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Ambulatory nursing

Annette L Gardner, Laura Clementz, Renée H Lawrence, Mary A Dolansky, Alli M Heilman, Anne R Rusterholtz, Simran Singh, Matthew Sparks, Mamta K Singh
Combining interprofessional education, clinical or workplace learning, and physician resident teachers in the ambulatory setting, the dyad model enhances teamwork skills and increases nurse practitioner students' clinical competence.
February 2019: Federal Practitioner
Erica D Hooper-Arana, Judy N Li, Wanda J Borges, Thomas Bodenheimer
BACKGROUND: With the aging population, the prevalence of chronic disease is increasing, requiring a team-based approach to care with registered nurses (RNs) playing a vital role. PROBLEM: Nursing education generally prioritizes acute care rather than ambulatory care; however, nursing students should also be prepared to adequately respond to the population needs for longitudinal chronic care management. APPROACH: To address the need for RNs to assume a role in chronic care management, a School of Nursing and Health Professions piloted a clinical option in which second-degree master of science in nursing students are prepared to function as health coaches on primary care teams at a local community health center...
March 7, 2019: Nurse Educator
Marcia Finlayson, Okechukwu Ekuma, Greg Finlayson, Depeng Jiang, Ruth Ann Marrie
Background: Nursing home (NH) care is expensive and restrictive. Understanding trajectories to NH entry among people with multiple sclerosis (MS) could facilitate monitoring and early risk identification. We investigated 10-year trajectories of health care use in matched cohorts of people with MS who did and did not enter NH, the characteristics associated with trajectory group membership, and whether group membership predicted NH entry. Methods: We used population-based administrative (health claims) data from Manitoba, Canada, to identify 226 NH entrants with MS between January 2005 and December 2012 and 896 age-, sex- and geographically matched non-NH entrants with MS...
February 2019: Neurology. Clinical Practice
Maria Goreti da Rocha Rodrigues, Sophie Pautex, Maya Zumstein-Shaha
PURPOSE: The dignity of patients is a major concern among health professionals engaged in the care of individuals with advanced cancer. Although several dignity promoting interventions have been developed, none of them have focused on a positive, resource-based approach. The aim of our study, entitled Revie ⊕, was to assess the feasibility and acceptability of a theory-guided life-review intervention, focusing on strength and resources, for patients with advanced cancer and for nurses delivering the intervention...
April 2019: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Vivian Chia-Rong Hsieh, Meng-Lun Hsieh, Jen-Huai Chiang, Andy Chien, Ming-Shun Hsieh
Many countries worldwide are aging rapidly, and the complex care needs of older adults generate an unprecedented demand for health services. Common reasons for elderly emergency department (ED) visits frequently involve conditions triggered by preventable infections also known as ambulatory care sensitive conditions (ACSCs). This study aims to describe the trend and the associated disease burden attributable to ACSC-related ED visits made by elderly patients and to characterize their ED use by nursing home residence...
March 7, 2019: Scientific Reports
Diana Comerford, Raakhee Shah
Ambulatory care (AC) involves providing inpatient chemotherapy and supportive care as an outpatient service. Nurses and the multidisciplinary team (MDT) have a major role in this. AC at a major London teaching hospital trust is a nurse-led service, headed by specialist cancer nurses with excellent knowledge of the needs and priorities of patients undergoing intensive treatment. An experienced MDT, including administrative support, maintains safety and continuity of care. The nurses, MDT and patient work closely to promote the patient's wellbeing, self-management and trust...
February 28, 2019: British Journal of Nursing: BJN
Emily Borman-Shoap, Erica King, Keri Hager, Patricia Adam, Nicole Chaisson, Mary Dierich, Mumtaz Mustapha, Heather Thompson Buum
Introduction: Team-based, interprofessional approaches to outpatient care are critical to high-quality patient care. However, few specific educational interventions promoting these skills in graduate level health care trainees have been described to date. Methods: University of Minnesota faculty from the Schools of Medicine, Pharmacy, and Nursing created an interprofessional workshop experience exploring core concepts in outpatient care for graduate level trainees in pediatrics, family medicine, medicine-pediatrics, internal medicine, graduate-level nursing, and pharmacy...
May 4, 2018: MedEdPORTAL Publications
Xinqiang Gao, Shipeng Yan, Wenqiong Wu, Rui Zhang, Yuliang Lu, Shuiyuan Xiao
Objective: We aimed to explain the operational mechanism of China National Patient Safety Incidents Reporting System, analyze patterns and trends of incidents reporting, and discuss the implication of the incidents reporting to improve hospital patient safety. Design: A nationwide, registry-based, observational study design. Data source: The database of China National Patient Safety Incidents Reporting System. Outcome measures: Outcome measures of this study included the temporal, regional, and hospital distribution of the reports, as well as the incident type, location, parties, and possible reasons for frequently occurring incidents...
2019: Therapeutics and Clinical Risk Management
Ron B Mitchell, Sanford M Archer, Stacey L Ishman, Richard M Rosenfeld, Sarah Coles, Sandra A Finestone, Norman R Friedman, Terri Giordano, Douglas M Hildrew, Tae W Kim, Robin M Lloyd, Sanjay R Parikh, Stanford T Shulman, David L Walner, Sandra A Walsh, Lorraine C Nnacheta
OBJECTIVE: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall...
February 2019: Otolaryngology—Head and Neck Surgery
Mélanie Dos Santos, Justine Lequesne, Audrey Emmanuelle Dugué, Jean-Michel Grellard, Céline Ory, Sébastien Jaffré, Kelly Lavergne, Anaïs Lelaidier, Lucie Laroche, Fabienne Divanon, Corinne Delcambre, Marie-Pierre Galais, Bénédicte Clarisse, Audrey Faveyrial
OBJECTIVE: We implemented the two-step OPTIMA program to anticipate chemotherapy prescription which aims to assess the discrepancy rate between anticipated and real prescription and its impact on waiting time and quality of care. METHODS: This prospective study included cancer patients receiving any intravenous chemotherapy. The OPTIMA program consists in a nurse phone call and a blood sample two days before the planned treatment. Collected information and biological results were used by a physician to issue a non-effective (step 1) or effective (step 2) anticipated prescription the day before the consultation...
February 20, 2019: European Journal of Cancer Care
Chenchen Feng, David Le, Allison B McCoy
OBJECTIVE:  We identified the methods used and determined the roles of electronic health records (EHRs) in detecting and assessing adverse drug events (ADEs) in the ambulatory setting. METHODS:  We performed a systematic literature review by searching PubMed and Google Scholar for studies on ADEs detected in the ambulatory setting involving any EHR use published before June 2017. We extracted study characteristics from included studies related to ADE detection methods for analysis...
January 2019: Applied Clinical Informatics
Lisa M Kern, Monika M Safford, Masha J Slavin, Evguenia Makovkina, Ahd Fudl, J Emilio Carrillo, Erika L Abramson
BACKGROUND: Patients with chronic conditions routinely see multiple outpatient providers, who may or may not communicate with each other. Gaps in information across providers caring for the same patient can lead to harm for patients. However, the exact causes and consequences of healthcare fragmentation are not understood well enough to design interventions to address them. OBJECTIVE: We sought to elicit patients' and providers' views on the causes and consequences of healthcare fragmentation...
February 19, 2019: Journal of General Internal Medicine
Anjail Z Sharrief, Evelyn Hinojosa, Gail Cooksey, Munachi N Okpala, Elenir B Avritscher, Claudia Pedroza, Mary Carter Denny, Joshua Samuels, Jon E Tyson, Sean I Savitz
INTRODUCTION: Hypertension is a major risk factor for recurrent stroke, and blood pressure (BP) reduction is associated with decreased risk of stroke recurrence. However, many stroke survivors have poorly controlled BP after their initial stroke. The Stroke Transitions Education and Prevention (STEP) Clinic was established to provide a comprehensive approach to stroke risk factor reduction. METHODS AND ANALYSIS: This randomised comparative effectiveness study was designed to assess the impact of care in the STEP clinic versus usual care on poststroke BP reduction...
February 19, 2019: BMJ Open
Christopher R Friese, James Yang, Kari Mendelsohn-Victor, Marjorie McCullagh
OBJECTIVES: To evaluate whether a web-based educational intervention improved personal protective equipment (PPE) use among oncology nurses who handle hazardous drugs. SAMPLE & SETTING: From 2015 to 2017, the authors partnered with 12 ambulatory oncology settings in the United States to enroll 396 nurses, 257 of whom completed baseline and primary endpoint surveys. METHODS & VARIABLES: In a cluster randomized controlled trial, 136 nurses in control settings received a one-hour educational module on PPE use with quarterly reminders, and 121 nurses in treatment settings received the control intervention plus tailored messages to address perceived barriers and quarterly data gathered on hazardous drug spills across all study settings...
March 1, 2019: Oncology Nursing Forum
David Hui
Multiple randomized controlled trials have underscored the importance of timely referral to palliative care for patients with advanced cancer. Outpatient palliative care can facilitate timely referral and is increasingly available in many cancer centers. The key question is which model of outpatient palliative care is optimal. There are currently many variations for how palliative care is delivered in the outpatient setting, including (1) Interdisciplinary Specialist Palliative Care in Stand-Alone Clinics, (2) Physician-Only Specialist Palliative Care in Stand-Alone Clinics, (3) Nurse-Led Specialist Palliative Care in Stand-Alone Clinics, (4) Nurse-Led Specialist Palliative Care Telephone-Based Interventions, (5) Embedded Specialist Palliative Care with Variable Team Makeup, and (6) Advanced Practice Providers-Based Enhanced Primary Palliative Care...
February 11, 2019: Current Treatment Options in Oncology
Yumi Ohtawa, Mizuki Yoshida, Kenichi Fukuda
The purpose of this study was to survey parental satisfaction with ambulatory anesthesia during dental treatment in disabled patients. Factors associated with parental preference for general anesthesia during future dental treatment in such patients were also investigated. A questionnaire was mailed to the parents of 181 disabled individuals who underwent dental treatment under ambulatory anesthesia at Tokyo Dental College Suidobashi Hospital between 2012 and 2016. A total of 71 responses were received (39...
January 31, 2019: Bulletin of Tokyo Dental College
Scott D Nelson, Hayley H Rector, Daniel Brashear, Janos L Mathe, Haomin Wen, Stacey Lynn English, William Hedges, Christoph U Lehmann, Asli Ozdas-Weitkamp, Shane P Stenner
BACKGROUND:  Managing prescription renewal requests is a labor-intensive challenge in ambulatory care. In 2009, Vanderbilt University Medical Center developed clinic-specific standing prescription renewal orders that allowed nurses, under specific conditions, to authorize renewal requests. Formulary and authorization changes made maintaining these documents very challenging. OBJECTIVE:  This article aims to review, standardize, and restructure legacy standing prescription renewal orders into a modular, scalable, and easier to manage format for conversion and use in a new electronic health record (EHR)...
January 2019: Applied Clinical Informatics
Antje Freytag, Markus Krause, Anna Bauer, Bianka Ditscheid, Maximiliane Jansky, Sabine Krauss, Thomas Lehmann, Ursula Marschall, Friedemann Nauck, Werner Schneider, Kathleen Stichling, Horst Christian Vollmar, Ulrich Wedding, Winfried Meißner
BACKGROUND: Since 2007, the German statutory health insurance covers Specialized Outpatient Palliative Care (SAPV). SAPV offers team-based home care for patients with advanced and progressive disease, complex symptoms and life expectancy limited to days, weeks or months. The introduction of SAPV is ruled by a directive (SAPV directive). Within this regulation, SAPV delivery models can and do differ regarding team structures, financing models, cooperation with other care professionals and processes of care...
January 26, 2019: BMC Palliative Care
Rüdiger Leutgeb, Sarah Jane Berger, Joachim Szecsenyi, Gunter Laux
OBJECTIVES: Demand for nursing home (NH) care is soaring due to gains in life expectancy and people living longer with chronic illness and disability. This is dovetailing with workforce shortages across the healthcare profession. Access to timely and appropriate medical care for NH residents is becoming increasingly challenging and can result in potentially avoidable hospitalisations (PAHs). In light of these factors, we analysed PAHs comparing NH patients with non-NH patients. DESIGN: Cross-sectional study with claims data from 2015 supplied by a large German health insurance company within the federal state of Baden-Wuerttemberg...
January 21, 2019: BMJ Open
Alon Nevet
The Hillel Yaffe Medical Center began its journey sixty years ago. Since its early days, the hospital's dedicated teams have struggled to bridge the gaps between limited resources and their uncompromising desire to meet patients' needs. Today, Hillel Yaffe Medical Center possesses more than five hundred beds in approximately eighty departments and units and dozens of ambulatory clinics. The Medical Center serves a population of half a million residents, with forecasts pointing to unprecedented growth, due to vast construction in the area and the settlement of the new city of Harish...
January 2019: Harefuah
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