Antibody-Mediated Encephalitis in Children: Focus on Diagnostic Clues and Acute Symptom Management

2021 ◽  
Vol 37 ◽  
pp. 100873
Author(s):  
Melissa L. Hutchinson ◽  
Anusha K. Yeshokumar ◽  
Thaís Armangue
Keyword(s):  
Symptom Management ◽  
Acute Symptom

Implementation of Symptom Care Clinic (SCC) for acute symptoms management at outpatient oncology ambulatory centers.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2030-2030
Author(s):  
Han Xiao ◽  
Rosanna Fahy ◽  
Rori Salvaggio ◽  
Maryellen OSullivan ◽  
Desiree Sokoli ◽  
...  
Keyword(s):  
Patient Experience ◽  
Symptom Management ◽  
Cancer Survival ◽  
Care Center ◽  
Urgent Care ◽  
Recidivism Rate ◽  
Time Saving ◽  
Care Clinic ◽  
Acute Symptom ◽  
Ambulatory Oncology

2030 Background: With improved overall cancer survival, increasing number of cancer patients are undergoing active treatment. This, in return, add burden in acute symptom management related to disease and treatment. This has resulted in increasing unplanned emergency room (ER) visits and negatively impacted patients experience and health cost. We establish Symptom Care Clinic (SCC) embedded in suburban ambulatory oncology centers to reduce unplanned ER lists and to improve patient experience. Methods: Together with all stakeholders, we developed six SCCs at regional ambulatory centers in NY and NJ. Clearly defined work flow and algorithm were developed to ensure appropriate patient referral. On-site radiology and laboratory services are available. The SCCs are staffed with combination of Advanced Practice Provided (APP) and physicians or APP alone supported by on site medical oncologist or remote central Urgent Care Center Attendings. We evaluated clinic volumes, reduction ins unplanned ER visits and patient experience. Results: From October 2017 to December 2019, total of 17,542 SCC visits were documented. Total of 17,479 lab and 5,355 radiology tests as well as 3,915 infusions were performed. The top five most common laboratory tests are CBC, blood cultures, CMP, respiratory panel and urine culture. The most common symptoms are fever, nausea/vomiting/dehydration, rash and pain. Among all SCC visits during this period, 83% were discharged home and 17% were transferred to ER or hospitals. During 2019, total 10,736 SCC visits were recored, APP evaluated 73.7% of visits and physicians 16.3% with comaprable recidivism rate, 2.52% and 2.75%, respectively. Conservatively, we estimated that approximately 40% of visits would have been Er visits based on numbers of CBC and other testes performed. Qualitative feedbacks from patients indicated positive experience in convenient access, cohesive care coordination and time saving from traveling to and waiting in ER. Conclusions: We successfully implemented an effective acute symptom management system in busy ambulatory oncology centers that is patient centric. Out data showed that SCC reduced unplanned ER visits and that APP/physician model has low recidivism rate.

scholarly journals Availability of Heart Failure Medications in Hospice Care

2016 ◽  
Vol 33 (10) ◽  
pp. 924-928 ◽  
Author(s):  
Hillary D. Lum ◽  
Carolyn Horney ◽  
David Koets ◽  
Jean S. Kutner ◽  
Daniel D. Matlock
Keyword(s):  
Heart Failure ◽  
Symptom Management ◽  
Hospice Care ◽  
Inotropic Therapy ◽  
Acute Symptom ◽  
Home Medication ◽  
Patients With Heart Failure ◽  
Hospice Patients ◽  
Individualized Approach ◽  
Cardiac Medication

Background: Availability of cardiac medications in hospice for acute symptom management of heart failure is unknown. This study explored hospice approaches to cardiac medications for patients with heart failure. Methods: Descriptive study using a quantitative survey of 46 US hospice agencies and clinician interviews. Results: Of 31 hospices that provided standard home medication kits for acute symptom management, only 1 provided medication with cardiac indications (oral furosemide). Only 22% of the hospice agencies had a specific cardiac medication kit. Just over half (57%) of the agencies could provide intravenous inotropic therapy, often in multiple hospice settings. Clinicians described an individualized approach to cardiac medications for patients with heart failure. Conclusion: This study highlights opportunities for practice guidelines that inform medical therapy for hospice patients with heart failure.

scholarly journals What are the perceived influences on asthma self-management at the workplace? A qualitative study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022126 ◽  
Author(s):  
Katherina Heinrichs ◽  
Patricia Vu-Eickmann ◽  
Stefan Hummel ◽  
Jalal Gholami ◽  
Adrian Loerbroks
Keyword(s):  
Social Support ◽  
Qualitative Study ◽  
Symptom Management ◽  
Qualitative Content Analysis ◽  
Influential Factors ◽  
Self Management ◽  
Chronic Obstructive ◽  
Successful Implementation ◽  
Symptom Monitoring ◽  
Acute Symptom

ObjectivesAsthma can represent a substantial challenge to the affected individual, but is usually well controlled by adequate asthma self-management behaviour (SMB). Asthma SMB comprises symptom prevention, symptom monitoring, acute symptom management and communication with important others. The implementation of asthma SMB seems to depend on contextual factors. For employed adults, working conditions may be important in this respect. We, therefore, aimed to explore the perceived influences on effective asthma SMB at work.DesignOur qualitative study built on semi-structured interviews and qualitative content analysis.SettingParticipants were recruited in two pulmonary rehabilitation clinics in Northern Germany.ParticipantsWe conducted 27 interviews among employees with asthma (female: n=15) who worked at least 20 hours per week and were diagnosed with asthma at least 6 months prior to interviewing. Patients with chronic obstructive pulmonary disease were excluded.ResultsAccording to participants, the most influential factors with regard to asthma SMB at work appeared to be job decision latitude (JDL) and social support. JDL (ie, the control over one’s tasks and when and how things were done) was perceived to affect symptom prevention, symptom monitoring, and acute symptom management, but not communication. Support by colleagues, line managers, and the employer, for example, practical, emotional, or structural support, was perceived to exert effects on symptom prevention, acute symptom management, and communication (ie, self-disclosure of one’s condition).ConclusionsPerceived JDL and social support were experienced as influencing successful implementation of asthma SMB at the workplace.Trial registration numberGerman Clinical Trials Register no: DRKS00011309.

60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
J. Downar ◽  
J. Mikhael
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Clinical Teaching ◽  
Intervention Group ◽  
Comfort Level ◽  
Control Group ◽  
Life Care ◽  
Comfort Levels

Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units. Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care. Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation. In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units. Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32. Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610. Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.

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