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https://www.readbyqxmd.com/read/28610934/boarding-icu-patients-are-our-rounding-practices-subpar
#1
Andrew M Nunn, Justin S Hatchimonji, Daniel N Holena, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Niels D Martin, Patrick M Reilly, C William Schwab, Jose L Pascual
INTRODUCTION: Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. MATERIAL AND METHODS: SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28607676/evaluating-the-quality-improvement-impact-of-the-global-tracheostomy-collaborative-in-four-diverse-nhs-hospitals
#2
Brendan A McGrath, James Lynch, Barbarella Bonvento, Sarah Wallace, Val Poole, Ann Farrell, Cristina Diaz, Sadie Khwaja, David W Roberson
Tracheostomies are predominantly used in Head & Neck Surgery and the critically ill. The needs of these complex patients frequently cross traditional speciality working boundaries and locations and any resulting airway problems can rapidly lead to significant harm. The Global Tracheostomy Collaborative (GTC) was formed in 2012 with the aim of bringing together international expertise in tracheostomy care in order to bring about rapid adoption of best practices and to improve the quality and safety of care to this vulnerable group...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28574531/do-hcahps-doctor-communication-scores-reflect-the-communication-skills-of-the-attending-on-record-a-cautionary-tale-from-a-tertiary-care-medical-service
#3
Vicente J Velez, Roop Kaw, Bo Hu, Richard M Frankel, Amy K Windover, Dan Bokar, Julie M Rish, Michael B Rothberg
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28566045/inpatient-rounding-practices-in-otolaryngology-residency-programs
#4
Mofiyinfolu Sokoya, Paul D Judge, Cristina Cabrera-Muffly, Peter M Vila
Inpatient rounding is an agelong tradition in the field of medicine. Among recent changes in health care, rounding is understudied as an area of research. The purpose of this study was to assess current methods of inpatient rounding in otolaryngology residency programs and assess satisfaction with current practices. Survey questions were designed by members of the resident committee of the Society of University Otolaryngologists. Surveys were sent to all 450 members, and we obtained a 32% response rate. Sixty-four percent of attendings perform bedside rounds; 44% of subjects reported that attending physicians participate in rounds at least once a week; and 21% reported daily participation...
June 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28439368/championing-mistakes-reclaiming-the-safe-learning-environment-for-family-centered-bedside-rounds
#5
EDITORIAL
Allyson McDermott
No abstract text is available yet for this article.
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28379901/the-utility-of-teleultrasound-to-guide-acute-patient-management
#6
REVIEW
Christian Becker, Mario Fusaro, Dhruv Patel, Isaac Shalom, William H Frishman, Corey Scurlock
Ultrasound has evolved into a core bedside tool for diagnostic and management purposes for all subsets of adult and pediatric critically-ill patients. Teleintensive care unit coverage has undergone a similar rapid expansion period throughout the United States. Round-the-clock access to ultrasound equipment is very common in today's intensive care unit, but 24/7 coverage with staff trained to acquire and interpret point-of-care ultrasound in real time is lagging behind equipment availability. Medical trainees and physician extenders require attending level supervision to ensure consistent image acquisition and accurate interpretation...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28363361/parent-participation-in-pediatric-intensive-care-unit-rounds-via-telemedicine-feasibility-and-impact
#7
Phoebe H Yager, Maureen Clark, Brian M Cummings, Natan Noviski
OBJECTIVES: To evaluate feasibility and impact of telemedicine for remote parent participation in pediatric intensive care unit (PICU) rounds when parents are unable to be present at their child's bedside. STUDY DESIGN: Parents of patients admitted to a 14-bed PICU were approached, and those unable to attend rounds were eligible subjects. Nurse and physician caregivers were also surveyed. Parents received an iPad (Apple Inc, Cupertino, California) with an application enabling audio-video connectivity with the care team...
March 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#8
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28316317/direct-two-minute-unassisted-breathing-evaluation-dtube-is-an-attractive-alternative-to-longer-spontaneous-breathing-trials-a-prospective-observational-study
#9
Matthew B Bloom, Jonathan Lu, Tri Tran, Marko Bukur, Rex Chung, Eric J Ley, Nicolas Melo, Ali Salim, Daniel R Margulies
We sought to identify a simple bedside method to predict successful extubation outcomes that might be used during rounds. We hypothesized that a direct 2-minute unassisted breathing evaluation (DTUBE) could replace a longer spontaneous breathing trial (SBT). Data were prospectively collected on all patients endotracheally intubated for >48 hours nearing extubation in a tertiary center's mixed trauma/surgical intensive care unit from August 2012 to August 2013. The SBT was performed for at least 30 minutes at 40 per cent FiO2, PEEP 5, and PS 8...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28282227/an-integrated-framework-for-effective-and-efficient-communication-with-families-in-the-adult-intensive-care-unit
#10
Jennifer B Seaman, Robert M Arnold, Leslie P Scheunemann, Douglas B White
The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician-family communication beyond traditional interdisciplinary family meetings (family meetings)-including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician-family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings...
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28272590/all-together-now-impact-of-a-regionalization-and-bedside-rounding-initiative-on-the-efficiency-and-inclusiveness-of-clinical-rounds
#11
Kristin T L Huang, Jacquelyn Minahan, Patricia Brita-Rossi, Patricia Aylward, Joel T Katz, Christopher Roy, Jeffrey L Schnipper, Robert Boxer
BACKGROUND: Attending rounds at academic medical centers are often disconnected from patients and team members who are not physicians. Regionalization of care teams may facilitate bedside rounding and more frequent interactions among doctors, nurses, and patients. OBJECTIVE: We used time-motion analysis to investigate how regionalization of medical teams and encouragement of bedside rounds affect participants on rounds and rounding time. DESIGN AND SETTING: We used pre-post analysis to study the effects of care redesign on teams' daily rounds on a general medicine service at an academic medical center...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272589/standardized-attending-rounds-to-improve-the-patient-experience-a-pragmatic-cluster-randomized-controlled-trial
#12
Bradley Monash, Nader Najafi, Michelle Mourad, Alvin Rajkomar, Sumant R Ranji, Margaret C Fang, Marcia Glass, Dimiter Milev, Yile Ding, Andy Shen, Bradley A Sharpe, James D Harrison
BACKGROUND: At academic medical centers, attending rounds (AR) serve to coordinate patient care and educate trainees, yet variably involve patients. OBJECTIVE: To determine the impact of standardized bedside AR on patient satisfaction with rounds. DESIGN: Cluster randomized controlled trial. SETTING: 500-bed urban, quaternary care hospital. PATIENTS: 1200 patients admitted to the medicine service...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272588/the-impact-of-bedside-interdisciplinary-rounds-on-length-of-stay-and-complications
#13
Andrew S Dunn, Maria Reyna, Brian Radbill, Michael Parides, Claudia Colgan, Tobi Osio, Ari Benson, Nicole Brown, Joy Cambe, Margo Zwerling, Natalia Egorova, Harold Kaplan
BACKGROUND: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. OBJECTIVE: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. DESIGN: Controlled trial. SETTING: 2 geographic areas of a medical unit using a clinical microsystem structure...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28261789/a-model-for-upscaling-global-partnerships-and-building-nurse-and-midwifery-capacity
#14
L A Spies, S L Garner, M A Faucher, M Hastings-Tolsma, C Riley, J Millenbruch, L Prater, S F Conroy
AIM: To provide a unique model for use in guiding global collaboration and policy to upscale nursing and midwifery partnerships. BACKGROUND AND INTRODUCTION: Nurses and midwives across nations need skills reaching beyond the bedside and unit level in today's complex, global, multifaceted healthcare milieu. Thoughtful consideration, research and concomitant development of models to guide appropriate upscaling of nurse and midwifery capacity within and between nations are needed...
March 5, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28259523/intensive-care-nurses-perceptions-of-inter-specialty-trauma-nursing-rounds-to-improve-trauma-patient-care-a-quality-improvement-project
#15
Fiona L Jennings, Marion Mitchell
BACKGROUND: Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. OBJECTIVES: The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement...
March 1, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28247873/optimizing-education-on-the-inpatient-dermatology-consultative-service
#16
REVIEW
Ladan Afifi, Kanade Shinkai
A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models...
March 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28225194/observing-bedside-rounds-for-faculty-development
#17
Somnath Mookherjee, Daniel Cabrera, Christy M McKinney, Elizabeth Kaplan, Lynne Robins
BACKGROUND: Bedside rounds are an ideal opportunity for clinical teaching. We previously offered faculty development on balancing learner autonomy, patient care and teaching. We noticed that participants often asked whether attending physicians and learners shared the same perceptions of the key elements (patient-centredness, efficiency and educational value) of bedside rounds. Understanding these perceptions and identifying areas of discordance would inform faculty development for optimal bedside rounds...
February 22, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28178911/bringing-mini-chalk-talks-to-the-bedside-to-enhance-clinical-teaching
#18
Michael B Pitt, Jay D Orlander
Chalk talks - where the teacher is equipped solely with a writing utensil and a writing surface - have been used for centuries, yet little has been written about strategies for their use in medical education. Structured education proximal to patient encounters (during rounds, at the bedside, or in between patients in clinic) maximizes the opportunities for clinical learning. This paper presents a strategy to bring mini-chalk talks (MCTs) to the bedside as a practical way to provide relevant clinical teaching by visually framing teachable moments...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28170431/bedside-or-not-bedside-evaluation-of-patient-satisfaction-in-intensive-medical-rehabilitation-wards
#19
Christophe Luthy, Patricia Francis Gerstel, Angela Pugliesi, Valérie Piguet, Anne-Françoise Allaz, Christine Cedraschi
BACKGROUND: Concerns that bedside presentation (BsP) rounds could make patients uncomfortable led many residency programs to move daily rounds outside the patients' room (OsPR). We performed a prospective quasi-experimental controlled study measuring the effect of these two approaches on patient satisfaction. METHODS: Patient satisfaction was measured using the Picker questionnaire (PiQ). Results are expressed in problematic percentage scores scaled from 0 = best-100 = worst...
2017: PloS One
https://www.readbyqxmd.com/read/28120233/methodological-study-to-develop-standard-operational-protocol-on-oral-drug-administration-for-children
#20
Sunil Kumar Bijarania, Sushma Kumari Saini, Sanjay Verma, Sukhwinder Kaur
OBJECTIVES: To develop standard operational protocol (SOP) on oral drug administration and checklist to assess the implementation of the developed SOP. METHODS: In this prospective methodological study, SOPs were developed in five phases. In the first phase, the preliminary draft of SOPs and checklists were prepared based on literature review, assessment of current practices and focus group discussion (FGD) with bedside working nurses. In the second phase, content validity was checked with the help of Delphi technique (12 experts)...
January 25, 2017: Indian Journal of Pediatrics
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