Sustained effects of a visual prompt on dish storage in a hospital unit

2014 ◽  
Vol 47 (4) ◽  
pp. 845-849 ◽  
Author(s):  
Emily K. Rubio ◽  
Sigurdur O. Sigurdsson
Keyword(s):  
Hospital Unit ◽  
Sustained Effects ◽  
Visual Prompt

A Special Mental Hospital Unit for the Treatment of Psychosis and Neurosis in Juveniles

1953 ◽  
Vol 99 (414) ◽  
pp. 123-129 ◽  
Author(s):  
Dalton E. Sands
Keyword(s):  
Mental Hospital ◽  
Psychiatric Illness ◽  
Adult Patients ◽  
Hospital Unit ◽  
Hospital Practice ◽  
Special Unit ◽  
The Past ◽  
Mental Hospitals ◽  
End Results

Since the treatment of juveniles as in-patients in a special unit is somewhat unusual in mental hospital practice, a brief introduction may not be out of place. These units might be considered as another development in a trend which has been progressing for the past 25 years. Until 1930 certification of all admissions to mental hospitals and a mainly custodial régime ensured the majority of patients being largely the end-results of psychiatric illness. Since 1930 the steadily increasing use of the voluntary system has brought many patients to hospital at a stage when their illness can be favourably influenced by modern therapeutic methods. An associated development was the increased provision of wards or units separate from the chronically disturbed cases, or even, as at this hospital, a complete villa system of detached and semi-detached wards for mainly voluntary adult patients.

scholarly journals Managing Anemia across the Stages of Kidney Disease in Those Hyporesponsive to Erythropoiesis-Stimulating Agents

2021 ◽  
Vol 52 (6) ◽  
pp. 450-466
Author(s):  
Matthew R. Weir
Keyword(s):  
Drug Targets ◽  
Iron Status ◽  
Therapeutic Option ◽  
Attractive Potential ◽  
Dialysis Modality ◽  
Erythroid Progenitors ◽  
Prolyl Hydroxylases ◽  
Erythropoiesis Stimulating Agents ◽  
Sustained Effects ◽  
Concomitant Medications

<b><i>Background:</i></b> Patients with CKD frequently have anemia that results from iron-restricted erythropoiesis and inflammation. Anemia of CKD is currently managed with iron supplements and erythropoiesis-stimulating agents (ESAs) to promote erythropoiesis and with RBC transfusion in severe cases. Hyporesponse to ESAs, or the need for larger than usual doses to attain a given hemoglobin (Hb) level, is associated with increased morbidity and mortality and presents a pressing clinical challenge, particularly for patients on dialysis. This paper reviews ESA hyporesponse and potential new therapeutic options in the management of anemia of CKD. <b><i>Summary:</i></b> The most common causes of ESA hyporesponse include iron deficiency and inflammation, and to a lesser degree, secondary hyperparathyroidism, inadequate dialysis, malnutrition, and concomitant medications. Management of ESA hyporesponse is multipronged and involves treating low level infections, ensuring adequate nutrition, and optimizing iron status and dialysis modality, although some patients can remain refractory. Inflammation directly increases production and secretion of hepcidin, contributes to an impaired response to hypoxia, and suppresses proliferation of erythroid progenitors. Coordination of renal and hepatic erythropoietin (EPO) production and iron metabolism is under the control of hypoxia-inducible factors (HIF), which are in turn regulated by HIF-prolyl hydroxylases (HIF-PHs). HIF-PHs and hepcidin are therefore attractive potential drug targets particularly in patients with ESA hyporesponse. Several oral HIF-PH inhibitors have been evaluated in patients with anemia of CKD and have been shown to increase Hb and reduce hepcidin regardless of inflammation, iron status, or dialysis modality. These sustained effects are achieved through more modest increases in endogenous EPO compared with ESAs. <b><i>Key Messages:</i></b> Treatments that address ESA hyporesponse remain a significant unmet clinical need in patients with anemia of CKD. New therapies such as HIF-PH inhibitors have the potential to address fundamental aspects of ESA hyporesponse and provide a new therapeutic option in these patients.

scholarly journals Decreased Wait Time and Increased Satisfaction With Bedside Pancreatic Enzyme Dosing for the Inpatient Adolescent With Cystic Fibrosis: A Quality Improvement Project Comparing Enzyme Self-Administration to Nurse Administration

2021 ◽  
Vol 8 ◽  
pp. 237437352098149
Author(s):  
Brandi Middour-Oxler ◽  
Margaret Gettis ◽  
Betsy Dye
Keyword(s):  
Cystic Fibrosis ◽  
Pancreatic Enzyme ◽  
Wait Time ◽  
Self Administration ◽  
Nurse Satisfaction ◽  
Improvement Project ◽  
Hospital Unit ◽  
Pediatric Inpatient ◽  
Inpatient Adolescent ◽  
Enzyme Delivery

For children with cystic fibrosis (CF), enzymes are essential with meals to absorb nutrients and ensure adequate growth. When hospitalized, CF patients typically rely on nurse-administered medications. Recently, a pediatric hospital unit began allowing adolescents with CF enzymes at the bedside. Postimplementation, a satisfaction questionnaire was administered to participating patients and nurses measuring patient and nurse satisfaction with access to bedside enzymes versus nurse administration and overall time for enzyme delivery. The survey utilized a 5-point Likert scale. The wait time for pancreatic enzymes decreased for self-administered enzymes when compared to those that were nurse administered. All (11/11) patients and 86% (12/14) of nurses preferred the self-administration of enzymes. Hospitalized pediatric CF patients and nurses had higher levels of satisfaction with enzyme self-administration. Immediate access to enzymes in room safes impact patient autonomy, reflecting home self-care practices. Decreases in wait times optimize nutritional growth and healing while hospitalized. As a result, a new limited scope policy allowing patient-administered enzymes is now in place in the pediatric inpatient CF unit.

Functional Communication Training and Most-To-Least Prompting as Treatments for Problem Behavior

2021 ◽  
pp. 153465012110302
Author(s):  
Judah B. Axe ◽  
Corinne M. Murphy ◽  
William L. Heward
Keyword(s):  
Problem Behavior ◽  
Functional Communication Training ◽  
Communication Training ◽  
Functional Communication ◽  
Communicative Behavior ◽  
Severe Developmental Disabilities ◽  
Abolishing Operation ◽  
Academic Responding ◽  
Multiple Treatments ◽  
Visual Prompt

Functional communication training (FCT) is a treatment for problem behavior in which the learner is taught a communicative behavior that fulfills the same function as the problem behavior. Although effective, when FCT is used to request breaks from work, limitations include increased time spent in breaks and reduced task-related responding. An alternative treatment is most-to-least prompting (MTL) of a task in which a therapist provides the most helpful prompts for task-related responding (e.g., physical guidance) and gradually reduces the amount of help (e.g., visual prompt and then verbal) until the learner responds independently. We evaluated FCT and MTL in a multiple treatments design with an 11-year-old girl with severe developmental disabilities. Both treatments reduced problem behavior from baseline levels, and academic responding was greater during MTL than during FCT. MTL is an errorless teaching approach conceptualized as an abolishing operation that reduces the aversiveness of a task and makes escape less valuable.

Perceived treatment difficulty and therapeutic alliance on an adolescent psychiatric hospital unit.

1991 ◽  
Vol 61 (2) ◽  
pp. 221-229 ◽  
Author(s):  
Donald B. Colson ◽  
Carol Cornsweet ◽  
Thomas Murphy ◽  
Flynn O'Malley ◽  
Patricia S. Hyland ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Psychiatric Hospital ◽  
Hospital Unit

scholarly journals Barriers to Physical Distancing among Healthcare Workers on an Academic Hospital Unit During the COVID-19 Pandemic

2021 ◽  
pp. 1-26
Author(s):  
Sara C. Keller ◽  
Sara Pau ◽  
Alejandra B. Salinas ◽  
Opeyemi Oladapo-Shittu ◽  
Sara E. Cosgrove ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Peer Leaders ◽  
Human Factors Engineering ◽  
Structured Interviews ◽  
Hospital Unit ◽  
Positive Behaviors ◽  
Cognitive Aids ◽  
Close Proximity

Abstract Background: Physical distancing among healthcare workers (HCW) is an essential strategy in preventing HCW-to-HCW transmission of the SARS-CoV-2 virus. Objective: To understand barriers to physical distancing among HCW on an inpatient unit and identify strategies for improvement. Design: Qualitative study including observations and semi-structured interviews over three months. Setting: A non-COVID adult general medical unit in an academic tertiary hospital. Participants: HCWs based on the unit. Methods: We performed a qualitative study in which we (1) observed HCWs activities and proximity to each other on the unit during weekday shifts July-October 2020 and (2) conducted semi-structured interviews of HCWs to understand their experiences with and perspectives of physical distancing in the hospital. Qualitative data were coded based on a human factors engineering model. Results: We completed 25 hours of observations and 20 HCW interviews. High-risk interactions often occurred during handoffs of care at shift changes and patient rounds, where HCWs gathered regularly in close proximity for at least 15 minutes. Identified barriers included spacing and availability of computers, the need to communicate confidential patient information, and the desire to maintain relationships at work. Conclusions: Physical distancing can be improved in hospitals by restructuring computer workstations, work rooms, and breakrooms; applying visible cognitive aids; adapting shift times; and supporting rounds and meetings with virtual conferencing. Additional strategies to promote staff adherence to physical distancing include rewarding positive behaviors, having peer leaders model physical distancing, and encouraging additional safe avenues for social connection at a safe distance.

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