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https://www.readbyqxmd.com/read/28425112/beyond-guidelines-discretionary-practice-in-face-to-face-triage-nursing
#1
Lars E F Johannessen
This article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses' discretionary application of guidelines. Specifically, it analyses nurses' discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients' complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning...
April 20, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28376993/a-model-to-improve-preparedness-and-strategically-enhance-resiliency-at-a-community-level-the-garden-state-approach
#2
Rodric Bowman, Alexander Newman
This paper focuses on community resiliency planning in high-density areas, concentrating on balancing critical infrastructure recovery needs with real-life limitations in funding, and knowledge for how emergency management is done. A case study examines how a New Jersey government agency and state university were able to pilot a community resiliency concept in order to rapidly inject emergency management knowledge into a community that was affected by Superstorm Sandy. The lessons learned are intuitively understood by emergency planning professionals: preparing continuity of operations plans, conducting training and exercises, and mitigating risk for future disasters...
December 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28353067/-conflict-matrix-risk-management-tool-in-the-operating-room
#3
D Andel, K Markstaller, H Andel
BACKGROUND: In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team...
March 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28342675/the-digital-heart-manual-a-pilot-study-of-an-innovative-cardiac-rehabilitation-programme-developed-for-and-with-users
#4
C Deighan, L Michalova, C Pagliari, J Elliott, L Taylor, H Ranaldi
OBJECTIVE: Patients are seeking greater choice and flexibility in how they engage with self-management programmes. While digital innovations offer opportunities to deliver supportive interventions to patients undergoing cardiac rehabilitation little is known about how accessible, useful and acceptable they are for this group. This project developed a digital version of a leading evidenced cardiac rehabilitation programme, the Heart Manual (HM). The prototype was developed and evaluated iteratively in collaboration with end users...
March 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28332886/inhaler-technique-mastery-and-maintenance-in-healthcare-professionals-trained-on-different-devices
#5
Sinthia Bosnic-Anticevich, Christina Callan, Henry Chrystyn, Federico Lavorini, Vasilis Nikolaou, Vicky Kritikos, P N Richard Dekhuijzen, Nicolas Roche, Leif Bjermer, Cynthia Rand, Nicholas Zwar, David B Price
OBJECTIVE: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). METHODS: We conducted a randomised, un-blinded, cross-over study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use)...
March 23, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28332303/measure-accurately-act-rapidly-and-partner-with-patients-an-intuitive-and-practical-three-part-framework-to-guide-efforts-to-improve-hypertension-control
#6
Romsai T Boonyasai, Michael K Rakotz, Lisa H Lubomski, Donna M Daniel, Jill A Marsteller, Kathryn S Taylor, Lisa A Cooper, Omar Hasan, Matthew K Wynia
Hypertension is the leading cause of cardiovascular disease in the United States and worldwide. It also provides a useful model for team-based chronic disease management. This article describes the M.A.P. checklists: a framework to help practice teams summarize best practices for providing coordinated, evidence-based care to patients with hypertension. Consisting of three domains-Measure Accurately; Act Rapidly; and Partner With Patients, Families, and Communities-the checklists were developed by a team of clinicians, hypertension experts, and quality improvement experts through a multistep process that combined literature review, iterative feedback from a panel of internationally recognized experts, and pilot testing among a convenience sample of primary care practices in two states...
March 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28317848/polyphonic-sonification-of-electrocardiography-signals-for-diagnosis-of-cardiac-pathologies
#7
Jakob Nikolas Kather, Thomas Hermann, Yannick Bukschat, Tilmann Kramer, Lothar R Schad, Frank Gerrit Zöllner
Electrocardiography (ECG) data are multidimensional temporal data with ubiquitous applications in the clinic. Conventionally, these data are presented visually. It is presently unclear to what degree data sonification (auditory display), can enable the detection of clinically relevant cardiac pathologies in ECG data. In this study, we introduce a method for polyphonic sonification of ECG data, whereby different ECG channels are simultaneously represented by sound of different pitch. We retrospectively applied this method to 12 samples from a publicly available ECG database...
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28254783/deepstack-expert-level-artificial-intelligence-in-heads-up-no-limit-poker
#8
Matej Moravčík, Martin Schmid, Neil Burch, Viliam Lisý, Dustin Morrill, Nolan Bard, Trevor Davis, Kevin Waugh, Michael Johanson, Michael Bowling
Artificial intelligence has seen several breakthroughs in recent years, with games often serving as milestones. A common feature of these games is that players have perfect information. Poker is the quintessential game of imperfect information, and a longstanding challenge problem in artificial intelligence. We introduce DeepStack, an algorithm for imperfect information settings. It combines recursive reasoning to handle information asymmetry, decomposition to focus computation on the relevant decision, and a form of intuition that is automatically learned from self-play using deep learning...
March 2, 2017: Science
https://www.readbyqxmd.com/read/28247467/professional-rescuers-experiences-of-motivation-for-cardiopulmonary-resuscitation-a-qualitative-study
#9
Abdolghader Assarroudi, Fatemeh Heshmati Nabavi, Abbas Ebadi, Habibollah Esmaily
Rescuers' psychological competence, particularly their motivation, can improve the cardiopulmonary resuscitation outcomes. Data were collected using semistructured interviews with 24 cardiopulmonary resuscitation team members and analyzed through deductive content analysis based on Vroom's expectancy theory. Nine generic categories were developed: (i) estimation of the chance of survival; (ii) estimation of self-efficacy; (iii) looking for a sign of effectiveness; (iv) supportive organizational structure; (v) revival; (vi) acquisition of external incentives; (vii) individual drives; (viii) commitment to personal values; and (ix) avoiding undesirable social outcomes...
February 28, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28179270/is-there-a-role-for-clowns-in-paediatric-intensive-care-units
#10
REVIEW
Guillaume Mortamet, Nadia Roumeliotis, Florence Vinit, Caroline Simonds, Laurent Dupic, Philippe Hubert
Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stressed. Relying on our experience with professionally trained clowns both in France and Canada, the purpose of this article is to offer a model for hospital clowning and to suggest standards of practice for the implementation of clowning in PICUs...
February 8, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28124383/-there-s-something-in-their-eyes-child-health-services-nurses-experiences-of-identifying-signs-of-postpartum-depression-in-non-swedish-speaking-immigrant-mothers
#11
Malin Skoog, Inger Hallström, Vanja Berggren
BACKGROUND: Due to the current world situation, Sweden has one of the highest asylum applications within the European Union. Immigrant mothers, specifically those who have immigrated during the last ten years and do not speak the language of the new country, are found to be at particular risk of being effected by postpartum depression. AIM: In this study, we elucidate Swedish Child Health Services nurses' experiences of identifying signs of postpartum depression in non-Swedish-speaking immigrant mothers...
January 25, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28122614/clinical-decision-making-in-the-recognition-of-dying-a-qualitative-interview-study
#12
Paul Taylor, Dawn Dowding, Miriam Johnson
BACKGROUND: Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" METHODS: This study used a descriptive approach to decision-making theory...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28113668/presentation-of-3d-scenes-through-video-example
#13
Andrea Baldacci, Fabio Ganovelli, Massimiliano Corsini, Roberto Scopigno
Using synthetic videos to present a 3D scene is a common requirement for architects, designers, engineers or Cultural Heritage professionals however it is usually time consuming and, in order to obtain high quality results, the support of a film maker/computer animation expert is necessary. We introduce an alternative approach that takes the 3D scene of interest and an example video as input, and automatically produces a video of the input scene that resembles the given video example. In other words, our algorithm allows the user to "replicate" an existing video, on a different 3D scene...
September 13, 2016: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/28044334/monitoring-the-anaesthetist-in-the-operating-theatre-professional-competence-and-patient-safety
#14
REVIEW
J Larsson
This article about competence and patient safety in anaesthesia was inspired by a statement in the 2015 AAGBI guidelines on monitoring during anaesthesia: 'the presence of an appropriately trained and experienced anaesthetist is important for patient safety during anaesthesia'. The review starts with a structured description of competence, presenting five dimensions of it; the first two dimensions are identical with the two classical attributes of competence, practical skills and theoretical knowledge. Concerning skills, the value of aiming for a high level of proficiency early in a traning programme is pointed out, and deliberate practice is given as an example of a pedagogical model where aiming for excellence is a core idea...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28035912/effectiveness-of-therapeutic-ultrasound-with-or-without-thumb-spica-splint-in-the-management-of-de-quervain-s-disease
#15
Waqar Ahmed Awan, Muhammad Naveed Babur, Tahir Masood
BACKGROUND: The management of De Quervain's disease is determined more by Intuition than scientific data. The choice of first line conservative option for the management of De Quervain's disease is still a topic of debate. AIM: To evaluate the effectiveness of therapeutic ultrasound with or without spica splint in the management of De Quervain's disease (DQD). DESIGN: Randomized controlled trial (RCT). SETTING: Outpatient department of Al-Nafees Medical College Hospital, Islamabad, Pakistan...
December 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27996189/-canaries-in-the-mine-parents-of-adult-children-with-schizophrenia-an-integrative-review-of-the-literature
#16
REVIEW
Debra Klages, Kim Usher, Debra Jackson
The purpose of this integrative review was to evaluate the current state of knowledge of parents who have adult children diagnosed with schizophrenia and their relationship with mental health professionals. Findings indicated that parents (primarily mothers) believed they intuitively knew when their adult children were becoming unwell and that they doggedly pursued connections with mental health care providers. Five themes were evident in the literature: trusting your instincts, feeling dismissed and devalued, making connections and making concessions, living with distress and sorrow, and becoming your own health-care provider...
December 20, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27938368/psychiatrists-experiences-of-suicide-assessment
#17
Margda Waern, Niclas Kaiser, Ellinor Salander Renberg
BACKGROUND: Clinical guidelines for suicide prevention often stress the identification of risk and protective factors as well as the evaluation of suicidal intent. However, we know very little about what psychiatrists actually do when they make these assessments. The aim was to investigate psychiatrists' own accounts of suicide assessment consultations, with a focus on their behaviors, attitudes and emotions. METHOD: Semi-structured in depth interviews were carried out with a purposive selection of 15 psychiatrists...
December 9, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27862757/easy-read-and-accessible-information-for-people-with-intellectual-disabilities-is-it-worth-it-a-meta-narrative-literature-review
#18
REVIEW
Deborah Chinn, Claire Homeyard
BACKGROUND: The proliferation of "accessible information" for people with intellectual disabilities in UK health care has accelerated in recent years, underpinned by policy guidance alongside the recent introduction of mandatory standards. However, questions have been raised as to the impact of such resources as a means of enhancing involvement in health care and addressing health inequalities. OBJECTIVE: To review and synthesize the evidence from different approaches used to evaluate the impact of accessible information for people with intellectual disabilities using a meta-narrative approach...
November 16, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/27858402/toward-an-international-classification-of-functioning-disability-and-health-clinical-data-collection-tool-the-italian-experience-of-developing-simple-intuitive-descriptions-of-the-rehabilitation-set-categories
#19
Melissa Selb, Francesca Gimigliano, Birgit Prodinger, Gerold Stucki, Germano Pestelli, Maurizio Iocco, Paolo Boldrini
BACKGROUND: As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. AIM: This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy...
November 18, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27836253/bi-manual-proximal-external-aortic-compression-after-major-abdominal-pelvic-trauma-and-during-ambulance-transfer-a-simulation-study
#20
M J Douma, D O'Dochartaigh, P G Brindley
BACKGROUND: Applying manual pressure after hemorrhage is intuitive, cost-free, and logistically-simple. When direct abdominal-pelvic compression fails, clinicians can attempt indirect proximal-external-aortic-compression (PEAC), while expediting transfer and definitive rescue. This study quantifies the sustainability of simulated bi-manual PEAC both immediately on scene and during subsequent ambulance transfer. The goal is to understand when bi-manual PEAC might be clinically-useful, and when to prioritize compression-devices or endovascular-occlusion...
January 2017: Injury
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