. RESULTS: Four comprehensive categories were obtained with their respective units of meaning by nursing: 1) vocation and gratification, 2) personal and professional challenge, 3) big responsibility, and 4) transmission of experience...
October 2017: Investigación y Educación en Enfermería
https://www.readbyqxmd.com/read/29767462/soluble-fiber-use-in-pediatric-short-bowel-syndrome-a-survey-on-prevailing-practices
#6
Meredith Linley Harvie, Margaret Alyssa Tucker Norris, Wednesday Marie A Sevilla
BACKGROUND: In pediatric short bowel syndrome (SBS), adding fiber to enteral feedings is 1 treatment method to manage increased stool output. However, there are no standardized recommendations on the use of fiber in this setting, including type, dosage, titration strategies, etc. OBJECTIVE: The aim of this study is to determine current prevailing practices on the use of fiber in the treatment of chronic high stool output in the pediatric SBS population. METHODS: An anonymous electronic survey with 13 questions was sent through health professional electronic mailing lists...
May 16, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29766259/a-telephone-outcall-program-to-support-caregivers-of-people-diagnosed-with-cancer-utility-changes-in-levels-of-distress-and-unmet-needs
#7
Leila Heckel, Kate M Fennell, Liliana Orellana, Anna Boltong, Monica Byrnes, Patricia M Livingston
PURPOSE: To evaluate the utility of a telephone outcall program for cancer caregivers and to examine longitudinal changes in their distress levels and supportive care needs. METHODS: As part of the PROTECT trial, caregivers assigned to the intervention arm (N = 108) received three telephone outcalls from a Cancer Council 13 11 20 nurse at three time points (7-10 days post-randomization, 1 and 4 months later). During each call, caregivers were screened for distress using the Distress Thermometer (range: 0-10) then six supportive care issues were raised for discussion...
May 15, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29762313/experiences-of-undergraduate-nursing-students-in-peer-assisted-learning-in-clinical-practice-a-qualitative-systematic-review
#8
Matthew C Carey, Bridie Kent, Jos M Latour
OBJECTIVES: The objective of this qualitative systematic review was to identify and synthesize the best available evidence on experiences of peer assisted learning (PAL) among student nurses in clinical practice so as to understand the value of PAL for this population. INTRODUCTION: Peer-assisted learning considers the benefits of peers working in collaboration and supporting each other in professional roles. This approach to facilitate learning is effective within universities, but there is limited exploration within the clinical practice environment...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29759258/improving-maternal-safety-at-scale-with-the-mentor-model-of-collaborative-improvement
#9
Elliott K Main, Ravi Dhurjati, Valerie Cape, Julie Vasher, Anisha Abreo, Shen-Chih Chang, Jeffrey B Gould
BACKGROUND: Obstetric safety bundles, consisting of action steps shown to improve outcomes, have been developed to address the most common and preventable causes of maternal morbidity and mortality. Implementing these best practices across all birthing facilities remains an important and challenging clinical and public health priority. METHODS: The California Maternal Quality Care Collaborative (CMQCC) developed an innovative external mentor model for large-scale collaborative improvement in which participating organizations were subdivided into small teams of six to eight hospitals, led by a paired dyad of physician and nurse leaders...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29754874/preoperative-screening-for-obstructive-sleep-apnea-and-outcomes-in-pacu
#10
Jill Setaro, Ruth Reinsel, Dana Brun
PURPOSE: Practice guidelines from the perianesthesia community suggest that preoperative identification of patients with obstructive sleep apnea (OSA) and standardized longer observation in postanesthesia care unit (PACU) promotes safety after general anesthesia. The purpose of this study was to determine if longer monitoring of patients with OSA in the PACU improves patient outcomes after general anesthesia. DESIGN: Evidence-based best practices literature review...
May 10, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29753297/a-clinical-trial-of-nurse-practitioner-care-in-residential-aged-care-facilities
#11
Glenn Arendts, Pamela Deans, Keith O'Brien, Christopher Etherton-Beer, Kirsten Howard, Gill Lewin, Moira Sim
BACKGROUND: Optimising quality of life and reducing hospitalisation for people living in residential aged care facilities (RACF) are important health policy goals. METHODS: A cluster controlled clinical trial of nurse practitioner care in RACF. Six facilities were included: three randomly allocated to intervention where nurse practitioners working with general practitioners and using a best practice guide were responsible for care, and three control. Participants were followed up for a minimum of 12 months unless dead or transferred to another facility...
May 4, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29752213/-when-no-one-s-looking-the-application-of-lung-recruitment-and-normal-saline-instillation-with-paediatric-endotracheal-suction-an-exploratory-study-of-nursing-practice
#12
Jessica A Schults, Marie Cooke, Debbie Long, Marion L Mitchell
BACKGROUND: The complex nature of the Paediatric Intensive Care Unit (PICU) patient requires the bedside nurse to make rapid, complex decisions regarding endotracheal suction (ETS) interventions. It is not understood what influences nurses' decision making in the context of ETS, however, the actions of the clinician have a direct impact on the efficacy of the ETS event and patient outcomes. OBJECTIVES: To explore and describe the use of normal saline instillation and lung recruitment with paediatric ETS in a cohort of Australian nurses, and to identify factors that influence normal saline use with ETS...
May 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29739393/involvement-in-decisions-about-intravenous-treatment-for-nursing-home-patients-nursing-homes-versus-hospital-wards
#13
Kristin Klomstad, Reidar Pedersen, Reidun Førde, Maria Romøren
BACKGROUND: Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient's best interest, assessment of capacity to consent, and on the patient's own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. METHODS: Using a questionnaire, we studied the decision-making process for 299 nursing home patients who were treated for dehydration using intravenous fluids, or for bacterial infections using intravenous antibiotics...
May 8, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29734019/embedding-fundamental-care-in-the-pre-registration-nursing-curriculum-results-from-a-pilot-study
#14
Rebecca Feo, Frank Donnelly, Lauren Frensham, Tiffany Conroy, Alison Kitson
International evidence suggests nursing is not providing fundamental care consistently or adequately, resulting in poor outcomes for patients and healthcare systems. One possible reason for this inadequate care delivery is nursing education, with fundamental care often implicit or invisible in nursing curricula. To understand how best to teach fundamental care to pre-registration (pre-licensure) students, we developed and piloted a six-week intervention that incorporated into the first-year curriculum a more explicit focus on fundamental care...
May 1, 2018: Nurse Education in Practice
https://www.readbyqxmd.com/read/29727825/expectations-and-experiences-of-nursing-students-in-clinical-courses-a-descriptive-study
#15
Kay J Cowen, Lori J Hubbard, Debbie Croome Hancock
BACKGROUND: Students entering nursing programs have expectations for what they will encounter in the clinical setting. OBJECTIVES: Nursing student excitement about beginning clinical, expectations for learning, anticipated time to prepare for each clinical day, and learning styles were examined. DESIGN: Descriptive study. SETTING: Baccalaureate nursing program in a public university in the Southeastern United States...
April 25, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29727348/a-quality-initiative-a-system-wide-reduction-in-serious-medication-events-through-targeted-simulation-training
#16
Kiran B Hebbar, Nora Colman, Lorisa Williams, Jessica Pina, Lisa Davis, James E Bost, Halli Jones, Gary Frank
INTRODUCTION: Medication administration events (MAEs) are a great concern to the healthcare industry, because they are both common and costly. Pediatric patients pose unique challenges to healthcare systems, particularly regarding the safety of medication administration. Our objectives were to improve adherence to best practices, decrease MAEs, and decrease cost related to error reduction rates by implementing a scenario-based simulation training program for frontline nursing staff in the general care units, emergency departments, and intensive care units within our institution...
April 30, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29724443/advocating-for-greater-usability-in-clinical-technologies-the-role-of-the-practicing-nurse
#17
REVIEW
Karen Dunn Lopez, Linda Fahey
Health care, especially ICUs, rely on multiple types of technology to promote the best patient outcomes. Unfortunately, too often these technologies are poorly designed, causing errors, additional workload, and unnecessary frustration. The purpose of this article is to (1) empower nurses with the needed usability and usability testing vocabulary to identify and articulate clinical technology usability problems and (2) provide ideas on ways nurses can advocate to have an impact on positive change related to technology usability within a health care organization...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29717068/nursing-and-dental-students-reflections-on-interprofessional-practice-after-a-service-learning-experience-in-appalachia
#18
Susan Nierenberg, Linda Paine Hughes, Molli Warunek, Joseph E Gambacorta, Suzanne S Dickerson, Nancy Campbell-Heider
Nowhere is the discrepancy between good and poor oral health status more pronounced in the U.S. than in the Appalachian region, where there is a high incidence of dental problems related to non-flouridated water, limited access to care, and tooth loss. To address these disparities, in 2016 University at Buffalo dental and nurse practitioner faculty members led a group of dental and nursing students on a two-day service-learning experience in rural Tennessee. The aim of this study was to assess the dental and nursing students' reflections on this interprofessional service-learning experience in Appalachia...
May 2018: Journal of Dental Education
https://www.readbyqxmd.com/read/29713688/nurse-practitioner-knowledge-attitudes-and-beliefs-when-caring-for-transgender-people
#19
Catherine Paradiso, Robin M Lally
Purpose: The aim of this study was to explore Nurse Practitioner (NP) knowledge, attitudes, and beliefs when working with transgender people and to inform about Practitioner education needs. Methods: A qualitative descriptive design was used to explore (NP) experiences. Focused semistructured interviews were conducted in 2016 with 11 ( N =11) NPs in the northeastern United States who represent various years of experience and encounters with transgender patients. The interviews explored NP knowledge attitudes and beliefs when caring for transgender patients and described their overall experiences in rendering care in the clinical setting...
2018: Transgender Health
https://www.readbyqxmd.com/read/29713235/antimalarial-drug-prescribing-by-healthcare-workers-when-malaria-testing-is-negative-a-qualitative-study-in-madagascar
#20
David Harimbola Rakotonandrasana, Takahiro Tsukahara, Noriko Yamamoto-Mitani
Background: Despite the World Health Organization and the National Malaria Program of Madagascar recommending that antimalarial drugs only be prescribed for patients with positive results on malaria rapid diagnostic tests, healthcare workers continue to prescribe these drugs for cases with negative test results. We explored why and how primary healthcare workers in Madagascar continue to prescribe antimalarial drugs despite this guidance. Methods: We purposively selected 14 medical doctors and 2 nurses from 11 primary health facilities (6 public, 5 private) in Toliara, Madagascar, and interviewed them regarding their antimalarial prescribing behaviors...
2018: Tropical Medicine and Health
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