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https://www.readbyqxmd.com/read/29016516/barriers-to-effective-teamwork-relating-to-pediatric-resuscitations-perceptions-of-pediatric-emergency-medicine-staff
#1
Joshua M Sherman, Todd P Chang, Nurit Ziv, Alan L Nager
BACKGROUND: In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28982549/achieving-a-3-star-society-of-thoracic-surgery-lobectomy-ranking-by-using-continuing-process-improvement-lean-methodology-and-root-cause-analysis
#2
Robert J Cerfolio, Douglas J Minnich, Benjamin Wei, Caroline Watson, Malcolm M DeCamp
Our purpose is to identify the metrics used by the Society of Thoracic Surgeons (STS) to rank lobectomy and to show our process to improve. This is a review of our STS data for lobectomy and our results using the process of root cause analysis and lean methodology to improve our outcomes. The STS metrics are 30-day mortality, pneumonia, adult respiratory distress syndrome, bronchopleural fistula, pulmonary embolus, initial ventilator support greater than 48 hours, reintubation and respiratory failure, tracheostomy, myocardial infarction, or unexpected return to the operating room...
August 18, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28982205/-how-to-become-a-respiratory-therapist-in-germany-status-quo-and-development-prospects
#3
O Karg
The profession respiratory therapist is well established in Germany 10 years after the introduction. 600 participants have successfully graduated from the training facilities.Our goals are high quality interprofessional teamwork and medical assistance inclusive delegation of formerly physician activities. The duties are comparable to the work pattern of Technical Assistants in surgery. For this profession different ways of qualification are possible: primary training, advanced training and academic studies Physician Assistance...
October 5, 2017: Pneumologie
https://www.readbyqxmd.com/read/28979111/factors-facilitating-and-hindering-the-intention-to-promote-pulmonary-rehabilitation-for-patients-with-copd-among-respiratory-therapists
#4
Yun-Ju Chen, Jun-Yu Fan, Su-Er Guo, Su-Lun Hwang, Tsung-Ming Yang
PURPOSE: Pulmonary rehabilitation (PR) is recognized as the chief non-pharmacologic management approach for patients with COPD, but is clinically under-utilized. In Taiwan, respiratory therapists (RTs) are one of the first-line health care providers who spend vast amounts of time with COPD patients in PR programs. To better enhance patients' knowledge of and participation in PR, it is necessary to understand how PR is viewed by RTs, as well as how these views influence their behavioral intentions toward promoting PR...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28978488/icu-team-composition-and-its-association-with-abcde-implementation-in-a-quality-collaborative
#5
Deena Kelly Costa, Thomas S Valley, Melissa A Miller, Milisa Manojlovich, Sam R Watson, Phyllis McLellan, Corine Pope, Robert C Hyzy, Theodore J Iwashyna
PURPOSE: Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. MATERIALS & METHODS: We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility...
September 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28977717/a-collaborative-in-situ-simulation-based-pediatric-readiness-improvement-program-for-community-emergency-departments
#6
Kamal Abulebda, Riad Lutfi, Travis Whitfill, Samer Abu-Sultaneh, Kellie J Leeper, Elizabeth Weinstein, Marc A Auerbach
BACKGROUND: More than 30 million children are cared for across 5,000 US emergency departments each year (ED). Most of these EDs are not facilities designed and operated solely for children. A web-based survey provided a national and state-by-state assessment of pediatric readiness and noted a national average score was 69 on a 100-point scale. This survey noted wide variations in ED readiness with scores ranging from 61 in low-pediatric-volume EDs to 90 in the high-pediatric-volume EDs...
October 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28974644/respiratory-therapist-managed-arterial-catheter-insertion-and-maintenance-program-experience-in-a-non-teaching-community-hospital
#7
Sasheen Pack, Peter Y Hahn, James K Stoller, Srinivas R Mummadi
BACKGROUND: Usual practice in community health-care settings indicates that arterial catheters are inserted by physicians. In the context of a respiratory therapist (RT)-managed arterial catheter placement protocol being implemented in our community hospital, the current study describes the implementation and outcomes of this RT-managed arterial catheter insertion and maintenance program. METHODS: Tuality Healthcare is a 215-bed community health-care system (10-bed ICU) in Hillsboro, Oregon...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28960563/health-professional-perspectives-of-patient-safety-issues-in-intensive-care-units-in-saudi-arabia
#8
Adel Al Malki, Ruth Endacott, Kelli Innes
AIM: To examine attitudes to patient safety in two intensive care units from the perspective of health care professionals in Saudi Arabia. BACKGROUND: Despite adverse errors leading to poor patient outcomes, there is a paucity of literature, including staff perceptions, on adverse errors in Saudi Arabian intensive care units. METHODS: A descriptive cross-sectional design was used. Health professionals (n = 144) completed the safety attitude questionnaire-intensive care unit...
September 27, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28887932/issues-in-the-intensive-care-unit-for-patients-with-extracorporeal-membrane-oxygenation
#9
REVIEW
Hitoshi Hirose, Harrison T Pitcher, Michael Baram, Nicholas C Cavarocchi
The care of patients on extracorporeal corporeal oxygenation support takes a coordinated effort among the team of nurses, midlevel providers, perfusionists, respiratory therapists, pharmacists, and physicians. Attention on the details of the circuitry and its interactions with the patient, the resolution of the disease process and the ongoing plan of care, and unique issues in the intensive care unit are crucial for success.
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28887292/protocol-for-usability-testing-and-validation-of-the-iso-draft-international-standard-19223-for-lung-ventilators
#10
Dev Minotra, Steven L Dain, Catherine M Burns
BACKGROUND: Clinicians, such as respiratory therapists and physicians, are often required to set up pieces of medical equipment that use inconsistent terminology. Current lung ventilator terminology that is used by different manufacturers contributes to the risk of usage errors, and in turn the risk of ventilator-associated lung injuries and other conditions. Human factors and communication issues are often associated with ventilator-related sentinel events, and inconsistent ventilator terminology compounds these issues...
September 8, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28878734/speech-and-voice-response-to-a-levodopa-challenge-in-late-stage-parkinson-s-disease
#11
Margherita Fabbri, Isabel Guimarães, Rita Cardoso, Miguel Coelho, Leonor Correia Guedes, Mario M Rosa, Catarina Godinho, Daisy Abreu, Nilza Gonçalves, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Parkinson's disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa's (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). OBJECTIVE: To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. METHOD: LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28877841/cognitive-behaviour-therapy-for-health-anxiety-in-medical-patients-champ-a-randomised-controlled-trial-with-outcomes-to-5-years
#12
Peter Tyrer, Paul Salkovskis, Helen Tyrer, Duolao Wang, Michael J Crawford, Simon Dupont, Sylvia Cooper, John Green, David Murphy, Georgina Smith, Sharandeep Bhogal, Shaeda Nourmand, Valentina Lazarevic, Gemma Loebenberg, Rachel Evered, Stephanie Kings, Antoinette McNulty, Yvonne Lisseman-Stones, Sharon McAllister, Kofi Kramo, Jessica Nagar, Steven Reid, Rahil Sanatinia, Katherine Whittamore, Gemma Walker, Aaron Philip, Hilary Warwick, Sarah Byford, Barbara Barrett
BACKGROUND: Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. OBJECTIVE: To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive-behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. DESIGN: Randomised controlled trial. SETTING: Five general hospitals in London, Middlesex and Nottinghamshire...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28874610/the-2017-global-initiative-for-chronic-obstructive-lung-disease-report-and-practice-implications-for-the-respiratory-therapist
#13
Michael W Hess
Since 1998, the Global Initiative for Obstructive Lung Disease (GOLD) has worked with health care professionals, medical researchers, and public health officials around the world to optimize the prevention, treatment, and management of COPD. GOLD has continually worked to ensure COPD management strategy recommendations are aligned with current published research. The 2017 GOLD report represents a major revision to GOLD strategy guidelines, the first such major revision in the last 5 years. As such, the 2017 report has significant implications for the diagnosis of COPD, the management of stable disease, and the treatment of exacerbations...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28808486/the-saudi-thoracic-society-guidelines-for-diagnosis-and-management-of-noncystic-fibrosis-bronchiectasis
#14
Hamdan Al-Jahdali, Abdullah Alshimemeri, Abdullah Mobeireek, Amr S Albanna, Nehad N Al Shirawi, Siraj Wali, Khaled Alkattan, Abdulrahman A Alrajhi, Khalid Mobaireek, Hassan S Alorainy, Mohamed S Al-Hajjaj, Anne B Chang, Stefano Aliberti
This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#15
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28777117/delays-in-treatment-seeking-decisions-among-women-with-myocardial-infarction
#16
Cynthia Arslanian-Engoren, Linda D Scott
BACKGROUND: Minimizing the time from myocardial infarction (MI) symptom onset to the implementation of lifesaving interventions decreases morbidity and mortality of women who experience an MI. However, not all women seek timely evaluation and treatment for their MI symptoms. OBJECTIVES: The aim of this article is to describe reasons for decision treatment delays among women who experience an initial MI. METHOD: A secondary analysis of narrative data collected as part of a qualitative study examining the triage experiences of women (N = 14) who presented to the emergency department with symptoms of acute MI...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28771042/a-critical-care-clinician-survey-comparing-attitudes-and-perceived-barriers-to-low-tidal-volume-ventilation-with-actual-practice
#17
Curtis H Weiss, David W Baker, Katrina Tulas, Shayna Weiner, Meagan Bechel, Alfred Rademaker, Angela Fought, Richard G Wunderink, Stephen D Persell
RATIONALE: Low tidal volume ventilation lowers mortality in patients with acute respiratory distress syndrome (ARDS) but is underused. Little is known about clinician attitudes toward and perceived barriers to low tidal volume ventilation use and their association with actual low tidal volume ventilation use. OBJECTIVES: The objectives of this study were to assess clinicians' attitudes toward and perceived barriers to low tidal volume ventilation (tidal volume <6...
August 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28765355/oxygen-requirements-for-acutely-and-critically-ill-patients
#18
EDITORIAL
Debra Siela, Michelle Kidd
Oxygen administration is often assumed to be required for all patients who are acutely or critically ill. However, in many situations, this assumption is not based on evidence. Injured body tissues and cells throughout the body respond both beneficially and adversely to delivery of supplemental oxygen. Available evidence indicates that oxygen administration is not warranted for patients who are not hypoxemic, and hyperoxia may contribute to increased tissue damage and mortality. Nurses must be aware of implications related to oxygen administration for all types of acutely and critically ill patients...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28739240/evaluation-of-situation-background-assessment-recommendation-tool-during-neonatal-and-pediatric-interfacility-transport
#19
Diane Wilson, Anuradha Kochar, Andrew Whyte-Lewis, Hilary Whyte, Kyong-Soon Lee
OBJECTIVE: We aimed to determine if the implementation of Situation, Background, Assessment, Recommendation (SBAR) training improved the quality of real-life telephone communication. We evaluated interfacility neonatal and pediatric transports performed by registered nurses, respiratory therapists, and physicians (MDs). METHODS: This was a quality improvement study performed to evaluate telephone communication before and after SBAR training. Training consisted of lectures, review of audio files, and simulated role-playing...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#20
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brian D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
October 2017: Pediatric Critical Care Medicine
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