scholarly journals Benefits of multidisciplinary collaborative care team-based nursing services in treating pressure injury wounds in cerebral infarction patients

2022 ◽  
Vol 10 (1) ◽  
pp. 43-50
Author(s):  
You-Hua Gu ◽  
Xun Wang ◽  
Si-Si Sun
Author(s):  
Lori Raney ◽  
Gina Lasky ◽  
Clare Scott
Keyword(s):  

2017 ◽  
Vol 43 (6) ◽  
pp. 621-630
Author(s):  
Brittaney Belyeu ◽  
Lydia Chwastiak ◽  
Joan Russo ◽  
Meghan Kiefer ◽  
Kathy Mertens ◽  
...  

Purpose The purpose of the study was to evaluate patient factors associated with nonengagement in a Diabetes Collaborative Care Team (DCCT) program in a safety-net clinic. Methods The first 18 months of a multidisciplinary care, team-based diabetes care management program in a safety-net primary care clinic were studied. Nonengagement was defined as fewer than 2 visits with a team member during the 18 months of the program. Patients who did not engage in the program were compared with those who did engage on demographics, comorbid medical and psychiatric diagnoses, and cardiovascular risk factors, using univariate and multivariable analyses. Results Of the 151 patients referred to the DCCT, 68 (45%) were nonengaged. In unadjusted analyses, patients who did not engage were more likely to be female and have higher baseline A1C values; they were less likely to have major depressive disorder, anxiety disorder, any depression diagnosis, and hyperlipidemia. Female gender and chronic pain were independently associated with nonengagement after multivariable adjustment. Conclusions The findings suggest that among patients with uncontrolled diabetes in an urban safety-net primary care clinic, there is a need to address barriers to engagement for female patients and to integrate chronic pain management strategies within multicondition collaborative care models.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lenka Vojtila ◽  
Iqra Ashfaq ◽  
Augustina Ampofo ◽  
Danielle Dawson ◽  
Peter Selby

Plain English summary Researchers have explored different types of treatment to help people with a mental illness with other problems they might be experiencing, such as their health condition and quality of life. Care models that involve many different health care providers working together to provide complete physical and mental health care are becoming popular. There has been a push from the research community to understand the value of including people with lived experience in such programs. While research suggests that people with lived experience may help a patient’s treatment, there is little evidence on including them in a team based program. This paper describes how our research team included a person with lived experience of psychosis in both the research and care process. We list some guiding principles we used to work through some of the common challenges that are mentioned in research. Lastly, experiences from the research team, lessons learned, and a personal statement from the person with lived experience (AA) are provided to help future researchers and people with lived experience collaborate in research and healthcare. Abstract Background In our current healthcare system, people with a mental illness experience poorer physical health and early mortality in part due to the inconsistent collaboration between primary care and specialized mental health care. In efforts to bridge this gap, hospitals and primary care settings have begun to take an integrated approach to care by implementing collaborative care models to treat a variety of conditions in the past decade. The collaborative care model addresses common barriers to treatment, such as geographical distance and lack of individualized, evidence-based, measurement-based treatment. Person(s) with lived experience (PWLE) are regarded as ‘experts by experience’ in the scope of their first-hand experience with a diagnosis or health condition. Research suggests that including PWLE in a patient’s care and treatment has significant contributions to the patient’s treatment and overall outcome. However, there is minimal evidence of including PWLE in collaborative care models. This paper describes the inclusion of a PWLE in a research study and collaborative care team for youth with early psychosis. Aims To discuss the active involvement of a PWLE on the research and collaborative care team and to describe the research team’s experiences and perspectives to facilitate future collaborations. Method This paper describes the inclusion of a PWLE on our research team. We provide a selective review of the literature on several global initiatives of including PWLE in different facets of the healthcare system. Additionally, we outline multiple challenges of involving PWLE in research and service delivery. Examples are provided on how recruitment and involvement was facilitated, with the guidance of several principles. Lastly, we have included a narrative note from the PWLE included in our study, who is also a contributing author to this paper (AA), where she comments on her experience in the research study. Conclusion Including PWLE in active roles in research studies and collaborative care teams can enhance the experience of the researchers, collaborative care team members, and PWLE. We showcase our method to empower other researchers and service providers to continue to seek guidance from PWLE to provide more comprehensive, collaborative care with better health outcomes for the patient, and a more satisfying care experience for the provider.


Author(s):  
Virginia Reising ◽  
Lauren Diegel-Vacek ◽  
Lisa Dadabo MSW ◽  
Susan Corbridge

INTRODUCTION Integrated behavioral health is a model of health care that aims to meet the complex health care needs of patients in primary care settings. Collaborative Care (CC) is an evidence-based model incorporating an interdisciplinary team to improve outcomes for behavioral health disorders commonly seen by primary care providers. OBJECTIVE CC was implemented in a nurse-managed health center in a medically underserved community of Chicago with a team of family nurse practitioners, psychiatric mental health nurse practitioners, and a licensed clinical social worker. METHOD Integration of the CC model required restructuring of the patient visit, the care team, and financial operations. Weekly team meetings were held for interdisciplinary case consultation and training for the primary care team by the psychiatric nurse practitioner. The model includes suggested goals of reducing patient scores of validated depression (Patient Health Questionnaire–9) and anxiety (Generalized Anxiety Disorder–7) screening tools to a score less than 5 points or to less than 50% of original score. RESULTS During the initial year of implementation, 166 patients received care under the CC model, with 64 patients currently receiving active care. In this cohort, 22% reached suggested goals for depression and 47% for anxiety. CONCLUSIONS CC has benefits for both patients and providers. Patients receive holistic treatment of both mental and physical health needs and access to psychiatric services for medication initiation and behavioral health modalities when necessary. We observed that the CC model improved collaboration with behavioral health specialists and the competence and confidence of family nurse practitioners.


2019 ◽  
Vol 32 (12) ◽  
pp. 1457-1465 ◽  
Author(s):  
Lydia W. Li ◽  
Jiang Xue ◽  
Yeates Conwell ◽  
Qing Yang ◽  
Shulin Chen

ABSTRACTBackground:Depression often coexists with other chronic conditions in older people. The COACH study is an ongoing random controlled trial (RCT) to test the effectiveness of a primary-care-based collaborative care approach to treat co-morbid hypertension and depression in Chinese rural elders. In the COACH model, a team—village doctor (VD), aging worker (AW), and psychiatrist consultant—provides collaborative care to enrolled subjects in each intervention village for 12 months. This study examines how COACH was implemented and identifies facilitators and barriers for its more widespread implementation.Methods:Five focus groups were conducted, two with VDs, two with AWs, and one with psychiatrists, for a total of 38 participants. Transcripts were analyzed using qualitative content analysis.Results:COACH care-team members showed shared understanding and appreciation of the team approach and integrated management of hypertension and depression. Team collaboration was smooth. All members regarded COACH to be effective in reducing depressive symptoms and improving patient health. Facilitators to implementation include training, leaders’ support, geographic proximity between VD and AW pairs, preexisting relationships among care-team members, comparability of COACH activities and existing practices of VDs and AWs, and care team members’ caring about older members of their villages. Barriers to sustainability include frustration of some VDs related to their low wages and feelings of overload of some AWs.Conclusions:COACH was positively perceived and successfully implemented. The findings offer guidance for planning primary-care-based collaborative depression care in low- and middle-income countries.


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