Safe chemotherapy: Clinicians driving technology and not the other way around.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 183-183
Author(s):  
Vishal Kukreti ◽  
Roxanne Cosby ◽  
Annie Cheung ◽  
Marie Hamasoor ◽  
Sherrie Hertz ◽  
...  
Keyword(s):  
Clinical Practice ◽  
System Integration ◽  
Quality Care ◽  
Management Strategies ◽  
User Involvement ◽  
Clinical Work ◽  
Future Research ◽  
Evidence Based ◽  
Unanticipated Consequences ◽  
Evidence Based Guideline

183 Background: Although information technology (IT) has the potential to improve the quality and safety of patient care, introduction into the clinical work flow may create unanticipated consequences. IT solutions such as computerized physician order entry (CPOE) are often designed and executed without end-user involvement. An evidence based guideline for systemic treatment (ST) CPOE was developed. The guideline looks at the features, functionalities and components of a ST CPOE system required to ensure safe and high-quality care. Methods: The guideline was developed by an interdisciplinary panel of physicians, nurses, pharmacists, methodologists, IT specialists, and human factors experts. A systematic review was conducted of the available clinical and technology literature and key informant interviews were conducted. Role-specific CPOE functionalities were process mapped for physicians, nurses and pharmacists. Two expert panels (i.e., clinical and supporting tools) were convened to review the information and provide feedback on guideline content. The guideline was also reviewed externally by content experts from provincial, national and international organizations. Results: The resulting evidence-based guideline focused on two distinct yet interconnected parts: clinical practice (e.g., error prevention, unanticipated consequences, impact on practice, clinical decision support), and technology requirements (e.g., usability features, system integration, effective alerts, audit logs, regimen building). The recommendations also highlight the importance of change management strategies and clinician engagement. Conclusions: This innovative guideline provides an approach to technology evaluation focusing on clinical practice needs driving IT solutions. Future research to help standardize design and usability of such systems is necessary. The non-vendor specific recommendations can be used as the foundation for evaluation of ST CPOE systems to reduce errors, improve safety, and support clinical practice. The application of the recommendations as an assessment of ST CPOE system guideline concordance will also be valuable.

scholarly journals Plain Language Summary: Benign Paroxysmal Positional Vertigo

2017 ◽  
Vol 156 (3) ◽  
pp. 417-425
Author(s):  
Neil Bhattacharyya ◽  
Deena B. Hollingsworth ◽  
Kathryn Mahoney ◽  
Sarah O’Connor
Keyword(s):  
Quality Improvement ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Benign Paroxysmal Positional Vertigo ◽  
Evidence Based ◽  
Plain Language ◽  
Positional Vertigo ◽  
Effective Diagnosis ◽  
Evidence Based Guideline ◽  
Paroxysmal Positional Vertigo

Objective. This plain language summary serves as an overview in explaining benign paroxysmal positional vertigo, abbreviated BPPV. This summary applies to patients ≥18 years old with a suspected or potential diagnosis of BPPV and is based on the 2017 “Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).” The evidence-based guideline includes research to support more effective diagnosis and treatment of BPPV. The guideline was developed as a quality improvement opportunity for managing BPPV by creating clear recommendations to use in medical practice.

The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

2021 ◽  
Author(s):  
Alaine E Reschke-Hernández
Keyword(s):  
Clinical Practice ◽  
Music Therapy ◽  
Behavioral Interventions ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Intervention Development ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

The global elements of vital signs' assessment: a guide for clinical practice

2021 ◽  
Vol 30 (16) ◽  
pp. 956-962
Author(s):  
Malcolm Elliott
Keyword(s):  
Clinical Practice ◽  
Outcomes Research ◽  
Quality Care ◽  
Vital Signs ◽  
Clinical Judgement ◽  
Evidence Based ◽  
Valuable Insight ◽  
High Quality ◽  
Culture Tradition ◽  
Insight Into

The assessment of vital signs is critical for safe, high-quality care. Vital signs' data provide valuable insight into the patient's condition, including how they are responding to medical treatment and, importantly, whether the patient is deteriorating. Although abnormal vital signs have been associated with poor clinical outcomes, research has consistently found that vital signs' assessment is often neglected in clinical practice. Factors contributing to this include nurses' knowledge, clinical judgement, culture, tradition and workloads. To emphasise the importance of vital signs' assessment, global elements of vital signs' assessment are proposed. The elements reflect key principles underpinning vital signs' assessment and are informed by evidence-based literature.

Using a Critical Appraisal Assignment to Infuse Evidence-Based Practice into a Therapeutic Modality Course

2014 ◽  
Vol 9 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Mary Beth Zwart ◽  
Bernadette Olson
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Clinical Findings ◽  
Therapeutic Modality ◽  
Future Research ◽  
Evidence Based ◽  
Clinical Question ◽  
Starting Point

Context It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding EBP concepts across the curriculum, a modified critical appraisal assignment was developed to teach therapeutic modality concepts. Objective The purpose of this action research project was to demonstrate how a modified critical appraisal assignment can be used to introduce the process and aspects of critical appraisal and begin scaffolding the development of critical appraisal skills over time. The objectives of this study were to evaluate the students' ability to (1) successfully locate relevant research needed to answer clinical questions and (2) successfully appraise the literature according to basic EBP strategy. From a program perspective, the modified critical appraisal assignment was a starting point from which to include EBP principles into didactic coursework. Design Seventeen athletic training students completed 3 modified critical appraisal assignments pertaining to the use of therapeutic modalities. Each paper included 5 sections: (1) clinical question, (2) key clinical findings, (3) clinical applicability based on information from the appraisal and significance of results, (4) article comparison table, and (5) implications for clinical practice, patient education, and future research. The instructor evaluated the assignments blind. Conclusions Students were generally able to complete the critical appraisal assignment; however, students had difficulty locating research that answered the clinical question. Students struggled to relate the key clinical findings of the research articles and implications for clinical practice to the given clinical question. Findings from this study have informed faculty teaching, including introducing EBP skills earlier in the curriculum and inserting assignments that stress various aspects of the critical appraisal process.

scholarly journals Obstetric Nursing: An Integrative Review

10.3823/2456 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Sidney Medeiros de Oliveira ◽  
Marianna Leite Barroso ◽  
Vânia Barbosa do Nascimento ◽  
Gislene Farias de Oliveira
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Research Method ◽  
Scientific Literature ◽  
Critical Assessment ◽  
Integrative Review ◽  
Future Research ◽  
Evidence Based ◽  
The Subject ◽  
Nursing Health

Evidence-based research, tend to encourage the development and / or use of the results found, in the clinical practice. The amount and complexity of information in health, requires the production of literature review methods, such as integrative review, which provide a support in the form of synthesis. The aim of this study was to analyze the scientific literature available on midwifery in SciELO database from 2010 to 2015. It presents general concepts and stages of development of the integrative review, as well as relevant aspects of the applicability of this method for research in nursing and health in general. The integrative review is a research method that allows a systematic search, critical assessment and the promotion of a synthesis of the available evidence on the subject investigated.The publications reviewed here, have shown how it is relevant to clinical practice, the participation of nursing in all stages of the gestational cycle, including childbirth and the postpartum period. Also provided to identify gaps that that will direct the development of future research, such as those relating to liability issues of the nursing area hardly contemplated in studies of care in obstetrics.  Keywords: Research. obstetric nursing. Health.

Future Directions and Conclusion

2016 ◽  
Author(s):  
Phillip M. Kleespies
Keyword(s):  
International Organizations ◽  
Interpersonal Violence ◽  
Clinical Work ◽  
Future Research ◽  
Evidence Based ◽  
Mental Health Providers ◽  
Health Providers ◽  
Future Directions ◽  
Behavioral Emergencies ◽  
And Training

In this concluding chapter, further emphasis is given to the critical need for education and training for psychologists and other mental health providers in the evaluation and management of behavioral emergencies. It is noted that the need for such training has been cited by several national and international organizations concerned with health care. Next, there is a discussion of some aspects of behavioral emergencies that are in need of future research and some promising directions for the prevention of suicide and interpersonal violence (e.g., means restriction and means restriction counseling). Finally, the importance of remaining evidence-based in clinical work is discussed, as well as what “evidence-based” might mean in a dynamic area of practice such as behavioral emergencies.

scholarly journals Plain Language Summary: Earwax (Cerumen Impaction)

2017 ◽  
Vol 156 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Helene J. Krouse ◽  
Anthony E. Magit ◽  
Sarah O’Connor ◽  
Seth R. Schwarz ◽  
Sandra A. Walsh
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Medical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Care Providers ◽  
Plain Language ◽  
Evidence Based Guideline

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.

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