A Preliminary Study of Nursing Practice Patterns Concerning Dysphagia Diet Modification: Implications for Interprofessional Education With SLPs

Purpose Speech-language pathologists (SLPs) are trained to evaluate and treat dysphagia. One treatment method is to modify diet consistency or viscosity to compensate for swallowing dysfunction and promote a safer intake; this typically involves softening solids and thickening liquids. Thickening liquids is not safer for all patients, and modification of dysphagia diets without adequate training may reduce the quality of dysphagia patient care. Over 90% of SLPs working in health care report exposure to nurses who regularly downgrade dysphagia diets without an SLP consult. This study explores dysphagia diet modification practices of nursing staff with and without dysphagia training. Method Practicing nurses and student nurses ( N = 298) in the United States were surveyed regarding their dysphagia diet modification training and practice patterns. Additionally, a pre-/posttest design was used to determine the efficacy of a short general tutorial on willingness to modify diets without an SLP consult. Results Downgrading diets without an SLP consult is a common practice. Fewer than one third of nurses (31.41%) would avoid it, whereas 73.65% would avoid upgrading without SLP consult. Formal dysphagia training made little difference to this practice. The short general tutorial also had no beneficial effect, in fact slightly reducing the willingness to consult SLPs. Conclusions Dysphagia diet modification practice by nurses is pervasive in U.S. health care. This is a previously unexplored but common issue SLPs face in work settings. This study identifies a need to clarify guidelines and increase interprofessional education between both professions to improve patient care.

Download Full-text

A Web- and App-Based Connected Care Solution for COVID-19 In- and Outpatient Care: Qualitative Study and Application Development (Preprint)

10.2196/preprints.19033 ◽

2020 ◽

Author(s):

Timo Schinköthe ◽

Mariano Rolando Gabri ◽

Manfred Mitterer ◽

Pedro Gouveia ◽

Volker Heinemann ◽

...

Keyword(s):

Health Care ◽

Patient Care ◽

Health Care Professionals ◽

Outpatient Care ◽

Digital Health ◽

Improve Patient Care ◽

The United States ◽

Application Development ◽

Absolute Minimum ◽

First Choice

BACKGROUND From the perspective of health care professionals, coronavirus disease (COVID-19) brings many challenges as well as opportunities for digital health care. One challenge is that health care professionals are at high risk of infection themselves. Therefore, in-person visits need to be reduced to an absolute minimum. Connected care solutions, including telehealth, remote patient monitoring, and secure communications between clinicians and their patients, may rapidly become the first choice in such public health emergencies. OBJECTIVE The aim of the COVID-19 Caregiver Cockpit (C19CC) was to implement a free-of-charge, web- and app-based tool for patient assessment to assist health care professionals working in the COVID-19 environment. METHODS Physicians in Argentina, Germany, Iran, Italy, Portugal, Switzerland, and the United States explained their challenges with COVID-19 patient care through unstructured interviews. Based on the collected feedback, the first version of the C19CC was built. In the second round of interviews, the application was presented to physicians, and more feedback was obtained. RESULTS Physicians identified a number of different scenarios where telemedicine or connected care solutions could rapidly improve patient care. These scenarios included outpatient care, discharge management, remote tracking of patients with chronic diseases, as well as incorporating infected physicians under quarantine into telehealth services. CONCLUSIONS The C19CC is the result of an agile and iterative development process that complements the work of physicians. It aims to improve the care and safety of people who are infected by COVID-19.

Download Full-text

A Web- and App-Based Connected Care Solution for COVID-19 In- and Outpatient Care: Qualitative Study and Application Development

JMIR Public Health and Surveillance ◽

10.2196/19033 ◽

2020 ◽

Vol 6 (2) ◽

pp. e19033 ◽

Cited By ~ 10

Author(s):

Timo Schinköthe ◽

Mariano Rolando Gabri ◽

Manfred Mitterer ◽

Pedro Gouveia ◽

Volker Heinemann ◽

...

Keyword(s):

Health Care ◽

Patient Care ◽

Health Care Professionals ◽

Outpatient Care ◽

Digital Health ◽

Improve Patient Care ◽

The United States ◽

Application Development ◽

Absolute Minimum ◽

First Choice

Background From the perspective of health care professionals, coronavirus disease (COVID-19) brings many challenges as well as opportunities for digital health care. One challenge is that health care professionals are at high risk of infection themselves. Therefore, in-person visits need to be reduced to an absolute minimum. Connected care solutions, including telehealth, remote patient monitoring, and secure communications between clinicians and their patients, may rapidly become the first choice in such public health emergencies. Objective The aim of the COVID-19 Caregiver Cockpit (C19CC) was to implement a free-of-charge, web- and app-based tool for patient assessment to assist health care professionals working in the COVID-19 environment. Methods Physicians in Argentina, Germany, Iran, Italy, Portugal, Switzerland, and the United States explained their challenges with COVID-19 patient care through unstructured interviews. Based on the collected feedback, the first version of the C19CC was built. In the second round of interviews, the application was presented to physicians, and more feedback was obtained. Results Physicians identified a number of different scenarios where telemedicine or connected care solutions could rapidly improve patient care. These scenarios included outpatient care, discharge management, remote tracking of patients with chronic diseases, as well as incorporating infected physicians under quarantine into telehealth services. Conclusions The C19CC is the result of an agile and iterative development process that complements the work of physicians. It aims to improve the care and safety of people who are infected by COVID-19.

Download Full-text

Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00078 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1175-1187

Author(s):

Rachel Glade ◽

Erin Taylor ◽

Deborah S. Culbertson ◽

Christin Ray

Keyword(s):

Health Care ◽

Clinical Practice ◽

Cochlear Implants ◽

Practice Patterns ◽

The United States ◽

Care Providers ◽

Aural Rehabilitation ◽

Starting Point ◽

Clinical Models ◽

Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

Download Full-text

Empowering Health Care Professionals: An Interprofessional Education Model Implementation and Evaluation

10.31219/osf.io/emz4c ◽

2019 ◽

Author(s):

Jessica Shank Coviello

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Interprofessional Education ◽

Healthcare Professionals ◽

The United States ◽

Healthcare Systems ◽

World Health ◽

Institute Of Medicine ◽

Care Needs ◽

Ensure Patient Safety

In 2016, the Institute of Medicine (IOM) reported medical error as the 3rd leading cause of death in healthcare systems in the United States. Effective communication of patient care needs across healthcare disciplines is critical to ensure patient safety, quality of care, and to improve operational efficiencies in healthcare systems. Ineffective collaboration and communication among healthcare professionals within the procedural areas increases the potential of harm as a patient moves from one healthcare professional to another. Health care systems are thus encouraged to train employees with a focus on interprofessional education (IPE) and collaborative practice. IOM and World Health Organization (WHO) recommend the use of IPE to help improve communication and collaboration. However the current educational structure in many institutions does not include IPE. As such, healthcare professionals work in silos, with little or no collaboration with one another, which may result in service duplication, increased service cost, and poor health outcomes for patients.

Download Full-text

The Future of Telepathology for the Developing World

Archives of Pathology & Laboratory Medicine ◽

10.5858/135.2.211 ◽

2011 ◽

Vol 135 (2) ◽

pp. 211-214 ◽

Cited By ~ 1

Author(s):

Charles L Hitchcock

Keyword(s):

Health Care ◽

Patient Care ◽

Digital Images ◽

Virtual Slide ◽

Digital Camera ◽

Improve Patient Care ◽

Limited Resources ◽

Software Application ◽

Open Platform ◽

Delays In Diagnosis

Abstract Physician shortages are acute in developing countries, where disease burden is the greatest and resources for health care are very limited. A lack of pathologists in these countries has lead to delays in diagnosis and misdiagnoses that adversely affect patient care and survival. The introduction of telepathology into countries with limited resources for health care is but one of multiple approaches that can be used to alleviate the problem. Telepathology is the electronic transmission of digital images that can be used for education and diagnostic consultation. A basic system consists of a microscope with a mounted digital camera linked to a computer. The ability to produce histologic slides, to repair and maintain equipment, and to provide training are also needed for the successful use of this technology. iPath is a Web-based, open platform, software application which was developed at the University of Basel, Switzerland, for telepathology and which brings together pathologists from around the world to provide telepathology support for diagnostic consultation and provides education to centers with limited resources. The use of virtual-slide technology to provide a digital image of an entire glass slide is another technology for diagnostic consultation and pathology education. This technology requires more costly resources to support it, which may limit its utility in many areas. Telepathology can generate collections of digital images and virtual slides needed for training indigenous pathologists in their countries to become self-sufficient. Thus, the long-term goal of this technology is to improve patient care and survival.

Download Full-text

Interprofessional Education

Teacher Training and Professional Development ◽

10.4018/978-1-5225-5631-2.ch023 ◽

2018 ◽

pp. 520-541

Author(s):

Rebecca Moote

Keyword(s):

Patient Care ◽

Student Learning ◽

Interprofessional Education ◽

Improve Patient Care ◽

Collaborative Practice ◽

Evidence Based ◽

High Quality ◽

Design And Implementation ◽

Assessment Strategies ◽

Improve Patient

Interprofessional education (IPE) is recognized as an important component in the education of healthcare students. The goal of bringing students together to learn with, from, and about each other is to ultimately impact collaborative practice and improve patient care. Over the last 20 years there has been increased focus on the design and implementation of IPE experiences. Several IPE collaborative organizations and IPE centers have been formed to provide evidence-based recommendations and guidelines. Strategies have been created for designing and implementing high quality IPE activities, developing faculty in IPE, overcoming student stereotypes, determining assessment strategies, and identifying barriers to IPE. This chapter will focus on each of these elements and provide specific recommendations on how to create and implement IPE that improves student learning.

Download Full-text

Perceptions of Interprofessional and Collaborative Practice in Collegiate Athletic Trainers

Journal of Athletic Training ◽

10.4085/1062-6050-308-17 ◽

2018 ◽

Vol 53 (7) ◽

pp. 703-708 ◽

Cited By ~ 6

Author(s):

Dorice Hankemeier ◽

Sarah A. Manspeaker

Keyword(s):

Health Care ◽

Patient Care ◽

Health Care Professionals ◽

Current Practice ◽

Practice Patterns ◽

Core Competencies ◽

Athletic Trainers ◽

Medical Model ◽

Collaborative Practice ◽

Cross Sectional

Context: The ability to engage in interprofessional and collaborative practice (IPCP) has been identified as one of the Institute of Medicine's core competencies required of all health care professionals. Objective: To determine the perceptions of athletic trainers (ATs) in the collegiate setting regarding IPCP and current practice patterns. Design: Cross-sectional study. Patients or Other Participants: Of 6313 ATs in the collegiate setting, 739 (340 men, 397 women, 2 preferred not to answer; clinical experience = 10.97 ± 9.62 years) responded (11.7%). Main Outcome Measure(s): The Online Clinician Perspectives of Interprofessional Collaborative Practice survey section 1 assessed ATs' perceptions of working with other professionals (construct 1), ATs engaged in collaborative practice (construct 2), influences of collaborative practice (construct 3), and influences on roles, responsibilities, and autonomy in collaborative practice (construct 4). Section 2 assessed current practice patterns of ATs providing patient care and included the effect of communication on collaborative practice (construct 5) and patient involvement in collaborative practice (construct 6). Between-groups differences were assessed using a Kruskal-Wallis H test and Mann-Whitney U tests (P < .05). Results: Athletic trainers in the collegiate setting agreed with IPCP constructs 1 through 4 (construct 1 = 3.56 ± 0.30, construct 2 = 3.36 ± 0.467, construct 3 = 3.48 ± 0.39, construct 4 = 3.20 ± 0.35) and indicated that the concepts of constructs 5 and 6 (1.99 ± 0.46, 1.80 ± 0.50, respectively) were sometimes true in their setting. Athletic trainers functioning in a medical model reported lower scores for construct 5 (1.88 ± 0.44) than did those in an athletic model (2.03 ± 0.45, U = 19 522.0, P = .001). A total of 42.09% of the ATs' patient care was performed in collaborative practice. Conclusions: Athletic trainers in the collegiate setting agreed that IPCP concepts were beneficial to patient care but were not consistently practicing in this manner. Consideration of a medical model structure, wherein more regular interaction with other health care professionals occurs, may be beneficial to increase the frequency of IPCP.

Download Full-text

Implementation, Evolution and Impact of ICU Telepharmacy Services Across a Health care System

Hospital Pharmacy ◽

10.1177/0018578719851720 ◽

2019 ◽

Vol 54 (4) ◽

pp. 232-240 ◽

Cited By ~ 2

Author(s):

Desiree E. Kosmisky ◽

Sonia S. Everhart ◽

Carrie L. Griffiths

Keyword(s):

Critical Care ◽

Patient Care ◽

Healthcare System ◽

Improve Patient Care ◽

The United States ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Use Of Technology ◽

American Society ◽

The Impact

Purpose: A review of the implementation and development of telepharmacy services that ensure access to a critical care-trained pharmacist across a healthcare system. Summary: Teleintensive care unit (tele-ICU) services use audio, video, and electronic databases to assist bedside caregivers. Telepharmacy, as defined by the American Society of Health-System Pharmacists, is a method in which a pharmacist uses telecommunication technology to oversee aspects of pharmacy operations or provide patient care services. Telepharmacists can ensure accurate and timely order verification, recommend interventions to improve patient care, provide drug information to clinicians, assist in standardization of care, and promote medication safety. This tele-ICU pharmacy team is one of the only entirely clinical-based tele-ICU pharmacy models among the tele-ICU programs across the United States. The use of technology for customized alert generation and intervention proposal with medication orders and chart notation are unique. In a 34-month period from September 2015 to July 2018, more than 110 000 alerts were generated and 13 000 interventions were performed by telepharmacists. Conclusions: Tele-ICU pharmacists employ limited resources to provide critical care pharmacy expertise to multiple sites within a healthcare system during nontraditional hours with documented clinical and financial benefits. Further study is needed to determine the impact of tele-ICU pharmacists on ICU and hospital length of stay, morbidity, and mortality.

Download Full-text