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.

scholarly journals What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review

2019 ◽  
Vol 54 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Ivan Lin ◽  
Louise Wiles ◽  
Rob Waller ◽  
Roger Goucke ◽  
Yusuf Nagree ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Quality Care ◽  
Surgical Care ◽  
High Quality ◽  
Eligibility Criteria ◽  
Evidence Database

ObjectivesTo identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis [OA] and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs).DesignSystematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations.Eligibility criteriaIncluded MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.Data sourcesFour scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories.Results6232 records were identified, 44 CPGs were appraised and 11 were rated as high quality (low back pain: 4, OA: 4, neck: 2 and shoulder: 1). We identified 11 recommendations for MSK pain care: ensure care is patient centred, screen for red flag conditions, assess psychosocial factors, use imaging selectively, undertake a physical examination, monitor patient progress, provide education/information, address physical activity/exercise, use manual therapy only as an adjunct to other treatments, offer high-quality non-surgical care prior to surgery and try to keep patients at work.ConclusionThese 11 recommendations guide healthcare consumers, clinicians, researchers and policy makers to manage MSK pain. This should improve the quality of care of MSK pain.

Questions healthcare boards should ask senior leaders about risk

2018 ◽  
Vol 31 (6) ◽  
pp. 223-229
Author(s):  
Polly Stevens ◽  
Annette Down ◽  
Jordan M. Willcox
Keyword(s):  
Quality Care ◽  
Evidence Based ◽  
Healthcare Organizations ◽  
Senior Leaders ◽  
High Quality ◽  
High Quality Care ◽  
The Core ◽  
Healthcare Insurance ◽  
Recommended Practices ◽  
Guiding Questions

Drawing on strong ethical and evidence-based principles, Healthcare Insurance Reciprocal of Canada, in collaboration with healthcare leaders, has developed guiding questions to help boards of healthcare organizations carry out a critical governance function—the oversight of key organizational risks. The resulting list of 21 questions is the first of its kind for healthcare and focuses on the core mandate of healthcare organizations which is providing high-quality care. Recommended practices accompany each question.

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 Improving Care for Patients Living with Prolonged Incurable Cancer

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2555
Author(s):  
Mariken E. Stegmann ◽  
Olaf P. Geerse ◽  
Lia van Zuylen ◽  
Larissa Nekhlyudov ◽  
Daan Brandenbarg
Keyword(s):  
Clinical Practice ◽  
Cancer Diagnosis ◽  
Quality Care ◽  
Psychosocial Problems ◽  
Care Pathways ◽  
High Quality ◽  
Incurable Cancer ◽  
Number Of Patients ◽  
Wide Range ◽  
Clinical Awareness

The number of patients that can no longer be cured but may expect to live with their cancer diagnosis for a substantial period is increasing. These patients with ‘prolonged incurable cancer’ are often overlooked in research and clinical practice. Patients encounter problems that are traditionally seen from a palliative or survivorship perspective but this may be insufficient to cover the wide range of physical and psychosocial problems that patients with prolonged incurable cancer may encounter. Elements from both fields should, therefore, be delivered concordantly to further optimize care pathways for these patients. Furthermore, to ensure future high-quality care for this important patient population, enhanced clinical awareness, as well as further research, are urgently needed.

scholarly journals Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care

2019 ◽  
Vol 43 (2) ◽  
pp. 126
Author(s):  
Sandra G. Leggat ◽  
Cathy Balding
Keyword(s):  
Health Service ◽  
Health Services ◽  
Care Delivery ◽  
Quality Care ◽  
Successful Implementation ◽  
Evidence Based ◽  
Quality And Safety ◽  
Quality Systems ◽  
High Quality ◽  
High Quality Care

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation’s pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.

scholarly journals Translating Knowledge to Optimize Value-Based Occupational Therapy: Strategies for Educators, Practitioners, and Researchers

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Lisa A. Juckett ◽  
Monica L. Robinson ◽  
Julie Malloy ◽  
Haley V. Oliver
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Quality Care ◽  
Successful Implementation ◽  
Evidence Based ◽  
Client Outcomes ◽  
High Quality ◽  
Value Based Care ◽  
Therapy Strategies ◽  
Payment Models

With the continued evolution of health care reform and payment models, it is imperative that the occupational therapy profession consistently and clearly articulate its distinct value. As payment models shift from paying for the volume of services provided to paying for the value of services, the field of occupational therapy must be sure to implement high-quality care by translating evidence into practice and facilitating improvements in client outcomes. Yet the process of translating evidence-based interventions and programs to real-world settings can be quite complex, and successful implementation often requires active collaboration across occupational therapy stakeholders. In this Health Policy Perspectives article, we provide occupational therapy educators, practitioners, and researchers with key recommendations for how the profession can translate evidence into practice, ultimately leading to the improvement of client outcomes and the provision of value-based care.

scholarly journals Development of an HIV Prevention Videogame: Lessons Learned

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Kimberly Hieftje ◽  
Lynn E. Fiellin ◽  
Tyra Pendergrass ◽  
Lindsay R Duncan
Keyword(s):  
Health Promotion ◽  
Hiv Prevention ◽  
Disease Prevention ◽  
Scientific Literature ◽  
Lessons Learned ◽  
Evidence Based ◽  
Valuable Insight ◽  
Effective Strategy ◽  
Prevention And Health Promotion ◽  
Insight Into

The use of videogames interventions is becoming an increasingly popular and effective strategy in disease prevention and health promotion; however, few health videogame interventions have been scientifically rigorously evaluated for their efficacy. Moreover, few examples of the formative process used to develop and evaluate evidence-based health videogame interventions exist in the scientific literature. The following paper provides valuable insight into the lessons learned during the process of developing the risk reduction and HIV prevention videogame intervention for young adolescents, PlayForward: Elm City Stories. 

Radiology

2018 ◽  
pp. 765-864
Author(s):  
Drew Provan
Keyword(s):  
Interventional Radiology ◽  
Clinical Practice ◽  
Minimally Invasive ◽  
Differential Diagnoses ◽  
Evidence Based ◽  
Clinical Conditions ◽  
Work Up ◽  
Insight Into

This chapter gives an overview of the role of radiological investigations in the management and work-up of common clinical conditions across a spectrum of specialties. It also provides an insight into basic interpretation skills and pitfalls when approaching common radiological tests. In addition to providing an evidence-based approach to the utilization of radiological resources, differential diagnoses are provided throughout. Where appropriate, indications and contraindications for radiological techniques are given to provide an essential bedside resource for the practising clinician. More advanced sections tackle the physics underlying each modality, as well as specialized interventional radiology and its role in minimally invasive clinical practice.

scholarly journals Commentary: De-implementation Science: A Virtuous Cycle of Ceasing and Desisting Low-Value Care Before Implementing New High Value Care

2017 ◽  
Vol 27 (4) ◽  
pp. 463 ◽  
Author(s):  
Karina W. Davidson ◽  
Siqin Ye ◽  
George A. Mensah
Keyword(s):  
Behavior Change ◽  
Implementation Science ◽  
Feedback Loop ◽  
Quality Care ◽  
Evidence Based ◽  
High Quality ◽  
Behavior Change Techniques ◽  
Virtuous Cycle ◽  
And Behavior ◽  
Evidence Based Care

<p>Implementation science has traditionally focused on increasing the delivery of evidence-based care. The science of systematically stopping low-value and wasteful care is substantially under-recognized, and if successful, may decrease the workload of clinicians. De-implementation science identifies problem areas of low-value and wasteful practice, carries out rigorous scientific examination of the factors that initiate and maintain such behaviors, and then employs evidence-based interventions to cease these practices. In this commentary, we describe how this approach for de-implementation might require a different set of health systems supports, economic and non-economic levers, and behavior change techniques that can lead to a virtuous cycle, ie, a complex chain of events that positively reinforce themselves through a feedback loop of removing low-value care to make room for high quality care. <em></em></p><p><em>Ethn Dis. </em>2017;27(4):463-468; doi:10.18865/ ed.27.4.463. </p>

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