Percutaneous Tracheostomy: A Multidisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 87-98 ◽  
Author(s):  
Vinciya Pandian ◽  
Thai Tran Nguyen ◽  
Marek Mirski ◽  
Nasir Islam Bhatti

Abstract The techniques of performing a tracheostomy has transformed over time. Percutaneous tracheostomy is gaining popularity over open tracheostomy given its advantages and as a result the number of bedside tracheostomies has increased necessitating the need for a Percutaneous Tracheostomy Program. The Percutaneous Tracheostomy Program at the Johns Hopkins Hospital is a comprehensive service that provides care to patients before, during, and after a tracheostomy with a multidisciplinary approach aimed at decreasing complications. Education is provided to patients, families, and health-care professionals who are involved in the management of a tracheostomy. Ongoing prospective data collection serves as a tool for Quality Assurance.

2018 ◽  
Author(s):  
Lisa McCann ◽  
Kathryn A McMillan ◽  
Christopher Hewitt

BACKGROUND A diagnosis of cancer in young adulthood can pose many different and unique challenges for individuals. The provision of adequate and appropriate information as well as care and support for teenagers and young adults at the time of diagnosis is central to their health care experience going forward. Moreover, appropriate and accessible information provision is critical to ensure that young individuals with cancer feel equipped and empowered to make decisions about, and be involved in, their treatment and recovery throughout their experience; this is a concept known as prehabilitation. As digital interventions and resources that support teenagers and young adults with cancer are an increasingly desirable part of health care provision, this study will focus on the development of an age- and population-appropriate electronic prehabilitation (e-Prehabilitation) system of care. OBJECTIVE We will conduct an exploratory, co-design research project that will inform the development of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. A collaborative approach to data collection and prototype design will ensure that a patient-centered approach is embedded throughout. METHODS A qualitative, co-design study utilizing surveys, interviews, and focus group discussions is being conducted with teenagers and young adults, health care professionals, and technologists. RESULTS This research study is in progress; recruitment and data collection activities have commenced and findings are expected in early 2019. CONCLUSIONS The findings of this study will have important implications for informing the future development and evaluation of an e-Prehabilitation system of care to support teenagers and young adults diagnosed with cancer. REGISTERED REPORT IDENTIFIER RR1-10.2196/10287


2018 ◽  
Vol 17 (1) ◽  
pp. 160940691775078 ◽  
Author(s):  
Rachel Flynn ◽  
Lauren Albrecht ◽  
Shannon D. Scott

This article discusses four challenges to conducting qualitative focus groups: (1) maximizing research budgets through innovative methodological approaches, (2) recruiting health-care professionals for qualitative health research, (3) conducting focus groups with health-care professionals across geographically dispersed areas, and (4) taking into consideration data richness when using different focus group data collection methods. In light of these challenges, we propose two alternative approaches for collecting focus group data: (a) extended period of quantitative data collection that facilitated relationship building in the sites prior to qualitative focus groups and (b) focus groups by videoconference. We share our experiences on employing both of these approaches in two national research programs.


KWALON ◽  
2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Monique Bussmann ◽  
Chris Kuiper ◽  
Alexander Maas

Sounding polyphonic stories, part II. The phase of listening in data collection Sounding polyphonic stories, part II. The phase of listening in data collection In the Netherlands, future staffing of elderly care will demand a big effort and a lot of creativity of health care organizations and the government. In this study an unconventional qualitative, narrative methodology is applied to throw a new light on the significance having a job and working in elderly care has for health care professionals and to use this as a source of inspiration for labor market policymakers. The methodology is rather unconventional because it doesn’t only focuses on the lingual content of the stories, but also includes other significant aspects of storytelling (e.g., voice and sound). Therefore musical work forms (e.g., music listening and singing) are used additionally.In the first phase of data collection stories of care professionals about the intertwining of their lifeline and career have been collected. In the second, listening phase HR-professionals listened to the stories told by the care professionals and used them as a source of inspiration for HR policy innovation.In a former article the methodology of the storytelling phase has been described. This article treats the methodology of the listening phase in the data collection. Later on the analysis methods will be described.


2020 ◽  
Vol 10 ◽  
Author(s):  
Alessandro Gozzetti ◽  
Francesca Bacchiarri ◽  
Vincenzo Sammartano ◽  
Marzia Defina ◽  
Anna Sicuranza ◽  
...  

Multiple myeloma survival has significantly improved in recent years, due to novel agents that are available for treatment. The anti-CD38 monoclonal antibody Daratumumab is particularly efficient for patients with relapse/refractory disease, and many studies have shown its unprecedented efficacy also as a first treatment. However, to avoid the incidence of infusion reactions, long infusion schedules of 8 h at first dose and 4 h in the following doses are required, which can reduce the compliance of patients and health care professionals. A reduced infusion time of 90 min has been reported previously, but data are missing on the prolonged safety of this over time as well as the efficacy of this approach. In this work, we investigate the safety of 484 rapid Daratumumab infusions given early after the second dose over a 22 months period in 39 myeloma patients.


10.2196/15380 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15380 ◽  
Author(s):  
Micheal O'Cathail ◽  
M Ananth Sivanandan ◽  
Claire Diver ◽  
Poulam Patel ◽  
Judith Christian

Background The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. Objective This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. Methods We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. Results The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. Conclusions Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.


KWALON ◽  
2013 ◽  
Vol 18 (3) ◽  
Author(s):  
Monique Bussmann ◽  
Chris Kuiper ◽  
Alexander Maas

Sounding polyphonic stories: what can be learned about the HR policy of elderly care organizations? Sounding polyphonic stories: what can be learned about the HR policy of elderly care organizations? In the Netherlands, future staffing of elderly care will demand a big effort and a lot of creativity of health care organizations and the government. In this study an unconventional qualitative, narrative methodology is applied to throw a new light on the significance having a job and working in elderly care has for health care professionals and to use this as a source of inspiration for labour market policy makers. The methodology is rather unconventional because it not only focuses on the lingual content of the stories, but also includes other significant aspects of storytelling (e.g., voice and sound). Therefore musical work forms (e.g., music listening and singing) are used additionally.In the first phase of data collection stories of care professionals about the intertwining of their lifeline and career have been collected. In the second phase HR professionals listened to the stories told by the care professionals and used them as a source of inspiration for HR policy innovation. This article treats the theoretical domains underlying this study and the methodology of the first stage of data collection, the storytelling phase. Later on the methodology of the listening phase and the analysis methods will be described.


2012 ◽  
Vol 17 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Brandy L Love ◽  
Louise A Jensen ◽  
Donald Schopflocher ◽  
Ban CH Tsui

From mitigating complications during hospital stay to reducing the incidence of chronic pain, improving pain management positively impacts short- and long-term outcomes of treatment. Quality assurance has become the focus of many health care programs in an effort to confront the challenges presented by pain and its management. The analysis of treatment strategies and patient responses form the basis of a reflective, evidence-based practice, which can raise awareness of about the importance of adequate pain management. The capabilities of an electronic database can be exploited to organize large amounts of data, which can then be used to characterize symptoms and analyze treatment responses. However, the types of data to collect, the burden of data collection on workers, and costs must be considered before implementing an electronic database for research and/or everyday practice. This study tested the relevance and usability of an electronic database in an acute pain service by assessing several variables important to database development and evaluation.BACKGROUND: Quality assurance is increasingly important in the current health care climate. An electronic database can be used for tracking patient information and as a research tool to provide quality assurance for patient care.OBJECTIVE: An electronic database was developed for the Acute Pain Service, University of Alberta Hospital (Edmonton, Alberta) to record patient characteristics, identify at-risk populations, compare treatment efficacies and guide practice decisions.METHOD: Steps in the database development involved identifying the goals for use, relevant variables to include, and a plan for data collection, entry and analysis. Protocols were also created for data cleaning quality control. The database was evaluated with a pilot test using existing data to assess data collection burden, accuracy and functionality of the database.RESULTS: A literature review resulted in an evidence-based list of demographic, clinical and pain management outcome variables to include. Time to assess patients and collect the data was 20 min to 30 min per patient. Limitations were primarily software related, although initial data collection completion was only 65% and accuracy of data entry was 96%.CONCLUSIONS: The electronic database was found to be relevant and functional for the identified goals of data storage and research.


Author(s):  
Lindsay B. Ragsdale

Patient care can have a significant impact on health care professionals both professionally and personally. Understanding and responding to these emotionally charged situations can help providers work through their emotions and build resiliency over time. Many institutions use debriefings to help providers unpack these situations and learn how to cope together. Debriefing after a significant patient event can help provide a time for medical staff to discuss the event, talk about their emotions, enhance teamwork, and improve the feeling of being supported by peers. Creating a space for these difficult conversations can help providers recover and get back to patient care.


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