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https://www.readbyqxmd.com/read/28812473/implementation-of-a-pathway-for-the-treatment-of-fever-and-neutropenia-in-pediatric-patients-with-cancer
#1
Joy Vanderway, Catherine Vincent, Susan M Walsh, Jennifer Obrecht
Fever and neutropenia is an oncologic emergency. Time-to-antibiotics (TTA) refers to the amount of time from initial provider evaluation for fever and neutropenia to intravenous antibiotic administration. Research supports that rapid time-to-antibiotics (RTTA) is associated with improved patient outcomes. This quality improvement project evaluated the success of implementing an RTTA pathway in pediatric oncology patients with fever and neutropenia. The setting was an advanced practice nurse-managed pediatric ambulatory infusion center where patients with fever and neutropenia were often evaluated and treated...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#2
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#3
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811394/overview-and-current-management-of-computerized-adaptive-testing-in-licensing-certification-examinations
#4
Dong Gi Seo
Computerized adaptive testing (CAT) has been implemented in the high stakes examinations such as National Council Licensure Examination-Registered Nurses (NCLEX-RN) in the United States since 1994. After that, The National Registry Emergency Medical Technician (NREMT) in the United States adopted a CAT to certify an Emergency Medical Technician (EMT) in 2007. It aimed at introducing CAT for the implementation in the medical health licensing examinations. Most CATs are based on the item response theory (IRT) which hypothesizes that both examinee and item has own characteristics that does not change...
July 26, 2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/28809180/exploring-socio-technical-insights-for-safe-nursing-handover
#5
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28808814/the-impact-of-being-a-migrant-from-a-non-english-speaking-country-on-healthcare-outcomes-in-frail-older-inpatients-an-australian-study
#6
David Basic, Chris Shanley, Rinaldo Gonzales
The purpose of this prospective study of 2180 consecutive index admissions to an acute geriatric service was to compare in-hospital outcomes of frail older inpatients born in non-English-speaking counties, referred to as culturally and linguistically diverse (CALD) countries in Australia, with those born in English-speaking countries. Multivariate logistic regression was used to model in-hospital mortality and new nursing home placement. Multivariate Cox proportional hazards regression was used to model length of stay...
August 14, 2017: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#7
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28807523/multidisciplinary-heart-failure-clinics-are-associated-with-lower-heart-failure-hospitalization-and-mortality-systematic-review-and-meta-analysis
#8
REVIEW
Sumeet Gandhi, Wassim Mosleh, Umesh C Sharma, Catherine Demers, Michael E Farkouh, Jon-David Schwalm
BACKGROUND: Heart failure (HF) clinics (HFCs) are an integral aspect of the strategy for community HF care. METHODS: A systematic search was conducted to retrieve studies. We searched for candidate articles in the PubMed, EMBASE, and Cochrane databases from 1990 to January 2017. RESULTS: We included 16 randomized controlled trials in the meta-analysis with 3999 patients. The HFC group had a lower incidence of the primary composite end point of HF hospitalization and all-cause mortality (odds ratio [OR], 0...
May 24, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28807499/making-the-hard-decisions-ethical-care-decisions-in-wartime-nursing-practice
#9
Janice Agazio, Petra Goodman
BACKGROUND: Codes of ethics set forth standards of ethical conduct for nurses. However, nurses involved in wartime operations, or disasters, may often have their moral compass challenged by the patient care decisions necessary under adverse conditions. Reverse triage, resource allocation, and promotion of patient autonomy present multiple challenges to meeting commonly applied ethical principles. PURPOSE: The purpose of this study was to use the International Council of Nursing code of ethics as a framework to organize the ethical issues emerging from wartime nursing...
June 30, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28807480/opportunities-and-challenges-in-screening-for-childhood-sexual-abuse
#10
Deepa L Sekhar, Jennifer L Kraschnewski, Heather L Stuckey, Pamela D Witt, Erica B Francis, Ginger A Moore, Paul L Morgan, Jennie G Noll
Retrospective studies suggest 1 in 4 girls and 1 in 6 boys will experience sexual abuse before 18 years of age, resulting in future morbidity. Successful interventions exist, however, victims are reluctant to disclose. Screening for childhood sexual abuse (CSA) may provide an opportunity to overcome this barrier, yet no current model for universal CSA screening exists. We sought to understand the perspective of key stakeholders on CSA screening through qualitative research. Eight focus groups of 7-10 participants each (n=62) were conducted from April-September 2016...
August 11, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28807433/influences-on-decision-making-regarding-antipsychotic-prescribing-in-nursing-home-residents-with-dementia-a-systematic-review-and-synthesis-of-qualitative-evidence
#11
REVIEW
Kieran A Walsh, Rebecca Dennehy, Carol Sinnott, John Browne, Stephen Byrne, Jennifer McSharry, Eoin Coughlan, Suzanne Timmons
BACKGROUND: Antipsychotic prescribing is prevalent in nursing homes for the management of behavioral and psychological symptoms of dementia (BPSD), despite the known risks and limited effectiveness. Many studies have attempted to understand this continuing phenomenon, using qualitative research methods, and have generated varied and sometimes conflicting findings. To date, the totality of this qualitative evidence has not been systematically collated and synthesized. AIMS: To synthesize the findings from individual qualitative studies on decision-making and prescribing behaviors for antipsychotics in nursing home residents with dementia, with a view to informing intervention development and quality improvement in this field...
August 11, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28806305/dimensions-of-posttraumatic-growth-in-patients-with-cancer-a-mixed-method-study
#12
Mehdi Heidarzadeh, Maryam Rassouli, Jeannine M Brant, Farahnaz Mohammadi-Shahbolaghi, Hamid Alavi-Majd
BACKGROUND: Posttraumatic growth (PTG) refers to positive outcomes after exposure to stressful events. Previous studies suggest cross-cultural differences in the nature and amount of PTG. OBJECTIVE: The aim of this study was to explore different dimensions of PTG in Iranian patients with cancer. METHODS: A mixed method study with convergent parallel design was applied to clarify and determine dimensions of PTG. Using the Posttraumatic Growth Inventory (PTGI), confirmatory factor analysis was used to quantitatively identify dimensions of PTG in 402 patients with cancer...
August 12, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28805550/moving-toward-a-universal-digital-era-in-mass-casualty-incidents-and-disasters-emergency-personnel-s-perspective-in-romania
#13
Adrian Stănescu, Peter Eliot Gordon, Sanda Maria Copotoiu, Cristian Marius Boeriu
BACKGROUND: Despite a recognized need for improved communications and logistics in high acuity situations, the integration of telemedicine services into the mainstream health services has been difficult. This study reports on the opinions of Romanian professional responders to mass casualty incidents and disasters regarding the use and requirements of specific electronic medical documentation solutions. MATERIALS AND METHODS: Doctors, nurses, paramedics, and fire department officers participated in a customized online structured questionnaire...
August 14, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28805115/hindrances-to-achieve-professional-confidence-the-nurse-s-participation-in-ethical-decision-making
#14
Anne Storaker, Dagfinn Nåden, Berit Sæteren
BACKGROUND: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient's dignity in their clinical work. OBJECTIVES: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28804393/ageism-among-physicians-nurses-and-social-workers-findings-from-a-qualitative-study
#15
Aya Ben-Harush, Sharon Shiovitz-Ezra, Israel Doron, Sara Alon, Arthur Leibovitz, Hava Golander, Yafa Haron, Liat Ayalon
This study investigated ageism among healthcare professionals in various therapeutic settings in Israel. Using a qualitative approach, the current study aimed to examine similarities and differences across healthcare disciplines. Three focus groups were conducted with physicians, nurses, and social workers. Data from each focus group were analyzed separately, and then commonalities and differences across the groups were evaluated. Three main themes relating to older adults emerged from the data. The first theme pertains to perceived difficulties that healthcare professionals experience in working with older adults and their family members; the second focuses on invisibility and discriminatory communication patterns; and the third theme relates to provision of inappropriate care to older adults...
March 2017: European Journal of Ageing
https://www.readbyqxmd.com/read/28802869/use-of-a-standardized-procedure-to-improve-behavioral-health-patients-care-a-quality-improvement-initiative
#16
Elizabeth J Winokur, Jeannine Loucks, Glenn H Raup
PROBLEM: Meeting the complex needs of behavioral health (BH) patients in the emergency department is an ongoing challenge. Delays in care can have adverse consequences for patient and staff safety and delay transfer to specialized care. METHODS: A quality improvement, nurse-driven initiative using a standardized procedure (STP) was developed and implemented in our busy Southern California Emergency Department, which focused on improving time to first medication and reduction of restraints...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28802868/development-and-implementation-of-an-ultrasound-guided-peripheral-intravenous-catheter-program-for-emergency-nurses
#17
Courtney Edwards, Jodi Jones
PROBLEM: Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. METHODS: The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28802638/spiritual-perspectives-of-emergency-medicine-doctors-and-nurses-in-caring-for-end-of-life-patients-a-mixed-method-study
#18
Yingting Zhang, Rakhee Yash Pal, Wai San Wilson Tam, Alice Lee, Mabel Ong, Lay Hwa Tiew
BACKGROUND: End-of-life care is becoming more prevalent in the Emergency Department. Quality end-of-life care includes spiritual support. As spirituality is a relatively vague concept, understanding healthcare professionals' spiritual perspectives is important. AIMS: To explore the perspectives of Emergency Department doctors and nurses in (i) spirituality, (ii) spiritual care domain in end-of-life care and (iii) factors influencing spiritual care provision in the Emergency Department...
August 9, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28801944/the-emergence-of-second-generation-lethal-injection-protocols-a-brief-history-and-review
#19
Daniel R Malcom, Frank Romanelli
The history of capital punishment in the United States is long and controversial. In many cases, lethal injection has brought medical personnel, ethically and professionally charged with preserving life, into the arena of assisting the state in taking life. Recent US Supreme Court decisions, including Baze v. Rees and Glossip v. Gross, have evaluated and condoned lethal injection protocols. Despite the judicial validation of some midazolam-containing protocols, controversy exists as to the level of unconsciousness provided due to the ceiling effects of the drug...
August 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28801110/risk-factors-for-30-day-readmission-in-patients-with-congestive-heart-failure
#20
Katelin A Mirkin, Laura M Enomoto, Gregory M Caputo, Christopher S Hollenbeak
BACKGROUND: Risk of readmission is elevated in patients congestive heart failure (CHF), and clinical decision makers need to better understand risk factors for 30-day readmissions. OBJECTIVE: To identify risk factors for readmission in patients with CHF. METHODS: We studied all admissions for patients with CHF during 2011 using a statewide discharge data set from Pennsylvania. The primary outcome was readmission to any Pennsylvania hospital within 30 days of discharge...
August 8, 2017: Heart & Lung: the Journal of Critical Care
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