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Team based care

Reem Y Dabbour, Tayseer A Hassan, Maha S Faqawi, Bettina Böttcher
BACKGROUND: The aim of this study was to assess the practice of pain management for women in labour at El-Emarati Hospital in Rafah, Gaza Strip, and to compare this management with the guidelines by the National Institute for Health and Care Excellence (NICE). METHODS: A data collection sheet was prepared and completed for each patient admitted to the delivery room. Patients were enrolled consecutively between Feb 1 and April 1, 2016. Data collection sheets, based on NICE guidelines, were completed by the audit team (TAH, MSF, and RYA)...
February 21, 2018: Lancet
Rami Musallam, Nabeel Salem, Ramez Al Halol, Hammam Al Deeb, Bettina Bottcher, Hanaa AlHamaida
BACKGROUND: Early pregnancy loss occurs in 10% of all clinically recognised pregnancies. 80% of pregnancy losses occur in the first trimester. Offering choice and participation in the management decisions is essential to patient-centred care. The aim of this study was to assess the management of first trimester pregnancy loss at the Emirati Hospital in Rafah, Gaza Strip. METHODS: In this retrospective audit, we compared the management of first trimester pregnancy loss at Emirati Hospital using the American College of Obstetricians and Gynecologists guidelines (ACOG, No...
February 21, 2018: Lancet
Mohammed B Sarhan, Rula Ghandour, Niveen M E Abu Rmeileh
BACKGROUND: The burden of type 2 diabetes is increasing rapidly in the occupied Palestinian territory. Different counselling interventions have been applied worldwide to reduce HbA1c concentrations in patients with type 2 diabetes. Achieving good glycaemic control is important for prevention of complications of type 2 diabetes. The aim of this modelling study was to assess the effectiveness of different counselling interventions in improving glycaemic control in patients with type 2 diabetes...
February 21, 2018: Lancet
Mohammed N Alkhatib, Tamer Abd-Alghafoor, AlaaEldeen Elmassry, Loai Albarqouni, Bettina Böttcher, Maha Alfaqawi
BACKGROUND: Stroke is a leading cause of morbidity and mortality worldwide. The aim of this study was to assess the standard of care for patients with acute ischaemic stroke at the internal medicine department of Nasser Hospital, Gaza Strip. METHODS: For this retrospective clinical audit, we selected a random sample of 100 medical records for patients with stroke who were admitted to Nasser Hospital between January and August, 2016. Clinical practice was compared with the recommendations in the 2013 American Heart Association and American Stroke Association guidelines...
February 21, 2018: Lancet
Audrey Lyndon, Jennifer Malana, Laura C Hedli, Jules Sherman, Henry C Lee
OBJECTIVE: To explore women's birth experiences to develop an understanding of their perspectives on patient safety during hospital-based birth. DESIGN: Qualitative description using thematic analysis of interview data. PARTICIPANTS: Seventeen women ages 29 to 47 years. METHODS: Women participated in individual or small group interviews about their birth experiences, the physical environment, interactions with clinicians, and what safety meant to them in the context of birth...
March 15, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Jie Chen, Jian Yang, Fen Hu, Si-Hong Yu, Bing-Xiang Yang, Qian Liu, Xiao-Ping Zhu
BACKGROUND: Simulation-based curriculum has been demonstrated as crucial to nursing education in the development of students' critical thinking and complex clinical skills during a resuscitation simulation. Few studies have comprehensively examined the effectiveness of a standardised simulation-based emergency and intensive care nursing curriculum on the performance of students in a resuscitation simulation. OBJECTIVE: To evaluate the impact of a standardised simulation-based emergency and intensive care nursing curriculum on nursing students' response time in a resuscitation simulation...
March 14, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Gabriele Gäbler, Michaela Coenen, Deborah Lycett, Tanja Stamm
BACKGROUND: High quality, continuity and safe interdisciplinary healthcare is essential. Nutrition and dietetics plays an important part within the interdisciplinary team in many health conditions. In order to work more effectively as an interdisciplinary team, a common terminology is needed. This study investigates which categories of the ICF-Dietetics are used in clinical dietetic care records in Austria and which are most relevant to shared language in different medical areas. METHOD: A national multicenter retrospective study was conducted to collect clinical dietetic care documentation reports...
March 3, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jenny H Ledikwe, Nora Joelle Kleinman, Maureen Mpho, Heather Mothibedi, Shreshth Mawandia, Bazghina-Werq Semo, Gabrielle O'Malley
OBJECTIVES: Healthcare workers (HWs) are prone to high levels of stress and burnout, particularly when caring for people with HIV/AIDS. This study assessed whether participation in Botswana's Workplace Wellness Programme (WWP) for HWs was associated with job satisfaction, occupational stress, well-being and burnout. METHODS: Using multistage sampling, a paper-based questionnaire was distributed to 1856 randomly selected HWs at 135 public facilities across Botswana...
March 16, 2018: BMJ Open
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
Jean Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sebastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method...
March 15, 2018: Annals of Intensive Care
Marnie J Meylor de Mooij, Rachael L Hodny, Daniel A O'Neil, Matthew R Gardner, Mekayla Beaver, Andrea T Brown, Barbara A Barry, Lorna M Ross, Amy J Jasik, Katharine M Nesbitt, Susan M Sobolewski, Susan M Skinner, Rajeev Chaudhry, Brian C Brost, Bobbie S Gostout, Roger W Harms
Using a human-centered design method, our team sought to envision a new model of care for women experiencing low-risk pregnancy. This model, called OB Nest, aimed to demedicalize the experience of pregnancy by providing a supportive and empowering experience that fits within patients' daily lives. To explore this topic, we invited women to use self-monitoring tools, a text-based smartphone application to communicate with their care team, and moderated online communities to connect with other pregnant women...
March 9, 2018: Mayo Clinic Proceedings
Thomas Stephan Hiller, Antje Freytag, Jörg Breitbart, Tobias Teismann, Elisabeth Schöne, Wolfgang Blank, Mercedes Schelle, Horst Christian Vollmar, Jürgen Margraf, Jochen Gensichen
BACKGROUND: Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. METHODS: JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Sarah Donnelly, Emer Begley, Marita O'Brien
In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes...
January 1, 2018: Dementia
Kenzie A Cameron, Elaine R Cohen, Joelle R Hertz, Diane B Wayne, Debi Mitra, Jeffrey H Barsuk
OBJECTIVES: The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. METHODS: Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas...
March 14, 2018: Journal of Patient Safety
Helen Benson, Cherie Lucas, Walter Kmet, Shalom I Benrimoj, Kylie Williams
Background Team based care has been used internationally to improve the delivery of best practice primary health care. The WentWest General Practice Pharmacist Project, involving the integration of pharmacists within general practice teams, was commissioned to improve medication management of general practice patients. A particular focus of the project was the performance of medication review to allow the detection and resolution of drug related problems (DRPs). Objective The objectives of this 6-month study (October 2016-March 2017) were to: (1) identify and classify the DRPs detected as a result of pharmacist activities within a general practice primary care setting...
March 14, 2018: International Journal of Clinical Pharmacy
Shane Sinclair, Thomas F Hack, Shelley Raffin-Bouchal, Susan McClement, Kelli Stajduhar, Pavneet Singh, Neil A Hagen, Aynharan Sinnarajah, Harvey Max Chochinov
BACKGROUND: Healthcare providers are considered the primary conduit of compassion in healthcare. Although most healthcare providers desire to provide compassion, and patients and families expect to receive it, an evidence-based understanding of the construct and its associated dimensions from the perspective of healthcare providers is needed. OBJECTIVES: The aim of this study was to investigate healthcare providers' perspectives and experiences of compassion in order to generate an empirically derived, clinically informed model...
March 14, 2018: BMJ Open
Brittany L Cornwell, Laurie M Brockmann, Elaine C Lasky, Jennifer Mach, John F McCarthy
OBJECTIVES: The Veterans Health Administration (VHA) has achieved substantial national implementation of primary care-mental health integration (PC-MHI) services. However, little is known regarding program characteristics, variation in characteristics across settings, or associations between program fidelity and performance. This study identified core elements of PC-MHI services and evaluated their associations with program characteristics and performance. METHODS: A principal-components analysis (PCA) of reports from 349 sites identified factors associated with PC-MHI fidelity...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Maria Lucia Specchia, Giuseppe La Torre, Giovanna Elisa Calabrò, Paolo Villari, Roberto Grilli, Antonio Federici, Walter Ricciardi, Chiara de Waure
Background: The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods: On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care...
March 12, 2018: European Journal of Public Health
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
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