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https://www.readbyqxmd.com/read/28106598/nurse-leadership-and-informatics-competencies-shaping-transformation-of-professional-practice
#1
Margaret Ann Kennedy, Anne Moen
Nurse leaders must demonstrate capacities and develop specific informatics competencies in order to provide meaningful leadership and support ongoing transformation of the healthcare system. Concurrently, staff informatics competencies must be planned and fostered to support critical principles of transformation and patient safety in practice, advance evidence-informed practice, and enable nursing to flourish in complex digital environments across the healthcare continuum. In addition to nurse leader competencies, two key aspects of leadership and informatics competencies will be addressed in this chapter - namely, the transformation of health care and preparation of the nursing workforce...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28104470/a-cluster-randomized-trial-of-a-primary-palliative-care-intervention-connect-for-patients-with-advanced-cancer-protocol-and-key-design-considerations
#2
Claire L Becker, Robert M Arnold, Seo Young Park, Margaret Rosenzweig, Thomas J Smith, Douglas B White, Kenneth J Smith, Yael Schenker
BACKGROUND: The addition of specialty palliative care to standard oncology care improves outcomes for patients with advanced cancer and their caregivers, but many lack access to specialty care services. Primary palliative care-meaning basic palliative care services provided by clinicians who are not palliative care specialists-is an alternative approach that has not been rigorously evaluated. METHODS: A cluster randomized, controlled trial of the CONNECT (Care management by Oncology Nurses to address supportive care needs) intervention, an oncology nurse-led care management approach to providing primary palliative care for patients with advanced cancer and their family caregivers, is currently underway at 16 oncology practices in Western Pennsylvania...
January 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28099059/family-physician-readiness-for-value-based-payments-does-ownership-status-matter
#3
Heidy Robertson-Cooper, Bradley Neaderhiser, Laura E Happe, Roy A Beveridge
Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28096041/advance-care-planning-in-adults-with-congenital-heart-disease-a-patient-priority
#4
Lisa X Deng, Lacey P Gleason, Abigail M Khan, David Drajpuch, Stephanie Fuller, Leah A Goldberg, Christopher E Mascio, Sara L Partington, Lynda Tobin, Yuli Y Kim, Adrienne H Kovacs
BACKGROUND: Adult congenital heart disease (ACHD) patients with moderate or great defect complexity are at risk for premature death. Although early engagement in advance care planning (ACP) is recommended, previous research suggests that it seldom occurs. METHODS: This study investigated ACHD patient preferences for ACP and factors that impact preferences. ACHD patients completed an ACP preferences questionnaire, the Hospital Anxiety and Depression Scale and a measure of attachment styles...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28095941/preparation-for-the-end-of-life-and-life-completion-during-late-stage-lung-cancer-an-exploratory-analysis
#5
Gail Adorno, Cara Wallace
OBJECTIVE: Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions...
January 18, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#6
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28086971/characteristics-and-use-of-urban-health-indicator-tools-by-municipal-built-environment-policy-and-decision-makers-a-systematic-review-protocol
#7
Helen Pineo, Ketevan Glonti, Harry Rutter, Nicole Zimmermann, Paul Wilkinson, Michael Davies
BACKGROUND: There is wide agreement that there is a lack of attention to health in municipal environmental policy-making, such as urban planning and regeneration. Explanations for this include differing professional norms between health and urban environment professionals, system complexity and limited evidence for causality between attributes of the built environment and health outcomes. Data from urban health indicator (UHI) tools are potentially a valuable form of evidence for local government policy and decision-makers...
January 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28086861/managing-shades-of-grey-a-focus-group-study-exploring-community-dwellers-views-on-advance-care-planning-in-older-people
#8
Natasha Michael, Clare O'Callaghan, Emma Sayers
BACKGROUND: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community. METHODS: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people's offspring/caregivers living in an Australian city and surrounding rural region...
January 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28079592/implementation-science-the-laboratory-as-a-command-centre
#9
Debrah I Boeras, John N Nkengasong, Rosanna W Peeling
PURPOSE OF REVIEW: Recent advances in point-of-care technologies to ensure universal access to affordable quality-assured diagnostics have the potential to transform patient management, surveillance programmes, and control of infectious diseases. Decentralization of testing can put tremendous stresses on fragile health systems if the laboratory is not involved in the planning, introduction, and scale-up strategies. RECENT FINDINGS: The impact of investments in novel technologies can only be realized if these tests are evaluated, adopted, and scaled up within the healthcare system with appropriate planning and understanding of the local contexts in which these technologies will be used...
January 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28078098/transfer-of-nursing-home-residents-to-emergency-departments-organizational-differences-between-nursing-homes-with-high-vs-low-transfer-rates
#10
Marie Kirsebom, Mariann Hedström, Ulrika Pöder, Barbro Wadensten
AIM: To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department. DESIGN: Explorative. METHOD: In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department...
January 2017: Nursing Open
https://www.readbyqxmd.com/read/28076709/phase-3-trial-of-177-lu-dotatate-for-midgut-neuroendocrine-tumors
#11
RANDOMIZED CONTROLLED TRIAL
Jonathan Strosberg, Ghassan El-Haddad, Edward Wolin, Andrew Hendifar, James Yao, Beth Chasen, Erik Mittra, Pamela L Kunz, Matthew H Kulke, Heather Jacene, David Bushnell, Thomas M O'Dorisio, Richard P Baum, Harshad R Kulkarni, Martyn Caplin, Rachida Lebtahi, Timothy Hobday, Ebrahim Delpassand, Eric Van Cutsem, Al Benson, Rajaventhan Srirajaskanthan, Marianne Pavel, Jaime Mora, Jordan Berlin, Enrique Grande, Nicholas Reed, Ettore Seregni, Kjell Öberg, Maribel Lopera Sierra, Paola Santoro, Thomas Thevenet, Jack L Erion, Philippe Ruszniewski, Dik Kwekkeboom, Eric Krenning
Background Patients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 ((177)Lu)-Dotatate in patients with advanced, progressive, somatostatin-receptor-positive midgut neuroendocrine tumors. Methods We randomly assigned 229 patients who had well-differentiated, metastatic midgut neuroendocrine tumors to receive either (177)Lu-Dotatate (116 patients) at a dose of 7...
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28074757/advanced-practice-nurse-transitional-care-model-promotes-healing-in-wound-care
#12
Carole Mackavey
: Optimally, transition in health care should be seamless and incorporate a well-thought-out patient-centered discharge plan; yet, many hospitalized patients are unprepared for discharge, thereby compromising patient safety and quality of care. Transition of care should include a broad range of time-limited services designed to ensure health care continuity to avoid poor outcomes among at-risk populations. This case study demonstrates that advanced practice nurses (APNs) are in the perfect position to bridge the existing gap, reduce readmissions, and improve patient health...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#13
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28069027/reliability-of-health-related-quality-of-life-assessments-made-by-older-adults-and-significant-others-for-health-states-of-increasing-cognitive-impairment
#14
Gina Bravo, Modou Sene, Marcel Arcand
BACKGROUND: Older adults are encouraged by many organizations to engage in advance care planning in the event of decisional incapacity. Planning for future health care often involves anticipating health-related quality of life (HRQoL) in states of reduced cognitive functioning. No study has yet examined whether anticipated HRQoL is stable over time. The accuracy with which significant others can predict how an older adult envisions HRQoL in a future state of cognitive impairment is also unknown...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28068789/pragmatic-trial-of-video-education-in-nursing-homes-the-design-and-rationale-for-a-pragmatic-cluster-randomized-trial-in-the-nursing-home-setting
#15
Vincent Mor, Angelo E Volandes, Roee Gutman, Constantine Gatsonis, Susan L Mitchell
Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28067032/outcomes-of-cancer-survivorship-care-provided-by-advanced-practice-rns-compared-to-other-models-of-care-a-systematic-review
#16
Julie Spears, Melissa Craft, Sara White
Problem Identification: Advanced practice RNs (APRNs) have become leaders in providing survivorship care. However, outcomes of survivorship care provided by APRNs compared to other providers remain unclear. Literature Search: A systematic literature search included articles published after 2005 that described a survivorship model of care and use of a survivorship care plan (SCP), as well as reported outcomes. Data Evaluation: Sixteen studies were appraised and ranked by strength...
6, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28065446/mechanical-dyssynchrony-in-heart-failure-still-a-valid-concept-for-optimizing-treatment
#17
REVIEW
Elena Galli, Christophe Leclercq, Erwan Donal
Cardiac resynchronization therapy (CRT) has had a major favourable impact on the care of patients with symptomatic heart failure, left ventricular ejection fraction<35% and enlarged QRS. Despite this, about 35% of patients who undergo CRT in accordance with current guidelines are "non-responders". Therefore, more accurate selection of CRT candidates would significantly improve patient benefit and decrease costs. In the past decade, some small non-randomized studies have shown that estimation of left ventricular dyssynchrony by echocardiography might be useful to ameliorate the selection of patients for CRT...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#18
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was employed to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included: (1) electronic navigation records, (2) navigator surveys (n=45), (3) claims-based patient outcomes (n=820), and (4) semi-structured navigator interviews (n=26)...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062339/defining-advance-care-planning-for-adults-a-consensus-definition-from-a-multidisciplinary-delphi-panel
#19
Rebecca L Sudore, Hillary D Lum, John J You, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Daniel D Matlock, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Jean S Kutner, Joan M Teno, Judy Thomas, Ryan D McMahan, Daren K Heyland
BACKGROUND: Despite increasing interest in advance care planning (ACP) and prior ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives. OBJECTIVE: To develop a consensus definition of ACP for adults. DESIGN: Delphi Panel SETTING/PARTICIPANTS: Participants included a multidisciplinary panel of international ACP experts consisting of 52 clinicians, researchers, and policy leaders from 4 countries, and a patient/surrogate advisory committee...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062337/using-laboratory-test-results-at-hospital-admission-to-predict-short-term-survival-in-critically-ill-patients-with-metastatic-or-advanced-cancer
#20
Lee Cheng, Alma Y DeJesus, Maria A Rodriguez
CONTEXT: Accurately estimating the life expectancy of critically ill patients with metastatic or advanced cancer is a crucial step in planning appropriate palliative or supportive care. OBJECTIVE: We evaluated the results of laboratory tests performed within 2 days of hospital admission to predict the likelihood of death within 14 days. METHODS: We retrospectively selected patients 18 years or older with metastatic or advanced cancer who were admitted to intensive care units or palliative and supportive care services in our hospital...
January 3, 2017: Journal of Pain and Symptom Management
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