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Holistic admission

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At The Christie NHS Foundation Trust, Manchester, concerns that end of life care discussions were occurring too late in breast cancer cases led to earlier introduction of palliative care. Benefits include reduced hospital admissions during end of life and improved symptom management. The authors encourage nurses to support an integrated approach to enhance care provision for patients.
October 12, 2016: Nursing Standard
Sandi Rowland, Jonathon P Leider, Clare Davidson, Joanne Brady, Alana Knudson
OBJECTIVES: To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). METHODS: We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015...
October 13, 2016: American Journal of Public Health
Jacqueline L Gauer, Josephine M Wolff, J Brooks Jackson
INTRODUCTION: The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. METHOD: Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011-2015) at the University of Minnesota Medical School (N=1,065)...
2016: Medical Education Online
Sarah S Conrad, Amy N Addams, Geoffrey H Young
Medical schools and residency programs have always sought excellence in the areas of education, research, and clinical care. However, these pursuits are not accomplished within a vacuum-rather, they are continually and necessarily influenced by social, cultural, political, legal, and economic forces. Persistent demographic inequalities coupled with rapidly evolving biomedical research and a complex legal landscape heighten our collective awareness and emphasize the continued need to consider medicine's social contract when selecting, educating, and developing physicians and physician-scientists...
September 13, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Claudia T Matthaeus-Kraemer, Daniel O Thomas-Rueddel, Daniel Schwarzkopf, Hendrik Rueddel, Bernhard Poidinger, Konrad Reinhart, Frank Bloos
PURPOSE: The purpose was to identify barriers to the early detection and timely management of severe sepsis throughout the emergency department (ED), general ward (GW), intermediate care unit (IMC), and the intensive care unit (ICU). MATERIALS AND METHODS: Five multicenter focus group discussions with 29 clinicians were conducted. Discussions were based on a moderation guide were recorded and transcribed. Qualitative analysis was performed according to the principles of the concept mapping method and the framework approach...
July 9, 2016: Journal of Critical Care
Andrew Lilley, Leanne Turner
INTRODUCTION: The local Clinical Commissioning Group has funded an innovative one-year pilot project to assess the value of providing specialist paediatric pharmacist and physiotherapist support direct to families and health care professionals (GP's, community pharmacists, practice nurses etc.) regarding asthma in the primary care setting. Currently no such support is provided within community setting by physiotherapy or pharmacy. METHODS: Joint holistic reviews by the clinical specialist physiotherapist and specialist paediatric pharmacist were performed in the patient's home environment or school...
September 2016: Archives of Disease in Childhood
Sepehr Shakib, Benjamin K Dundon, John Maddison, Josephine Thomas, Melinda Stanners, Gillian E Caughey, Robyn A Clark
OBJECTIVE: To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital. DESIGN AND PARTICIPANTS: A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital...
2016: PloS One
Shireen Madani Sims, James W Lynch
INTRODUCTION: The College of Medicine at our institution underwent a major curricular revision in order to develop a patient-centered context for learning. The admission process was revised to reflect this change, adopting a holistic review process, with the hope of attracting students who were particularly well suited to a patient-centered curriculum and learning culture. METHODS: Patients from a single practitioner, who were accustomed to working with medical students, were asked if they would like to select the next generation of physicians...
2016: Medical Education Online
Greer Glazer, Angela Clark, Karen Bankston, Jennifer Danek, Malika Fair, Julia Michaels
UNLABELLED: Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. PURPOSE: The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs...
July 2016: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
Mei-Fang Chuang, Heng-Hsin Tung, Daniel L Clinciu, Jing-Shan Huang, Usman Iqbal, Chih-Ju Chang, I-Chang Su, Fu-Chih Lai, Yu-Chuan Li
BACKGROUND: Educating patients about receiving surgical procedures is becoming an important issue, as it can reduce anxiety and uncertainty while helping to hasten decisions for undergoing time sensitive surgeries. We evaluated a new integrated education model for patients undergoing cervical disc herniation surgery using a quasi-experimental design. METHODS: The participants were grouped into either the new integrated educational model (n = 32) or the standard group (n = 32) on the basis of their ward numbers assigned at admission...
September 2016: Computer Methods and Programs in Biomedicine
Elizabeth A Bayliss, Deanna B McQuillan, Jennifer L Ellis, Matthew L Maciejewski, Chan Zeng, Mary B Barton, Cynthia M Boyd, Martin Fortin, Shari M Ling, Ming Tai-Seale, James D Ralston, Christine S Ritchie, Donna M Zulman
OBJECTIVES: To inform the development of a data-driven measure of quality care for individuals with multiple chronic conditions (MCCs) derived from an electronic health record (EHR). DESIGN: Qualitative study using focus groups, interactive webinars, and a modified Delphi process. SETTING: Research department within an integrated delivery system. PARTICIPANTS: The webinars and Delphi process included 17 experts in clinical geriatrics and primary care, health policy, quality assessment, health technology, and health system operations...
September 2016: Journal of the American Geriatrics Society
Alze Pereira Dos Santos Tavares, Carolina Paparelli, Carolina Sassaki Kishimoto, Silvia Avo Cortizo, Karen Ebina, Mariana Sarkis Braz, Sandra Regina Gonçalves Mazutti, Marcio José Cristiano Arruda, Bárbara Antunes
BACKGROUND: Gathering clinical evidence data on patients' palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. AIM: To implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients...
July 6, 2016: Palliative Medicine
Theodosios Saranteas, Andreas F Mavrogenis
Holistic ultrasound is a total body examination using an ultrasound device aiming to achieve immediate patient care and decision making. In the setting of trauma, it is one of the most fundamental components of care of the injured patients. Ground-breaking imaging software allows physicians to examine various organs thoroughly, recognize imaging signs early, and potentially foresee the onset or the possible outcome of certain types of injuries. Holistic ultrasound can be performed on a routine basis at the bedside of the patients, at admission and during the perioperative period...
October 2016: Injury
Catherine Elaine Longworth Ford, Donna Malley, Andrew Bateman, Isabel C H Clare, Adam P Wagner, Fergus Gracey
BACKGROUND: Outcome measurement challenges rehabilitation services to select tools that promote stakeholder engagement in measuring complex interventions. OBJECTIVES: To examine the suitability of outcome measures for complex post-acute acquired brain injury (ABI) rehabilitation interventions, report outcomes of a holistic, neuropsychological ABI rehabilitation program and propose a simple way of visualizing complex outcomes. METHODS: Patient/carer reported outcome measures (PROMS), experience measures (PREMS) and staff-rated measures were collected for consecutive admissions over 1 year to an 18-week holistic, neuropsychological rehabilitation programme at baseline, 18 weeks and 3- and 6-month follow-up...
June 23, 2016: NeuroRehabilitation
Julian Raffay, Emily Wood, Andrew Todd
BACKGROUND: Within the UK National Health Service (NHS), Spiritual and Pastoral Care (SPC) Services (chaplaincies) have not traditionally embraced research due to the intangible nature of their work. However, small teams like SPC can lead the way towards services across the NHS becoming patient- centred and patient-led. Using co-production principles within research can ensure it, and the resulting services, are truly patient-led. METHODS: A series of interviews were conducted with service users across directorates of a large NHS mental health Trust...
2016: BMC Psychiatry
Oyewale Mayowa Morakinyo, Matlou Ingrid Mokgobu, Murembiwa Stanley Mukhola, Raymond Paul Hunter
Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done...
2016: International Journal of Environmental Research and Public Health
K Joory, A Farroha, N Moiemen
Self-inflicted burns (SIB) consistently account for a small proportion of burn injuries. There is a wide spectrum of SIB, from minor burns through to major life threatening burn injuries in suicidal patients who have committed self-immolation. Non-fatal deliberate self-harm (DSH) is a common reason for presenting to hospital. This occurs in many forms including wounding, burning and poisoning to name a few. Such behaviours are commonly repeated, sometimes with increasing severity. DSH is a major risk factor for subsequent suicide...
September 30, 2015: Annals of Burns and Fire Disasters
Peter Gliatto, I Michael Leitman, David Muller
In recent years, medical educators have been making meaningful attempts to rethink how premedical students are prepared for medical school, and how medical students are prepared for residency. Among the many challenges to redesigning premedical and medical school curricula, one that stands out is the constraint imposed by our current methods of assessing aptitude, particularly our use of the Medical College Admissions Test (MCAT) and the United States Medical Licensing Examination (USMLE). For much of the past century, medical school and residency admissions committees have relied heavily on MCAT and USMLE scores to evaluate and rank candidates to their programs...
May 31, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Fiona Aspinal, Jon Glasby, Tine Rostgaard, Hanne Tuntland, Rudi G J Westendorp
As the overwhelming majority of older people prefer to remain in their own homes and communities, innovative service provision aims to promote independence of older people despite incremental age associated frailty. Reablement is one such service intervention that is rapidly being adopted across high-income countries and projected to result in significant cost-savings in public health expenditure by decreasing premature admission to acute care settings and long-term institutionalisation. It is an intensive, time-limited intervention provided in people's homes or in community settings, often multi-disciplinary in nature, focussing on supporting people to regain skills around daily activities...
September 2016: Age and Ageing
Deborah Birch
This is the third in a short series that presents case study examples of the application of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic assessment model, which is designed to determine a frail older person's medical and mental health status, as well as functional, social and environmental issues. When undertaken by nurses, it can enable individualised care planning. The case study presented explores the application of CGA with an 89-year-old patient with complex health and social care needs...
May 2016: Nursing Older People
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