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https://www.readbyqxmd.com/read/29446155/not-just-trust-factors-influencing-learners-attempts-to-perform-technical-skills-on-real-patients
#1
Susan L Bannister, Mark S Dolson, Lorelei Lingard, David A Keegan
CONTEXT: As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. METHODS: A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning...
February 15, 2018: Medical Education
https://www.readbyqxmd.com/read/29425367/a-rapid-handheld-device-to-assess-respiratory-resistance-clinical-and-normative-evidence
#2
Aaron B Holley, Wesley D Boose, Michael Perkins, Karen L Sheikh, Nancy P Solomon, Angela M Dietsch, Jafar Vossoughi, Arthur T Johnson, Jacob F Collen
Introduction: Following reports of respiratory symptoms among service members returning from deployment to South West Asia (SWA), an expert panel recommended pre-deployment spirometry be used to assess disease burden. Unfortunately, testing with spirometry is high cost and time-consuming. The airflow perturbation device (APD) is a handheld monitor that rapidly measures respiratory resistance (APD-Rr) and has promising but limited clinical data. Its speed and portability make it ideally suited for large volume pre-deployment screening...
February 7, 2018: Military Medicine
https://www.readbyqxmd.com/read/29403646/barriers-and-facilitators-to-early-rehabilitation-in-mechanically-ventilated-patients-a-theory-driven-interview-study
#3
Shannon L Goddard, Fabiana Lorencatto, Ellen Koo, Louise Rose, Eddy Fan, Michelle E Kho, Dale M Needham, Gordon D Rubenfeld, Jill J Francis, Brian H Cuthbertson
Background: Despite a supportive evidence base and a push to implement, the uptake of early rehabilitation in critical care has been inconsistent. The objective of this study was to explore barriers and facilitators to early rehabilitation for critically ill patients receiving invasive mechanical ventilation. Methods: Using the Theoretical Domains Framework (TDF) of behavior change, we conducted semi-structured interviews exploring barriers and facilitators to early rehabilitation among four purposively sampled ICU clinician groups (nurses, rehabilitation professionals, respiratory therapists, and physicians)...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29397270/device-related-pressure-ulcers-pre-and-post-identification-and-intervention
#4
Pamela Clay, Casey Cruz, Keith Ayotte, Jeremy Jones, Susan B Fowler
PROBLEM: From 2014 to 2016, device related pressure injuries accounted for 62-81% of all hospital acquired pressure injuries. From January to June 2014, there were 5 BiPAP/CPAP pressure injuries noted, accounting for 3.579 injuries per 1000 ventilator days. In 2015, hospital data revealed that 26.5% of all hospital acquired pressure injuries occurred to prone surgical spine patients. METHODS: Collaborative teams including respiratory therapists and operating room staff were convened and crafted new strategies...
January 31, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29362219/incentive-spirometry-adherence-a-national-survey-of-provider-perspectives
#5
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Patient adherence is a critical factor for success of patient-administered therapies, including incentive spirometry (IS). Patient adherence with IS is not known, so we sought to evaluate providers'perspectives on the current state of IS adherence and elucidate possible factors hindering patient adherence. METHODS: Respiratory therapists (RTs) and nurses across the United States were surveyed via social media and online newsletters. Surveys were distributed to the relevant national RT and nursing societies: the American Association for Respiratory Care, the Academy of Medical-Surgical Nurses, the American Society of Peri-Anesthesia Nurses, and the American Association of Critical-Care Nurses...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362218/increasing-awareness-of-the-roles-knowledge-and-skills-of-respiratory-therapists-through-an-interprofessional-education-experience
#6
John B Zamjahn, Ellen O Beyer, Kelly L Alig, Donald E Mercante, Katherine L Carter, Tina P Gunaldo
BACKGROUND: The objectives of this study were: (1) to assess the use of interprofessional education (IPE) to improve the knowledge and skill levels of nursing and occupational therapy students regarding respiratory therapy (RT) medical devices and techniques, nursing and RT students regarding safe patient transfers, and RT and occupational therapy students regarding safe handling of a patient's medical lines during transfers and (2) to promote collaborative behaviors. METHODS: A prospective mixed methods approach was used for data collection of an IPE high-fidelity simulation experience involving 73 nursing, occupational therapy, and RT students at an academic medical institution...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29354201/evaluating-pediatrics-residents-ethics-learning-needs-using-multisource-interprofessional-feedback
#7
Peter MacPherson, Julie Emberley
Background: Ethics education is a required component of pediatric residency training. Limited instructional time requires educators to identify and prioritize learning needs. This is the first study to identify pediatric residents' ethics learning needs using a multisource (360 degree) assessment. We hypothesized that pediatricians or allied health care professionals would identify unperceived ethics learning needs. Methods: Pediatric residents, pediatricians, respiratory therapists (RTs), and registered nurses (RNs) working at a university children's hospital rated the importance of twelve ethics themes as learning needs for trainees using a Likert-type scale...
December 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#8
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29306991/asthma-and-medicines-long-term-side-effects-monitoring-and-dose-titration
#9
REVIEW
Satnam Kaur, Varinder Singh
Asthma is a major pediatric respiratory morbidity requiring long-term management. A thorough knowledge of long-term medication side-effects in children is, thus, essential for every physician dealing with childhood asthma. Establishing diagnosis and initiating treatment is just a beginning of the journey. Ongoing monitoring is an essential component of comprehensive asthma management programme. Monitoring includes not only assessment of asthma control but also checking for adherence to treatment, technique of inhaler device use, associated co-morbities, if any, and potential environmental exposure...
January 6, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29237868/copd-and-physical-activity-a-call-to-action-for-respiratory-therapists-and-patients
#10
EDITORIAL
David M Burnett
No abstract text is available yet for this article.
January 2018: Respiratory Care
https://www.readbyqxmd.com/read/29227288/physician-and-nurse-perceptions-of-gentle-cesarean-birth
#11
Rebecca J Mercier, Julia C Durante
BACKGROUND: Protocols for neonatal care and mother-baby interaction at cesarean birth frequently differ from those at vaginal birth. There is increasing interest in adopting family-friendly or gentle protocols for women having cesarean birth. Current evidence suggests challenges in achieving interdepartmental cooperation and consensus are potential barriers to implementing gentle cesarean protocols. PURPOSE: To describe how care providers' professional role and characteristics may affect perception about gentle cesarean birth techniques and inform specific concerns about protocol changes...
December 8, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29217101/a-novel-in-situ-simulation-intervention-used-to-mitigate-an-outbreak-of-methicillin-resistant-staphylococcus-aureus-in-a-neonatal-intensive-care-unit
#12
Kathleen Gibbs, Samuel DeMaria, Scarlett McKinsey, Andrea Fede, Anne Harrington, Deborah Hutchison, Carol Torchen, Adam Levine, Andrew Goldberg
OBJECTIVE: To describe the successful implementation of an in situ simulation program to diagnose and correct latent safety threats in a level 4 neonatal intensive care unit (NICU) to mitigate a methicillin-resistant Staphylococcus aureus (MRSA) outbreak. STUDY DESIGN: An investigational report describes a simulation intervention that occurred during a 4-month MRSA outbreak in a single-center, 46-bed, newly renovated level 4 NICU. The simulation program was developed for all NICU providers in which they were exposed to a 30-minute in situ human simulation intervention that included education, evaluation, and debriefing to resolve perceived or observed latent safety threats...
December 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#13
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29206729/extracorporeal-cardiopulmonary-resuscitation-in-the-pediatric-cardiac-population-in-search-of-a-standard-of-care
#14
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29202248/bag-valve-mask-ventilation-as-a-perceptual-cognitive-skill
#15
Joel M Mumma, Francis T Durso, Michelle Dyes, Rogelio Dela Cruz, Valerie P Fox, Mary Hoey
Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Background BVMV is a common and critical procedure for managing pediatric respiratory emergencies. However, providers do not consistently deliver effective BVMV. Efforts to improve BVMV have ignored the question of how providers effectively use feedback often available during BVMV...
December 1, 2017: Human Factors
https://www.readbyqxmd.com/read/29194491/healthcare-providers-perceptions-of-a-situational-awareness-display-for-emergency-department-resuscitation-a-simulation-qualitative-study
#16
Lisa A Calder, Abhi Bhandari, George Mastoras, Kathleen Day, Kathryn Momtahan, Matthew Falconer, Brian Weitzman, Benjamin Sohmer, A Adam Cwinn, Stanley J Hamstra, Avi Parush
Importance: Emergency resuscitation of critically ill patients can challenge team communication and situational awareness. Tools facilitating team performance may enhance patient safety. Objectives: To determine resuscitation team members' perceptions of the Situational Awareness Display's utility. Design: We conducted focus groups with healthcare providers during Situational Awareness Display development. After simulations assessing the display, we conducted debriefs with participants...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29184048/utilizing-respiratory-therapists-to-reduce-costs-of-care
#17
Ellen A Becker, Cheryl A Hoerr, Kimberly S Wiles, Debra L Skees, Corinne H Miller, Douglas S Laher
INTRODUCTION: Changes to the reimbursement of respiratory care services over the past 26 years make it imperative that respiratory therapists (RTs) demonstrate cost savings to establish their value. Therefore, this systematic review evaluated the cost-related impacts from utilizing RTs to deliver care when compared to other care providers. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the search process...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29182746/experiences-of-persons-with-parkinson-s-disease-engaged-in-group-therapeutic-singing
#18
Elizabeth L Stegemöller, Tera R Hurt, Margaret C O'Connor, Randie D Camp, Chrishelda W Green, Jenna C Pattee, Ebony K Williams
Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder that leads to altered neural control of movement, including the control of voice, respiration, and swallowing. There is a prevalent need to provide therapy for voice, respiration, and swallowing difficulties because current pharmacological and surgical treatments do not effectively treat these impairments. Previous research has demonstrated that singing may be a treatment option to target voice, respiratory, and swallowing impairments, as well as quality of life...
January 13, 2018: Journal of Music Therapy
https://www.readbyqxmd.com/read/29171566/knowledge-and-practices-of-critical-care-health-professionals-related-to-ventilator-associated-pneumonia-in-tertiary-care-hospitals-of-islamabad-and-rawalpindi
#19
Hassan Bin Usman Shah, Iffat Atif, Farah Rashid, Hafsa Zulfiqar, Kashmala Mian, Maria Sarfraz, Mariam Batool, Umbreen Gul Khan
OBJECTIVE: To assess knowledge and practices of critical care health professionals related to ventilator associated pneumonia. METHODS: This cross-sectional survey was conducted at eight tertiary care public and private hospitals of Islamabad/Rawalpindi, Pakistan, from September 2015 to March 2016, and comprised healthcare professionals. Stratified random sampling was used. Data was collected using close-ended validated questionnaire. SPSS 22 was used for data analysis...
November 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29162728/evaluating-the-value-of-the-respiratory-therapist-where-is-the-evidence-focus-on-the-barnes-jewish-hospital-experience
#20
Marin H Kollef
Currently, >20 million people in the United States have asthma, and approximately 15 million adults have been diagnosed with COPD, with approximately the same number not yet having been diagnosed with this condition. Moreover, the overall burden of respiratory diseases is still increasing, in part due to environmental factors, such as air pollution. At the same time, the number of patients requiring hospitalization as well as the number of individuals admitted to ICUs from emergency departments has been on the rise over the last decade...
December 2017: Respiratory Care
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