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https://www.readbyqxmd.com/read/29790445/a-study-of-deficiencies-in-teamwork-skills-among-jordan-caregivers
#1
Omar Al-Araidah, Nader Al Theeb, Mariam Bader, Nabeel Mandahawi
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790142/-application-of-care-bundles-to-reduce-medical-device-related-pressure-injury-mdrpi-incidence-in-a-coronary-care-unit
#2
Shu-Ling Wang, Pao-Yu Chuang, Wan-Chuan Su
BACKGROUND & PROBLEMS : Pressure injuries increase the cost of medical care and prolong hospitalization. The incidence of pressure injury at the target coronary care unit (CCU) from January to August 2016 was 1.1%, which was significantly higher than the 0.4% defined in the 2015 Taiwan Clinical Performance Indicators (TCPI) system. Medical device related pressure injury (MDRPI) accounted for 73.1% of the pressure injuries (incidence: 0.8%). The main causes of the high incidence of MDRPI were: (1) inadequate decompression dressing and restraint equipment, (2) incomplete implementation of prevention interventions in the CCU, (3) inadequate knowledge of MDRPI prevention among nurses, (4) deficient standards for preventing MDRPI, (5) ineffective MDRPI-related education, and (6) insufficient auditing frequencies...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29790141/-using-trm-to-enhance-the-accuracy-of-ventilator-associated-pneumonia-preventive-measures-implemented-by-neonatal-intensive-care-unit-medical-staffs
#3
Yu-Ting Huang, Chao-Ya Huang, Hsiu-Ya Su, Chen-Te Ma
BACKGROUND & PROBLEMS: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789183/-do-not-do-recommendations-of-the-working-groups-of-the-spanish-society-of-intensive-and-critical-care-medicine-and-coronary-units-semicyuc-for-the-management-of-critically-ill-patients
#4
F J González de Molina Ortiz, F Gordó Vidal, A Estella García, P Morrondo Valdeolmillos, J F Fernández Ortega, J Caballero López, P V Pérez Villares, M A Ballesteros Sanz, C de Haro López, J A Sanchez-Izquierdo Riera, A Serrano Lázaro, M P Fuset Cabanes, L J Terceros Almanza, X Nuvials Casals, J Baldirà Martínez de Irujo
The project "Commitment to Quality of Scientific Societies", promoted since 2013 by the Spanish Ministry of Health, seeks to reduce unnecessary health interventions that have not proven effective, have little or doubtful effectiveness, or are not cost-effective. The objective is to establish the "do not do" recommendations for the management of critically ill patients. A panel of experts from the 13 working groups (WGs) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) was selected and nominated by virtue of clinical expertise and/or scientific experience to carry out the recommendations...
May 19, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29788245/implementation-science-in-low-resource-settings-using-the-interactive-systems-framework-to-improve-hand-hygiene-in-a-tertiary-hospital-in-ghana
#5
Brianne Kallam, Christie Pettitt-Schieber, Medge Owen, Rebecca Agyare Asante, Elizabeth Darko, Rohit Ramaswamy
Quality issue: Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them. Initial assessment: Ridge Regional Hospital (RRH), a tertiary referral hospital in Accra, Ghana experienced a spike in rates of neonatal sepsis and launched a quality improvement (QI) initiative that identified poor adherence to hand hygiene in the neonatal intensive care unit as a potential source of infections...
May 19, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29788110/long-term-compliance-with-a-validated-intravenous-insulin-therapy-protocol-in-cardiac-surgery-patients-a-quality-improvement-project
#6
Guillaume Besch, Andrea Perrotti, Lucie Salomon du Mont, Raphaelle Tucella, Guillaume Flicoteaux, Aline Bondy, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
Quality problem: Safe and efficient blood glucose (BG) level control after cardiac surgery relies on an intensive care unit (ICU) team-based approach, including implementation of a dynamic insulin therapy protocol (ITP). Long-term compliance with such a complex protocol is poorly addressed in the literature. The aim of this study was to assess the long-term compliance of nurses with the ITP, 7 years after its implementation in the ICU. Initial assessment: A professional practice evaluation, integrated in a process of quality improvement program, was retrospectively conducted on 224 consecutive cardiac surgery patients over a 6-month period (PHASE 1)...
May 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29784237/quality-of-life-and-well-being-following-inpatient-and-partial-hospitalization-treatment-for-opioid-use-disorder
#7
Claire E Blevins, Ana M Abrantes, Megan E Kurth, Alan L Gordon, Michael D Stein
Treatment of opioid use disorder often begins with brief intensive inpatient or outpatient programs. Given the high relapse rates following intensive treatment, it is important to determine factors that lead to success post-discharge. Incorporating assessment during and early post-discharge may help determine such factors. The current study evaluated changes in quality of life among individuals during and after discharge from inpatient and partial hospitalization opiate treatment programs. Participants (n = 143) were recruited while in the programs and were re-assessed one month later (n = 113)...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#8
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#9
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29779520/person-centered-care-for-patients-with-pessaries
#10
REVIEW
Gwendolyn L Hooper
Pelvic organ prolapse is a common condition affecting women of any age but more likely to occur in the aging woman. Prolapse has a significant impact on quality of life, sexuality, and body image. Vaginal support pessaries have been used since ancient times and are a safe and effective nonsurgical treatment option. Fitting a pessary results in immediate symptom improvement. A comprehensive evaluation for pessary fitting is time intensive but necessary. Nurse providers perform direct pessary care and have a role in caring for women with prolapse expanding access to care...
June 2018: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29779398/handoff-tool-enabling-standardized-transitions-between-the-emergency-department-and-the-hospitalist-inpatient-service-at-a-major-cancer-center
#11
Carmen E Gonzalez, Norman Brito-Dellan, Srinivas R Banala, David Rubio, Mohamed Ait Aiss, Terry W Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29770557/developing-a-set-of-consensus-indicators-to-support-maternity-service-quality-improvement-using-core-outcome-set-methodology-including-a-delphi-process
#12
Kathryn J Bunch, Benjamin Allin, Matthew Jolly, Tom Hardie, Marian Knight
OBJECTIVE: To develop a core metric set to monitor the quality of maternity care. DESIGN: Delphi process followed by a face-to-face consensus meeting. SETTING: English Maternity units. POPULATION: Three representative expert panels: service designers, providers and users. MAIN OUTCOME MEASURES: Maternity care metrics judged important by participants. METHODS: Participants were asked to complete a two phase Delphi process, scoring metrics from existing local maternity dashboards...
May 16, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29769247/dementia-and-physical-activity-dapa-trial-of-moderate-to-high-intensity-exercise-training-for-people-with-dementia-randomised-controlled-trial
#13
Sarah E Lamb, Bart Sheehan, Nicky Atherton, Vivien Nichols, Helen Collins, Dipesh Mistry, Sukhdeep Dosanjh, Anne Marie Slowther, Iftekhar Khan, Stavros Petrou, Ranjit Lall
OBJECTIVE: To estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia. DESIGN: Multicentre, pragmatic, investigator masked, randomised controlled trial. SETTING: National Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions. PARTICIPANTS: 494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care...
May 16, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29769242/implementing-parental-tobacco-dependence-treatment-within-bronchiolitis-qi-collaboratives
#14
Susan C Walley, Grant M Mussman, Michele Lossius, Kristin A Shadman, Lauren Destino, Matthew Garber, Shawn L Ralston
BACKGROUND AND OBJECTIVES: We sought to implement systematic tobacco dependence interventions for parents and/or caregivers as secondary aims within 2 multisite quality improvement (QI) collaboratives for bronchiolitis. We hypothesized that iterative improvements in tobacco dependence intervention strategies would result in improvement in outcomes between collaboratives. METHODS: This study involved 2 separate yearlong, multisite QI collaboratives that were focused on care provided to inpatients with a primary diagnosis of bronchiolitis...
May 16, 2018: Pediatrics
https://www.readbyqxmd.com/read/29768977/primary-care-physicians-perceptions-of-practice-improvement-as-a-professional-responsibility-a-cross-sectional-study
#15
Christopher R Stephenson, Christopher M Wittich, Joel E Pacyna, Matthew K Wynia, Omar Hasan, Jon C Tilburt
Continuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians' perceptions of the practice improvement (Part IV) components of MOC. We aimed to determine primary care physicians' perceptions of their professional responsibility to participate in Part IV MOC. This was a cross-sectional study of primary care physicians using the American Medical Association Masterfile...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29766622/evaluating-the-implementation-of-confusion-assessment-method-intensive-care-unit-using-a-quality-improvement-approach
#16
C Stewart, S Bench
Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium...
May 15, 2018: Nursing in Critical Care
https://www.readbyqxmd.com/read/29761488/psychological-therapies-for-treatment-resistant-depression-in-adults
#17
REVIEW
Sharea Ijaz, Philippa Davies, Catherine J Williams, David Kessler, Glyn Lewis, Nicola Wiles
BACKGROUND: Antidepressants are a first-line treatment for adults with moderate to severe major depression. However, many people prescribed antidepressants for depression don't respond fully to such medication, and little evidence is available to inform the most appropriate 'next step' treatment for such patients, who may be referred to as having treatment-resistant depression (TRD). National Institute for Health and Care Excellence (NICE) guidance suggests that the 'next step' for those who do not respond to antidepressants may include a change in the dose or type of antidepressant medication, the addition of another medication, or the start of psychotherapy...
May 14, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757845/impact-of-the-acute-care-nurse-practitioner-in-reducing-the-number-of-unwarranted-daily-laboratory-tests-in-the-intensive-care-unit
#18
Brian K Jefferson, Joan E King
BACKGROUND: Frequent laboratory testing may be necessary at times for critically ill patients. However, the practice of indiscriminate laboratory test ordering is common. PURPOSE: The purpose of this quality improvement project was to assess the effectiveness of the acute care nurse practitioner (ACNP) in reducing the number of unwarranted laboratory tests ordered for ICU patients. To determine whether the presence of an ACNP would make a difference, an ACNP was present on daily ICU multidisciplinary rounds to facilitate the discussion of the laboratory testing needs for each patient for the following 24-hour period...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29756527/when-will-telemedicine-appear-in-the-icu
#19
Mark V Avdalovic, James P Marcin
As our population ages and the demand for high-level intensive care unit (ICU) services increase, the ICU physician supply continues to lag. In addition, hospitals, physician groups, and patients are demanding rapid access for the highest level of expertise in the care of critically ill patients. Telemedicine in the ICU combined with remote patient monitoring has been increasingly touted as a model of care to increase efficiencies and quality of care. Telemedicine in the ICU provides the potential to connect critically ill patients to sophisticated specialty care on a 24/7 basis, even for those hospitalized in rural locations where access to timely specialty consultations are uncommon...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29756290/a-standardized-closed-loop-system-for-monitoring-pediatric-tracheostomy-related-adverse-events
#20
Mallory McKeon, Daphne Munhall, Brian K Walsh, Roger Nuss, Reza Rahbar, Mark Volk, Karen Watters
OBJECTIVES/HYPOTHESIS: Advancement in neonatal and pediatric intensive care has increased the need for chronic-care interventions, including tracheostomy. It is well established that children with a tracheostomy are at a high risk for adverse events, many of which are preventable. Despite this, there is no standardized method of monitoring tracheostomy-related adverse events (TRAEs). Our objective was to describe and assess a standardized, closed-loop system for monitoring TRAEs. STUDY DESIGN: Prospective Study...
May 14, 2018: Laryngoscope
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