Development of coupled patient care experience courses to enhance patient care skills in the ambulatory and acute care settings

Introduction: In the Emergency Department (ED), increasing time pressures and acuity require physicians to have access to quick and reliable data to guide patient care decisions. Blood gases (BGs) allow quick access to key information, and are used frequently in the ED. Our objective was to review the literature on reliability and accuracy of electrolyte measurements obtained from BGs in high acuity settings. Methods: A comprehensive literature review was conducted in September of 2015. The search strategy, done in conjunction with a medical librarian, identified studies that assessed the accuracy of BGs when compared to traditional laboratory serum measurements. Prior to the review we determined sodium and potassium would be the area of focus. Eligibility parameters for the studies included samples from acute care areas - the ED and ICU - and a comparison of BG and serum values taken simultaneously from the patient. Results: Our review included 12 studies, 9 in adult and 3 in pediatrics. There were approximately 1,135 patients included, consisting of 851 adult and 284 pediatric cases. The results were mixed; 9 studies agreed that sodium and potassium readings from BGs were accurate enough to guide acute care decisions, 5 did not. Furthermore, important questions were raised regarding the varying accuracy of BGs depending on what physiological level the electrolytes were at during the time of collection, i.e. at critical vs non-critical levels. Conclusion: This is the first literature review to examine the existing evidence on the accuracy of BGs in acute care environments. Given the variability in the results, a larger study needs to be done to determine the validity and reliability of blood gases for electrolytes in acute care settings. Only by ensuring the accuracy of data collected via point-of-care BGs can the most informed decisions be made surrounding patient care in acute care settings.

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When time matters: The reality of patient care in acute care settings

International Journal of Nursing Practice ◽

10.1111/j.1440-172x.2011.01945.x ◽

2011 ◽

Vol 17 (4) ◽

pp. 388-395 ◽

Cited By ~ 1

Author(s):

Heleena Laitinen ◽

Marja Kaunonen ◽

Päivi Åstedt-Kurki

Keyword(s):

Patient Care ◽

Acute Care ◽

Acute Care Settings

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A Role to Alleviate Burnout and Maintain Quality of Care

Journal of the Advanced Practitioner in Oncology ◽

10.6004/jadpro.2021.12.2.7 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Jessica Zucker, RN, MSN, AGNP-BC ◽

Glen J. Peterson, RN, DNP, ACNP ◽

Angela Falco, RN, MS, MPH, FNP-C ◽

Jessica Casselberry, RN, MSN, ANP-BC, AOCNP

Keyword(s):

Health Care ◽

Patient Care ◽

Acute Care ◽

Health Care Providers ◽

Quality Care ◽

Treatment Options ◽

Care Providers ◽

University Of Colorado ◽

Acute Care Settings ◽

The University

Health care in acute care settings has become increasingly complex and stressful with rapidly evolving treatment options, a growing aging population with multiple comorbidities, and expectations to deliver high-quality care with less resources to curb rising costs. Numerous studies have documented the ever-growing problem of burnout in health-care providers working in acute care settings and increased provider interruptions leading to medical errors. From 2018 to 2019, a new advanced practice provider (APP) role was tested on a 36-bed inpatient bone marrow transplant unit at the University of Colorado to address these issues. The goal of this role was to alleviate stressors and minimize interruptions that could otherwise contribute to compromised patient care and safety. In addition to improving patient care, the goal of the role is to improve job satisfaction. A description of the role and its development and implementation at the University of Colorado Hospital, Anschutz Medical Campus, is highlighted in this article.

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What Evidence Informs the Nursing Care of People with Class III Obesity in an Acute Care Setting? A Scoping Review.

10.21203/rs.3.rs-31488/v1 ◽

2020 ◽

Author(s):

Beverley Ewens ◽

Vivien Kemp ◽

Amanda Towel-Barnard ◽

Lisa Whitehead

Keyword(s):

Patient Care ◽

Acute Care ◽

Nursing Care ◽

Scoping Review ◽

Improve Patient Care ◽

Well Being ◽

Class Iii ◽

Inclusion Criteria ◽

Class Iii Obesity ◽

Acute Care Settings

Abstract Background: Obesity is a complex psycho-social construct which is strongly linked with health and well-being. The health and socioeconomic impacts of obesity on individuals and health care systems can be significant. The nursing care of people with Class III obesity needs careful attention to ensure the provision of appropriate care. This scoping review aims to synthesise available evidence on the nursing care of Class III obese patients in acute care settings. Methods : A scoping review informed by the Joanna Briggs Institute approach was undertaken. We searched CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase databases for primary research articles relating to the nursing management of people classified as Class III obese in acute care settings. The methodological quality of all studies that met the inclusion criteria were assessed and data relating to methods and the findings extracted and synthesised into themes. Results : 3809 records were identified. Thirteen studies met the inclusion criteria and were included in the review. Three themes were generated from the synthesis of the findings: Access, knowledge and training related to equipment; Patient care; and Opportunities to improve care. Conclusions : The need for proactive planning to improve the nursing care provided to people classified as class III obese and admitted to acute care settings is vital. Access to appropriate equipment to support moving and handling and education on equipment use to prevent injury to both patients and staff is necessary. Education and support to promote engagement with patients, adapt nursing care practices and promote self-care have the potential to improve patient care and patient outcomes.

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Improving Patient Safety and Patient–Provider Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0021 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 1

Author(s):

Richard R. Hurtig ◽

Rebecca M. Alper ◽

Karen N. T. Bryant ◽

Krista R. Davidson ◽

Chelsea Bilskemper

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Health Care Team ◽

Provider Communication ◽

Alternative Communication ◽

Patient Provider Communication ◽

Acute Care Settings ◽

Nurses Perceptions ◽

Communication Needs ◽

The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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