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https://www.readbyqxmd.com/read/28526976/how-to-achieve-patient-centered-testing-role-of-the-protocol-nurse
#1
Patricia N Salimi, Joelyn B Niggel, Friederike K Keating
INTRODUCTION: Patient-centered cardiac testing is predicated on choosing the right test for the right patient. We studied the effects of changing from script-driven scheduling to nurse-driven protocoling of stress tests. METHODS AND RESULTS: A protocol nurse reviewed records before scheduling and communicated with patients and ordering providers if needed. We found that instituting nurse protocolling of all non-imaging (ETT) and nuclear (MPI) stress tests (N = 3071) resulted in protocol changes in 37% of our patients, and reduced the proportion of tests that could not be performed as scheduled by 56% and cancelations by 71% (P < 0...
May 19, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28509654/clinical-reasoning-embodied-meaning-making-in-physiotherapy
#2
Anoop Chowdhury, Wenche Schrøder Bjorbækmo
This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes...
May 16, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28508725/evaluating-change-in-virtual-reality-adoption-for-brain-injury-rehabilitation-following-knowledge-translation
#3
Stephanie M N Glegg, Liisa Holsti, Sue Stanton, Steven Hanna, Diana Velikonja, Barbara Ansley, Denise Sartor, Christine Brum
PURPOSE: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists. HYPOTHESES: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR. METHOD: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres...
April 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28508440/has-evidence-based-medicine-ever-been-modern-a-latour-inspired-understanding-of-a-changing-ebm
#4
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trish Greenhalgh
Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals of a changing EBHC. In this paper, we present French philosopher Bruno Latour's vision on modernity as a framework to discuss current changes in the discourse on EBHC/EBM. Drawing on Latour's work, we argue that the early EBM movement had a strong modernist agenda with an aim to "purify" clinical reality into a dichotomy of objective "evidence" from nature and subjective "preferences" from human society and culture...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28502866/what-is-inappropriate-hospital-use-for-elderly-people-near-the-end-of-life-a-systematic-review
#5
REVIEW
Magnolia Cardona-Morrell, James C H Kim, Mikkel Brabrand, Blanca Gallego-Luxan, Ken Hillman
BACKGROUND: Older people with advance chronic illness use hospital services repeatedly near the end of life. Some of these hospitalizations are considered inappropriate. AIM: To investigate extent and causes of inappropriate hospital admission among older patients near the end of life. METHODS: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital...
May 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28497983/promoting-responsible-electronic-documentation-validity-evidence-for-a-checklist-to-assess-progress-notes-in-the-electronic-health-record
#6
Jennifer A Bierman, Kathryn Kinner Hufmeyer, David T Liss, A Charlotta Weaver, Heather L Heiman
Construct: We aimed to develop an instrument to measure the quality of inpatient electronic health record- (EHR-) generated progress notes without requiring raters to review the detailed chart or know the patient. BACKGROUND: Notes written in EHRs have generated criticism for being unnecessarily long and redundant, perpetuating inaccuracy and obscuring providers' clinical reasoning. Available assessment tools either focus on outpatient progress notes or require chart review by raters to develop familiarity with the patient...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28495811/randomised-controlled-trial-of-online-continuing-education-for-health-professionals-to-improve-the-management-of-chronic-fatigue-syndrome-a-study-protocol
#7
Sophie H Li, Carolina X Sandler, Sally M Casson, Joanne Cassar, Tina Bogg, Andrew R Lloyd, Benjamin K Barry
INTRODUCTION: Chronic fatigue syndrome (CFS) is a serious and debilitating illness that affects between 0.2%-2.6% of the world's population. Although there is level 1 evidence of the benefit of cognitive behaviour therapy (CBT) and graded exercise therapy (GET) for some people with CFS, uptake of these interventions is low or at best untimely. This can be partly attributed to poor clinician awareness and knowledge of CFS and related CBT and GET interventions. This trial aims to evaluate the effect of participation in an online education programme, compared with a wait-list control group, on allied health professionals' knowledge about evidence-based CFS interventions and their levels of confidence to engage in the dissemination of these interventions...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28483995/clinical-reasoning-a-45-year-old-man-with-weakness-and-myalgia-after-orthopedic-surgery
#8
Rocio Vazquez do Campo, Jason Siegel, Eric Goldstein, Elliot Dimberg
No abstract text is available yet for this article.
May 9, 2017: Neurology
https://www.readbyqxmd.com/read/28481688/effect-of-fascia-dry-needling-on-non-specific-thoracic-pain-a-proposed-dry-needling-grading-system
#9
Sudarshan Anandkumar, Murugavel Manivasagam
This case report describes a 42-year-old female who presented with complaints of diffuse pain in her thoracic paraspinal region from T2 to T7. Physical examination revealed tenderness, increased turgor and restriction of her superficial fascia. A potential first time description of successful management utilizing fascia dry needling is described in this report with improvements noted in pain, range of motion, and functional activities. The patient was discharged from physiotherapy after four treatment sessions, and a follow-up after 3 months revealed that she was pain free and fully functional...
May 8, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28474589/use-of-snapps-model-for-pediatric-outpatient-education
#10
Anju Kapoor, Anil Kapoor, Ashish Kalraiya, Sheela Longia
OBJECTIVE: To assess and compare the educational effectiveness of SNAPPS model with traditional method in developing reasoning skills of Pediatric residents in Out-patient department. METHODS: 40 case presentations with 4 residents (20 each with traditional and SNAPPS methods) were audiotaped and compared with respect to making differentials, reasoning for analyzing differentials, raising uncertainties by probing preceptor, and selecting case-related issues for self study...
April 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28454903/how-exemplary-inpatient-teaching-physicians-foster-clinical-reasoning
#11
Nathan Houchens, Molly Harrod, Karen E Fowler, Stephanie Moody, Sanjay Saint
PURPOSE: Clinical reasoning is a crucial component of training in health professions. These cognitive skills are necessary to provide quality care and avoid diagnostic error. Much previous literature has focused on teaching clinical reasoning in non-clinical environments and does not include learner reflections. The authors sought to explore, through multiple perspectives including learners, techniques employed by exemplary inpatient clinician-educators for explicitly cultivating clinical reasoning...
April 25, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28450567/circulating-tumor-dna-reflects-tumor-metabolism-rather-than-tumor-burden-in-chemotherapy-naive-patients-with-advanced-non-small-cell-lung-cancer-nsclc-an-18-f-fdg-pet-ct-study
#12
Silvia Morbelli, Angela Alama, Giulia Ferrarazzo, Simona Coco, Carlo Genova, Erica Rijavec, Francesca Bongioanni, Federica Biello, Maria Giovanna Dal Bello, Giulia Barletta, Michela Massollo, Irene Vanni, Roberta Piva, Alberto Nieri, Matteo Bauckneht, Gianmario Sambuceti, Francesco Grossi
We aimed to evaluate the relationship between Circulating tumor Cells (CTCs) and plasma Cell-free DNA (cfDNA) on one side and a comprehensive range of (18)F-fluorodeoxyglucose (FDG)-PET/CT-derived parameters on the other side in chemotherapy-naïve patients with advanced NSCLC. Methods: Among the seventy-nine patients included in the VeriStrat® trial (evaluating the role of pretreatment circulating tumor markers as predictors of prognosis), we selected patients submitted to FDG-PET/CT for clinical reasons just before the inclusion in the trial...
April 27, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28450428/impact-of-the-5as-team-study-on-clinical-practice-in-primary-care-obesity-management-a-qualitative-study
#13
Jodie Asselin, Eniola Salami, Adedayo M Osunlana, Ayodele A Ogunleye, Andrew Cave, Jeffrey A Johnson, Arya M Sharma, Denise L Campbell-Scherer
BACKGROUND: The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices. METHODS: This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta...
April 26, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28449293/a-novel-approach-to-study-medical-decision-making-in-the-clinical-setting-the-own-point-of-view-perspective
#14
Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Bernard Charlin
BACKGROUND: Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision-making in an authentic setting are increasing significantly. They are based on the use of qualitative methods which are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording...
April 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28438848/clinical-reasoning-a-71-year-old-woman-with-subacute-progressive-distal-weakness-and-paresthesia-after-vaccination
#15
Simão Cruz, Andrew M Schaefer, Abhijit Joshi, Mark R Baker
No abstract text is available yet for this article.
April 25, 2017: Neurology
https://www.readbyqxmd.com/read/28434131/knowing-how-and-knowing-why-testing-the-effect-of-instruction-designed-for-cognitive-integration-on-procedural-skills-transfer
#16
Jeffrey J H Cheung, Kulamakan M Kulasegaram, Nicole N Woods, Carol-Anne Moulton, Charlotte V Ringsted, Ryan Brydges
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill...
April 22, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28425221/conceptualizing-movement-by-expert-bobath-instructors-in-neurological-rehabilitation
#17
Julie Vaughan-Graham, Kara Patterson, Karl Zabjek, Cheryl A Cott
RATIONALE, AIMS, AND OBJECTIVES: Movement, a core aspect of physiotherapy practice, and integral to the clinical reasoning process has undergone limited theoretical development. Instead, research has focused on intervention effectiveness embedded within the positivist paradigm. The purpose of this study was to explore how expert neurorehabilitation therapists conceptualize movement as part of their clinical reasoning. METHOD: A qualitative interpretive descriptive approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews was used...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28425112/beyond-guidelines-discretionary-practice-in-face-to-face-triage-nursing
#18
Lars E F Johannessen
This article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses' discretionary application of guidelines. Specifically, it analyses nurses' discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients' complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning...
April 20, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28421952/implementing-spiritual-care-interventions
#19
S Ílvia Caldeira, Fiona Timmins
This article, the third and final in a series of three, discusses the implementation of spiritual care interventions by nurses. It describes how nurses can use clinical reasoning and the nursing process to implement appropriate spiritual care for patients, and outlines the competencies necessary to identify spiritual distress and meet the spiritual needs of patients. Spiritual care interventions are discussed as part of a multidisciplinary team approach to the provision of holistic care.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28421651/self-management-of-first-trimester-medical-termination-of-pregnancy-a-qualitative-study-of-women-s-experiences
#20
Carrie Purcell, Sharon Cameron, Julia Lawton, Anna Glasier, Jeni Harden
OBJECTIVE: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. DESIGN: Qualitative interview study. SETTING: One National Health Service health board (administrative) area in Scotland. POPULATION OR SAMPLE: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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