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morning rounds

Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
Christy L Cummings
Wait, what? I've been fired?" I repeated, in the middle of morning rounds in the neonatal intensive care unit. Finally, the nurse who was taking care of our patient, Angela, responded, "Her parents fired you last night. They've already called Patient Relations. They want a new doctor." My heart sank. Only days into my block of service time as the attending physician in the NICU and I was fired, axed, canned, rejected by a family. How could this have happened? On my first day of service, I had introduced myself to Angela's parents, and I had then met with them daily to review results and the plan and to answer their questions...
September 2016: Hastings Center Report
Ana M Cingolani, Iván Barberá, Daniel Renison, Fernando R Barri
Littering of public areas is a significant problem worldwide. Here we evaluate the success of persuasive and demonstrative messages at reducing littering in highly visited river beaches in Argentina. We made an intervention at the beaches which consisted of a personalized verbal request asking visitors to take their litter to the waste cans (persuasive message) while they were exposed to the example of picking up the litter already left on the beach (demonstrative message). We conducted 102 observations distributed over 29 dates, two years and four beaches...
September 6, 2016: Waste Management
Eric Young, Jaime Paulk, James Beck, Mel Anderson, McKenna Burck, Luke Jobman, Chad Stickrath
Interdisciplinary rounds provide a valuable venue for delivering patient-centered care but are difficult to implement due to time constraints and coordination challenges. In this article, we describe a unique model for fostering a culture of bedside interdisciplinary rounds through adjustment of the morning medication administration time, auditing physician communication with nurses, and displaying physician performance in public areas. Implementation of this model led to measurable improvements in physician-to-nurse communication on rounds, teamwork climate, and provider job satisfaction...
September 8, 2016: Journal of Nursing Care Quality
Rhian Isaac, Astrid Gerrard, Kevin Bazaz
BACKGROUND: Pressures to open pharmacy services 7 days a week, with no financial input for these extra resources, has knock on effects that may dilute accessibility to clinical pharmacists in specialist areas. AIMS: The aim of this survey was to assess opinions of the users of the current pharmacy services to PICU and the planned extended hours provision. METHOD: An e-survey was sent to PIC Consultants, Advanced Nurse Practitioners, and Senior Nursing Staff following a six month period of increased clinical pharmacists time allocation to PIC...
September 2016: Archives of Disease in Childhood
Deena Kelly Costa, Jennifer Dammeyer, Matthew White, Jose Galinato, Robert Hyzy, Milisa Manojlovich, Anne Sales
BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU...
2016: BMC Research Notes
A Nama, S Sviri, A Abutbul, I Stav, P V van Heerden
We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient...
July 2016: Anaesthesia and Intensive Care
Karan Dua, William C McAvoy, Sybil A Klaus, David I Rappaport, Rebecca E Rosenberg, Joshua M Abzug
PURPOSE: The benefits of hospitalist co-management of pediatric surgical patients include bettering patient safety, decreasing negative patient outcomes, providing comprehensive medical care, and establishing a dedicated resource to patients for postoperative care. The purpose of this study was to characterize the nature of patients co-managed by a pediatric hospitalist. The authors hypothesize that hospitalist co-management is safe and efficacious in pediatric orthopaedic surgical patients who are admitted to a community hospital...
2016: Maryland Medicine: MM: a Publication of MEDCHI, the Maryland State Medical Society
Veronica Perry, Mollie Christiansen, Angela Simmons
Interprofessional bedside rounds are essential for patient-centered care. However, it may be difficult for nurses to round with physicians on medical-surgical units. Using a daily goals tool for indirect rounds improved nurse-physician communication and interprofessional care for patients.
March 2016: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
Daniel Msellemu, Hagai I Namango, Victoria M Mwakalinga, Alex J Ntamatungiro, Yeromin Mlacha, Zacharia J Mtema, Samson Kiware, Neil F Lobo, Silas Majambere, Stefan Dongus, Christopher J Drakeley, Nicodem J Govella, Prosper P Chaki, Gerry F Killeen
BACKGROUND: In the Tanzanian city of Dar es Salaam, high coverage of long-lasting insecticidal nets (LLINs), larvicide application (LA) and mosquito-proofed housing, was complemented with improved access to artemisinin-based combination therapy and rapid diagnostic tests by the end of 2012. METHODS: Three rounds of city-wide, cluster-sampled cross-sectional surveys of malaria parasite infection status, spanning 2010 to 2012, were complemented by two series of high-resolution, longitudinal surveys of vector density...
2016: Malaria Journal
Stanislav Henkin, Tony Y Chon, Marie L Christopherson, Andrew J Halvorsen, Lindsey M Worden, John T Ratelle
BACKGROUND: Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician-nurse teamwork are often suboptimal. OBJECTIVE: To improve nurse-physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds. INTERVENTION: From July 2013 through October 2013, physicians (attendings and residents) and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients' bedside...
2016: Journal of Multidisciplinary Healthcare
Filippo Ceccato, Marco Boscaro
Endogenous Cushing's syndrome (CS) is a rare disease, and usually characterized by hypertension, diabetes, obesity, osteoporosis, facial rounding, dorsocervical fat pad, thin skin, purple striae, hirsutism, and mood disorders. Efficient diagnostic and screening strategies lead to the diagnosis of a significantly higher number of cases of CS. As a screening test for CS, the Endocrine Society's Clinical Practice Guidelines recommend a single test with a high diagnostic accuracy, among the 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and 24 h urinary free cortisol (UFC)...
September 2016: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Krisda H Chaiyachati, Andre N Sofair, Jeremy I Schwartz, David Chia
OBJECTIVES: Patient throughput and early discharges are important for decreasing emergency department wait times and creating available beds for new hospital admissions. The educational schedule of internal medicine trainees can interfere with timely discharges, but targeted interventions can help residents meet the hospital's patient flow needs. Our training program instituted daily morning discharge rounds on the inpatient service, requiring each team to prepare potential discharges 1 day ahead and prioritizing these discharges the next day...
May 2016: Southern Medical Journal
Alireza Esteghamati, Hamidreza Baradaran, Alireza Monajemi, Hamid Reza Khankeh, Mehrnaz Geranmayeh
INTRODUCTION: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students' knowledge, attitudes, and practice; therefore, it should be properly planned.  Due to the extensiveness   of the clinical   environment   and   its   importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents' learning by improving their learning environment...
April 2016: Journal of Advances in Medical Education & Professionalism
Marie Blomberg
INTRODUCTION: In 2006 the overall rates of instrumental deliveries (10%) and cesarean sections (CS) (20%) were high in our unit. We decided to improve quality of care by offering more women a safe and attractive normal vaginal delivery. The target group was primarily nulliparous women at term with spontaneous onset of labor and cephalic presentation. MATERIAL AND METHODS: Implementation of a "nine-item list" of structured organizational and cultural change in Linköping 2006-15...
May 2016: Acta Obstetricia et Gynecologica Scandinavica
Ganesh Acharya
No abstract text is available yet for this article.
March 2016: Acta Obstetricia et Gynecologica Scandinavica
Siyu Qian, Ping Yu, David M Hailey, Ning Wang
AIMS: To examine nursing time spent on administration of medications in a residential aged care (RAC) home, and to determine factors that influence the time to medicate a resident. BACKGROUND: Information on nursing time spent on medication administration is useful for planning and implementation of nursing resources. METHODS: Nurses were observed over 12 morning medication rounds using a time-motion observational method and field notes, at two high-care units in an Australian RAC home...
April 2016: Journal of Nursing Management
Vasundara Ramarajan, Harjinder S Chima, LaWanda Young
Traditionally, morning blood draws are collected by hospital staff from 3:00 AM through 6:00 AM to have the results ready by 9:00 AM for physician rounds. These laboratory results help physicians to make important patient disposition decisions, including discharging patients within the daily hospital cutoff times. However, morning draws can adversely impact patient care due to sleep disruption. In this paper, we describe the systematic implementation of later-morning blood draw times at our large urban hospital...
February 2016: Laboratory Medicine
Daniel Hagg, Hannah Lobingier, Kelsey Priest, Nancy McCully, Marge Willis
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Paola Nardone, Laura Lauria, Marta Buoncristiano, Enrica Pizzi, Daniela Galeone, Angela Spinelli
OBJECTIVES: to describe the dietary behaviour of children attending primary school and the school activities which promote healthy dietary habits. DESIGN OF THE STUDY: surveillance system with biannual prevalence studies. SETTING AND PARTICIPANTS: the fourth round of data collection of the surveillance system OKkio alla SALUTE took place in 2014, promoted and financed by the Ministry of Health and coordinated by the National Institute of Health in collaborations with all regions...
September 2015: Epidemiologia e Prevenzione
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