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https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#1
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28710700/enhancing-state-medical-home-capacity-through-a-care-coordination-technical-assistance-model
#2
Susan Berry, Patti Barovechio, Emily Mabile, Tri Tran
Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28701889/education-for-community-based-family-medicine-a-social-need-in-the-real-world
#3
REVIEW
Shin-Ichi Taniguchi, Daeho Park, Kazuoki Inoue, Toshihiro Hamada
One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues...
June 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#4
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28697736/end-of-life-perceptions-among-physicians-in-intensive-care-units-managed-by-anesthesiologists-in-germany-a-survey-about-structure-current-implementation-and-deficits
#5
Manfred Weiss, Andrej Michalsen, Anke Toenjes, Franz Porzsolt, Thomas Bein, Marc Theisen, Alexander Brinkmann, Heinrich Groesdonk, Christian Putensen, Friedhelm Bach, Dietrich Henzler
BACKGROUND: Structural aspects and current practice about end-of-life (EOL) decisions in German intensive care units (ICUs) managed by anesthesiologists are unknown. A survey among intensive care anesthesiologists has been conducted to explore current practice, barriers and opinions on EOL decisions in ICU. METHODS: In November 2015, all members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthesiologists (BDA) were asked to participate in an online survey to rate the presence or absence and the importance of 50 items...
July 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28697523/-assessment-of-idc-pal-as-a-diagnostic-tool-for-family-physicians-to-identify-patients-with-complex-palliative-care-needs-in-germany-a-pilot-study
#6
María Rosa Salvador Comino, Victor Regife Garcia, Maria Auxiliadora Fernández López, Berend Feddersen, María Luisa Martin Roselló, Linda Sanftenberg, Jörg Schelling
Background Palliative medicine is an essential component of the health care system. Basic palliative care should be provided by primary care services (family physician and home nursing) with palliative-medical basic qualification. Often it is very difficult to identify patients that would profit from a specialized palliative care team. For the evaluation of the case complexity of a palliative patient, we present a Spanish diagnostic tool IDC-Pal, which tries to specify when, why and where a palliative patient should be referred...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28681381/epilepsy-transition-from-pediatric-to-adult-care-recommendations-of-the-ontario-epilepsy-implementation-task-force
#7
REVIEW
Danielle M Andrade, Anne S Bassett, Eduard Bercovici, Felippe Borlot, Esther Bui, Peter Camfield, Guida Quaglia Clozza, Eyal Cohen, Timothy Gofine, Lisa Graves, Jon Greenaway, Beverly Guttman, Maya Guttman-Slater, Ayman Hassan, Megan Henze, Miriam Kaufman, Bernard Lawless, Hannah Lee, Lezlee Lindzon, Lysa Boissé Lomax, Mary Pat McAndrews, Dolly Menna-Dack, Berge A Minassian, Janice Mulligan, Rima Nabbout, Tracy Nejm, Mary Secco, Laurene Sellers, Michelle Shapiro, Marie Slegr, Rosie Smith, Peter Szatmari, Leeping Tao, Anastasia Vogt, Sharon Whiting, O Carter Snead
The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health and Long-Term Care of the Province of Ontario, Canada, created a transition working group (TWG) to develop recommendations for the transition process for patients with epilepsy in the Province of Ontario. Herein we present an executive summary of this work. The TWG was composed of a multidisciplinary group of pediatric and adult epileptologists, psychiatrists, and family doctors from academia and from the community; neurologists from the community; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; an occupational therapist; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability; and project managers...
July 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/28627845/efficacy-of-interprofessionnality-evidence-and-challenges
#8
Valérie Santschi, Philippe Germanier, Joëlle Tischhauser, Nicolas Senn, Alain Pecoud
Skillmix is often proposed as a measure to address the growing needs of an aging population with its expected increase in chronic diseases. This article reports on a symposium on interprofessional collaboration which took place in the canton of Valais in Switzerland. Reviews of the literature on interprofessional collaboration show evidence in favor of the effectiveness of having interactions between physicians, nurses, pharmacists and physiotherapists. A critical analysis of different forms of coordinated care within family medicine supports the effectiveness of these approaches...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28627844/patient-care-in-family-medicine-what-s-new-in-the-2016-literature-findings
#9
Christine Cohidon, Nicolas Senn
During the last two decades in Europe, the scope of activities regarding chronic diseases management in family medicine has increased while technical activities and preventative care have decreased. A new literature review and meta-analysis confirms that the use of electronic health records improves the quality of care. In the field of interprofessionnality, the task delegation in chronic care management to nurses or medical assistants is a source of satisfaction for these professionals. At the same time, this could improve patients' quality of life...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28618913/a-multidisciplinary-approach-to-prevention
#10
Catriona Jennings, Felicity Astin
Cardiovascular disease accounts for 17,500 deaths globally, representing nearly half of all non-communicable disease deaths. The World Health Organization has set nine lifestyle, risk factor and medicines targets to achieve by 2025 with the aim of reducing premature mortality from non-communicable diseases by 25%. In order to succeed in this, we need to equip our global health professional workforce with the skills to support patients and their families with making lifestyle changes and being in concordance with cardioprotective medication regimes at every opportunity...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28595577/complementary-and-conventional-providers-in-cancer-care-experience-of-communication-with-patients-and-steps-to-improve-communication-with-other-providers
#11
Trine Stub, Sara A Quandt, Thomas A Arcury, Joanne C Sandberg, Agnete E Kristoffersen
BACKGROUND: Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. METHOD: This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire...
June 8, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28592480/implementing-family-centered-care-through-facilitated-sensemaking
#12
Judy E Davidson, Sidney Zisook
The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28592473/implementing-the-sccm-family-centered-care-guidelines-in-critical-care-nursing-practice
#13
Maureen Coombs, Kathleen A Puntillo, Linda S Franck, Elizabeth A Scruth, Maurene A Harvey, Sandra M Swoboda, Judy E Davidson
Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#14
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and have role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many U.S. hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28586939/-urgent-visits-to-nursing-homes-a-general-practitioner-s-perspective
#15
Markus Bleckwenn, David Ashrafnia, Rieke Schnakenberg, Klaus Weckbecker
Aim of the study Due to demographic changes, home visits to nursing care facilities are increasing. Urgent home visits represent a challenge for general practitioners. There are no recommendations for the implementation of urgent home visits. Therefore, in this study, we investigated how GP practices deal with urgent home visits and what improvements can be made to the medical emergency care. Methods A total of 15 teaching doctors of the Department of Family Medicine at the University of Bonn were interviewed using semi-structured interviews on the subject...
June 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28572102/complementary-health-practitioners-in-the-acute-and-critical-care-setting-nursing-considerations
#16
Debra Kramlich
In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28553153/interprofessional-education-development-not-for-the-faint-of-heart
#17
Deborah B Fahs, Linda Honan, Rosana Gonzalez-Colaso, Eve R Colson
Interprofessional education (IPE) has the potential to improve communication, collaboration and coordination of care, leading to improved health care outcomes. Promoting IPE has become an aim for many professional schools. However, there are challenges to implementing meaningful curricula that involve multiple health care professional schools. In this study, we outline 12 lessons learned when designing and implementing an Interprofessional Longitudinal Clinical Experience (ILCE) for 247 students from a School of Nursing, Medicine and Physician Associate Program in New England...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28530309/-monitoring-units-in-departments-of-internal-medicine-frequency-impact-and-satisfaction
#18
David Raveh-Brawer, Tanya Itzekson, Ruth Henshke-Bar-Meir, Noa Sylvetsky, Reuven Friedmann, Ranana Siegman, Tanya Mor, Moshe Hersch, Amos M Yinnon, Shoshana Zevin
BACKGROUND: Due to increasing numbers of elderly, seriously ill patients and shortage of ICU beds, many hospitals have established monitoring units (MU) in their medical departments. OBJECTIVES: (1) To assess the national prevalence of MUs in medical departments; (2) to determine the outcome of consecutively admitted MU patients; (3) to evaluate patient/ family satisfaction with care. METHODS: The case control study included all 123 patients hospitalized in the MU during a 5-month period, compared with two control groups: (1) 123 patients admitted to medical departments, matched at a ratio of 1:1 by gender, age±10 years and mechanical ventilation; (2) all 52 medical patients treated in the ICU...
January 2017: Harefuah
https://www.readbyqxmd.com/read/28512360/bullying-behavior-and-mental-health-in-healthcare-and-educational-sectors-in-kaunas-lithuania
#19
Lina Bernotaite, Vilija Malinauskiene, Palmira Leisyte
BACKGROUND: Investigations on workplace bullying in the countries of Eastern Europe are yet not too extensive. The aim of the study has been to identify the most frequent bullying behavior and to explore the associations with psychological distress and post-traumatic stress symptoms in 3 female-dominated occupations in Kaunas, Lithuania. MATERIAL AND METHODS: This crosssectional study employed 517 teachers (response rate (RR) = 71.3%), 174 family physicians (RR = 65...
May 16, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#20
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
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