Colorectal cancer

2021 ◽  
pp. 351-366
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
Long Term Care ◽  
Biological Therapy ◽  
Term Care ◽  
Detailed Treatment ◽  
The Uk

The colorectal cancer chapter explores one of the top four cancers being diagnosed in the UK. Within this chapter are explanations of the staging of colorectal cancer. There are also descriptions of the symptoms and causes associated with cancer within the colon or rectum. The incidence and necessary investigations are detailed. Treatment for colorectal cancer is explored in relation to surgery, chemotherapy, radiotherapy, and biological therapy. Ways the nurse can advise prevention of colorectal cancer are identified and bowel screening is examined. Additionally, prognosis for people with colorectal cancer is described. The important nursing issue of long-term care, termed survivorship is reported upon. Succinct details on the issues related to colorectal cancer can be used by the nurse within clinical practice.

Organizing across borders

2005 ◽  
Vol 48 (5) ◽  
pp. 643-653 ◽  
Author(s):  
Chris Holden
Keyword(s):  
Case Studies ◽  
Long Term Care ◽  
Care Work ◽  
Term Care ◽  
User Choice ◽  
Care Services ◽  
Organization Of Care ◽  
The Uk

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.

Frailty Status and Cognitive Function Should Guide Prescribing in Long-term Care Facilities

2021 ◽  
Vol 36 (10) ◽  
pp. 469-473
Author(s):  
Shin J. Liau ◽  
J. Simon Bell
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Long Term Care ◽  
Adverse Drug Events ◽  
Cognitive Status ◽  
Term Care ◽  
Care Facilities ◽  
Disease Specific

Frailty, dementia and complex multimorbidity are highly prevalent among residents of long-term care facilities (LTCFs). Prescribing for residents of LTCFs is often informed by disease-specific clinical practice guidelines based on research conducted among younger and more robust adults. However, frailty and cognitive impairment may modify medication benefits and risks. Residents with frailty and advanced dementia may be at increased susceptibility to adverse drug events (ADEs) and often have a lower likelihood of achieving long-term therapeutic benefit from chronic preventative medications. For this reason, there is a strong rationale for deprescribing, particularlyamong residents with high medication burdens, swallowing difficulties or limited dexterity. Conversely, frailty and dementia have also been associated with under-prescribing of clinically indicated medications. Unnecessarily withholding treatment based on assumed risk may deprive vulnerable population groups from receiving evidence-based care. There is a need for specific evidence regarding medication benefits and risks in LTCF residents with frailty and dementia. Observational studies conducted using routinely collected health data may complement evidence from randomized controlled trials that often exclude people living with dementia, frailty and in LTCFs. Balancing over- and under-prescribing requires consideration of each resident’s frailty and cognitive status, therapeutic goals, time-to-benefit, potential ADEs, and individual values or preferences. Incorporating frailty screening into medication review may also provide better alignment of medication regimens to changing goals of care. Timely identification of frail residents as part of treatment decision-making may assist with targeting interventions to minimize and monitor for ADEs. Shifting away from rigid application of conventional disease-specific clinical practice guidelines may provide an individualized and more holistic assessment of medication benefits and risks in the LTCF setting.

scholarly journals Development and Evaluation of Clinical Practice Guideline for Delirium in Long-Term Care

2020 ◽  
Vol 17 (21) ◽  
pp. 8255
Author(s):  
Eunhye Jeong ◽  
Jinkyung Park ◽  
Sung Ok Chang
Keyword(s):  
Clinical Practice ◽  
Development Process ◽  
Healthcare Professionals ◽  
Long Term Care ◽  
Structured Interviews ◽  
Term Care ◽  
Barriers To Implementation ◽  
Selection For ◽  
Search Quality

Delirium is highly prevalent and leads to several bad outcomes for older long-term care (LTC) residents. For a more successful translation of delirium knowledge, Clinical Practice Guidelines (CPGs) tailored to LTC should be developed and applied based on the understanding of the barriers to implementation. This study was conducted to develop a CPG for delirium in LTC and to determine the barriers perceived by healthcare professionals related to the implementation of the CPG. We followed a structured, evidence- and theory-based procedure during the development process. After a systematic search, quality appraisal, and selection for eligible up-to-date CPGs for delirium, the recommendations applicable to the LTC were drafted, evaluated, and confirmed by an external group of experts. To evaluate the barriers to guideline uptake from the users’ perspectives, semi-structured interviews were conducted which resulted in four major themes: (1) a lack of resources, (2) a tendency to follow mindlines rather than guidelines, (3) passive attitudes, and (4) misunderstanding delirium care in LTC. To minimize adverse prognoses through prompt delirium care, the implementation of a CPG with an approach that comprehensively considers various barriers at the system, practice, healthcare professional, and patients/family levels is necessary.

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