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https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#1
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28439133/importance-of-pharmacy-involvement-in-the-treatment-of-sepsis
#2
Joseph B Cavanaugh, Jesse B Sullivan, Nicole East, Jessica N Nodzon
Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#3
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28438479/family-presence-during-resuscitation-fpdr-observational-case-studies-of-emergency-personnel-in-victoria-australia
#4
Joanne E Porter, Nareeda Miller, Anita Giannis, Nicole Coombs
INTRODUCTION: Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#5
Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte, Frédéric Adnet
BACKGROUND: Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. METHODS: This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit...
April 24, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28437783/evacuation-of-a-tertiary-neonatal-centre-lessons-from-the-2016-kumamoto-earthquakes
#6
Osuke Iwata, Akihiko Kawase, Masanori Iwai, Kazuko Wada
BACKGROUND: Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. OBJECTIVE: The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters...
April 25, 2017: Neonatology
https://www.readbyqxmd.com/read/28437203/using-the-surprise-question-to-identify-those-with-unmet-palliative-care-needs-in-emergency-and-inpatient-settings-what-do-clinicians-think
#7
Samir A Haydar, Lisa Almeder, Lauren Michalakes, Paul K J Han, Tania D Strout
BACKGROUND: The surprise question (SQ), "Would you be surprised if this patient died within the next year?" is effective in identifying end-stage renal disease and cancer patients at high risk of death and therefore potentially unmet palliative care needs. Following implementation of the SQ in our acute care setting, we sought to explore hospital-based providers' perceptions of the tool. OBJECTIVES: To evaluate (1) providers' perceptions regarding the feasibility of SQ use in emergency and inpatient settings, (2) clinician perceptions regarding the utility of the SQ, and (3) barriers to SQ use...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#8
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28436601/management-of-skin-adverse-events-associated-with-immune-checkpoint-inhibitors-in-patients-with-melanoma-a-nursing-perspective
#9
Melissa Thebeau, Krista Rubin, Matthias Hofmann, Julia Grimm, Alyona Weinstein, Jennifer N Choi
PURPOSE: Immune checkpoint inhibitors are associated with a unique immune-related side effect profile that requires prompt recognition and management. Skin toxicities are the most common, and often earliest occurring, drug-related adverse events (AEs) of any grade observed upon treatment with these agents. The purpose of this review is to provide practical guidance on the identification and treatment of skin AEs associated with the immune checkpoint inhibitors (ipilimumab, nivolumab, and pembrolizumab) from a nursing perspective, and demonstrate hands-on application of the guidance using relevant patient case studies...
April 24, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#10
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#11
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#12
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435420/qualitative-evaluation-of-the-implementation-of-an-integrated-care-delivery-model-for-chronic-patients-with-multi-morbidity-in-the-basque-country
#13
María Luz Jauregui, Carmen Silvestre, Pedro Valdes, Idoia Gaminde
INTRODUCTION: The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement. METHODS: We organised four nominal groups composed of representatives from different categories of clinicians involved in the development of an integrated healthcare organisation and in the integrated care of patients with multiple diseases, namely, internists, general practitioners, and primary care and hospital nurses...
August 19, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435282/managing-the-patient-with-osteogenesis-imperfecta-a-multidisciplinary-approach
#14
REVIEW
Caroline Marr, Alison Seasman, Nick Bishop
Osteogenesis imperfecta (OI) is a heterogeneous heritable connective tissue disorder characterized by low bone density. The type and severity of OI are variable. The primary manifestations are fractures, bone deformity, and bone pain, resulting in reduced mobility and function to complete everyday tasks. OI affects not only the physical but also the social and emotional well-being of children, young people, and their families. As such, medical, surgical, and allied health professionals' assessments all play a role in the management of these children...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28435234/strengthening-care-teams-to-improve-adherence-in-cystic-fibrosis-a-qualitative-practice-assessment-and-quality-improvement-initiative
#15
Allison J Gardner, Alice L Gray, Staci Self, Jeffrey S Wagener
BACKGROUND: Treatment regimens for patients with cystic fibrosis (CF) are complex, time consuming, and burdensome, and adherence to CF treatment is suboptimal. CF care teams play a critical role in supporting patients' chronic self-management skills, but there is no uniform method for assessing patients' adherence to treatment or standard interventions to help patients improve when necessary. METHODS: Between May 2015 and March 2016, care team members from 10 CF centers in the USA participated in a practice assessment and quality improvement (QI) initiative...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28435229/medication-adherence-and-persistence-in-type-2-diabetes-mellitus-perspectives-of-patients-physicians-and-pharmacists-on-the-spanish-health-care-system
#16
Elena Labrador Barba, Marta Rodríguez de Miguel, Antonio Hernández-Mijares, Francisco Javier Alonso-Moreno, Maria Luisa Orera Peña, Susana Aceituno, María José Faus Dader
OBJECTIVE: A good relationship between diabetes patients and their health care team is crucial to ensure patients' medication adherence and self-management. To this end, we aimed to identify and compare the views of type 2 diabetes mellitus (T2DM) patients, physicians and pharmacists concerning the factors and strategies that may be associated with, or could improve, medication adherence and persistence. METHODS: An observational, cross-sectional study was conducted using an electronic self-administered questionnaire comprising 11 questions (5-point Likert scale) concerning factors and strategies related to medication adherence...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28434918/forming-and-activating-an-internal-facilitation-group-for-successful-implementation-a-qualitative-study
#17
Megan B McCullough, Chris Gillespie, Beth Ann Petrakis, Ellen A Jones, Angela M Park, Carol VanDeusen Lukas, Adam J Rose
BACKGROUND: This study focuses on an implementation facilitation strategy to improve the delivery of anticoagulation care within pharmacy-run clinics across 8 Veterans Health Administration (VA) medical centers. Other studies have explored various models of implementation facilitation, including external facilitation (EF), internal facilitation (IF), and blended facilitation (BF) combining both approaches. This study focuses on the use of an internal facilitation team of anticoagulation coordinators representing 8 VA anticoagulation clinics to enhance the implementation process...
April 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28434913/development-of-school-based-asthma-management-programs-in-rochester-ny
#18
REVIEW
Jill S Halterman, Reynaldo Tajon, Paul Tremblay, Maria Fagnano, Arlene Butz, Tamara Perry, Ken McConnochie
In the spirit of Dr. Haggerty's teachings, we present an overview of our work to improve care for children with asthma in the context of 3 lessons learned:(1) 1) The importance of providing integrated services across disciplinary boundaries for children with chronic illness, 2) The need to move from a care model focused only on the individual child to a model focused on the child, family, and community, and 3) The need to expand beyond the local community and take a broad perspective on improving health on a national level...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28434454/measuring-to-improve-medication-reconciliation-in-a-large-subspecialty-outpatient-practice
#19
Elizabeth Kern, Meg B Dingae, Esther L Langmack, Candace Juarez, Gary Cott, Sarah K Meadows
BACKGROUND: To assess performance in medication reconciliation (med rec)-the process of comparing and reconciling patients' medication lists at clinical transition points-and demonstrate improvement in an outpatient setting, sustainable and valid measures are needed. METHODS: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs), and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR)...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434390/how-preferences-for-continuity-and-access-differ-between-multimorbidity-and-healthy-patients-in-a-team-care-setting
#20
Katherine M Ehman, Mark Deyo-Svendsen, Zachary Merten, Anne Marie Kramlinger, Gregory M Garrison
INTRODUCTION: Team-based care has become an essential part of modern medical practice. Patient-centered medical homes often struggle to balance the dual competing goals of acute access and continuity of care. Multimorbidity patients may value continuity more than healthy patients, and thus may prefer to wait to see their primary care physician (PCP). METHODS: A total of 1700 randomly selected healthy adults and multimorbidity patients were asked to rate satisfaction with care and presented with 4 acute and 4 chronic scenarios to choose an access and continuity preference in an anonymous mailed survey...
April 1, 2017: Journal of Primary Care & Community Health
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