The Role of Ultrasound in the Ambulatory Setting

It may be presumptuous to point out to pediatricians new ways of insuring that children have improved health care and the benefits of preventive pediatrics from early infancy. As a group, we have done a great deal in moving academic departments towards expanding the role of ambulatory services and making the ambulatory setting a place where exciting educational developments take place. We have also made a real contribution in bringing the needs of preventive pediatrics to the attention of various levels of government as well as incorporating outpatient departments as important sites for the teaching of medical students, house staff, and a wide variety of health professionals.

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The Changing Role of Monitored Anesthesia Care in the Ambulatory Setting

Anesthesia & Analgesia ◽

10.1097/00000539-199806000-00047 ◽

1998 ◽

Vol 86 (6) ◽

pp. 1336

Author(s):

Paul F. White ◽

Monica M. Sa Rego

Keyword(s):

Ambulatory Setting ◽

Anesthesia Care ◽

Monitored Anesthesia Care ◽

Changing Role

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Dalbavancin Use in the Emergency Department Setting

Annals of Pharmacotherapy ◽

10.1177/1060028019855159 ◽

2019 ◽

Vol 53 (11) ◽

pp. 1093-1101 ◽

Cited By ~ 7

Author(s):

Mitulkumar Patel ◽

Samantha Smalley ◽

Yanina Dubrovskaya ◽

Justin Siegfried ◽

Christopher Caspers ◽

...

Keyword(s):

Emergency Department ◽

Selection Criteria ◽

Primary Objective ◽

Ambulatory Setting ◽

Time To Recurrence ◽

Emergency Department Setting ◽

Patient Selection Criteria ◽

Dosing Strategy

Background: Although dalbavancin’s (DBV’s) long half-life and one-time dosing strategy confer ideal administration in the ambulatory setting, the optimal role of DBV in the management of acute bacterial skin and skin structure infections (ABSSSIs) remains to be elucidated. Objectives: The primary objective of this study was to compare treatment outcomes of ABSSSI between patients who received DBV in the emergency department (ED) as part of standard care versus patients who received DBV as part of a telehealth program. Methods: This was a retrospective cohort study evaluating patients who received DBV at 3 urban EDs. The primary end point was the incidence of ABSSSI recurrence. Secondary outcomes included need for hospital admission and ED length of stay (LOS; in hours). Results: A total of 65 ABSSSI treatment courses were included; 42 were included in the telehealth criteria (TC) cohort and 23 in the initial criteria (IC) cohort. There were 14% (6/42) infection recurrences in the TC cohort and 22% (5/23) in the IC cohort, with median time to recurrence being 4 and 14 days, respectively. Median ED LOS was significantly shorter in the TC (5 vs 25 hours, P < 0.05). Numerically fewer individuals in the TC cohort required inpatient admission (0 vs n = 2, 9%). Conclusion and Relevance: Our results suggest that patients may be safely administered DBV in an ED setting, with telehealth follow-up. Providing structured patient selection criteria is an effective method of assisting ED providers in selecting appropriate DBV candidates to limit potential recurrences and readmissions.

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The Changing Role of Monitored Anesthesia Care in the Ambulatory Setting

Anesthesia & Analgesia ◽

10.1097/00000539-199806000-00046 ◽

1998 ◽

Vol 86 (6) ◽

pp. 1335-1336

Author(s):

James R. Markey ◽

Raul Montiague ◽

Alon P. Winnie

Keyword(s):

Ambulatory Setting ◽

Anesthesia Care ◽

Monitored Anesthesia Care ◽

Changing Role

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Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age — A randomized control trial

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702521500098 ◽

2021 ◽

pp. 1-10

Author(s):

Frederico Ramos Pinto ◽

Ana Silva Alexandrino ◽

Liane Correia-Costa ◽

Ineˆs Azevedo

Keyword(s):

Emergency Room ◽

Positive Impact ◽

Intervention Group ◽

Chest Physiotherapy ◽

Ambulatory Setting ◽

Control Group ◽

Clinical Trial Registration ◽

Respiratory Status ◽

Intervention Protocol

Objective: The aim of this study was to compare the role of a chest physiotherapy (CP) intervention to no intervention on the respiratory status of children under two years of age, with mild-to-moderate bronchiolitis. Methods: Out of 80 eligible children observed in the Emergency Room, 45 children completed the study with 28 randomized to the intervention group and 17 to the control group. The intervention protocol, applied in an ambulatory setting, consisted of combined techniques of passive prolonged slow expiration, rhinopharyngeal clearance and provoked cough. The control group was assessed with no chest physiotherapy intervention. The efficacy of chest physiotherapy was assessed using the Kristjansson Respiratory Score at the admission and discharge of the visit to the Emergency Room and during clinical visits at day 7 and day 15. Results: There was a significant improvement in the Kristjansson Respiratory Score in the intervention group compared to the control group at day 15 [1.2 (1.5) versus 0.3 (0.5); [Formula: see text]-value[Formula: see text], in the control and intervention groups, respectively], with a mean difference (95% CI) of [Formula: see text] ([Formula: see text] to [Formula: see text]). Conclusion: Chest physiotherapy had a positive impact on the respiratory status of children with mild-to-moderate bronchiolitis. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04260919 .

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The Role of Advice in Medication Administration Errors in the Pediatric Ambulatory Setting

Journal of Patient Safety ◽

10.1097/pts.0b013e3181b3a9b0 ◽

2009 ◽

Vol 5 (3) ◽

pp. 168-175 ◽

Cited By ~ 17

Author(s):

Claire Lemer ◽

David W. Bates ◽

Catherine Yoon ◽

Carol Keohane ◽

Garrett Fitzmaurice ◽

...

Keyword(s):

Medication Administration ◽

Ambulatory Setting ◽

Medication Administration Errors

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INNV-18. THE AVAILABILITY AND ROLE OF CLINICAL PHARMACISTS IN THE AMBULATORY NEURO-ONCOLOGY SETTING: AN INTERNATIONAL SURVEY

Neuro-Oncology ◽

10.1093/neuonc/noz175.561 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi134-vi134

Author(s):

Mallika Patel ◽

Eric Lipp ◽

Elizabeth Miller Patrick Healy ◽

James Herndon ◽

Katherine Peters

Keyword(s):

Clinical Pharmacist ◽

Guideline Development ◽

Primary Brain Tumor ◽

Ambulatory Setting ◽

Oncology Patients ◽

Team Members ◽

Clinical Pharmacists ◽

Patient Interaction ◽

Academic Practices

Abstract BACKGROUND Outpatient clinics treating neuro-oncology patients are becoming more multidisciplinary. Utilization of all team members is critical for the holistic care of these complex patients. Specifically, the role of a clinical pharmacist in the ambulatory multidisciplinary clinic remains undefined and will likely evolve as more therapeutic options are developed to treat central nervous system malignancies. We queried the Society for Neuro-Oncology (SNO) membership about the availability of a clinical pharmacist in their ambulatory setting and, if present, the role of that clinical pharmacist. METHODS In an IRB exempt study, we surveyed the SNO community (targeting primarily clinicians) and analyzed responses to queries about clinical pharmacists in the ambulatory neuro-oncology setting. RESULTS Of the 65 SNO members who responded, 52 of these were clinical members. Of these 52 clinical members, the majority were physicians (88.5%, n=46). Of these 46 physicians, most were in academic practices (93.5%, n=43). Over half of the 52 clinical respondents (51.9%, n=27) reported that they saw ≥ 30 primary brain tumor patients a month, thus typifying busy clinical neuro-oncology ambulatory clinics. Despite having busy clinics, only 12 (28.6%) of the 42 providers with access to a clinical pharmacist reported that their clinical pharmacist was solely dedicated to neuro-oncology patients. For the respondents who had access to a clinical pharmacist, only 28 (66.7%) of those pharmacists had direct patient interaction in the clinic. The top three roles of the clinical pharmacist included medication review (81%, n=34), chemotherapy dosing and modifications (73.8%, n=31), and practice guideline development (61.9%, n=26), none of which are associated with direct patient interaction. CONCLUSIONS We found that while our surveyed population of SNO clinical members have demanding outpatient neuro-oncology practices, most do not have the support or expertise of dedicated neuro-oncology clinical pharmacists.

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