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https://www.readbyqxmd.com/read/29227288/physician-and-nurse-perceptions-of-gentle-cesarean-birth
#1
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
#2
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
#3
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
#4
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...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29202248/bag-valve-mask-ventilation-as-a-perceptual-cognitive-skill
#5
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
#6
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
#7
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
#8
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...
November 22, 2017: 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
#9
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
#10
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
https://www.readbyqxmd.com/read/29154574/a-multivariate-dynamic-systems-model-for-psychotherapy-with-more-than-one-client
#11
Jonathan E Butner, Carlene Deits-Lebehn, Alexander O Crenshaw, Travis J Wiltshire, Nicholas S Perry, Robert G Kent de Grey, Jasara N Hogan, Timothy W Smith, Katherine J W Baucom, Brian R W Baucom
The dynamics of the give and take between therapist and client(s) is frequently of interest to therapy process researchers. Characterizing the ways that therapists respond to clients and clients respond to therapists can be challenging in therapeutic encounters involving a single therapist and a single client. The complexity of this challenge increases as the number of people involved in a therapeutic encounter increases not only because there are more people responding to one another but also because the patterns of responding can become more complex...
November 2017: Journal of Counseling Psychology
https://www.readbyqxmd.com/read/29121299/gender-power-and-leadership-the-effect-of-a-superior-s-gender-on-respiratory-therapists-ability-to-challenge-leadership-during-a-life-threatening-emergency
#12
N Pattni, M D Bould, M A Hayter, D McLuckie, L M K Noble, A Malavade, Z Friedman
Background: Effective communication within teams is crucial, especially in crisis situations. Hierarchy gradients between team members can contribute to communication failures and are influenced by many factors. The effect of gender on team performance has not been well studied. The objective of this study was to examine the effect of the physician's gender on respiratory therapists' ability to effectively challenge clearly incorrect clinical decisions during a life-threatening crisis...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29101086/beyond-idiopathic-pulmonary-fibrosis-diagnosis-multidisciplinary-care-with-an-early-integrated-palliative-approach-is-associated-with-a-decrease-in-acute-care-utilization-and-hospital-deaths
#13
Meena Kalluri, Francisca Claveria, Emily Ainsley, Maged Haggag, Susan Armijo-Olivo, Janice Richman-Eisenstat
CONTEXT: Idiopathic Pulmonary Fibrosis (IPF) is a progressive, incurable interstitial lung disease with heavy symptom burden and poor quality of life. The last year of life is characterized by increased acute care utilization and hospital deaths. Clinical guidelines recommend early integration of palliative care but is rarely implemented. In 2012, we reorganized our clinic into a multidisciplinary team comprising two pulmonologists (expertise in ILD and palliative respiratory care respectively), nurse, respiratory therapist, physiotherapist, and a dietitian...
October 31, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29070945/minimal-important-difference-and-responsiveness-of-2-minute-walk-test-performance-in-people-with-copd-undergoing-pulmonary-rehabilitation
#14
Kylie Nicole Johnston, Adrian James Potter, Anna Caroline Phillips
BACKGROUND AND OBJECTIVES: Field exercise tests (eg, 6-minute walk test [6MWT]) are important measures of functional exercise capacity in people with COPD. Shorter tests such as the 2-minute walk test (2MWT) may offer advantages in some populations but lack information about responsiveness to change. This study examined responsiveness, minimal important difference (MID), test-retest reliability, and construct validity of the 2MWT in people with stable COPD attending outpatient pulmonary rehabilitation (PR)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29058510/medical-student-perceptions-of-an-initial-collaborative-immersion-experience
#15
Joseph B House, Jacob Cedarbaum, Fatema Haque, Michael Wheaton, Jennifer Vredeveld, Joel Purkiss, Laurel Moore, Sally A Santen, Michelle Daniel
Recent reviews of interprofessional education (IPE) highlight the need for innovative curricula focused on longitudinal clinical learning. We describe the development and early outcomes of the initial clinical experience (ICE), a longitudinal practice-based course for first-year medical students. While IPE courses focus on student-to-student interaction, ICE focuses on introducing students to interprofessional collaboration. Students attend 14 sessions at one of 18 different clinical sites. They work directly with different health professionals from among 17 possible professions, including nurses, pharmacists, social workers, and respiratory, occupational, and physical therapists...
October 23, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29016516/barriers-to-effective-teamwork-relating-to-pediatric-resuscitations-perceptions-of-pediatric-emergency-medicine-staff
#16
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
#17
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
#18
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
#19
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
#20
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
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