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ward rounds

Sarah Sims, Mary Leamy, Nigel Davies, Katy Schnitzler, Ros Levenson, Felicity Mayer, Robert Grant, Sally Brearley, Stephen Gourlay, Fiona Ross, Ruth Harris
BACKGROUND: Intentional rounding (IR) is a structured process whereby nurses conduct one to two hourly checks with every patient using a standardised protocol. OBJECTIVE: A realist synthesis of the evidence on IR was undertaken to develop IR programme theories of what works, for whom, in what circumstances and why. METHODS: A three-stage literature search and a stakeholder consultation event was completed. A variety of sources were searched, including AMED, CINAHL, MEDLINE, PsycINFO, HMIC, Google and Google Scholar, for published and unpublished literature...
March 14, 2018: BMJ Quality & Safety
Danielle Alice Banfield, Carly Adamson, Amy Tomsett, James Povey, Tony Fordham, Sarah Kathryn Richards
Background: The surgical post-take ward round is a complex multidisciplinary interaction in which new surgical patients are reviewed and management plans formulated. Its fast-paced nature can lead to poor communication and inaccurate or incomplete documentation with potential detriment to patient safety. Junior team members often do not fully understand the diagnosis and management plan. Aims: The aims of this project were to improve both communication and documentation on the surgical post-take ward round, influencing patient safety...
2018: BMJ open quality
William Levack, Kounosuke Tomori, Kayoko Takahashi, Aidan J Sherrington
OBJECTIVE: This study aimed to investigate the content of an English-language version of a Japanese iPad application designed to facilitate shared decision-making around goal setting in rehabilitation: Aid for Decision-making in Occupational Choice-English (ADOC-E). DESIGN: Phase 1: Delphi methods to reach consensus with an international group of expert occupational therapists on the text and images in ADOC-E. Phase 2: Testing correct recognition (unprompted and prompted) of images in ADOC-E by health service users in inpatient rehabilitation and residential care...
March 1, 2018: BMJ Open
J C T Lau, A C Leong
The C-MAC® video monitor attachment is suitable for all otolaryngological scenarios, including post-operative follow up and difficult airway examination. Currently, there are no studies looking at the effectiveness of C-MAC® portable monitor with portable flexible nasoendoscopy. Our study demonstrates that the C-MAC® monitor with portable flexible nasoendoscopy is an excellent tool in terms of medical education, improving patient-doctor communication, efficiency of ward rounds and for medico-legal documentation, with distinct advantages over traditional direct flexible nasoendoscopy...
March 1, 2018: Clinical Otolaryngology
Bernice Redley, Lauren McTier, Mari Botti, Alison Hutchinson, Harvey Newnham, Donald Campbell, Tracey Bucknall
BACKGROUND: Meaningful partnering with patients is advocated to enhance care delivery. Little is known about how this is operationalised at the point of care during hospital ward rounds, where decision-making concerning patient care frequently occurs. OBJECTIVE: Describe participation of patients, with differing preferences for participation, during ward rounds in acute medical inpatient services. METHODS: Naturalistic, multimethod design...
February 23, 2018: BMJ Quality & Safety
Steve Evans, Jai Darvall, Alexandra Gorelik, Rinaldo Bellomo
PURPOSE: To examine the effect of order in which patients are seen on an Intensive Care Unit (ICU) ward round on ICU length of stay (LOS), mortality and duration of mechanical ventilation. MATERIALS AND METHODS: Retrospective observational study in a tertiary metropolitan ICU over a 12month period. All patients who occupied the first and last three bed spaces of the ICU ward round, without having moved bed spaces during admission, were included. Separate analyses were performed for the absolute first and last patients...
February 3, 2018: Journal of Critical Care
Yasmin Hassen, Pritam Singh, Philip H Pucher, Maximilian J Johnston, Ara Darzi
BACKGROUND: Postoperative care quality is variable. Risk-adjusted mortality rates differ between institutions despite comparable complication rates. This indicates that there are underlying factors rooted in how care is delivered that determines patient safety. This study aims to evaluate systematically the surgical ward environment with respect to process-driven and structural factors to identify quality markers for safe care, from which new safety metrics may be derived. METHODS: Semistructured interviews of clinicians, nurses, patients and administrators were undertaken for the study...
January 17, 2018: Surgery
Kwaku W Baryeh, David Elliott, Ziad Harb, Radcliffe Lisk
INTRODUCTION: In the UK, more than 60 000 patients present with a fractured neck of femur each year. These patients represent a huge financial cost. This study looks at the 30-day readmissions and total length of hospital stay of patients presenting with a fractured neck of femur, as well as length of stay in non-hip fracture trauma patients, following the change to a daily consultant-led ward round. METHODS: A total of 200 records of patients with fractured neck of femur were reviewed with data collected retrospectively and prospectively following the introduction of the daily consultant-led ward round...
January 2, 2018: British Journal of Hospital Medicine
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
Chukwuemeka Ubaka, Erich Brechtelsbauer, Debra A Goff
Health-system and community pharmacy practice in the United States is experiencing transformational change; however, this transformation is lagging in the international arena. As a result, efforts are being made to provide support and education to the international pharmacy leaders and practitioners. This article describes one effort, the Mandela Washington Fellows Program, and suggests areas where pharmacy leaders can be involved to help advance the practice of pharmacy on an international level. The Mandela Washington Fellows Program for young Africa leaders consists of a US-Africa pharmacy-mentoring program identified ranging from educational opportunities to collaboration for implementation of patient care programs...
July 2017: Hospital Pharmacy
Sarah Tougher, Varun Dutt, Shreya Pereira, Kaveri Haldar, Vasudha Shukla, Kultar Singh, Paresh Kumar, Catherine Goodman, Timothy Powell-Jackson
BACKGROUND: How to harness the private sector to improve population health in low-income and middle-income countries is heavily debated and one prominent strategy is social franchising. We aimed to evaluate whether the Matrika social franchising model-a multifaceted intervention that established a network of private providers and strengthened the skills of both public and private sector clinicians-could improve the quality and coverage of health services along the continuum of care for maternal, newborn, and reproductive health...
December 20, 2017: Lancet Global Health
Robert Bing-You, Saradha Ramesh, Victoria Hayes, Kalli Varaklis, Denham Ward, Maria Blanco
Construct: Medical educators consider feedback a core component of the educational process. Effective feedback allows learners to acquire new skills, knowledge, and attitudes. Learners' perceptions of feedback are an important aspect to assess with valid methods in order to improve the feedback skills of educators and the feedback culture. BACKGROUND: Although guidelines for delivering effective feedback have existed for several decades, medical students and residents often indicate that they receive little feedback...
December 14, 2017: Teaching and Learning in Medicine
Yura Lee, Yu Rang Park, Junetae Kim, Jeong Hoon Kim, Woo Sung Kim, Jae-Ho Lee
BACKGROUND: Recently, many hospitals have introduced mobile electronic medical records (mEMRs). Although numerous studies have been published on the usability or usage patterns of mEMRs through user surveys, investigations based on the real data usage are lacking. OBJECTIVE: Asan Medical Center, a tertiary hospital in Seoul, Korea, implemented an mEMR program in 2010. On the basis of the mEMR usage log data collected over a period of 4.5 years, we aimed to identify a usage pattern and trends in accordance with user occupation and to disseminate the factors that make the mEMR more effective and efficient...
December 13, 2017: JMIR MHealth and UHealth
Maria Gustafsson, Claire Englund, Gisselle Gallego
BACKGROUND AND PURPOSE: The purpose of this article is to describe and evaluate the use of a three-dimensional virtual world (3DVW) in a clinical pharmacy course. EDUCATIONAL ACTIVITY AND SETTING: Students are provided with training opportunities in simulated ward rounds and patient meetings in a 3DVW. The 3DVW enables students to practice communication with patients and colleagues in a professional manner. To evaluate the course and use of the 3DVW, an online course evaluation was completed by students after they had finished the clinical pharmacy course...
September 2017: Currents in Pharmacy Teaching & Learning
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
Charmaine J Tang, Wen T Zhou, Sally W-C Chan, Sok Y Liaw
AIM: To explore the collaboration experiences of junior physicians and nurses in the general ward setting. BACKGROUND: Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. METHODS: Nineteen junior physicians and nurses were interviewed in 2012 and 2013...
January 2018: Journal of Nursing Management
Riaz Agha
Ward rounds permeate health care delivery worldwide and form an important daily activity within all hospitals. In this study, the daily morning ward round in plastic surgery was examined from a teleological and systems point of view. Methods: Data were gathered from the following sources to inform the systems analysis: patient interviews, staff interviews, direct observations of the ward round on multiple occasions, and through process mapping. Results: To better understand the ward and its layout, a schematic of it was developed...
August 2017: International Journal of Surgery. Oncology
Jacques Kerr, Helen Maitland, Claire Bell, Julie White, Alan Hunter
INTRODUCTION: ED crowding is associated with increased mortality, poor staff and patient experience, an increased inpatient length of stay and poor compliance with the four-hour emergency access standard.1 Where crowding is caused by exit block, the focus needs to be on whole system patient management, reducing the temporal mismatch between admissions and discharges since at times of peak demand hospitals may become gridlocked until patients are discharged.In an attempt to tackle exit block, the Scottish Government Unscheduled Care Team have implemented the Daily Dynamic Discharge (DDD) approach, which aims to increase the number of inpatient discharges by 12 pm, thus enabling more timeous flow through the ED...
December 2017: Emergency Medicine Journal: EMJ
Thet Su Win, Metin Nizamoglu, Ritesh Maharaj, Sarah Smailes, Naguib El-Muttardi, Peter Dziewulski
OBJECTIVE: The aims of this study are: firstly, to investigate if admission to specialized burn critical care units leads to better clinical outcomes; secondly, to elucidate if the multidisciplinary critical care contributes to this superior outcome. METHODS: A multi-centre cohort analysis of a prospectively collected national database of 1759 adult burn patients admitted to 13 critical care units in England and Wales between 2005 and 2011. Units were contacted via telephone to establish frequency and constitution of daily ward rounds...
February 2018: Burns: Journal of the International Society for Burn Injuries
Philip H Pucher, Rajesh Aggarwal
No abstract text is available yet for this article.
December 2017: Annals of Surgery
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