Implementing an Evidence-Based Bundle to Reduce Early Labor Admissions and Increase Adherence to Labor Arrest Guidelines: A Quality Improvement Initiative

2021 ◽  
pp. JDNP-D-20-00026
Author(s):  
Michelle Telfer ◽  
Jessica Illuzzi ◽  
Diana Jolles
Keyword(s):  
World Health ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Labor Management ◽  
Management Guidelines ◽  
Cesarean Birth ◽  
National Quality ◽  
Chart Audits ◽  
Evidenced Based ◽  
Health Organization

BackgroundAt many hospitals, the cesarean birth rate among nulliparous term singleton vertex (NTSV) pregnancies is higher than World Health Organization benchmarks. Reducing NTSV cesarean birth is a national quality imperative. The aim of this initiative was to implement an evidence-based bundle at an urban community teaching hospital in at least 50% of labors in 60 days in order to reduce early labor admissions and increase adherence to evidence-based labor management guidelines shown to decrease cesarean birth.MethodsChart audits, root-cause analysis, and staff engagement informed bundle development. An early labor triage guide, labor walking path, partograph, and pre-cesarean checklist were implemented to drive change. Four Rapid Cycle Plan Do Study Act cycles were conducted over 8 weeks.ResultsThe bundle was implemented in 58% of births. The bundle reduced early labor admissions labor from 41% to 25%. Team knowledge reflecting current guidelines in labor management increased 35% and 100% of cesareans for labor arrest met criteria. Patient satisfaction scores exceeded 98%.ConclusionsImplementing an evidenced-based bundle was effective in reducing early labor admissions and increasing utilization of and adherence to labor management guidelines.Implications for NursingImplementation of evidence-based bundles has the potential to achieve meaningful quality improvements in maternity care.

scholarly journals Comprehensive physiotherapy management in covid-19 – a narrative review

2020 ◽  
Vol 30 (1) ◽  
pp. 38030 ◽  
Author(s):  
Deivendran Kalirathinam ◽  
Raj Guruchandran ◽  
Prabhakar Subramani
Keyword(s):  
Narrative Review ◽  
World Health ◽  
Evidence Based ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Related Quality ◽  
Health Related ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Uk

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient’s level of cooperation.

Endocrine Tumors of the Appendix: A Pathologic Review

2010 ◽  
Vol 134 (6) ◽  
pp. 871-875
Author(s):  
Lydia Deschamps ◽  
Anne Couvelard
Keyword(s):  
Goblet Cell ◽  
Patient Management ◽  
Recent Literature ◽  
Surgical Intervention ◽  
Right Hemicolectomy ◽  
World Health ◽  
Endocrine Tumors ◽  
Management Guidelines ◽  
Pathologic Analysis ◽  
Health Organization

Abstract Context.—Although rare, appendiceal endocrine tumors are the most common neoplasms of the appendix. Pathologic analysis is important for guiding the management of patients. Objective.—To provide recent data that focus on the pathology of endocrine tumors of the appendix including classifications and guidelines for patient management. Data Sources.—A review of the recent literature including TNM classifications and patient management guidelines. Conclusions.—Appendiceal endocrine tumors are separated into 2 main groups: classic endocrine tumors and goblet cell carcinoids. They can be classified according to World Health Organization and TNM classifications. Evaluation of their prognoses and risks of malignancy, according to these classifications, depends on several parameters including tumor size, proliferation rate, and infiltration of appendiceal wall and mesoappendix. Most patients with classic endocrine tumors of the appendix have a favorable prognosis. Indications for postappendectomy, complementary surgery, which are still controversial, especially for tumors between 1 and 2 cm, are presented and discussed. In contrast, in patients presenting with a goblet cell carcinoid, a right hemicolectomy after the initial appendectomy is considered the standard surgical intervention.

scholarly journals Women’s advice to healthcare professionals regarding breastfeeding: “offer sensitive individualized breastfeeding support”- an interview study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ingrid Blixt ◽  
Margareta Johansson ◽  
Ingegerd Hildingsson ◽  
Zoi Papoutsi ◽  
Christine Rubertsson
Keyword(s):  
Healthcare Professionals ◽  
World Health ◽  
Evidence Based ◽  
Breastfeeding Support ◽  
Telephone Interviews ◽  
Self Confidence ◽  
Practical Support ◽  
Women’S Perceptions ◽  
Social Media Platforms ◽  
Health Organization

Abstract Background The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women’s advice to healthcare professionals is important for the provision of optimal breastfeeding support. The aim of this study was to explore women’s advice to healthcare professionals regarding support for continuing to breastfeed for at least 6 months. Methods This investigation used an exploratory study design, and a purposive sample of women was recruited between 2015 and 2016 through social media platforms. The work is a follow-up of an earlier study exploring women’s perceptions of the factors that assisted them in breastfeeding for at least 6 months. Telephone interviews were conducted with 139 Swedish women who reported that they had breastfed for at least 6 months. Women were asked the question, “Do you have any advice that you would like to give to healthcare professionals regarding breastfeeding support?”. The data were analysed using content analysis. Results The theme, “Professionals need to offer women sensitive, individualized breastfeeding support to promote a positive breastfeeding experience”, describes the women’s advice based on five categories: 1) providing evidence-based care, 2) preparing expectant parents during pregnancy, 3) creating a respectful and mutual dialogue, 4) offering individual solutions to breastfeeding problems, and 5) offering practical support. Conclusions This study highlights the importance of professionals providing evidence-based breastfeeding support in a sensitive and individualized manner. This consideration is an important prerequisite to strengthening women’s self-confidence and assisting them in reaching their breastfeeding goals, which may enhance the positive nature of their breastfeeding experience.

scholarly journals A review of studies on the COVID-19 epidemic crisis disease with a preventive approach

Work ◽  
2020 ◽  
Vol 66 (4) ◽  
pp. 717-729 ◽  
Author(s):  
Maryam Feiz Arefi ◽  
Mohsen Poursadeqiyan
Keyword(s):  
Social Distance ◽  
Preventive Measures ◽  
World Health ◽  
Definitive Treatment ◽  
Evidence Based ◽  
Public Places ◽  
Preventive Vaccine ◽  
The World ◽  
Health Organization ◽  
Presence Of People

BACKGROUND: COVID-19 is a highly contagious acute respiratory syndrome and has been declared a pandemic in more than 209 countries worldwide. At the time of writing, no preventive vaccine has been developed and tested in the community. This study was conducted to review studies aimed at preventing the spread of the coronavirus worldwide. METHODS: This study was a review of the evidence-based literature and was conducted by searching databases, including Google Scholar, PubMed, and ScienceDirect, until April 2020. The search was performed based on keywords including “coronavirus”, “COVID-19”, and “prevention”. The list of references in the final studies has also been re-reviewed to find articles that might not have been obtained through the search. The guidelines published by trustworthy organizations such as the World Health Organization and Center for Disease Control have been used in this study. CONCLUSION: So far, no vaccine or definitive treatment for COVID-19 has been invented, and the disease has become a pandemic. Therefore, observation of hand hygiene, disinfection of high-touch surfaces, observation of social distance, and lack of presence in public places are recommended as preventive measures. Moreover, to control the situation and to reduce the incidence of the virus, some of the measures taken by the decision-making bodies and the guidelines of the deterrent institutions to strengthen telecommuting of employees and reduce the presence of people in the community and prevent unnecessary activities, are very important.

scholarly journals Protecting healthcare workers from SARS-CoV-2 infection: practical indications

2020 ◽  
Vol 29 (155) ◽  
pp. 200068 ◽  
Author(s):  
Martina Ferioli ◽  
Cecilia Cisternino ◽  
Valentina Leo ◽  
Lara Pisani ◽  
Paolo Palange ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Noninvasive Ventilation ◽  
Healthcare Workers ◽  
World Health ◽  
Evidence Based ◽  
The World ◽  
Health Organization ◽  
Respiratory Devices

The World Health Organization has recently defined the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection a pandemic. The infection, that may cause a potentially very severe respiratory disease, now called coronavirus disease 2019 (COVID-19), has airborne transmission via droplets. The rate of transmission is quite high, higher than common influenza. Healthcare workers are at high risk of contracting the infection particularly when applying respiratory devices such as oxygen cannulas or noninvasive ventilation. The aim of this article is to provide evidence-based recommendations for the correct use of “respiratory devices” in the COVID-19 emergency and protect healthcare workers from contracting the SARS-CoV-2 infection.

scholarly journals Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

2020 ◽  
Vol 7 ◽  
Author(s):  
Jacqueline Désirée Jack ◽  
Rick McCutchan ◽  
Sarah Maier ◽  
Michael Schirmer
Keyword(s):  
Rheumatoid Arthritis ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Anatomical Therapeutic Chemical ◽  
Cohort Analysis ◽  
World Health ◽  
Management Guidelines ◽  
The Mean ◽  
Health Organization

Objective: To assess polypharmacy and related medication aspects in Middle-European rheumatoid arthritis (RA) patients, and to discuss the results in view of a systematic literature review.Methods: In this retrospective cohort study, charts were reviewed from RA-patients consecutively recruited between September 27, 2017 and April 29, 2019. Drugs were assigned to the Anatomical Therapeutic Chemical (ATC) groups as proposed by the World Health Organization (WHO). Results were compared to those of a systematic literature review.Results: One hundred seventy-five consecutive RA-patients were included. The mean number of drugs was 6.6 ± 3.5, with 2.4 ± 1.2 drugs taken specifically for RA—compared to 2.6 in the literature. 33.7% of patients experienced polypharmacy defined by ≥5 drugs, compared to 61.6% in the literature–with women affected more frequently than men. After 7 years of follow-up, the number of drugs increased in all ATC-groups by an average of 12.7 %, correlating with age (Corrcoeff = 0.46) and comorbidities (Corrcoeff = 0.599). In the literature, polypharmacy is not always defined precisely, and has not been considered in management guidelines so far.Conclusion: Polypharmacy is a frequent issue in RA-management. With an increasing number of comorbidities during the course of the disease, polypharmacy becomes even more relevant.

Press Report: Who Criticized for Neglecting Evidence

2007 ◽  
Vol 37 (4) ◽  
pp. 783-785
Author(s):  
Maria Cheng ◽  
Jean McMahon
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Evidence Based ◽  
The World ◽  
Press Report ◽  
Health Organization ◽  
Evidence Based Guidelines

A study published in The Lancet reveals that when developing “evidence-based” guidelines, the World Health Organization routinely forgets one key ingredient: evidence. The study is based on interviews with senior WHO officials and analyses of various guidelines to determine how they were produced. The authors found a distinctly non-transparent process.

scholarly journals Protecting Rights and Building Capacities: Challenges to Global Mental Health Policy in Light of the Convention on the Rights of Persons with Disabilities

2013 ◽  
Vol 41 (1) ◽  
pp. 48-73 ◽  
Author(s):  
Sheila Wildeman
Keyword(s):  
Mental Health ◽  
International Development ◽  
Global Mental Health ◽  
Mental Health Policy ◽  
Disabled Persons ◽  
World Health ◽  
Evidence Based ◽  
Persons With Disabilities ◽  
The World ◽  
Health Organization

The World Health Organization (WHO) has in the last decade identified mental health as a priority for global health promotion and international development, to be targeted through promulgation of evidence-based medical practices, health systems reform, and respect for human rights. Yet these overlapping strategies are marked by tensions as the historical primacy of expert-led initiatives is increasingly subject to challenge by new social movements — in particular, disabled persons’ organizations (DPOs). These tensions come into focus upon situating the WHO’s contributions to the analysis of global mental health in light of the negotiation and early stages of implementation of the Convention on the Rights of Persons with Disabilities (CRPD), particularly as it applies to persons with mental disabilities.

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