scholarly journals THE ROAD TO ACCEPTANCE OF DRIVER RETIREMENT FOR PATIENTS WITH DEMENTIA: PHYSICIANS’ AND PATIENTS’ PERSPECTIVES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S117-S117
Author(s):  
Theresa L Scott ◽  
Jacki Liddle ◽  
Nancy A Pachana ◽  
Elizabeth Beattie ◽  
Geoffrey Mitchell
Keyword(s):  
Focus Groups ◽  
Best Practice ◽  
Current System ◽  
Driving Safety ◽  
Evidence Based ◽  
Driving Cessation ◽  
Safe Driving ◽  
The Road ◽  
Assessment Measures ◽  
Evidence Based Guidelines

Abstract People living with Alzheimer’s disease and related dementias (ADRD) must eventually stop driving. While some will voluntarily retire, many others will continue to drive until a crisis. In Australia, like many other countries, general physicians/practitioners (“GPs”) play a key role in monitoring driving safety and driver retirement with their patients with ADRD. Advising patients about driving cessation is one of the most challenging aspects of clinical dementia care, complicated by limited time in consultations, lack of patient awareness and insight, and objective screening and assessment measures. We examined how to support best practice in relation to management of driving cessation with patients with ADRD through focus groups with 29 GPs and contrasted their perspectives with those of 11 retired drivers with ADRD. Focus groups and interviews were transcribed and thematically analysed. Themes discovered highlighted the importance of providing education about the effects of dementia on safe driving and incorporating regular assessment of driving safety into the care continuum. Key strategies that GPs successfully employed included acknowledging loss and encouraging continued community engagement, providing referral pathways, and deferring to other GPs within the practice in challenging circumstances. In conclusion, there is demand for an overhaul of the current system of management and a need to establish nationally aligned, standardized and evidence-based guidelines, in particular relating to assessment of safe driving. In the meantime, we can learn from these GPs who have implemented particular strategies that mitigate some of the challenges and complex driving related issues that present in primary care.

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.

Safe Dance Practice

2015 ◽  
Author(s):  
Edel Quin ◽  
Sonia Rafferty ◽  
Charlotte Tomlinson
Keyword(s):  
Best Practice ◽  
Academic Research ◽  
The Body ◽  
Evidence Based ◽  
Safe Practice ◽  
Company Directors ◽  
Collective Experience ◽  
Dance Educators ◽  
Creative Artists ◽  
Evidence Based Guidelines

Every dancer of every age, ability, and style should be able to engage fully in the act of dancing and be encouraged to achieve their potential without risk of harm to the body or mind. Practical information on all aspects of safe practice that is not too simplistic or complex has not always been easy to find. Enter Safe Dance Practice, by Edel Quin, Sonia Rafferty, and Charlotte Tomlinson. With nearly 60 years of collective experience in the dance profession as creative artists, teachers, and researchers, the authors translate extensive research and evidence-based practice in order to present the principles of safe practice that are essential to any dance experience. Guidelines in Implementing Principles The authors offer evidence-based guidelines on implementing diverse principles in practice, informing and supporting dance practitioners in an ever-growing pool of styles and genres. These guidelines and principles are of use not only to dancers and dance educators but also to choreographers, rehearsal and company directors, and studio managers. The information is underpinned by research in dance science and applied with contextual delivery in mind, ensuring an engaging experience for those accessing the book. Bridging the Gap Between Science and Practice Safe Dance Practice bridges the gap between academic research and its application for dancers and educators in all levels and genres. It illuminates the principles of working safely in dance so as to support best practice and encourages all dance practitioners and leaders to better understand, communicate, and apply principles of safe dance practice.

Use of Video Intervention to Increase Elders’ Awareness of Low-Cost Vehicle Modifications that Enhance Driving Safety and Comfort

2005 ◽  
Vol 1922 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Nina M. Silverstein ◽  
Alison S. Gottlieb ◽  
Elizabeth Van Ranst
Keyword(s):  
Low Cost ◽  
Older Drivers ◽  
Driving Safety ◽  
The Internet ◽  
Sufficient Time ◽  
Driving Cessation ◽  
The Road ◽  
Video Intervention ◽  
On The Road

Use of vehicle modifications might enable older drivers to stay on the road safely and provide a more gradual pathway between driving and driving cessation. Although adaptive features for automobiles have long been known by the disabilities community, they have not been well known by professionals in the network of aging programs and services or by elders themselves. This study examined the use of a video intervention to increase elders’ awareness of low-tech vehicle features. It was hypothesized that participants would have an increased awareness after viewing a video and would take steps toward using the features. The 23–min video was shown to 157 drivers age 70+ at seven Councils on Aging and senior centers in Massachusetts. The median age was 79, and 11% were age 85 and older. The participants completed pre- and postvideo questionnaires, and 127 of the participants (81%) were surveyed by phone approximately 2 months later. Familiarity significantly increased for 10 of 13 demonstrated features. On average, participants had taken two of five follow-up steps: 85% had read handouts, 63% had discussed features with family or friends, 20% had looked for features in stores or on the Internet, 9% had tried features, and only 2% had contacted a professional. Eleven percent of the telephone interviewees had purchased features. The video served the intended purpose of increasing awareness of vehicle modifications. Although some change was noted, 2 months may not have been sufficient time to observe change for the majority of the participants. Moreover, it is not known to what extent the participants may draw on this knowledge in the future, if and when they perceive a more direct need.

scholarly journals Improving Management of Infantile Spasms by Adopting Implementation Science

2020 ◽  
Vol 51 (06) ◽  
pp. 377-388
Author(s):  
Debopam Samanta
Keyword(s):  
Health Care ◽  
Best Practice ◽  
Clinical Care ◽  
Infantile Spasms ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Patient Centered ◽  
Practice Parameters ◽  
Health Care Structure ◽  
Evidence Based Guidelines

AbstractOver the last several decades, significant progress has been made in the discovery of appropriate therapy in the management of infantile spasms (IS). Based on several well-controlled studies, the American Academy of Neurology and the Child Neurology Society have published the current best practice parameters for the treatment of IS. However, dissemination and implementation of evidence-based guidelines remain a significant challenge. Though the number of well-performed controlled trials and systematic reviews is increasing exponentially, the proportion of valuable new information subsequently embedding into the routine clinical care is significantly lower. Planned and systematic implementation of evidence-based interventions in a given health care structure may outstrip the benefits of discovering a new insight, procedure, or drug in another controlled setting. Implementation problems can be broad-ranging to hinder effective, efficient, safe, timely, and patient-centered care without significant variation. The first part of this review article provides a detailed summary of some crucial comparative treatment studies of IS available in the literature. In the second part, practical challenges to mitigate the gap between knowledge and practice to improve outcomes in the management of IS has been explored, and a consolidated framework approach for systematic implementation research methodology has been discussed to implement evidence-based guidelines for the management of IS. Although large multicenter controlled studies will help gather quality evidence in the treatment of IS, a more comprehensive range of scientific methodologies, including qualitative research and mixed research methodologies, will hold the more considerable promise for implementing evidence-based practices in the health care system.

scholarly journals Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 142 ◽  
Author(s):  
Greg Sharplin ◽  
Pam Adelson ◽  
Kate Kennedy ◽  
Nicola Williams ◽  
Roslyn Hewlett ◽  
...  
Keyword(s):  
Focus Groups ◽  
Best Practice ◽  
Evidence Based Practice ◽  
South Australia ◽  
Governance Structure ◽  
Evaluation Framework ◽  
Successful Implementation ◽  
Evidence Based ◽  
Implementation Evaluation ◽  
Healthcare Settings

Background: Nurses and midwives are central to the implementation and delivery of quality care through evidence-based practice (EBP). However, implementation of EBP in nursing and midwifery is under-researched with few examples of systematic and sustained change. The Registered Nurses Association of Ontario’s Best-Practice Spotlight Organization (BPSO) Program was adopted in South Australia as a framework to systematically implement EBP in two diverse and complex healthcare settings. Methods: The study was a post-implementation, mixed-method evaluation conducted at two healthcare settings in Adelaide, South Australia utilizing qualitative and quantitative data. Proctor’s implementation evaluation framework guided the evaluation design. Information sources included; interviews, focus groups, questionnaires, and document review. Results: Clinical and executive staff (n = 109 participants) from a broad range of stakeholder groups participated in the interviews, focus groups, and returned questionnaires. A number of facilitators directly affecting program implementation were identified; these pertained to embedding continuity into the program’s implementation and delivery, a robust governance structure, and executive sponsorship. Barriers to implementation were also identified. These barriers pertained to organizational or workforce challenges; staff turnover and movement (e.g., secondment), insufficient staff to allow people to attend training, and a lack of organizational commitment to the program, especially at an executive level. As a result of successful implementation, it was observed that over three years, the BPSO program positively influenced the uptake and implementation of EBP by clinicians and the organizations into which they were introduced. Conclusions: The BPSO model can be translocated to new healthcare systems and has the potential to act as a mechanism for establishing and sustaining EBP change. This study was the first to apply an implementation evaluation framework to the BPSO program, which allowed for structured analysis of facilitating or impeding factors that affected implementation success. The findings have important implications for other health systems looking to translocate the same or similar EBP programs, as well as contributing to the growing body of implementation evaluation literature.

scholarly journals Endoscopic tattoo: the importance and need for standardised guidelines and protocol

2017 ◽  
Vol 110 (7) ◽  
pp. 287-291 ◽  
Author(s):  
Mei Yang ◽  
Daniel Pepe ◽  
Christopher M Schlachta ◽  
Nawar A Alkhamesi
Keyword(s):  
Minimally Invasive Surgery ◽  
Clinical Practice ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Best Practice ◽  
Operative Time ◽  
Evidence Based ◽  
Intraoperative Endoscopy ◽  
Evidence Based Guidelines ◽  
Prolonged Operative Time

Preoperative endoscopic tattoo is becoming more important with the advent of minimally invasive surgery. Current practices are variable and are operator-dependent. There are no evidence-based guidelines to aid endoscopists in clinical practice. Furthermore, there are still a number of issues with endoscopic tattoo including poor intraoperative visualisation, complications from tattooing and inaccurate documentation leading to the need for intraoperative endoscopy, prolonged operative time and reoperation due to lack of oncologic resection. This review aims to collate and summarise evidence for the best practice of endoscopic tattoo for colorectal lesions in order to provide guidance for endoscopists.

scholarly journals A collaborative research project on evidence-based and eco-effective design

2009 ◽  
Vol 6 (2) ◽  
Author(s):  
Mardelle M. Shepley ◽  
Mara Baum ◽  
Bill Rostenberg
Keyword(s):  
Focus Groups ◽  
Best Practice ◽  
Evidence Based ◽  
Healthcare Facilities ◽  
Academic Researchers ◽  
University Researcher ◽  
Critical Approaches ◽  
Narrative Response ◽  
Effective Design

The primary purpose of this study was to provide information regarding the design of healthcare facilities in the context of two important considerations, evidence-based design (EBD) andeco-effective design (EED). The secondary purpose was to test the effectiveness of research involving collaboration between practitioners and academic researchers, and the collaboration between EBD and EED professionals. The research team included designers and staff from a firm specializing in EBD andEED and a university researcher. Methods employed included focus groups, snowball surveys, and questionnaires. Practitioner focus groups specializing in EBD and EED identified critical questions that were translated into a 22-question, Likert and narrative-response survey. EBD and EED experts, via asnowball survey, selected the best practice institutions that would be the most appropriate recipients of a questionnaire that would address the role of EBD and EED. Administrators, representing theseinstitutions, participated in the survey. This study is significant in that it demonstrates that in spite of prior perceptions that EBD and EED are in conflict with one another, administrators perceived the twoas being fundamentally compatible. This conclusion is useful to designers and facility administrators by freeing them to incorporate both of these critical approaches in the design of new facilities. Observations are made regarding the collaborative process between practitioners and researchers.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Treatment of Pediatric Hydrocephalus: Update of the 2014 Guidelines

Neurosurgery ◽  
2020 ◽  
Vol 87 (6) ◽  
pp. 1071-1075
Author(s):  
David F Bauer ◽  
Lissa C Baird ◽  
Paul Klimo ◽  
Catherine A Mazzola ◽  
Dimitrios C Nikas ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Full Text ◽  
Best Practice ◽  
Medical Literature ◽  
Task Force ◽  
Relevant Literature ◽  
Evidence Based ◽  
Pediatric Hydrocephalus ◽  
Evidence Based Guidelines

ABSTRACT BACKGROUND The Congress of Neurological Surgeons reviews its guidelines according to the Institute of Medicine's recommended best practice of reviewing guidelines every 5 yrs. The authors performed a planned 5-yr review of the medical literature used to develop the “Pediatric hydrocephalus: systematic literature review and evidence-based guidelines” and determined the need for an update to the original guideline based on new available evidence. OBJECTIVE To perform an update to include the current medical literature for the “Pediatric hydrocephalus: systematic literature review and evidence-based guidelines”, originally published in 2014. METHODS The Guidelines Task Force used the search terms and strategies consistent with the original guidelines to search PubMed and Cochrane Central for relevant literature published between March 2012 and November 2019. The same inclusion/exclusion criteria were also used to screen abstracts and to perform the full-text review. Full text articles were then reviewed and when appropriate, included as evidence and recommendations were added or changed accordingly. RESULTS A total of 41 studies yielded by the updated search met inclusion criteria and were included in this update. CONCLUSION New literature resulting from the update yielded a new recommendation in Part 2, which states that neuro-endoscopic lavage is a feasible and safe option for the removal of intraventricular clots and may lower the rate of shunt placement (Level III). Additionally a recommendation in part 7 of the guideline now states that antibiotic-impregnated shunt tubing reduces the risk of shunt infection compared with conventional silicone hardware and should be used for children who require placement of a shunt (Level I). <https://www.cns.org/guidelines/browse-guidelines-detail/pediatric-hydrocephalus-guideline>

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