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Leading change in nursing practice

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https://www.readbyqxmd.com/read/28931399/principles-practices-and-knowledge-of-clinicians-when-assessing-febrile-children-a-qualitative-study-in-kenya
#1
Anneka M Hooft, Kelsey Ripp, Bryson Ndenga, Francis Mutuku, David Vu, Kimberly Baltzell, Linnet N Masese, John Vulule, Dunstan Mukoko, A Desiree LaBeaud
BACKGROUND: Clinicians in low resource settings in malaria endemic regions face many challenges in diagnosing and treating febrile illnesses in children. Given the change in WHO guidelines in 2010 that recommend malaria testing prior to treatment, clinicians are now required to expand the differential when malaria testing is negative. Prior studies have indicated that resource availability, need for additional training in differentiating non-malarial illnesses, and lack of understanding within the community of when to seek care play a role in effective diagnosis and treatment...
September 20, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#2
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28902701/diabetes-self-management-education-training-for-community-health-center-nurses-in-indonesia-a-best-practice-implementation-project
#3
Sugiharto Sugiharto, Matthew Stephenson, Yu-Yun Hsu, Nuniek Nizmah Fajriyah
BACKGROUND: Diabetes complications can increase progressively, leading to morbidity and mortality among diabetes sufferers. To address this, diabetes self-management education is a strategy to increase patients' knowledge and awareness in self-care. However some issues related to diabetes self-management education have emerged for health care providers and patients. OBJECTIVES: The objective of this project was to improve nurses' skills and confidence in delivering diabetes self-management education among type 2 diabetes patients by promoting evidence based practice in community health centers, thereby enhancing patients' knowledge and skills in performing self-care...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28851786/barriers-and-facilitators-to-the-implementation-of-a-community-based-multidisciplinary-family-focused-childhood-weight-management-programme-in-ireland-a-qualitative-study
#4
Emily Kelleher, Janas M Harrington, Frances Shiely, Ivan J Perry, Sheena M McHugh
OBJECTIVE: To explore the barriers and facilitators experienced by those implementing a government-funded, community-based childhood weight management programme. DESIGN: Qualitative using semistructured interviews. SETTING: Two geographical regions in the south and west of Ireland. PARTICIPANTS: 29 national-level and local-level stakeholders responsible for implementing the programme, including professionals from dietetics, psychology, public health nursing, physiotherapy, health promotion and administration...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28851485/recalmin-ii-eight-years-of-hospitalisation-in-internal-medicine-units-2007-2014-what-has-changed
#5
A Zapatero-Gaviria, R Barba-Martín, J Canora Lebrato, C Fernández-Pérez, R Gómez-Huelgas, J L Bernal-Sobrino, J Díaz-Manglano, J Marco-Martínez, F J Elola-Somoza
OBJECTIVES: To analyse the evolution of care provided by the internal medicine units (IMU) of the Spanish National Health System from 2007 to 2014. MATERIAL AND METHODS: We analysed all discharges from the IMU of the Spanish National Health System in 2007 and 2014, using the Minimum Basic Data Set. We compared the risk factors by episode, mortality and readmissions between the two periods. We prepared specific fits for the risk for mortality and readmissions in heart failure, pneumonia and chronic obstructive pulmonary disease, as well as the Charlson index for all activity...
August 26, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28840930/trauma-informed-care-and-practice-practice-improvement-strategies-in-an-inpatient-mental-health-ward
#6
Paul Beckett, Douglas Holmes, Monique Phipps, Declan Patton, Luke Molloy
A growing body of evidence highlights that trauma is the single most significant predictor that an individual will need support from mental health services. Yet despite this association, mental health services have been slow to provide approaches to care and treatment that deal directly with trauma. Embedding the principles of trauma-informed care and practice (TICP) in acute inpatient ward practice can lead to practice improvement and cultural change over a number of areas. The current service evaluation highlights how these principles can inform practice and the positive affect this has on areas such as seclusion and restraint, therapeutic engagement, and ward routines...
August 24, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28833728/the-culture-contributing-to-interruptions-in-the-nursing-work-environment-an-ethnography
#7
Susan G Hopkinson, Debra L Wiegand
AIMS AND OBJECTIVES: The purpose of this study was to understand the occurrence of interruptions within the culture of the medical nursing unit work environment. BACKGROUND: Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. DESIGN: A micro-focused ethnographic study was conducted. METHOD: Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses...
August 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28831847/how-to-use-a-corticosteroid-nasal-spray
#8
Janette Bartle
Rationale and key points This article outlines the appropriate and effective technique for using a corticosteroid nasal spray. If these sprays are used inappropriately, they will be ineffective and might reduce the patient's adherence to the treatment. Nurses can use the information in this article to advise patients on the appropriate technique for using a corticosteroid nasal spray. » Topical corticosteroid nasal sprays are commonly used to treat seasonal and persistent allergic rhinitis, which cause inflammation inside the nose and can lead to nasal blockage...
August 23, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28815784/nursing-care-for-stroke-patients-a-survey-of-current-practice-in-eleven-european-countries
#9
Zeliha Tulek, Ingrid Poulsen, Katrin Gillis, Ann-Cathrin Jönsson
AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death and disability globally. Optimal organisation of interdisciplinary stroke care is expected to ameliorate outcome after stroke. Consequently, universal access to stroke care based on evidence-based guidelines is a priority...
August 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28807424/a-national-collaborative-approach-to-reduce-catheter-associated-urinary-tract-infections-in-nursing-homes-a-qualitative-assessment
#10
Sarah L Krein, Molly Harrod, Sue Collier, Kristina K Davis, Andrew J Rolle, Karen E Fowler, Lona Mody
BACKGROUND: Reducing health care-associated infections (HAIs), such as catheter-associated urinary tract infection (CAUTI), is a critical performance improvement target in nursing homes. The Agency for Healthcare Research and Quality Safety Program for Long-term Care: Health Care-Associated Infections/Catheter-Associated Urinary Tract Infection, a national performance improvement program, was designed to promote implementation of a CAUTI prevention program through state-based or regional collaboratives in more than 500 nursing homes across the United States...
August 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28806234/delirium-in-the-critically-ill-child
#11
REVIEW
Sharon Norman, Asma A Taha, Helen N Turner
PURPOSE/OBJECTIVE: The purposes of this article are to describe the scientific literature on assessment, prevention, and management of delirium in critically ill children and to articulate the implications for clinical nurse specialists, in translating the evidence into practice. DESCRIPTION: A literature search was conducted in 4 databases-OvidMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Web of Science-using the terms "delirium," "child," and "critically ill" for the period of 2006 to 2016...
September 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28765362/driving-organizational-change-from-the-bedside-the-aacn-clinical-scene-investigator-academy
#12
Susan R Lacey, Caryl Goodyear-Bruch, Adrienne Olney, Dave Hanson, Marian S Altman, Natasha S Varn-Davis, Debbie Brinker, Ramón Lavandero, Karen S Cox
BACKGROUND: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes. OBJECTIVES: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28756443/enhancing-general-practitioners-participation-in-a-virtual-community-of-practice-for-continuing-medical-education-an-exploratory-study
#13
Abdulaziz Murad, Reeva Lederman, Rachelle Bosua, Shanton Chang, John D Wark
As sources of medical information grow online, Virtual Communities of Practice (VCoPs) have evolved into a potential tool that allows General Practitioners (GPs) to interact through the sharing of their experience and knowledge. However, literature reports that GPs are reluctant to participate in VCoPs especially for their continuing medical education (CME). Currently, no study has explored the design and structural aspects of VCoPs that may lead to enhancing GPs' participation in such online communities. Hence, this paper explores how GPs envisage the use of a VCoP for their CME and how to enhance their participation by conducting an exploratory qualitative study of two focus groups with 10 GPs in each group, accompanied by a specialist and a nurse...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28717813/cut-off-points-for-muscle-mass-not-grip-strength-or-gait-speed-determine-variations-in-sarcopenia-prevalence
#14
F Masanés, X Rojano I Luque, A Salvà, J A Serra-Rexach, I Artaza, F Formiga, F Cuesta, A López Soto, D Ruiz, A J Cruz-Jentoft
OBJECTIVES: The European Working Group on Sarcopenia in Older People (EWGSOP) has proposed different methods and cut-off points for the three parameters that define sarcopenia: muscle mass, muscle strength and physical performance. Although this facilitates clinical practice, it limits comparability between studies and leads to wide differences in published prevalence rates. The aim of this study was to assess how changes in cut-off points for muscle mass, gait speed and grip strength affected sarcopenia prevalence according to EWGSOP criteria...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28665905/implementation-of-practice-transformation-patient-experience-according-to-practice-leaders
#15
Denise D Quigley, Alina I Palimaru, Alex Y Chen, Ron D Hays
OBJECTIVE: Examine practice leaders' perceptions and experiences of how patient-centered medical home (PCMH) transformation improves patient experience. SUBJECTS: Thirty-six interviews with lead physicians (n = 13), site clinic administrators (n = 13), and nurse supervisors (n = 10). METHODS: Semi-structured interviews at 14 primary care practices within a large urban Federally Qualified Health Center (FQHC) delivery system to identify critical patient experience domains and mechanisms of change...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28662287/weight-management-a-concept-analysis
#16
Connie L Winik, C Elizabeth Bonham
AIM: There is a need to develop sound healthcare practices where patients and providers are able to succeed in meeting weight management goals. The aim of this analysis is to develop a better understanding the concept of weight management. BACKGROUND: Obesity is a rapidly growing healthcare issue, reaching epidemic levels around the world. According to the World Health Organization, the current incident rate of obesity makes it the leading risk for death across the globe...
June 29, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28659157/supporting-medication-discontinuation-provider-preferences-for-interventions-to-facilitate-deprescribing
#17
Amy Linsky, Mark Meterko, Kelly Stolzmann, Steven R Simon
BACKGROUND: One approach to prevent adverse drug events is to discontinue ("deprescribe") medications that are outdated, not indicated, or of limited benefit relative to risk for a particular patient. However, there is little guidance to clinicians about how to integrate the process of deprescribing into the workflow of clinical practice. We sought to determine clinical prescribers' preferences for interventions that would improve their ability to appropriately and proactively discontinue medications...
June 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28653946/the-truth-on-current-peritoneal-dialysis-state-of-the-art
#18
R T Krediet, A C Abrahams, C W H de Fijter, M G H Betjes, W H Boer, B C van Jaarsveld, C J A M Konings, F W Dekker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28639548/a-leadership-perspective-on-a-shared-vision-for-healthcare
#19
Tracy Kitch
Our country's recent negotiations for a new Health Accord have shone light on the importance of more accessible and better home care. The direction being taken on health funding investments has sent a strong message about healthcare system redesign. It is time to design a healthcare system that moves us away from a hospital-focused model to one that is more effective, integrated and sustainable and one that places a greater emphasis on primary care, community care and home care. The authors of the lead paper (Sharkey and Lefebre 2017) provide their vision for people-powered care and explore the opportunity for nursing leaders to draw upon the unique expertise and insights of home care nursing as a strategic lever to bring about real health system transformation across all settings...
2017: Nursing Leadership
https://www.readbyqxmd.com/read/28632953/updates-to-the-us-food-and-drug-administration-regulations-for-mifepristone-implications-for-clinical-practice-and-access-to-abortion
#20
Katherine E Simmonds, Margaret W Beal, Meghan K Eagen-Torkko
This article provides information on recent changes in the US Food and Drug Administration (FDA) labeling and safety regulations for mifepristone (Mifeprex). The revised label now permits midwives, advanced practice nurses, and physician assistants to order and prescribe mifepristone, eliminating the requirement for physician supervision. The updated label also extends eligibility for use from 49 to 70 days' gestation and decreases the number of required visits from 3 to 2. The recommended dose of mifepristone has been reduced, and the dosage, timing, and route of administration for misoprostol have also been changed to reflect current research...
May 2017: Journal of Midwifery & Women's Health
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