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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29144998/work-based-learning-in-health-care-organisations-experienced-by-nursing-staff-a-systematic-review-of-qualitative-studies
#2
REVIEW
Marja Nevalainen, Nina Lunkka, Marjo Suhonen
The aim of this review is to systematically summarise qualitative evidence about work-based learning in health care organisations as experienced by nursing staff. Work-based learning is understood as informal learning that occurs inside the work community in the interaction between employees. Studies for this review were searched for in the CINAHL, PubMed, Scopus and ABI Inform ProQuest databases for the period 2000-2015. Nine original studies met the inclusion criteria. After the critical appraisal by two researchers, all nine studies were selected for the review...
November 11, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29142376/intensive-care-nurses-attitude-on-palliative-and-end-of-life-care
#3
Swagata Tripathy, Pragyan K Routray, Jagdish C Mishra
Background: Intensive Care Unit (ICU) nurses have a vital role in the implementation of end of life (EOL) care. There is limited data on the attitude of ICU nurses toward EOL and palliation. Aim: This study aimed to investigate knowledge, attitude, and beliefs of intensive care nurses in eastern India toward EOL. Materials and Methods: A self-administered questionnaire was distributed to delegates in two regional critical care nurses' training programs...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29141622/am-i-getting-an-accurate-picture-a-tool-to-assess-clinical-handover-in-remote-settings
#4
Malcolm Moore, Chris Roberts, Jonathan Newbury, Jim Crossley
BACKGROUND: Good clinical handover is critical to safe medical care. Little research has investigated handover in rural settings. In a remote setting where nurses and medical students give telephone handover to an aeromedical retrieval service, we developed a tool by which the receiving clinician might assess the handover; and investigated factors impacting on the reliability and validity of that assessment. METHODS: Researchers consulted with clinicians to develop an assessment tool, based on the ISBAR handover framework, combining validity evidence and the existing literature...
November 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29140836/pyoderma-gangrenosum-a-critical-appraisal
#5
Eran Shavit, Afsaneh Alavi, R Gary Sibbald
GENERAL PURPOSE: To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities...
December 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29139608/current-state-of-screening-high-ace-youth-and-emerging-adults-in-primary-care
#6
Michelle Pardee, Elizabeth Kuzma, Chin Hwa Gina Y Dahlem, Nicole Boucher, Cynthia S Darling-Fisher
BACKGROUND AND PURPOSE: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed...
November 15, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29137860/quality-of-anthropometric-measurements-in-spanish-intensive-care-units-the-camies-study
#7
M A García-Martínez, T Cherednichenko, Y Hidalgo Encinas, A I Catalá Espinosa, A Arrascaeta Llanes, J A Acosta Escribano
INTRODUCTION: Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the clinical practice guides. OBJECTIVE: To describe anthropometric quality in CIP, health professional perception of such quality, and its influencing factors...
November 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29135779/impact-of-cross-level-measurement-noninvariance-on-hospital-rankings-based-on-patient-experiences-with-care-in-7-european-countries
#8
Benedict O Orindi, Emmanuel Lesaffre, Walter Sermeus, Luk Bruyneel
BACKGROUND: Hospital-level findings on patient experiences with care are increasingly reported publicly. A critical aspect left unexamined is the commonality of composite measures of patient experiences across different groups of patients, nursing units, hospitals, and countries. Absence of commonality is termed measurement noninvariance and is hypothesized to have a strong impact on performance assessment. AIM: The aim of this study is to examine measurement invariance across groups and levels under study (patients, nursing units, hospitals, and countries) and illustrate the degree to which this method of analysis impacts hospital rankings...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135750/student-and-educator-experiences-of-maternal-child-simulation-based-learning-a-systematic-review-of-qualitative-evidence
#9
Karen MacKinnon, Lenora Marcellus, Julie Rivers, Carol Gordon, Maureen Ryan, Diane Butcher
BACKGROUND: Although maternal-child care is a pillar of primary health care, there is a global shortage of maternal-child health care providers. Nurse educators experience difficulties providing undergraduate students with maternal-child learning experiences for a number of reasons. Simulation has the potential to complement learning in clinical and classroom settings. Although systematic reviews of simulation are available, no systematic reviews of qualitative evidence related to maternal-child simulation-based learning (SBL) for undergraduate nursing students and/or educators have been located...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29133329/involvement-of-people-with-dementia-in-making-decisions-about-their-lives-a-qualitative-study-that-appraises-shared-decision-making-concerning-daycare
#10
Leontine Groen-van de Ven, Carolien Smits, Fuusje de Graaff, Marijke Span, Jan Eefsting, Jan Jukema, Myrra Vernooij-Dassen
OBJECTIVE: To explore how people with dementia, their informal caregivers and their professionals participate in decision making about daycare and to develop a typology of participation trajectories. DESIGN: A qualitative study with a prospective, multiperspective design, based on 244 semistructured interviews, conducted during three interview rounds over the course of a year. Analysis was by means of content analysis and typology construction. SETTING: Community settings and nursing homes in the Netherlands...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132455/going-beyond-the-9-1-1-call-what-bc-emergency-health-services-is-doing-to-improve-timely-access-to-emergency-care
#11
Kerry Campbell, Jessica Jaiven, Kimberly Banfield, Corinne Begg, Janice Butler, Leanne Thain
British Columbia Emergency Health Services (BCEHS) uses an internationally recognized Medical Priority Dispatch System to assign appropriate responses to 9-1-1 calls based on patients' clinical acuity. In 2015, 71% of Omega calls (classified as calls involving low acuity injuries) were assigned an ambulance. To better meet patients' needs, BCEHS collaborated with HealthLink BC's Nursing Services (HLBC NS) to audit over 2,000 calls. Based on the results, three Plan, Do, Study, Act (PDSA) cycles were implemented, yielding a 35% decrease in ambulances assigned and a 173% increase in referrals to HLBC NS to provide more suitable support...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29131465/psychometric-analysis-of-subjective-sedation-scales-used-for-critically-ill-paediatric-patients
#12
Xiaohua Ge, Tingting Zhang, Lingling Zhou
AIMS: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. BACKGROUND: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales...
November 12, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29130288/optimising-early-neonatal-nutrition-using-translational-research-methodology
#13
Denise Page, Melissa Gilroy, Elizabeth Hurrion, Lisa Clark, Shelley Wilkinson
AIM: Preterm birth has been described as a 'nutritional emergency', with these infants often born with minimal nutrition reserves. Failure to provide adequate early nutrition jeopardises growth and neurodevelopment. Consensual nutrition guidelines exist for infants who weigh <1500 g; however, audits have identified shortfalls in their adherence, consequently highlighting an evidence-practice gap. This work aimed to identify the barriers to the delivery of early optimal nutrition in a tertiary-level Neonatal Critical Care Unit to inform an implementation project to ensure best practice care...
November 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29130275/feng-shui-and-emotional-response-in-the-critical-care-environment-farce-study
#14
R Charles, S Glover, K Bauchmüller, D Wood
The aim of this study was to investigate the relationship between nursing staff emotions and their surrounding environment, using the ancient system of feng shui. Two orientations of critical care bed spaces (wind and water groups, respectively) were mapped using a western bagua. Energy or 'chi' scores for nine emotions were calculated based on the positive or negative flow of chi in each of the two groups. During a two-week period, nursing staff were allocated to work in a bed space in either the wind or water groups; nursing staff who were not allocated to a study bed space acted as a control group...
December 2017: Anaesthesia
https://www.readbyqxmd.com/read/29129456/a-canadian-cross-sectional-survey-on-psychosocial-supports-for-people-living-type-1-or-2-diabetes-health-care-providers-awareness-capacity-and-motivation
#15
Jennica Nichols, Michael Vallis, Stephanie Boutette, Carolyn Gall Casey, Catherine H Yu
OBJECTIVES: Addressing psychosocial issues is critical for diabetes self-management. This work explores health-care professionals' (HCPs') 1) perceived relevance of various psychosocial issues in diabetes management and 2) confidence in working on these issues within their services. METHODS: An online cross-sectional survey was developed based on the Capacity-Opportunity-Motivation Behaviour Model. It assessed self-rated confidence in supporting patients with psychosocial issues (capability), perceived relevance of these issues (motivation) and facilitators of skill development (opportunity)...
November 9, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#16
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
November 8, 2017: Lancet
https://www.readbyqxmd.com/read/29121983/early-psychological-screening-of-intensive-care-unit-survivors-a-prospective-cohort-study
#17
Anna Milton, Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
BACKGROUND: A majority of patients survive their episode of critical illness but up to 30% of patients suffer from psychological problems such as post-traumatic stress, anxiety and depression in the year after intensive care unit (ICU) stay. A method to identify discharged patients at risk for adverse psychological outcome would be helpful in the triage for ICU follow-up and could enable early intervention. The aim of this study was to evaluate whether early screening with validated questionnaires after ICU discharge can identify patients at risk for symptoms of post-traumatic stress, anxiety and depression 3 months after ICU stay...
November 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29120912/effects-of-a-system-thinking-based-simulation-program-for-congestive-heart-failure
#18
Hyeon-Young Kim, Eun Kyoung Yun
This study evaluated a system thinking-based simulation program for the care of patients with congestive heart failure. Participants were 67 undergraduate nursing students from a nursing college in Seoul, South Korea. The experimental group was given a 4-hour system-thinking program and a 2-hour simulation program, whereas the control group had a 4-hour case study and a 2-hour simulation program. There were significant improvements in critical thinking in both groups, but no significant group differences between educational methods (F = 3...
November 8, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29119685/fundamental-care-and-knowledge-interests-implications-for-nursing-science
#19
José Granero-Molina, Cayetano Fernández-Sola, Ester Mateo Aguilar, Cayetano Aranda Torres, Pablo Román López, José Manuel Hernández-Padilla
AIMS AND OBJECTIVES: The aim of this discursive paper was to characterize the intra-theoretical interests of knowledge in nursing science as an epistemological framework for fundamental care. BACKGROUND: For Jürgen Habermas, theory does not separate knowledge interests from life. All knowledge, understanding and human research is always interested. Habermas formulated the knowledge interests in empirical-analytical, historical-hermeneutic and critical social sciences; but said nothing about health sciences and nursing science...
November 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29118081/perceptions-of-dental-hygienists-and-dentists-about-preventing-early-childhood-caries-a-qualitative-study
#20
Alice M Horowitz, Dushanka V Kleinman, Wendy Child, Sarah D Radice, Catherine Maybury
Purpose: The objective of this qualitative pilot study was to gain an in-depth understanding of dental hygienists and dentists perspectives regarding children's oral health and what needs to be done to prevent early childhood caries (ECC), the most frequent chronic disease of childhood.Methods: A skilled facilitator conducted four focus groups and four phone interviews with 20 dental hygienists and 17 dentists practicing in a variety of locations within the state of Maryland. The interview guide was based on results from previous state-wide surveys of dental hygienists and dentists...
August 2017: Journal of Dental Hygiene: JDH
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