scholarly journals Checklist feasibility and impact in gastrointestinal endoscopy: a systematic review and narrative synthesis

2021 ◽  
Vol 09 (03) ◽  
pp. E453-E460
Author(s):  
Véronique Bitar ◽  
Myriam Martel ◽  
Sophie Restellini ◽  
Alan Barkun ◽  
Omar Kherad
Keyword(s):  
Safety Culture ◽  
Gastrointestinal Endoscopy ◽  
Positive Impact ◽  
Barriers And Facilitators ◽  
Narrative Synthesis ◽  
Team Communication ◽  
Post Intervention ◽  
Ovid Medline ◽  
Physician Perspectives ◽  
Checklist Implementation

Abstract Background and study aim Checklists prevent errors and have a positive impact on patient morbidity and mortality in surgical settings. Despite increasing use of checklists in gastrointestinal endoscopy units across many countries, a summary of cumulated experience is lacking. The aim of this study was to identify and evaluate the feasibility of successful checklist implementation in gastrointestinal endoscopy units and summarise the evidence of its impact on the commitment in safety culture. Methods A comprehensive literature search was performed identifying the use of a checklist or time-out in endoscopy units from 1978 to January 2020 using OVID MEDLINE, EMBASE, and ISI Web of Knowledge databases, with search terms related to checklist and endoscopy. We summarised overall adherence to checklists from included studies through a narrative synthesis, characterizing barriers and facilitators according to nurse and physician perspectives, while also summarizing safety endpoints. Results The seven studies selected from 673 screened citations were highly heterogeneous in terms of methodology, context, and outcomes. Across five of these, checklist adherence rates post-intervention varied for both nurses (84 % to 96 %) and physicians (66 % to 95 %). Various facilitators (education, continued reassessment) and barriers (lack of safety culture, checklist completion time) were identified. Most studies did not report associations between checklist implementation and clinical outcomes, except for better team communication. Conclusion Implementation of a gastrointestinal endoscopy checklist is feasible, with an understanding of relevant barriers and facilitators. Apart from a significant increase in the perception of team communication, evidence for a measurable impact attributable to gastrointestinal checklist implementation on endoscopic processes and safety outcomes is limited and warrants further study.

Implementation of a checklist before colonoscopy: a quality improvement initiative

Endoscopy ◽  
2017 ◽  
Vol 50 (03) ◽  
pp. 203-210 ◽  
Author(s):  
Omar Kherad ◽  
Sophie Restellini ◽  
Charles Ménard ◽  
Myriam Martel ◽  
Alan Barkun
Keyword(s):  
Quality Improvement ◽  
Positive Impact ◽  
Quality Improvement Intervention ◽  
Quality Improvement Initiative ◽  
Team Communication ◽  
Intervention Period ◽  
Retrospective Audit ◽  
Safety Outcomes ◽  
Checklist Implementation ◽  
Improvement Intervention

Abstract Background and study aims Checklists can prevent errors and have a positive impact on patient morbidity and mortality in different surgical settings, and possibly also in gastrointestinal endoscopy. The aims of this study were to reinforce commitment in safety culture and better communication among team members in endoscopy, and to prove the feasibility of successful checklist adoption before colonoscopy. Patients and methods The study involved a pre – post quality improvement intervention involving all consecutive patients undergoing a colonoscopy at a single academic endoscopy unit. The first part of the study was a retrospective audit, carried out over a 3-month period (July to September 2016). A checklist developed through a formal validation process was implemented during the intervention period (October to December 2016). Primary outcomes were changes in patient and team satisfaction after the quality improvement intervention, using validated 5-point scale questionnaires. Secondary outcomes included successful procedure completion rates and safety outcomes. Results During the baseline and comparative intervention period, 1317 and 1141 colonoscopies, respectively, were performed. Overall, checklists were fully completed by nurses and physicians for 791 patients (69.3 %). Mean overall patient satisfaction was high at baseline and did not differ following the quality improvement intervention (4.66 vs. 4.63; P  = 0.5). Perception of team communication and teamwork was improved after checklist implementation. Comparative analyses of per-procedure and safety outcomes did not differ between the pre- and post-checklist implementation. Conclusion Adoption of an endoscopy checklist before colonoscopy is feasible, and significantly increases perception of team communication and teamwork. Additional studies are needed to assess the generalizability of these results to complex endoscopic procedures and to characterize any improvement in patient safety outcomes.

scholarly journals Driving and Dementia: Workshop Module on Communicating Cessation to Drive

2017 ◽  
Vol 20 (4) ◽  
pp. 241-245
Author(s):  
Anna Byszewski ◽  
Barbara Power ◽  
Linda Lee ◽  
Glara Gaeun Rhee ◽  
Robert Parson ◽  
...  
Keyword(s):  
Health Professionals ◽  
Positive Impact ◽  
Communication Strategies ◽  
Emotional Reactions ◽  
Accurate Information ◽  
Driving Cessation ◽  
Ovid Medline ◽  
Online Tools ◽  
Background Material ◽  
The Subject

BackgroundFor persons with dementia (PWD), driving becomes very dangerous. Physicians in Canada are legally responsible to report unfit drivers and then must disclose that decision to their patients. That difficult discussion is fraught with challenges: physicians want to maintain a healthyrelationship; patients often lack insight into their cognitive loss and have very strong emotional reactions to the loss of their driving privileges. All of which may stifle the exchange of accurate information. The goal of this project was to develop a multimedia module that would provide strategies and support for health professionals having these difficult conversations.MethodsLiterature search was conducted of Embase and OVID MedLine on available driving and dementia tools, and on websites of online tools for communication strategies on driving cessation. A workshop module was developed with background material, communication strategies, links to resources and two videos demonstrating the “bad” then the “good” ways of managing this emotionally charged discussion.ResultsWhen the module was tested with internal medicine trainees, results demonstrated that confidence increased significantly (p < .001), and comfort and willingness in discussing the subject improved.ConclusionThis project demonstrated the positive impact of the module on improving health professionals’ attitude and readiness to communicate driving cessation to PWD.

scholarly journals Impact of low vision services on the quality of life of low vision patients in Ghana

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Godwin O. Ovenseri-Ogbomo ◽  
Harriette Osafo-Agyei ◽  
Ralph E.U. Akpalaba ◽  
James Addy ◽  
Elizabeth O. Ovenseri
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Positive Impact ◽  
Low Vision ◽  
Care Quality ◽  
Eastern Region ◽  
Post Intervention ◽  
Low Vision Clinic ◽  
The Impact

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana

I see you’re in pain – The effects of partner validation on emotions in people with chronic pain

2015 ◽  
Vol 6 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Sara M. Edlund ◽  
Maria L. Carlsson ◽  
Steven J. Linton ◽  
Alan E. Fruzzetti ◽  
Maria Tillfors
Keyword(s):  
Chronic Pain ◽  
Negative Affect ◽  
Negative Impact ◽  
Positive Impact ◽  
Training Session ◽  
The Other ◽  
Pain Level ◽  
Interpersonal Interactions ◽  
Post Intervention ◽  
Promising Tool

AbstractBackground and aimsChronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person’s experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain.MethodsParticipants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner’s knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention.ResultsResults showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training.ConclusionsOur results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person.ImplicationsThis study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.

scholarly journals 3015 Enhancing Outcomes in Childcare Settings for Young Children with Behavior Disorders: An Examination of Conscious Discipline Implementation

2019 ◽  
Vol 3 (s1) ◽  
pp. 88-88
Author(s):  
Sufna Gheyara John ◽  
Nicola Edge ◽  
Michael Cucciare ◽  
Nicholas Long
Keyword(s):  
Early Childhood ◽  
Focus Group ◽  
Focus Groups ◽  
Positive Impact ◽  
Teacher Perspectives ◽  
Self Control ◽  
Barriers And Facilitators ◽  
Full Implementation ◽  
Perceived Impact ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: 1. Identify the extent of CD implementation for trained childcare teachers. 2. Explore teacher perspectives on the impact of CD. 3. Explore teacher perspectives on barriers and facilitators to full implementation of CD. METHODS/STUDY POPULATION: We conducted a survey with 267 childcare teachers who had been trained in CD across the state, representing early childhood educational environments in urban and rural settings. Specific questions were asked related to level of CD implementation, perceived benefit, and facilitators/barriers to full implementation. A random subset of the sample (8 teachers) participated in a subsequent focus group to explore survey themes in greater depth. Focus group members were asked about their rationale for attending CD training, CD implementation (including barriers/facilitators to full implementation), and perceived impact on their classrooms. The focus group was recorded and transcribed to capture questions and comments. RESULTS/ANTICIPATED RESULTS: Objective 1: 1. 30% of teachers reported full implementation of CD. 2. 50% of teachers reported partial implementation of CD. Objective 2: 1. The vast majority of teachers (95%) agreed that CD had a positive impact on their classroom, including better structure and enhanced relationships with the children. 2. The vast majority of teachers (85%) agreed that CD had a positive impact on the children in their classroom, including increases in problem-solving abilities and self-control. Objective 3: 1. Most teachers (71%) reported experiencing barriers to CD implementation, with the majority of those surveyed (93%) stating that additional implementation support would be helpful. 2. The top three barriers to implementation elicited in survey and focus groups included uncertainty regarding how to begin implementing CD in the classroom, lacking materials for CD implementation, and lacking time to focus on applying knowledge from training into the classroom. 3. The top three facilitators for implementation elicited in survey and focus groups included coaching support for teachers, training agency leadership in CD, and greater perceived impact of CD. DISCUSSION/SIGNIFICANCE OF IMPACT: Childhood disruptive behaviors are among the most frequent reasons for referral to specialized services in and out of the classroom (Sukhodolsky, Smith, McCauley, Ibrahim, & Piasecka, 2016). Disruptive and aggressive behaviors are problematic, not only for victims of children who are aggressive but also for aggressive children as they age. Although effective treatments exist, the level of effective implementation of these interventions are understudied. These results demonstrate that 2/3 of teachers trained in CD are not fully implementing the model and provides concrete barriers and facilitators to current implementation. These data will provide the initial foundation for the development of a targeted implementation strategy that supports full implementation of CD within early childhood education settings.

Evaluating the Elklan Talking Matters Programme: Exploring the impact of a training programme for early years professionals on pre-school children’s language development

2020 ◽  
Vol 36 (2) ◽  
pp. 108-125
Author(s):  
Judy Clegg ◽  
Carla Rohde ◽  
Henrietta McLachlan ◽  
Liz Elks ◽  
Alex Hall
Keyword(s):  
Language Development ◽  
Positive Impact ◽  
Training Programme ◽  
Early Years ◽  
Post Intervention ◽  
Main Effect ◽  
Tentative Evidence ◽  
Effectiveness Of Training ◽  
And Control ◽  
The Impact

Training early years practitioners to facilitate the language development of young children is a widely used intervention. Evidence to support the effectiveness of training in terms of the impact of children’s language development is limited. The Elklan Talking Matters programme is an accredited training programme for early years practitioners. Practitioners train to be Lead Communication Practitioners (LCPs) who cascade training across early years settings or Key Communication Practitioners (KCPs) who are embedded into these settings. The aim of this study was to identify if the Talking Matters Programme is effective in facilitating the language development of pre-school children. One hundred and twenty-six children from 13 early years settings were recruited (mean age 27.81 months; SD 4.90). Thirteen settings participated in the Talking Matters Programme (five LCP+KCP settings, four LCP settings and four control settings). At time 1, prior to practitioners participating in the programme, children completed the Pre-School Language Scales 5th Edition (PLS-5), a standardized assessment of receptive and expressive language. At time 1, 126 children completed the baseline assessment ( n = 43 in the LCP+KCP settings, n = 43 in the LCP settings and n = 40 in the control settings). Children then completed the post intervention (time 2) assessment approximately six months later. Children in the intervention groups (LCP+KCP settings and LCP settings) made more progress in their language development from time 1 to time 2 compared to the control. The children in the LCP+KCP settings made more gains than the children in the LCP settings. A significant main effect of groups and time was found but not an interaction of group scores with time, meaning the increases in scores were not statistically significant between the intervention and control groups. The study provides tentative evidence that the Talking Matters programme has a positive impact on pre-school children’s language development.

scholarly journals THE IMPACT OF PILATES EXERCISES ON THE POSTURAL ALIGNMENT OF HEALTHY ADULTS

2016 ◽  
Vol 22 (6) ◽  
pp. 485-490
Author(s):  
Bruna Krawczky ◽  
Míriam Raquel Meira Mainenti ◽  
Antonio Guilherme Fonseca Pacheco
Keyword(s):  
Sagittal Plane ◽  
Positive Impact ◽  
Healthy Adults ◽  
The Body ◽  
Exercise Session ◽  
Post Intervention ◽  
Horizontal Alignment ◽  
Postural Alignment ◽  
Pilates Method ◽  
The Impact

ABSTRACT Introduction: Exercises of Pilates method have been widely used to improve postural alignment. There is strong evidence favoring their use in improving flexibility and balance, as well as some evidence of improvement in muscle strength. However, the benefits related to posture are not well established. Objective: To investigate in healthy adults, the impact of the Pilates method in the postural alignment through some angles in the sagittal plane and the occurrence of pain before and after an exercise session, and after the completion of a 16-session program. Methods: This is a quasi-experimental study of pre and post-intervention type. Healthy adults (n = 37) interested in starting Pilates were evaluated for acute effects on posture after a Pilates session (n = 37) and after a 16-session program, for a period of 10 weeks (n = 13). Using the postural assessment software (SAPO), six angles were analyzed: head horizontal alignment (HHA), pelvis horizontal alignment (PHA), hip angle (HA), vertical alignment of the body (VAB), thoracic kyphosis (TK), and lumbar lordosis (LL). The occurrence of pain was investigated to control adverse effects. Results: Statistically significant (p<0.05) differences found after one session include increased HHA (left view), decreased VAB (left view) and TK (both side views). After 16 sessions, we observed an increase of HHA, and a decrease of TK, LL (both side views) and HA (right view). All the differences point to an improvement of postural alignment. A significant reduction of prevalence of pain was verified after the first session (40.5% vs. 13.5%; p=0.004) and after the full program (30.8% vs. 15.3%; p=0.02). Conclusions: Our results suggest that the Pilates method has a positive impact on postural alignment in healthy adults, besides being a safe exercise.

scholarly journals Reducing prolonged chemoradiation treatment times for cervical cancer

2019 ◽  
Vol 8 (3) ◽  
pp. e000516 ◽  
Author(s):  
Lucas Vitzthum ◽  
Jianling Yuan ◽  
Daniel Jones ◽  
Anne Boldt ◽  
Kathryn Dusenbery
Keyword(s):  
Cervical Cancer ◽  
Positive Impact ◽  
Prolonged Treatment ◽  
Quality Improvement Initiative ◽  
Process Mapping ◽  
Post Intervention ◽  
Treatment Delays ◽  
Intervention Treatment ◽  
Total Treatment ◽  
Education And Care

Prolonged total treatment times (TTTs) beyond 56 days are associated with worse outcomes for cervical cancer treated with radiation therapy. We reviewed treatment times in a cohort of 24 consecutive patients treated with definitive chemoradiation (CRT) at our institution and found that only 14 patients (58.3%) completed treatment in less than or equal to 56 days. The primary objectives of this institutional quality improvement initiative were to identify sources for delays in treatment completion and to implement effective measures in an effort to minimise prolonged TTT. Pareto plot and process mapping were used to identify and resolve root causes of prolonged treatment. The Plan-Do-Study-Act method was then implemented to reduce treatment duration. Post-intervention treatment times were prospectively evaluated in 81 subsequent patients treated with definitive CRT. Process mapping identified inefficiencies with scheduling, staggered treatments and inadequate patient and staff education. Institutional changes were implemented, heavily utilising oncology nurses’ skill set in staff re-education and care coordination. Our workflow was redesigned to reduce/eliminate treatment delays. These interventions led to a significant improvement in the percentage of patients meeting the goal TTT compared with the pre-intervention cohort (85.2% vs 58.3%, p<0.01), and results were sustainable in additional 47 patients prospectively followed subsequently, potentially making a positive impact on their treatment outcomes.

scholarly journals 45 Helping the Helpers: Peer Critical Incident Stress Management for NICU Health Care Providers to Improve Resilience, Burnout and Patient Safety

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e19-e19
Author(s):  
Natasha Lifeso ◽  
Matthew Hicks ◽  
Chloe Joynt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Safety Culture ◽  
Critical Incident ◽  
Care Providers ◽  
Post Intervention ◽  
Critical Incident Stress Management ◽  
Critical Incident Stress ◽  
Patient Load ◽  
Stress Recognition

Abstract Introduction/Background Health care providers in neonatal intensive care units (NICU) experience critical or distressing events that can overwhelm their usual coping skills and lead to significant stress. Ineffective support for health care providers dealing with critical incidents can lead to poor unit resilience, staff burnout and compromised patient care behaviours. A formalized peer program and process to address critical workplace incidents and support care providers, “Critical Incident Stress Management (CISM)” is used in many first responder professions. While there is growing interest in implementing peer CISM teams in critical care units, there is a lack of research describing the impact of CISM in NICU. Objectives This study examined the effect of implementing a multidisciplinary NICU health care provider peer CISM team on resilience, burnout, and team/safety culture in a tertiary NICU. Design/Methods Multidisciplinary team members were peer selected and formally CISM trained. Change management strategies were employed to introduce CISM to the NICU. All health care providers were invited to complete an anonymous online or paper survey before and 1 year after NICU CISM team implementation. The survey contained validated measures of resilience, burnout, and team/safety culture that were analyzed pre and post intervention. Results The response rate pre-intervention was 66% (114/172 staff) and 32% post (60/186 staff). Stress recognition significantly improved as fewer staff reported being less effective at work when feeling stressed post incident (74% vs 61%, pre and post CISM respectively, p&lt;0.05) (Table 1). Fewer staff reported feeling burned out from their work (41% vs 31%, p=0.4), trending towards improved resilience (Table 1). Communication in the NICU significantly improved as staff indicated debriefing methods met their needs (38% vs 57%, p&lt;0.05) and felt comfortable speaking up about safety concerns (66% vs 78%) (Table 1). Post-intervention, despite feelings of increased workload indicated by a significant decrease in agreement that “NICU staff levels were sufficient for patient load” (54% vs 33%, p&lt;0.001), a majority of staff reported a supportive environment in the NICU (59% vs 77%, p=0.08) (Table 1). Work culture significantly improved as staff felt rewarded and recognized for improving quality (13% vs 31%, p&lt;0.05) (Table 1). Conclusion Implementation of a peer CISM team led to improved NICU care provider resilience, stress recognition, and team culture, all of which can mitigate the effects of increased patient load. Findings from this research and knowledge gained from the CISM implementation process should be shared with other health care environments.

Sign in / Sign up

Export Citation Format

Share Document