Creation of a palliative care advanced practice registered nurse peer-review process

2019 ◽  
Vol 25 (12) ◽  
pp. 596-602
Author(s):  
Patrice R. Fedel ◽  
Nicole E. Hembel ◽  
Lindsey M. Mueller
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Peer Review ◽  
Professional Growth ◽  
Review Process ◽  
Clinical Decision Making ◽  
Peer Review Process ◽  
Clinical Decision ◽  
Advanced Practice ◽  
Case Review

The mark of a true profession is the ability to self-regulate. As such, advanced practice registered nurses (APRNs) are challenged by their professional organisations to participate in self-evaluation and peer review. Peer review is a method for evaluating the care provided by the APRN to both ensure quality nursing care and promote professional growth. Despite guidelines to participate in a formal peer-review process, there is little information within the nursing profession on how to accomplish peer review. A comprehensive literature review failed to provide a framework for peer review that is practice focused, fosters a learning environment and encompasses the thought process and clinical decision-making of the palliative care advanced practice nurse. A group of palliative care APRNs set out to create a process that encompassed the breadth of clinical decision-making in palliative care advanced nursing practice. Using the eight domains of palliative care, a narrative case review structure was created. The resulting process both assisted the APRNs in professional growth and provided timely feedback for the annual performance evaluation.

scholarly journals Analysis of an inter-centre, web-based radiation oncology peer-review case conference

2015 ◽  
Vol 14 (2) ◽  
pp. 135-142
Author(s):  
Chamunyonga Crispen ◽  
Osama M. Kellini ◽  
Milind Kumar
Keyword(s):  
Decision Making ◽  
Peer Review ◽  
Radiation Oncology ◽  
Professional Growth ◽  
Clinical Decision Making ◽  
Good Practice ◽  
Clinical Decision ◽  
Case Conference ◽  
Web Based ◽  
The Web

AbstractPurposePeer-review programmes in radiation oncology are used to facilitate the process and evaluation of clinical decision-making. However, web-based peer-review methods are still uncommon. This study analysed an inter-centre, web-based peer-review case conference as a method of facilitating the decision-making process in radiation oncology.MethodologyA benchmark form was designed based on the American Society for Radiation Oncology targets for radiation oncology peer review. This was used for evaluating the contents of the peer-review case presentations on 40 cases, selected from three participating radiation oncology centres. A scoring system was used for comparison of data, and a survey was conducted to analyse the experiences of radiation oncology professionals who attended the web-based peer-review meetings in order to identify priorities for improvement.ResultsThe mean scores for the evaluations were 82·7, 84·5, 86·3 and 87·3% for cervical, prostate, breast and head and neck presentations, respectively. The survey showed that radiation oncology professionals were confident about the role of web-based peer-reviews in facilitating sharing of good practice, stimulating professionalism and promoting professional growth. The participants were satisfied with the quality of the audio and visual aspects of the web-based meeting.ConclusionThe results of this study suggest that simple inter-centre web-based peer-review case conferences are a feasible technique for peer review in radiation oncology. Limitations such as data security and confidentiality can be overcome by the use of appropriate structure and technology. To drive the issues of quality and safety a step further, small radiotherapy departments may need to consider web-based peer-review case conference as part of their routine quality assurance practices.

Peer Review or Lottery? A Critical Analysis of Two Different Forms of Decision-making Mechanisms for Allocation of Research Grants

2019 ◽  
Vol 44 (6) ◽  
pp. 994-1019 ◽  
Author(s):  
Lambros Roumbanis
Keyword(s):  
Decision Making ◽  
Peer Review ◽  
Review Process ◽  
Selection Process ◽  
Peer Review Process ◽  
Dynamic Selection ◽  
Funding Agencies ◽  
Epistemic Diversity ◽  
Alternative Decision ◽  
Made In

At present, peer review is the most common method used by funding agencies to make decisions about resource allocation. But how reliable, efficient, and fair is it in practice? The ex ante evaluation of scientific novelty is a fundamentally uncertain endeavor; bias and chance are embedded in the final outcome. In the current study, I will examine some of the most central problems of peer review and highlight the possible benefits of using a lottery as an alternative decision-making mechanism. Lotteries are driven by chance, not reason. The argument made in the study is that the epistemic landscape could benefit in several respects by using a lottery, thus avoiding all types of bias, disagreement, and other limitations associated with the peer review process. Funding agencies could form a pool of funding applicants who have minimal qualification levels and then select randomly within that pool. The benefits of a lottery would not only be that it saves time and resources, but also that it contributes to a more dynamic selection process and increases the epistemic diversity, fairness, and impartiality within academia.

Reversibility of Delirium in Palliative Care (DRAFT)

2018 ◽  
Author(s):  
Tiffany Shaw ◽  
Eric Prommer
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Palliative Care ◽  
Clinical Case ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Factors Associated ◽  
Frequent Event ◽  
Study Intervention

Delirium is a frequent event in patients with advanced cancer. Untreated delirium affects assessment of symptoms, impairs communication including participation in clinical decision-making. This study used specific diagnostic criteria for delirium and prospectively identified precipitating causes of delirium. The study identified factors associated with reversible and irreversible delirium. Impact of delirium on prognosis was evaluated. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case. Topics covered include delirium, neoplasms, palliative care, polypharmacy, risk factors, and therapeutics.

scholarly journals Awareness of predatory journals and open access among medical oncologists: results of an online survey

ESMO Open ◽  
2019 ◽  
Vol 4 (6) ◽  
pp. e000580 ◽  
Author(s):  
Georg Richtig ◽  
Erika Richtig ◽  
Alexandra Böhm ◽  
Christoph Oing ◽  
Farastuk Bozorgmehr ◽  
...  
Keyword(s):  
Open Access ◽  
Peer Review ◽  
Online Survey ◽  
Clinical Decision Making ◽  
Scientific Practice ◽  
Peer Review Process ◽  
Clinical Decision ◽  
University Hospital ◽  
Predatory Journals ◽  
Number Of Publications

IntroductionPredatory journals harm the integrity of science as principles of ‘good scientific practice’ are bypassed by omitting a proper peer-review process. Therefore, we aimed to explore the awareness of predatory journals among oncologists.MethodsAn online survey among oncologists working in Germany or Austria of various professional surroundings was conducted between October 2018 and April 2019.ResultsOne hundred and eighty-eight participants (55 women (29.2%), 128 men (68.1%)) completed the questionnaire. 41 (21.8%) participants indicated to work in a hospital, 24 (12.8%) in private practice and 112 (59.6%) in a university hospital. 98.9% of participants indicated to actively read scientific articles and consider them in clinical decision-making (96.3%). 90.4% of participants indicated to have scientific experience by publishing papers in journals with peer-review system. The open-access system was known by 170 (90.4%), predatory journals by 131 (69.7%) and Beall’s list by 52 participants (27.7%). Predatory journals were more likely to be known by participants with a higher number of publications (p<0.001), with more high-impact publications (p=0.005) and with recent publications (p<0.001). Awareness of predatory journals did not correlate with gender (p=0.515) or translation of scientific literature into clinical practice (p=0.543).ConclusionsThe problematic topic of ‘predatory journals’ is still unknown by a considerable amount of oncologist, although the survey was taken in a cohort of oncologists with scientific experience. Dedicated educational initiatives are needed to raise awareness of this problem and to aid in the identification of predatory journals for the scientific oncology community.

scholarly journals Competências do enfermeiro para o cuidado paliativo em cardiologia

2018 ◽  
Vol 12 (9) ◽  
pp. 2341 ◽  
Author(s):  
Bruna Christine Floriano Brabo ◽  
Manoela Gomes Grossi Laprano
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Structured Interview ◽  
Social Needs ◽  
Joint Decision ◽  
Multiprofessional Team ◽  
Terapia Intensiva

RESUMOObjetivo: analisar as competências profissionais do enfermeiro para o cuidado paliativo em Unidade de Terapia Intensiva Cardiológica. Método: estudo qualitativo, descritivo e exploratório fundamentado no referencial teórico das Competências Centrais em Cuidados Paliativos e realizado na UTI de um hospital cardiológico. Realizou-se a entrevista semiestruturada com oito enfermeiros. Para a interpretação dos dados, utilizaram-se a análise de conteúdo e a categorização. Resultados: prevaleceram enfermeiras de 31 a 41 anos, com mais de dez anos de experiência na profissão e com, ao menos, um curso de pós-graduação. As competências mais citadas estão relacionadas aos constituintes centrais dos cuidados paliativos, à família, ao autoconhecimento, ao desenvolvimento profissional e ao conforto físico. As categorias menos citadas retratam as necessidades psicológicas, espirituais, o trabalho em equipe, a comunicação e a tomada de decisão ética e clínica. Não houve relatos das necessidades sociais. As competências não aplicadas referem-se à atuação na equipe multiprofissional, à tomada de decisão conjunta e à educação dos profissionais e da família. Conclusão: prevaleceram citações de competências relacionadas à assistência. Após recente implantação do serviço, observa-se a necessidade do fortalecimento da equipe multiprofissional e da educação dos profissionais de Enfermagem. Descritores: Cuidados Paliativos; Competência Profissional; Cuidados Críticos; Enfermagem; Unidade de Terapia Intensiva; Cardiologia.ABSTRACT Objective: to analyze the professional competencies of the nurse for palliative care in the Cardiology Intensive Care Unit. Method: a qualitative, descriptive, exploratory study based on the theoretical reference of the Central Skills in Palliative Care and carried out at the ICU of a cardiological hospital. A semi-structured interview was conducted with eight nurses. For the interpretation of the data, the content analysis and the categorization were used. Results: nurses from 31 to 41 years old, with more than ten years of experience in the profession and with at least one postgraduate course prevailed. The most cited competences are related to the central constituents of palliative care, family, self-knowledge, professional development and physical comfort. The less-quoted categories portray psychological, spiritual, teamwork, communication, and ethical and clinical decision-making. There were no reports of social needs. The competences that were not applied, refer to the performance in the multiprofessional team, the joint decision making and the education of the professionals and the family. Conclusion: citations of competence related to care prevailed. After the recent implementation of the service, the need to strengthen the multiprofessional team and the education of nursing professionals is observed. Descritores: Palliative Care; Profissional Competence; Critical Care; Nursing; Intensive Care Units; Cardiology.RESUMEN Objetivo: analizar las competencias profesionales del enfermero para el cuidado paliativo en Unidad de Terapia Intensiva Cardiológica. Método: estudio cualitativo, descriptivo, exploratorio fundamentado en el referencial teórico de las Competencias Centrales en Cuidados Paliativos y realizado en la UTI de un hospital cardiológico. Se realizó la entrevista semiestructurada con ocho enfermeros. Para la interpretación de los datos, se utilizaron el análisis de contenido y la categorización. Resultados: prevalecieron enfermeras de 31 a 41 años, con más de diez años de experiencia en la profesión y con, al menos, un curso de postgrado. Las competencias más citadas están relacionadas a los constituyentes centrales de los cuidados paliativos, a la familia, al autoconocimiento, al desarrollo profesional y al confort físico. Las categorías menos citadas retratan las necesidades psicológicas, espirituales, el trabajo en equipo, la comunicación y la toma de decisión ética y clínica. No hubo informes de las necesidades sociales. Las competencias no aplicadas se refieren a la actuación en el equipo multiprofesional, a la toma de decisión conjunta y a la educación de los profesionales y de la familia. Conclusión: prevalecieron citaciones de competencias relacionadas a la asistencia. Después de la reciente implantación del servicio, se observa la necesidad del fortalecimiento del equipo multiprofesional y de la educación de los profesionales de Enfermería. Descritores: Cuidados Paliativos; Competencia Profissional; Cuidados críticos; Enfermería; Unidades de cuidados intensivos; Cardiología.   

Diagnostic Decisions in Child Language Assessment: Findings From a Case Review Assessment Task

2019 ◽  
Vol 50 (3) ◽  
pp. 385-398 ◽  
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Decision Making ◽  
Standardized Testing ◽  
Clinical Decision Making ◽  
Child Language ◽  
Language Assessment ◽  
Clinical Decision ◽  
Case Review ◽  
Assessment Data ◽  
Assessment Task ◽  
Diagnostic Decision

Purpose The current study used a case review diagnostic assessment task to examine the diagnostic decisions speech-language pathologists (SLPs) working in the United States made after reviewing child language cases. Method Fourteen SLPs were given 5 case studies that presented either congruent or incongruent results between standardized testing and informal measures. After reviewing the assessment data, SLPs were asked to make a diagnostic decision. Results Unanimous consensus regarding diagnostic decisions was found when the assessment data were congruent. When the data were incongruent, unanimous consensus was not achieved. Standardized testing seemed to guide the diagnostic decision. This pattern of reliance on standardized testing was evident even when 80% of SLPs reviewed informal language data. In 97% of cases, a standardized test was used to guide clinical decision making. Conclusion Three patterns of clinical decision making in child language assessment emerged: (a) use of both standardized testing and informal measures, (b) a reported concern tool as a 1st step in the process, and (c) standardized testing as the most influential data for guiding diagnostic decisions. Although this study provides initial evidence regarding the process of diagnostic decision making, future studies should examine decision making in real time to further validate the implicit rules used during decision making. Supplemental Material https://doi.org/10.23641/asha.7991174

Sign in / Sign up

Export Citation Format

Share Document