scholarly journals Clinical decision making in the provision of audiovisual care for upper limb trauma: a survey of UK experiences

Hand Therapy ◽  
2020 ◽  
pp. 175899832097213
Author(s):  
Emily McMullen ◽  
Megan Robson ◽  
Mark Paul Brewin ◽  
Poonam Valand ◽  
Leela Sayed ◽  
...  
Keyword(s):  
Decision Making ◽  
Upper Limb ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Service Planning ◽  
Cross Sectional Survey ◽  
Visual Technology ◽  
Limb Trauma ◽  
The Uk ◽  
Decision Making Tool

Introduction For many patients, audio-visual appointments have provided a timely and efficient way of seeking advice, assessment and treatment for their hand injuries during the NHS response to COVID-19. This study aimed to explore the experience of hand units across the UK in determining the safe and judicious use of audio-visual outpatient care for the management of acute upper limb trauma. Methods An online cross-sectional survey was sent to the therapy leads of hand units across the UK. Questions focused on the experience of using audio-visual technology in the management of upper limb trauma, and the relevant factors in determining its appropriate use. A deductive mixed methods analysis was used to identify both common themes and capture community experience and characteristics. Results A total of 51 out of 76 hand therapy units completed the survey; a response rate of 67%. Of these, 82% (42/51) reported using audio-visual technology to manage upper limb trauma during the UK COVID-19 lockdown. When determining patient suitability for audio-visual consultations, 73% (37/51) of respondents reported the use of COVID-19 guidelines, but only 35% (18/51) reported the use of a clinical decision-making tool. In agreement with our experience at Salisbury Hospital Foundation Trust, 92% (47/51) had concerns relating to the use of audio-visual care. Conclusion The choice of safely managed remote care or in-person consultation has, to date, largely relied on the discretion of the clinician. A carefully designed clinical decision-making tool for the management of upper limb trauma is needed for use both in clinical practice and in future service planning.

scholarly journals Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer

2014 ◽  
Vol 110 (7) ◽  
pp. 1688-1697 ◽  
Author(s):  
E A Rakha ◽  
D Soria ◽  
A R Green ◽  
C Lemetre ◽  
D G Powe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Prognostic Index ◽  
Clinical Decision ◽  
Nottingham Prognostic Index ◽  
Decision Making Tool

Choosing care

2017 ◽  
Author(s):  
Alan Cribb
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Health Systems ◽  
Social Action ◽  
Agenda Setting ◽  
Clinical Decision Making ◽  
Active Role ◽  
Clinical Decision ◽  
Service Planning ◽  
Design Decisions

This chapter focuses on some of the mainstream and circumscribed examples of rethinking agency. Once one starts seeing and treating people as healthcare actors—as having something to contribute to their own care and to health systems and environments—many possibilities emerge. Some of these are already absorbed into mainstream thinking and others are more challenging or radical. The former includes the expectation that patients should play an active role in clinical decision making that affects them. The latter extend much more widely—questioning why ‘lay people’ are often allowed to be influential only in circumscribed instances, when their agency and perspectives could be equally influential in agenda setting and design decisions in all aspects of service planning, care provision, research, resource allocation and so on. This question highlights the potential to move beyond an individualist or consumerist conception of agency and towards more civic, social and democratic conceptions of social action.

Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization

1987 ◽  
Vol 40 (5) ◽  
pp. 385-397 ◽  
Author(s):  
Sylvia Wassertheil-Smoller ◽  
Richard M. Steingart ◽  
John P. Wexler ◽  
Jonathan Tobin ◽  
Nancy Budner ◽  
...  
Keyword(s):  
Decision Making ◽  
Cardiac Catheterization ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Decision Making Tool

Understanding critical care nurses’ autonomy in Jordan

2017 ◽  
Vol 30 (4) ◽  
pp. 432-442 ◽  
Author(s):  
Mahmoud Maharmeh
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Content Type

Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Prediction of Intravesical Recurrence After Radical Nephroureterectomy: Development of a Clinical Decision-making Tool

2014 ◽  
Vol 65 (3) ◽  
pp. 650-658 ◽  
Author(s):  
Evanguelos Xylinas ◽  
Luis Kluth ◽  
Niccolo Passoni ◽  
Quoc-Dien Trinh ◽  
Malte Rieken ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Radical Nephroureterectomy ◽  
Decision Making Tool

scholarly journals Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Breda H. F. Eubank ◽  
Sebastian W. Lackey ◽  
Mel Slomp ◽  
Jason R. Werle ◽  
Colleen Kuntze ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Shoulder Pain ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Primary Care Providers ◽  
Rapid Review ◽  
Diagnosis And Management ◽  
Joint Health ◽  
Decision Making Tool

Abstract Background Shoulder pain is a highly prevalent condition and a significant cause of morbidity and functional disability. Current data suggests that many patients presenting with shoulder pain at the primary care level are not receiving high quality care. Primary care decision-making is complex and has the potential to influence the quality of care provided and patient outcomes. The aim of this study was to develop a clinical decision-making tool that standardizes care and minimizes uncertainty in assessment, diagnosis, and management. Methods First a rapid review was conducted to identify existing tools and evidence that could support a comprehensive clinical decision-making tool for shoulder pain. Secondly, provincial consensus was established for the assessment, diagnosis, and management of patients presenting to primary care with shoulder pain in Alberta, Canada using a three-step modified Delphi approach. This project was a highly collaborative effort between Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN) and the Alberta Bone and Joint Health Institute (ABJHI). Results A clinical decision-making tool for shoulder pain was developed and reached consensus by a province-wide expert panel representing various health disciplines and geographical regions. This tool consists of a clinical examination algorithm for assessing, diagnosis, and managing shoulder pain; recommendations for history-taking and identification of red flags or additional concerns; recommendations for physical examination and neurological screening; recommendations for the differential diagnosis; and care pathways for managing patients presenting with rotator cuff disease, biceps pathology, superior labral tear, adhesive capsulitis, osteoarthritis, and instability. Conclusions This clinical decision-making tool will help to standardize care, provide guidance on the diagnosis and management of shoulder pain, and assist in clinical decision-making for primary care providers in both public and private sectors.

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