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https://www.readbyqxmd.com/read/29650072/patient-centered-bedside-rounds-and-the-clinical-examination
#1
REVIEW
Peter R Lichstein, Hal H Atkinson
Bedside hospital rounds promote patient-centered care in teaching and nonteaching settings. Patients and families prefer bedside rounds and provider acceptance is increasing. Efficient bedside rounds with an interprofessional team or with learners requires preparation of the patient and the rounding team. Bedside "choreography" provides structure and sets expectations for time spent in the room. By using relationship-centered communication, rounds can be both patient proximate and patient centered...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29607602/bedside-nurses-roles-in-discharge-collaboration-in-general-internal-medicine-disconnected-disempowered-and-devalued
#2
Joanne Goldman, Kathleen MacMillan, Simon Kitto, Robert Wu, Ivan Silver, Scott Reeves
Collaboration among nurses and other healthcare professionals is needed for effective hospital discharge planning. However, interprofessional interactions and practices related to discharge vary within and across hospitals. These interactions are influenced by the ways in which healthcare professionals' roles are being shaped by hospital discharge priorities. This study explored the experience of bedside nurses' interprofessional collaboration in relation to discharge in a general medicine unit. An ethnographic approach was employed to obtain an in-depth insight into the perceptions and practices of nurses and other healthcare professionals regarding collaborative practices around discharge...
April 1, 2018: Nursing Inquiry
https://www.readbyqxmd.com/read/29581808/standardized-reporting-system-use-during-handoffs-reduces-patient-length-of-stay-in-the-emergency-department
#3
Robert T Dahlquist, Karina Reyner, Richard D Robinson, Ali Farzad, Jessica Laureano-Phillips, John S Garrett, Joseph M Young, Nestor R Zenarosa, Hao Wang
Background: Emergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change. Methods: We performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented...
May 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29561389/a-novel-implementation-of-magnetic-levitation-to-quantify-leukocyte-size-morphology-and-magnetic-properties-to-identify-patients-with-sepsis
#4
Mikkel S Andersen, Shulin Lu, Gregory J Lopez, Annmarie T Lassen, Nathan I Shapiro, Ionita C Ghiran
BACKGROUND: We have developed a novel, easily implementable methodology using magnetic levitation to quantify circulating leukocyte size, morphology, and magnetic properties, which may help in rapid, bed side screening for sepsis. OBJECTIVE: Our objectives were 1) to describe our methodological approach to leukocyte assessment; and 2) to perform a pilot investigation to test the ability of magnetic levitation to identify and quantify changes in leukocyte size, shape, density and/or paramagnetic properties in healthy controls and septic patients...
March 20, 2018: Shock
https://www.readbyqxmd.com/read/29509096/impact-of-interdisciplinary-rounds-in-the-spinal-cord-injury-unit-on-relational-coordination-for-patients-with-pressure-injury-a-pilot-study
#5
Yuewei Wu-Fienberg, Mary K Henzel, Mary Ann Richmond, Devra B Becker
CONTEXT/OBJECTIVE: Multiple medical specialties are often involved in the management of patients with both spinal cord injuries (SCI) and pressure injuries (PIs), sometimes leading to inadequate communication. Our Veterans Affairs (VA) hospital has an interdisciplinary team for PI patients in the SCI unit. This team conducts monthly bedside rounds and journal clubs; there is no similar team for patients with PIs outside the SCI unit. This pilot study aims to determine whether such an interdisciplinary team improves care coordination among practitioners...
March 6, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29437836/prospective-observational-study-on-high-value-care-topics-discussed-on-multidisciplinary-rounds
#6
Jimmy B Beck, Corrie E McDaniel, Miranda C Bradford, Doug Brock, Carolyn D Sy, Tiffany Chen, Jeffrey Foti, Andrew A White
OBJECTIVES: Establishing a high-value care (HVC) culture within an institution requires a multidisciplinary commitment and participation. Bedside rounds provide an ideal environment for role modeling and learning behaviors that promote an HVC culture. However, little is understood regarding the types of HVC discussions that take place at the bedside and who participates in those discussions. METHODS: A prospective observational study at a tertiary-care, university-affiliated, free-standing children's hospital...
March 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29377988/outcomes-from-the-delphi-process-of-the-thoracic-robotic-curriculum-development-committee
#7
Giulia Veronesi, Patrick Dorn, Joel Dunning, Giuseppe Cardillo, Ralph A Schmid, Justin Collins, Jean-Marc Baste, Stefan Limmer, Ghada M M Shahin, Jan-Hendrik Egberts, Alessandro Pardolesi, Elisa Meacci, Sasha Stamenkovic, Gianluca Casali, Jens C Rueckert, Mauro Taurchini, Nicola Santelmo, Franca Melfi, Alper Toker
OBJECTIVES: As the adoption of robotic procedures becomes more widespread, additional risk related to the learning curve can be expected. This article reports the results of a Delphi process to define procedures to optimize robotic training of thoracic surgeons and to promote safe performance of established robotic interventions as, for example, lung cancer and thymoma surgery. METHODS: In June 2016, a working panel was spontaneously created by members of the European Society of Thoracic Surgeons (ESTS) and European Association for Cardio-Thoracic Surgery (EACTS) with a specialist interest in robotic thoracic surgery and/or surgical training...
January 25, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29350514/hospitalized-patients-and-family-members-preferences-for-real-time-transparent-access-to-their-hospital-records
#8
Michael J Waxman, Kurt Lozier, Lana Vasiljevic, Kira Novakofski, James Desemone, John O'Kane, Elizabeth M Dufort, David Wood, Ashar Ata, Louis Filhour, Richard J Blinkhorn
OBJECTIVES: To better understand patient satisfaction and perceived engagement with traditional hospital-based communication and to elicit patient preferences for health information technologies that would lead to improved satisfaction and engagement. STUDY DESIGN: We performed a mixed-methods study involving qualitative interviews followed by a survey of hospitalized patients and their family members at a single large academic medical center. METHODS: We conducted semi-structured interviews with 41 patients and surveyed 267 patients or family members to elicit their perspectives on satisfaction with traditional hospital communication methods, information needed to more fully engage in the patients' medical care, and potential solutions for improved hospital-based communication...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#9
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
April 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29314328/nurse-to-nurse-shift-handoffs-on-medical-surgical-units-a-process-within-the-flow-of-nursing-care
#10
Katherine M Ernst, Sara A McComb, Cathaleen Ley
AIMS AND OBJECTIVES: To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. BACKGROUND: The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality...
March 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29300237/dedicated-afternoon-rounds-for-icu-patients-families-and-family-satisfaction-with-care
#11
Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kevin B Huang, Muhammad Hamza, Jessica White, Anna Coppola, Kathleen M Akgün, David M Greer, Evie G Marcolini, Emily J Gilmore, Nils H Petersen, Nona Timario, Kelly Poskus, Kevin N Sheth, David Y Hwang
OBJECTIVE: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN: Pre- and postimplementation (pre-I and post-I) design. SETTING: Single academic neuroscience ICU. PATIENTS: Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission...
April 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#12
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29171329/defining-curricular-priorities-for-student-as-teacher-programs-a-national-delphi-study
#13
Jasmine Rana, Amy Sullivan, Molly Brett, Amy R Weinstein, Katharyn M Atkins
BACKGROUND: "Student-as-Teacher" (SaT) programs have been growing in number to prepare medical students for their teaching roles in residency and beyond, but it remains unknown what content areas should be covered in SaT curricula. AIM: To determine five to ten "essential" content areas for inclusion in SaT curricula using expert opinion. METHODS: Using a three-round Delphi process, moderators iteratively surveyed a panel of 28 medical educators (25 academy directors and three individuals identified as having expertise in undergraduate medical education) representing 25 medical schools in the United States...
November 24, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29167032/using-the-evidence-based-practice-service-nursing-bundle-to-increase-patient-satisfaction
#14
Mary Kate Dilts Skaggs, Juli F Daniels, Angela J Hodge, Valerie L DeCamp
ABSTRACTINTRODUCTION: Patient satisfaction and patient experience goals are often linked to financial consequences. Although the link does exist, the bottom line is not only about money; it's about providing a quality experience for ED patients and creating an environment that engages staff. Evidence-based practice (EBP) strategies that have positive impact on patient perceptions of their ED care and increased satisfaction ratings include AIDET, Hourly Rounding, and Bedside Shift Report, which incorporate updates of test results and explanations of events occurring during a patient's visit...
January 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29117055/improving-patient-experience-through-nursing-satisfaction
#15
Amanda McNicholas, Abby McCall, Alanna Werner, Ronda Wounderly, Erin Marinchak, Pamela Jones
Patient experience is a vital component of quality health care. In our institution we sought to improve both nursing satisfaction and collaboration, in conjunction with improving patient experience, predicting the two are directly proportional. We hypothesized that a more satisfied nursing team would result in an overall improvement in patient experience. To explore this hypothesis, we implemented multiple process changes to create an advanced practitioner-directed floor (APDF) on our 28-bed trauma, medical-surgical unit...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29094620/tele-attending-can-emulate-and-even-improve-bedside-teaching-and-learning
#16
Robert J Adams
Telemedicine can be used for education as well as clinical care. Wearable platforms now allow a remote student to "tele-present" cases to "Tele-Attending" elsewhere in real time. Most of the features that medical students rate as important can be accommodated in this paradigm. Augmenting the bedside case presentation with teaching material from on-line sources may even improve bedside rounds. Tele-attending should be explored in particular to meet needs of students at Regional Medical Centers.
November 2, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29073318/bedside-assessment-of-the-necessity-of-daily-lab-testing-for-patients-nearing-discharge
#17
Surafel Tsega, Michelle O'Connor, Jashvant Poeran, Colin Iberti, Hyung J Cho
As part of the Choosing Wisely® campaign, the Society of Hospital Medicine recommends against performing "repetitive complete blood count chemistry testing in the face of clinical and lab stability." With this recommendation as a framework, we targeted 2 hospitalist-run inpatient medicine units that employed bedside, scripted, interdisciplinary rounds. Our multifaceted intervention included prompting the hospitalist to identify clinically stable patients for next-day discharge and to discontinue labs when appropriate...
January 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29064517/framtidens-rond-%C3%A2-ett-personcentrerat-och-teambaserat-m%C3%A3-te-med-patienten-den-traditionella-ronden-g%C3%A3-r-inte-att-f%C3%A3-rsvara-etiskt-eller-juridiskt
#18
Anders Ågård, Ingemar Engström, Ulrika Sandén, Valdemar Erling
The aim of this article is to elucidate the traditional ward round from an historical, ethical and legal perspective. On the traditional ward round in hospitals, a senior clinician leads a group of other clinicians and health professionals on a walking tour through the ward to visit the patients for whom they are responsible at bedside. It is a long-lived tradition or routine, which has been substantially resistant to change. We recommend that work designed to improve the ward round should begin from values or ethical principles, such as respecting the patient's integrity and right to participate in decision-making...
October 17, 2017: Läkartidningen
https://www.readbyqxmd.com/read/29017863/surgical-volunteerism-as-a-collaborative-teaching-activity-can-benefit-surgical-residents-in-low-middle-income-countries
#19
EDITORIAL
Ryan A Hayton, Dustin K Donley, Arega Fekadu, Bradley K Woods, Cassandra K Graybill, Tamara N Fitzgerald
Surgical care is desperately needed in low-middle income countries (LMIC). Due to small numbers of faculty in local training programs, residents have limited exposure to subspecialists. We describe a teaching activity between visiting surgeons from the U.S. and a residency program in Malawi as an example for how surgeons in high income countries can meaningfully contribute. A short-term education activity was developed where residents participated in a pre-test on pediatric surgical management, lectures, intra-operative instruction, bedside rounds and a post-test...
December 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28956551/a-return-to-humane-medicine-osler-s-legacy
#20
Lucia Craxì, Simona Giardina, Antonio Gioacchino Spagnolo
Sir William Osler is celebrated today not only for his contributions to the advancement of medical education, but also for the humanism he brought to the practice of medicine. He was a doctor whose bedside skills and manners were emulated, and can legitimately be called an infectious diseases specialist. Nonetheless, he was also a humanist in the broader sense of the term, a student of human affairs and human nature, who emphasised compassion for the individual. To what extent, if any, are today's challenges influenced by departures from the paradigms created by Osler? In this paper we sought to ascertain whether such a tradition is still relevant to current practice and may foster a new perspective...
September 1, 2017: Le Infezioni in Medicina
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