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https://www.readbyqxmd.com/read/28188012/-end-of-life-care-difficulties-in-intensive-care-units-the-nurses-perspective
#1
Juan Francisco Velarde-García, Raquel Luengo-González, Raquel González-Hervías, Sergio González-Cervantes, Beatriz Álvarez-Embarba, Domingo Palacios-Ceña
OBJECTIVE: To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). METHOD: A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes...
February 7, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28185398/reconciling-conceptualizations-of-relationships-and-person-centred-care-for-older-people-with-cognitive-impairment-in-acute-care-settings
#2
Carole Rushton, David Edvardsson
Relationships are central to enacting person-centred care of the older person with cognitive impairment. A fuller understanding of relationships and the role they play facilitating wellness and preserving personhood is critical if we are to unleash the productive potential of nursing research and person-centred care. In this article, we target the acute care setting because much of the work about relationships and older people with cognitive impairment has tended to focus on relationships in long-term care...
February 10, 2017: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/28157394/how-well-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-icu
#3
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. While the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare students adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
February 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28141938/patient-centered-care-turning-the-rhetoric-into-reality
#4
Joel S Weissman, Michael L Millenson, R Sterling Haring
Although patient-centered care (PCC) was proclaimed a core health system aim in a 2001 Institute of Medicine report, it remains one of the most-used and least-understood terms in healthcare. We interviewed leaders at 15 Medicare accountable care organizations (ACOs) across the country that have been the most successful in putting patient-centeredness into actual practice to develop an operational definition. The ACOs we spoke with had a 3-pronged practical approach of: 1) patients as partners, 2) proactive customer-service orientation, and 3) care coordination with a whole-person approach...
January 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28075691/complexity-of-brain-signals-is-associated-with-outcome-in-preterm-infants
#5
Cristine Sortica da Costa, Michal M Placek, Marek Czosnyka, Brenno Cabella, Magdalena Kasprowicz, Topun Austin, Peter Smielewski
A characteristic feature of complex healthy biological systems is the ability to react and adapt to minute changes in the environment. This 'complexity' manifests itself in highly irregular patterns of various physiological measurements. Here, we apply Multiscale Entropy (MSE) analysis to assess the complexity of systemic and cerebral near-infrared spectroscopy (NIRS) signals in a cohort of 61 critically ill preterm infants born at median (range) gestational age of 26 (23-31) weeks, before 24 h of life. We further correlate the complexity of these parameters with brain injury and mortality...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28068134/psychologists-in-patient-centered-medical-homes-pcmhs-roles-evidence-opportunities-and-challenges
#6
Anne E Kazak, Justin M Nash, Kimberly Hiroto, Nadine J Kaslow
The patient-centered medical home (PCMH) is an increasingly common model of health care delivery with many exciting opportunities for psychologists. The PCMH reflects a philosophy and model of care that is highly consistent with psychological science and practice. It strives to provide patient-centered, comprehensive, team-based, coordinated, accessible, and quality and safety-oriented health care delivery to individuals and families. Moreoever, in keeping with changes in the health care system more broadly, the PCMH model prioritizes the integration of behavioral and physical health care, and this emphasis lays the foundation for active and full engagement of psychologists in this context...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28055143/no-wrong-doors-findings-from-a-critical-review-of-behavioral-randomized-clinical-trials-for-individuals-with-co-occurring-alcohol-drug-problems-and-posttraumatic-stress-disorder
#7
REVIEW
Tracy L Simpson, Keren Lehavot, Ismene L Petrakis
Prior reviews of behavioral treatments for individuals with comorbid alcohol and drug use disorders (substance use disorder SUD) and posttraumatic stress disorder (PTSD) have not systematically considered whether comparison conditions are matched to target treatments on time and attention. A systematic literature search using PubMed MESH terms for alcohol and substance use disorders, PTSD, and treatment identified relevant behavioral randomized clinical trials (RCTs) that evaluated PTSD-oriented exposure-based treatments, addiction-focused treatments, and coping-based treatments that do not involve exposure to trauma memories...
January 5, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28025323/role-of-emerging-private-hospitals-in-a-post-soviet-mixed-health-system-a-mixed-methods-comparative-study-of-private-and-public-hospital-inpatient-care-in-mongolia
#8
Uranchimeg Tsevelvaanchig, Hebe Gouda, Peter Baker, Peter S Hill
BACKGROUND: The collapse of the Soviet Union in 1990 severely impacted the health sector in Mongolia. Limited public funding for the post-Soviet model public system and a rapid growth of poorly regulated private providers have been pressing issues for a government seeking to re-establish universal health coverage. However, the evidence available on the role of private providers that would inform sector management is very limited. This study analyses the current contribution of private hospitals in Mongolia for the improvement of accessibility of health care and efficiency...
December 26, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/28011046/promoting-the-appropriate-use-of-advanced-radiation-technologies-in-oncology-summary-of-a-national-cancer-policy-forum-workshop
#9
Grace L Smith, Patricia A Ganz, Justin E Bekelman, Steven J Chmura, James J Dignam, Jason A Efstathiou, Reshma Jagsi, Peter A Johnstone, Michael L Steinberg, Stephen B Williams, James B Yu, Anthony L Zietman, Ralph R Weichselbaum, Ya-Chen Tina Shih
PURPOSE: Leaders in the oncology community are sounding a clarion call to promote "value" in cancer care decisions. Value in cancer care considers the clinical effectiveness, along with the costs, when selecting a treatment. To discuss possible solutions to the current obstacles to achieving value in the use of advanced technologies in oncology, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop, "Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology" in July 2015...
March 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28006972/identifying-hiv-care-enrollees-at-risk-for-cannabis-use-disorder
#10
Bryan Hartzler, Beatriz H Carlini, Howard Newville, Heidi M Crane, Joseph J Eron, Elvin H Geng, W Christopher Mathews, Kenneth H Mayer, Richard D Moore, Michael J Mugavero, Sonia Napravnik, Benigno Rodriguez, Dennis M Donovan
Increased scientific attention given to cannabis in the United States has particular relevance for its domestic HIV care population, given that evidence exists for both cannabis as a therapeutic agent and cannabis use disorder (CUD) as a barrier to antiretroviral medication adherence. It is critical to identify relative risk for CUD among demographic subgroups of HIV patients, as this will inform detection and intervention efforts. A Center For AIDS Research Network of Integrated Clinical Systems cohort (N = 10,652) of HIV-positive adults linked to care at seven United State sites was examined for this purpose...
December 23, 2016: AIDS Care
https://www.readbyqxmd.com/read/27987568/-icd-coding-quality-for-outpatient-cancer-diagnoses-in-shi-claims-data
#11
Jonas Czwikla, Dominik Domhoff, Klaus Giersiepen
BACKGROUND: Despite their importance for the morbidity-oriented risk structure compensation scheme, the ICD coding quality for outpatient diagnoses is often criticized. However, the coding quality for outpatient cancer diagnoses remains unclear. In this study, we examined the ICD-10 coding quality for outpatient breast, prostate and colorectal cancer diagnoses in statutory health insurance (SHI) claims data. METHODS: The cohort study comprised 34,756 members of the BARMER GEK statutory health insurance fund diagnosed with breast, prostate or colorectal cancer in 2012 and with no respective diagnosis in the previous 4 quarters...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27984406/correlates-of-interorganizational-relationship-strategies-among-critical-access-hospitals
#12
Larry R Hearld, Nathaniel W Carroll, Kristine R Hearld, William Opoku-Agyeman
BACKGROUND: Interorganizational relationships (IORs) between hospitals and other health care providers have many potential benefits for critical access hospitals (CAHs) that operate in resource-constrained environments. Given the potential benefits of IORs, especially for CAHs, it is important to identify the conditions that support or hinder IOR development. However, most research examining IORs isolates individual types of relationships while ignoring the practical reality that many hospitals participate in a portfolio of relationships simultaneously...
December 15, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27908947/integrating-nurse-practitioners-into-intensive-care-units
#13
Shari Simone, Carmel A McComiskey, Brooke Andersen
As demand for nurse practitioners in all types of intensive care units continues to increase, ensuring successful integration of these nurses into adult and pediatric general and specialty intensive care units poses several challenges. Adding nurse practitioners requires strategic planning to define critical aspects of the care delivery model before the practitioners are hired, develop a comprehensive program for integrating and training these nurses, and create a plan for implementing the program. Key strategies to ensure successful integration include defining and implementing the role of nurse practitioners, providing options for orientation, and supporting and training novice nurse practitioners...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27907958/critical-care-management-after-cardiac-arrest
#14
Hans Friberg, Tobias Cronberg
Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27900714/is-there-asymmetry-between-the-concave-and-convex-pedicles-in-adolescent-idiopathic-scoliosis-a-ct-investigation
#15
Colin M Davis, Caroline A Grant, Mark J Pearcy, Geoffrey N Askin, Robert D Labrom, Maree T Izatt, Clayton J Adam, J Paige Little
BACKGROUND: Adolescent idiopathic scoliosis is a complex three-dimensional deformity of the spine characterized by deformities in the sagittal, coronal, and axial planes. Spinal fusion using pedicle screw instrumentation is a widely used method for surgical correction in severe (coronal deformity, Cobb angle > 45°) adolescent idiopathic scoliosis curves. Understanding the anatomic difference in the pedicles of patients with adolescent idiopathic scoliosis is essential to reduce the risk of neurovascular or visceral injury through pedicle screw misplacement...
March 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27886943/use-of-ehealth-technologies-to-enable-the-implementation-of-musculoskeletal-models-of-care-evidence-and-practice
#16
REVIEW
Helen Slater, Blake F Dear, Mark A Merolli, Linda C Li, Andrew M Briggs
Musculoskeletal (MSK) conditions are the second leading cause of morbidity-related burden of disease globally. EHealth is a potentially critical factor that enables the implementation of accessible, sustainable and more integrated MSK models of care (MoCs). MoCs serve as a vehicle to drive evidence into policy and practice through changes at a health system, clinician and patient level. The use of eHealth to implement MoCs is intuitive, given the capacity to scale technologies to deliver system and economic efficiencies, to contribute to sustainability, to adapt to low-resource settings and to mitigate access and care disparities...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27884867/narrative-medicine-and-death-in-the-icu-word-clouds-as-a-visual-legacy
#17
Meredith Vanstone, Feli Toledo, France Clarke, Anne Boyle, Mita Giacomini, Marilyn Swinton, Lois Saunders, Melissa Shears, Nicole Zytaruk, Anne Woods, Trudy Rose, Tracey Hand-Breckenridge, Diane Heels-Ansdell, Shelley Anderson-White, Robert Sheppard, Deborah Cook
OBJECTIVE: The Word Cloud is a frequent wish in the 3 Wishes Project developed to nurture peace and ease the grieving process for dying critically ill patients. The objective was to examine whether Word Clouds can act as a heuristic approach to encourage a narrative orientation to medicine. Narrative medicine is an approach which can strengthen relationships, compassion and resilience. DESIGN: Word Clouds were created for 42 dying patients, and we interviewed 37 family members and 73 clinicians about their impact...
November 24, 2016: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#18
Barbara J Daly, Sara L Douglas, Elizabeth O'Toole, James Rowbottom, Alan Hoffer, Amy R Lipson, Christopher Burant
RATIONALE: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life. OBJECTIVE: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27862651/critical-thinking-and-contemporary-mental-health-care-michel-foucault-s-history-of-the-present
#19
Marc Roberts
In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence-based, collaborative and recovery-focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, innovative and influential thinkers of the 20th century...
November 11, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/27862154/health-professionals-perceive-teamwork-with-relatives-as-an-obstacle-in-their-daily-work-a-focus-group-interview
#20
Jannie Laursen, Malene Broholm, Jacob Rosenberg
BACKGROUND: Health professionals must often balance between different rationalities within the hospital organisation. Having adequate time with patients, shorter waiting time and the ability to greater professional autonomy have been shown to help provide a higher quality of care. Empathy and sympathy appear to be crucial components for the health professionals and their relationship to patients. AIM: The aim of this study was to explore health professionals' experiences of relatives to critically ill patients in order to identify aspects that may facilitate a better understanding of this teamwork...
November 8, 2016: Scandinavian Journal of Caring Sciences
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