scholarly journals 1149 Increasing access and use of interpreting services in everyday clinical practice to improve patient care

2021 ◽  
Author(s):  
Shanghavie Loganathan ◽  
Esther Quinn ◽  
Sahana Rao
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Improve Patient Care ◽  
Everyday Clinical Practice ◽  
Improve Patient

scholarly journals Practice-Based Research Networks, Part I: Clinical Laboratories to Generate and Translate Research Findings Into Effective Patient Care

2012 ◽  
Vol 47 (5) ◽  
pp. 549-556 ◽  
Author(s):  
Eric L. Sauers ◽  
Tamara C. Valovich McLeod ◽  
R. Curtis Bay
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Translational Research ◽  
Athletic Training ◽  
Improve Patient Care ◽  
Single Site ◽  
Practice Based Research ◽  
Research Findings ◽  
Human Participants ◽  
Improve Patient

Context To improve patient care, athletic training clinicians and researchers should work together to translate research findings into clinical practice. Problems with patient care observed in clinical practice should be translated into research frameworks, where they can be studied. Practice-based research networks (PBRNs) provide a compelling model for linking clinicians and researchers so they can conduct translational research to improve patient care. Objective To describe (1) the translational research model, (2) practice-based research as a mechanism for translating research findings into clinical practice, (3) the PBRN model and infrastructure, (4) the research potential using the PBRN model, and (5) protection of human participants in PBRN research. Description Translational research is the process of transforming research findings into health behavior that ultimately serves the public and attempts to bridge the gap between research and clinical practice. Practice-based research represents the final step in the translational research continuum and describes research conducted by providers in clinical practices. The PBRNs are characterized by an organizational framework that transcends a single site or study and serves as the clinical research “laboratory” for conducting comparative-effectiveness studies using patient-oriented measures. The PBRN approach to research has many benefits, including enhanced generalizability of results, pooling of resources, rapid patient recruitment, and collaborative opportunities. However, multisite research also brings challenges related to the protection of human participants and institutional review board oversight. Clinical and Research Advantages Athletic training studies frequently include relatively few participants and, consequently, are able to detect only large effects. The incidence of injury at a single site is sufficiently low that gathering enough data to adequately power a treatment study may take many years. Collaborative efforts across diverse clinical practice environments can yield larger patient samples to overcome the limitations inherent in single-site research efforts.

scholarly journals Biomarker Evaluation and Clinical Development

2020 ◽  
Vol 1 (1) ◽  
pp. 16-22
Author(s):  
Andrew J Vickers ◽  
Melissa Assel
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Decision Analysis ◽  
Patient Care ◽  
Real World ◽  
Improve Patient Care ◽  
Clinical Development ◽  
Biomarker Research ◽  
Biomarker Evaluation ◽  
Improve Patient

Most candidate biomarkers are never adopted into clinical practice. The likelihood that a biomarker with good predictive properties will be incorporated into urologic decision-making and will improve patient care can be enhanced by following established principles of biomarker development. Studies should follow the REMARK guidelines, should have clinically relevant outcomes, and should evaluate the biomarker on the same patients to whom the biomarker would be applied in practice. It is also important to recognize that biomarker research is comparative: the question is not whether a biomarker provides information, but whether it provides better information than is already available. Continuous biomarkers should not be categorized above or below a fixed cutpoint: risk prediction allows for individualization of care. The risk predictions must be calibrated, that is, close to a patient’s true risk, and decision analysis is required to determine whether using the biomarker in clinical practice would change decisions and improve outcomes. Finally, impact studies are needed to evaluate how use of the biomarker in the real world affects outcomes.

Handbook of Communication in Anaesthesia & Critical Care

2010 ◽  
Keyword(s):  
Critical Care ◽  
Clinical Practice ◽  
Communication Skills ◽  
Improve Patient Care ◽  
Care Staff ◽  
Communication Tools ◽  
Everyday Clinical Practice ◽  
Professional Groups ◽  
Clinical Interactions ◽  
Improve Patient

This book provides anesthetists, intensivists and other critical care staff with a comprehensive resource that offers ways of improving communication in everyday clinical practice, and provides practical communication tools that can be used in difficult or unfamiliar circumstances. It demonstrates how communication can be structured to improve patient care and safety with numerous practical examples and vignettes illustrating how the concepts discussed can be integrated into clinical practice, and presents ideas in a way that enhances clinical interactions with patients and colleagues and facilitate the teaching of trainees. Edited by practicing anesthetists with particular expertise in teaching communication, and with contributions from expert clinicians based in North America, Europe and Australasia, this book will stimulate and complement the development of comprehensive resources for communication skills teaching in anesthesia and other related professional groups.

scholarly journals Implementation Science: Lessons Learned From Evaluating Practice Recommendations for the Care of Patients With Spine Injuries

2019 ◽  
Vol 54 (2) ◽  
pp. 192-197
Author(s):  
Alison R. Snyder Valier ◽  
Cailee E. Welch Bacon ◽  
Kristen L. Kucera ◽  
Richelle M. Williams
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Implementation Science ◽  
Patient Outcomes ◽  
Implementation Research ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
Practice Recommendations ◽  
Spine Injuries ◽  
Improve Patient

Health care providers are encouraged to provide care according to practice recommendations because these suggestions should improve patient care and promote optimal patient outcomes. The goals of these practice recommendations are to improve patient care and promote optimal patient outcomes. However, without integration into clinical practice, the value of practice recommendations in supporting patient care is lost. Unfortunately, little is known about the success of integrating practice recommendations into clinical practice, and targeted efforts to promote integration are likely needed. Implementation research is a broad area of study that focuses on how guidelines, programs, or interventions are put into practice and delivered. The Translating Research Into Injury Prevention Practice (TRIPP) framework consists of 6 stages that support implementation science, and the framework has been used to assist in integrating injury-prevention programs into patient care. The structure of the TRIPP framework makes it applicable to other programs that would benefit from implementation science, including practice recommendations. Stages 5 and 6 of the TRIPP framework emphasize the need to explore the implementation context and factors related to uptake of a program by end users. This commentary highlights our efforts to use methods for implementation research to evaluate stage 5 of the TRIPP framework as it relates to acute care for patients with suspected spine injuries and provides 6 lessons learned that may assist in future efforts to better implement practice recommendations in patient care. Targeted efforts to assist clinicians in implementing practice recommendations may promote their use and ultimately enhance the care provided for patients with a variety of health conditions. An essential component of any implementation effort is understanding end users via stages 5 and 6 of the TRIPP framework, and this understanding may maximize knowledge translation and encourage practice change and advancement.

Abstract 11119: Real-Time Nanopore Sequencing for Bacterial Pneumonia After Out-of-Hospital Cardiac Arrest, a Pilot Proof-of-Concept Study

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Alexandra Weissman ◽  
Mariam Bramah Lawani ◽  
Thomas Rohan ◽  
Clifton W CALLAWAY
Keyword(s):  
Patient Care ◽  
Pathogen Detection ◽  
Bacterial Pathogen ◽  
Improve Patient Care ◽  
Antibiotic Administration ◽  
Nanopore Sequencing ◽  
Proof Of Concept ◽  
Chi Square ◽  
Significant Difference ◽  
Improve Patient

Introduction: Pneumonia is common after OHCA but is difficult to diagnose in the first 72 hours following ROSC, this results in early untargeted antibiotic administration based on non-specific imaging and laboratory findings. Antibiotic resistance is rising, is influenced by untargeted antibiotic administration, and can increase patient morbidity and mortality as well as healthcare costs. Precision methods of bacterial pathogen detection in OHCA patients are needed to improve patient care. This proof-of-concept pilot study aimed to assess feasibility of bacterial pathogen sequencing and comparability of sequencing results to clinical culture after OHCA. Methods: Blood and bronchoalveolar lavage (BAL) were obtained from residual clinical specimens collected within 12 hours of ROSC. Bacterial DNA was extracted using the Qiagen PowerLyzer PowerSoil DNA kit, sequenced using the MinION nanopore sequencer, and analyzed with Oxford Nanopore Technologies’ EPI2ME bioinformatics software. Sequencing results were compared to culture results using McNemar’s chi-square statistic. Study-defined pneumonia was based on presence of at least two characteristics within 72 hours of ROSC: fever (temperature ≥38°C); persistent leukocytosis >15,000 or leukopenia <3,500 for 48 hours; persistent chest radiography infiltrates for 48 hours per clinical radiology read; bacterial pathogen cultured. Results: We enrolled 38 consecutive OHCA subjects: mean age 61.8 years (18.0); 16 (42%) female; 25 (66%) White, 7 (18%) Black, 6 (16%) “Other” race; 7 subjects (18%) survived and 31 (82%) died; 16 (42%) subjects had pneumonia. Sequencing results were available in 12 hours while culture results were available in 48-72 hours after collection. There was a non-significant difference in the proportion of the same pathogens identified for each method per McNemar’s chi-square: p = 0.38, difference of 0.095 (-0.095, 0.286). Conclusions: Nanopore sequencing detects pathogenic bacteria comparable to clinical microbiologic culture and in less time. This technology can produce a paradigm shift in early bacterial pathogen detection in OHCA survivors, which can improve patient care. The technology is applicable to other patient populations and for viral and fungal pathogens.

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