Monitoring a Remote Phototherapy Unit via Telemedicine

2005 ◽  
Vol 9 (2) ◽  
pp. 47-53 ◽  
Author(s):  
Jennifer Klotz ◽  
Linda Muir ◽  
Crystal Cameron ◽  
Laura Delaney
Keyword(s):  
Health Care ◽  
Nova Scotia ◽  
Side Effects ◽  
Patient Care ◽  
Family Physician ◽  
Delivery Of Health Care ◽  
Treatment Time ◽  
Evidence Based ◽  
Number Of Patients ◽  
Before And After

Background: The delivery of effective phototherapy to patients with psoriasis living in areas devoid of dermatologists is difficult. Telemedicine has proven useful in the delivery of health care in such locations. Objective: This evidence-based study sought to investigate the use of telemedicine in the monitoring of phototherapy of psoriasis patients located in a Nova Scotia region with no dermatologist. Methods: Psoriatic patients were reviewed six months before and after protocols and monitoring were instituted. First, charts of 23 patient treated with phototherapy were reviewed from the Aberdeen Hospital in New Glasgow. Patients were either self-referred or referred by a family physician and occasionally a dermatologist. Treatments were not monitored by a specialist. Second, a group of 33 patients receiving treatment were supervised via telemedicine by a dermatologist 250 km away in Halifax. Results: During the study period, treatment time decreased from 140 to 37 days. In the monitored group, 40% more patients were clear of psoriasis at time of discharge. The number of patients with side effects decreased. The number of self-and family practice–referred patients dropped; the clinic became a referral center for dermatologists. Conclusion: Telemedicine provided an excellent way to monitor patients receiving phototherapy in an area without a dermatologist. Overall, patient care improved: More patients were treated effectively with better outcomes and fewer side effects.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Manejo da dor em punção venosa pediátrica: um pacote de medidas

2021 ◽  
Vol 11 (33) ◽  
pp. 157-168
Author(s):  
Larissa Grispan e Silva Guimarães ◽  
Natália Shinkai Binotto ◽  
Stela Faccioli Ederli ◽  
Mauren Teresa Grubisich Mendes Tacla
Keyword(s):  
Pain Management ◽  
Patient Care ◽  
Nursing Staff ◽  
Professional Growth ◽  
Management Strategies ◽  
Care Bundle ◽  
Evidence Based ◽  
Topical Anesthetic ◽  
Care Research ◽  
Before And After

Apresentar o processo de elaboração de um pacote de medidas para manejo da dor de crianças submetidas à punção venosa pela equipe de enfermagem. Pesquisa Convergente Assistencial, do tipo antes e após intervenção, realizada com a equipe de enfermagem de uma unidade pediátrica do sul do Brasil. Elaboração de pacote de medidas com seis estratégias selecionadas pela equipe de enfermagem a serem utilizadas antes e durante a punção venosa: preparo da criança e/ou acompanhante, posicionamento da criança, distração, amamentação, solução adocicada associada ou não à sucção não nutritiva e anestésico tópico. Os participantes manifestaram satisfação quanto ao modo de elaboração do mesmo, destacando a contribuição deste para seu crescimento profissional. O pacote de medidas otimizou a adoção das estratégias para manejo da dor. A Pesquisa Convergente Assistencial alicerçada na prática baseada em evidências mostrou-se adequada, visto que propiciou a aplicação de achados científicos no cenário assistencial considerando suas particularidades.Descritores: Manejo da Dor, Criança, Cateterismo Periférico, Enfermagem Baseada em Evidências. Management of pediatric venipuncture pain: a package of measuresAbstract: To present the process of elaboration of a patient care package for pain management in children undergoing venipuncture by the nursing staff. Convergent Care Research, before and after intervention, conducted with the nursing staff of a southern pediatric unit in Brazil. Patient care packege with six strategies, selected by the nursing staff, to be used before and during venipuncture: preparation of the child and/or companion, child positioning, distraction, breastfeeding, sweet-tasting solution with or without non-nutritive suction and topical anesthetic usage. The package of measures optimized the adoption of pain management strategies, highlighting its contribution to their professional growth. The patient care bundle optimized the adoption of strategies for pain management. The Convergent Care Research grounded in evidence-based practice showed appropriate, since it allowed the application of scientific findings in the care setting, considering its peculiarities.Descriptors: Pain Management, Child, Catheterization, Peripheral, Evidence-Based Nursing. Manejo del dolor de la venopunción pediátrica: un paquete de medidasResumen: Presentar el proceso de elaboración de un paquete de medidas para manejo del dolor de niños sometidos a la venopunción por el equipo de enfermería. Investigación Convergente Asistencial, del tipo antes y después de la intervención, realizada con el equipo de enfermería de una unidad pediátrica en el sur de Brasil. Paquete de medidas con seis estrategias seleccionadas por el equipo de enfermería que deben ser utilizadas antes y durante la venopunción: preparación del niño y/o acompañante, posicionamiento del niño, distracción, amamantamiento, solución dulce asociada o no a succión no nutritiva y anestésica tópica. Los participantes manifestaron satisfacción en cuanto al modo de elaboración del mismo, destacando la contribución de este para su crecimiento profesional. El paquete de medidas optimizó la adopción de estrategias para manejo del dolor. La Investigación Convergente Asistencial cimentada en la práctica basada en evidencias se mostró adecuada, visto que propició la aplicación de hallazgos científicos en el escenario asistencial considerando sus particularidades.Descriptores: Manejo del Dolor, Niño, Cateterismo Periférico, Enfermería Basada en la Evidencia.

(Re)descriptions of medical professional work: exploring accounting as a performative device within an emergency unit health-care context

2020 ◽  
Vol 32 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Cemil Eren Fırtın ◽  
Tom S. Karlsson
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Treatment Time ◽  
Medical Professional ◽  
Care Quality ◽  
Medical Terminology ◽  
Professional Work ◽  
Content Type ◽  
Emergency Health Care ◽  
Number Of Patients

PurposeThis article addresses issues of calculation and economization in contemporary public organizations. In particular, it investigates how choices of organizing emergency health-care have been affected by accounting as a performative device. Special attention has been paid to how accounting brings about performative consequences in shaping the medical profession and its context.Design/methodology/approachThe article employs qualitative research methods and draws its analysis on empirical data from in-depth interviews at an emergency health-care unit in Sweden.FindingsIt is demonstrated how accounting, in the form of calculations of treatment time and number of patients, enables performative consequences for medical professional work. It is also demonstrated how the use of accounting engages (re)descriptions of practices and roles, creates accounts of patients, and helps to sustain such (re)descriptions. Accounting terms (such as efficiency and control) have been reframed into medical terminology (such as health-care quality and security), ensuring and retaining (re)described medical professional work in terms of practices and emerging roles.Originality/valueThis article contributes to (1) the literature on accounting practices within health-care contexts by demonstrating a case where the accounting ideas and practices of medical professionals are coexistent and interwoven and (2) the increasing body of literature focusing on accountingization by showing how emerging calculative technologies carry performative power over medical professional work through formative (re)descriptions.

scholarly journals Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits

2016 ◽  
Vol 12 (4) ◽  
pp. e359-e368 ◽  
Author(s):  
Robert Ignoffo ◽  
Katherine Knapp ◽  
Mitchell Barnett ◽  
Sally Yowell Barbour ◽  
Steve D’Amato ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Patient Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Delphi Panel ◽  
Potential Contribution ◽  
Oncology Patient ◽  
Care Services ◽  
Number Of Patients

Purpose: With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties–certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Methods: Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. Results: By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. Conclusion: BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits.

scholarly journals Interdisciplinary Collaboration among Health Professionals: A Panacea for effective and Evidence-based Health Care delivery

2020 ◽  
Vol 34 (1) ◽  
pp. 12-23
Author(s):  
Joseph D Z ◽  
Aminu B ◽  
Halilu S ◽  
Mark A D ◽  
Kayode O ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Patient Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Interdisciplinary Collaboration ◽  
Healthcare Delivery ◽  
Evidence Based ◽  
Search Term ◽  
The Impact

Introduction: Interdisciplinary collaboration (IDC) is important in health care settings as the complex nature and demands of the health care work environment requires the expertise and knowledge of different individuals or specialists working together to solve multifaceted and complex patient care problems. Objective: To assess the health professionals' attitude towards the development of an interdisciplinary collaborative approach to patient care in health institutions and to systematically review the impact of IDC as a panacea for effective health outcomes in Nigeria. Methodology: The research is a systematic review that provides various approaches for studying interdisciplinary teams. Fifty articles were selected from different search engines such as Google, google scholar, science direct and research gate with the search term Interdisciplinary collaboration among health care professionals. Articles were arranged based on most relevant, relevant and closely related articles. Result: The study revealed that IDC is pivotal in evidence-based care and contributes immensely to effective and efficient health outcomes. It puts the patient at the centre of the healthcare team's focus and allows all health professionals, with the patient, to collaboratively provide input, be part of the decision making, and improve outcomes. Although there are several obstacles to IDC, adopting this team-based culture of mutual respect and understanding is possible and, in fact, necessary. Conclusion: This study reveals that there are many benefits to IDC. It can improve safety and healthcare delivery, as well as reduce costs. The interprofessional team supports patient and personnel engagement, organizational efficiency and innovation.

scholarly journals Building Capacity for Implementation – The KT Challenge

2020 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the KT Challenge program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Building Capacity for Implementation – The KT Challenge

2021 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

scholarly journals Effects of psychological problems on surgical outcomes

2019 ◽  
Vol 65 (5) ◽  
pp. 586-588
Author(s):  
Rafael Melillo Laurino Neto ◽  
Fernando A. M. Herbella
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Surgical Outcomes ◽  
Acute Stress ◽  
Technical Skills ◽  
Psychological Problems ◽  
Significant Rate ◽  
Number Of Patients ◽  
The Impact

SUMMARY Surgeons are becoming aware that surgical outcomes are not only based on technical skills. The impact of psychological problems on outcomes must be studied from both the patient's and the health care provider's viewpoint. Psychological problems may affect up to 20% of the population, with almost half of them non-treated. Surgeons have to deal with a significant number of patients with psychological problems, which affect surgical outcomes changing how symptoms, results and side effects are interpreted. Surgeons also face psychological problems at a significant rate. Although there are no studies on the effect of chronic psychological problems of the surgeon on outcomes, in simulated scenarios, acute stress usually leads to worse performance. Some initiatives can be implemented to improve outcomes based on the effect of psychological problems.

scholarly journals Inter-professional collaboration to improve outpatient attendance rates on a cochlear implant aural rehabilitation programme

2020 ◽  
pp. 201010582094889
Author(s):  
Kenneth Wei De Chua ◽  
Heng Wai Yuen
Keyword(s):  
Health Care ◽  
Cochlear Implant ◽  
Clinical Outcomes ◽  
Professional Education ◽  
Health Care Professionals ◽  
Professional Collaboration ◽  
Attendance Rates ◽  
Aural Rehabilitation ◽  
Number Of Patients ◽  
Before And After

Background: The cochlear implant (CI) programme at Changi General Hospital started in 2010. As the number of patients gradually increased over the years, a review of attendance rates from 2010 to 2016 showed that CI patients were not compliant in attending post-surgical aural rehabilitation sessions. A significant number of no-shows or appointment cancellations without rescheduling suggest that patients may not be motivated enough to go through aural rehabilitation. Hence, it was hard to evaluate clinical outcomes, which was demoralising for both the patient and health-care professionals involved. As transdisciplinary care is often involved in the aural rehabilitation process, we reviewed the existing CI clinical pathway to identify gaps in services, and with better fostering of inter-professional collaboration (IPC) in 2017, we compared the difference in outpatient aural rehabilitation attendance rates for patients seen before and after 2017. Methods: A retrospective review was undertaken of the outpatient administrative system to look at appointment cancellation rates before and after IPC for CI patients undergoing post-surgical aural rehabilitation from 2010 to 2019. A paired-sample t-test of significance was used, with the level of significance set at p=0.05. Problem analysis using the Problem, Intervention, Comparison, Outcomes framework helped in identifying the possible reasons for non-compliance with aural rehabilitation attendance. Inter-professional education among audiologists, otologists and speech therapists allowed for a close-knit IPC. Results: There were 78 patients with CIs from 2010 to 2019. Of these, 46 patients were implanted between 2010 and 2016, and 32 were implanted after IPC was introduced in 2017. The median cancellations rates were significantly reduced from 23% to 15%, with a p-value of 0.00. Days to switch-on and aural rehabilitation, number of appointment cancellations and total number of individual visits were significant independent predictors of the percentage of cancellations in regression analysis. Conclusion: Future studies are warranted to see if IPC can indirectly drive clinical outcomes, given that IPC encouraged better compliance with aural rehabilitation attendance post CI. It is imperative to have IPC in this dynamic health-care landscape with increasing complexities. IPC cannot be achieved without a close-knit relationship among the relevant health professionals.

Sign in / Sign up

Export Citation Format

Share Document