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https://www.readbyqxmd.com/read/29333500/improving-the-written-medical-handover
#1
Rhys Martin, Melanie Huddart, Cara Garbett, Wendell Storr, Olivia Watts, Sanjeev Gupta
The handover of large numbers of medical patients, during on call periods when staffing levels are reduced, is a challenge for all acute medical services. At the Royal Cornwall Hospital, a large district general hospital, we identified that foundation doctors were reviewing medical inpatients during weekend on call periods with limited written handover information. We chose to address this problem by developing an intervention, a weekend handover sticker, and piloting it. We used the review of documentation to measure improvement and feedback from users to assess the processes involved...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29331798/engaging-students-in-a-community-of-learning-renegotiating-the-learning-environment
#2
Karen A Theobald, Carol A Windsor, Elizabeth M Forster
Promoting student engagement in a student led environment can be challenging. This article reports on the process of design, implementation and evaluation of a student led learning approach in a small group tutorial environment in a three year Bachelor of Nursing program at an Australian university. The research employed three phases of data collection. The first phase explored student perceptions of learning and engagement in tutorials. The results informed the development of a web based learning resource...
December 27, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#3
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29325452/inherited-cancer-in-the-age-of-next-generation-sequencing
#4
Kristin S Price, Ashley Svenson, Elisabeth King, Kaylene Ready, Gabriel A Lazarin
Next-generation sequencing (NGS) technology has led to the ability to test for multiple cancer susceptibility genes simultaneously without significantly increasing cost or turnaround time. With growing usage of multigene testing for inherited cancer, ongoing education for nurses and other health-care providers about hereditary cancer screening is imperative to ensure appropriate testing candidate identification, test selection, and posttest management. The purpose of this review article is to (1) provide an overview of how NGS works to detect germline mutations, (2) summarize the benefits and limitations of multigene panel testing, (3) describe risk categories of cancer susceptibility genes, and (4) highlight the counseling considerations for patients pursuing multigene testing...
January 1, 2018: Biological Research for Nursing
https://www.readbyqxmd.com/read/29324539/trial-of-optimal-personalised-care-after-treatment-gynaecological-cancer-topcat-g-a-randomized-feasibility-trial
#5
Val Morrison, Llinos H Spencer, Nikki Totton, Kirstie Pye, Seow Tien Yeo, Caryl Butterworth, Liz Hall, Rhiannon Whitaker, Rhiannon Tudor Edwards, Laura J Timmis, Zoe Hoare, Richard D Neal, Clare Wilkinson, Simon Leeson
OBJECTIVE: This study aimed to evaluate the feasibility of completing a parallel-group randomized controlled trial to compare usual follow-up care for women who have completed treatment of gynecological cancer against a nurse-led telephone intervention, known as Optimal Personalised Care After Treatment-Gynaecological. METHODS: The unblinded trial aimed to recruit patients who had completed treatment of cervical, endometrial, epithelial ovarian, or vulval cancer within the previous 3 months at 3 North Wales hospitals...
January 10, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29323978/nurse-led-epistaxis-management-within-the-emergency-department
#6
Navid Hakim, Sangha Mitra Mummadi, Karan Jolly, Julian Dawson, Adnan Darr
BACKGROUND: the incidence of epistaxis has increased secondary to increased life expectancy and morbidities. This study sought to assess the knowledge, practice and opinion relating to adequacy of training of advanced nurse practitioners (ANPs) and staff nurses (SNs) in the emergency department. METHODS: a national survey was distributed over an 8-week period; this included a 3-point scoring system based on the National Institute for Health and Care Excellence Clinical Knowledge Summaries guidance on epistaxis management to assess overall performance...
January 11, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29323832/influences-of-a-church-based-intervention-on-falls-risk-among-seniors
#7
Morgan Briggs, Jeffrey A Morzinski, Julie Ellis
BACKGROUND AND OBJECTIVES: Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29319274/evaluating-a-co-facilitation-approach-to-service-user-and-carer-involvement-in-undergraduate-nurse-education
#8
Anne Felton, Joan Cook, Roni Anthony
Partnership working with service users and carers is an integral aspect of healthcare practice and education. Increasingly complex healthcare environments, alongside changes in higher education, have led to the development of innovative learning strategies, resulting in opportunities for service users to participate in nurse education. This article describes the planning, implementation and evaluation of a co-facilitation approach to learning, in which service users and carers worked alongside lecturers to facilitate small seminar group activities with first-year undergraduate nursing students...
January 10, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29318326/-reimbursement-of-intensive-care-services-in-austria-use-of-the-lkf-system
#9
REVIEW
M Joannidis, S J Klein, P Metnitz, A Valentin
In Austria, the reimbursement of intensive care services is based on a Diagnosis-Related Groups (DRG) system which has been adapted to the Austrian framework conditions. Compared to Germany where economic considerations had led to personnel cuts, mandatory targets outlined in both the LKF ("Leistungsorientierte Krankenanstaltenfinanzierung", Performance-oriented Hospital Financing) and ÖSG ("Österreichischer Strukturplan Gesundheit", Austrian Health Care Structure Plan) plans ensure a high level of medical and intensive care...
January 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29310746/nurse-practitioner-s-perceptions-of-the-impact-of-the-nurse-practitioner-led-clinic-model-on-the-quality-of-care-of-complex-patients
#10
Roberta Heale, Susan James, Elizabeth Wenghofer, Marie-Luce Garceau
Aim To evaluate the organizational processes that influence the quality of care for patients with multimorbidity at nurse practitioner-led clinics (NPLCs). BACKGROUND: People are living longer, most with one or more chronic diseases (mulitmorbidity) and primary healthcare for these patients has become increasingly complex. One response was the establishment of new models of primary healthcare. NPLCs are an example of a model developed in Ontario, Canada, which feature nurse practitioners as the primary care providers practicing within an interprofessional team...
January 9, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29306752/turning-education-into-action-impact-of-a-collective-social-education-approach-to-improve-nurses-ability-to-recognize-and-accurately-assess-delirium-in-hospitalized-older-patients
#11
Catherine Travers, Amanda Henderson, Fred Graham, Elizabeth Beattie
BACKGROUND: Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. METHODS: Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium...
December 29, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29300824/winter-is-coming-plant-freezing-resistance-as-a-key-functional-trait-for-the-assembly-of-annual-mediterranean-communities
#12
David S Pescador, Ana M Sánchez, Arantzazu L Luzuriaga, Angela Sierra-Almeida, Adrián Escudero
Background and Aims: In Mediterranean annual plants, germination mainly occurs during the autumn and only those seedlings that survive winter freezing can flower and produce seedlings in spring. Surprisingly, the effect of freezing events as an abiotic determinant of these communities remains unexplored. The present study aimed to investigate how freezing events affect annual Mediterranean communities and whether their functional structure as related to freezing resistance is linked to the main biotic and abiotic determinants of these communities...
December 29, 2017: Annals of Botany
https://www.readbyqxmd.com/read/29298737/a-feasible-model-for-early-intervention-for-high-risk-substance-use-in-the-emergency-department-setting
#13
Rebecca Howard, Stephanie Fry, Andrew Chan, Brigid Ryan, Yvonne Bonomo
Objective In response to escalating alcohol and other drug (AOD)-related emergency department (ED) presentations, a tertiary Melbourne hospital embedded experienced AOD clinical nurse consultants in the ED on weekends to trial a model for screening, assessment and brief intervention (BI). The aim of the present study was to evaluate the relative contributions of AOD to ED presentations and to pilot a BI model.Methods Using a customised AOD screening tool and a framework for proactive case finding, screened participants were offered a comprehensive AOD assessment and BI in the ED...
January 4, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29290372/signs-of-severity-sos-ed-escalation-guide-bridging-the-experience-gap
#14
Marcia Schram, Vivian Fuentes, Brenda Rojas, Martha Tijerino, Michelle Thomas, Christine Williams, Eve Butler, Andrea Prentiss
INTRODUCTION: This study evaluated the introduction of an ED Escalation Guide (EDEG) as an early warning system for the many new graduate nurses in the emergency department. The EDEG is a chart that provides ED-appropriate parameters to prioritize both vital signs and critical symptoms. Scenario quizzes were used to evaluate its usefulness. METHODS: Comparative quizzes that required prioritizing the urgency of patient symptoms were given to emergency nurses with varying levels of experience, with and without the use of the EDEG...
December 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29288173/population-level-impact-of-diabetes-integrated-care-on-commissioner-payments-for-inpatient-care-among-people-with-type-2-diabetes-in-cambridgeshire-a-postintervention-cohort-follow-up-study
#15
Dahai Yu, Wei Yang, Yamei Cai, Zhanzheng Zhao, David Simmons
OBJECTIVES: Few studies have estimated the effect of diabetes integrated care at a population level. We have assessed the impact of introducing a community service-led diabetes integrated care programme on commissioner payments (tariff) for inpatient care in rural England. METHODS: The Diabetes Integrated Care Initiative was delivered by a separate enhanced community diabetes service, increasing specialist nursing, dietetic, podiatry and medical support to primary care and patients, while linking into other diabetes specialist services...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29285846/development-of-a-modified-swallowing-screening-tool-to-manage-post-extubation-dysphagia
#16
Martin Christensen, Michaela Trapl
Post-extubation dysphagia is a condition that is becoming a growing concern. The condition occurs in 3-62% of extubated patients and can be related to mixed aetiologies, such as neuromuscular impairment, critical illness and laryngeal damage. The risk factors for developing dysphagia in critically ill patients are under-diagnosed and perhaps underestimated. Recent studies recommend the implementation of a standardized swallowing screen to prevent aspiration and decrease pneumonia rate and mortality. The aim of this quality improvement initiative was the development of a bedside swallowing screening tool to assess effective swallowing post-endotracheal extubation...
December 28, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29282265/does-the-implementation-of-a-novel-intensive-care-discharge-risk-score-and-nurse-led-inpatient-review-tool-improve-outcome-a-prospective-cohort-study-in-two-intensive-care-units-in-the-uk
#17
Jez Fabes, William Seligman, Carolyn Barrett, Stuart McKechnie, John Griffiths
OBJECTIVE: To develop a clinical prediction model for poor outcome after intensive care unit (ICU) discharge in a large observational data set and couple this to an acute post-ICU ward-based review tool (PIRT) to identify high-risk patients at the time of ICU discharge and improve their acute ward-based review and outcome. DESIGN: Retrospective patient cohort of index ICU admissions between June 2006 and October 2011 receiving routine inpatient review. Prospective cohort between March 2012 and March 2013 underwent risk scoring (PIRT) which subsequently guided inpatient ward-based review...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29281941/a-randomized-controlled-trial-on-the-effect-of-behavioral-strategies-for-adherence-to-oral-antidiabetic-drugs-study-protocol
#18
Danilo D Trevisan, Thaís M São-João, Marilia E Cornélio, Fernanda F Jannuzzi, Roberta C M Rodrigues, Maria Helena M Lima
BACKGROUND: Non-adherence to oral antidiabetics drugs (OADs) has been a common problem and may contribute to poor glycemic control. AIM: To describe an experimental study protocol according to the SPIRIT 2013 guidelines that aims at implementing and evaluating the effect of the "action planning and coping planning" interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services. DESIGN: A randomized controlled trial...
December 27, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29281775/experiences-of-patients-with-chronic-kidney-disease-and-their-family-members-in-an-advanced-practice-nurse-led-counseling-service
#19
Patrizia Zala, Gisela Rütti, Spyridon Arampatzis, Elisabeth Spichiger
Chronic kidney disease (CKD) is a major health problem worldwide, but not enough is known about effective self-management interventions. In this qualitative study, we explore how outpatients with CKD Stages 1-5 (without renal replacement therapy) and their family members experienced an individually tailored CKD counseling service led by an advanced practice nurse (APN). Using thematic analysis, 10 pair interviews (N = 20) were conducted and analyzed stepwise. Findings revealed iterative processes along the course of the disease...
November 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29280907/a-quality-improvement-initiative-to-reduce-out-of-icu-cardiopulmonary-arrests-in-a-tertiary-care-hospital-in-india-a-2-year-learning-experience
#20
Vidya P Menon, Preetha Prasanna, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Rajesh D Pai, Sanjeev Singh
QUALITY PROBLEM OR ISSUE: To assess impact of medical emergency team (MET) in reducing "out-of-ICU" cardiopulmonary arrests and identify barriers to its optimal utilization. INITIAL ASSESSMENT: Frequently observed critical clinical signs and laboratory values of "out-of-ICU" crashes were used to develop Amrita Early Warning Criteria. CHOICE OF SOLUTION: A physician-led MET was established to respond to code MET, activated by a primary nurse...
January 2018: Quality Management in Health Care
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