scholarly journals GAINING INTERPROFESSIONAL COMPETENCE THROUGH A GERIATRICS CASE CONFERENCE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S151-S151
Author(s):  
Amber S McIlwain ◽  
Danielle Backus ◽  
Kristine Marcus ◽  
Jeff Fortner
Keyword(s):  
Interprofessional Education ◽  
Healthcare Providers ◽  
Core Competency ◽  
Healthcare Team ◽  
Case Conference ◽  
Her Family ◽  
Centered Care ◽  
Geriatric Disorder ◽  
Positive Response Rate ◽  
Care Conference

Abstract There is increased demand to provide health professions students with interprofessional education and practice experience. Interprofessional Case Conferences (ICC) allow students to work in teams to learn about different professions while exploring a topic through the lens of an interprofessional core competency. The goal of this particular ICC was to provide students an experience to witness and discuss team-based, person-centered care for a common geriatric disorder. The case was designed to develop the interprofessional competency of teams and teamwork. Students were divided into teams and observed live vignettes of a care conference involving an 80-year old female admitted to a rehabilitation facility following a hip fracture and replacement. Students witnessed how patients, families, and healthcare providers work together during a stressful time. After each vignette, students discussed questions related to miscommunications, motivations of the different actors involved, and how the healthcare team should respond. In the first offering, 93 students participated, increasing to 150 in the next year. Students completed a post-survey to determine if the session delivered a positive interprofessional experience. The average positive response rate was 92.5% (92-94%, n = 53) in year-1 and 93.5% (90-97%, n = 71) in year-2. By allowing students to witness a simulated live care conference, they had a tangible event to dissect instead of discussing hypotheticals. By discussing a geriatrics case in a rehabilitation setting, students witnessed how numerous healthcare professions coordinate care for a patient and her family, thereby demonstrating competence in teamwork.

Withdrawal of Cardiac Medications and Devices

2007 ◽  
Vol 18 (4) ◽  
pp. 415-425
Author(s):  
Debra Lynn-McHale Wiegand ◽  
Peggy G. Kalowes
Keyword(s):  
Treatment Options ◽  
Healthcare Providers ◽  
Ventricular Assist Devices ◽  
Healthcare Team ◽  
Ventricular Assist ◽  
Her Family ◽  
Cardiac Devices ◽  
Implantable Cardiac Devices ◽  
Ethical And Legal Considerations ◽  
Cardioverter Defibrillators

Withdrawal of life-sustaining therapies such as cardiac medications, pacemakers, internal cardioverter defibrillators, and ventricular assist devices occurs in patients with advanced cardiac disease as goals of treatment transition from active to less aggressive. This article defines life-sustaining therapies and describes ethical and legal considerations related to withdrawal of cardiac medications and cardiac devices. Healthcare providers need to anticipate clinical situations in which implantable cardiac devices and medications are no longer desired by patients and/or are no longer medically appropriate. Discussions are important between patients, families, and healthcare providers that focus on each patient’s condition, prognosis, advance directives, goals of care, and treatment options. Critical care nurses support each patient and his or her family and work with other members of the healthcare team to achieve a peaceful death.

scholarly journals The principles of physical restraint use for hospitalized elderly people: an integrated literature review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Azam Sharifi ◽  
Narges Arsalani ◽  
Masoud Fallahi-Khoshknab ◽  
Farahnaz Mohammadi-Shahbolaghi
Keyword(s):  
Elderly People ◽  
Scientific Information ◽  
Physical Restraint ◽  
Healthcare Providers ◽  
Routine Care ◽  
Ethical Challenges ◽  
Eligibility Criteria ◽  
Her Family ◽  
Hospitalized Elderly ◽  
Ensure Patient Safety

Abstract Background Physical restraint (PR) is a routine care measure in many hospital wards to ensure patient safety. However, it is associated with many different professional, legal, and ethical challenges. Some guidelines and principles have been developed in some countries for appropriate PR use. The present study aimed to explore the principles of PR use for hospitalized elderly people. Methods This was an integrative review. For data collection, a literature search was conducted in Persian and English databases, namely Magiran, Scientific Information Database (SID), Scopus, Google Scholar, Web of Science, and PubMed as well as the websites of healthcare organizations and associations. Eligibility criteria were publication in English or Persian between January 1, 2010, and January 1, 2021, and description of the principles of PR use for hospitalized elderly people. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for document screening and selection, while the critical appraisal tools of the Joanna Briggs Institute (JBI) and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument were used for quality appraisal. The data were analyzed through constant comparison. Results Primarily, 772 records were retrieved, while only twenty were eligible for the study. The principles of PR use for hospitalized elderly people were categorized into six main categories, namely principles of education for PR use, principles of decision making for PR use, principles of implementing the PR procedure, principles of monitoring patients with PR, principles of PR use documentation, and principles of PR management. Conclusion PR should be used only by trained healthcare providers, with the consent of patient or his/her family members, with standard devices and safe techniques, based on clear guidelines, and under close managerial supervision. Moreover, elderly people with PR should continuously be monitored for any PR-related complications. The findings of the present study can be used for developing clear PR-related guidelines.

scholarly journals Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Effect Size ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Clinical Excellence ◽  
Dementia Care ◽  
Person Centered Care ◽  
Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

scholarly journals Should COVID-19 Mother Breastfeed her Newborn Child? A Literature Review on the Safety of Breastfeeding for Pregnant Women with COVID-19

2021 ◽  
Author(s):  
Harshil Bhatt
Keyword(s):  
Direct Contact ◽  
Preventive Measures ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Limited Evidence ◽  
Her Family ◽  
Viral Antibodies ◽  
Newborn Child ◽  
Droplet Transmission

Abstract Purpose of Review Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding. Recent Findings Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Summary Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.

Interprofessional Collaborative Practice and School Nursing: A Model for Improved Health Outcomes

2017 ◽  
Vol 22 (3) ◽  
Author(s):  
Robin Fleming ◽  
Mayumi Willgerodt
Keyword(s):  
Case Management ◽  
Health Professionals ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Core Competencies ◽  
School Setting ◽  
Healthcare Providers ◽  
School Nurse ◽  
Collaborative Practice ◽  
Interprofessional Collaborative Practice

Effective communication, teamwork, and interprofessional collaboration, or teams of health and non-health professionals working together, are critical to improving the patient experience of care; improving population health; and reducing healthcare costs (i.e., the Triple Aim). In 2016, the Interprofessional Education Collaborative (IPEC) Expert Panel updated its Core Competencies for Interprofessional Collaborative Practice. As health professionals who collaborate with an extensive network of health and non-health professionals, school nurses embody the aims of interprofessional collaboration (IPC). This article briefly reviews the background of interprofessional collaboration and describes ways that school nurse practice aligns with IPC core competencies to incorporate interprofessional collaboration. We discuss successes, such as case management and care coordination, and include challenges to IPC in the school setting. In conclusion, through case management and collaborative care, school nurse expertise in effective IPC fosters knowledge through which core competencies can be strengthened, with benefits for both patients and other healthcare providers.

Athletic Trainers’ Viewpoints of Patient-Centered Care

2021 ◽  
Author(s):  
Carly J. Wilson ◽  
Lindsey E. Eberman ◽  
Ansley S. Redinger ◽  
Elizabeth R. Neil ◽  
Zachary K. Winkelmann
Keyword(s):  
Athletic Training ◽  
Task Force ◽  
Athletic Trainers ◽  
Core Competency ◽  
Principal Component ◽  
Patient Centered Care ◽  
International Classification Of Functioning ◽  
Patient Centered ◽  
Centered Care ◽  
Icf Model

Abstract Background The core competency of patient-centered care (PCC) states that for positive patient outcomes, the provider must respect the patient’s views and recognize their experiences. The Athletic Training Strategic Alliance Research Agenda Task Force identified a profession-wide belief that examining the extent to which athletic trainers (ATs) provide PCC in their clinical practice would benefit the profession. To first address this line of inquiry, we must study the subjectivity of how ATs view PCC. Methods We used Q methodology to allow participants to share their viewpoints while simultaneously exploring the study aim from a quantitative and qualitative perspective. A total of 115 (males = 62, females = 53, age = 37 ± 10 y, experience = 13 ± 10 y) ATs dispersed between 11 job settings volunteered for this study. Participants were asked to pre-sort (agree, disagree, neutral) 36 validated statements representing the 8 dimensions of PCC. The participants completed a Q-sort where they dragged-and-dropped the pre-sorted statements based on perceived importance in providing PCC. The Q-sorts were analyzed using QMethod software. A principal component analysis was used to identify statement rankings and factors. Factors were determined by an Eigenvalue > 1 and analyzed using a scree plot. The 6 highest selected statements per factor were assessed to create the distinguishing viewpoints. Results Two distinguishing viewpoints emerged from the Q-sorts. The statement “ATs treat patients with dignity and respect” appeared as a high ranked statement in both distinguishing viewpoints. The lowest ranked statement from viewpoint 1 was “ATs integrate the International Classification of Functioning, Disability, and Health (ICF) model as a framework for delivery of patient care.” The lowest ranked statement from viewpoint 2 was “Appointment scheduling is easy.” Conclusions ATs value patient’s preferences. However, a lack of importance was identified for incorporating the ICF model, which is a core competency and adopted framework by the NATA since 2015.

scholarly journals Measurement of Family-centered care perception and parental stress in a neonatal unit

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Flávia Simphronio Balbino ◽  
Maria Magda Ferreira Gomes Balieiro ◽  
Myriam Aparecida Mandetta
Keyword(s):  
Parental Stress ◽  
Neonatal Intensive Care ◽  
Neonatal Unit ◽  
University Hospital ◽  
Care Staff ◽  
Healthcare Team ◽  
Family Centered Care ◽  
Brazilian Version ◽  
Centered Care ◽  
Family Centered

ABSTRACT Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress.

Healthcare Providers’ Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey

2018 ◽  
Vol 36 (5) ◽  
pp. 387-395 ◽  
Author(s):  
Frances R. Nedjat-Haiem ◽  
Tamara J. Cadet ◽  
Anup Amatya ◽  
Shiraz I. Mishra
Keyword(s):  
Online Survey ◽  
Survey Design ◽  
Healthcare Providers ◽  
Medical Decision ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Practice Behaviors ◽  
Centered Care ◽  
Seriously Ill Patients

Background: Advance care planning for end-of-life care emerged in the mid-1970’s to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers’ perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers’ views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers’ views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.

scholarly journals Youth-Centered Maternity Care: A Binational Qualitative Comparison of the Experiences and Perspectives of Latina Adolescents and Healthcare Providers

2020 ◽  
Author(s):  
Martha J. Decker ◽  
Noelle Pineda ◽  
Abigail Gutmann-Gonzalez ◽  
Claire D. Brindis
Keyword(s):  
Decision Making ◽  
Maternity Care ◽  
Quality Care ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Qualitative Comparison ◽  
Latina Adolescents ◽  
Provider Perspectives ◽  
Centered Care ◽  
Delivery Options

Abstract Background Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives. Methods Qualitative interviews and focus groups were conducted with a total of 89 respondents, including pregnant and parenting adolescents as well as providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers. Results Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth’s life choices. Conclusion Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents.

scholarly journals Mobile Traveling Healthcare Teams: An Innovative Delivery System for Underserved Populations

2018 ◽  
Vol 23 (3) ◽  
Author(s):  
Glenda Walker ◽  
Viviana Martinez-Gómez ◽  
Roberto Gonzalez
Keyword(s):  
Delivery System ◽  
Underserved Populations ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Department ◽  
State Mental Health ◽  
Social Determinant ◽  
Healthcare Team ◽  
Health Project

Reaching disenfranchised clients who are either underinsured or who have no insurance presents unique challenges for healthcare providers and organizations. To reach clients experiencing disparities in healthcare access, a social determinant of health, innovative models of healthcare delivery must be developed. The Juntos for Better Health project directly focused on the social determinant of lack of access to care for prevention and treatment of diabetes, depression, and obesity. In the article, we discuss the background that provided the framework for this project, reviewing literature related to mobile vans and traveling nurses, and then describe the geographical traveling healthcare team setting. The article discusses the Juntos for Better Health project, including several phases of implementation, services of the traveling healthcare team delivery system, and partnerships that included four healthcare providers and a state university in a United States-Mexico border town located in Texas. Partnering agencies included a community-based federally qualified healthcare center, the local state mental health authority, the city health department, and the local drug treatment agency. The conclusion briefly describes plans for the future.

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