Assessing Parental Discharge Readiness by Using the Ticket to Home Survey Tool

2021 ◽  
Vol 12 (1) ◽  
pp. 85-93
Author(s):  
Zephyr D. Dworsky ◽  
Kyung E. Rhee ◽  
Aarti R. Patel ◽  
Molly K. McMahon ◽  
Heather C. Pierce ◽  
...  

OBJECTIVES Ticket to Home (TTH), a survey tool designed to assess parental comprehension of their child’s hospitalization and postdischarge care needs, allows providers to address knowledge gaps before discharge. Our goal was to evaluate the impact of TTH on parents’ retention of discharge teaching. METHODS In this pilot study, we enrolled a convenience sample of families admitted to pediatric hospital medicine and randomly assigned families on the basis of team assignment. The intervention group received TTH before discharge. The control group received usual care (without TTH survey tool). Both groups were sent a survey 24 to 72 hours postdischarge to assess parental understanding of discharge teaching. A senior-level provider also completed a survey; responses were compared with evaluate parent level of understanding. Descriptive statistics and logistic regression were used for analysis. RESULTS Although 495 parents consented to participate, only 100 completed the necessary surveys (41 intervention and 59 control). Both groups showed high parent-provider concordance regarding reason for admission (92.7% intervention versus 86.4% control; P = .33). The intervention group had significantly higher concordance for return precautions (90.2% vs 58.2%; P < .001), which remained significant when controlling for covariates (odds ratio 6.24, 95% confidence interval 1.78–21.93). Most parents in the intervention group felt sharing TTH responses with their medical team was beneficial (95.0%). CONCLUSIONS Parents who received TTH before discharge were more likely to accurately recall return precautions and valued sharing TTH results with the team. Given that response bias may have affected pilot results, additional studies in which researchers use larger samples with more diverse patient populations is required.

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034378 ◽  
Author(s):  
Heidrun Golla ◽  
Charlotte Nettekoven ◽  
Claudia Bausewein ◽  
Jörg-Christian Tonn ◽  
Niklas Thon ◽  
...  

​IntroductionRandomised controlled trials (RCTs) have shown a positive effect of early integration of palliative care (EIPC) in various advanced cancer entities regarding patients’ quality of life (QoL), survival, mood, caregiver burden and reduction of aggressiveness of treatment near the end of life. However, RCTs investigating the positive effect of EIPC for patients suffering from glioblastoma multiforme (GBM) are lacking. After modelling work identifying the specific needs of GBM patients and their caregivers, the aim of this study is to investigate the impact of EIPC in this particular patient group.​Methods and analysisThe recruitment period of this multicenter RCT started in May 2019. GBM patients (n=214) and their caregivers will be randomly assigned to either the intervention group (receiving proactive EIPC on a monthly basis) or the control group (receiving treatment according to international standards and additional, regular assessment of QoL (‘optimised’ standard care)).The primary outcome is QoL assessed by subscales of the Functional Assessment of Cancer Therapy for brain tumour (FACT-Br) from baseline to 6 months of treatment. Secondary outcomes are changes in QoL after 12 (end of intervention), 18 and 24 months (end of follow-up), the full FACT-Br scale, patients’ palliative care needs, depression/anxiety, cognitive impairment, caregiver burden, healthcare use, cost-effectiveness and overall survival.​Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki and has been approved by the local ethics committees of the University Clinics of Cologne, Aachen, Bonn, Freiburg and Munich (LMU). Results of the trial will be submitted for publication in a peer-reviewed, open access journal and disseminated through presentations at conferences.Trial registration numberGerman Register for Clinical Studies (DRKS) (DRKS00016066); Pre-results.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Abdullah Karaksha ◽  
Gary Grant ◽  
S. Niru Nirthanan ◽  
Andrew K. Davey ◽  
Shailendra Anoopkumar-Dukie

Objectives. To design a series of e-learning tools within the framework of a defined educational pedagogy to complement the conventional pharmacology curriculum at Griffith University and evaluate the impact of this strategy on student level of understanding through taxonomic classification of student final exam answers.Methods. A series of 148 e-learning tools was designed for 3rd year undergraduate pharmacy students and incorporated into their curriculum during 2012. The educational benefits of the e-learning tools were evaluated by analyses of student level of understanding (by SOLO taxonomy) at the final exams between the control group (standard curricula) in 2011 and the intervention group (standard curricula + e-learning tools) in 2012.Results. Backward linear regression analysis demonstratedGPAto be the most significant predictor of level of understanding, while theinterventiongroup was a highly significant predictor for greater level of understanding in semester two.Conclusion. E-learning tools appeared to significantly improve student level of understanding as scored by the SOLO taxonomy when students engaged highly with the tools.


2010 ◽  
Author(s):  
Mary Croft

<p>Postoperative hypothermia is a continuing problem in surgical patients. Preoperative warming has been shown to benefit patients undergoing major surgical procedures but studies are lacking in patients in the ambulatory setting.</p> <p>Objective: The purpose of this study was to explore the effect of warming ambulatory surgical patients preoperatively prior to anesthesia induction and surgery on maintenance of core body temperature, prevention of hypothermia in PACU, and patient comfort.</p> <p>Method: A convenience sample of96 adult patients undergoing ambulatory surgery was provided standard care (cotton bath blankets) <em>(n=4 </em><em>7) </em>or pre-warming (Bair Paws®Flex warming gown) <em>(n =49). </em>All patients received forced air warming intraoperatively.</p> <p>Results: The mean pre-warming time was 58.6 minutes. The intervention group mean temperatures were significantly improved (intervention mean 97.304 pre vs. 98.044 post; p = 0.002 vs. control mean 97.54 pre vs. 97.87 post; p = 0.063) upon discharge from the preoperative holding area and prior to transport to the OR surgical suite. There was a 0.13 degree F increase in mean core temperature to PACU in the pre-warmed group as compared to control (intervention means 97.66 vs. control mean 97.53; 95% CI). The control group had a mean temperature decrease of 0.01 F from preop temperature to PACU while the intervention groups' mean temperatures increased by 0.19° F. Seven patients in the control group arrived to PACU complaining of cold and one shivering, compared to one patient in the intervention group.</p> <p>Conclusions: Preoperative warming utilizing the Bair Paws® flex warming gowns increased patients' core temperatures on arrival to PACU and lessened the number of patients arriving to PACU complaining of cold.</p>


2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.


2021 ◽  
pp. 019394592110207
Author(s):  
Min Wen ◽  
Yaqin Liang ◽  
Qianqian Shen ◽  
Juping Yu ◽  
Pingping He ◽  
...  

This cluster randomized controlled trial aimed to investigate the effects of an intervention to teach resourcefulness on depression and coping style of patients with coronary heart disease (CHD). A convenience sample of 72 patients in community settings took part. Participants in the intervention group (n = 36) received an 8-week intervention based on the concept of resourcefulness, plus routine health education. Participants in the control group (n = 36) received routine health education only. After the intervention, participants in the intervention group had significantly higher scores on resourcefulness and coping styles, and lower scores on depression than those in the control group (both ps < .001). The findings suggest that a well-developed intervention to teach resourcefulness could help patients with CHD to be more resourceful, improve their level of depression, and choose more effective strategies to cope with stress.


2021 ◽  
pp. 019459982199474
Author(s):  
Maggie Xing ◽  
Dorina Kallogjeri ◽  
Jay F. Piccirillo

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.


Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (&gt;45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P &lt; 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.


Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.


2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.


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