scholarly journals Beyond EMT 2 Minimum Standards

2019 ◽  
Vol 34 (s1) ◽  
pp. s24-s24
Author(s):  
Dianne Stephens ◽  
Jane Thomas
Keyword(s):  
Best Practice ◽  
Gap Analysis ◽  
Clinical Care ◽  
National Standards ◽  
Hospital Environment ◽  
World Health ◽  
Field Hospital ◽  
Minimum Standards ◽  
Accreditation Standards ◽  
Minimum Requirements

Introduction:The World Health Organization’s (WHO) minimum standards are used to verify Emergency Medical Teams (EMTs) internationally. The National Critical Care and Trauma Response Center (NCCTRC) was one of the first few EMT 2 verified teams globally.Aim:The NCCTRC aims to innovate and provide leadership in the provision of best practice clinical care in the EMT 2 setting in disaster-affected countries.Methods:The NCCTRC developed a clinical governance framework and committee with a view of improving practice in the deployed environment. A gap analysis against the Australian National Standards was done and a decision was made to proceed with accreditation against the ACHS EQUIP 6 framework.Results:The process of accreditation required a self-assessment that identified gaps in our guidelines and care processes thereby leading to innovative projects to meet the criterion in a sustainable way for the deployed field hospital environment. The NCCTRC has developed adapted clinical tools to manage pressure injury, falls risk, handover, hand hygiene, audits, and consumer feedback.Discussion:The deployed field hospital environment can meet national accreditation standards for clinical care. The WHO minimum standards were introduced in 2013 and serve as a marker of the minimum requirements in the field. The challenge is to do better than the minimum. This study demonstrated that it is possible to adapt hospital accreditation standards to the field environment and provide a higher, safer quality of care to affected populations. EMT teams should maintain their clinical care standards from their home environment wherever possible in the field hospital environment. Striving to provide the best and safest care is the duty of care for vulnerable populations.

Preventing Suicide in Detention and Correctional Facilities

2016 ◽  
Author(s):  
Robert D. Canning ◽  
Joel A. Dvoskin
Keyword(s):  
Suicide Prevention ◽  
Best Practice ◽  
Suicide Attempts ◽  
Clinical Care ◽  
The United States ◽  
National Standards ◽  
Individual Risk ◽  
Correctional Facilities ◽  
Prevention Strategies ◽  
Essential Components

This essay describes and critiques suicide-prevention strategies in prison, including the extent to which screening and prevention programs are used in the United States. The epidemiology of suicide and suicide attempts in both jails and prisons is reviewed, with discussions of differences in suicide risk by demographic factors, individual risk and suicide protective factors, and contextual factors. A cross-section of legal cases leading to the establishment of a legal basis for suicide prevention in US correctional facilities is provided, followed by an overview of current national standards and best practice guidelines for preventing inmate suicides. The essential components of correctional suicide-prevention strategies are described and critiqued, including core values at the center of these strategies, aspects of most effective systems management, and evidenced-based clinical care. Finally, special considerations for different types of confinement settings are described.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

Aligning the flow cytometric evaluation with the diagnostic need: an evidence-based approach

2017 ◽  
Vol 70 (9) ◽  
pp. 740-744 ◽  
Author(s):  
Dawn Williams-Voorbeijtel ◽  
Francisco Sanchez ◽  
Christine G Roth
Keyword(s):  
Clinical Care ◽  
Cost Savings ◽  
Value Added ◽  
Cost Effective ◽  
Just In Time ◽  
Evidence Based ◽  
Flow Cytometric ◽  
A Value ◽  
Screening Approach ◽  
Minimum Requirements

AimsElimination of non-value added testing without compromising high-quality clinical care is an important mandate for laboratories in a value-based reimbursement system. The goal of this study was to determine the optimal combination of flow cytometric markers for a screening approach that balances efficiency and accuracy.MethodsAn audit over 9 months of flow cytometric testing was performed, including rereview of all dot plots from positive cases.ResultsOf the 807 cases in which leukaemia/lymphoma testing was performed, 23 were non-diagnostic and 189 represented bronchoalveolar lavage specimens. Of the remaining 595 cases, 137 (23%) were positive for an abnormal haematolymphoid population. Review of the positive cases identified minimum requirements for a screening tube as well as analysis strategies to overcome the diagnostic pitfalls noted. It is estimated that 38% fewer antibodies would be used in a screening approach, representing an opportunity for significant cost savings.ConclusionsWe provide a framework for developing an evidence-based screening combination for cost-effective characterisation of haematolymphoid malignancies, promoting adoption of ‘just-in-time’ testing systems that tailor the evaluation to the diagnostic need.

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

Evidence-based guidelines for acute stabilization and management of neonates with persistent pulmonary hypertension of the newborn

2021 ◽  
Author(s):  
Molly K Ball ◽  
Ruth Seabrook ◽  
Elizabeth M Bonachea ◽  
Bernadette Chen ◽  
Omid Fathi ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neonatal Intensive Care ◽  
Best Practice ◽  
Clinical Care ◽  
Persistent Pulmonary Hypertension ◽  
High Morbidity ◽  
Evidence Based ◽  
Extensive Literature ◽  
Disciplinary Expertise ◽  
Evidence Based Guidelines

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

scholarly journals Enterprise Content Management Implementation: An Overview of Phases, Standards and Best Practice Guidelines

2012 ◽  
Vol 13 (2) ◽  
pp. 457-476
Author(s):  
Shadrack Katuu
Keyword(s):  
Practice Guidelines ◽  
Best Practice ◽  
Gap Analysis ◽  
Content Management ◽  
Digital Content ◽  
Review Of Literature ◽  
Software Applications ◽  
Best Practice Guidelines ◽  
Application Systems ◽  
Enterprise Content Management

The management of digital records has been a subject of numerous scholarly discussions for several years. Discussions on the application systems used to manage these records and other digital content have often used diff erent terminology, frequently interchangeably, with little regard to nuanced diff erences. In addition, a number of standards and best practice guidelines have been developed in diff erent countries to address the challenges of assessing and implementing these applications. While it may look like a lot of resources are available to records professionals as they tackle the challenges of implementing software applications, there is need to clarify terminology and identify implementation phases, as well, as the appropriate standards and best practice guidelines. This article, using primarily a review of literature, suggests definitional clarity and connectedness of diff erent terms used for Enterprise Content Management (ECM) applications. It identifies the various phases of implementation of ECM applications and off ers an overview of standards and best practice guidelines. Lastly it provides an assessment of the connection between phases of implementation in relation to standards and best practice guidelines, providing a gap analysis while also suggesting ways of addressing the variance.

scholarly journals International Interprofessional Collaborative Office Rounds (iiCOR): Addressing Children's Developmental, Behavioral, and Emotional Health Using Distance Technology

2021 ◽  
Vol 9 ◽  
Author(s):  
Jennifer S. H. Kiing ◽  
Heidi M. Feldman ◽  
Chris Ladish ◽  
Roopa Srinivasan ◽  
Craig L. Donnelly ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Best Practice ◽  
Emotional Health ◽  
Clinical Care ◽  
Learning Technology ◽  
Cultural Variation ◽  
Co Morbidity

Developmental, behavioral, and emotional issues are highly prevalent among children across the globe. Among children living in low- and middle-income countries, these conditions are leading contributors to the global burden of disease. A lack of skilled professionals limits developmental and mental health care services to affected children globally. Collaborative Office Rounds are interprofessional groups that meet regularly to discuss actual cases from the participants' practices using a non-hierarchical, peer-mentoring approach. In 2017, International Interprofessional Collaborative Office Rounds was launched with several goals: to improve the knowledge and skills of practicing child health professionals in high and low resourced settings regarding developmental and mental health care, to support trainees and clinicians in caring for these children, and to promote best practice in diagnosis and management of these conditions. Five nodes, each comprised of 3–4 different sites with an interprofessional team, from 8 countries in North America, Africa, Asia, and South America met monthly via videoconferencing. This report describes and evaluates the first 2 years' experience. Baseline surveys from participants (N = 141) found that 13 disciplines were represented. Qualitative analysis of 51 discussed cases, revealed that all cases were highly complex. More than half of the cases (N = 26) discussed children with autism or traits of autism and almost all (N = 49) had three or more themes discussed. Frequently occurring themes included social determinants of health (N = 31), psychiatric co-morbidity (N = 31), aggression and self-injury (N = 25), differences with the healthcare provider (N = 17), cultural variation in accepting diagnosis or treatment (N = 19), and guidance on gender and sexuality issues (N = 8). Participants generally sought recommendations on next steps in clinical care or management. A survey of participants after year 1 (N = 47) revealed that 87% (N = 41) had expectations that were completely or mostly met by the program. Our experience of regular meetings of interprofessional groups from different countries using distance-learning technology allowed participants to share on overlapping challenges, meet continuing educational needs while learning about different approaches in high- and low-resourced settings. International Interprofessional Collaborative Office Rounds may prove a useful strategy for increasing the work force capacity for addressing developmental, behavioral, and emotional conditions worldwide. More systematic studies are needed.

World psychiatric association task force on best practice in working with service users and carers

2011 ◽  
Vol 26 (S2) ◽  
pp. 2103-2103
Author(s):  
H. Herrman
Keyword(s):  
Mental Health ◽  
Best Practice ◽  
Task Force ◽  
Action Plan ◽  
Clinical Care ◽  
Service Users ◽  
Standing Committee ◽  
Health Community ◽  
Extensive Consultation ◽  
Essential Contribution

The WPA has invited service users and family carers to join in its work as members of a taskforce, recognising their essential contribution to improving mental health in any country. WPA President Prof. Mario Maj established the project within the WPA Action Plan 2008 to 2011. The taskforce has prepared recommendations for the international mental health community on best practices in working with service users and carers. It has also worked with the WPA Standing Committee on Ethics to prepare a new paragraph for the WPA Declaration of Madrid. The WHO Department of Mental Health has offered its experience and advice.Ten recommendations are ready for dissemination after extensive consultation. Each country will need specific guidelines to apply these recommendations. The recommendations begin by declaration that respecting human rights is the basis of successful partnerships for mental health. The second recommendation is that legislation, policy and clinical practice relevant to the lives and care of people with mental disorders need to be developed in collaboration with users and carers. The series continues with a recommendation that the best clinical care of any person in acute or rehabilitation situations is done in collaboration between the user, the carers and the clinicians. Education, research and quality improvement in mental health care also require this collaboration. The next step is developing a series of projects to apply these broad principles in each country and local communities. The WPA hopes to support partnership and participatory developments worldwide, and learn from these experiences.

scholarly journals Oral care after stroke: Where are we now?

2018 ◽  
Vol 3 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Mary Lyons ◽  
Craig Smith ◽  
Elizabeth Boaden ◽  
Marian C Brady ◽  
Paul Brocklehurst ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Best Practice ◽  
Clinical Care ◽  
Oral Care ◽  
Research Priorities ◽  
Stroke Care ◽  
Weak Evidence ◽  
Perspective Drawing ◽  
Increased Risk ◽  
Risk Of Aspiration

Purpose There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia – a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. Methods A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities. Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. Discussion Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. Conclusion Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.

scholarly journals Framing advance care planning in Parkinson disease

Neurology ◽  
2019 ◽  
Vol 92 (22) ◽  
pp. e2571-e2579 ◽  
Author(s):  
Hillary D. Lum ◽  
Sarah R. Jordan ◽  
Adreanne Brungardt ◽  
Roman Ayele ◽  
Maya Katz ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Advance Care Planning ◽  
Best Practice ◽  
Clinical Care ◽  
Active Role ◽  
Care Planning ◽  
Care Partners ◽  
Interdisciplinary Approaches ◽  
Advance Care ◽  
Partner Perceptions

ObjectiveAdvance care planning (ACP) is a core quality measure in caring for individuals with Parkinson disease (PD) and there are no best practice standards for how to incorporate ACP into PD care. This study describes patient and care partner perspectives on ACP to inform a patient- and care partner-centered framework for clinical care.MethodsThis is a qualitative descriptive study of 30 patients with PD and 30 care partners within a multisite, randomized clinical trial of neuropalliative care compared to standard care. Participants were individually interviewed about perspectives on ACP, including prior and current experiences, barriers to ACP, and suggestions for integration into care. Interviews were analyzed using theme analysis to identify key themes.ResultsFour themes illustrate how patients and care partners perceive ACP as part of clinical care: (1) personal definitions of ACP vary in the context of PD; (2) patient, relationship, and health care system barriers exist to engaging in ACP; (3) care partners play an active role in ACP; (4) a palliative care approach positively influences ACP. Taken together, the themes support clinician initiation of ACP discussions and interdisciplinary approaches to help patients and care partners overcome barriers to ACP.ConclusionsACP in PD may be influenced by patient and care partner perceptions and misperceptions, symptoms of PD (e.g., apathy, cognitive dysfunction, disease severity), and models of clinical care. Optimal engagement of patients with PD and care partners in ACP should proactively address misperceptions of ACP and utilize clinic teams and workflow routines to incorporate ACP into regular care.

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